State v. Heath, 453 P.3d 955

Background:

Victim (20) saw chiropractor Dale Heath nine times between Oct–Dec 2012 for back pain; from the 5th visit the treatment allegedly progressed to repetitive genital contact over and then under clothing, producing orgasms on multiple occasions.
Victim reported the conduct after the December sessions; two other women (J.T. in 2011 and E.B. in 2015) later reported similar genital contact by Heath; DOPL corresponded with Heath and issued discipline/probation documents.
The State charged Heath with three counts of sexual battery, one count of forcible sexual abuse, and one count of object rape arising from Victim’s visits; other-victim allegations were severed but admitted at trial under Utah R. Evid. 404(b) and the doctrine of chances to prove mens rea.
Trial testimony included a chiropractic expert who said there was no medical reason to touch below the pubic bone and that draping could prevent such contact; Heath testified he did not intentionally touch Victim’s genitals and that incidental contact was possible.
A jury convicted Heath on all counts; the trial court denied motions to arrest judgment (including on penetration for object rape) and sentenced Heath to concurrent jail/prison terms; Heath appealed.

Issues:

Issue	Plaintiff's Argument	Defendant's Argument	Held
Admissibility of Other-Acts evidence under Rule 404(b)/doctrine of chances	Other-acts (J.T., E.B., DOPL records, statements) were admissible to show intent/absence of mistake under the doctrine of chances and were probative, not unduly prejudicial.	Admission was improper: frequency foundational requirement not met; evidence was prejudicial and diverted jury from the core credibility contest.	Court affirmed admission for mens rea under doctrine of chances (frequency satisfied for defendant-specific repeated incidents); rule 403 balancing not shown to be abused.
Sufficiency – Sexual battery (knowledge conduct would likely cause affront/alarm)	Evidence (nature, duration, lack of medical purpose, prior DOPL complaints) supported that Heath knew or should have known his touching would cause affront/alarm.	Victim returned for treatment, gave no overt protest, and interactions appeared normal—insufficient to prove knowledge element.	Court affirmed: circumstantial evidence (Victim’s questions, progression, expert testimony, prior complaints) supported that Heath knew or should have known.
Sufficiency – Forcible sexual abuse (specific intent to arouse/gratify and nonconsent)	Circumstantial evidence (progression, duration, lack of medical purpose, other-acts) supported specific intent and nonconsent under the health-professional guise exception.	No direct proof of sexual intent or awareness of Victim’s nonconsent; Victim’s lack of resistance and return visits undermine nonconsent/intent.	Court affirmed: specific intent can be inferred from circumstances; Victim’s reasonable belief in treatment and health-professional exception supported nonconsent; evidence sufficient.
Sufficiency – Object rape (penetration of "genital or anal opening")	Victim testified Heath’s finger went beyond the labia majora and contacted her clitoris; penetration satisfied by entry between outer labial folds per Utah precedent.	"Genital opening" should be read to mean vaginal opening only; touching clitoris/labia does not meet object-rape penetration element.	Court affirmed: statutory "genital opening" is broad and includes entry between the outer folds of the labia; Victim’s testimony that finger went beyond labia majora to the clitoris supported penetration.

Key Cases Cited

State v. Simmons, 759 P.2d 1152 (Utah 1988) (defines "penetration" as entry between outer folds of the labia for rape contexts).
State v. Patterson, 407 P.3d 1002 (Utah Ct. App. 2017) (applies Simmons definition of penetration to object-rape issues).
State v. Verde, 296 P.3d 673 (Utah 2012) (describes doctrine of chances and its logical relevance rationale).
State v. Lopez, 417 P.3d 116 (Utah 2018) (sets foundational requirements for doctrine of chances: materiality, similarity, independence, frequency).
State v. Holgate, 10 P.3d 346 (Utah 2000) (plain-error standard and use of circumstantial evidence to infer intent).
State v. Barela, 349 P.3d 676 (Utah 2015) (mens rea as to victim’s nonconsent is required and is fact-intensive; left to jury).
Strickland v. Washington, 466 U.S. 668 (U.S. 1984) (standard for ineffective assistance of counsel).
State v. Martin, 423 P.3d 1254 (Utah 2017) (trial courts afforded broad discretion on evidentiary rulings under rule 404(b)).