Sarah M. Sifuentes v. State ( 2013 )


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  •                               Fourth Court of Appeals
    San Antonio, Texas
    MEMORANDUM OPINION
    No. 04-12-00607-CR
    Sarah M. SIFUENTES,
    Appellant
    v.
    The STATE of Texas,
    Appellee
    From the 227th Judicial District Court, Bexar County, Texas
    Trial Court No. 2009CR13036A
    Honorable Philip Kazen, Judge Presiding
    Opinion by:       Marialyn Barnard, Justice
    Sitting:          Catherine Stone, Chief Justice
    Marialyn Barnard, Justice
    Luz Elena D. Chapa, Justice
    Delivered and Filed: July 3, 2013
    AFFIRMED
    A jury convicted appellant Sarah M. Sifuentes of injury to a child by omission. Based on
    the jury’s recommendation, the trial court sentenced Sifuentes to confinement for nineteen years
    in the Texas Department of Criminal Justice–Institutional Division. On appeal, Sifuentes raises
    nine points of error, challenging the admission of certain evidence. We affirm the trial court’s
    judgment.
    04-12-00607-CR
    BACKGROUND
    Paramedics, including Officer Stacey Casburn, were dispatched to a home where they
    found a two-year-old female, C.G., on the floor. Officer Casburn testified that when he arrived,
    C.G. was not breathing and had no heartbeat or pulse. The officer told the jury the child was pale,
    bruised all over her body, and had a deformity in her arm.                         Resuscitation attempts were
    unsuccessful. Officer Casburn stated they placed C.G. into an ambulance and took her to the
    hospital. C.G. died.
    Detective John Doyle was dispatched to Methodist Hospital to investigate C.G.’s death.
    Detective Doyle testified C.G. had “bruises all over her body.” He took photographs of C.G. at
    the hospital.
    The record shows that at the time of the event, a man, a woman, and several children were
    at the home. The woman, Sifuentes, identified herself as C.G.’s aunt; however, it was later learned
    Sifuentes was not C.G.’s aunt, but a friend of C.G.’s mother, Crystal. The man was identified as
    Sifuentes’s husband, Marc Valadez. Crystal, her children, and later her husband, had, at times,
    lived with Sifuentes. When asked what happened to C.G., Sifuentes said the child was sick so she
    gave her some medicine and then left the room for several minutes. Sifuentes stated when she
    came back into the room, C.G. was unresponsive.
    In addition to firefighters and paramedics, a San Antonio patrol officer, Luis Guzman, was
    dispatched to the home regarding an injured child. Officer Guzman testified the home was filthy,
    covered in trash – food containers, beverage containers, chicken bones, etc. 1 As for the child,
    1
    The officer testified that after paramedics took C.G. to the hospital, he called and asked that homicide detectives be
    sent to the home. When he learned they would not arrive immediately, he left the home and waited outside, ensuring
    that no one entered. Officer Guzman testified that when the homicide detectives arrived approximately forty-five
    minutes later, the home had been cleaned.
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    Officer Guzman testified she was covered in bruises. He specifically stated she was so bruised
    she was “spotted, looked like a leopard.”
    Carrie Wilcoxson, a night unit investigator for Child Protective Services (“CPS”), was
    called by police. When Wilcoxson learned C.G. was deceased and had a four-year-old brother,
    A.G., who was still at the home, she went to the home. When she arrived, Wilcoxson discovered
    A.G. was not at the home, but was in a home belonging to Sifuentes’s brother. Wilcoxson was
    then escorted by police to the brother’s home. Once there, she assessed A.G. for injuries or other
    signs of abuse or neglect. She also assessed four other children found in the home. These four
    children were Sifuentes’s biological children. Wilcoxson noticed A.G. had blood at the bottom of
    his nose, blood near his right ear, and red marks in the white part of his eye. He also had multiple
    scratch marks on his neck and bruising on his lower legs. A.G.’s clothing was “very dirty.” In
    contrast, Sifuentes’s children appeared uninjured and clean. Although Wilcoxson was denied
    permission to take A.G. into CPS custody, a police sergeant refused to leave him with Sifuentes
    and took the boy to the hospital.
