ÿWPC ݈—O*g¦"$)2¾‘§ MÛÖ>¦Ù‚¦•Žœ”J­"?)þÂ'£v²íŽm „nÞ"Áìÿi½l‚~Šž±‡s]#/½(Í𡨇%6ïõ;_«îDÀÀ‚(‹=v@ˆnlYÎE°Êm÷Ñ¥¥4íw|[{B;Q¤~µÉÖÖ‘v¿ÏÑ^ytñÕ!"¡ž–¹K…„Cwp!Sô$ž2ïÆ%pšw…å˜Èb#2nî‚‘°F!=nXŒ€N3YÁ[ÙpbãR-C$*´-¸MÉ7^žÙ$á!hŠ} ½¾õc@êD­ŠÂ× *sü¤û²üLð¼¡E%’t½[þ€ù©kØË¾^$d'ÊÀzÏ&»/_°±·á››™ Æ× Æ ÆcÆ))NïïïEññññññññññññññññññññññññbóóóóóóóóóóóóóóóóóóóóóóóóóóóóóóóóóóóó 0ëûûûû Bææ 0¤ D5§ D-Ü 0K   ASTƧ 0¤m 0D A«U»–x‚/Ï (`£ª$¡¡Ñ€.ÑÑ8€½­»»d»»d8ÑÑ ý ÑÓ  Ó(í€"  Z6Times New Roman Regularyö.ê:i¢×+003|x ˜C:\PROGRA~1\COREL\WORDPE~1\TEMPLATE\CUSTOM~1\REVISE~1.WPTC:\Program Files\Corel\WordPerfect Office 2000\Template\Custom WP Templates\revised standard opinion.wptÿU‹ÿÀÀÀ˜\\IB01S02\CLERKJACÈÈ,,,,ÈÈ0ô\  `‹&Times New RomanLevel 1Level 2Level 3Level 4Level 5‚Level 1Level 2Level 3Level 4Level 5„Level 1Level 2Level 3Level 4Level 5…Level 1Level 2Level 3Level 4Level 5- ù-(|G2Å$¤¤Ý ƒ£ª!ÝÑ€.ÑÑ8€Ù™»»dXXdé8ÑÑ ý ÑÓ  ÓÝ  Ýà  àòòÚ  Ú0Ú  ÚóóÔ€ôé|ò»»Ô d(|3¸¼$££Ý ƒ£ª!ÝÑ€.ÑÑ8€Ù™»»dXXdé8ÑÑ ý ÑÓ  ÓÝ  ÝVVVV)ÿÿ!dxdx)!ÈÈÈÈdxdx( ±þ$’’ò òFigure€Ú  Ú1Ú  Úó ó^_X`YEþÿ<<CÿÿƒLevel 1Level 2Level 3Level 4Level 5(|3¸¼$¢¢Ý ƒ£ª!ÝÑ€.ÑÑ8€Ù™»»dXXdé8ÑÑ ý ÑÓ  ÓÝ  Ý($$””ò òÚ  Ú1Ú  Úó óX[Z&OLE 2.0 Box <=8ÿÿÿÿÿÿÿÿÿÿCÿÿ HKKKKÝ ƒ£ª!ÝÑ€.ÑÑ8€É»»ddÈ8ÑÑ ý ÑÓ  ÓÝ  ÝÔ_ÔÑ  ÑÑ  ÑÔ€¼É»»»ÔÑ8€ŽwXXdé»»d8Ñà@hhìàÔ‡î*†î»¼ÉÔIN€THE€COURT€OF€CRIMINAL€APPEALS€OF€TENNESSEEˆÐ ° Ðà@òò%ìàAT€JACKSONÔ#†¼É»îî*† #ԈРÓ# ÐÓ  ÓJuly€8,€2003€SessionÐ öF ÐÔ‡XŽwX»¼ÉÔÌò òÔ#†¼É»XXŽwø#ÔSTòòATE€OFóó€TENNESSEE€v.€Ô_ÔANGALEEÔ_Ô€LOVEòòóóÔ‡XŽwX»¼ÉÔó óÐ ï? ÐÌà@@½½ìàò òDirect€Appeal€from€the€Criminal€Court€for€Shelby€CountyÐ é 9 Ðà@@øøìàNo.€96„09431€€€€€€J.€C.€Ô_ÔMcLinÔ_Ô,€JudgeÐ Ó # ÐÌÌà@@ìì*ìàßA€V) °°` d€÷E<` AßÐ ‘á  ÐÌà@@TTìàNo.€W2002„03063„CCA„R3„CD€€„€Filed€November€26,€2003Ð ŠÚ  ÐÌßA€V) °°` dE<]` AßÐ ^®  Ðó óÌÓ  ÓThe€defendant€was€convicted€of€aggravated€child€abuse€of€her€seventeen„month„old€daughter.€€TheÐ V¦  Ðdefendant€contends€on€appeal€that€the€evidence€was€insufficient€to€support€the€conviction,€and€theÐ ? Ðtrial€court€erred€in€allowing€testimony€by€Dr.€Lazar€concerning€the€effects€of€acetone.Ô#†¼É»XXŽwŒ#ÔÔ‡XŽwX»¼ÉÔ€€We€concludeÐ (x Ðthat€the€evidence€presented€was€sufficient€to€support€the€conviction,€and€any€error€in€admitting€theÐ a Ðtestimony€of€Dr.€Lazar€concerning€the€effects€of€acetone€was€harmless.€Ô#†¼É»XXŽw"#ÔÔ‡XŽwX»¼ÉÔ€The€judgment€of€the€trialÐ úJ Ðcourt€is€affirmed.Ð ã3 ÐÓ±ÓÌò òTenn.€R.€App.€P.€3€Appeal€as€of€Right;€Judgment€of€the€Criminal€Court€Affirmedó óÐ µ ÐÌòòÓ  ÓÔ#†¼É»àXŽwF#ÔÔ‡XŽwX.¼ÉÔJohn€Everett€Williams,€J.óó,€delivered€the€opinion€of€the€court,€in€which€òòGary€R.€Wade,€Ô_ÔP.J.Ô_Ô,óó€andÐ ˆØ ÐòòRobert€W.€Ô_ÔWedemeyerÔ_Ô,€J.óó,€joined.Ð qÁ ÐÌWilliam€D.€Massey€and€C.€Michael€Robbins€(on€appeal),€Ô#†¼É»XXŽwh#ÔÔ‡XŽwX»¼ÉÔand€Coleman€Ô_ÔGarrettÔ_Ô€and€Michelle€Ô_ÔBotseriÔ_ÔÐ C“ Ð(at€trial),€Memphis,€Tennessee,€for€the€appellant,€Ô_ÔAngaleeÔ_Ô€Love.Ð ,| ÐÌPaul€G.€Summers,€Attorney€General€and€Reporter;€Kathy€D.€Ô_ÔAslingerÔ_Ô,€Assistant€Attorney€General;€Ð þN ÐWilliam€L.€Gibbons,€District€Attorney€General;€and€Patience€Ô_ÔBranhamÔ_Ô€and€Jennifer€Ô_ÔNicholsÔ_Ô,Ð ç 7  ÐAssistant€District€Attorneys€General,€for€the€appellee,€State€of€Tennessee.