noting that direct testimony regarding truthfulness of complainant in case involving sexual abuse of child is inadmissible
How later courts described this case
- noting that direct testimony regarding truthfulness of complainant in case involving sexual abuse of child is inadmissible
- observing that it was not necessary for witness to have inquired into whether victim appreciated need to be truthful where victim was ten years old and was “sufficiently mature to be interviewed outside her grandmother’s presence”
Written by the judges who cited it.
The opinion
TEXAS COURT OF APPEALS, THIRD DISTRICT, AT AUSTIN
NO. 03-22-00528-CR
Lewis Wheeler, Appellant
v.
The State of Texas, Appellee
FROM THE 331ST DISTRICT COURT OF TRAVIS COUNTY
NO. D-1-DC-22-904011, THE HONORABLE CHANTAL ELDRIDGE, JUDGE PRESIDING
MEMORANDUM OPINION
Lewis Wheeler was convicted of continuous sexual abuse and was sentenced to
fifty years’ imprisonment. See Tex. Penal Code §§ 12.32, 21.02. On appeal, Wheeler contends
that the trial court erred by allowing a forensic examiner to testify regarding statements made
during a forensic examination. We will modify the trial court’s judgment of conviction to correct
a clerical error and affirm the judgment as modified.
BACKGROUND
Wheeler met Mother and began dating her before moving in with her and her
two young children: Amber and Allan.1 When Wheeler moved in with the family, Amber was
1
Because the complainant, her brother, and her boyfriend were minors when the alleged
offense occurred, we will refer to them and to the complainant’s mother by using pseudonyms.
See Tex. R. App. P. 9.10 (defining sensitive information).
approximately five years old, and Allan was approximately three years old. After Wheeler and
Mother dated for several years, the couple broke up, and Wheeler left the home. Several years
later, when Amber was seventeen years old, she told her then boyfriend Harry Jones that Wheeler
had raped her when he lived with her family. Jones told Amber that she needed to tell Mother
about the abuse or that he would. After telling Jones about the alleged abuse, Amber ran away
from home, and Jones told Mother about the abuse. Jones and Mother searched for and found
Amber a few days later.
After Amber returned home, the police were called. One of the responding officers
arranged for a forensic interview and a sexual-assault forensic examination, and Amber submitted
to the interview and the examination. Following the interview and the examination, Wheeler was
charged with continuous sexual abuse of a child, and a trial was held. During the trial, several
witnesses testified, including Amber; Mother; Jones; Allan; Dr. Katherine Snyder, who was the
forensic examiner; Shelby Duarte, who was the forensic interviewer; and Wheeler.
Jones testified that Amber told him that Wheeler had raped her. Next, Amber
related that when Wheeler dated Mother, he would physically assault Mother regularly, and Amber
stated that she was afraid that Wheeler would kill Mother. Amber testified that Wheeler began
sexually abusing her when she was five years old and generally described the abuse as occurring
a few times per month during the years that Wheeler dated Mother. While testifying, Amber also
described specific incidents of abuse, including his groping her vagina, rubbing her vagina,
inserting his penis into her vagina, performing oral sex on her, and forcing her to perform oral
sex on him. Amber testified that each of those types of incidents happened more than once and
that the incidents involving penetration caused her tremendous pain and resulted in injuries to
2
her genitals. Amber also related that Wheeler would sometimes give her a sleeping pill before
the incidents.
In her testimony, Amber admitted that she had previously made a false allegation
of sexual abuse against her father. When discussing why she made the allegation, she explained
that she was being abused by Wheeler at the time but identified her father as the abuser instead
because she was living with Wheeler, because she was afraid of Wheeler, and because Wheeler
had already physically assaulted Mother and threatened to kill Mother and Allan if she said
anything about the abuse. For these reasons, Amber testified that she did not feel comfortable
identifying her real abuser but could identify her father whom she knew would never hurt her.
