State of Iowa v. Karen Sue Huston

IN THE SUPREME COURT OF IOWA
No. 11–1262
Filed January 25, 2013
STATE OF IOWA,
Appellee,
vs.
KAREN SUE HUSTON,
Appellant.
On review from the Iowa Court of Appeals.
Appeal from the Iowa District Court for Lee (North) County,
John G. Linn, Judge.
Defendant appeals the judgment and sentence following her
conviction for child endangerment causing serious injury. COURT OF
APPEALS DECISION AFFIRMED IN PART AND VACATED IN PART;
DISTRICT COURT JUDGMENT AND SENTENCE REVERSED, AND
CASE REMANDED FOR NEW TRIAL.
Mark C. Smith, State Appellate Defender, Samuel S. Berbano,
Student Legal Intern, and Shellie L. Knipfer, Assistant State Appellate
Defender, for appellant.
Thomas J. Miller, Attorney General, Bridget A. Chambers,
Assistant Attorney General, Michael P. Short, County Attorney, and
Clinton R. Boddicker, Assistant County Attorney, for appellee.
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WATERMAN, Justice.
Defendant, Karen Sue Huston, was one of several adult caregivers
for a five-year-old girl suffering from malnutrition. This appeal presents
the question whether the district court committed reversible error in
Huston’s criminal jury trial by allowing a caseworker for the Iowa
Department of Human Services (DHS) to testify that a child abuse report
against Huston was administratively determined to be “founded.”
Huston objected to this testimony as irrelevant and unfairly prejudicial.
The jury found Huston guilty of child endangerment causing
serious injury. The district court sentenced Huston to a term of fifteen
years in prison. Huston appealed, contending the evidence was
insufficient to prove a “serious injury” and that the district court erred by
allowing testimony on the DHS administrative finding. The court of
appeals affirmed, and we granted Huston’s application for further review.
We exercise our discretion to limit our review to the evidentiary
ruling on the founded child abuse report. See State v. Marin, 788 N.W.2d
833, 836 (Iowa 2010). Division III of the court of appeals decision shall
stand as the final opinion in this appeal on the sufficiency of the
evidence to support Huston’s conviction. For the reasons explained
below, we hold it was reversible error to allow testimony that DHS had
determined the child abuse complaint against Huston was founded.
Accordingly, we vacate Division II of the decision of the court of appeals,
reverse the judgment of the district court, and remand the case for a new
trial.
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I. Background Facts and Proceedings.
The victim, T.H., was born in January 2005 to Brandon Holmes
and Christie Polhans. Brandon is now married to Mandy Holmes, who
has four children. Mandy is the daughter of Karen and Fred Huston. 1
In November 2008, T.H. began living with Brandon and his wife,
Mandy, in Fort Madison, Iowa, after DHS removed T.H. from the care of
her mother. Approximately one month later, Brandon, Mandy, T.H., and
Mandy’s four children moved into the Hustons’ two-bedroom home,
where they all stayed until April or May 2010. Mandy was T.H.’s primary
caregiver during this time. In April of that year, shortly before Brandon
and Mandy moved out, Huston returned home from serving a ten-month
federal prison sentence in Texas for passing money orders in violation of
18 U.S.C. § 500.
Although Karen and Fred initially denied that T.H. lived with them,
Huston admitted at trial that when Brandon and Mandy moved out T.H.
remained at the Hustons’ home. During this eight-month period, Karen,
Fred, and Mandy were all involved in caring for T.H. Fred would
occasionally make breakfast or dinner for T.H., but was otherwise gone
most of the day. Mandy would come over daily and sometimes would
prepare T.H.’s breakfast or lunch. Mandy was also the one who would
bathe T.H.
Huston is disabled and confined to a wheelchair. She weighs 395
pounds, and her right hip socket is “broke off.” She suffers from COPD
and asthma. She is unable to climb stairs and, for that reason, sleeps
on a bed in the dining room. In light of her limited mobility, Huston
could only prepare sandwiches and other quick meals for T.H.
1References to “Huston” throughout this opinion are to Karen Huston.
