State of Tennessee v. Marcos Acosta Raymundo, A/K/A Marcos Raymundo Acosta ( 2010 )


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  •         IN THE COURT OF CRIMINAL APPEALS OF TENNESSEE
    AT NASHVILLE
    Assigned on Briefs August 18, 2010
    STATE OF TENNESSEE v. MARCOS ACOSTA RAYMUNDO,
    a.k.a. MARCOS RAYMUNDO ACOSTA
    Appeal from the Criminal Court for Davidson County
    No. 2007-C-2655    Cheryl Blackburn, Judge
    No. M2009-00726-CCA-R3-CD - Filed November 10, 2010
    The Defendant, Marcos Acosta Raymundo, a.k.a. Marcos Raymundo Acosta, was charged
    with one count of aggravated child abuse of a child less than eight years old, a Class A
    felony, one count of aggravated child neglect of a child less than eight years old, a Class A
    felony, and two counts of child abuse of a child less than six years old, a Class D felony. See
    
    Tenn. Code Ann. §§ 39-15-401
    (a), -402(b). Following a jury trial, he was convicted of four
    offenses: one count of attempted aggravated child abuse of a child less than eight years old,
    a Class B felony, and the other three offenses as charged. He was sentenced as a Range I,
    standard offender to twelve years for count one, attempted aggravated child abuse, twenty-
    five years for count two, aggravated child neglect, four years for count three, child abuse, and
    four years for count four, child abuse. The trial court ordered that count two was to be served
    concurrently with count one, and that counts three and four were to be served concurrently
    with each other, but consecutively to count two. Thus, the trial court sentenced the
    Defendant to a total effective sentence of twenty-nine years in the Department of Correction.
    In this direct appeal, the Defendant contends that: (1) the State presented evidence
    insufficient to convict him; and (2) his convictions for counts one, two, and four violated the
    principles of double jeopardy. After reviewing the record, we conclude that the State
    presented insufficient evidence to convict the Defendant of count two, aggravated child
    neglect, and that the Defendant’s convictions for count one, attempted aggravated child
    abuse, and count four, child abuse, violate the principles of double jeopardy. Thus, we
    reverse the Defendant’s convictions on counts two and four, and affirm his convictions on
    counts one and three. We remand to the trial court for a redetermination of concurrent and
    consecutive sentencing.
    Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Criminal Court Affirmed in
    Part; Reversed in Part; Remanded
    D AVID H. W ELLES, J., delivered the opinion of the Court, in which N ORMA M CG EE O GLE and
    R OBERT W. W EDEMEYER, JJ., joined.
    Paul J. Walwyn, Madison, Tennessee, for the appellant, Marcos Acosta Raymundo, a.k.a.
    Marcos Raymundo Acosta.
    Robert E. Cooper, Jr., Attorney General and Reporter; Benjamin A. Ball, Assistant Attorney
    General; Victor S. Johnson, III, District Attorney General; and Brian Holmgren, Assistant
    District Attorney General, for the appellee, State of Tennessee.
    OPINION
    Factual Background
    This case arises out of allegations that the Defendant abused his girlfriend’s three-
    year-old daughter, L.S.,1 hereinafter referred to as the victim, between May 2007 and July
    5, 2007. The Defendant was indicted and charged with one count of aggravated child abuse,
    one count of aggravated child neglect, and two counts of child abuse. The Defendant’s trial
    was held November 3-6, 2008.
    Trina Moss testified that she started dating the Defendant in September 2006 and that
    he lived with her from February 2007 to July 5, 2007. She said that her daughter, the victim,
    also lived with them during that time. Both Ms. Moss and the Defendant worked, and the
    victim was often cared for by various babysitters, including Mesha Russell, Ms. Moss’s
    mother Pamela Sage, and Ms. Moss’s brother and sister-in-law. At the end of May 2007, Ms.
    Moss stopped using Ms. Russell as the victim’s primary babysitter. She stated that Ms.
    Russell brought some bruises on the victim to Ms. Moss’s attention and that after discussing
    it with the Defendant, she decided not to have Ms. Russell watch the victim anymore. Ms.
    Russell had pointed out that the victim had two circular bruises on her stomach, one on her
    left cheek, and one on the right side of her forehead. Ms. Moss testified that the victim was
    clumsy and that she believed the bruises on the victim’s face were from running into a car
    door and a bedroom door. At the time, she believed that the marks on the victim’s stomach
    were from running into a dog gate at Ms. Sage’s house. Ms. Moss later testified that Ms.
    Russell also pointed out that the victim had a bite mark on her upper arm. Ms. Moss stated
    that, while the Defendant and the victim were playing, she once saw the Defendant starting
    to bite the victim, but that she told him to stop. She recalled that he said he was “just
    kidding” and stopped. Ms. Moss said that was the only time she ever saw him exhibit any
    type of biting behavior.
    1
    Out of respect for the privacy of the minor victim, we will identify her only by her initials.
    -2-
    Ms. Moss testified that she worked on July 5, 2007, and that her mother, Ms. Sage,
    watched the victim from approximately 7:15 a.m. to 1:30 p.m., while Ms. Moss was at work.
    She stated that she and the victim arrived back at their apartment about 1:45 p.m., and that
    they were alone until the Defendant returned home around 5:00 p.m. Ms. Moss testified that
    she did not do anything during that time to cause any injury to her daughter. She recalled that
    her friend, Yvonne Kirby, was going to dye Ms. Moss’s hair and that Ms. Kirby arrived at
    her apartment around 5:30 p.m. so that they could go to Wal-Mart to get supplies. Ms. Moss
    testified that she was going to take the victim with her but that the Defendant said, “[L]eave
    [the victim] here so that I know you’ll come back.”2 Ms. Moss complied with his request and
    left the victim at home with the Defendant, despite the fact that the victim was crying and did
    not want to stay with the Defendant. She testified that she and Ms. Kirby were only gone
    for approximately thirty minutes.
    When they got back to Ms. Moss’s apartment, the Defendant answered the door,
    carrying the victim in his arms. Ms. Moss recalled that the victim had vomit on her and that
    the Defendant had vomit on his chest. She also testified that the victim had vomited the
    previous day. Ms. Moss stated that, when she was cleaning up the victim, she noticed that
    the victim had several bruises on her body. She described that she saw three bruises on the
    victim’s chest and that they looked like spaced-out fingerprints. She later explained that the
    victim had been playing with three children the night before and that she thought that was
    how the victim became bruised. She also stated that she saw a mark on the victim’s upper
    right arm, which she later came to believe was a bite mark. Ms. Moss testified that she also
    saw a long bruise on the victim’s cheek. She said that she first noticed the long bruise when
    she picked the victim up from her brother’s house on July 1, 2007. She stated that she asked
    her brother if he knew where the victim obtained the bruise but that he said he did not know.
    After Ms. Moss cleaned the victim, she gave her some Tylenol and let her watch a
    movie with Ms. Kirby’s two children. Ms. Moss testified that the victim then fell asleep in
    Ms. Moss’s room. She said that after Ms. Kirby left her apartment around 8:00 p.m., she
    took a shower. Ms. Moss recalled that she heard the victim cry while she was in the shower
    and, after she got out, she saw that the victim was sitting on the couch with the Defendant.
