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State v. Nieves4/15/2004
five days. She also reported the baby was eating well. Dr. Yamada said the baby did not have a fever during the visit. Michelle was well-hydrated and had a normal heart rate. He diagnosed diarrhea caused by a common intestinal virus. Dr. Yamada said he was not told Michelle had recently lost consciousness, which would have been a "fairly significant" development warranting further examination.
13 Dr. John Hu, a medical examiner, testified that he conducted an autopsy one day after Michelle died. His examination revealed no abnormalities. He found no evidence of trauma, nasal blocking, infections, or problems with Michelle's lungs, heart, organs, or brain. Dr. Hu said there was no organic reason for Michelle's death and that the cause of death was undetermined. He reported to police that there was no evidence of suffocation and that Michelle's was "probably a SIDS death." [FN4]
FN4. Dr. Hu testified that "SIDS" refers to Sudden Infant Death Syndrome. According to Dr. Hu, it is a sudden death that remains unexplained after a complete autopsy. SIDS occurs in children under the age of one year, and is most common in children between the ages of two months and six months. In reaching his conclusion about Michelle's death, Dr. Hu further testified that when making his initial findings, he relied on evidence that Nieves's husband had an infant in a previous relationship that died of SIDS.
14 Two weeks after Dr. Hu conducted the autopsy, Detective John Cleary met with Pastora Talavera and was told about Nieves's admission that she had suffocated Michelle. It was later that day when Nieves made her statements to Detective Cisneros, and Detective Cleary then conveyed this information to Dr. Hu. Only after hearing about Nieves's admissions did Dr. Hu conclude that "asphyxia due to smothering" could not be ruled out as a cause of death. [FN5] Even then, Dr. Hu acknowledged it was only possible, not probable, that smothering caused Michelle's death. [FN6]
FN5. Dr. Hu further testified that apart from SIDS, two other natural causes of death could not be ruled out, although he said that it was "highly, extremely unlikely, if not impossible," that they caused Michelle's death. Dr. Hu described these other two causes of death as metabolic acidosis, a condition caused by "underlying metabolic disease" and marked by severe dehydration, and hypokalemia, a condition marked by insufficient blood levels of potassium or electrolytes.
FN6. With respect to ruling out a diagnosis of possible positional asphyxia, or self-suffocation, Dr. Hu's testimony was less definite. He initially testified that there was no indication self-suffocation occurred
and that it was quite unlikely in a baby of Michelle's age. He later stated that he could not rule out the possibility of self-suffocation, but then testified that after reviewing materials from the scene investigation, he was able to rule out self-suffocation to a reasonable degree of medical certainty.
15 Dr. Hu candidly admitted that he changed his conclusion from SIDS as the probable cause of death to being unable to rule out suffocation after he learned about the confessions. Our supreme court has held that if evidence aside from a defendant's confession does not establish the corpus delicti, a defendant's confession in a police report cannot be used. State v. Janise, 116 Ariz. 557, 559, 570 P.2d 499, 501 (1977) (citation omitted).
**855 *442 16 We have been unable to find any Arizona cases with facts similar to those presented here. Cases from Washington and California are, however, remarkably similar to Nieves's case. The Washington case, State v. Pineda, 99 Wash.App. 65, 992 P.2d 525, 527 (2000), involved the death of a nine-day-old child who was found dead in bed
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