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Dr. Frank Artinian, T.H.’s pediatrician, first became concerned
about T.H.’s weight in November 2009. T.H. had lost approximately five
pounds or twelve percent of her body weight since her last doctor’s visit
in May. Dr. Artinian tested T.H. for various medical conditions that
could be at the root of her failure to thrive, but all the tests came back
negative. Dr. Artinian wished to have T.H. admitted to the hospital at
that time for further testing and evaluation, but Mandy lacked authority
to consent to T.H.’s hospitalization, and DHS declined to force T.H.’s
hospitalization. In lieu of hospitalization, Mandy brought T.H. in for
weekly weight checks for the next month. T.H.’s weight remained stable
during this time period.
Dr. Artinian did not see T.H. again until ten months later when
Mandy brought T.H. in at the request of DHS. DHS caseworker, Sharon
Andrusyk, had received a report that T.H. was not wearing the glasses
prescribed for her to correct her crossed eyes. Andrusyk contacted
Mandy, and she brought T.H. into the DHS office a day later on
October 20, 2010. During this meeting, Andrusyk immediately noticed
that something was wrong with T.H. Andrusyk noted that T.H.’s skin
was “pale and gray,” her affect was flat, and the hair on the top of her
head was extremely thin. Andrusyk asked Mandy to take T.H. to see a
doctor.
Mandy took T.H. in to see Dr. Artinian. Dr. Artinian determined
T.H. was failing to thrive. Failure to thrive is not a diagnosis but, rather,
“a description of what’s going on with a child.” There are numerous
potential causes for failure to thrive. Dr. Artinian described T.H.’s failure
to thrive as “very serious” and noted that he “was actually worried about
her life at that point in time” because T.H. had not gained any weight in
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nearly a year. Dr. Artinian was unable to identify an illness or disease
that could account for T.H.’s condition.
After examining T.H., Dr. Artinian wrote Andrusyk a letter
expressing his concerns regarding T.H.’s condition. Dr. Artinian wrote:
“[T.H.] had not grown or gained any weight in 10 months. Her hair is
thinning, she is emaciated and has a wasted appearance. [T.H.]’s skin is
dry and loose. Her affect is flat.” Dr. Artinian told Mandy that he was
“profoundly concerned about [T.H.]’s medical and psychological health.”
Nevertheless, Mandy remained unconcerned. Dr. Artinian, therefore,
urged DHS to compel T.H.’s hospitalization. He noted: “As a pediatrician,
I have grave concerns regarding the physical and mental health of [T.H.].
I am very concerned that she is undergoing abuse/neglect in her home.
DHS absolutely needs to take action to help this child.”
After receiving Dr. Artinian’s letter, Andrusyk obtained
authorization to remove T.H. from the Hustons’ home, to admit her to the
hospital, and to place her in foster care thereafter. On November 2,
Andrusyk went to Brandon and Mandy’s home to remove T.H., but she
was not there. Brandon told Andrusyk that T.H. was with Mandy at an
appointment, but refused to tell Andrusyk where they were. Eventually,
Andrusyk found Mandy, but T.H. was not with her. Mandy took
Andrusyk to the Hustons’ home and went inside the home and removed
T.H. Andrusyk noted the following about T.H.’s condition that day:
She was very dirty. Her clothing was dirty. Her hair
was matted. She, again, would not make eye contact, would
not talk, except to repeat some things. She did state she
was hungry. Her skin was very gray and loose appearing,
again, very flat affect. She just didn’t talk hardly.
Andrusyk took T.H. to the hospital, where she was admitted by
Dr. Christopher Youngman. T.H. stayed in the hospital for five days.
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Andrusyk returned to the hospital the day after T.H. was admitted and
took photographs of T.H, including some bruising that appeared after
she was rehydrated. Andrusyk noted T.H.’s skin tone and affect had
improved markedly since her admission to the hospital the previous day.
During T.H.’s hospitalization, Dr. Artinian and Dr. Youngman
ruled out a number of medical causes for T.H.’s failure to thrive. While
in the hospital, T.H. ate everything presented to her and sometimes
asked for more to eat. On the last day of her hospitalization, T.H. ate a
lot of food and vomited. By the time T.H. was released from the hospital,
she had gained nine pounds.