    Ms. Moss testified that she then left the apartment to get something to eat. She recalled that
    she asked the victim whether she wanted to come with her, but the victim said that she did
    not. She testified that approximately twenty-five minutes after she left, the Defendant called
    her on her cell phone and told her that she needed to get home because something was wrong
    with the victim. The Defendant told her that the victim was shaking, and Ms. Moss testified
    that, based on what she could hear through the phone, she could tell from a noise the victim
    2
    Ms. Moss testified that the Defendant spoke to her in Spanish and that she also spoke fluent
    Spanish.
    -3-
    was making that the victim’s mouth was clamped shut. Ms. Moss testified that she was able
    to get home within five minutes of his call.
    Ms. Moss stated that when she entered her apartment, the victim was on the couch and
    the Defendant was kneeling by her, putting rubbing alcohol on her stomach. Ms. Moss
    recalled that the victim’s “hands were turned in, her knees were knot kneed, and . . . her toes
    were actually pointing inward and downward and her eyes were rolled back in the back of
    her head and her jaw was clamped shut.” She also stated that the victim’s head was shaking
    from left to right. She testified that it was immediately apparent that she needed to call 911,
    so she called and told them that she thought the victim might be having a seizure. The
    paramedics arrived within ten minutes, she recalled. Until just before the paramedics arrived,
    the victim was unresponsive to Ms. Moss’s requests that her daughter “wake up.” However,
    she said that shortly before the paramedics arrived, the victim opened her eyes, said
    “Mommy,” and wrapped her arms around Ms. Moss’s neck.
    Ms. Moss testified that the paramedics put the victim in the ambulance and that she
    was also allowed to ride to Vanderbilt Children’s Hospital with them. She recalled that the
    Defendant “said he didn’t want to go to the hospital, but I told him he’s coming to the
    hospital.” She stated that her mother and stepfather brought the Defendant to the hospital
    with them. Describing what happened when Ms. Moss and the Defendant went into the
    victim’s hospital room later, she testified, “[M]y little girl jumped up and screamed, no, and
    jumped into my mother’s arm.”
    At the hospital, Ms. Moss spoke to Detective Sarah Bruner about her daughter’s
    injuries. She testified that she told Detective Bruner that she did not know how her daughter
    received her injuries and that she did not remember the Defendant doing anything
    intentionally or accidentally to hurt the victim. However, when she was interviewed again
    a few weeks later, Ms. Moss told the detective that, on July 2 or July 3, 2007, she saw the
    Defendant “pop” the victim on her right upper thigh. She explained that a “pop” was when
    you heard a popping sound on the skin. Ms. Moss testified that immediately before the
    Defendant “popped” the victim on the right upper thigh, the victim was acting “fussy” and
    “kept crying.”
    Ms. Moss testified that, although the Defendant was not regularly alone with the
    victim, he was alone with her for two hours in May—approximately five to six days before
    Ms. Russell confronted Ms. Moss about the victim’s bruises—and that, several times, he
    would be alone with her when Ms. Moss would leave to buy something to eat. Ms. Moss
    also testified that, on several occasions, the victim had cried when the Defendant came home
    from work. She described, “[W]hen she would hear his keys in the lock, she would come
    running to me and say, Marcos is home, no.” Ms. Moss testified that, while the victim was
    -4-
    sick,3 the Defendant once said, “[L]et [the victim] die so we can have children.” However,
    she said that the Defendant later said he was “just kidding.”
    When asked whether she had previously done anything to injure her daughter, Ms.
    Moss testified that when she and the victim were in Blockbuster sometime between July 2
    and July 4, 2007, the victim acted “real fussy” and had been screaming and crying for fifteen
    or twenty minutes. Ms. Moss admitted to grabbing the victim on her lower jaw and stated
    that she later saw a corresponding bruise on the victim’s face. Ms. Moss testified that she
    was also charged with various offenses arising from the circumstances that led to her
    daughter’s hospitalization. She stated that she pleaded guilty to child abuse and attempted
    child neglect and that she was in the State’s custody at the time of the Defendant’s trial.
    Ms. Sage, the victim’s maternal grandmother, testified that she babysat the victim on
    July 5, 2007, while Ms. Moss was at work. She recalled that Ms. Moss dropped the victim
    off at her house at approximately 6:30 a.m. and picked her up at about 2:30 p.m. Ms. Sage
    testified that she had taken care of the victim approximately five or six days per week since
    the end of May 2007.
    Ms. Sage testified that, on the evening of July 5, 2007, Ms. Moss called to inform her
    that the victim needed to go to the hospital and asked Ms. Sage if she could pick up the
    Defendant and drive him to the hospital. Ms. Sage testified that she saw the victim at the
    hospital on the evening of July 5, 2007, and described that the victim “was beat to a pulp”
    and “had bruises and bite marks from the top of her head down to her feet.” She stated that
    when the victim left her house on the afternoon of July 5, 2007, the victim did not have any
    noticeable injuries. She also testified that she would have seen marks on the victim’s body
    because she saw the victim without her shirt on that day.
    Ms. Sage recalled that she was in the victim’s hospital room when Ms. Moss and the
    Defendant walked in. Ms. Sage stated that the victim screamed “and jumped out of the bed
    into my arms” when she saw the Defendant. She also testified that this was not the first time
    that she had witnessed the victim exhibit this type of behavior. Ms. Sage recalled that
    approximately two weeks before July 5, 2007, the Defendant was in the car when Ms. Moss
    came to pick up the victim from her house and that the victim did not want to get in the car.
    Ms. Sage testified that she had previously seen marks on the victim. She said that she first
    noticed a long bruise on the victim’s face, running from her left ear to her chin, in June 2007.
    She also stated that she noticed marks on the victim’s belly and arm in mid-June 2007. She
    said that she later learned that they were bite marks but that she did not realize it at the time.
    3
    The record is not clear whether Ms. Moss meant the Defendant said this while the victim was in
    the hospital in July 2007, or whether he made the remark at a prior time when the victim was ill.
    -5-
    Yvonne Kirby testified that she was friends with Ms. Moss and that she went over to
    Ms. Moss’s apartment on July 5, 2007, to dye her hair. She said that, after she picked Ms.
    Moss up, they went to Wal-Mart for about thirty minutes. Ms. Kirby testified that, when they
    returned to Ms. Moss’s apartment, the Defendant was holding the victim, who was covered
    in vomit, and that the victim “was crying and shaking.” She also stated that the Defendant
    seemed irritated that she was there and that he did not move from the couch the whole time
    she was at the apartment. Ms. Kirby testified that she dyed Ms. Moss’s hair and that by the
    time she left the apartment, it was getting dark outside.
    Ms. Russell testified that she babysat the victim from the end of November 2006 to
    the beginning of June 2007. Ms. Russell recalled that Ms. Moss typically worked on
    weekends during that time and that she would watch the victim continuously, including
    overnight, from Friday through Sunday or Monday. She stated that on the weekend of May
    25, 2007, she noticed some bruises on the victim. Ms. Russell testified that she observed a
    large bruise on the victim’s hairline, some small bruises on her face, a long bruise on her
    upper thigh, and a large circular bruise on her stomach. She stated that she mentioned the
    bruises twice to Ms. Moss, the second time expressing concern that the Defendant may have
    caused them. Ms. Russell testified that Ms. Moss subsequently stopped using her day care
    services.
