Opinion
No. 10-04-00248-CR
Opinion delivered and filed October 26, 2005. DO NOT PUBLISH.
Appeal from the 258th District Court, Polk County, Texas, Trial Court No. 17398. Affirmed.
Before Chief Justice GRAY, Justice VANCE, and Justice REYNA.
MEMORANDUM OPINION
Appellant Jonathon P. Durham (Durham) appeals his conviction of injury to a child and sixty-year sentence, asserting twenty-two issues. Durham's issues complain of the sufficiency of the evidence, the admission of autopsy photographs and extraneous-offense evidence, alleged prosecutorial misconduct, and an error by the trial court in jury instructions. He also asserts that the trial judge improperly entered the jury room during deliberations. We will overrule each issue and affirm the judgment.
I. Background
On the morning of July 12, Durham and Angela Miller, the parents of 29-day-old Chelsea Durham, took her to a Livingston hospital emergency room, reporting that she had choked on formula. Chelsea was lifeless, but medical personnel were able to revive her and have her transferred to Hermann Hospital in Houston, where she was found to be brain dead. She died on July 13 after being removed from life support. Because her brain injuries and the scratches and bruises on her head and face were suspicious and did not fit with the history of choking, hospital personnel notified police. Livingston police detective Ken Bohnert began an investigation. Bohnert learned from the Harris County Medical Examiner that Chelsea had previously suffered broken ribs. Durham was arrested about six weeks later and charged with injury to a child: intentionally or knowingly causing serious bodily injury "by causing trauma to the head of said Chelsea Durham and said trauma was inflicted by the hand of the Defendant [Durham] or other object unknown to the Grand Jury, or by manner and means unknown to the Grand Jury" on July 12, 2003. See TEX. PEN. CODE ANN. § 22.04(a)(1), (e) (Vernon 2003). A jury found Durham guilty after a two-week trial and assessed a prison sentence of sixty years.II. Injury to a Child
A person commits the offense of injury to a child if he intentionally or knowingly by act causes serious bodily injury to a child. Id. Serious bodily injury is an injury that creates a substantial risk of death or that causes death, serious permanent disfigurement, or protracted loss or impairment of the function of any body member or organ. Id. § 1.07(46) (Vernon 2003). Texas case law is replete with holdings that when an adult defendant has had sole access to a child at the time its injuries are sustained, the evidence is sufficient to support a conviction for injury to a child, or murder if the child dies. See Bryant v. State, 909 S.W.2d 579, 583 (Tex.App.-Tyler 1995, no pet.) (where evidence showed child had been left alone with defendant and injuries to child occurred approximately thirty minutes prior to child being brought to emergency room, evidence was sufficient to support conviction); Elledge v. State, 890 S.W.2d 843, 846 (Tex.App.-Austin 1994, pet. ref'd) (undisputed medical testimony placing adult defendant alone with child when fatal injuries were sustained supported conviction for injury to a child); Butts v. State, 835 S.W.2d 147, 151 (Tex.App.-Corpus Christi 1992, pet. ref'd) (injuries sustained by child established by medical testimony to have occurred at time adult defendant admitted to sole possession of child). Garcia v. State, 16 S.W.3d 401, 405 (Tex.App.-El Paso 2000, pet. ref'd).III. Legal Sufficiency of the Evidence
Durham's first two issues attack the legal sufficiency of the evidence, asserting that the State failed to prove that Chelsea suffered serious bodily injury, or, if she had suffered serious bodily injury, that Durham inflicted that injury. A. Standard of Review When reviewing a challenge to the legal sufficiency of the evidence to establish the elements of a penal offense, we must determine whether, after viewing all the evidence in the light most favorable to the verdict, any rational trier of fact could have found the essential elements of the offense beyond a reasonable doubt. See Jackson v. Virginia, 443 U.S. 307, 318-19, 99 S.Ct. 2781, 2789, 61 L.Ed.2d 560 (1979). The standard is the same for both direct and circumstantial evidence cases. Kutzner v. State, 994 S.W.2d 180, 184 (Tex.Crim.App. 1999). We do not resolve any conflict of fact or assign credibility to the witnesses, as this was the function of the trier of fact. See Dewberry v. State, 4 S.W.3d 735, 740 (Tex.Crim.App. 1999); Adelman v. State, 828 S.W.2d 418, 421 (Tex.Crim.App. 1992); Matson v. State, 819 S.W.2d 839, 843 (Tex.Crim.App. 1991). Instead, our duty is to determine if the findings of the trier of fact are rational by viewing all of the evidence admitted at trial in the light most favorable to the verdict. Adelman, 828 S.W.2d at 422. In so doing, any inconsistencies in the evidence are resolved in favor of the verdict. Curry v. State, 30 S.W.3d 394, 406 (Tex.Crim.App. 2000); Matson, 819 S.W.2d at 843. B. The evidence Because of the numerous witnesses who testified at trial and the competing medical theories and voluminous medical testimony, our discussion of the evidence at trial is lengthy and detailed. Angela Miller. Angela, Chelsea's mother, began living with Durham in Livingston in October 2002 when she was 17; they were not married. Angela's pregnancy with Chelsea was planned, and Chelsea was born without complications on June 13, 2003. Chelsea had no serious injuries before her death; she had only a small bruise on her right temple a few days before July 12 that Angela and Durham thought was caused by the plastic on Chelsea's bouncer. Chelsea occasionally scratched herself, so they put mittens or socks on her hands, but the scratches were tiny. In early July, Angela invited Tim Moseley, a friend, to stay with them after he had trouble with his girlfriend, Kandyce Puckett. Sometime in the week before July 12, Angela, Durham, Moseley, and a neighbor smoked marihuana and snorted methamphetamine ("meth"). They used meth three or more times that week, but she could not remember the last day they had used it. Before July 12, Chelsea was behaving normally — she did not cry much and normally slept five to six hours at night. Angela fed her for the last time around midnight on the 11th; Chelsea took most of her bottle, and Durham took her to the nursery to rock her to sleep. That night Chelsea did not wake up — if Chelsea cried, it would awaken Angela, who could hear her through a baby monitor. When Chelsea woke up crying around 10:00 a.m., Durham volunteered — after Angela nudged him — to get up and feed her. Angela stayed in bed to go back to sleep; she heard Durham running water to make Chelsea's formula bottle and talking to Chelsea as he went into her room. The next thing that Angela recalled was Durham coming to her with