    Upon investigation, it was discovered that C.G. and A.G. were in the temporary custody of
    Sifuentes while their mother, Crystal, was incarcerated. 2 Sifuentes told police she had custody of
    C.G. and A.G. for approximately eight months before C.G.’s death. Crystal signed a power of
    attorney that gave Sifuentes authority to look after the children. This also allowed Sifuentes to
    receive food stamps and Medicaid on behalf of the children. Initially, Sifuentes kept Crystal
    apprised of the children’s condition, telling her the children were well. However, Sifuentes
    2
    According to Crystal, the original plan was for Sifuentes to take care of Crystal’s youngest child, and C.G. and A.G.
    would be cared for by Crystal’s relatives. However, the plan fell through and the two older children were taken by
    their biological father. The father was unable to care for the children, prompting an investigation by CPS. Sifuentes
    offered to take C.G. and A.G., and Crystal agreed to the arrangement, allowing Sifuentes to take temporary custody
    of the two older children. Crystal testified she wished to avoid further inquiry by CPS as she had been investigated
    before by the agency. The biological father stated C.G. and A.G. were clean and healthy when he took them from
    Crystal and surrendered them to Sifuentes.
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    ultimately broke off contact with Crystal–no more letters or phone calls–when Crystal was moved
    from the jail to a prison facility. Crystal was in prison when she learned C.G. had died; C.G.’s
    biological father was also in jail at the time of her death.
    Sifuentes was questioned by police. When asked about the bruises on C.G., Sifuentes told
    the detective, Randy Jones, her only explanation was that her autistic son was responsible. She
    said she only noticed bruises on C.G.’s back, but she denied seeing any bruises on her chest or
    face. Sifuentes said the bruises on the chest must have been caused by their CPR attempts prior to
    the arrival of paramedics. With regard to the broken arm, Sifuentes denied knowing it was broken.
    She claimed C.G.’s bloody lip was caused by C.G. biting her own lip while she was eating.
    Sifuentes said she noticed C.G. was “throwing up” and running a slight fever, so she gave her
    liquid Benadryl and Motrin for infants. Thereafter, C.G. stopped throwing up. However, Sifuentes
    said she noticed C.G. was “staring” and would not respond. Sifuentes picked her up and soon
    after, C.G. stopped breathing. Sifuentes told the detective she then called 911. She denied
    knowing the child was in need of medical attention until she stopped breathing. During the
    interview, Sifuentes denied that she, her husband, her sister, or any other family member had
    abused or mishandled C.G. She could not explain the numerous injuries to C.G. as depicted in the
    photographs shown to her by Detective Jones. Sifuentes was allowed to leave with her family at
    the conclusion of the interview.
    A neighbor and babysitter noticed C.G. had injuries before her death. A neighbor noticed
    a problem with C.G.’s arm. Sifuentes told her that the child fell on the tile floor, but she had taken
    her to the doctor and it was only a sprain. The neighbor believed it was broken because the arm
    was warm and painful to the touch. Sifuentes admitted to the neighbor at C.G.’s funeral that she
    had not taken the child to the doctor. The neighbor also mentioned that Sifuentes’s six-year-old
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    autistic son was aggressive and abusive, having once attacked the neighbor’s daughter. The
    neighbor told police the boy would attack other children.
    The babysitter also noticed the injury to C.G.’s arm, as well as bruises on C.G.’s face.
    Sifuentes told the babysitter C.G. injured her arm when she jumped from a chair to the bed.
    Sifuentes explained the bruises on C.G.’s face, stating A.G. had thrown a boot and hit C.G. in the
    face. The babysitter also noticed C.G. had a bloody lip.