    Ms. Russell also testified that, a few weeks before she noticed the bruises, the victim
    started to act very frightened when Ms. Moss came to pick her up. She recalled that, at first,
    the victim said, “[N]o, no, no, I don’t want to go home.” Ms. Russell testified that the
    victim’s protests got worse over time. She recalled that the last time Ms. Moss came to pick
    the victim up, the Defendant was in the car too. She stated that the victim did not want to
    leave Ms. Russell’s house and even grabbed on to her house door while screaming that she
    did not want to go home.
    Officer Ralph Fernandez, employed by the Metropolitan Nashville Police Department,
    testified that he speaks fluent Spanish and often assists other officers by translating for
    Hispanic witnesses. He stated that on the morning of July 6, 2007, he assisted Detective
    Bruner in her interview with the Defendant at Vanderbilt Children’s Hospital. He said that
    the interview was recorded and that he reviewed the recording before testifying at the trial.
    Regarding what transpired after Ms. Moss left the apartment to get food, Officer
    Fernandez testified as follows:
    He said after a few minutes, a few short minutes, he was sitting on the
    couch. [The victim] came out of the bedroom. And he believes that she
    -6-
    maybe wasn’t feeling real good because she sat next to him and said her
    stomach was hurting.
    ....
    After that—he said after a few minutes, maybe about five minutes or
    ten minutes after [Ms. Moss] had left, he noticed as he looked at her that it
    looked like she was about to pass out on him.
    ....
    He said that it looked like she was trembling. She was starting to
    tremble.
    ....
    At that point he said that he had called [Ms. Moss], and he picked up
    [the victim]. At that point he went and got some rubbing alcohol and rubbed
    alcohol on her chest.4
    Officer Fernandez later clarified that the Defendant said the victim’s trembling started about
    ten minutes after Ms. Moss left. Officer Fernandez testified that the Defendant was asked
    about all of the injuries to the victim’s body, but the Defendant “said that he knew nothing
    about it.” Officer Fernandez also stated that the Defendant did not accuse Ms. Moss of
    causing the injuries at any point during the interview. However, he noted that the Defendant
    did admit to seeing bruises on the victim previously but blamed them on the babysitter.
    Detective Sarah Bruner, with the Metropolitan Nashville Police Department, testified
    that she was a detective in the Youth Services Division. Detective Bruner stated that she was
    called to Vanderbilt Children’s Hospital at about 2:00 a.m. or 3:00 a.m. on July 6, 2007, to
    investigate what happened to the victim. She testified that she observed the victim’s injuries
    and began to photograph them. Detective Bruner recalled that she interviewed Ms. Moss,
    Ms. Sage, and the Defendant. She also stated that, after receiving Ms. Moss’s consent, she
    went to Ms. Moss’s home to look for evidence and take photographs.
    Detective Bruner recalled that she took two sets of photographs of the victim’s
    injuries. She first photographed the victim at around 7:00 a.m. on July 6, 2007, and took a
    second set around 4:00 p.m. because more bruises had appeared on the victim’s body. She
    acknowledged that the lighting was different in the two sets of pictures because the first set
    was taken in the emergency room and the second set was taken in the pediatric intensive care
    unit. The photographs were introduced as evidence and viewed by the jury.
    4
    Officer Fernandez also interjected that, in his experience, “some Hispanics use alcohol as a cure-
    all.”
    -7-
    Detective Bruner stated that the victim remained at Vanderbilt Children’s Hospital for
    four days and that after she was released, Detective Bruner arranged for a forensic dentist to
    examine some of the marks on the victim’s body because she suspected they might be bite
    marks. She also testified that she had subpoenaed relevant phone records for July 5, 2007,
    and verified that the Defendant called Ms. Moss at 8:46 p.m. and that Ms. Moss called 911
    at 8:52 p.m.
    Detective Bruner testified that she interviewed the Defendant a second time on August
    27, 2007, at the police station. She stated that Detective Marvin Rivera served as a translator
    for that interview.5 She testified that the Defendant first stated that the victim probably hurt
    herself by playing with other children, or while she was being watched by the various
    babysitters. Detective Bruner recalled that the Defendant acknowledged making the
    statement that he wished the victim would die, but he claimed he was “just kidding.” During
    the interview, the Defendant claimed that, when Ms. Moss was at Wal-Mart, he had thrown
    the victim in the air and that was what caused her to throw up. Later in the interview, the
    Defendant explained that he threw the victim in the air, let her fall, and that she fell on her
    toy stroller, causing the injuries to her stomach. He also stated that he had pushed her around
    in her toy stroller and that she had fallen out three or four times. At another time during the
    interview, he said he threw a ball at the victim several times.6 Detective Bruner recalled that
    the Defendant “also admitted that he had pinched her cheek several times, that he had bit her
    on at least two occasions, and he did say that when he threw her up that that might have
    caused the bruises on her chest.” Detective Bruner estimated that over the course of the
    second interview, the Defendant gave her ten different stories to explain how the victim was
    injured. Detective Bruner also recalled that the Defendant admitted to spanking the victim;
    however, he said it was not for disciplinary reasons and could not explain why he spanked
    her.
    Dr. Michael Tabor, deemed an expert in the field of forensic odontology by the trial
    court, testified that he examined some of the victim’s injuries. He testified that the injuries
    to her right shoulder and left arm were consistent with adult human bite injuries. He said that
    it was impossible that the victim’s bite injuries were self-inflicted and that they were also
    inconsistent with “biting while playing.” By examining the different colors of some of the
    victim’s bruises and bite marks, Dr. Tabor concluded the bite marks were inflicted on
    different days than some of the victim’s other injuries. He also opined that the two bite
    5
    She also testified that Detective Rivera was not available to testify at the Defendant’s trial because
    he was sick with the flu.
    6
    It is not clear from the record whether the Defendant said he did all of these things while Ms. Moss
    was at Wal-Mart, or whether he did them while she went out to get food later in the evening.
    -8-
    marks, to her right shoulder and left arm, were made at different times. Dr. Tabor testified
    that the bite marks were consistent with non-accidental trauma.
    Dr. Tyler Berutti, an assistant professor in pediatric critical care at Vanderbilt Medical
    Center, testified as an expert in the fields of pediatric medicine and pediatric critical care.
    He testified that he treated the victim after she had been transferred from the emergency
    department and into the pediatric intensive care unit. He stated that the victim was in critical
    condition when she first arrived in the emergency department.
    Dr. Berutti testified that he observed a number of bruises on the victim’s body:
    Most notably the ones I had documented in my note were a bruise to the
    left ear, she had some bruising to the face, a couple of bruises to the right of
    her sternum, one bruise to the le[f]t of her sternum, and some bruising on the
    back of her thighs. And then she had a round circular bruise, oval kind of
    shaped bruise, on the back of her right arm and one that appeared similar in
    nature to that one that was on the left scapula, which is the back of the—your
    left shoulder.
    He also testified that he typically sees bruises on the shins and forearms of young children
    and that the victim’s abnormal bruising patterns made him concerned about non-accidental
    trauma. Dr. Berutti recalled that, when he examined the victim, she had bruises that were not
    documented on the initial exam, and that led him “to believe that at least some of these
    bruises were very new.” He specifically stated that bruises on the victim’s lower back and
    jaw line appeared to be “relatively new,” judging by the color of the bruises. Regarding a
    bruise on the victim’s left ear, Dr. Berutti testified that he was concerned it was caused by
    non-accidental trauma because it would have taken “a decent amount of force” to inflict such
    an injury. He recalled that the victim had multiple bruises on her chest and that the injuries
    were inflicted “[c]ertainly within the last day.”