Chelsea and telling her that there was something wrong — that Chelsea wasn't breathing; she was gasping for air. Angela telephoned their neighbor Amber for help. Angela immediately noticed that Chelsea had fresh scratches on her nose that were unlike the scratches Chelsea had made herself and that had not been there the night before. Also, her face was bruised; she had a bruise on her cheek and another bruise behind her ear, and neither had been there the night before. Angela asked Durham what had happened, and he told her that Chelsea had choked on her formula and that he had tried a few things to get her to breathe — the Heimlich maneuver, a bulb syringe to clear out her throat, patting her on the back, and massaging her throat. Amber arrived after a couple of minutes, and they all raced Chelsea to the Livingston hospital, where Durham carried Chelsea into the emergency room. Chelsea was then flown to Hermann Hospital in Houston. After talking to doctors and the police, Angela and Durham drove to Houston with Moseley and Kandyce. Durham appeared very upset to Angela that day, but she questioned how upset he really was because he smoked marihuana on the drive to Houston. Chelsea was taken off life support at Hermann on July 13, and she died. Amber Granger. Amber, a neighbor, came over after being called by Angela. She saw that Chelsea's lips were turning blue; she looked lifeless and was unresponsive. Chelsea had bruises near her eye and jawline, scratches on her collarbone, and blood around her nostrils. Amber had last seen Chelsea a week before, and she had appeared okay then. Tim Moseley. Moseley, 19, said that on July 6, he and Durham bought a bag of meth, which they used that week. He used it once, and Durham used it three or more times through the week. Moseley slept on the couch the night of July 11 and did not hear Chelsea wake up during the night. At the hospital, Moseley overheard Durham tell the doctors that Chelsea had choked on her milk. As they were all getting in the car to go to Houston, Durham remarked to Moseley that "if it weren't for some of the things Angela said, he [Durham] would have got away with it." On the drive to Houston, Moseley and Durham were in the back seat, and they smoked marihuana. After waiting at Hermann for several hours, Moseley and Kandyce returned to Livingston. On the night of July 13, after Chelsea's death, Durham and Moseley played video games and smoked marihuana. Durham did not seem upset; he was just "his normal self." Durham told him that if he signed papers to have Chelsea taken off life support, he would be charged with murder. Moseley further heard Durham say that Chelsea "didn't deserve to be here in this hell anyway." In Moseley's opinion, Durham had admitted to him at Hermann Hospital that he had accidentally killed Chelsea, but at trial that he no longer believed that Durham had not intentionally harmed Chelsea. Kandyce Puckett. Kandyce, Moseley's girlfriend, saw Chelsea two or three days a week, and she never noticed Chelsea having any injuries or ailments. Before Saturday July 11, she had last seen Chelsea on Wednesday, and she seemed normal. Kandyce saw no scratches or abrasions, but she had two bruises on the right side of her face. At Hermann, Kandyce overheard Durham say, "If Angela hadn't said what she said, I might could have gotten away with this." On cross-examination she agreed that Durham made this comment in the car or at home, not at Hermann. She also recalled telling police that Durham said, "I'm probably going to go to jail for this" and that he figured he would probably get the blame. Kandyce further overheard Durham say in Houston that "they're going to get me for murdering my baby because I was the last one with her." When Kandyce returned to Livingston on the evening of July 12, she found a baby rag with blood on it in the nursery. She put it in a pile of clothes and later told the police about it. She returned to Houston the next day and saw Chelsea; she noticed that Chelsea had marks on her nose and was swollen. She had not seen the marks before that day and did not know how they got there. Kandyce thought that Durham did not seem concerned about Chelsea's welfare. While Durham did cry some over Chelsea, Angela was a "disaster" compared to him. He said that Chelsea "didn't deserve to be in this hell anyways, she was in a better place now." After they all returned to Livingston the night of July 13, Durham did not seem to Kandyce to be grieving; he was just playing video games. Jonathan Durham. Durham testified in his own defense. After he and Angela began living together, they decided to have a baby, and Angela became pregnant. Durham recalled that Chelsea got a bruise on her temple at some point before July 12, and he believed it was caused by the swing. Durham did not think that either Moseley or Angela did anything to Chelsea. Durham could not recall what time he went to bed on the night of July 11. On the morning of July 12, Angela nudged him to get up when Chelsea's crying woke her. He got up to fix her bottle, and he remembered saying, "Daddy's got your bottle." As he was fixing the bottle, Chelsea was crying. When he walked in the nursery, Chelsea was lying in the crib. He picked her up and wrapped her in a blanket. Sitting in a rocking chair, he put Chelsea between his knees and started to feed her. While she was feeding, Chelsea had reflux and the formula came out of her nose. He took the bottle out of her mouth, and she started choking on the formula. She had never choked while he was alone with her, and he had never seen it happen while she was feeding. He did not know if Angela was awake, and he did not think of calling her for help. He rolled Chelsea on her side, held her head in his palm, and patted her on the back. She was not breathing normally, but was coughing. She then stopped making any sound, and her whole face got red. He did not know how long Chelsea choked or how long he was in the room with her. He pushed her chest to try CPR, but first he tried the Heimlich. As he tried to revive her, she spit up. She moved her arms a little, and then she went limp. He tried "mouth-to-mouth" to get her air, and he used a bulb syringe to get the substance out of her nose. Using his thumb and finger, he then pinched her nose to draw out the substance. After ten or fifteen minutes, Durham took Chelsea to Angela in their bedroom and told her there was something wrong. Angela got up and called Amber, who arrived in a few minutes, and they took Chelsea to the hospital. Although Chelsea's grandmother and great-grandmother went into the treatment room in the Livingston ER to see Chelsea, Durham did not; he said he did not know he could go in to see her. At the Livingston hospital, he talked to Detective Bohnert, telling him what had happened with Chelsea. On the drive to Houston, he was