Ariel K. Ragan, Appellant-Defendant v. State of Indiana, Appellee-Plaintiff (2025)

MEMORANDUM DECISION

Case Summary

[1] Ariel K. Ragan appeals her conviction and sentence for Level 3 felony neglect of a dependent resulting in serious bodily injury. She argues that the trial court erred in admitting certain testimony and that her sentence is inappropriate. We affirm.

Facts and Procedural History

[2] In 2023, Ragan lived with her husband, William Ragan, and their four children, V.R., R.R., B.R., and H.R. That May, William's adult daughter asked him if her son, three-year-old S.W., could stay with his family for the summer. William agreed, and S.W. moved in with them at the end of May.

[3] On July 20, Ragan and William had to take H.R. to the hospital for a procedure, so Ragan's stepmother, Kim Norman, watched the rest of the children. During breakfast, S.W. fell while trying to get into his booster seat and “landed on his ․ behind.” Tr. Vol. 3 p. 173. Later, while S.W. was getting dressed, he fell face-first onto a large plastic toy. S.W. “seemed fine” after both falls and didn't cry or complain of pain either time. Id. at 176. Norman told Ragan about the falls when she, William, and H.R. returned from the hospital, but Ragan “didn't say anything really” or “ask if [S.W.] was hurt.” Id. at 177. When Norman left about ten minutes later, S.W. was “fine” and playing with toys. Id. Shortly after that, William left the house with V.R. and R.R. Ragan noticed that S.W. had new bruises, a gash on his cheek, and a bleeding wound on his nose but didn't seek medical care for S.W.’s injuries.

[4] That evening, Kimberly Ankrom, the Ragans’ next-door neighbor, received a call from Ragan “crying and asking for help and asking [Ankrom] to come over.” Tr. Vol. 2 p. 206. Ankrom and her husband, Jerrod Nunnelly, went to Ragan's house and found her in the front yard on the phone with William. Ragan pointed to the front door and told Ankrom and Nunnelly “to help [S.W.].” Id. at 208. Ankrom asked Ragan if she called 911, and Ragan said no. Ankrom and Nunnelly found S.W. lying on the floor in the doorway, “blue and not moving” or breathing. Id. at 211. Ankrom called 911, and Nunnelly performed CPR on S.W. Ragan told a sheriff's deputy who responded to the scene that she'd heard S.W. fall and found him lying on the ground.

[5] When paramedics arrived, S.W. was having a seizure. He had cuts, scratches, and bruises all over his body, some fresh and others old. S.W. was taken to the pediatric ICU, where he regained consciousness but couldn't move on his own. He had compression fractures in his spine, bilateral subdural hematomas, a concussion, a liver injury, and a laceration under his tongue so deep that “air had actually [gotten] into the wound and come across into the subcutaneous tissues of his left-sided jaw and neck.” Tr. Vol. 3 p. 97. Based on S.W.’s condition, the trauma team at the hospital was concerned about child abuse or neglect and requested a consultation from Dr. Cortney Demetris, who is board-certified in child-abuse pediatrics. Dr. Demetris concluded that “the only plausible medical diagnosis that would account for the constellation of injuries seen in [S.W.] is child physical abuse.” Id. at 101. Given the extent of his injuries, S.W. spent a month in the hospital.

[6] After receiving a report of S.W.’s injuries, the Department of Child Services (DCS) removed Ragan and William's children and placed them in foster care. DCS referred V.R., R.R., and B.R. for therapy “in order to process the trauma of the removal and then the allegations that they witnessed the abuse that had occurred in the home.” Tr. Vol. 2 p. 7. (H.R. was not referred for therapy because she was only two years old.) In August 2023, five-year-old B.R. began seeing a therapist with Lifeline Youth & Family Services. That November, she changed therapists to Tara Oakley. Oakley and B.R. met twice a week in the social-work office at B.R.’s school. When they first started meeting, Oakley had B.R. use a trauma-focused cognitive behavioral therapy workbook, which is used to build rapport with patients, “make them feel safe in talking,” and help them process their trauma. Id. at 17. During one session, Oakley asked B.R. how Ragan got along with everyone in her family, and B.R. said that “mommy and [S.W.] fight.” Id. at 18. When Oakley asked how Ragan would fight with S.W., B.R. “held her hands over” her head, said that “Mommy thr[ew] [S.W.] on the floor,” and made a throwing motion. Id. at 19. After this disclosure, V.R., R.R., and B.R. underwent forensic interviews.

[7] The State charged Ragan with Level 3 felony domestic battery resulting in serious bodily injury to a person under 14, Level 3 felony neglect of a dependent resulting in serious bodily injury, and Level 6 felony domestic battery committed in the presence of a child under 16.¹ Before trial, the State moved for admission of B.R.’s disclosures to Oakley during therapy as statements made for medical diagnosis or treatment under Indiana Evidence Rule 803(4).