    Dr. Berutti also stated that the victim had multiple internal injuries. He said the victim
    had a bilateral pneumothoraces, that he explained was caused by a disruption to the
    membrane covering the lung, which could allow air into the space between the lung and chest
    wall. Dr. Berutti testified that the victim had air in her mediastinum, the space between the
    lungs and heart, which is called pneumomediastinum, and that she also had air around her
    heart, referred to as pneumopericardium. He testified that these types of internal “injuries
    are seen in accidents that are generated by a lot of force like a motor vehicle accident.” He
    stated that he might expect to see these types of injuries in other “high impact type accidents”
    such as getting hit by a car, getting hit very hard playing football, falling from the second
    story of a building, or getting thrown off of a bicycle. Dr. Berutti testified that he thought
    -9-
    an adult could have inflicted the victim’s injuries by hitting her with a fist or foot. He
    testified that he did not think a child could obtain such internal injuries by tripping, by falling
    off a bed, or by being hit in the chest with a ball. He opined that her internal injuries were
    “very recent” and that they were not consistent with trauma that happened weeks, or even
    days, before her hospital admission.
    Dr. Berutti said that the victim’s condition was “very serious” and said that, with the
    injuries she had, doctors were concerned that both of her lungs could collapse, causing
    respiratory arrest, and that air would compress her heart, causing cardiac arrest. He testified
    that the victim was admitted to the critical care unit for close observation and that it could
    only take “seconds to minutes” for the victim’s condition to worsen. Dr. Berutti stated that
    if the victim had not been presented to the hospital, “she certainly would have the potential
    to progress to either a respiratory or cardiac arrest.” Dr. Berutti also testified that “[t]here
    was concern for a duodenal hematoma,” which is a bruise to the first part of the small
    intestine, and that there was evidence of injury to the victim’s liver and pancreas. He said
    that, in his opinion, the victim suffered some direct trauma to her liver and spleen. Dr.
    Berutti also opined that it was a separate trauma that caused injury to the victim’s lungs.
    Regarding the onset of symptoms when a child has a pneumothoraces and a
    pneumopericardium, Dr. Berutti testified that the signs—such as increased respiratory rate,
    potentially increased difficulty of breathing, and shortness of breath—would be visible
    within minutes. He said that he would also expect to see abdominal discomfort, leading to
    vomiting, with abdominal injuries. Dr. Berutti also testified that he had never seen a case
    where a child had serious internal injuries from trauma but did not have any external
    bruising. Dr. Berutti testified that it was “very important” for the victim to receive
    immediate medical care with the type of traumatic injuries she sustained. The prosecutor
    asked, “In your opinion, Doctor, did the fact that [the victim did] not get medical attention
    shortly after she received these injuries cause her ultimate collapse that precipitated the 911
    call?” Dr. Berutti responded, “Yes.”
    The State made the following election of offenses:
    Count One of the Indictment alleges an act of aggravated child abuse
    against [the victim], and refers to the following conduct: the [D]efendant
    caused internal trauma to [the victim] involving pneumothoraces,
    pneumopericardium and pneumomediastinum, air surrounding her internal
    organs, on July 5, 2007.
    Count Two of the Indictment alleges an act of aggravated child neglect
    against [the victim], and refers to the following conduct: the [D]efendant
    -10-
    delayed seeking medical treatment for [the victim] after causing internal
    injuries to her, resulting in her condition worsening to the point where she
    ultimately collapsed and had to be admitted to the pediatric intensive care unit
    in critical condition for observation and [sic] on July 5, 2007.
    Count Three of the Indictment alleges an act of child abuse against [the
    victim], and refers to the following conduct: the [D]efendant caused multiple
    bite injuries to [the victim] between May 2007 and July 4, 2007.
    Count Four of the Indictment alleges an act of child abuse against [the
    victim], and refers to the following conduct: the [D]efendant caused multiple
    bruises to [the victim] on or about July 5, 2007.
    The Defendant testified in his own defense.7 He stated that when Ms. Moss would
    take the victim to a babysitter, she often would come back with bruises. He testified that
    many different people would babysit the victim, including his mother, his sister-in-law, Ms.
    Moss’s mother, Ms. Moss’s friends, and Ms. Moss’s ex-sister-in-law.
    When asked whether he had ever bitten the victim, he said, “I tried to but [Ms. Moss]
    told me not to.” He then said that he was not trying to bite the victim, rather only pressing
    down with his lips. However, on cross examination, he admitted that he had tried to bite her
    and that they were not playing at the time. He testified that he gave the detectives more
    information during the second interview than the first interview because they “were
    pressuring me to say things.”
    The Defendant maintained that on July 5, 2007, he came home from work around 5:00
    p.m. He testified that Ms. Moss and her friend were going to go to Wal-Mart and that he
    asked her to leave the victim home “so that she would come back quickly.” He elaborated,
    “I had just gotten back from work, and I didn’t have a car. I needed to buy something to eat.”
    He testified that he did not do anything to make the victim vomit while Ms. Moss was at
    Wal-Mart. He said that the victim was playing, and he was watching TV right before she
    vomited.
    He testified that while Ms. Moss was gone to get them something to eat, he was
    playing with the victim with a little stroller and a ball. He said that she fell out of the stroller
    a couple of times while they were playing but that she would just get back in it so they could
    play some more. The Defendant claimed that when they were playing with the ball, he threw
    7
    Because the Defendant was not fluent in English, interpreters simultaneously translated the court
    proceedings for him. They also translated his testimony for the jury.
    -11-
    it softly at her. He later also said that he lifted her up in the air and suspended her but that
    she never fell while he was doing this. The Defendant said that after they had been playing,
    the victim sat down in the chair in which he was sitting and started to faint. He recalled,
    “And then I held her to see what was wrong, and she started to shake. And then I called [Ms.
    Moss]. And then I went to the bathroom with her in my arms to get some alcohol to put it
    on her chest.” When asked why he did not call 911 himself, the Defendant said, “Because
    I didn’t know how to explain myself of what was happening to the girl.” He claimed that he
    told Ms. Moss “to hurry up so that she could see the child and to—so that she could call the
    ambulance.”
    The Defendant testified that at the time he called Ms. Moss, he was worried because
    the victim “was really trembling.” He said that after the ambulance arrived and Ms. Moss
    prepared to go to the hospital with her daughter, Ms. Moss “asked me if I would go with her,
    but her car didn’t have enough gasoline.” He claimed that because the car did not have
    enough gas, he asked Ms. Moss to call Ms. Sage so she could drive him. The Defendant
    testified that when he went with Ms. Moss into the victim’s hospital room, she did not jump
    into anybody’s arms, like Ms. Sage had claimed, and that she had machines attached to her.
    When asked whether he wished the victim would die, he said “[n]ot really” and that
    his comment to Ms. Moss was made “jokingly.” He claimed he made the comment before
    summer and described the circumstances surrounding his comment as: “That day [Ms. Moss]
    had said to me that—asking if we were going to have another child. And I said that with [the
    victim] it was enough. I said to her jokingly the only way we would have another child is if
    [the victim] died. Playing.”