scared, so he smoked marihuana because he needed help dealing with the situation. Durham denied admitting guilt to anyone and denied intentionally hurting Chelsea. Chelsea had rolled off a footstool in the nursery several days before July 11 after he left her on it and left the room. When he returned and found her on the floor, she did not appear to be hurt. Durham denied ever trying to make excuses to the police about the footstool or crib vibrator as causing Chelsea's injuries, and he denied that Chelsea's needs irritated him or interfered with him. When Durham and his attorney met with the prosecutor and the police on July 24, he did not mention reflux or preexisting bruises or scratches; he did not mention some things because his attorney would not let him talk much. In response to whether his story had evolved over time, Durham said that his attorney thought it was best for Durham to keep certain details to himself. And when asked whether he was more concerned with his fate than giving an accurate history to the medical providers, Durham said, "I was told to keep my mouth shut" and "I was just doing what they told to me." Durham said that he may not have been exact in talking to Det. Bohnert, and he did not explain further to police because his father, a criminal defense attorney, had told him not to talk. Durham could not explain why he did not call 9-1-1 or call out for Angela that morning, particularly with the baby monitor right there. He said that Chelsea did not bleed at all that morning; her abrasions and scratches had previously occurred. The scratches were there two or three days before July 12, but at the July 24 meeting he said that Chelsea did not have any injuries. The blood on the blanket or towel came from Chelsea cutting her gum one day, and Durham said he used a blanket to blot it. As for the blood on Chelsea's clothing, he suggested that hospital personnel had caused her abrasions to bleed. When questioned further about the scratches on Chelsea's nose, Durham denied testifying that she had scratched herself. After his previous contradictory testimony was read back, he said that Chelsea had not scratched herself but that he had scratched her two or three days before; he later said that he did it by pinching her nose to clear it. Regarding his statements to Kandyce and Moseley that he could have "gotten out of it" if Angela had kept her mouth shut, Durham admitted making the statement. He explained: "I remember saying it and I think she [Angela] was talking to Detective Bohnert. . . . and she said something and I had figured that they were going to suspect me, so I can't really remember what she said that made it look like I was to blame." He further agreed that he told Kandyce at Hermann that he would probably go to jail for murdering his daughter. As for his statement that Chelsea did not "deserve to be in this hell," Durham explained that he and Angela "went a little fast" and "should have thought about having a child." Durham and Angela did not stay at Hermann until Chelsea's life support was disconnected, but instead returned to Livingston because he did not want to see Chelsea take her last breaths. Willie Hawkins, M.D. On July 12, Dr. Hawkins was on duty in the Livingston hospital emergency room. Durham carried Chelsea into the ER; she was "code blue and lifeless." While reviving Chelsea, Dr. Hawkins observed obvious injuries, including facial bruises, head abrasions, and bloody nostrils that he said were not caused by his and his staff's treatment. They used suction to clear her airway because of some type of secretion, but it wasn't blocking her airway. After reviving Chelsea, they arranged a transfer to Houston. Durham told Dr. Hawkins that Chelsea had choked on her formula about twenty minutes before they arrived at the hospital and that Chelsea's bruises were caused by his turning her head from one side to the other. Dr. Hawkins's notes in the hospital records stated that Durham said that Chelsea's nose abrasions were from his cleaning her nose. In comparing Chelsea's actual injuries to the history that Durham had given, Dr. Hawkins thought that Durham's history did not make sense; he suspected foul play and had police contacted. Dr. Hawkins was not surprised when he later learned of Chelsea's brain trauma. He had reviewed Chelsea's autopsy report, and he said that he and his staff did not cause Chelsea's broken ribs and head injuries. Dr. Hawkins explained that infants sustain few rib fractures during CPR because their ribs are much more pliable. Stacy Wilson. Wilson, a Livingston hospital nurse, was on duty in the ER as a charge nurse when Chelsea was brought in. They began resuscitation efforts, suctioning four or five teaspoons of milky substance from the back of her throat and intubating her. Wilson undressed Chelsea, noticed obvious bruising to her head, face, and one hand, and noted the injuries, including a Battle sign (an injury behind the ear seen often with head injuries), in Chelsea's chart. Because Chelsea's injuries did not correspond to the father's history, Wilson instructed the ER staff to call the police. Karrie Lewis. Lewis, a pediatric transport nurse, assisted with the helicopter transport from Livingston to Hermann. Chelsea's appearance was not consistent with that of a child who had choked. Lewis said that Chelsea's injuries were not caused by the helicopter transport, as they were very careful with Chelsea. She also did not think that CPR caused Chelsea's rib fractures because children's bones are pliable. She said that if rib fractures occur during CPR, they are usually located near the sternum on the chest, not near the spinal column like Chelsea's fractures. Lewis testified that, in her experience, injuries like Chelsea's were always caused by abuse or some form of trauma such as a car accident. Singaraju Katari, M.D. Dr. Katari, a pediatrician, was called to the Livingston ER on July 12 because he had previously treated Chelsea. Chelsea appeared to be neurologically dead. Dr. Katari talked to Angela and Durham about what had happened, and Durham said that he had been feeding the baby when she choked and vomited. When he examined Chelsea, he noticed abrasions near her nose. Dr. Katari could not make a specific diagnosis, but he did note SIDS as a possibility because it is a common cause of death among children Chelsea's age. However, Durham's story did not fit with what he saw, and Dr. Katari noted that non-accidental injury needed to be excluded as a cause. Julie McInnis. McInnis was a pediatric intensive care nurse at Hermann, where Chelsea was placed on a ventilator. McInnis noted the bruises and abrasions on Chelsea's face, neck, and head, including bruises behind the ear, on top of the head, and on both sides of the neck. Although Livingston medical personnel had not reported neck bruising, McInnis