à  àÐ Ð! ! ÐÓ9ÓÌÌà@@OO&ìàò òOPINIONó óÔ#†¼É»XXŽwÙ #ÔÔ‡XŽwX»¼ÉÔÐ ‹$Û$ ÐÌòòóóÔ#†¼É»XXŽwí #ÔÓ  ÓÔ€XŽwX»¼ÉÔà  àThe€defendant,€Ô_ÔAngaleeÔ_Ô€Love,€was€convicted€of€aggravated€child€abuse€(Class€A€felony)€ofÐ ^&®!& Ðher€seventeen„month„old€daughter.€€She€was€sentenced€as€a€standard€offender€to€the€presumptiveÐ G'—"' Ðsentence€of€twenty€years€in€the€Tennessee€Department€of€Correction.€€This€appeal€timely€followed.€Ð 0(€#( ÐThe€defendant€contends€on€appeal€that€the€evidence€was€insufficient€to€support€the€conviction,€andÐ )i$) Ðthe€trial€court€erred€in€allowing€testimony€by€Dr.€Lazar€concerning€the€effects€of€acetone.€€TheÐ *R%* Ðjudgment€of€the€trial€court€is€affirmed.€Ð ë*;&+ ÐÌÌÓ  Óò òFactsÐ ¦-ö(.ý ÐÔ_Ô‡ó óÓ  Óà  àDr.€Linda€Lazar,€a€pediatric€gastroenterologist,€first€saw€the€victim€in€this€case,€Bianca€Cage,€Ð ° Ðin€January€of€1995,€when€the€victim€was€ten€months€old.€€The€victim€was€having€problems€ð ðspittingÐ ™é Ðup.ðð€€She€was€prescribed€medication,€but€the€problem€persisted.€€Shortly€thereafter,€the€victim€hadÐ ‚Ò Ðan€endoscopy€performed,€which€is€a€procedure€by€which€a€flexible€tube€with€a€lens€attached€isÐ k» Ðplaced€down€the€esophagus€and€into€the€stomach€to€allow€a€doctor€to€look€for€ulcers€or€anything€elseÐ T¤ Ðwhich€would€explain€the€vomiting.€€However,€nothing€was€found.€€She€also€had€a€biopsy€of€herÐ =  Ðesophagus,€which€came€back€normal.€€Later,€the€victim€was€hospitalized€for€an€extended€period€ofÐ & v Ðtime€with€vomiting€and€diarrhea.€€She€would€not€tolerate€oral€feedings,€so€a€feeding€tube,€known€asÐ  _ Ða€G„tube,€was€surgically€implanted€into€the€victimððs€stomach.€€This€tube€allowed€her€to€be€fedÐ ø H Ðdirectly€into€her€stomach€by€the€use€of€a€special€syringe.€€She€also€underwent€surgery€to€prevent€herÐ á 1  Ðfrom€vomiting.€€The€doctor€saw€the€victim€again€in€April€of€1995,€and€she€continued€to€haveÐ Ê   Ðproblems€with€feeding.€€Ð ³  Ðà  àThe€victim€was€readmitted€to€the€hospital€in€September€of€1995.€€At€that€time,€she€hadÐ œì  Ðevidence€of€ð ðbubbles€of€airðð€in€the€wall€of€her€stomach€and€in€the€blood€vessels€of€her€liver.€€TheÐ …Õ  Ðvictim€was€ð ðextremely€illðð€and€was€placed€in€the€intensive€care€unit€for€several€days,€where€she€wasÐ n¾  Ðunder€constant€observation.€€The€physicians€were€concerned€that€she€might€have€a€severeÐ W§  Ðgastrointestinal€infection.€€Tests€ran€on€the€victim€came€back€negative€for€infection.Ð @ ÐÌà  àDr.€Lazar€saw€the€victim€again€a€few€days€later€after€she€had€been€moved€to€a€regular€room.€Ð b ÐThe€victim€was€unresponsive,€and€she€appeared€limp.€€Her€eyes€were€open,€but€they€were€deviatedÐ ûK Ðto€the€right€and€were€unresponsive.€€Her€teeth€were€clinched,€and€her€stomach€ð ðlooked€firm.ðð€€Dr.Ð ä4 ÐLazar€drained€the€ð ðblood„tingedðð€stomach€contents€through€the€tube.€€Dr.€Lazar€was€concerned€thatÐ Í Ðthe€victim€might€be€having€a€seizure,€so€she€referred€her€to€Dr.€Douglas€Rose,€a€pediatricÐ ¶ Ðneurologist.€€The€victim€was€returned€to€the€intensive€care€unit€and€was€given€seizure€medication.€Ð Ÿï ÐÌÌà  àAfter€spending€a€few€days€in€intensive€care,€the€victim€returned€to€normal€and€was€againÐ Zª Ðplaced€in€a€regular€room.€€The€next€day,€she€again€had€a€seizure„like€episode.€€Dr.€Lazar€observedÐ C“ Ðthat€the€victim€was€limp,€her€teeth€were€clinched,€and€she€was€not€responding€to€stimuli.