    The jury heard testimony from many of Sifuentes’s family members. All of them denied
    that Sifuentes would injure or allow anyone else to injure a child without taking steps to prevent
    the abuse. They generally denied seeing the injuries noted by medical personnel and police or
    knowing that C.G. was injured or sick. Sifuentes’s sister noted only that a few weeks before her
    death, C.G. fell off the bed, falling between the dresser and the bed. According to her, C.G.
    complained about her head and she put an ice pack on it. She also noted a facial bruise caused
    when A.G. accidentally closed the car door on C.G. Several family members noted Sifuentes’s
    autistic son had a tendency to attack and injure other children and adults.
    Sifuentes testified on her own behalf. She told the jury she was unaware of any injuries to
    C.G. prior to her death. Sifuentes did not suspect a fractured arm; much less that C.G. was slowly
    dying from peritonitis. She claimed that on the day of C.G.’s death, she looked normal and had
    only a slight fever and a runny nose. Although she saw some bruising on C.G.’s back, she saw
    nothing as severe as what was later depicted in photographs taken after C.G.’s death. She testified
    she believed the bruising she saw was inadvertently caused by her autistic son. Sifuentes stated
    she could not explain what happened to C.G.
    During trial, Dr. Elizabeth Peacock, a forensic pathologist with the Bexar County Medical
    Examiner’s Office, testified C.G. had numerous contusions and abrasions on her body, including
    on her head, neck, torso, and extremities. Some of the bruises were older than others–some perhaps
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    as much as a week old. C.G. also had a healing fracture of her left ulna, and was suffering from
    bronchitis. An internal examination showed multiple blunt force injuries. The doctor opined that
    C.G. died as a result of blunt force trauma to the abdomen, which resulted in peritonitis.
    Dr. James Lukefahr, a pediatrician specializing in child abuse, testified it would take a
    “high degree of force” to inflict the abdominal injury suffered by C.G. He stated that poking a
    child in the stomach would not be sufficient; rather, the most common cause of an injury like the
    one in this case would be the sudden impact of the seat belt on the abdomen in a high speed motor
    vehicle collision.
    Ultimately, after hearing testimony from the State’s witnesses and those presented by
    Sifuentes, including her own testimony, the jury found Sifuentes guilty of injury to a child by
    omission. The trial court sentenced Sifuentes to confinement for nineteen years. Thereafter, she
    perfected this appeal.
    ANALYSIS
    In nine points of error, Sifuentes complains the trial court erred in admitting certain
    evidence, including photographs and alleged extraneous offense evidence. We will review the
    points raised by Sifuentes in groups, as set forth in her appellate brief.
    Hospital Photographs–Rule 403
    In her first two points of error, Sifuentes contends the trial court erred when it overruled
    her objections to the admission into evidence of State’s exhibits 1, 2, and 5–34, which are
    photographs of C.G. Sifuentes argues the photographs should not have been admitted because the
    probative value of the photographs was substantially outweighed by the danger of prejudice.
    We review a trial court’s decision to admit photographs under an abuse of discretion
    standard. Gallo v. State, 
    239 S.W.3d 757
    , 762 (Tex. Crim. App. 2007). A trial court abuses its
    discretion if no reasonable view of the record could support its ruling. Riley v. State, 378 S.W.3d
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    453, 457–58 (Tex. Crim. App. 2012). Thus, we must determine if the trial court’s ruling was
    outside the zone of reasonable disagreement. McGee v. State, 
    233 S.W.3d 315
    , 318 (Tex. Crim.
    App. 2007); Montgomery v. State, 
    810 S.W.2d 372
    , 391 (Tex. Crim. App. 1990) (op. on reh’g).
    There should be a reluctance on the part of an appellate court to reverse a trial court’s decision on
    the admission or exclusion of evidence. 
    Montgomery, 810 S.W.2d at 378
    .
    “Generally, a photograph is admissible if verbal testimony as to matters depicted in the
    photographs is also admissible.” 