said that it sometimes takes a while for bruising to show. Because Chelsea was obviously the victim of some type of trauma, McInnis called in various specialists and social workers. The next day, McInnis participated in a care conference with Chelsea's family. When the doctor told Durham that Chelsea was not going to survive and that someone "did this" to Chelsea, Durham just bowed his head and said nothing. Giuseppe Colasurdo, M.D. Dr. Colasurdo, an attending pediatrician at Hermann, treated Chelsea on July 13. By the time that Chelsea was admitted to Hermann, she was clinically dead, though on life support. Their goal became looking for the cause of death because there was little treatment to offer her. His diagnosis was severe traumatic brain injury with brain death likely due to abuse. The history provided to him was a choking incident and apnea. Asked to consider all of Durham's explanations (Heimlich attempt, CPR attempt, massaging the throat, falling from a footstool, and a spring hitting the head), Dr. Colasurdo concluded that none would explain Chelsea's injuries. After treating her and reviewing the autopsy findings, he had no doubt that Chelsea was intentionally injured. There was no medical explanation other than child abuse for the totality of Chelsea's injuries. Stephen Fletcher, D.O. To explain Chelsea's injuries, Dr. Fletcher, chief of pediatric neurosurgery at Hermann, described the various layers of flesh and bone overlying the brain and various types of brain injuries that can occur. "Diffuse axonal injury" is trauma where the gray matter and white matter planes in the brain are caused by external forces to slide "out of kilter." The types of external forces — acceleration or deceleration forces — that might cause diffuse axonal injury in a child include car accidents, falls off a bike, riding a roller coaster, being forcibly struck, and being banged against a wall or other object forcefully. The degree of injury depends in part on the magnitude of force applied. "Shaken impact syndrome" refers to a baby that is shaken and also thrown or hit. In shaken baby cases, injuries generally include diffuse cerebral edema, sometimes external injuries, and injuries to the cranial-cervical junction (where the head meets the spine). Where more external injury is seen, the case is more likely shaken impact syndrome. Such external signs of injury can include subscalpular hematomas, as well as surface bruises and abrasions. Neurosurgeons also look for bruising behind the ear, swelling and bruising on the back of the head, and swelling on the scalp. Dr. Fletcher consulted on Chelsea's case and observed her external signs of trauma, including multiple bruises and the Battle sign behind her left ear. He reviewed her CT scan results and determined that she was brain dead as a result of traumatic brain injury, specifically a blow to the back left portion of the head. Dr. Fletcher also reviewed the Harris County Medical Examiner's autopsy report on Chelsea, and it revealed subscalpular hemorrhage, subdural and subarachnoid hemorrhaging, swollen brain, and hemorrhage in the ligaments or soft tissue at the base of the skull on the left side. She also had blood in the subdural space in the thoracic spinal canal. In Dr. Fletcher's opinion, Chelsea suffered an impact to the skull and had a skull fracture because she had widenings along the occipital suture lines of the posterior skull plates. Morna Gonsulin, M.D. Dr. Gonsulin, an assistant Harris County medical examiner, performed Chelsea's autopsy on July 14 and described her findings in great detail. According to Dr. Gonsulin, the resuscitation efforts described by Durham would not explain Chelsea's injuries, nor could a fall from a footstool or a blow from a spring have caused such head trauma or all the other injuries. Richard Hirshberg, M.D. Dr. Hirshberg, a retired neurosurgeon, testified as an expert witness for the defense. In his opinion, Chelsea died from lack of oxygen after choking on formula. Durham had tried to perform a Heimlich maneuver, which squeezed Chelsea's chest, and medical personnel performing CPR could have fractured ribs, which he said commonly occurs in CPR. Because of the choking, her brain swelled from lack of oxygen. He did not believe that Chelsea had suffered any external head injury. Relying on the Hermann CT scan, Dr. Hirshberg said that Chelsea had only mild or tiny subdural and subarachnoid hemorrhaging, and the presence of DIC caused later additional hemorrhaging found in the autopsy. The subdural hematoma found on autopsy could not have been very large because it did not displace or crush the brain. If Chelsea had a head injury that caused her to stop breathing, there should have been evidence of diffuse axonal injury to the brain stem, which he believed was not found. He said that Chelsea was treated for DIC and believed such treatment meant that she suffered from DIC. He concluded that whatever hemorrhages occurred inside or outside her skull resulted from DIC or lack of oxygen and had no effect on her brain stem function and did not contribute to her death. Chelsea's fresh rib fractures were caused by CPR at the hospital and the older rib fractures were at least four weeks old. His opinion was that Chelsea had a brittle bone disease; the rib fractures were not caused by a direct blow because there was no bruising around the fracture locations. Also, the four separate subscalpular hemorrhages were caused by spontaneous bleeding during the resuscitation attempts due in part to DIC. Dr. Hirshberg did not believe that Chelsea had either a shearing injury or diffuse axonal injury because he said she had small subdural hematomas, her brain stem was not injured except for lack of oxygen, and her brain stem had no hemorrhages or diffuse axonal injury. He contended that Chelsea had no head or brain trauma other than oxygen deprivation and that it was reasonable that Durham caused the scratches to Chelsea's nose by trying to clear milk from her nose. Harry Wilson, M.D. Dr. Wilson, a pediatric pathologist board certified in pediatrics, pediatric hema-oncology, anatomic pathology, clinical pathology, and pediatric pathology, was called by the State in rebuttal. Dr. Wilson concluded that, to a reasonable degree of medical certainty, Chelsea died from homicide as a result of lethal blunt force trauma to her head, damaging her brain and causing severe brain swelling. He agreed with Dr. Gonsulin's conclusion that Chelsea sustained a lethal blow to the head that was evidenced by the bruise behind her left ear, the large band of subscalpular hemorrhage corresponding to that bruise, the subdural hematoma corresponding to those injuries, and severe brain swelling. He said that these factors were classic symptoms of Tin Ear Syndrome, where an infant receives a severe blow to the side of the head. These