€€TheÐ ,| Ðvictimððs€stomach€appeared€to€be€distended.€€Dr.€Lazar€removed€the€stomach€contents.€€The€stomachÐ e Ðcontents€had€a€ð ðfunny€smell,ðð€like€acetone€or€fingernail€polish€remover.€€Dr.€Lazar€sent€the€stomachÐ þN Ðcontents€to€the€lab€for€testing,€which€revealed€the€presence€of€acetone.€€A€blood„acetone€test€wasÐ ç 7 Ðalso€performed,€which€revealed€a€blood„acetone€ratio€of€1:32.€€According€to€Dr.€Lazar,€acetoneÐ Ð!   Ðshould€not€normally€be€present€in€the€bloodstream.€€Acetone€is€sometimes€present€when€a€personÐ ¹" ! Ðhas€diabetes€under€poor€control€or€a€metabolism€problem.€€However,€the€victim€did€not€haveÐ ¢#ò" Ðdiabetes€or€any€metabolism€problem.€€Dr.€Lazar€testified€that€she€was€not€an€expert€on€the€effectsÐ ‹$Û# Ðof€acetone€on€the€body.€€However,€she€researched€the€symptoms€of€acetone€ingestion€and€discoveredÐ t%Ä $ Ðthat€it€can€cause€a€ð ðseizure„like€looking€appearance.ðð€€Dr.€Lazar€felt€that,€in€her€medical€opinion,Ð ]&­!% Ðacetone€could€have€caused€the€victimððs€symptoms.€€Ð F'–"& ÐÌà  àThe€victim€was€transferred€back€to€the€intensive€care€unit.€€Her€condition€improved,€and€herÐ )h$( Ðacetone€level€dropped.€€On€September€13,€she€was€placed€in€a€seizure€monitoring€room,€which€wasÐ *Q%) Ðunder€constant€video€surveillance.€€The€doctors€were€unable€to€determine€the€cause€of€the€seizuresÐ ê*:&* Ðand€felt€that€video€monitoring€might€help€them€understand€how€the€seizures€started€and€progressed.€Ð Ó+#'+ ÐDr.€Rose€explained€that€the€hospital€has€two€seizure€monitoring€rooms€with€a€control€room€betweenÐ ° Ðthem.€€There€are€two€video€cameras€in€each€monitoring€room,€which€show€what€is€occurring€in€theÐ ™é Ðrooms€on€a€screen€in€the€control€room.€€The€video€screen€also€depicts€the€EEG.€€The€cameras€recordÐ ‚Ò Ðcontinuously€and€are€capable€of€recording€in€very€low€light.€€There€is€a€marker€button€in€theÐ k» Ðmonitoring€room,€which€the€parent€is€instructed€to€press€when€an€event€occurs,€to€place€a€time€markÐ T¤ Ðon€the€videotape.€€Additionally,€there€is€a€technologist€in€the€control€room€who€watches€for€changesÐ =  Ðin€the€patient€and€can€switch€between€cameras.Ð & v ÐÌà  àDr.€Rose€testified€that€when€he€explains€the€monitoring€process€to€the€parents,€he€usuallyÐ ø H Ðdoes€not€explain€that€the€cameras€will€still€function€even€when€the€lights€are€turned€off.€€The€victimÐ á 1  Ðwas€moved€to€the€monitoring€room€on€September€13,€at€approximately€2:00€in€the€afternoon.€Ð Ê   ÐApproximately€two€hours€after€the€victim€was€moved€to€the€monitoring€room,€Dr.€Rose€checked€inÐ ³  Ðon€the€victim,€who€appeared€to€be€doing€fine.€€After€leaving€the€victimððs€room,€he€went€into€theÐ œì  Ðcontrol€room,€where€the€technologist€and€a€nurse€were€monitoring€the€situation.€€The€technologistÐ …Õ  Ðnoticed€that€the€defendant€turned€off€the€lights€in€the€room€and€appeared€to€be€doing€something€toÐ n¾  Ðthe€victim.€€He€directed€Dr.€Roseððs€attention€to€the€monitor.€€The€technologist€switched€to€the€close„Ð W§  Ðup€view€to€get€a€better€look.€€The€defendant€opened€the€cap€to€the€feeding€tube€and€inserted€a€syringeÐ @ Ðfilled€with€some€type€of€liquid.€€She€emptied€the€contents€of€the€syringe€into€the€feeding€tube€andÐ )y Ðwalked€away.