    Gallo, 239 S.W.3d at 762
    . “In other words, if verbal testimony
    is relevant, photographs of the same are also relevant.” 
    Id. Relevant evidence
    is “evidence having
    any tendency to make the existence of any fact that is of consequence to the determination of the
    action more probable or less probable than it would be without the evidence.” Id.; TEX. R. EVID.
    401. Photographs of the injuries inflicted on the victim are relevant to a jury’s determination.
    
    Gallo, 239 S.W.3d at 762
    . That relevance is not diminished merely because the jury also heard
    testimony about the same injuries. 
    Id. Rule 403
    of the Texas Rules of Evidence favors the admission of relevant evidence, and
    carries a presumption that relevant evidence will be more probative than prejudicial. Aragon v.
    State, 
    229 S.W.3d 716
    , 724 (Tex. App.—San Antonio 2007, no pet.) (citing Jones v. State, 
    944 S.W.2d 642
    , 652–53 (Tex. Crim. App. 1996); Legate v. State, 
    52 S.W.3d 797
    , 807 (Tex. App.—
    San Antonio 2001, pet. ref’d)). However, Rule 403 allows for the exclusion of otherwise relevant
    evidence when the probative value of the evidence is “substantially outweighed by the danger of
    unfair prejudice, confusion of the issue, or misleading the jury, or by considerations of undue
    delay, or needless presentation of cumulative evidence.” TEX. R. EVID. 403; see Gigliobianco v.
    State, 
    210 S.W.3d 637
    , 641–42 (Tex. Crim. App. 2006). Evidence is unfairly prejudicial when it
    has “an undue tendency to suggest that a decision be made on an improper basis.” Reese v. State,
    
    33 S.W.3d 238
    , 240 (Tex. Crim. App. 2000). In determining whether the probative value of
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    04-12-00607-CR
    photographs is substantially outweighed by the danger of unfair prejudice, a court may consider
    several factors, including: “the number of exhibits offered, their gruesomeness, their detail, their
    size, whether they are black and white or color, whether they are close-up, and whether the body
    depicted is naked or clothed.” 
    Gallo, 239 S.W.3d at 762
    . A court must also consider “[t]he
    availability of other means of proof and the circumstances unique to each individual case.” 
    Id. These considerations
    are part of the Rule 403 analysis, allowing the court to determine: (1) how
    probative the evidence is; (2) the potential for the evidence to affect the jury in some irrational,
    indelible way; (3) the time the proponent needs to develop the evidence; and (4) the proponent’s
    need for the evidence. Shuffield v. State, 
    189 S.W.3d 782
    , 787 (Tex. Crim. App. 2006); Bibbs v.
    State, 
    371 S.W.3d 564
    , 575 (Tex. App.—Amarillo 2012, pet. ref’d), cert. denied, 
    133 S. Ct. 1591
    (2013).
    State’s exhibits 1 and 2 were admitted during the testimony of Officer Casburn, the
    paramedic who attended to C.G. He stated the photographs were of C.G. and fairly and accurately
    depicted her condition on the day he responded to the 911 call. State’s exhibit 1 is a picture of
    C.G.’s face; State’s exhibit 2 is a picture of her entire body. As noted above, Officer Casburn
    testified C.G. was pale and bruised all over her body – forehead, chest, abdomen, and arms.
    State’s exhibits 5–34 are photographs of C.G. taken at the hospital by Detective Doyle and
    an evidence technician. They were admitted during Detective Doyle’s testimony. As previously
    noted, Detective Doyle testified C.G. was badly bruised from her head to her toes. Detective Doyle
    testified the exhibits fairly and accurately represented C.G.’s condition when he saw her at the
    hospital.
    All of the photographs admitted at trial were black and white, average in size and displayed
    different views of the bruises and scrapes that covered C.G.’s body. The State did not spend an
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    inordinate amount of time developing the photographic evidence. In fact, all of the photographs
    were admitted fairly expeditiously through two witnesses.