    Miriam Areli Otero, the Defendant’s sister-in-law, testified that she babysat the victim
    on June 25, 2007. She recalled that the victim was dirty and that her clothes smelled, so she
    bathed her. While she was giving the victim a bath, Ms. Otero saw bruises on the victim’s
    back, stomach, and leg. She also testified that she saw the victim on July 4, 2007, and that
    the victim had bruises on her face. When shown pictures of the victim’s bruises taken when
    she was in the hospital on July 6, 2007, Ms. Otero testified that the bruises she had previously
    seen on the victim’s back, stomach, leg, and face were in the same places as some of the
    bruises represented in the pictures. She testified that Ms. Moss was a bad mother but that the
    Defendant “was normal” toward the victim.
    On November 6, 2008, the jury convicted the Defendant of one count of attempted
    aggravated child abuse, a lesser included offense of aggravated child abuse, one count of
    aggravated child neglect, and two counts of child abuse. On January 7, 2009, the trial court
    sentenced the Defendant to twelve years for count one (attempted aggravated child abuse),
    twenty-five years for count two (aggravated child neglect), four years for count three (child
    -12-
    abuse), and four years for count four (child abuse). The trial court ordered that count two
    was to be served concurrently with count one and that counts three and four were to be
    served concurrently with each other, but consecutively to count two. Thus, the trial
    sentenced the Defendant to a total effective sentence of twenty-nine years in the Department
    of Correction. He now appeals.
    Analysis
    I. Sufficiency of the Evidence
    The Defendant contends that the evidence was insufficient to convict him.8 Tennessee
    Rule of Appellate Procedure 13(e) prescribes that “[f]indings of guilt in criminal actions
    whether by the trial court or jury shall be set aside if the evidence is insufficient to support
    the findings by the trier of fact of guilt beyond a reasonable doubt.” A convicted criminal
    defendant who challenges the sufficiency of the evidence on appeal bears the burden of
    demonstrating why the evidence is insufficient to support the verdict, because a verdict of
    guilt destroys the presumption of innocence and imposes a presumption of guilt. See State
    v. Evans, 
    108 S.W.3d 231
    , 237 (Tenn. 2003); State v. Carruthers, 
    35 S.W.3d 516
    , 557-58
    (Tenn. 2000); State v. Tuggle, 
    639 S.W.2d 913
    , 914 (Tenn. 1982). This Court must reject
    a convicted criminal defendant’s challenge to the sufficiency of the evidence if, after
    considering the evidence in a light most favorable to the prosecution, we determine that any
    rational trier of fact could have found the essential elements of the crime beyond a reasonable
    doubt. See Jackson v. Virginia, 
    443 U.S. 307
    , 319 (1979); State v. Hall, 
    8 S.W.3d 593
    , 599
    (Tenn. 1999).
    On appeal, the State is entitled to the strongest legitimate view of the evidence and all
    reasonable and legitimate inferences which may be drawn therefrom. See Carruthers, 
    35 S.W.3d at 558
    ; Hall, 
    8 S.W.3d at 599
    . A guilty verdict by the trier of fact accredits the
    testimony of the State’s witnesses and resolves all conflicts in the evidence in favor of the
    prosecution’s theory. See State v. Bland, 
    958 S.W.2d 651
    , 659 (Tenn. 1997). Questions
    about the credibility of witnesses, the weight and value of the evidence, as well as all factual
    issues raised by the evidence are resolved by the trier of fact, and this Court will not re-weigh
    or re-evaluate the evidence. See Evans, 
    108 S.W.3d at 236
    ; Bland, 
    958 S.W.2d at 659
    . Nor
    will this Court substitute its own inferences drawn from circumstantial evidence for those
    drawn by the trier of fact. See Evans, 
    108 S.W.3d at 236-37
    ; Carruthers, 
    35 S.W.3d at 557
    .
    8
    It is unclear whether the Defendant is challenging his conviction for all four counts or just the
    aggravated child neglect conviction. His brief does give the statutory elements for all four convictions but
    only discusses, in one paragraph, aggravated child neglect. However, we will address the sufficiency of the
    evidence for all four of the Defendant’s convictions.
    -13-
    At the time of the offense, the relevant child abuse and neglect statute stated as
    follows:
    (a) Any person who knowingly, other than by accidental means, treats
    a child under eighteen (18) years of age in such a manner as to inflict injury
    commits a Class A misdemeanor; provided, however, that, if the abused child
    is six (6) years of age or less, the penalty is a Class D felony.
    (b) Any person who knowingly abuses or neglects a child under
    eighteen (18) years of age, so as to adversely affect the child’s health and
    welfare, commits a Class A misdemeanor; provided, that, if the abused or
    neglected child is six (6) years of age or less, the penalty is a Class E felony.
    
    Tenn. Code Ann. § 39-15-401
    (a)-(b) (2006). The relevant aggravated child abuse and
    aggravated child neglect statute stated as follows:
    (a) A person commits the offense of aggravated child abuse or
    aggravated child neglect or endangerment, who commits the offense of child
    abuse, as defined in § 39-15-401(a), or who commits the offense of child
    neglect or endangerment, as defined in § 39-15-401(b), and:
    (1) The act of abuse or neglect results in serious bodily injury to the
    child.
    
    Tenn. Code Ann. § 39-15-402
    (a)(1) (2006). “‘Serious bodily injury’ means bodily injury that
    involves: (A) A substantial risk of death; (B) Protracted unconsciousness; (C) Extreme
    physical pain; (D) Protracted or obvious disfigurement; or (E) Protracted loss or substantial
    impairment of a function of a bodily member, organ or mental faculty.” 
    Tenn. Code Ann. § 39-11-106
    (a)(34).
    Our supreme court has held that child abuse is a “nature-of-conduct” offense and that,
    “[a]s such, the prosecution need not prove that the defendant ‘intended’ to cause injury to the
    child.” State v. Toliver, 
    117 S.W.3d 216
    , 230 (Tenn. 2003). However, the State must show
    that the Defendant was “aware of the nature of the conduct” when he treated the victim “in
    such a manner as to inflict injury.” 
    Tenn. Code Ann. §§ 39-11-302
    (b), -15-401(a); State v.
    Hanson, 
    279 S.W.3d 265
    , 277 (Tenn. 2009). Our supreme court has also instructed “that
    before a conviction for child neglect may be sustained, the State must show that the
    defendant’s neglect produced an actual, deleterious effect or harm upon the child’s health and
    welfare.” State v. Mateyko, 
    53 S.W.3d 666
    , 671-72 (Tenn. 2001). Finally, because the
    Defendant was convicted of attempted aggravated child abuse, we note that our criminal
    attempt statute states as follows:
    -14-
    (a) A person commits criminal attempt who, acting with the kind of
    culpability otherwise required for the offense:
    (1) Intentionally engages in action or causes a result that would
    constitute an offense, if the circumstances surrounding the conduct were as the
    person believes them to be;
    (2) Acts with intent to cause a result that is an element of the offense,
    and believes the conduct will cause the result without further conduct on the
    person’s part; or
    (3) Acts with intent to complete a course of action or cause a result that
    would constitute the offense, under the circumstances surrounding the conduct
    as the person believes them to be, and the conduct constitutes a substantial step
    toward the commission of the offense.
    (b) Conduct does not constitute a substantial step under subdivision
    (a)(3), unless the person’s entire course of action is corroborative of the intent
    to commit the offense.
    (c) It is no defense to prosecution for criminal attempt that the offense
    attempted was actually committed.
    
    Tenn. Code Ann. § 39-12-101
    .