€€The€defendant€looked€towards€the€door€several€times€while€injecting€the€victim.€€SheÐ b Ðreturned€a€few€moments€later€and€injected€another€full€syringe€of€liquid€into€the€infant.€€SecondsÐ ûK Ðlater,€the€victimððs€condition€changed.€€The€victim€turned€suddenly€to€the€right€and€drew€up€her€legs.€Ð ä4 ÐThe€movement€did€not€look€normal€to€the€doctor.€€The€defendant€then€pushed€the€marker€button.€Ð Í ÐDr.€Rose€was€concerned€about€what€had€just€transpired€and€entered€the€room.€€Ð ¶ ÐÌà  àDr.€Rose€asked€the€defendant€several€times€if€the€victim€had€received€anything€through€herÐ ˆØ Ðfeeding€tube.€€The€defendant€responded€ð ðnoðð€each€time.€€Dr.€Rose€examined€the€victim€and€saw€thatÐ qÁ Ðher€eyes€were€deviated€to€one€side€and€that€her€abdomen€was€distended.€€He€stepped€out€of€the€roomÐ Zª Ðto€order€a€blood„gas€test€and€to€call€security.€€He€then€reentered€the€room€and€removed€the€cap€fromÐ C“ Ðthe€feeding€tube.€€Bubbles€were€coming€out€of€the€tube,€which€is€not€normal.€€Dr.€Rose€smelled€theÐ ,| Ðfeeding€tube€and€detected€the€smell€of€acetone€or€fingernail€polish€remover.€€Without€commentingÐ e Ðon€his€suspicions,€he€then€asked€the€defendant€to€smell€the€tube.€€She€stated€that€it€smelled€likeÐ þN Ðfingernail€polish€remover.€€She€then€volunteered€that€it€could€not€be€anything€that€she€had€doneÐ ç 7 Ðbecause€she€did€not€use€fingernail€polish€remover.€€Dr.€Rose€continued€to€examine€the€victim€whileÐ Ð!   Ðquestioning€the€defendant.€€Her€legs€were€ð ðfloppy,ðð€and€her€eyes€continued€to€be€deviated€to€oneÐ ¹" ! Ðside.€The€victimððs€breathing€pattern€changed,€and€she€started€having€gurgling€sounds€in€herÐ ¢#ò" Ðbreathing.€€Dr.€Rose€was€concerned€that€her€airway€might€close€and€that€she€could€go€into€cardiacÐ ‹$Û# Ðarrest.€€Dr.€Rose€realized€that€the€victim€was€in€an€emergency€situation€and€that€the€child€was€at€riskÐ t%Ä $ Ðof€dying.€€He€attached€a€syringe€to€the€feeding€tube€and€pulled€out€the€stomach€contents.€€HeÐ ]&­!% Ðimmediately€sent€the€gastric€contents€to€the€lab€for€testing.€€The€victim€was€then€transferred€to€theÐ F'–"& Ðintensive€care€unit.Ð /(#' ÐÌà  àDr.€Rose€and€a€social€worker€then€confronted€the€defendant€with€the€fact€that€she€had€beenÐ *Q%) Ðobserved€giving€the€victim€a€substance€through€the€feeding€tube.€€The€defendant€stated€that€she€knew€Ð ê*:&* Ðthe€cameras€were€recording€the€whole€time.€€She€claimed€that€she€had€given€the€victim€waterÐ Ó+#'+ Ðthrough€the€feeding€tube€and€nothing€else.€€Dr.€Rose€then€received€the€lab€results€from€the€testingÐ ° Ðof€the€gastric€contents.€€They€tested€positive€for€a€very€high€level€of€acetone.€€On€the€morning€ofÐ ™é ÐSeptember€13,€before€the€victim€was€moved€to€the€monitoring€room,€she€had€a€blood€acetone€ratioÐ ‚Ò Ðof€1:4.€€The€gastric€contents€had€an€acetone€ratio€of€1:1024.€€The€victimððs€blood€acetone€ratio€at€4:00Ð k» Ðthe€next€morning€was€0.4€percent.€€Approximately€five€hours€later,€her€acetone€level€was€still€at€0.31Ð T¤ Ðpercent.€€Dr.€Rose€stated€that€if€he€had€not€removed€the€stomach€contents€when€he€did,€even€moreÐ =  Ðwould€have€been€absorbed.€€A€toxic€level€is€considered€to€be€0.02€percent.€€Almost€twelve€hoursÐ & v Ðafter€the€event,€her€acetone€level€was€twenty€times€higher€than€what€is€considered€to€be€toxic.