Opinion
C081564
07-05-2017
THE PEOPLE, Plaintiff and Respondent, v. SILVIA CATA, Defendant and Appellant.
NOT TO BE PUBLISHED California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115. (Super. Ct. No. 13F00783)
Defendant Silvia Cata appeals her conviction for elder abuse claiming there is insufficient evidence of neglect. She claims we should abandon the well-established deferential review for sufficiency of evidence and instead review de novo because the case was submitted to the trial court via documentary evidence. We disagree and shall affirm the judgment.
FACTUAL AND PROCEDURAL BACKGROUND
The People charged defendant with elder abuse and involuntary manslaughter. Defendant waived her right to a jury trial and the parties submitted the case on various items of documentary evidence. The trial court found defendant guilty of elder abuse (Pen. Code, § 368, subd. (b)(1)—count 1) and not guilty of involuntary manslaughter based on the following evidence.
Georgia H. (the victim) lived at defendant's residential care facility for five years. She suffered from Alzheimer's disease and urinary incontinence. On June 17, 2012, the victim experienced diarrhea. While cleaning her, defendant noticed two pressure ulcers on the victim's backside (right above her tailbone). Defendant cleaned and bandaged the ulcers. She did not notify the victim's family or doctor. The next day, defendant removed the bandages. The victim's skin surrounding the pressure ulcers peeled off with the bandages. Defendant called the victim's family and emergency services, and the victim was rushed to the hospital.
Pressure ulcers develop because a person lies in one position for a prolonged period. There are four stages to a pressure ulcer. "Stage one" is red from the blood cells trapped in the very superficial layer of the skin. "Stage two" is partial disruption of the affected skin. "Stage three" is penetration through the two upper layers of the skin to subcutaneous tissue. "Stage four" is to the underlying muscle, joint, or bone. A pressure ulcer covered with dead black tissue is "unstageable" because it cannot be determined whether it is stage three or stage four. --------
An experienced registered nurse examined the victim at the hospital. Apparently considering the "two" pressure ulcers as one "large pressure ulcer on her coccyx," he rated the victim's pressure ulcer a 10 on a scale of 1 to 10. He described the ulcer as "at a minimum a 'Stage III,' " " 'very extensive,' " and " 'foul smelling.' " The nurse observed that the victim had not been cared for very well; that she had been lying on her back for a long time prior to her arrival to the hospital; and that the severity of the ulcer indicated " 'weeks to months' " of development. He noted his belief that the victim had been neglected.
The admitting physician at the hospital also examined the victim. He described her pressure wounds as one of the worst he had ever seen. He noted the ulcers were " '[S]tage 4, large, deep, full tissue thickness, purulent drainage (with puss), [and] foul smelling.' " He believed the victim was bed-bound prior to her arrival at the hospital and her pressure ulcers developed over a period of weeks. He doubted the victim would live through the night. A wound-ostomy-continence nurse also evaluated the victim and noted her suspicion that the victim had a " 'Kennedy terminal ulcer' " (KTU).
Five days after being admitted to the hospital, the victim was transferred to a skilled nursing facility, where a geriatrician examined her. The doctor diagnosed the victim's pressure ulcers as unstageable and opined that her ulcers were avoidable or would not have been so bad had her family been notified sooner. The victim died at the skilled nursing facility two days later. The geriatrician indicated on her death certificate that " 'debility and decline,' " coupled with her advanced Alzheimer's, may have caused her death, but he also expressed that the pressure ulcer definitely contributed to her debility and decline.
Defendant introduced expert evidence from a registered nurse to explain how the victim's pressure ulcers developed so quickly. Her expert opined that the victim suffered from a KTU, which she described as a unique form of pressure ulcer development in terminally ill patients. These ulcers, she explained, appear quickly and are not due to poor care, but rather impending death. She reviewed color photographs of the victim's pressure ulcers and stated that the victim's pressure ulcer was "[S]tage III" and "could have been present for weeks, but for certain started in the past 72 hours." She also posited that the black necrotic tissue could have been from fecal contamination of the open ulcer, which started from urinary incontinence.