factors are indicative of child abuse in the absence of a reasonable explanation of injury such as falling out of a window or being in a car crash. Dr. Wilson testified that no natural events could have caused Chelsea's bleeding distribution. Ken Bohnert. Detective Bohnert responded to the hospital at 11:25 a.m. on Saturday, July 12. He viewed Chelsea and saw some scratches and bruising, then interviewed her family members, including Angela and Durham. Durham told Bohnert his version of the events. Bohnert took photographs of Chelsea at the hospital that showed scratches on the left side of her face and under her eye and a bruised area behind her left ear. Bohnert thought that Durham's explanation about Chelsea's choking on her formula was plausible, but it did not explain the bruising and scratching. After talking to the family and learning that they were going to Houston, Bohnert told them that he would need written statements from them later. Bohnert took a statement from Angela and interviewed family friends, including Durham's mother, and on July 24, Bohnert, the prosecutor, and an investigator questioned both Durham and his attorney, who both answered their questions and were told there were no other suspects. C. Analysis of the evidence in the light most favorable to the verdict Durham testified that Chelsea was crying when he got up that morning to feed. Angela corroborated that Chelsea was awake and crying when Durham got up to feed her. Durham was alone with Chelsea for ten to fifteen minutes before bringing her to Angela, who had last bathed Chelsea the day before and saw no bruises on her. The State's physician witnesses testified that Chelsea was rendered unconscious almost immediately from a blow to the head. Dr. Fletcher testified that Chelsea had a traumatic brain injury from a blow to her head, that in all probability she was rendered immediately unconscious, and that had she sustained this injury earlier, she would not have awakened, cried, or tried to feed. Dr. Gonsulin discussed Chelsea's internal head and neck injuries in detail and testified that she died from subdural and subarachnoid hemorrhage as a result of blunt force trauma. Dr. Wilson said that Chelsea had probably already started nursing from her bottle when she sustained the blow, and that the blow or blows to her head made her choke. Considering all of the evidence in the light most favorable to the verdict, the jury could rationally have found beyond a reasonable doubt that Durham committed the offense of injury to a child. Jackson, 443 U.S. at 318-319, 99 S.Ct. at 2788-89, Garcia, 16 S.W.3d at 405. Finding the evidence to be legally sufficient to support the conviction, we overrule Durham's first, second and sixteenth issues.IV. Factual Sufficiency of the Evidence
Issues three and four attack the factual sufficiency of the evidence, asserting that the State failed to prove that Chelsea suffered serious bodily injury, or if she had suffered serious bodily injury, that Durham inflicted that injury. Issue three complains of the trial court's denial of his motion for instructed verdict grounded on factual insufficiency and is treated as an attack on the sufficiency of the evidence. McDuff, 939 S.W.2d at 613. A. Standard of Review In a factual-sufficiency review, we view all of the evidence in a neutral light and consider only whether a jury was rationally justified in finding guilt beyond a reasonable doubt. Zuniga v. State, 144 S.W.3d 477, 484 (Tex.Crim.App. 2004). However, there are two ways in which the evidence may be insufficient. Id. First, when considered by itself, evidence supporting the verdict may be too weak to support the finding of guilt beyond a reasonable doubt. Id. Second, there may be both evidence supporting the verdict and evidence contrary to the verdict. Id. Weighing all the evidence under this balancing scale, the contrary evidence may be strong enough that the beyond-a-reasonable-doubt standard could not have been met, so the guilty verdict should not stand. Id. at 485. This standard acknowledges that evidence of guilt can preponderate in favor of conviction but still be insufficient to prove the elements of the crime beyond a reasonable doubt. Id. Stated another way, evidence supporting guilt can outweigh the contrary proof and still be factually insufficient under a beyond-a-reasonable-doubt standard. Id. Zuniga also reminds us that we must defer to the jury's determination. See id. at 481. (citing Cain v. State, 958 S.W.2d 404, 407 (Tex.Crim.App. 1997)). The jury determines the credibility of the witnesses and may "believe all, some, or none of the testimony." Chambers v. State, 805 S.W.2d 459, 461 (Tex.Crim.App. 1991). It is the jury that accepts or rejects reasonably equal competing theories of a case. Goodman v. State, 66 S.W.3d 283, 285 (Tex.Crim.App. 2001). The evidence is not factually insufficient merely because the factfinder resolved conflicting views of evidence in favor of the State. Cain, 958 S.W.2d at 410. B. Additional evidence in a neutral light In preparation for Chelsea, Durham helped fix a room into a nursery for the baby. After Chelsea's June 13 birth, he took about a week off of work to help Angela. Durham helped with feeding and diaper-changing when he was not at work. Durham said that while still at the hospital the day after her birth, Chelsea had an incident when she turned red and choked, and a nurse picked her up and patted her back. The nurse showed them how to use a bulb syringe if Chelsea had reflux. Before July 12, Angela had no reason to believe that anyone had abused Chelsea. Chelsea had no serious medical problems, but several times she had "reflux," which Angela described as spitting up milk and sometimes almost choking on it, which only occurred about three times. When Durham went in to feed Chelsea on July 12, the baby monitor was on and Angela only heard Durham talking to Chelsea softly. Angela said that the bruises on Chelsea's check looked like fingerprints, and she did not see the bruise behind Chelsea's ear until she saw it first in a photograph. She admitted that she told the police a week later that she had seen a bruise on Chelsea's left cheek earlier and thought it might have been caused by the swing. Angela told the police that Durham was very upset as they waited at the hospital for news about Chelsea and that she had never seen him cry before that day. He did cry at the hospital that day, was "very sad" and "very upset" about Chelsea, and took off a whole week of work because he was so upset over Chelsea. Kandyce agreed that Durham had cried "a few tears" at the ICU and that it was possible that Durham was grieving by playing video games. Durham told Amber that the bruise near Chelsea's eye was from where he had rubbed her head, that the bruises on Chelsea's jawline and collarbone were from her position in the