Next, Mother testified that Wheeler regularly assaulted her when she lived with him
and that the violence occurred in front of Amber and Allan. Further, Mother related that Wheeler
brandished and pointed a gun at her multiple times in front of her children. Moreover, Mother
stated that Wheeler was alone with her children regularly because of her work schedule. In her
testimony, Mother testified that when Wheeler was living with her and her children, she noticed
that Amber started imitating sexual activity and engaging in other age-inappropriate behavior and
asked Amber to explain her behavior. Mother recalled that after she asked Amber to explain why
she was behaving in a sexual manner, Amber said that her father had abused her.
After Mother finished testifying, Allan was called as a witness. In his testimony,
Allan related that Wheeler hit Mother and pulled a gun on her and that this abuse happened in front
of Amber and him. Although Allan said that he never saw any sexual activity, he testified that he
saw interactions between Wheeler and Amber that seemed suspicious. Specifically, Allan recalled
that on two occasions he saw Wheeler in Amber’s bedroom with Amber while she was undressed.
3
During a hearing held outside the presence of the jury, the State announced that it
intended to call Dr. Snyder to testify regarding the forensic examination that she performed on
Amber, including statements that Amber made during the exam. Wheeler objected to Dr. Snyder
testifying on the ground that the testimony was inadmissible hearsay. At the hearing, Dr. Snyder
explained that she was the medical director for the child-abuse-resource-and-education-team for a
local hospital, that she had performed close to a thousand sexual-assault exams, and that those
types of exams have a national standard by which they are performed. Concerning this case,
Dr. Snyder recalled that she performed “a nonacute medical evaluation of” Amber, meaning that
the exam occurred more than five days after the last alleged incident of sexual abuse and meaning
that it was unlikely that there would be any physical evidence still present at the time of the exam.
Regarding the exam, Dr. Snyder testified that she obtained a medical history from
Amber and Mother, that she also reviewed one of the investigating officer’s summaries of Amber’s
forensic interview, and that during the exam Amber made statements indicating that Wheeler
sexually abused her and threatened to hurt her and her family if she told anyone. Moreover,
Dr. Snyder specified that obtaining a history helps her to know what symptoms and parts of the
body might be involved and whether any present symptoms could be explained by the medical
history. Additionally, Dr. Snyder related that the information gathered from the history is used for
the “purposes of diagnosis and treatment” because it is used to make decisions regarding whether
any testing needs to be done or any medications should be taken and to decide whether the patient
should be referred to therapy or some other type of specialist. Concerning her ultimate conclusion,
Dr. Snyder stated that she would testify that her diagnosis was that Amber’s medical history was
“consistent with child sexual abuse.”
4
After considering the parties’ arguments and Dr. Snyder’s testimony, the trial
court determined that Dr. Snyder could testify regarding the examination and the statements that
Amber made during the examination. However, the trial court concluded that Dr. Snyder could
not testify as an expert regarding her conclusion that Amber’s medical history was consistent with
sexual assault.
Following that ruling, Dr. Snyder later testified in front of the jury that she
performed a forensic examination on Amber when Amber was seventeen years old. When
discussing the examination, Dr. Snyder mentioned obtaining a medical history from Amber.
Further, Dr. Snyder said that Amber revealed that Wheeler sexually abused her by inserting his
penis into her vagina and her mouth, touching her vagina with his hand, making her touch his
penis, and performing oral sex on her.
Additionally, Duarte testified that Amber agreed to attend a forensic interview and
that during that interview Amber discussed different acts of sexual abuse committed against her
by Wheeler. More specifically, Duarte related that Amber discussed Wheeler’s groping her
vagina, forcing her to perform oral sex on him, performing oral sex on her, and inserting his penis
into her vagina. Further, Duarte recalled that Amber described the penetrative acts as causing her
pain. In addition, Duarte testified that Amber stated during the interview that Wheeler threatened
to hurt her family if she said anything about the abuse.
When the State rested, Wheeler elected to testify and admitted that he dated Mother
for several years, that he lived with her and her children, that they would fight and argue a lot,
and that he had been convicted of assaulting Mother more than once. However, he denied ever
brandishing or aiming a gun at Mother and further denied ever engaging in any sexual activity
with Amber.
