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State v. Muro11/2/2004
anna earlier, she would have had a chance to survive the brain injury. The medical testimony as a whole demonstrates that in this type of injury, the sooner treatment is sought, the better the chances of survival are, and that the absence of treatment decreases the chance of survival.
Considering all of this evidence in a light most favorable to the prosecution, we do not find clearly erroneous the court's finding beyond a reasonable doubt that the death of Vivianna was the inevitable result of Muro's failure to seek care. The trial court also specifically found that the "deprivation of care substantially and materially contributed in a natural and continuous sequence unbroken by any efficient intervening cause to the death of [Vivianna]." The above evidence supports the court's finding and provides a basis on which a rational trier of fact could find that Muro's failure to seek care for Vivianna materially contributed in a natural sequence to Vivianna's death because she was deprived of the chance to be saved by prompt treatment.
The evidence indicates that Vivianna's survival for nearly 4 hours demonstrated that the injury was not invariably fatal and that she had an opportunity to survive if she had received timely treatment. Muro failed to secure such treatment for a period of 4 hours, by which time the opportunity to survive was gone. Dr. Alexander testified that "because of a delay in getting medical attention it turned into a hopeless case," and Dr. Parys testified that "there was very, very little chance of saving [Vivianna's] life" by the time she received medical attention.
Had timely treatment been secured, Vivianna had a reasonable likelihood of survival; as a result of Muro's actions, according to Dr. Alexander, "it was too late by the time she finally did get care." As a result, we cannot find the court's findings on proximate cause to be clearly erroneous.
The present case is significantly distinguishable from the case cited by Muro, State v. Doyle, 205 Neb. 234, 287 N.W.2d 59 (1980). State v. Doyle involved a prosecution for manslaughter after a dead human infant was found on premises occupied by the defendant and her family where evidence indicated that the defendant had been pregnant prior to the discovery of the infant. The medical evidence was that the infant was at or near term and had been born alive and that there was no evidence of internal or external trauma. The pathologist was unable to testify as to the cause of death. On the issue of proximate cause, the Nebraska Supreme Court found that there was no evidence that the defendant had willfully or negligently done, or failed to do, anything which caused or permitted the life of the infant to be endangered. In the present case, however, there is abundant evidence of Muro's failure to seek medical attention at a time when she knew Vivianna was seriously injured or ill. Additionally, there is abundant evidence that such failure deprived Vivianna of the chance to survive her injuries. Therefore, we do not find State v. Doyle to be applicable.
Although we are mindful of the concerns raised by the dissent herein, we reject the argument that the State had the burden to show by a reasonable degree of medical certainty that Vivianna's chances of survival had Muro sought medical care sooner were "more likely than not" or some other bright-line percentage. See Eversley v. State, 748 So.2d 963, 968 (Fla. 1999) (medical evidence as to cause of death need not be expressed in terms of medical certainty; it is sufficient if expert testifies that conduct "'could,'" "'might have,'" or "'probably did'" cause death). See, also, Mallory v. State, 563 N.E.2d 640, 642 (Ind. App. 1990) (doctor testified c
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