    Officer Casburn, Detective Doyle, and Officer Guzman testified about the severely bruised
    condition of C.G.’s body; the photographs support their verbal descriptions. Officer Guzman
    testified the bruises were so extensive C.G. had a leopard–like appearance. The photographs are
    visual representations of the testimony from Officer Casburn, Detective Doyle, and Officer
    Guzman regarding C.G.’s condition. Their verbal testimony was clearly admissible. As the court
    stated in Gallo, “[g]enerally, a photograph is admissible if verbal testimony as to the matters
    depicted in the photographs is also 
    admissible.” 239 S.W.3d at 762
    .
    Sifuentes argues the photographs should not have been admitted because they are
    gruesome, beg for a highly emotional reaction, and invoke the deepest disgust from anyone who
    views them. She further argues that although the photographs have probative value, they are so
    extreme in nature, and of such force, they tend to invite an improper emotional reaction that would
    overwhelm any rational consideration of the evidence.          Moreover, Sifuentes contends the
    photographs were not needed to prove the State’s case and only served to inflame the jury.
    Photographs showing a victim’s bruises may be admitted to clarify and support
    observations and conclusions about the victim’s injuries, so long as they are not admitted solely to
    inflame the minds of the jurors. See Madden v. State, 
    799 S.W.2d 683
    , 696–97 (Tex. Crim. App.
    1990) (en banc). The mere fact that the photographs depicted C.G.’s badly bruised body does not
    automatically render them more prejudicial than probative. See Hicks v. State, 
    860 S.W.2d 419
    ,
    426 (Tex. Crim. App. 1993), overruled on other grounds by Sanchez v. State, 
    376 S.W.3d 767
    (Tex. Crim. App. 2012). “A trial court does not err merely because it admits into evidence
    photographs which are gruesome.” Sonnier v. State, 
    913 S.W.2d 511
    , 519 (Tex. Crim. App. 1995)
    (en banc).
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    Furthermore, Sifuentes was charged with causing serious bodily injury by omission. One
    of her defenses was that she never noticed anything wrong or out of the ordinary with regard to
    the child. The photographs were necessary to refute this defense. Moreover, Sifuentes suggested
    the bruising might have been caused during the efforts to resuscitate C.G. The extensive, body-
    encompassing bruising shown by the photographs negates any such suggestion. The photographs
    are strong evidence that Sifuentes must have known something was going on with C.G. and chose
    to ignore it. The Texas Court of Criminal Appeals has stated, “[v]isual evidence accompanying
    testimony is most persuasive and often gives the fact finder a point of comparison against which
    to test the credibility of a witness and the validity of his conclusions.” Chamberlain v. State, 
    998 S.W.2d 230
    , 237 (Tex. Crim. App. 1999). We hold this was the purpose served by the admission
    of the photographs in this case.
    Based on the foregoing, we hold the trial court did not abuse its discretion in admitting
    State’s exhibits 1, 2, and 5–34. The photographs, although admittedly disturbing, were relevant
    and of extreme probative value, particularly given the testimony and the defenses asserted by
    Sifuentes. Considering the relevant law and the specific circumstances of the case, the trial court
    was certainly within its discretion in determining the probative value of the photographs was not
    substantially outweighed by the danger of unfair prejudice. See TEX. R. EVID. 403. Accordingly,
    we overrule Sifuentes’s first and second points of error.
    Autopsy Photographs–Rule 403, Cumulative
    In Sifuentes’s third through fifth points of error, she contends the photographs taken during
    C.G.’s autopsy should not have been admitted because any probative value of the photographs was
    substantially outweighed by the danger of unfair prejudice, particularly given that they were
    cumulative of the testimony of numerous witnesses. The proper standard of review is the same as
    noted above – abuse of discretion. See 
    Gallo, 239 S.W.3d at 762
    .
