State v. S. Santillan, 2017 MT 314

In July 2013, 2‑year‑old A.C. suffered a severe occipital skull fracture and contrecoup brain injury while in the care of Stephen Santillan; symptoms (vomiting, lethargy) appeared the same day and imaging and ophthalmologic findings were consistent with abusive head trauma.
Medical experts (treating and consulting physicians) testified the injuries were severe, unlikely to result from a toddler throwing a toy car, and were acute or most likely occurred within hours before ER arrival.
Child Protective Services (CPS) worker Kathy Rogers investigated at the hospital and removed A.C. and her brother from Santillan’s care; Rogers later testified about that removal over Santillan’s pretrial objection.
A jury convicted Santillan of aggravated assault; at sentencing the court admitted a life‑care plan prepared by a registered nurse (Rau) estimating lifetime costs for A.C., including psychiatric care, counseling, family therapy, and group‑home care through age 60, and ordered restitution of $3,568,861.69.
Santillan appealed, arguing (1) Rogers’s testimony about CPS removal was irrelevant/prejudicial and (2) the restitution awards for future services were speculative and unsupported by the evidence.

Issue	Plaintiff's Argument (State)	Defendant's Argument (Santillan)	Held
Admissibility of CPS testimony that children were removed from Santillan’s care	Testimony was relevant to CPS’s safety decision and to show the investigation’s result; excluding it would mislead jury about CPS’s interpretation.	Testimony was irrelevant to elements of aggravated assault and unfairly prejudicial under M. R. Evid. 403 because Rogers had no personal knowledge of who caused the injury.	Court: Admission was error (testimony irrelevant and Rogers lacked personal knowledge), but error was harmless given abundant admissible evidence identifying Santillan as the only adult present and medical testimony on timing/seriousness. Conviction affirmed.
Restitution for future psychiatric treatment, counseling, family therapy, and group‑home care (age 18–60)	The life‑care Plan and Rau’s testimony provided reasonable, evidence‑based estimates using best evidence available; restitution statutes permit future medical/therapy costs substantiated by record.	Awards were speculative and not proven by a preponderance; future costs (esp. long‑term group home) not reasonably certain.	Court: Restitution upheld. Findings supported by substantial evidence (life‑care Plan, expert nurse testimony, consultation with treating clinicians); uncertainty does not invalidate award if based on best evidence available.

State v. Van Kirk, 306 Mont. 215 (Mont. 2001) (harmless error framework and cumulative‑evidence test for trial errors)
Arizona v. Fulminante, 499 U.S. 279 (U.S. 1991) (distinction between structural and trial error)
State v. Passwater, 379 Mont. 372 (Mont. 2015) (standard for reviewing restitution and use of life care plans)
State v. Passmore, 355 Mont. 187 (Mont. 2010) (trial court’s discretion on evidentiary rulings)
State v. Derbyshire, 349 Mont. 114 (Mont. 2009) (abuse‑of‑discretion review for admissibility and harmless‑error analysis)
State v. Jent, 369 Mont. 468 (Mont. 2013) (definition of substantial evidence for restitution determinations)