Dr. Artinian testified it was his opinion, to a reasonable degree of
medical certainty, that
the reason why [T.H.] was failing to grow properly and gain
weight over time was that she was not receiving an adequate
amount of calories, meaning she was not getting enough
food. This was—this was determined by ruling out the other
problems that could cause it, but more than that, by
hospitalizing her for five days, we were able to control her
environment and control her caloric intake, and when given
calories, she gained weight. We did no other intervention for
her. We gave her no other medicine or therapies that would
cause weight gain, and during that five days, [T.H.] came
into the hospital at 34 pounds and was discharged at 43
pounds, which is a nine pound weight gain in five days,
which is—just speaks to the fact that when given calories,
she was able to grow.
Dr. Youngman similarly concluded, to a reasonable degree of medical
certainty, that the cause of T.H.’s failure to thrive was “inadequate
caloric intake . . . she just was not receiving enough calories to grow.”
Dr. Youngman also noted that if left untreated, “people can die of
malnutrition,” and even short of death, they can suffer “[n]eurological
consequences . . . and other organ damage as well.”
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After T.H.’s release from the hospital, she was placed in foster care.
Apart from another episode of vomiting, T.H. has thrived in her new
environment. T.H. has continued to gain weight since her release from
the hospital and, as of her last appointment, was between the 50 and 75
percentiles on the growth chart for weight. In addition to these
improvements, the hair on the top of T.H.’s head has filled in, and she
has grown two inches.
Leslie Boyer, a caseworker with DHS, was assigned to investigate
the allegations brought against Karen and Fred regarding T.H.’s care.
Boyer interviewed Karen and Fred at their home as part of this
investigation. During both interviews, Karen and Fred denied that T.H.
was living with them at the time DHS intervened. They later admitted at
trial that, after Brandon and Mandy moved from their home, T.H. stayed
behind with them.
During these interviews, Huston also reported that she had seen
T.H. overeat and vomit several times. At trial, Fred and Mandy testified
to similar behavior. Huston also told Boyer that T.H. would eat more
than any of the other children and that she believed T.H. had an eating
disorder. Moreover, Huston and Mandy testified that they thought T.H.’s
failure to thrive may have resulted from the stress she experienced when
Brandon cut ties with his own mother and prevented T.H. from seeing
her siblings and maternal grandparents.
On December 27, 2010, the State charged Karen and Fred each
with two counts of child endangerment. Count I alleged they knowingly
acted in a manner creating a substantial risk to T.H. or willfully
depriving T.H. of food, causing serious injury in violation of Iowa Code
sections 726.6(1)(a), 726.6(1)(d), and 726.6(5) (2009). Count II alleged
Karen and Fred intentionally used unreasonable force, torture, or cruelty
8
on T.H. causing bodily injury in violation of Iowa Code sections
726.6(1)(b) and 726.6(6). The cases against Karen and Fred were
consolidated for trial.
The three-day trial began on June 20, 2011. Nine witnesses
testified, including Karen and Fred, who were the defendants’ only
witnesses. One of the State’s witnesses, DHS caseworker Boyer, testified
regarding her investigation of the child abuse allegations against Karen
and Fred and her conclusions following that investigation. Boyer and the
county attorney had the following exchange:
Q. As a result of your investigation, were you, as part
of your work, able to reach a conclusion—you talked earlier
about founded, not confirmed, so forth. Did you reach a
conclusion with respect to that? A. Yes.
....
Q. And what was your conclusion?
MR. DIAL: Objection. Relevancy and lower burden of
proof, Your Honor.
MR. ORT: Same objection.
THE COURT: Overruled. You may answer.
[BOYER]: My outcome of my report was a founded
child abuse report, two separate, actually, reports: One on
Karen Huston and one on Fred Huston. It was founded on
denial of critical care, failure to provide adequate
supervision, also on physical abuse, and failure to provide
adequate food.
Boyer had previously testified that a report would be founded if there was
a preponderance of evidence. The county attorney then asked Boyer
whether there was a process for appealing a founded child abuse report.
The court, over defense counsel’s objection, permitted Boyer to explain
the appeal process. The county attorney next asked Boyer whether
either Karen or Fred had appealed the founded reports against them.
Before Boyer was allowed to answer, the court sustained the objections
of defense counsel.
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At the close of the State’s case, defense counsel for Karen and Fred
moved for a judgment of acquittal on both counts. The court granted the
motions for both defendants as to count II, but denied the motions as to
count I.