€€TheÐ  _ Ðvictim€recovered€while€in€the€intensive€care€unit.€Ð ø H ÐÌà  àEric€Cage,€the€victimððs€father,€arrived€at€the€hospital€shortly€after€the€event€had€occurred.€Ð Ê   ÐHe€and€the€defendant€had€been€separated€since€1993.€€He€had€been€with€the€victim€in€the€monitoringÐ ³  Ðroom€earlier€that€day.€€Mr.€Cage€indicated€that€the€victim€was€fine€when€he€saw€her.€€She€was€havingÐ œì  Ðno€problems€breathing,€her€eyes€looked€normal,€and€she€did€not€have€a€distended€stomach.€€Dr.€RoseÐ …Õ  Ðtook€him€aside€and€explained€what€had€happened.€€At€first,€he€was€in€disbelief.€€Dr.€Rose€took€himÐ n¾  Ðinto€the€control€room€and€showed€him€the€tape€of€the€defendant€injecting€the€victim.€€Mr.€Cage€leftÐ W§  Ðthe€control€room€and€went€into€the€monitoring€room.€€He€looked€through€the€defendantððs€bag€andÐ @ Ðfound€a€nearly€empty€bottle€of€fingernail€polish€remover.€€Carl€Bailey€and€other€hospital€securityÐ )y Ðofficers€arrived€on€the€scene€a€few€minutes€after€being€summoned€by€Dr.€Rose.€€Mr.€Cage€turnedÐ b Ðthe€bottle€of€fingernail€polish€remover€over€to€security.€€Security€also€removed€two€syringes€and€aÐ ûK Ðhydrogen€peroxide€bottle€from€the€room.€€The€items€were€later€turned€over€to€the€police.€€Ð ä4 ÐÌà  àThe€police€turned€the€items€over€to€a€toxicology€lab€for€testing.€€The€gastric€contentsÐ ¶ Ðcontained€acetone.€€The€fingernail€polish€remover€bottle€tested€positive€for€acetone.€€There€was€noÐ Ÿï Ðacetone€found€on€the€syringe€tested€or€on€the€hydrogen€peroxide€bottle€tested.€€The€other€syringe€wasÐ ˆØ Ðapparently€lost.€€Harold€Nichols,€a€forensic€toxicologist,€testified€that€one€would€likely€not€detectÐ qÁ Ðthe€presence€of€acetone€on€a€syringe€exposed€to€the€air.€€He€stated€that€acetone€would€evaporate€inÐ Zª Ða€matter€of€minutes€at€room€temperature.€€The€gastric€contents€were€apparently€destroyed€by€the€lab,Ð C“ Ðprior€to€trial.Ð ,| Ðà  àÌà  àDr.€Rose€testified€that,€in€his€opinion,€there€was€a€direct€relationship€between€what€wasÐ þN Ðintroduced€by€the€defendant€and€the€victimððs€reaction.€€Water€would€not€cause€those€symptoms.€€InÐ ç 7 Ðhis€medical€opinion,€acetone€caused€the€symptoms.€€Dr.€Rose€did€not€know€of€any€other€medication,Ð Ð!   Ðcondition,€or€anything€that€would€account€for€the€victimððs€symptoms.€€He€testified€that€the€level€ofÐ ¹" ! Ðacetone€present€in€the€victim€after€the€defendant€injected€the€substance€could€not€have€been€presentÐ ¢#ò" Ðwhen€he€saw€the€infant€a€few€minutes€earlier.€€He€stated:Ð ‹$Û# Ðà8  àAcetone€is€rapidly€absorbed€in€the€body€.€.€.€.€With€that€much€acetone,€I€would€notÐ t%Ä $ Ðhave€seen€a€normal€baby€when€I€walked€into€the€room€just€before€the€„€„€the€incidentÐ ]&­!% Ðof€the€syringes€occurred.€€I€would€„€„€I€would€not€have€seen€a€normal€child.€€So€thatÐ F'–"& Ðwas€my€medical€opinion.€€That€was€something€that€was€introduced€into€the€„€„€intoÐ /(#' Ðthe€stomach.€€And€from€the€stomach€moved€into€the€body€.€.€.€.€[Acetone€is]€a€toxin.€Ð )h$( ÐAnd€it€could€well€account€for€all€the€findings€that€I€saw.Ð*Q%)Ð Ð  Ðâ âÐ ê*:&* Ðà  àMr.€Cage€has€had€custody€of€the€victim€ever€since€this€event€occurred.€€The€victimððs€feedingÐ ° Ðâ âtube€was€removed€approximately€six€months€after€this€episode.