    A. Attempted Aggravated Child Abuse
    The State elected that count one of the indictment, aggravated child abuse, referred
    “to the following conduct: the [D]efendant caused internal trauma to [the victim] involving
    pneumothoraces, pneumopericardium and pneumomediastinum, air surrounding her internal
    organs, on July 5, 2007.”
    The evidence presented at trial showed that the Defendant was alone with the victim
    two times on the evening of July 5, 2007—around 5:30 p.m. for about thirty minutes while
    Ms. Moss went to Wal-Mart and also later in the evening, for about thirty minutes, when Ms.
    Moss went to get something to eat. When Ms. Moss returned home the second time, she
    immediately called 911 because the victim was lying on the couch with her head shaking
    from left to right, her eyes rolled in the back of her head, and her jaw clamped shut.
    Dr. Berutti testified that when the three-year-old victim presented to Vanderbilt
    Children’s Hospital on July 5, 2007, in critical condition, she was diagnosed with a bilateral
    pneumothoraces (a disruption to the membrane covering the lung, which could allow air into
    the space between the lung and chest wall), pneumomediastinum (air in the space between
    her lungs and heart), and pneumopericardium (air around her heart). He stated that he
    believed her injuries were “very recent” and that the types of internal injuries she had were
    -15-
    generated by a lot of force. He testified that he thought an adult could have inflicted the
    victim’s injuries by hitting her with a fist or foot. He classified the victim’s injuries as non-
    accidental trauma. Dr. Berutti also testified that the victim’s injuries were very serious and
    that he was concerned she might experience respiratory or cardiac arrest.
    The jury also heard testimony that the Defendant was interviewed twice by Detective
    Bruner. The first time, conducted at the hospital on July 6, 2007, the Defendant claimed that
    he did not know anything about the victim’s injuries. The second time, conducted at the
    police station on August 27, 2007, the Defendant gave several different explanations for how
    the victim could have been injured. Among the stories he told was that he threw the victim
    in the air and that she fell onto her toy stroller, that he pushed the victim around in her toy
    stroller and that she fell out three or four times, and that he threw a ball at the victim several
    times. The Defendant testified at trial and acknowledged that he said to Ms. Moss “jokingly
    the only way we would have another child is if [the victim] died. Playing.” After a thorough
    review of the evidence, we conclude that the jury had sufficient evidence to find that the
    Defendant committed attempted aggravated child abuse beyond a reasonable doubt. This
    issue is without merit.
    B. Aggravated Child Neglect
    The State elected that count two of the indictment referred to the following conduct:
    “[T]he [D]efendant delayed seeking medical treatment for [the victim] after causing internal
    injuries to her, resulting in her condition worsening to the point where she ultimately
    collapsed and had to be admitted to the pediatric intensive care unit in critical condition for
    observation and [sic] on July 5, 2007.” Although the Defendant mentions the other three
    convictions in his brief, he only presents an argument to support his assertion with regard to
    the conviction of aggravated child neglect. He contends that the State did not present proof
    that demonstrated the act of neglect caused serious bodily injury to the victim.
    The Tennessee Supreme Court has held that the “mere risk of harm” is insufficient to
    prove child neglect. State v. Mateyko, 
    53 S.W.3d 666
    , 671 (Tenn. 2001). Moreover, “before
    a conviction for child neglect may be sustained, the State must show that the defendant’s
    neglect produced an actual, deleterious effect or harm upon the child’s health and welfare.”
    
    Id. at 671-72
    . In State v. Denise Wiggins, we found sufficient evidence to support the State’s
    claim that the defendant burned her five-year-old daughter with an iron and, thus, affirmed
    the defendant’s conviction for aggravated child abuse. No. W2006-01516-CCA-R3-CD,
    
    2007 WL 3254716
    , at *4 (Tenn. Crim. App., Jackson, Nov. 2, 2007). The State had also
    charged Wiggins with aggravated child neglect because she failed to seek medical attention
    for her daughter after she inflicted the burn. 
    Id. at *5
    . This Court held, however, that there
    was insufficient evidence to convict the defendant of aggravated child neglect because “[t]he
    -16-
    proof at trial fail[ed] to demonstrate that it was the act of neglect, or failure to seek medical
    treatment, which resulted in serious bodily injury.” 
    Id.
    Similarly, in State v. Vernita Freeman, we upheld the defendant’s conviction for
    aggravated child abuse; however, we found that insufficient evidence was presented to
    support her conviction for aggravated child neglect. No. W2005-02904-CCA-R3-CD, 
    2007 WL 426710
    , at *1 (Tenn. Crim. App., Jackson, Feb. 6, 2007). We noted that a doctor
    testifying at the defendant’s trial said that the victim “might have survived” if she received
    prompt medical treatment. 
    Id.
     at *8 n.1. However, we concluded that “the proof does not
    demonstrate that it was the act of neglect which caused the serious bodily injury. Rather, the
    proof established that it was the Appellant’s acts of abuse which produced the serious bodily
    injury to the minor victim.” 
    Id. at *8
    ; see also State v. Janet Huffine Dykes, No. E2001-
    01722-CCA-R3-CD, 
    2002 WL 1974147
    , at *7 (Tenn. Crim. App., Knoxville, Aug. 16, 2002)
    (reversing the defendant’s conviction for aggravated child abuse through neglect because
    “there [was] no proof from which a rational jury could conclude that the delay—that is, the
    neglect—caused serious bodily injury as required by the statute”).
    In State v. John Barlow, No. W2008-01128-CCA-R3-CD, 
    2010 WL 1687772
     (Tenn.
    Crim. App., Jackson, Apr. 26, 2010), this Court was presented with a case similar to the
    instant case. The defendant in Barlow was convicted of aggravated child abuse and
    aggravated child neglect. 
    Id. at *1
    . The two-year-old victim suffered a skull fracture and
    severe head injury. 
    Id.
     Barlow testified that he thought something was wrong with the
    victim at around 2:20 a.m., when he noticed her body felt “limp.” 
    Id. at *6
    . However, he did
    not leave to take her to the hospital until approximately 3:30 a.m. 
    Id.
     The State argued that
    Barlow’s delay in obtaining medical attention for the victim worsened her brain injury
    because it allowed her brain to continue to swell. 
    Id. at *11
    . During Barlow’s trial, the
    victim’s surgeon testified that he thought “the victim’s ‘course would have been worse’
    because ‘she would have had more swelling.’” 
    Id. at *2
    . This Court noted that the surgeon
    “immediately added, ‘[Y]ou never know what difference it would make.’” 
    Id.
     The surgeon
    also testified, “I can never tell how much difference it makes how quickly [the injured child
    gets medical treatment]—but the quicker the better.” 
    Id. at *3
    . We upheld Barlow’s
    conviction for aggravated child abuse, noting that he was the only adult present at the time
    of the victim’s injuries. 
    Id. at *9
    . However, we vacated Barlow’s conviction for aggravated
    child neglect because we found that the State “did not establish that Barlow’s delay in
    seeking medical treatment had an ‘actual, deleterious effect’ on the victim’s health. Instead,
    the evidence showed that Barlow’s initial act of abuse caused serious bodily injury to the
    victim.” 
    Id. at *11
    .
