Commonwealth v. Millien, 474 Mass. 417

Background

Six‑month‑old Jahanna arrived unconscious with a large subdural hematoma, brain swelling, extensive bilateral retinal hemorrhages, and a comminuted left parietal skull fracture; the defendant was the sole caretaker when she became unresponsive.
Commonwealth experts (treating physicians) testified the injuries constituted the "triad" of abusive head trauma (shaken baby syndrome/abusive head trauma) and opined violent shaking (and impact) caused the injuries.
Defendant consistently told investigators he was feeding the infant on a loveseat, reached for a bottle, and the baby fell backward ~17.5 inches to the hardwood floor; he denied shaking.
Trial counsel (privately retained but the defendant indigent) did not seek court funds for a medical expert and presented no expert rebuttal; defense focused on multiple caretakers and obtained acquittals on old‑injury counts but was convicted on head‑injury and vertebral‑fracture counts.
On a posttrial Saferian motion, a defense expert (neurosurgeon) testified that (a) shaking alone is biomechanically implausible to produce the triad and (b) a short fall could account for the skull fracture, subdural bleeding, elevated intracranial pressure, and retinal hemorrhages; trial judge denied a new trial, finding Commonwealth evidence overwhelming.
Supreme Judicial Court held trial counsel was constitutionally ineffective for failing to seek funds for an expert where the prosecution’s case rested almost entirely on medical causation, vacated convictions, and ordered a new trial; conviction as to timing/causation of vertebral fractures was upheld as sufficient for jury to infer contemporaneous violent shaking.

Issues

Issue	Commonwealth's Argument	Millien's Argument	Held
Whether counsel's failure to seek funds for a medical expert denied effective assistance of counsel and warrants a new trial	Counsel’s performance was reasonable; Commonwealth's powerful medical evidence made an expert unnecessary and would not have changed the outcome	Failure to request public funds for an expert was manifestly unreasonable and deprived Millien of a substantial available defense on causation	Counsel was ineffective under Saferian; prejudice shown because there is serious doubt the verdict would stand if an expert had presented/rebutted alternative causation; new trial ordered
Sufficiency of evidence for assault causing fractured vertebrae (timing/causation)	Evidence (medical testimony linking extreme flexion/ crushing force to vertebral fractures and contemporaneous head injuries) permitted a reasonable jury to find defendant caused fractures on Oct 20	Defense argued fractures’ timing/causation uncertain; no reasonable jury could find beyond a reasonable doubt they occurred during defendant’s care on Oct 20	Held sufficient: viewing evidence in Commonwealth’s favor, jury could find vertebral fractures were caused by the same violent shaking that produced head injuries on Oct 20

Key Cases Cited

Commonwealth v. Saferian, 366 Mass. 89 (Mass. 1974) (governs ineffective‑assistance test; counsel’s failure must likely deprive defendant of a substantial ground of defense)
Strickland v. Washington, 466 U.S. 668 (U.S. 1984) (federal standard for prejudice from counsel errors: reasonable probability of different result)
Commonwealth v. Satterfield, 373 Mass. 109 (Mass. 1977) (discusses prejudice/investigation failures and whether better work might have achieved material results for defense)
Hinton v. Alabama, 134 S. Ct. 1081 (U.S. 2014) (failure to seek additional funding for an adequate expert constitutes deficient performance)
People v. Ackley, 497 Mich. 381 (Mich. 2015) (vacated conviction where counsel failed to secure expert in abusive‑head‑trauma prosecution)
State v. Hales, 152 P.3d 321 (Utah 2007) (vacated conviction where defense failed to obtain expert to challenge CT/causation evidence)