At the close of the defendants’ case, the court denied defendants’
renewed motions for judgment of acquittal on count I. The court
submitted the case to the jury. The jury found Huston guilty on the
felony charge of child endangerment causing serious injury. Fred was
found guilty of a lesser included misdemeanor—child endangerment
causing no injury, in violation of Iowa Code sections 726.6(1) and
726.6(7). Huston admitted she had at least two prior felonies, making
her a habitual offender eligible for an enhanced sentence under Iowa
Code sections 902.8 and 902.9(3). The court denied the defendants’
motions for a new trial on August 5. The court sentenced Huston to a
term not to exceed fifteen years.
Huston appealed, alleging the district court erred in admitting DHS
caseworker Boyer’s testimony that the child abuse report against Huston
was founded and describing the process for appealing an administrative
finding of child abuse. Huston also contends her trial counsel was
ineffective when he failed to move for judgment of acquittal after the
State failed to prove T.H. suffered serious injury. Fred did not appeal the
judgment or sentence entered against him. We transferred the case to
the court of appeals.
A three-judge panel of the court of appeals affirmed Huston’s
conviction and sentence for child endangerment causing serious injury.
The court of appeals concluded the district court acted within its
discretion by admitting Boyer’s testimony as relevant:
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Boyer’s testimony regarding the report described T.H.’s
weight loss, failure to grow, and poor condition—evidence
consistent with intentional abuse or neglect, an essential
element the State needed to prove. The testimony explained
the investigatory and protective steps taken by DHS to
determine whether evidence supported the initial information
DHS received, and how the investigation resulted in a
“founded” report. The testimony explained why further
action was taken against Huston and what measures were
taken to protect T.H.
The court of appeals further held Boyer’s testimony was not unfairly
prejudicial:
[T]he probative value of the evidence outweighed any danger
of unfair prejudice to Huston [because] . . . [u]nder these
facts, evidence of a founded child abuse report is hardly the
type of information that would arouse horror or surprise in
the jury or lure the jury into declaring guilt on a ground
different from proof specific to the offense charged.
The court of appeals also found that any error in admitting Boyer’s
testimony was harmless.
We granted Huston’s application for further review.
II. Scope of Review.
We review evidentiary rulings for abuse of discretion. State v.
Rodriquez, 636 N.W.2d 234, 239 (Iowa 2001); McClure v. Walgreen Co.,
613 N.W.2d 225, 235 (Iowa 2000) (“We reverse a ruling that the district
court makes in the balancing process under rule 403 only if the district
court has abused its discretion.”).
III. Analysis.
We must decide whether the district court committed reversible
error by allowing the DHS caseworker to testify that the child abuse
report against Huston was determined to be founded. Huston argues
“the danger here was that the jury would find [her] guilty because DHS
found her to have committed child abuse.” The State contends testimony
that the abuse report was deemed founded was admissible to explain the
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actions taken by DHS to remove T.H. from Huston’s care and that any
error in admitting this testimony was harmless.
We recognize that a DHS caseworker may need to provide some
context when she testifies in a child endangerment case as to her
personal observations of the victim or home environment and when she
recounts the statements made by the defendant during interviews. But,
we have also cautioned “ ‘the line of inadmissibility’ ” may be crossed
when an investigator’s testimony goes “ ‘beyond the point of merely
explaining why certain responsive actions were taken.’ ” State v. Elliot,
806 N.W.2d 660, 668 (Iowa 2011) (quoting State v. Doughty, 359 N.W.2d
439, 442 (Iowa 1984)). Here, T.H.’s removal for hospitalization and the
interviews of Karen and Fred Huston all occurred before the DHS’s
determination that the child abuse allegations were founded. Boyer
could have simply testified that she acted in response to a report of child
abuse to provide the context necessary for this testimony, without telling
the jury that DHS determined the abuse report to be founded.
Huston argues any probative value of the fact DHS deemed the
abuse report against Huston to be founded was substantially outweighed
by the danger of unfair prejudice. We agree. Even relevant evidence is
inadmissible “ ‘if its probative value is substantially outweighed by the
danger of unfair prejudice.’ ” McClure, 613 N.W.2d at 235 (quoting Iowa
R. Evid. 5.403). Rule 5.403 provides:
Although relevant, evidence may be excluded if its probative
value is substantially outweighed by the danger of unfair
prejudice, confusion of the issues, or misleading the jury, or
by considerations of undue delay, waste of time, or needless
presentation of cumulative evidence.
