Court: Court of Appeals of South Carolina; November 11, 2014; South Carolina; State Appellate Court
Donna Lynn Phillips was convicted of homicide by child abuse following the death of her twenty-two-month-old grandson, who died from a hydrocodone overdose. The child was brought to the hospital on March 17, 2008, without a heartbeat, and a urine test revealed opiates. A prescription cough syrup, Tussionex, containing hydrocodone was found in Phillips' home, leading to her indictment under South Carolina law for allegedly facilitating the excessive ingestion of opiate drugs.
During the trial, Phillips moved for a directed verdict, arguing insufficient evidence to prove she administered the drug or possessed the required mental state for guilt. The trial court denied her motion, and the jury convicted her, resulting in a twenty-five-year prison sentence.
Key evidence included statements from Phillips and the child's parents, detailing the child's care over the weekend before his death. Phillips claimed the child had a runny nose and was given children’s Tylenol, but did not know the dosage. After returning the child to his mother, he appeared to have difficulty breathing. The mother later found the child unresponsive, prompting a 911 call. Additionally, Phillips expressed concern during police questioning about the child potentially accessing her prescription medication, Lortab, which also contains hydrocodone.
Phillips stated she spoke with Brandon Roper at the hospital, mentioning she had Lortab but doubted the child could have accessed it. Investigator Charlie Lark recounted a conversation with Morris, who claimed he did not witness Phillips administer medication to the child. Morris noted that Phillips stored her prescriptions for Lortab and Tussionex in a basket on a high shelf, which he helped her access twice over the weekend. Although Morris observed the child playing with medication bottles, he confirmed the tops were on and no medication had been dispensed.
Phillips expressed concern to Lark about a hydrocodone pill she might have dropped, but she did not see the child take any medication. Chemist Jeffrey Morris Hollifield tested the Tussionex bottle, finding it contained hydrocodone and chloropheniramine, with over eight teaspoons missing from the original twelve. Forensic toxicologist Robert Foery detected high levels of hydrocodone in the child's blood, significantly exceeding therapeutic levels for adults, and concluded the child’s death resulted from multiple doses of Tussionex rather than a single dose. He ruled out Lortab as a cause since acetaminophen was absent in the child's system.
Forensic pathologist Michael Ward indicated that timely medical intervention could have saved the child. He identified a pressure ulcer consistent with prolonged immobility and noted signs of severe constipation indicative of multiple doses of hydrocodone. Ward described behavioral effects of hydrocodone, including respiratory depression and lethargy.
In her defense, Phillips testified that while the child had a runny nose, he was otherwise active until he began crying on Sunday afternoon. She denied administering Tussionex and asserted she would never give a child medication not prescribed for them.
Morris denied giving Tussionex to the child, asserting he believed his son knew better than to take it. He testified that on Saturday morning, he retrieved a basket of medicine from the top shelf of his closet, claiming the child only grabbed a bottle but did not ingest any medication. Morris stated it was impossible for the child to access the medication without his knowledge. Co-defendants testified about the child's condition over the weekend; Morris noted the child had a mild cough but did not think his symptoms warranted a doctor's visit. He contacted the Department of Social Services (DSS) for a Medicaid card on Saturday, which he later found and gave to Honeycutt for a doctor’s appointment on Sunday. Morris admitted to retrieving Tussionex but denied administering any medication to the child, except for Tylenol on Sunday afternoon. Contrarily, witness Kayla Roper claimed she heard Phillips admit to giving the child cough medicine, and Brandon testified that Phillips acted suspiciously after being informed of opiates found in the child's urine.
Regarding the directed verdict motion, the court must assess evidence favorably to the State. To convict for homicide by child abuse, the State must demonstrate that the defendant caused the child's death while committing abuse or neglect, under circumstances showing extreme indifference to human life. Phillips contended the trial court wrongly denied her directed verdict motion due to insufficient evidence for these elements. The standard dictates a motion must be denied if there is any direct evidence or substantial circumstantial evidence indicating the defendant’s guilt. Direct evidence, based on observation, immediately establishes the fact in question, while circumstantial evidence involves inferring a fact from a chain of related circumstances.
The State must present 'substantial' circumstantial evidence to justify denying a motion for a directed verdict if no direct evidence of guilt exists. In this case, the evidence against the defendant, Phillips, was entirely circumstantial. The court reviewed the trial court’s denial of Phillips’ motion under the 'substantial circumstantial evidence' standard. The State did not argue the existence of direct evidence at trial but suggested in its appellate brief that 'substantial evidence' supported its case. At oral argument, testimony from a witness, Kayla, was debated; Phillips' counsel argued it was circumstantial, requiring assumptions about the cough medicine discussed, while the State claimed it was direct evidence. The court concluded that Kayla's testimony constituted direct evidence of child abuse, as it could directly establish that Phillips gave the child cough medicine, especially when combined with medical testimony linking the medicine to the child's death.
To convict Phillips of homicide by child abuse, the State must demonstrate that the death occurred under circumstances showing extreme indifference to human life. Phillips argued that the State failed to establish this mental state, asserting her intent was to help the child. However, the law does not require proof of intent to harm to establish extreme indifference. Instead, the State must show that Phillips engaged in a deliberate act while knowing it posed a risk of death to the child. A deliberate act taken with such knowledge demonstrates reckless disregard for the child’s life, qualifying as extreme indifference, as seen in prior case law.
To establish that Phillips acted with extreme indifference to her child's life, the State needed to demonstrate that she intended to administer Tussionex, fully aware of the associated risks. The evidence showed that Phillips acknowledged the danger of giving unprescribed medication to her child, asserting multiple times during her testimony that she would never do so. Her statements highlighted her awareness of the health risks involved, aligning with common knowledge about the dangers of administering prescription medications meant for adults to children. Federal law stipulates that such medications are only safe under a licensed practitioner's supervision, and Phillips' Tussionex bottle confirmed this restriction.
Furthermore, the case referenced Commonwealth v. Walker, where the court emphasized that a reasonable person understands the risks of prescription drugs, reinforcing the notion that they require careful administration. The medical evidence indicated that Phillips provided the child with multiple doses of Tussionex, leading to a hydrocodone level significantly above the safe threshold for adults, which underscores her reckless disregard for the child's safety. Additionally, the State presented evidence of Phillips attempting to conceal her actions by misattributing blame regarding the child's medication intake, supporting an inference of consciousness of guilt.
Phillips was aware that Morris needed to reposition the child in the car seat to assist with breathing on the way to Honeycutt’s home. Additionally, Phillips acknowledged informing Honeycutt that the child required medical attention, and Morris instructed Honeycutt to take the child to the doctor due to the child's poor breathing. This evidence allowed the jury to infer that Phillips acted with extreme indifference to the child's life, justifying the trial court's decision to submit the case to the jury. Consequently, the court upheld the denial of Phillips’ directed verdict motion and affirmed her conviction for homicide by child abuse. Morris was found guilty of aiding and abetting, while Honeycutt was acquitted, and the court affirmed Morris's conviction in a separate opinion. The State also argued that Phillips’ failure to seek medical care after administering multiple doses of Tussionex constituted child abuse or neglect, as defined under South Carolina law. However, the court found sufficient direct evidence of child abuse based on Phillips administering multiple doses of Tussionex, which resulted in a drug concentration in the child's blood significantly exceeding therapeutic levels. Specifically, the child's level was measured at 102 nanograms per milliliter, far above the therapeutic range for an adult of 10 to 40 nanograms per milliliter.