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    These two points of error concern nine black and white autopsy photographs, State’s
    exhibits 43, 87, 90, 92, 97–98, and 100–102. Dr. Peacock, the medical examiner who oversaw the
    autopsy of C.G., testified the photographs fairly and accurately represented the condition of C.G.’s
    body at the time of the autopsy and what she observed during the autopsy. Dr. Peacock testified
    State’s exhibit 43, which depicted C.G.’s face above a series of numbers, was a photograph the
    medical examiner’s office considered “the I.D. photo of [C.G.].” It contained the unique identifier
    number assigned to the autopsy; the number used to identify all evidence removed from the body.
    In addition to showing the identifier number, it showed numerous contusions on C.G.’s face.
    The other exhibits, also sponsored by Dr. Peacock, depicted the numerous bruises,
    contusions, and other injuries to C.G. noted during the autopsy. Each photograph showed a
    different part of C.G.’s body upon which injuries were noted. State’s exhibit 87 showed the bruises
    and injuries to C.G.’s face. Exhibit 90 is a view of the injuries to C.G.’s chin, right ear, and neck.
    This picture shows irregular abrasions under her chin, extensive healed scars, older injuries on her
    neck and contusions at the tip of her chin and on her upper chest. State’s exhibit 92 depicts the
    injuries to the left side of the child’s neck and upper chest. More specifically, it depicts small
    white scars and multiple sites on the anterior lateral parts of her neck, chin, and upper chest. State’s
    exhibit 97 shows the injuries to C.G.’s back, specifically a cluster of abrasions over the midline
    and back of her waistline along the spinal column. Exhibit 98 shows the right side of C.G.’s shaven
    head and the upper right front of her ear where there is bruising. Exhibit 100 shows the numerous
    abrasions and contusions on the top of C.G.’s shaven head. State’s exhibit 101 focused specifically
    on the contusions to the left side of the child’s shaven head. This photo also showed abrasions and
    contusions on her back and her neck. Exhibit 102 depicts the abrasions to the back of C.G.’s shave
    head as well as those on the back of her neck.
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    When pictorial evidence helps a jury to understand verbal testimony, such as technical
    language used by an expert or medical doctor describing injuries that a victim sustained during a
    crime, the photograph is generally admissible. Harris v. State, 
    661 S.W.2d 106
    , 107 (Tex. Crim.
    App. 1983) (en banc). A “[p]hotograph must be relevant, thus, it must be helpful to the jury.”
    Erazo v. State, 
    144 S.W.3d 487
    , 491 (Tex. Crim. App. 2004). Like any other demonstrative
    evidence, photographs should assist the jury in making a decision, whether that is deciding guilt
    or punishment. 
    Id. Photographs are
    admissible as competent evidence where they accurately portray
    anything which it is competent for a witness to describe in words, or where they are
    helpful as an aid to a verbal description of objects and conditions, provided they
    are relevant to some material issue; and they are not rendered inadmissible merely
    because they vividly bring to jurors the details of a shocking crime or incidentally
    tend to arouse passion or prejudice.
    
    Id. at 490.
    Where photographs demonstrate the nature, location, and extent of a wound, this court
    has held their probative value outweighs any prejudicial effect. Legate v. State, 
    52 S.W.3d 797
    ,
    807 (Tex. App.—San Antonio 2001, pet. ref’d).
    Autopsy photographs are generally admissible unless they depict some mutilation caused
    by the autopsy itself. Rayford v. State, 
    125 S.W.3d 521
    , 529 (Tex. Crim. App. 2003). However,
    if the troubling nature of the photographs is due primarily to the injuries caused by the defendant,
    then the changes to the body caused by the autopsy are only of minor significance. See Hayes v.
    State, 
    85 S.W.3d 809
    , 816 (Tex. Crim. App. 2002) (citing Santellan v. State, 
    939 S.W.2d 155
    , 173
    (Tex. Crim. App. 1997) (holding that pulling back victim’s skin did not make photograph more
    gruesome)).