We employ a two-part test to decide whether evidence should be excluded
under rule 5.403. See State v. Cromer, 765 N.W.2d 1, 8 (Iowa 2009).
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First, we “consider the probative value of the evidence.” Id. Second, we
balance the probative value “ ‘against the danger of its prejudicial or
wrongful effect upon the triers of fact.’ ” Id. (quoting State v. Harmon,
238 N.W.2d 139, 145 (Iowa 1976)).
“[T]he purpose of all evidence is to sway the fact finder.” State v.
Mitchell, 633 N.W.2d 295, 301 (Iowa 2001) (Neuman, J., dissenting). In
child abuse cases, much evidence will be “at least somewhat prejudicial.
Exclusion is required only when evidence is unfairly prejudicial [in a way
that] substantially outweighs its probative value.” Id. “ ‘Unfair prejudice’
is the ‘ “undue tendency to suggest decisions on an improper basis,
commonly though not necessarily, an emotional one.” ’ ” McClure, 613
N.W.2d at 235 (quoting State v. Plaster, 424 N.W.2d 226, 231 (Iowa
1988)).
We see no probative value to the DHS determination the abuse
report against Huston was founded. Whether or not the abuse report
was deemed founded is irrelevant to any issue for the jury to decide.
Additionally, we see a real danger the jury will be unfairly influenced by
that agency finding, which gives the “imprimatur” of a purportedly
unbiased state agency on a conclusion that Huston was guilty of child
abuse. A federal court recently applied the same balancing test under
Federal Rule of Evidence 403 to exclude from evidence a fire department
report on the cause of a fire. EMK, Inc. v. Fed. Pac. Elec. Co., 677
F. Supp. 2d 334, 338 (D. Me. 2010). The court concluded,
Because . . . the report . . . carries the imprimatur of
municipal government, the jury could well place undue
emphasis on its summary causation conclusion on the
assumption that it reflects the considered opinion of a fire
investigator, who is cloaked with governmental objectivity
and expertise.
Id. We see the same danger here.
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Other courts have recognized the danger a jury will be unfairly
influenced by an administrative agency finding. In Rambus, Inc. v.
Infineon Technologies, AG, 222 F.R.D. 101, 110 (E.D. Va. 2004), the court
held that Rule 403 required exclusion of a decision by an administrative
law judge. The court surveyed the authorities as follows:
First, the jury, when confronted with the Initial
Decision, likely would give undue weight to the findings of
the ALJ. See Martin v. Cavalier Hotel Corp., 48 F.3d 1343,
1358 (4th Cir. 1995) (upholding trial court’s decision under
Fed. R. Evid. 403 to exclude report of state agency because
“jury would have placed undue weight on such evidence”)
(internal citations and quotations omitted); accord Williams
v. Nashville Network, 132 F.3d 1123, 1129 (6th Cir. 1997) (“A
strong argument can made that a jury would attach undue
weight to this . . . agency determination.”). Similarly, the
jurors’ ability to reach their own determinations respecting
the facts at issue in this case would be undermined by the
admission of the Initial Decision. United States v.
MacDonald, 688 F.2d 224, 230 (4th Cir. 1982) (upholding
trial court’s decision under Fed. R. Evid. 403 to exclude
executive branch investigator’s findings and conclusions
because report “tend[ed] to undermine the exclusive province
of the jury”); see also Steven P. Grossman & Stephen J.
Shapiro, The Admission of Government Fact Findings Under
Federal Rule of Evidence 803(8)(C): Limiting the Dangers of
Unreliable Hearsay, 38 U. Kan. L. Rev. 767, 778–779 (1990)
(“Jurors learning that a presumably objective public official
has reached a certain conclusion after hearing evidence
similar to what they have heard may have difficulty reaching
an opposite conclusion. Further, the jury is likely to
deliberate on the correctness of the previous fact finding,
rather than retaining the open-minded, first impression
approach to the issues our system prefers.”).
Rambus, Inc., 222 F.R.D. at 110.