€€She€has€had€no€more€seizure„likeÐ ™é Ðepisodes€since€that€day.à  àÐ ‚Ò Ðà  àÌà  àThe€defendant€testified€at€trial.€€She€stated€that€she€had€never€done€anything€to€harm€theÐ T¤ Ðvictim.€€She€did€not€know€how€the€fingernail€polish€remover€got€in€her€bag.€€She€admits€turning€offÐ =  Ðthe€lights€and€injecting€a€substance€into€the€childððs€feeding€tube,€but€stated€that€it€was€only€water.€Ð & v ÐShe€said€that€on€the€tape,€she€was€looking€at€the€television€and€not€at€the€door€while€injecting€theÐ  _ Ðvictim.€€The€defendant€was€found€guilty€of€aggravated€child€abuse.Ð ø H ÐÌÓ  Óò òAnalysisÐ Ê   ÐÌó óÓ  Óà  àThe€defendant€contends€on€appeal€that€the€evidence€was€insufficient€to€support€theÐ žî  Ðconviction,€and€the€trial€court€erred€in€allowing€testimony€by€Dr.€Lazar€concerning€the€effects€ofÐ ‡×  Ðacetone.€€We€first€address€the€sufficiency€of€the€evidence€claim.€€Ô‡ X‡iXXXŽwÔWhen€a€defendant€challenges€theÐ pÀ  Ðsufficiency€of€the€evidence,€the€standard€of€review€is€whether,€after€viewing€the€evidence€in€the€lightÐ Y©  Ðmost€favorable€to€the€State,€any€rational€trier€of€fact€could€have€found€the€essential€elements€of€theÐ B’ Ðcrime€beyond€a€reasonable€doubt.€€Tenn.€R.€App.€P.€13(eÔ#†XŽwXX X‡i|K#ÔÔ‡ X‡iXXXŽwÔ);€òòJackson€v.€Virginiaóó,€443€U.S.€307,€319,Ð +{ Ð(1979);€òòState€v.€Evansóó,€838€S.W.2d€185,€190„91€(Tenn.€1992).€€On€appeal,€the€State€is€entitled€to€theÐ d Ðstrongest€legitimate€view€of€the€evidence€and€all€reasonable€or€legitimate€inferences€which€may€beÐ ýM Ðdrawn€therefrom.€€òòState€v.€Elkinsóó,€102€S.W.3d€578,€581€(Tenn.€2003).€€This€Court€will€not€re„weighÐ æ6 Ðthe€evidence,€reevaluate€the€evidence,€or€substitute€its€evidentiary€inferences€for€those€reached€byÐ Ï Ðthe€jury.€€òòState€v.€Careyóó,€914€S.W.2d€93,€95€(Tenn.€Crim.€App.€1995).€€Furthermore,€in€a€criminalÐ ¸ Ðtrial,€great€weight€is€given€to€the€result€reached€by€the€jury.€€òòState€v.€Johnsonóó,€910€S.W.2d€897,€899Ð ¡ñ Ð(Tenn.€Crim.€App.€1995).Ð ŠÚ ÐÌà  àOnce€approved€by€the€trial€court,€a€jury€verdict€accredits€the€witnesses€presented€by€the€StateÐ \¬ Ðand€resolves€all€conflicts€in€favor€of€the€State.€€òòState€v.€Williamsóó,€657€S.W.2d€405,€410€(Tenn.€1983).€Ð E• ÐThe€credibility€of€witnesses,€the€weight€to€be€given€their€testimony,€and€the€reconciliation€ofÐ .~ Ðconflicts€in€the€proof€are€matters€entrusted€exclusively€to€the€jury€as€trier€of€fact.€€òòState€v.€Sheffieldóó,Ð g Ð676€S.W.2d€542,€547€(Tenn.€1984);€òòState€v.€Breweróó,€932€S.W.2d€1,€19€(Tenn.€Crim.€App.€1996).€Ð  P ÐA€juryððs€guilty€verdict€removes€the€presumption€of€innocence€enjoyed€by€the€defendant€at€trial€andÐ é 9 Ðraises€a€presumption€of€guilt.€€òòState€v.€Tuggleóó,€639€S.W.2d€913,€914€(Tenn.€1982).€€The€defendantÐ Ò!"  Ðthen€bears€the€burden€of€overcoming€this€presumption€of€guilt€on€appeal.€€òòState€v.€Blackóó,€815€S.W.2dÐ »" ! Ð166,€175€(Tenn.€1991).Ô#†XŽwXX X‡i M#ÔÐ ¤#ô" Ðà  àÌà  àThe€defendant€first€contends€that€the€evidence€was€insufficient€to€establish€that€the€victimÐ v%Æ $ Ðsuffered€ð ðserious€bodily€injury.ðð€€€A€person€commits€the€offense€of€aggravated€child€abuse€when€thatÐ _&¯!% Ðperson€knowingly,€other€than€by€accidental€means,€treats€a€child€under€eighteen€years€of€age€in€suchÐ H'˜"& Ða€manner€as€to€inflict€injury,€and€the€act€of€abuse€results€in€serious€bodily€injury.