    Sifuentes contends all of the exhibits complained of were exceedingly prejudicial because
    they show the child naked and in some of them her head had been shaved. She argues the nudity
    and shaving, which were part of the autopsy process, are a form of mutilation, changing the natural
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    appearance of the child and inflaming and prejudicing the jury. Sifuentes claims the photographs
    made C.G. look like a “grotesque mannequin,” something that no longer looks human. She also
    argues the photographs are needless presentations of cumulative evidence.
    Of course the photographs are graphic and disturbing – they are, after all, autopsy
    photographs of a battered and bruised two-year-old. It is also true they depict what several
    witnesses described regarding C.G.’s injuries. However, it is undisputed that the photographs
    depict the injuries suffered by C.G. – injuries Sifuentes claimed she never noticed. Although some
    of the photographs reflect alterations of C.G.’s body due to autopsy procedures, these alterations
    were fully explained to the jury as necessary for a thorough examination of the injuries. Moreover,
    shaving the head and removing the diaper allowed the jury to see additional injuries that were not
    otherwise apparent. The photographs were not notably duplicate or cumulative; rather they show
    injuries to different areas of the body. The photographs also served as an aid to Dr. Peacock’s
    explanation of the physical injuries suffered by C.G. The photos were relevant to the State’s claim
    that Sifuentes committed the offense of injury to a child by omission, and negated the defenses
    asserted by Sifuentes. Although the photographs are visual representations of the testimony of
    several witness, and perhaps “cumulative” in that respect, a photograph is admissible if verbal
    testimony as to the matters depicted in the photographs is also admissible. See 
    Gallo, 239 S.W.3d at 782
    .
    Accordingly, we hold the trial court did not err in concluding the probative value of the
    photos was not substantially outweighed by any prejudicial effect. See TEX. R. EVID. 403. We
    therefore overrule points of error three through five.
    Testimony/Pictures of Injuries to A.G.–Extraneous Offense Evidence, Rule 403
    Sifuentes contends in her sixth through ninth points of error that the trial court erred when
    it allowed the State to introduce testimony describing, and photographs depicting, the injuries to
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    A.G., C.G.’s four-year-old brother. She argues the testimony should have been excluded because
    it was inadmissible extraneous offense evidence under Rule 404(b) of the Texas Rules of Evidence,
    and she argues the photographs were likewise inadmissible under Rule 404(b), but also
    inadmissible under Rule 403.
    “Whether extraneous offense evidence has relevance apart from character conformity, as
    required by Rule 404(b), is a question for the trial court.” De La Paz v. State, 
    279 S.W.3d 336
    ,
    343 (Tex. Crim. App. 2009). And, as noted above, a ruling on the balance between probative value
    and the counter factors set out in Rule 403 is also a question for the trial court. 
    Id. However, “that
    balance is always slanted toward admission, not exclusion, of otherwise relevant evidence.” 
    Id. Therefore, we
    review a trial court’s ruling on the admissibility of extraneous offense evidence
    under an abuse of discretion standard. 
    Id. As with
    other evidentiary rulings, as long as the trial
    court’s decision is within the “zone of reasonable disagreement,” there is no abuse of discretion,
    and we must uphold the trial court’s ruling. 
    Id. at 343–44.
    “A trial court’s ruling is generally
    within this zone if the evidence shows that (1) an extraneous transaction is relevant to a material,
    non-propensity issue, and (2) the probative value of that evidence is not substantially outweighed
    by the danger of unfair prejudice, confusion of the issues, or misleading of the jury.” 
    Id. at 344.
    In addition, if a trial court’s evidentiary ruling is correct on any theory of law applicable, it will
    not be disturbed. 
