Defendant appeals from a judgment of conviction, following a jury trial, for one count of sexual abuse in the first degree, ORS 163.427, and one count of endangering the welfare of a minor, ORS 163.575. He asserts, among other assignments of error, that the trial court erred in admitting a medical expert’s diagnosis of the child complainant as “highly concerning of sexual abuse” where that diagnosis was rendered in the absence of any confirming physical evidence. As explained below, and consistently with the analysis in
State v. Lovern,
The material circumstances for purposes of our review are uncontroverted. Defendant was indicted for criminal mistreatment in the first degree, unlawful sexual penetration in the second degree, three counts of sexual abuse in the first degree, attempted sodomy in the first degree, and two counts of endangering the welfare of a minor, based on allegations made by R, his then 14-year-old daughter.
Specifically, in the fall of2006, R reported to her boyfriend, her mother, a school counselor, and a police officer that defendant had earlier abused her. The conduct that she described included defendant touching her vagina with a vibrator, penetrating her vagina with his finger, touching her breasts, playing pornographic videos, and masturbating in front of her.
After her disclosures, R was evaluated at CARES Northwest, a child abuse assessment center. Munson, a pediatric nurse practitioner, was part of the team that evaluated R at CARES. At trial, Munson testified about her training and experience in the area of child abuse, described the CARES evaluation process, and explained how child abuse diagnoses typically are made. Munson testified that, at CARES, the possible diagnoses with respect to child sexual abuse are “no indication, possible, highly concerning, and diagnostic,” and that, without a physical examination, “highly concerning” is the most definitive diagnosis that can be made.
Munson further testified — over defendant’s objection (described below) — that her diagnosis of R was “highly concerning of sexual abuse.” That diagnosis was based on an interview with R, which Munson observed through a one-way mirror, and her physical examination of R. Munson also reviewed the police officer’s report of his interview with R and the school counselor’s report to the child abuse hotline; from that review, she concluded that the “core details” of what R had reported earlier were consistent with R’s disclosures during her CARES evaluation. R refused the anogenital part of the physical examination, which, in Munson’s experience, is “relatively common” for adolescents to do, so there was no physical evidence supporting Munson’s diagnosis. In any event, Munson testified that she would not necessarily have expected to have found physical evidence, given the type of sexual abuse R reported and possible physiological factors.
In objecting to evidence of Munson’s diagnosis, defense counsel first argued that the evidence was inadmissible because it was an improper comment on R’s credibility. In response, the state cited
State v. Sanchez-Cruz,
On appeal, defendant argues,
inter alia,
that the trial court erred under
Southard
in admitting evidence of Munson’s diagnosis of R as “highly concerning of sexual abuse,” where that diagnosis was rendered “in the absence of any physical evidence of abuse.”
Southard,
We do not understand the state here to raise any contentions materially different from those addressed in
Lovern
as to whether the asserted error was plain error. Thus, the only question is whether we should affirmatively exercise our discretion to remedy the plain error in this case.
See Ailes,
The state argues against the exercise of discretion in this case, contending that, because the erroneously admitted diagnosis here was “highly concerning” rather than definitive for child sexual abuse, as was the case in Lovern, the error is not sufficiently grave to warrant correction. The state does not argue that that distinction renders Southard inapplicable; indeed, at oral argument, the state explicitly agreed that Munson’s statement was a medical diagnosis that would have been inadmissible under Southard if defendant had invoked OEC 403 as a basis for exclusion. Rather, the state contends that, because the diagnosis was not conclusive for sexual abuse, defendant was better able to attack it on cross-examination and, as a result, the error was not sufficiently “grave” to compel reversal.
We disagree for several reasons. First, we find no support in
Southard
for the distinction that the state posits. Like the definitive diagnosis at issue in
Southard
— indeed, perhaps more so — a diagnosis of “highly concerning of sexual abuse” without confirming physical evidence has marginal
probative value.
See Southard,
Second, as in Lovern, the state’s case was premised on the complainant’s credibility. Here, other than R’s own testimony, the state presented no eyewitness testimony or direct evidence that the events in question occurred. Rather — in addition to Munson’s testimony — -the state’s case consisted primarily of R’s testimony, the videotape of her interview at CARES, and testimony from several witnesses as to what R had told them about the alleged abuse. Conversely, defendant’s theory of the case was that R fabricated the accusations. Defense counsel pointed out inconsistencies in the various accounts that R gave and presented testimony from R’s boyfriend and other witnesses that R had a reputation for being untruthful. The defense also presented testimony from R’s former therapist that R had previously “heard voices” and attempted to show that R was lying on the stand. Finally, the defense posited that R made up the allegations to get attention and because she was mad at her mother for not letting her see her boyfriend.
In short, as the prosecutor told the jury in closing argument, “[T]his case has really come down to do you believe [R].” Under those circumstances, the potential prejudice from the erroneous admission of Munson’s diagnosis is patent.
Finally, the state suggests that the interests of the justice system in avoiding unnecessary retrials,
see State v. Fults,
In sum, the gravity of the error and the interests of justice militate conclusively in favor of us exercising our discretion to correct the error in this case.
6
As a final point, although the parties do not actually raise it, we must consider whether that conclusion requires us to reverse and remand both of defendant’s convictions. Munson diagnosed R as “highly concerning of sexual abuse” based on all of R’s disclosures, including her statements that defendant had touched himself and masturbated in her presence — and the latter conduct, presumably, formed the basis for the endangerment charges.
7
Thus, there is a substantial danger that the jury
Reversed and remanded.
Notes
ORAP 5.45(1) provides, in part:
“No matter claimed as error will be considered on appeal unless the claim of error was preserved in the lower court * * *, provided that the appellate court may consider an error of law apparent on the face of the record.”
Our analysis and disposition obviates any need to address defendant’s other assignments of error, which pertain to purported instructional error that may not recur on remand or, at least, may be presented in a different posture.
ORS 163.427 provides, in part:
“(1) A person commits the crime of sexual abuse in the first degree when that person:
“(a) Subjects another person to sexual contact and:
“(A) The victim is less than 14 years of age[.]”
ORS 163.575 provides, in part:
“(1) A person commits the crime of endangering the welfare of a minor if the person knowingly:
“(a) Induces, causes or permits an unmarried person under 18 years of age to witness an act of sexual conduct * * * as defined by ORS 167.060[.]”
ORS 167.060(10), in turn, defines “sexual conduct” to mean
“human masturbation, sexual intercourse, or any touching of the genitals, pubic areas or buttocks of the human male or female, or the breasts of the female, whether alone or between members of the same or opposite sex or between humans and animals in an act of apparent sexual stimulation or gratification.”
To the extent that the state relies on the fact that the jury acquitted defendant of other counts as support for its argument, we reject the state’s logic for the reason that we rejected it in
Lovern. See
Lovern,
The state’s argument that defendant may have had a tactical reason for not properly objecting to Munson’s diagnosis — and for that reason it is not appropriate for us to address its admission as plain error — is, for the reasons stated in
Lovern,
unavailing.
See Lovern,
Similarly, as in
Lovern,
a positive exercise
oí Ailes
discretion in these circumstances does not subvert the general policies underlying the preservation doctrine.
See Lovern,
As noted, defendant was charged with two counts of endangering the welfare of a minor. The jury acquitted him of one count and convicted him of the other.