[8] The trial court held a hearing on the admissibility of B.R.’s statements during therapy. Oakley testified that she told B.R. what her job is and that the purpose of their meetings was “to talk about thoughts, feelings and emotions and ․ whatever [B.R.] wanted to talk about.” Id. at 15. She explained to B.R. that her role was “the same thing as what the previous therapist was doing.” Id. Oakley said B.R. “appear[ed] to be receptive when speaking with her,” “understood that [Oakley] was there to help her,” and knew the difference between the truth and a lie. Id. at 15. Oakley opined that, “based off [their] rapport,” B.R. understood their conversations and “what [Oakley] tell[s] her” during sessions. Id. at 30-31. Oakley also testified that throughout therapy, B.R. was consistent in her disclosures about what happened to S.W. The trial court ruled that the State laid a sufficient foundation for B.R.’s statements to be admissible as statements made for medical diagnosis or treatment.

[9] A jury trial was held in July 2024. Oakley testified that B.R. disclosed during therapy that “Mommy was mad at [S.W.]” and “Mommy threw [S.W.].” Tr. Vol. 3 p. 20. Oakley explained that when she asked B.R. what she saw the last time she'd seen S.W. (the night of July 20, 2023), B.R. told her that “she saw [S.W.] sleeping and [he] had to be taken off in an ambulance.” Id. Ragan's counsel made a continuing objection to Oakley's testimony.

[10] Ragan testified in her own defense. She acknowledged that although she came home on July 20, 2023, to S.W. with new bruises, a gash on his cheek, and an open wound on his nose, she “just went about the rest of the day” because she “really didn't know what to do” about S.W.’s injuries. Tr. Vol. 4 p. 100. Ragan testified that S.W. collapsed while she was cooking dinner that night but denied throwing him. She said she went over to him and saw that his eyes were closed, he was “not alert,” and he “was turning a little blue.” Id. at 104, 105. She “[tr]ied ․ to [s]hake” him, but “he wasn't moving.” Id. at 104. Ragan admitted that she knows CPR but didn't perform it on S.W. because she was afraid she would “mess up.” Id. at 105. She testified that she didn't call 911 but called Ankrom and waited outside for her to come over.

[11] The jury found Ragan guilty of Level 3 felony neglect of a dependent resulting in serious bodily injury but could not reach a verdict on the two domestic-battery charges. At sentencing, the trial court found the following aggravators: (1) the harm suffered by S.W. was significant and greater than the elements necessary to prove the commission of the offense; (2) S.W. was only three years old at the time of the offense; (3) Ragan was in a position of care, custody, and control of S.W.; (4) S.W.’s injuries were the result of “shaken baby syndrome”; (5) Ragan's failure to render aid, which the court did “not giv[e] much weight”; (6) the offense occurred in front of other minor children; and (7) Ragan's lack of remorse, which the court again didn't “giv[e] that much weight.” Tr. Vol. 5 pp. 38, 39. The court identified as mitigators that Ragan has no criminal history, imprisonment will result in undue hardship to her children, Ragan suffered traumas during her childhood, and she has PTSD. Finding the aggravators to outweigh the mitigators, the court sentenced Ragan to 15 years in the Department of Correction.²

[12] Ragan now appeals.

Discussion and Decision

I. The trial court did not commit reversible error in admitting B.R.’s statements made during therapy

[13] Ragan first argues that the trial court erred in allowing Oakley to testify about B.R.’s statements during therapy. Generally, trial courts have broad discretion in ruling on the admissibility of evidence, and we review only for an abuse of that discretion. Chambless v. State, 119 N.E.3d 182, 188 (Ind. Ct. App. 2019), trans. denied.

[14] Ragan contends B.R.’s statements during therapy are inadmissible hearsay. Hearsay is a statement, not made by the declarant while testifying at trial, “offered in evidence to prove the truth of the matter asserted.” Ind. Evidence Rule 801(c). Hearsay is inadmissible unless it falls under an exception. Evid. R. 802. One such exception is a statement made for purposes of medical diagnosis or treatment, which is a statement that:

(A) is made by a person seeking medical diagnosis or treatment;

(B) is made for--and is reasonably pertinent to--medical diagnosis or treatment; and

(C) describes medical history; past or present symptoms, pain or sensations; their inception; or their general cause.

Evid. R. 803(4). This exception is “grounded in a belief that the declarant's self-interest in obtaining proper medical treatment makes such a statement reliable enough for admission at trial.” VanPatten v. State, 986 N.E.2d 255, 260 (Ind. 2013).

[15] Admissibility under Rule 803(4) requires a two-step inquiry: (1) whether the declarant was motivated to provide truthful information in order to promote diagnosis and treatment and (2) whether the content of the statement is such that an expert in the field would reasonably rely upon it in rendering diagnosis or treatment. Id. Where, as here, the declarant is a young child, to satisfy the first prong, “there must be evidence that the declarant understood the professional's role in order to trigger the motivation to provide truthful information.” Id. at 261. Such evidence may consist of foundational testimony from the medical professional detailing their interaction with the declarant, how they explained their role to the declarant, and an affirmation that the declarant understood that role. Id.