swing, and that Chelsea had blood around her nose because they had wiped her nose so much from her spitting up that her nose had become raw. On July 13, Durham told Moseley for the first time that he had been messing with a spring on a box on the side of the baby bed when it shot off and hit Chelsea in the head. Durham also told Moseley that he had placed Chelsea on a footstool and that she had rolled off and hit her head. Durham told Kandyce that Chelsea had a fractured skull and cheekbone and said that she had rolled off the stool and that a spring had hit her in the head. Durham denied using meth the week before Chelsea died. He said that he and Moseley had bought and used the meth a week or two after Chelsea's birth, disputing Angela's and Moseley's testimony that they had used meth the week before Chelsea's death. He said that the meth made him feel calm. When he used meth, he went for days without sleeping, staying up all night and "partying" or playing video games. Durham disputed Angela's memory that she last fed Chelsea at midnight and put her down to sleep at 1:00 a.m. on July 12. He did not know when Chelsea had last been fed that night, and he did not know if anyone got up to feed her during the night. Durham said that Chelsea was a good baby and generally slept all night, as much as eight hours. On the morning of July 12, he was not angry with Chelsea's causing him to have to wake up or with her crying. C. Analysis of the evidence in a neutral light In his factual sufficiency points, Durham claims that his expert was as "equally persuasive" as the State's experts. When the defense recalled Dr. Hirshberg, he reiterated that Chelsea had no head trauma but suffered from DIC, which caused her to bleed excessively. Dr. Colasurdo, Dr. Fletcher, Dr. Gonsulin, and Dr. Wilson all disagreed with and dismissed Dr. Hirshberg's opinion that Chelsea's choking on formula led to anoxia, that DIC caused her bruising and brain hemorrhaging, and that CPR caused her rib fractures. Dr. Hirshberg had not gone to the Medical Examiner's office and reviewed the available microscopic slides and had not interviewed Durham. He had never performed an autopsy for the legal purpose of determining the cause and manner of death. He agreed that impact on an immature brain is more likely to cause a shearing injury rather than typical brain contusions that occur in older children because the impact's force is more effectively transferred through the thin pliant skull and across the shallow subarachnoid space of a young child's head and because the brain tissue consistency is soft. He also agreed that, in general, rotational movements of the brain result in shearing injury or diffuse axonal injury. The jury was free to reject Durham's inconsistent and controverted versions of what happened to Chelsea in the nursery and her preexisting injuries and Dr. Hirshberg's competing medical theory that Chelsea's death was the result of oxygen deprivation resulting from choking on formula and DIC. Goodman, 66 S.W.3d at 285; Chambers, 805 S.W.2d at 461. Considering all of the evidence in a neutral light, we cannot say that the jury was not rationally justified in finding Durham guilty. Zuniga, 144 S.W.3d at 484. The evidence supporting the finding of guilt, considered alone, was not too weak to support the finding beyond a reasonable doubt, and the contrary evidence was not so strong that the reasonable-doubt standard was not met. See id. at 484-85. We must defer to the jury's determination of the credibility of the witnesses, and we may not ignore evidence that supports the jury's verdict. Johnson v. State, 23 S.W.3d 1, 7 (Tex.Crim.App. 2000); Cain, 958 S.W.2d at 407. The jury's finding of guilt was rational; we find the evidence factually sufficient, and we overrule Durham's third and fourth issues.V. Jury Instruction Error
Issue seventeen asserts that the trial court erred in instructing the jury that they were authorized to convict Durham if they found that the manner and means of causing injury to Chelsea was unknown to the grand jury and the State offered no evidence to that effect. He contends that the jury instruction allowed the jury to speculate about the manner and means of Chelsea's injury beyond the evidence presented by the State and reduced the State's burden of beyond a reasonable doubt because the jury allegedly was given its own option of deciding the manner and means of the injuries. Durham admits that the State was not required to present evidence that the grand jury used due diligence to determine the manner and means of injury. See Rosales v. State, 4 S.W.3d 228, 230-31 (Tex.Crim.App. 1999). He also admits that sufficiency of the evidence is measured against a hypothetical charge containing the elements of the offense. See Malik v. State, 953 S.W.2d 234, 236-40 (Tex.Crim.App. 1997). Durham has not cited authority in support of this issue, and in any event, both Dr. Gonsulin and Dr. Wilson testified that the injury could have been inflicted by a hand or other object by striking Chelsea's head or causing her head to strike another object. Issue seventeen is overruled.VI. Autopsy Photographs
Issues ten through fifteen assert that the trial court abused its discretion in admitting ten autopsy photographs because their probative value was substantially outweighed by their prejudicial effect. The trial court has discretion to admit photographs, and its decision will not be disturbed on appeal unless it falls outside the "zone of reasonable disagreement"; i.e., the trial court abused its discretion. Jones v. State, 944 S.W.2d 642, 651 (Tex.Crim.App. 1996); Montgomery v. State, 810 S.W.2d 372, 391 (Tex.Crim.App. 1990). Durham does not contend that the autopsy photographs were irrelevant. Thus, "[w]hen determining whether the trial court erred in admitting the relevant photographs into evidence, our review is limited to determining whether the probative value of the photos is substantially outweighed by the danger of unfair prejudice, confusion of the issues, or misleading the jury, or by considerations of undue delay, or needless presentation of cumulative evidence." Wyatt v. State, 23 S.W.3d 18, 29 (Tex.Crim.App. 2000). Evidence is unfairly prejudicial when it has "an undue tendency to suggest that a decision be made on an improper basis." Montgomery, 810 S.W.2d at 389. A Rule 403 analysis by the trial court should include, but is not limited to, the following factors: (1) how probative is the evidence; (2) the potential of the evidence to impress the jury in some irrational, but nevertheless indelible way; (3) the time the proponent needs to develop the evidence; and (4) the proponent's need for the evidence. Reese v. State, 33 S.W.3d 238, 240-41 (Tex.Crim.App. 2000). Like other demonstrative evidence, photographs should assist the factfinder with its guilt or punishment decision; a