5
After considering the evidence presented at trial, the jury found Wheeler guilty of
the charged offense. Wheeler appeals his conviction.
DISCUSSION
Rule 803(4) Statement Made for Medical Diagnosis or Treatment
In his issue on appeal, Wheeler contends that the trial court erred by overruling his
objection and allowing Dr. Snyder to testify regarding statements Amber made during the
examination. Although Wheeler contends that the trial court correctly prohibited Dr. Snyder from
testifying as an expert regarding her “ultimate opinion,” he asserts that allowing her “to parrot”
Amber’s “statements during the forensic exam . . . was improper.” When presenting his arguments,
Wheeler acknowledges that there is an exception to the bar against hearsay for statements made
for medical diagnosis or treatment but argues that the exception did not apply because the
examination was non-acute in nature and that, therefore, the exam was for investigative purposes
rather than medical ones. Wheeler argues that the testimony did not contain sufficient indicia of
reliability to be admissible. From the above, Wheeler asserts that because Amber was seventeen
years old at the time of the examination, she was mature enough to realize that she was seeing
Dr. Snyder as part of the investigation process rather than for medical treatment, particularly when
she had already discussed the abuse with others. Relatedly, Wheeler argues that the trial court’s
decision to exclude Dr. Snyder’s expert medical opinion about the abuse established that the
medical treatment exception to hearsay did not apply. Stated differently, Wheeler contends
that the trial court determined that testimony regarding Dr. Snyder’s medical conclusion was
inadmissible and should have similarly concluded that her testimony regarding statements used to
6
formulate that opinion were also inadmissible. Finally, Wheeler urges that the admission of
Dr. Snyder’s testimony harmed him.2
Appellate courts review a trial court’s ruling regarding the admission or exclusion
of evidence for an abuse of discretion. See Tillman v. State, 354 S.W.3d 425, 435 (Tex. Crim.
App. 2011). Under that standard, a trial court’s ruling will only be deemed an abuse of discretion
if it is so clearly wrong as to lie outside “the zone of reasonable disagreement,” Lopez v. State,
86 S.W.3d 228, 230 (Tex. Crim. App. 2002), or is “arbitrary or unreasonable,” State v. Mechler,
153 S.W.3d 435, 439 (Tex. Crim. App. 2005). Moreover, the ruling will be upheld provided that
the trial court’s decision “is reasonably supported by the record and is correct under any theory of
law applicable to the case.” Carrasco v. State, 154 S.W.3d 127, 129 (Tex. Crim. App. 2005).
Under the Rules of Evidence, hearsay is defined as a statement that “the declarant
does not make while testifying at the current trial or hearing” and that “a party offers in evidence
to prove the truth of the matter asserted.” Tex. R. Evid. 801. Hearsay is generally inadmissible,
see id. R. 802, but the Rules of Evidence provide that the following types of statements are
excluded from the rule against hearsay: “A statement that . . . is made for—and is reasonably
pertinent to—medical diagnosis or treatment . . . and . . . describes medical history; past or present
2
In its appellee’s brief, the State argues that Wheeler did not preserve for appellate
consideration his argument regarding the testimony failing to have sufficient indicia of reliability.
Essentially, the State reasons that the appellate arguments made in his brief do not comport with
the objections made at the hearing. However, Wheeler did argue during the hearing that the
testimony should not be admitted under the medical-treatment exception and presented several
broad challenges to the admissibility of the evidence, including arguing that the testimony lacked
a sufficiently reliable foundation for admission. Moreover, during the hearing, Wheeler
questioned Dr. Snyder about the non-acute nature of the exam, about whether Amber might have
been lying, about whether Dr. Snyder considered information from one of the investigating
officer’s reports, and about Amber’s having several years to formulate a story. In light of the
broadly worded objections and the nature of Wheeler’s questioning, we will assume for the
purpose of resolving this issue that the arguments have been preserved for appellate consideration.