    We must agree with the analysis set forth in the cases discussed above and will
    examine the instant case in a similar fashion. Ms. Moss testified that, on the evening of July
    -17-
    5, 2007, she left the victim at home with the Defendant while she went to out to get
    something to eat. She testified that when she had been out about twenty-five minutes, the
    Defendant called her and told her to come home because something was wrong with the
    victim. She stated that she was able to get home within five minutes and that, when she
    walked into her apartment, she saw the victim on the couch, with the Defendant kneeling by
    her, putting rubbing alcohol on her stomach. Ms. Moss recalled that the victim’s “hands
    were turned in, her knees were knot kneed, and . . . her toes were actually pointing inward
    and downward and her eyes were rolled back in the back of her head and her jaw was
    clamped shut.” She also stated that the victim’s head was shaking from left to right. She
    testified that it was immediately apparent to her that she needed to call 911. Phone records
    verified that the Defendant called Ms. Moss at 8:46 p.m. and that Ms. Moss called 911 at
    8:52 p.m. During the trial, the Defendant testified that, when he called Ms. Moss, he was
    worried about the victim because she “was really trembling.” However, the Defendant stated
    that he did not call 911 “[b]ecause I didn’t know how to explain myself of what was
    happening to the girl.”
    It appears that the State attempted to distinguish count one, the initial abuse causing
    the victim’s internal injuries, from count two, the delay in seeking medical treatment, in its
    election by referencing the victim’s “collapse,” as if it was an entirely new injury. However,
    after a thorough review of the record, we cannot conclude that the evidence supports such
    a factual finding. Dr. Berutti did not mention the victim’s “collapse,” besides answering only
    “Yes” to the following question posed by the prosecutor: “In your opinion, Doctor, did the
    fact that [the victim] not get medical attention shortly after she received these injuries cause
    her ultimate collapse that precipitated the 911 call?” There is nothing else in the record that
    supports the proposition that the victim “collapsed” from other causes besides the act of
    abuse that caused the victim’s internal injuries. Dr. Berutti’s testimony, however, does
    indicate that there was risk of further harm if the victim had not received prompt medical
    attention. He stated that if the victim had not been presented to the hospital, “she certainly
    would have the potential to progress to either a respiratory or cardiac arrest.” However, “a
    mere risk of harm in the neglect context is . . . insufficient.” Mateyko, 
    53 S.W.3d at 671-72
    .
    In our view, the State failed to show that the Defendant’s delay in obtaining medical attention
    for the victim had an “actual, deleterious effect” on the victim’s health. Therefore, the
    judgment of conviction for aggravated child neglect must be reversed, and that charge must
    be dismissed.
    C. Child Abuse—Bite Injuries
    The State elected that count three of the indictment, child abuse, referred “to the
    following conduct: the [D]efendant caused multiple bite injuries to [the victim] between May
    2007 and July 4, 2007.”
    -18-
    Ms. Moss testified that, before she stopped using her daycare services in May 2007,
    Ms. Russell pointed out that the victim had a bite mark on her upper arm. Ms. Moss testified
    that she once saw the Defendant start to bite the victim while they were playing. She testified
    that he said he was “just kidding” and stopped. Detective Bruner testified that, during their
    second interview, the Defendant admitted to biting the victim on at least two occasions. Dr.
    Tabor, an expert in the field of forensic odontology, testified that he examined the victim and
    found that injuries on her left arm and right shoulder were consistent with adult human bite
    injuries. He stated that the marks on the victim’s body were not self-inflicted, nor were they
    consistent with “biting while playing.” Dr. Tabor testified that the bite marks were consistent
    with non-accidental trauma. He further opined that the bite marks were inflicted on different
    days than some of the victim’s other injuries. Finally, the Defendant gave inconsistent
    testimony regarding whether he had bitten the victim. First, he testified that he “tried to but
    [Ms. Moss] told me not to.” Then, he said that he was not trying to bite the victim, but rather
    only pressed down with his lips. Later, he admitted that he had tried to bite her and that they
    were not playing at the time. After reviewing the evidence, we conclude that the State
    presented sufficient evidence for a reasonable trier of fact to conclude, beyond a reasonable
    doubt, that the Defendant knowingly inflicted injury on the victim by biting her. Thus, the
    Defendant’s conviction for count three, child abuse, is affirmed. This issue has no merit.
    D. Child Abuse—Multiple Bruises
    The State elected that count four of the indictment, child abuse, referred “to the
    following conduct: the [D]efendant caused multiple bruises to [the victim] on or about July
    5, 2007.”
    Ms. Sage testified that she babysat the victim until about 2:30 p.m. on July 5, 2007.
    She recalled that she saw the victim without her shirt on that day and that the victim had no
    noticeable injuries. Ms. Moss testified that when she was cleaning the victim after she came
    home from Wal-Mart, at approximately 6:00 p.m., after the Defendant had been alone with
    the victim for about thirty minutes, she noticed several bruises on the victim that she had not
    seen before—three bruises on the victim’s chest and a mark on the victim’s upper right arm.
    Ms. Moss testified that she witnessed the Defendant “pop” the victim on the upper right thigh
    on July 2 or July 3, 2007. Dr. Berutti testified that he observed a number of bruises on the
    victim’s body, including bruises on her left ear, face, lower back, and back of her thighs. He
    testified that, when he examined the victim, she had bruises that were not documented on the
    initial exam, and that led him “to believe that at least some of these bruises were very new.”
    He testified that he was concerned that the bruises were a result of non-accidental trauma.
    Moreover, the jury saw photographs taken by Detective Bruner that showed that the victim
    also had bruises in the middle of her back, on her right side, lower right arm, and right
    buttocks. After reviewing the evidence, we conclude that the State presented sufficient
    evidence for a reasonable trier of fact to conclude, beyond a reasonable doubt, that the
    -19-
    Defendant knowingly inflicted injury on the victim, causing her bruises. This issue has no
    merit.
    II. Double Jeopardy
    The Defendant also alleges that counts one (attempted aggravated child abuse for the
    internal injuries), two (aggravated child neglect for the delay in obtaining medical
    assistance), and four (child abuse for the multiple bruises) all charge him with the same
    crime. He contends that his three convictions violate the principles of double jeopardy and
    only one conviction should stand. Although the Defendant did not raise this issue in the trial
    court, and only devotes three sentences of argument to this issue in his brief, we may address
    this issue on its merits if we find plain error.
    Rule 36(b) of the Tennessee Rules of Appellate Procedure provides that “[w]hen
    necessary to do substantial justice, an appellate court may consider an error that has affected
    the substantial rights of a party at any time, even though the error was not raised in the
    motion for a new trial or assigned as error on appeal.” We apply a five-factor test to
    determine whether there is plain error:
    (a) the record must clearly establish what occurred in the trial court;
    (b) a clear and unequivocal rule of law must have been breached;
    (c) a substantial right of the accused must have been adversely affected;
    (d) the accused did not waive the issue for tactical reasons; and
    (e) consideration of the error is ‘necessary to do substantial justice.’
    State v. Adkisson, 
    899 S.W.2d 626
    , 641-42 (Tenn. Crim. App. 1994).
