DOSS v. STATE (2025)

MEMORANDUM DECISION

[1] Angela Doss appeals her conviction for felony neglect of a dependent resulting in serious bodily injury, which arose from Doss's two-year-old granddaughter's ingestion of fentanyl while in Doss's care. Doss contends that the trial court committed fundamental error by failing to adequately instruct the jury on causation and that the State presented insufficient evidence to prove her actions caused the child's injury. We affirm.

Facts

[2] In October 2021, Doss was babysitting her two-year-old granddaughter, A.G., in the home that Doss shared with Jessie Barber, an elderly man. When Barber found A.G. unconscious, he called 911. First responders observed A.G. unconscious with little to no breathing and pupils the size of pinpoints. Recognizing these symptoms as consistent with an opioid overdose, paramedics administered Narcan, which restored A.G.’s breathing, and transported her to the hospital.

[3] A search of Doss's home revealed a tray with fentanyl residue and cut straws on a nightstand in Doss's bedroom—the room where A.G. had slept the night before. Toxicology reports showed both A.G. and Doss tested positive for fentanyl whereas Barber's test was negative.

[4] The State charged Doss with Level 3 felony neglect of a dependent resulting in serious bodily injury and Level 6 felony possession of a narcotic drug. The State also alleged Doss was a habitual offender.

[5] At Doss's two-day jury trial, two responding paramedics testified to A.G.’s symptoms, explaining that the child demonstrated agonal breathing, or respirations “inadequate for life” often seen in people “that are dying or have just recently died.” Tr. Vol. II, pp. 127, 129. They further testified that Narcan “doesn't work on anything but opiates and opioids.” Id. at 128. After the trial, the jury found Doss guilty as charged, and Doss admitted to being a habitual offender. The trial court sentenced Doss to an aggregate term of twenty-five years. Doss appeals.

Discussion and Decision

[6] On appeal, Doss raises two issues: (1) whether the trial court committed fundamental error by failing to specifically instruct the jury on causation; and (2) whether the State presented insufficient evidence to prove her actions caused the child's injury. Unpersuaded by either argument, we affirm.

I. Jury Instructions

[7] Doss first argues that the trial court erred by failing to properly instruct the jury on the causation element of the offense. Because Doss did not object to the jury instructions at trial or propose alternate instructions on causation, she must demonstrate fundamental error to prevail. See Wright v. State, 730 N.E.2d 713, 716 (Ind. 2000). Fundamental error is an “extremely narrow” rule that applies “only when the error constitutes a blatant violation of basic principles, the harm or potential for harm is substantial, and the resulting error denies the defendant fundamental due process.” Boesch v. State, 778 N.E.2d 1276, 1279 (Ind. 2002).

[8] When assessing jury instructions for fundamental error, we consider them as a whole and in the context of all relevant information given to the jury, including closing arguments and other instructions. Id. There is no violation where the information as a whole does not mislead the jury as to the correct understanding of the law. Id.

[9] Here, the jury was instructed that to convict Doss of the neglect charge, the State must prove beyond a reasonable doubt that Doss knowingly placed A.G. in a situation that endangered A.G.’s life or health when Doss had care of A.G., and that “the offense resulted in serious bodily injury to A.G.” Tr. Vol. II, p. 188. The jury was further instructed that if a person is charged with knowingly causing a result, the State must prove that “she must have been aware of a high probability that her conduct would cause the result.” Id. at 190.

[10] Doss complains that these instructions inadequately explained causation, particularly the concepts of actual and proximate cause. We agree that the neglect statute implicates proximate cause—meaning at minimum the injury would not have occurred “but for the defendant's conduct.” Jordan v. State, 244 N.E.3d 445, 455 (Ind. Ct. App. 2024) (quoting Patel v. State, 60 N.E.3d 1041, 1052 (Ind. Ct. App. 2016)). But we cannot conclude that the absence of more specific causation instructions constituted fundamental error here.

[11] The court's instructions, when read as a whole, adequately informed the jury of the State's burden to prove the causal connection between Doss's actions and A.G.’s injuries. The jury was instructed that the State had to prove Doss knowingly placed A.G. in a dangerous situation that “resulted in” serious bodily injury and that Doss had to be aware of a high probability that her conduct would “cause” the result. Tr. Vol. II, pp. 188, 190. These instructions sufficiently conveyed the causation requirement without misleading the jury.

[12] Doss's reliance on Yeary v. State, 186 N.E.3d 662 (Ind. Ct. App. 2022) is unpersuasive. In that case, a defendant was accused of dealing in a controlled substance resulting in death. The jury was instructed, over defendant's objection and proposed alternative instruction, that the dealing must have “resulted in” the death and that “cause of death” is an “event which initiates a chain of events, however short or protracted, that results in the death of an individual.” Id. at 679-80. This Court found these instructions inadequate because they could be interpreted to require only that the death followed the drug sale and ingestion when, in fact, proof that the ingestion of drugs caused the death was necessary.