7
symptoms or sensations; their inception; or their general cause.” Id. R. 803(4). “For a statement
to be admissible under this exception, the declarant must make the statement for the purpose of
receiving medical treatment and the content of the statement must be such as is reasonably relied
on by a physician in treatment or diagnosis.” Barnes v. State, 165 S.W.3d 75, 82 (Tex. App.—
Austin 2005, no pet.). “[A] child’s statements to a physician or other health care professional
describing sexually abusive acts and identifying the abuser can be admissible under rule 803(4).”
Id. Courts have held that statements given during a forensic examination can qualify for admission
under Rule 803(4). See San German-Reyes v. State, No. 03-15-00432-CR, 2017 WL 2229873,
at *11 (Tex. App.—Austin May 17, 2017, no pet.) (mem. op., not designated for publication);
Fahrni v. State, 473 S.W.3d 486, 499 (Tex. App.—Texarkana 2015, pet. ref’d); Franklin v. State,
459 S.W.3d 670, 678 (Tex. App.—Texarkana 2015, pet. ref’d).
The exception contained in Rule 803(4) is based on the patient’s selfish motive in
receiving appropriate medical treatment, Jones v. State, 92 S.W.3d 619, 623 (Tex. App.—Austin
2002, no pet.), overruled in part on other grounds by Taylor v. State, 268 S.W.3d 571, 589 (Tex.
Crim. App. 2008), and on “the assumption that the declarant appreciates that the effectiveness of
the diagnosis or treatment may depend on the accuracy of the information provided,” Munoz v.
State, 288 S.W.3d 55, 58 (Tex. App.—Houston [1st Dist.] 2009, no pet.). The assumption that
someone seeking medical treatment will tell the truth may not always apply to children because
they may not fully understand “the need to be truthful with a physician.” See Barnes, 165 S.W.3d
at 82.
When addressing arguments similar to Wheeler’s regarding whether an
examination was an investigative one rather than one for medical treatment or diagnosis, this
Court explained in Barnes v. State that although a physician was gathering evidence for possible
8
prosecution during a forensic examination, the physician “was also conducting a legitimate
medical examination.” See id. at 83; see also Rodriguez v. State, 280 S.W.3d 288, 290 (Tex.
App.—Amarillo 2007, no pet.) (observing that “Texas courts applying the exception for hearsay
statements established by Rule of Evidence 803(4) have held the presence of a parallel law
enforcement purpose does not preclude application of the exception”). Further, this Court affirmed
the admission of the examiner’s testimony even though the abuse occurred years before the exam.
See Barnes, 165 S.W.3d at 83; see also Wells v. State, 558 S.W.3d 661, 664, 668 (Tex. App.—
Fort Worth 2017, pet. ref’d) (concluding that examination was done for medical diagnosis or
treatment even though police officer referred victim for medical examination four years after abuse
stopped). Essentially, this Court reasoned that the exception applied to the forensic exam even
though the last abusive act occurred years prior because the exam would allow the examiner “to
determine if the abuse was continuing or if the child suffered from a sexually transmitted disease”
or other injury “as a result of the prior abuse.” See Barnes, 165 S.W.3d at 83.3
3
As support for his arguments on appeal, Wheeler refers to cases that do not address the
medical-diagnoses-or-treatment exception or are otherwise distinguishable. See Palmer v.
Hoffman, 318 U.S. 109, 112-15 (1943) (concluding that business’s accident reports did not qualify
under exception for reports prepared in regular course of business); Cole v. State, 839 S.W.2d 798,
810-13 (Tex. Crim. App. 1992) (on reh’g) (addressing admissibility under business-record and
public-record exceptions); Hardy v. State, 71 S.W.3d 535, 537-38 (Tex. App.—Amarillo 2002, no
pet.) (discussing admissibility under business-record exception); Sneed v. State, 955 S.W.2d 451,
455 (Tex. App.—Houston [14th Dist.] 1997, pet. ref’d) (concluding that “[s]elf-serving medical
records, offered to show past physical injury and medication usage, created after arrest simply do
not contain the substitutive circumstantial guarantees of trustworthiness necessary to bring the
statements within Rule 803(4)” and that admission was “trumped by the bar on self-serving
statements”). In addition, Wheeler points to cases from other states and from the eleventh federal
circuit, but those cases are not binding authority on this Court. See Jeffrey v. State, 169 S.W.3d
439, 443 n.1 (Tex. App.—Texarkana 2005, pet. ref’d) (stating that Texas appellate courts are only
obligated to follow decisions by higher Texas courts and United States Supreme Court); State v.