€€Tenn.€Code€Ann.Ð 1(#' Ððððð€39„15„401(a),€39„15„402(a)(1).€€If€the€child€is€less€than€six€years€of€age,€the€offense€is€a€Class€AÐ )j$( Ðfelony.€€òòId.óó€at€„402(b).€€Serious€bodily€injury€is€defined€as€bodily€injury€which€involves€a€substantialÐ *S%) Ðâ ârisk€of€death,€protracted€unconsciousness,€extreme€physical€pain,€protracted€or€obviousÐ ì*<&* Ðdisfigurement,€or€protracted€loss€or€substantial€impairment€of€a€function€of€a€bodily€member,€organ,Ð ° Ðor€mental€faculty.€€òòId.óó€at€„11„106(a)(34).Ð ™é Ðâ âÌà  àÔ‡ X‡iXXXŽwÔAfter€viewing€the€evidence€in€the€light€most€favorable€to€the€State,€any€rational€trier€of€factÐ k» Ðcould€have€found€that€the€victim€suffered€serious€bodily€injury.€€Dr.€Rose€testified€that€after€theÐ T¤ Ðvictim€was€injected€by€the€mother,€Ô#†XŽwXX X‡i!Y#Ôher€legs€were€ð ðfloppyðð€and€her€eyes€were€deviated€to€one€side.€Ð =  ÐThe€victimððs€breathing€pattern€changed,€and€she€started€having€gurgling€sounds€in€her€breathing.€Ð & v ÐDr.€Rose€was€concerned€that€her€airway€might€close€and€that€she€could€go€into€cardiac€arrest.€€Dr.Ð  _ ÐRose€realized€that€the€victim€was€in€an€emergency€situation€and€that€the€child€was€at€risk€of€dying.€Ð ø H ÐHe€attached€a€syringe€to€the€feeding€tube€and€pulled€out€the€stomach€contents.€€Dr.€Rose€thenÐ á 1  Ðreceived€the€lab€results€from€the€testing€of€the€gastric€contents.€€Ð Ê   ÐÌà  àThe€stomach€contents€tested€positive€for€a€very€high€level€of€acetone.€€On€the€morning€ofÐ œì  ÐSeptember€13,€before€the€victim€was€moved€to€the€monitoring€room,€she€had€a€blood€acetone€ratioÐ …Õ  Ðof€1:4.€€The€gastric€contents€had€an€acetone€ratio€of€1:1024.€€The€victimððs€blood€acetone€ratio€at€4:00Ð n¾  Ðthe€next€morning,€almost€twelve€hours€after€the€event,€was€0.4€percent.€€Dr.€Rose€stated€that€if€heÐ W§  Ðhad€not€removed€the€stomach€contents€when€he€did,€even€more€would€have€been€absorbed.€€A€levelÐ @ Ðof€0.02€percent€is€considered€to€be€toxic.€€Her€acetone€level€was€twenty€times€higher€than€what€isÐ )y Ðconsidered€to€be€toxic.€€Approximately€five€hours€later,€her€acetone€level€was€still€at€0.31€percent.€Ð b ÐDr.€Rose€testified€that€the€victim€was€ð ðat€very€significant€riskðð€when€she€was€transferred€to€intensiveÐ ûK Ðcare.€€The€record€supports€the€juryððs€finding€that€the€defendantððs€actions€involved€ð ða€substantial€riskÐ ä4 Ðof€death.ðð€€This€argument€is€without€merit.Ð Í ÐÌà  àThe€defendant€next€contends€that€the€evidence€was€insufficient€to€establish€that€the€substanceÐ Ÿï Ðinjected€into€the€victim€was€acetone.€€The€defendant€argues€that€there€are€problems€with€the€chainÐ ˆØ Ðof€custody€of€the€evidence€(syringes,€stomach€contents,€nail€polish€remover€bottle,€peroxide€bottle)Ð qÁ Ðafter€it€left€the€hospital.€€We€agree€with€the€Stateððs€argument€that€the€defendantððs€guilt€was€notÐ Zª Ðestablished€by€the€later€testing€of€items€seized€from€the€hospital€that€day.€€Therefore,€the€chain€ofÐ C“ Ðcustody€of€those€items€has€virtually€no€bearing€on€the€defendantððs€guilt€or€innocence.€€Ð ,| ÐÌà  àIt€is€undisputed€that€the€defendant€turned€off€the€lights€and€injected€a€liquid€substance€intoÐ þN Ðthe€victim.