[13] That error was deemed prejudicial because the evidence showed multiple drugs in the victim's system, presenting possible alternative causes of the death that could have broken the causal chain between the defendant's drug sale and the victim's death. Therefore, proximate cause was a central issue in Yeary.

[14] In contrast, there is no evidence here of other intervening factors between Doss's actions and A.G.’s injuries. The evidence showed a straightforward connection: Doss left unsecured fentanyl within A.G.’s reach, A.G. ingested it, and A.G. suffered a life-threatening overdose that was reversed with Narcan. The only drug in A.G.’s system was fentanyl. Therefore, the concern about the causal chain identified in Yeary is not present here. And the language of both “resulted in” and “caused by” in the given instructions adequately conveyed that more than mere chronology was required. Additionally, Yeary dealt with a claim properly preserved for appeal, rather than the narrow fundamental error exception that we apply here.¹

[15] Finally, Doss argues that the State “capitalized on the lowered burden of not having to prove causation” by referencing in closing argument other neglectful conditions in the home. Appellant's Br., p. 13. However, the jury instructions specifically identified exposure to fentanyl as the alleged act of endangerment. The State's arguments about additional neglectful conditions were presented to illustrate Doss's knowledge of the dangerous environment, not as separate bases for conviction.

[16] We therefore conclude that the jury instructions did not constitute fundamental error as they adequately explained the essential elements of the offense.

II. Sufficiency of the Evidence

[17] Doss next contends there was insufficient evidence to prove her actions caused A.G.’s injuries. When reviewing sufficiency claims, we consider only the evidence favorable to the verdict and all reasonable inferences that can be drawn therefrom. See Wright v. State, 828 N.E.2d 904, 905-06 (Ind. 2005). We neither reweigh evidence nor judge witness credibility. Id. at 906. We affirm if there is substantial evidence of probative value from which a reasonable trier of fact could have found the defendant guilty beyond a reasonable doubt. Id.

[18] To sustain Doss's conviction for neglect of a dependent resulting in serious bodily injury, the State needed to prove that Doss knowingly placed A.G. in a situation that endangered her life or health and that this resulted in serious bodily injury. See Ind. Code § 35-46-1-4. Doss challenges only the proof of the causation element, claiming the State failed to present sufficient evidence that: (1) A.G.’s injuries resulted from the fentanyl that was found; and (2) Doss's neglect was the proximate cause of A.G.’s injuries. We disagree.

[19] The evidence presented at trial showed that fentanyl was found on a nightstand in Doss's bedroom, where A.G. had slept the night before the incident. The nightstand was just six inches taller than A.G., making it within reach of the child. When paramedics arrived, A.G. was unconscious with pinpoint pupils and agonal breathing—symptoms consistent with an opioid overdose. Paramedics then administered Narcan, which “doesn't work on anything but opiates and opioids,” and A.G. recovered. Tr. Vol. II, p. 128. Toxicology later confirmed fentanyl in A.G.’s system. This evidence was sufficient for the jury to reasonably conclude that A.G.’s injuries resulted from her ingestion of the fentanyl that Doss left accessible.

[20] In terms of proximate causation, a reasonable jury could conclude that A.G.’s injuries were foreseeable, meaning they were a “natural and probable consequence” of Doss's actions. Cannon v. State, 142 N.E.3d 1039, 1043 (Ind. Ct. App. 2020) (defining proximate cause in terms of foreseeability). It is foreseeable that leaving unsecured fentanyl—a potent and dangerous opioid—within reach of a two-year-old child creates a substantial risk that the child might come into contact with it or ingest it and suffer a life-threatening overdose.

[21] Despite this evidence, Doss argues that the State failed to present medical evidence establishing the cause of A.G.’s injuries. However, multiple paramedics testified about A.G.’s symptoms being consistent with an opioid overdose, her positive response to Narcan, and the toxicology results showing fentanyl in A.G.’s system. This provided sufficient evidence for the jury to conclude that A.G.’s injuries resulted from fentanyl ingestion. Doss's argument to the contrary is merely an invitation to reweigh the evidence, which we will not do. See Wright, 828 N.E.2d at 906.

Conclusion

[22] The trial court did not commit fundamental error in instructing the jury, and sufficient evidence supported Doss's conviction for neglect of a dependent resulting in serious bodily injury. Accordingly, we affirm.

[23] Affirmed.

FOOTNOTES

1.   Doss also supports her claim by citing Abney v. State, 766 N.E.2d 1175 (Ind. 2002), which we find distinguishable for many of the same reasons. That case dealt with an affirmative misstatement of law in the jury instructions (requiring defendant's conduct be merely a “contributing cause” rather than a “substantial cause”) and the evidence presented multiple potential causes of death. Here, the instructions did not misstate the law, and no evidence suggested any cause for A.G.’s injuries other than the fentanyl in Doss's possession.

Weissmann, Judge.

Pyle, J., and Felix, J., concur.