photograph should add something that is "relevant, legitimate, and logical to the testimony that accompanies it" and that assists the factfinder in its decision-making duties. Erazo v. State, 144 S.W.3d 487, 491 (Tex.Crim.App. 2004). If a photograph is genuinely helpful, the photograph is inadmissible only if its emotional and prejudicial aspects substantially outweigh the helpful aspects. Id. at 491-92. In general, photographs are admissible if verbal testimony about the matter shown in the photographs would be admissible and the probative value is not outweighed by Rule 403 counter-factors. Threadgill v. State, 146 S.W.3d 654, 670-71 (Tex.Crim.App. 2004); see TEX. R. EVID. 403. A trial court may consider numerous factors when determining whether the probative value of relevant photographs is substantiality outweighed by the danger of unfair prejudice. See Hayes v. State, 85 S.W.3d 809, 815 (Tex.Crim.App. 2002). The court should consider the number of photographs offered, their detail, their gruesomeness, their size, whether they are close-up, whether they are in black and white or color, and whether the body is clothed or naked. See Wyatt, 23 S.W.3d at 29 (citing Long v. State, 823 S.W.2d 259, 271 (Tex.Crim.App. 1991)). While autopsy photographs are usually admitted, they should be excluded if they show mutilation to the victim caused by the autopsy. Rojas v. State, 986 S.W.2d 241, 249 (Tex.Crim.App. 1998). However, if the disturbing nature of the photographs is due primarily to the injuries caused by the defendant, the changes to the victim's body caused by the autopsy are of minor significance. See Hayes, 85 S.W.3d at 816 (citing Santellan v. State, 939 S.W.2d 155, 173 (Tex.Crim.App. 1997)) (holding that photograph depicting victim's skin pulled back to show extent of the gunshot wound to her face was admissible; pulling back victim's skin did not make evidence more gruesome); Salazar v. State, 38 S.W.3d 141, 151-52 (Tex.Crim.App. 2001) (holding that autopsy photographs showing internal organs removed from victim's body were probative because they showed that internal injuries to victim did not support appellant's version of incident). Given the State's and defense's competing medical theories and the extensive pathology testimony by Dr. Gonsulin and Dr. Wilson, the photographs were highly probative on the issue of the extent of Chelsea's brain injuries and cause of death. They were disturbing, but they were clinical and did not show unnecessary portions of Chelsea's body; her cut-away scalp masked a view of her face. Only one photograph of each injury aspect was admitted, and the time spent by Dr. Gonsulin to offer and describe the photographs (20 pages of testimony out of more than 1,500 pages of guilt-innocence testimony) was not unreasonable. We hold that the trial court did not abuse its discretion in admitting these ten autopsy photographs. We overrule issues ten through fifteen.VII. Extraneous Offense Evidence
Issues seven and eight complain of the relevance of extraneous offense evidence of Durham's drug use and its prejudicial effect: use of meth in the week before the offense, and use of marihuana on the drive to Houston. His ninth issue complains of expert testimony on the effects of meth withdrawal on the body. A trial court has broad discretion in determining the admissibility of evidence. Coffin v. State, 885 S.W.2d 140, 149 (Tex.Crim.App. 1994). We will not reverse the trial court's ruling absent an abuse of discretion. Williams v. State, 535 S.W.2d 637, 639-40 (Tex.Crim.App. 1976). Under Texas Rule of Evidence 404(b), evidence of other crimes, wrongs, or acts is not admissible to prove the character of a person to show action in conformity therewith. TEX. R. EVID. 404(b). But the "other crime, wrong, or act" may have relevance "apart from character conformity; that it tends to establish some elemental fact, such as identity or intent; that it tends to establish some evidentiary fact, such as motive, opportunity or preparation, leading inferentially to an elemental fact; or that it rebuts a defensive theory by showing, e.g., absence of mistake or accident." Montgomery v. State, 810 S.W.2d 372, 388-89 (Tex.Crim.App. 1990). Additionally, same transaction contextual evidence is admissible when it is necessary to the jury's understanding of the offense. Rogers v. State, 853 S.W.2d 29, 33 (Tex.Crim.App. 1993). As a general rule, the jury is entitled to know all relevant surrounding facts and circumstances of the charged offense. Moreno v. State, 721 S.W.2d 295, 301 (Tex.Crim.App. 1996). Same transaction contextual 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 before and after the commission of the act so that it may realistically evaluate the evidence. Wesbrook v. State, 29 S.W.3d 103, 115 (Tex.Crim.App. 2000). The purpose of admitting same transaction contextual evidence is to put the instant offense in context. Camacho v. State, 864 S.W.2d 524, 532 (Tex.Crim.App. 1993). Angela testified that she and Durham used meth on three or more occasions the week before Chelsea's death. Moseley testified that he and Durham obtained the meth on Sunday, July 6, and that on Thursday, July 10, Angela and Durham used meth. Dr. Ashoaf Mozayani, the lab director and toxicology chief for the Harris County Medical Examiner, described the phases of the effects of binge use of meth and withdrawal from meth, which first causes a high and then, as the drug wears off, causes the person to become very sleepy, exhausted, and unsteady. In the latest stage, called "tweaking," the person cannot sleep but cannot keep his eyes open, is uncoordinated, can't follow instructions, and loses balance. Tweaking can last up to 36 hours or even longer, depending on the amount of meth taken, its purity, and the user's tolerance. If a person used meth repeatedly from July 6 to July 10, that person could still be in withdrawal stages from the drug on the morning of July 12. An analysis of a sample of Durham's hair follicles did not disclose the presence of meth. The testimony about meth use and evidence of its withdrawal effect placed the offense in context. The evidence of meth withdrawal was relevant to the jury's understanding of how parents might sleep through the night without hearing Chelsea cry, how Durham might have been unusually irritable and sleep-deprived that morning, and how Chelsea might have been extra fussy or inconsolable, triggering the possible frustration that caused Durham to inflict her fatal and non-fatal injuries that morning. Because the testimony was admissible as same transaction contextual evidence, the trial court did not abuse its discretion in admitting it. The trial court also did not abuse its discretion under Rule 403 in finding that the meth testimony's probative value outweighed its unfairly prejudicial effect. The evidence was probative and necessary to