    In the instant case, the record clearly establishes that the Defendant was convicted of
    both attempted aggravated child abuse for inflicting the victim’s internal injuries and child
    abuse for inflicting multiple bruises. As to the second and third factors, we conclude that
    if the Defendant’s double jeopardy protections were violated, a substantial right of the
    Defendant was affected. See Adkisson, 
    899 S.W.2d at 639
     (noting that “[a] ‘substantial
    right’ is a right of ‘fundamental proportions in the indictment process, a right to the proof of
    every element of the offense, and is constitutional in nature’”) (footnotes omitted); see also
    State v. Epps, 
    989 S.W.2d 742
    , 745 (Tenn. Crim. App. 1998) (applying the plain error
    doctrine to review whether the defendant’s convictions for both theft and attempted theft
    violated the principles of double jeopardy). Regarding the fourth factor, we see no indication
    that the Defendant waived the issue for tactical reasons. Finally, under the fifth factor, we
    conclude that consideration of a double jeopardy violation is necessary to do substantial
    justice. Accordingly, we will review this issue as plain error. Having already determined
    that there was insufficient evidence to convict the Defendant of count two, aggravated child
    -20-
    neglect, we will only examine whether convictions on both count one, attempted aggravated
    child abuse, and count four, child abuse, violate the principles of double jeopardy.
    As our supreme court has explained, “three fundamental principles underlie double
    jeopardy: (1) protection against a second prosecution after an acquittal; (2) protection against
    a second prosecution after conviction; and (3) protection against multiple punishments for
    the same offense.” State v. Denton, 
    938 S.W.2d 373
    , 378 (Tenn. 1996) (footnote omitted).
    It is the third of these protections that the Defendant contends is being violated. In order for
    multiple convictions to stand, “it must be clear that the offenses are wholly separate and
    distinct.” State v. Goins, 
    705 S.W.2d 648
    , 650 (Tenn. 1986) (citations omitted). If we find
    that multiple convictions cannot stand, the proper remedy for such situations is a merger of
    the two convictions into one by vacating the conviction on the lesser offense. State v. Zirkle,
    
    910 S.W.2d 874
    , 889 (Tenn. Crim. App. 1995). Initially, we note that Tennessee’s
    constitutional protection against double jeopardy has been construed to be greater than that
    offered by the federal Constitution. See Denton, 
    938 S.W.2d at 378-81
    ; State v. Hayes, 
    7 S.W.3d 52
    , 55 (Tenn. Crim. App. 1999).
    In Denton, our supreme court stated:
    [R]esolution of a double jeopardy punishment issue under the Tennessee
    Constitution requires the following: (1) a Blockburger9 analysis of the statutory
    offenses; (2) an analysis, guided by the principles of Duchac,10 of the evidence
    used to prove the offenses; (3) a consideration of whether there were multiple
    victims or discrete acts; and (4) a comparison of the purposes of the respective
    statutes. None of these steps is determinative; rather the results of each must
    be weighed and considered in relation to each other.
    
    938 S.W.2d at 381
     (footnotes added). The subject offenses must first survive the federal
    Blockburger test in order to satisfy the requirements of the federal Double Jeopardy Clause.
    State v. Hayes, 
    7 S.W.3d 52
    , 55 (Tenn. Crim. App. 1999). If the offenses are the “same”
    under Blockburger, the federal constitutional double jeopardy protections have been violated
    and the inquiry may end. 
    Id.
     Under the Blockburger test, two offenses are not the “same”
    for double jeopardy purposes if each “requires proof of an additional fact which the other
    does not.” Blockburger, 284 U.S. at 304.
    At the time of the offense, the child abuse statute stated as follows:
    9
    Blockburger v. United States, 
    284 U.S. 299
     (1932).
    10
    Duchac v. State, 
    505 S.W.2d 237
     (1973).
    -21-
    (a) Any person who knowingly, other than by accidental means, treats
    a child under eighteen (18) years of age in such a manner as to inflict injury
    commits a Class A misdemeanor; provided, however, that, if the abused child
    is six (6) years of age or less, the penalty is a Class D felony.
    
    Tenn. Code Ann. § 39-15-401
    (a) (2006). The aggravated child abuse statute stated: “(a) A
    person commits the offense of aggravated child abuse or aggravated child neglect or
    endangerment, who commits the offense of child abuse, as defined in § 39-15-401(a) . . . and:
    (1) The act of abuse or neglect results in serious bodily injury to the child.” 
    Tenn. Code Ann. § 39-15-402
    (a)(1) (2006). Thus, the aggravated child abuse statute required all of the
    elements of the child abuse statute plus a result of serious bodily. The lesser included
    offense of child abuse did not require any additional proof beyond that which was required
    for a conviction of aggravated child abuse. “The greater offense is therefore by definition
    the ‘same’ for purposes of double jeopardy as any lesser offense included in it.” Brown v.
    Ohio, 
    432 U.S. 161
    , 168 (1977) (applying the Blockburger test and determining that joyriding
    was a lesser included offense of auto theft and that they were the “same” offenses for the
    purposes of double jeopardy); see Hayes, 
    7 S.W.3d at 55-56
     (“An offense encompassed in
    total within another offense—what we call a ‘lesser included offense’—does not require
    proof of an additional fact, and it is therefore considered the same offense and barred by
    double jeopardy.”). In this case, we need not proceed further with the Denton test because
    we determine that child abuse and attempted aggravated child abuse are considered the same
    offense and barred by double jeopardy when the convictions refer to the same instance of
    conduct.
    In our view, the dual convictions punish the Defendant twice for the same
    offense—once for causing the victim’s internal injuries and then again for causing the
    bruising on her chest, which would have accompanied, and been inflicted at the same time
    as, the internal injuries. The State elected that the first count referred to the victim’s internal
    injuries—the pneumothoraces, pneumopericardium, and pneumomediastinum—inflicted on
    July 5, 2007. During his testimony, Dr. Berutti discussed the victim’s serious internal
    injuries and also stated that he had never seen a case where a child had serious internal
    injuries from trauma but did not have any external bruising. The State elected that the fourth
    count referred to the “multiple bruises” inflicted on the victim “on or about July 5, 2007.”
    As discussed above, the State presented evidence, via testimony and photographs, that the
    victim had about two dozen bruises on her body. Ms. Moss testified that she saw three
    bruises on the victim’s chest when she came home from Wal-Mart around 6:00 p.m. on July
    5, 2007. Dr. Berutti testified that he observed a number of bruises on the victim’s body,
    including bruises on her left ear, face, lower back, and back of her thighs. He also noted that
    he saw bruises on her chest that were inflicted within the last day. Detective Bruner’s
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    photographs showed that the victim also had bruises in the middle of her back, on her right
    side, lower right arm, and right buttocks. Had the State specified in its election that the
    “multiple bruises” did not refer to any of the bruises on the victim’s chest, we could conclude
    that the jury did not convict the Defendant twice for inflicting those injuries—once under
    count one and once under four. However, because the State’s election did not separate the
    conduct supporting each count, we cannot ascertain that the jury convicted the Defendant for
    “wholly separate and distinct” offenses. Because of double jeopardy prohibitions, we are
    required to vacate the conviction in count four and to merge the two convictions into a single
    conviction for attempted aggravated child abuse.
    Conclusion
    Based on the foregoing authorities and reasoning, we conclude that the State presented
    insufficient evidence to convict the Defendant of count two, aggravated child neglect. We
    also conclude that the Defendant’s convictions for both count one, attempted aggravated
    child abuse, and count four, child abuse, violate the principles of double jeopardy. Thus, we
    conclude that the conviction on count four must be vacated and merged into the conviction
    on count one. We affirm his convictions on counts one and three. We remand to the trial
    court to allow the trial court to consider whether the sentences for count one and count three
    should be served concurrently or consecutively.
    ___________________________________
    DAVID H. WELLES, JUDGE
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