State v. Sanchez-Alfonso, 238 Or. App. 160

Defendant Sanchez-Alfonso, residing with his girlfriend T and her child C, faced multiple abuse charges related to injuries to C.
CARES Northwest pediatrician Dr. Skinner diagnosed physical abuse by defendant based on exams, CAT scan results, and statements from family.
Skinner concluded C had a parietal occipital skull fracture and multiple injuries requiring significant force, tying injuries to abuse.
Defendant gave several explanations for C's injuries, including blacking out, accidental falls, and throwing C into a dresser, over multiple interviews.
Skinner wrote a report opining that defendant clearly caused C’s injuries and that statements by defendant supported the diagnosis.
At trial, the court admitted Skinner’s report and allowed testimony under OEC 104 and State v. O’Key/Brown framework; defendant testified inconsistently.
The jury convicted defendant of assault in the second and third degrees and two counts of criminal mistreatment.
On appeal, defendant challenged the admission of Skinner’s diagnosis as inadmissible scientific evidence, arguing it violated Brown/O’Key standards.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether a medical diagnosis of physical child abuse is admissible scientific evidence	Sanchez-Alfonso argues diagnosis is inadmissible under Brown/O’Key	Sanchez-Alfonso contends diagnosis improperly assigns the perpetrator and is not scientifically valid without physical evidence	Yes, diagnosis is scientific evidence if foundations are adequate
Whether any error in admitting Skinner’s diagnosis was harmless beyond a reasonable doubt	State contends evidence was minor and cumulative and not central to guilt	Defendant argues admission could have biased the jury against him	Harmless error; conviction affirmed

State v. Southard, 347 Or. 127 (2009) (medical diagnosis of sexual abuse is scientific evidence; admissibility balanced under Brown/O’Key)
State v. O'Key, 321 Or. 285 (1995) (criteria for admissibility of scientific evidence)
State v. Brown, 297 Or. 404 (1984) (probative value vs prejudice under OEC 403 for scientific testimony)
State v. Marrington, 335 Or. 555 (2003) (recognizes medical diagnosis of abuse as scientific evidence subject to Brown/O’Key)
State v. Perry, 347 Or. 110 (2009) (expert testimony founded on studies and literature is scientific evidence; admissibility framework)
State v. Willis, 348 Or. 566 (2010) (applies Brown/O’Key to determine harmless error in scientific evidence admission)
State v. Gibson, 338 Or. 560 (2005) (harmless error analysis under Oregon Constitution Article VII, section 3)
State v. Davis, 336 Or. 19 (2003) (heart-of-the-case concept in harmless-error assessment)