    Id. Although evidence
    of an extraneous offense is normally inadmissible pursuant to Rule
    404(b) of the Texas Rules of Evidence, evidence of an extraneous offense is admissible as same
    transaction contextual evidence to show the context in which a criminal act occurred. Wesbrook
    v. State, 
    29 S.W.3d 103
    , 115 (Tex. Crim. App. 2000). “This evidence is considered ‘res gestae,’
    under the reasoning that events do not occur in a vacuum, and the jury has a right to hear what
    occurred immediately prior to and subsequent to the commission of that act so that it may
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    realistically evaluate the evidence.” 
    Id. This type
    of evidence results when an extraneous matter
    is so intertwined with the State’s proof of the charged offense that avoiding reference to it would
    make the State’s case incomplete or difficult to understand. Smith v. State, 
    316 S.W.3d 688
    , 699
    (Tex. App.—Fort Worth 2010, pet. ref’d). “Such evidence imparts to the trier of fact information
    essential to understanding the context and circumstances of events which, although legally separate
    offenses, are blended or interwoven.” Camacho v. State, 
    864 S.W.2d 524
    , 532 (Tex. Crim. App.
    1993).
    In this case, the State argues the testimony and photographs showing A.G.’s injuries were
    admissible as probative evidence and same transaction contextual evidence. The State contends
    the evidence regarding A.G.’s injuries rebutted testimony that Sifuentes would never ignore a
    child’s injuries or allow them to be injured in her presence. However, we hold such evidence was
    not “so intertwined with the State’s proof of the charged offense” or that without it, the State’s
    case would be “incomplete or difficult to understand.” See 
    Smith, 316 S.W.3d at 699
    . The State
    presented considerable evidence regarding the injuries C.G. suffered, and admitting evidence of
    A.G.’s injuries did not provide “essential information” to the jury regarding the events or
    circumstances leading to C.G.’s death. See 
    Camacho, 864 S.W.2d at 532
    . As Sifuentes argues, it
    was possible for the jury to understand the allegations regarding Sifuentes’s omission with regard
    to C.G.’s injuries without evidence of A.G.’s injuries. We also hold the evidence did not meet the
    Rule 403 balancing test because it was more prejudicial than probative.           Specifically, the
    photographs of A.G.’s injuries were not relevant to a material issue, and had the ability to impress
    the jury in a prejudicial manner. See 
    Erazo, 144 S.W.3d at 490
    , 494–95. Therefore, we hold the
    trial court erred in admitting evidence of A.G.’s injuries.
    Although the trial court erred in admitting this extraneous evidence, we hold such error
    was harmless and does not entitle Sifuentes to a reversal. The error complained of by Sifuentes is
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    04-12-00607-CR
    nonconstitutional error, and is therefore governed by Rule 44.2(b) of the Texas Rules of Appellate
    Procedure. Rule 44.2(A) states nonconstitutional error must be disregarded unless the reviewing
    court finds it affected the defendant’s substantial rights. See TEX. R. APP. P. 44.2(b). A harm
    analysis assesses whether the defendant’s substantial rights were affected—that is, whether the
    error had a substantial and injurious effect or influence in determining the jury’s verdict. Rich v.
    State, 
    160 S.W.3d 575
    , 577 (Tex. Crim. App. 2005). As mentioned throughout this opinion, there
    was an abundance evidence presented to the jury which supported its verdict. Among the extensive
    evidence, there was trial testimony that: (1) many of C.G.’s injuries were visible; (2) Sifuentes was
    made aware of such injuries, but yet could not explain the numerous injuries depicted in C.G.’s
    photographs; and (3) C.G. died as a result of such injuries. Therefore, in light of the evidence
    presented at trial, we hold the trial court’s improper admission of evidence regarding A.G.’s
    injuries did not have a substantial and injurious effect on the jury’s verdict. Accordingly, we
    overrule points of error six through nine.
    CONCLUSION
    Based on the foregoing, we overrule Sifuentes’s points of error and affirm the trial court’s
    judgment.
    Marialyn Barnard, Justice
    Do Not Publish
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