€€It€is€undisputed€that€shortly€thereafter,€the€victim€became€ill.€€It€is€undisputed€that€anÐ ç 7 Ðextremely€high€level€of€acetone€was€found€in€the€victimððs€stomach€contents€that€were€removedÐ Ð!   Ðwithin€minutes€of€the€injections.€€It€is€undisputed€that€an€almost€empty€bottle€of€fingernail€polishÐ ¹" ! Ðremover€was€found€in€the€monitoring€room.€€It€was€certainly€reasonable€for€the€jury€to€find€that€theÐ ¢#ò" Ðsubstance€injected€by€the€defendant€was€acetone€and€that€it€alone€caused€the€symptoms€suffered€byÐ ‹$Û# Ðthis€infant.€€This€argument€is€without€merit.€€Ð t%Ä $ ÐÌà  àThe€defendant€also€contends€on€appeal€that€the€trial€court€erred€in€allowing€testimony€by€Dr.Ð F'–"& ÐLazar€concerning€the€effects€of€acetone€ingestion€on€the€body.€€When€asked€about€the€effects€ofÐ /(#' Ðacetone€ingestion,€Dr.€Lazar€stated€that€she€was€not€an€expert.€€The€defendant€objected€to€theÐ )h$( Ðquestion,€and€the€trial€court€sustained€the€objection.€€However,€the€trial€court€indicated€that€it€wouldÐ *Q%) Ðâ âallow€it€if€a€proper€foundation€was€laid.€€Questioning€continued,€and€the€doctor€stated€that€she€hadÐ ê*:&* Ðresearched€the€effects€of€acetone.€€The€court€then€allowed€her€to€testify€that,€in€her€medical€opinion,€Ð ° Ðthe€presence€of€acetone€ð ðcould€well€have€caused€these€symptoms.ðð€€Ð ™é Ðâ âÌà  àThe€admission€of€evidence€is€a€matter€entrusted€to€the€sound€discretion€of€the€trial€court,€andÐ k» Ðthe€trial€courtððs€ruling€on€an€evidentiary€issue€will€not€be€reversed€absent€a€clear€showing€of€anÐ T¤ Ðabuse€of€that€discretion.€€òòState€v.€Banksóó,€564€S.W.2d€947,€949€(Tenn.€1978).€€The€error€will€notÐ =  Ðresult€in€reversal€ð ðunless€the€error€affirmatively€appears€to€have€affected€the€result€of€the€trial€on€theÐ & v Ðmerits,€or€considering€the€whole€record,€the€error€involves€a€substantial€right€which€more€probablyÐ  _ Ðthan€not€affected€the€judgment€or€would€result€in€prejudice€to€the€judicial€process.ðð€òòState€v.€Harrisóó,Ð ø H Ð989€S.W.2d€307,€315€(Tenn.€1999)€(citations€omitted).€€Even€if€the€admission€of€this€testimony€wasÐ á 1  Ðerror,€it€was€harmless.€€Dr.€Rose€testified€that,€in€his€opinion,€there€was€a€direct€relationship€betweenÐ Ê   Ðwhat€was€introduced€by€the€defendant€and€the€victimððs€reaction.€€In€his€medical€opinion,€acetoneÐ ³  Ðcaused€the€symptoms.€€Dr.€Rose€did€not€know€of€any€other€medication,€condition,€or€anything€thatÐ œì  Ðwould€account€for€the€victimððs€symptoms.€€Even€without€the€testimony€of€Dr.€Lazar€regarding€theÐ …Õ  Ðeffects€of€acetone,€Dr.€Rose€came€to€the€same€conclusion.€€We€cannot€say€that€the€admission€of€Dr.Ð n¾  ÐLazarððs€brief€statement€about€the€effects€of€acetone€more€probably€than€not€affected€the€result€of€theÐ W§  Ðtrial.€€This€issue€is€without€merit.Ð @ ÐÌò òÓ  ÓConclusionÐ b ÐÌó óÓ  Óà  àThe€evidence€presented€was€sufficient€to€support€the€conviction,€and€any€error€in€admittingÐ æ6 Ðthe€testimony€of€Dr.€Lazar€concerning€the€effects€of€acetone€was€harmless.€€Based€on€the€foregoingÐ Ï Ðand€the€record€as€a€whole,€the€judgment€of€the€trial€court€is€affirmed.Ð ¸ ÐÌÌÌÌà  àà ` àà ¸ àà  àà h àà À àà  à___________________________________€Ð E• Ðà  àà ` àà ¸ àà  àà h àà À àà  àJOHN€EVERETT€WILLIAMS,€JUDGE