The People submitted an expert declaration from a board-certified physician in geriatric medicine who opined the information regarding KTU's was largely anecdotal and there was not adequate scientific evidence that such a phenomenon exists. A forensic geriatric specialist also reviewed the victim's medical records and presented a report of her findings on behalf of the People. She opined that the victim arrived at the hospital in a life-threatening condition. Additionally, based on her review of color photographs of the victim's pressure ulcer, the expert concluded it was a classic pressure ulcer that covered the victim's entire buttocks region, with a large amount of dead tissue that had developed over weeks or longer. The expert disputed that KTU's exist; however, she opined that even if KTU's did exist, the victim's pressure ulcer lacked the typical butterfly appearance commonly associated with a KTU. It was the expert's opinion that defendant had neglected the victim, and had deprived her of medical attention and basic personal care which would have prevented the pressure ulcer from developing at all.
DISCUSSION
Defendant contends the record does not support her conviction for elder abuse. She acknowledges that generally such a claim implicates a review pursuant to the deferential standard requiring us to determine whether the record includes substantial evidence to permit a reasonable trier of fact to find the defendant guilty of the crime beyond a reasonable doubt. (People v. Johnson (1980) 26 Cal.3d 557, 576.) Nevertheless, she claims that we should instead apply a nondeferential standard of review here to determine that the record does not support her conviction beyond a reasonable doubt. The basis of her claim is that the rationale for the deferential substantial evidence standard of review does not apply where, as here, all the evidence submitted at trial was documentary in nature. We reject her contention.
Generally, we review factual findings made in the trial court for sufficiency of the evidence. (People v. Yu (1983) 143 Cal.App.3d 358, 368-369.) Under this standard of review, we determine whether the record contains substantial evidence—i.e., evidence that is reasonable in nature, credible, and of solid value—such that a rational trier of fact could find the defendant guilty beyond a reasonable doubt. (People v. Edwards (2013) 57 Cal.4th 658, 715; People v. Ewing (2016) 244 Cal.App.4th 359, 371.) In assessing whether substantial evidence exists, we view all factual matters in the light most favorable to the prevailing party and presume the existence of facts that can be reasonably deduced from the evidence in support of the judgment. (People v. McCurdy (2014) 59 Cal.4th 1063, 1104.)
We apply this deferential standard principally because the trial court is in a better position to assess the demeanor of witnesses and the manner in which they testify. (People v. Jones (2013) 57 Cal.4th 899, 917.) Therefore, when there is conflicting evidence, the trier of fact is the exclusive judge of the credibility of witnesses and the attendant weight to be given to their testimony. (See Maslow v. Maslow (1953) 117 Cal.App.2d 237, 243.) Defendant would have us conclude that no deference should be given to the trial court's factual findings because we are in as good a position as the trial court was to assess the credibility of witnesses and the attendant weight to be given to their testimony, which was presented in affidavit form. Nonetheless, our Supreme Court has held repeatedly that whether factual findings are made based on declarations and other written evidence as opposed to live testimony does not lessen the deference due to those findings. (Haraguchi v. Superior Court (2008) 43 Cal.4th 706, 711, fn. 3; Griffith Co. v. San Diego College for Women (1955) 45 Cal.2d 501, 508 [substantial evidence standard of review applies regardless whether evidence is oral or documentary].) As we are bound by Supreme Court precedent applying the substantial evidence standard of review regardless whether evidence is oral or documentary, we must necessarily reject defendant's request to engage in a de novo review. (Auto Equity Sales, Inc. v. Superior Court (1962) 57 Cal.2d 450, 455.)
Defendant does not argue the evidence was legally insufficient under the deferential substantial evidence standard of review. Thus, she has failed to demonstrate error.
DISPOSITION
The judgment is affirmed.
BUTZ, J. We concur: BLEASE, Acting P. J. NICHOLSON, J.