explain the context of the offense and Durham's motive and intent that morning. The time required to develop the evidence was comparably minimal, and it was not likely to impress the jury unfairly. The trial court did not abuse its discretion in admitting testimony that Durham smoked marihuana on the drive to Houston. Its probative value outweighed its unfairly prejudicial effect, as it suggested Durham's lack of remorse or concern about Chelsea. It also was appropriately offered as rebuttal in Angela's redirect examination after she had testified on cross-examination that Durham was very sad and upset about Chelsea and took off a whole week of work after her death. We overrule Durham's issues seven, eight, and nine. Durham complains in issue nineteen of punishment-phase testimony by Durham's grandmother that a probation officer found Durham — who was staying with her at the time — in possession of a firearm. At trial he objected on grounds that the probative value of this testimony was substantially outweighed by its unfairly prejudicial effect. In the punishment phase of a non-capital felony trial, the admission of evidence is a question of policy, not of logical relevance. Mendiola v. State, 21 S.W.3d 282, 285 (Tex.Crim.App. 2000). "Determining what is relevant . . . should be a question of what is helpful to the jury in determining the appropriate sentence in a particular case." Rogers v. State, 991 S.W.2d 263, 265 (Tex.Crim.App. 1999). We cannot say that the trial court abused its discretion. Issue nineteen is overruled.VIII. Jury Argument
Issues five and eighteen contend that the trial court erred in overruling Durham's objections that the prosecutor was striking at him over the shoulders of counsel. Issue five complains that the State improperly used Durham's silence at the July 24 meeting — which he said was the result of his attorney's instructions to not talk — to attack his credibility, which was an attack over the shoulders of counsel. Improperly striking over the defense attorney's shoulders occurs when the prosecutor's argument refers to defense counsel personally and when the argument explicitly impugns defense counsel's character. Guy v. State, 160 S.W.3d 606, 617 (Tex.App.-Fort Worth 2005, pet. ref'd). "Generally, a remark that strikes at the defendant through his counsel is impermissible because such attacks only inflame the minds of the jury to the defendant's detriment." Id. at 616. We find that the testimony at issue was not a strike at Durham over his counsel's shoulders; it was a direct comment on Durham's conduct and testimony. With his testimony that he was told by his father (a criminal defense attorney) and his trial attorney not to talk, Durham opened the door to questions and testimony about why he did not tell the full story about Chelsea to medical providers, social workers, and police. The State did not impermissibly or unfairly ask questions that elicited testimony having the tendency to show that Durham was more concerned with protecting himself when he did not give medical personnel and police a complete and accurate history of Chelsea. We overrule issue five. In issue eighteen, Durham asserts that the prosecutor struck at him over the shoulders of counsel during closing argument by stating:He [Durham's attorney] is doing the very best he can to make sure that his client gets a fair trial and his rights are represented, just as he was back in July of last year when we all sat down together. . . . I'm not going to suggest for a minute that Mr. Linderman [one of Durham's attorneys], on behalf of his client, misrepresented anything. . . . There was nothing ambiguous whatsoever about the question that was asked at the time: Did this child have any prior injuries? The answer was no. And Mr. Linderman cannot help it if his client had not been forthright with him beforehand.
MR. LINDERMAN: Objection, Your Honor. This invites — evades [invades] the province to suggest the attorney-client communication privilege, and I object.
THE COURT: All right. Move along, Mr. Hon [the prosecutor].MR. LINDERMAN: I'd ask the jury to disregard. THE COURT: Overruled. Durham did not object at trial that the prosecutor was striking at him over his counsel's shoulders. His complaint on appeal thus does not comport with the objection that he made in the trial court, which is necessary for preservation of the complaint. See Broxton v. State, 909 S.W.2d 912, 918 (Tex.Crim.App. 1995) (point of error must correspond to objection made at trial, and objection stating one legal theory may not be used to support a different legal theory on appeal). For this reason, his complaint has not been preserved for our review. See Rezac v. State, 782 S.W.2d 869, 870 (Tex.Crim.App. 1990). Issue eighteen is overruled. In his sixth issue, Durham contends that the trial court erred in denying his motion for mistrial because in opening statement the prosecutor stated that Chelsea "in every sense of the word became a murder victim." The trial court sustained Durham's objection and instructed the jury to disregard the comment, but denied his mistrial request. We review a trial court's denial of a motion for mistrial for abuse of discretion. Ladd v. State, 3 S.W.3d 547, 567 (Tex.Crim.App. 1999). In most instances, an instruction to disregard will cure the error. Wesbrook v. State, 29 S.W.3d 103, 115-16 (Tex.Crim.App. 2000). The prosecutor's comment was quickly followed by an instruction to disregard from the trial court, which we presume was complied with by the jury. See Colburn v. State, 966 S.W.2d 511, 520 (Tex.Crim.App. 1998). Only offensive or flagrant error warrants reversal when there has been an instruction to disregard, and in the case at bar, this comment was not so flagrant that the instruction to disregard was ineffective. See Wilkerson v. State, 881 S.W.2d 321, 327 (Tex.Crim.App. 1994). We cannot say that the trial court abused its discretion in denying the mistrial motion, and we overrule Durham's sixth issue. In closing argument in punishment, the prosecutor stated: "Your verdict last week was on the front page of the Polk County Enterprise on Sunday." Durham objected that the statement was "outside the record." The trial court sustained the objection and instructed the jury to disregard, but denied a request for a mistrial. In issue twenty, Durham asserts that the prosecutor's argument was not a plea for law enforcement. His complaint on appeal thus does not comport with the objection that he made in the trial court, which is necessary for preservation of the complaint. See Broxton, 909 S.W.2d at 918; Rezac, 782 S.W.2d at 870. In any event, the comment was not so flagrant that the instruction to disregard was ineffective. See Wilkerson, 881 S.W.2d at 327. We cannot say that the trial court abused its discretion in denying the mistrial motion. Issue twenty is overruled.