Cardenas, 36 S.W.3d 243, 245 n.3 (Tex. App.—Houston [1st Dist.] 2001, pet. ref’d) (explaining
that federal circuit “precedent is not binding on Texas courts”).
9
Although the examination in this case, like that in Barnes, occurred years after
the abuse allegedly stopped, Dr. Snyder explained that obtaining a medical history for Amber,
including information about the alleged abuse, was for diagnosis and treatment to allow her to
make decisions regarding what additional testing and treatment Amber might have needed,
including ascertaining whether Amber should be referred to a therapist or some other specialist.
Even though Dr. Snyder may have been gathering evidence for a possible prosecution, the trial
court could have concluded based on her testimony that she was also conducting a legitimate
medical examination and that the exception under Rule 803(4) applied. This is true even though
the examination took place years after the abuse stopped because Dr. Snyder was seeking to
ascertain whether Amber sustained injuries or required additional treatment because of the
prior abuse. See id. Moreover, although Wheeler contends that Amber’s statements during the
examination should not be considered reliable because she likely knew that her statements were
going to be used as part of the investigation and potential prosecution, nothing in the record
indicates that Amber did not understand the importance of telling the truth during the examination.
See id. (observing that it was not necessary for witness to have inquired into whether victim
appreciated need to be truthful where victim was ten years old and was “sufficiently mature to
be interviewed outside her grandmother’s presence”); see also Taylor, 268 S.W.3d at 589
(explaining that for cases in which person is “on the physician’s cold examination table” for
diagnosis or treatment, it is “natural to presume that adults, and even children of a sufficient age
or apparent maturity, will have an implicit awareness that the doctor’s questions are designed
to elicit accurate information and that veracity will serve their best interest” and that courts
typically review record “not for evidence of such an awareness, but for any evidence that would
10
negate such an awareness, even while recognizing that the burden is on the proponent . . . to show
that the . . . exception applies”).
Turning to Wheeler’s second set of arguments that the trial court’s exclusion of
Dr. Snyder’s ultimate medical conclusion was inconsistent with its decision to allow Dr. Snyder
to testify about the examination, we do not agree that the trial court’s ruling was inconsistent with
the purpose of Rule 803(4) or that the exclusion of some of Dr. Snyder’s testimony established
that the remainder of Dr. Snyder’s testimony should have been excluded. When making its ruling,
the trial court allowed Dr. Snyder to testify regarding statements Amber made during the
examination but prohibited Dr. Snyder from testifying to her ultimate diagnosis that Amber’s
medical history was consistent with sexual abuse. This type of ruling is consistent with case law
regarding the propriety of expert testimony in child-sexual-abuse cases and did not indicate that
Amber’s statements during the examination were not made for medical diagnosis or treatment.
See Salinas v. State, 166 S.W.3d 368, 371 (Tex. App.—Fort Worth 2005, pet. ref’d) (explaining
that forensic examiner could testify regarding results of physical exam but could not testify “that
she had diagnosed sexual abuse based on the child’s medical history”); see also Yount v. State,
872 S.W.2d 706, 711 n.8 (Tex. Crim. App. 1993) (noting that direct testimony regarding
truthfulness of complainant in case involving sexual abuse of child is inadmissible).
In light of the preceding, we conclude that the trial court did not abuse its discretion
by allowing Dr. Snyder to testify regarding Amber’s statements made during the examination
under Rule 803(4). See Barnes, 165 S.W.3d at 83.