Other courts have applied the Rule 403 balancing test to exclude
evidence of administrative agency determinations in employment
discrimination cases. One such court pointedly observed, “presenting
the administrative findings with respect to plaintiff’s charge of
discrimination is ‘tantamount to saying “this has already been decided
and here is the decision.” ’ ” Brom v. Bozell, Jacobs, Kenyon & Eckhardt,
14
Inc., 867 F. Supp. 686, 692 (N.D. Ill. 1994) (quoting Tulloss v. Near N.
Montessori Sch., Inc., 776 F.2d 150, 154 (7th Cir. 1985)). The Eighth
Circuit affirmed the trial court’s ruling to exclude from evidence in a jury
trial the EEOC’s administrative determination of racial discrimination.
Johnson v. Yellow Freight Sys., Inc., 734 F.2d 1304, 1309–10 (8th Cir.
1984). The Johnson court observed that to allow the agency finding into
evidence
would amount to admitting the opinion of an expert witness
as to what conclusions the jury should draw, even though
the jury had the opportunity and the ability to draw its own
conclusions from the evidence presented regarding disparate
treatment.
Id. at 1309; see also Jones v. Cargill, Inc., 490 F. Supp. 2d 989, 992–93
(N.D. Iowa 2007) (excluding evidence of finding by Cedar Rapids Civil
Rights Commission of no probable cause as to race discrimination).
These cases are persuasive. Telling the jury the DHS determined
the child abuse complaint against Huston was founded was unfairly
prejudicial due to the risk the jury would substitute the DHS
determination for its own finding of guilt or would give the determination
undue weight.
The State argues the risk of prejudice was mitigated by testimony
from the DHS caseworker as to the lower burden of proof to establish a
child abuse complaint as founded by the agency. The district court gave
no curative or limiting instruction to the jury regarding the DHS
determination. Other courts have allowed testimony as to administrative
findings with a curative or limiting instruction. See, e.g., United States v.
W.R. Grace, 455 F. Supp. 2d 1203, 1207 (D. Mont. 2006) (allowing
evidence of EPA environmental risk assessment because the jury is
capable of “[d]ifferentiating between the different standards” with the
15
help of a limiting jury instruction); Commonwealth v. Hernandez, 615
A.2d 1337, 1341 (Pa. Super. Ct. 1992) (affirming conviction for sexual
abuse of minor when trial court gave cautionary instruction “that only
the jury was the factfinder . . . and [that] it ‘must not and may not accept
any standard adopted by DHS’ ”). We do not believe it would have been
proper in this case to allow testimony that the child abuse report was
determined to be founded even with a limiting instruction. In any event,
we conclude Boyer’s testimony as to the lower burden of proof was
insufficient to cure the unfair prejudice.
The risk of unfair prejudice to Huston was exacerbated by further
testimony as to the right to appeal the DHS determination, followed by
the district court’s evidentiary ruling preventing testimony as to whether
Huston appealed. The jury could improperly infer Huston’s guilt from
the absence of a successful appeal overturning the DHS finding that the
child abuse complaint against her was founded.
For all these reasons, we hold the district court abused its
discretion by allowing the jury to hear testimony the child abuse
complaint against Huston was founded. Nor are we persuaded the error
was harmless. Prejudice is presumed, and the State bears the burden of
showing lack of prejudice. State v. Howard, ___N.W.2d ___, ___ (Iowa
2012). The evidence against Huston was strong, but not overwhelming.
Huston shared responsibility for feeding T.H. with several other
caregivers. Huston’s own mobility was limited. The child–victim had
problems vomiting in the hospital and with her new foster parents. The
seriousness of the child’s injury from malnutrition and Huston’s intent
and role in the victim’s endangerment were disputed issues. We cannot
conclude the record affirmatively establishes that Huston was not
16
prejudiced by the erroneous admission of evidence that the child abuse
complaint against her was founded. She is entitled to a new trial.
IV. Conclusion.
We hold the district court abused its discretion by allowing the
DHS caseworker to testify the child abuse report against Huston was
founded. That evidentiary error was not harmless, and accordingly,
Huston is entitled to a new trial. We therefore vacate Division II of the
court of appeals decision and reverse the judgment and sentence of the
district court. We remand the case for a new trial.
COURT OF APPEALS DECISION AFFIRMED IN PART AND
VACATED IN PART; DISTRICT COURT JUDGMENT AND SENTENCE
REVERSED, AND CASE REMANDED FOR NEW TRIAL.