Moreover, even if the trial court erred in admitting Dr. Snyder’s testimony, we
would be unable to conclude that the error harmed Wheeler. The erroneous admission of evidence
is non-constitutional error. Sandoval v. State, 409 S.W.3d 259, 287 (Tex. App.—Austin 2013,
11
no pet.). For non-constitutional errors, reviewing courts should only reverse the conviction if the
error affected the defendant’s substantial rights. Tex. R. App. P. 44.2(b). “A substantial right is
affected when the error had a substantial and injurious effect or influence in determining the jury’s
verdict.” Thomas v. State, 505 S.W.3d 916, 926 (Tex. Crim. App. 2016) (quoting King v. State,
953 S.W.2d 266, 271 (Tex. Crim. App. 1997)).
Although Wheeler contends that he was harmed in this case because Dr. Snyder’s
repeating Amber’s statements “added undue credibility” due to her role as a medical professional,
it is well settled that the improper admission of evidence is rendered harmless when other evidence
proving the same fact is properly admitted elsewhere or comes in elsewhere without an objection.
See Brooks v. State, 990 S.W.2d 278, 287 (Tex. Crim. App. 1999); Hitt v. State, 53 S.W.3d 697,
708 (Tex. App.—Austin 2001, pet. ref’d). Further, this Court has determined that any error from
the admission of testimony from a sexual-assault nurse examiner was not harmful where similar
evidence was introduced through the complainant and another witness. See San German-Reyes,
2017 WL 2229873, at *12.
As set out above, prior to Dr. Snyder testifying, Amber testified regarding the
sexual abuse and went into greater detail than Dr. Snyder, and Jones also testified that Amber told
him that Wheeler had raped her. Moreover, after Dr. Snyder testified, Duarte testified regarding
statements Amber made during the forensic interview detailing the abuse. Accordingly, even if
Dr. Snyder’s testimony should not have been admitted, the error would not have affected
Wheeler’s substantial rights because Dr. Snyder’s testimony was duplicative of the testimony from
other witnesses. Cf. Anderson v. State, 717 S.W.2d 622, 627 (Tex. Crim. App. 1986) (explaining
that “[w]hether or not the testimony complained of was admissible as an exception to the hearsay
rule is irrelevant. If the fact to which the hearsay relates is sufficiently proved by other competent
12
and unobjected to evidence, as in the instant case, the admission of the hearsay is properly deemed
harmless and does not constitute reversible error”).
For these reasons, we overrule Wheeler’s issue on appeal.
Clerical Error
In its appellee’s brief, the State contends that there is a clerical error in the trial
court’s judgment of conviction. Specifically, the State notes that although the trial court assessed
Wheeler’s punishment, the judgment of conviction states that the jury determined his punishment.
Accordingly, the State requests that this Court modify the judgment of conviction.
This Court has the authority to modify incorrect judgments when it has the
information necessary to do so. See Tex. R. App. P. 43.2(b); Bigley v. State, 865 S.W.2d 26, 27-28
(Tex. Crim. App. 1993). As pointed out by the State, the trial court assessed Wheeler’s
punishment, but the judgment of conviction incorrectly reflects that the punishment was assessed
by the jury. Accordingly, we modify the judgment to show that the punishment was assessed
by the trial court. See Tex. R. App. P. 43.2(b); see also Gutierrez v. State, No. 05-16-00755-CR,
2017 WL 2351346, at *1 (Tex. App.—Dallas May 31, 2017, pet. ref’d) (mem. op., not designated
for publication) (modifying trial court’s judgment to reflect that trial court, not jury, assessed
defendant’s punishment).
CONCLUSION
Having overruled Wheeler’s issue on appeal and having modified the trial court’s
judgment, we affirm the trial court’s judgment of conviction as modified.
13
__________________________________________
Thomas J. Baker, Justice
Before Justices Baker, Triana, and Smith
Modified and, as Modified, Affirmed
Filed: September 14, 2023
Do Not Publish
14