[16] Ragan claims there is insufficient evidence that B.R. understood Oakley's role as a therapist. We disagree. When she began seeing Oakley in November 2023, B.R. had already been seeing a different therapist for several months, and Oakley told B.R. her role was the same as the previous therapist's. Oakley and B.R. met twice a week in the social-work office at B.R.’s school, and Oakley explained that the purpose of their meetings was “to talk about thoughts, feelings and emotions and ․ whatever [B.R.] wanted to talk about.” Oakley used a trauma-focused cognitive behavioral therapy workbook with B.R. to help her process her trauma and feel safe sharing. As the two built a rapport, B.R. began opening up to Oakley and “felt comfortable with talking about her thoughts and her feelings and emotions.” Tr. Vol. 3 p. 18. Oakley testified that B.R. was receptive when speaking with her, understood what Oakley was telling her, and knew Oakley was there to help her. Oakley also testified that B.R. knew the difference between the truth and a lie and was consistent in her disclosures about what happened to S.W. Oakley's foundational testimony sufficiently established that B.R. understood Oakley's role such that she was motivated to provide truthful information. The trial court did not err in admitting B.R.’s statements as statements made for medical diagnosis or treatment.

[17] Even so, the admission of B.R.’s statements was harmless. When an appellate court determines whether a non-constitutional error was harmless, Indiana Appellate Rule 66(A)’s “probable impact test” controls. Hayko v. State, 211 N.E.3d 483, 492 (Ind. 2023), reh'g denied, cert. denied. In conducting our review under this test, “we consider the likely impact of the improperly admitted or excluded evidence on a reasonable, average jury in light of all the evidence in the case.” Id. “[T]he error's probable impact is sufficiently minor when—considering the entire record—our confidence in the outcome is not undermined.” Id.

[18] Our confidence in the outcome is not undermined here. To begin, B.R.’s statements that “Mommy was mad at [S.W.]” and “Mommy threw [S.W.]” weren't relevant to the elements of the neglect charge; rather, they bore on the domestic-battery charges, on which the jury couldn't reach a verdict. And looking at the entire record, there was ample evidence beyond B.R.’s statements to convict Ragan of neglect of a dependent resulting in serious bodily injury. When Ragan came home from H.R.’s procedure, Norman told her that S.W. had fallen out of his booster seat and fell face-first onto a large plastic toy, but Ragan didn't say anything or ask if S.W. was hurt. Ragan noticed that S.W. had new bruises, a gash on his cheek, and a bleeding wound on his nose but “just went about the rest of the day” and didn't seek medical care for S.W.’s injuries. Ragan testified that when S.W. lost consciousness that night, she “[tr]ied ․ to [s]hake” him, but “he wasn't moving” and “was turning a little blue.” She admitted that she didn't call 911 or perform CPR on S.W. even though she knows CPR. Instead, she called Ankrom and waited outside for Ankrom to come over, leaving S.W. inside unconscious. S.W. received medical care only after Nunnelly performed CPR and Ankrom called 911. He had cuts, scratches, and bruises all over his body, compression fractures in his spine, bilateral subdural hematomas, a concussion, a liver injury, and a deep laceration under his tongue. Dr. Demetris concluded that “the only plausible medical diagnosis that would account for” these injuries “is child physical abuse.” And S.W.’s injuries were so serious that he was in the hospital for a month. The admission of B.R.’s statements was harmless.

II. Ragan's sentence is not inappropriate

[19] Ragan also asks us to reduce her sentence under Indiana Appellate Rule 7(B), which provides that an appellate court “may revise a sentence authorized by statute if, after due consideration of the trial court's decision, the court finds that the sentence is inappropriate in light of the nature of the offense and the character of the offender.” The court's role under Rule 7(B) is to “leaven the outliers,” and “we reserve our 7(B) authority for exceptional cases.” Faith v. State, 131 N.E.3d 158, 160 (Ind. 2019). “Whether a sentence is inappropriate ultimately turns on the culpability of the defendant, the severity of the crime, the damage done to others, and a myriad of other factors that come to light in a given case.” Thompson v. State, 5 N.E.3d 383, 391 (Ind. Ct. App. 2014) (citing Cardwell v. State, 895 N.E.2d 1219, 1224 (Ind. 2008)). Because we generally defer to the judgment of trial courts in sentencing matters, defendants must persuade us that their sentences are inappropriate. Schaaf v. State, 54 N.E.3d 1041, 1044-45 (Ind. Ct. App. 2016).

[20] Ragan was convicted of Level 3 felony neglect of a dependent resulting in serious bodily injury. The sentencing range for a Level 3 felony is 3 to 16 years, with an advisory sentence of 9 years. Ind. Code § 35-50-2-5(b). The trial court sentenced Ragan to an above-advisory term of 15 years. Rather than addressing the nature of her offense or her character, Ragan spends most of her sentencing argument challenging the trial court's balancing of the aggravators and mitigators. See Appellant's Br. pp. 11, 17-18. But the weight given to aggravators and mitigators is not reviewable on appeal. See Anglemyer v. State, 868 N.E.2d 482, 491 (Ind. 2007) (“The relative weight or value assignable to reasons [for imposing a particular sentence] ․ is not subject to review for abuse.”), clarified on reh'g, 875 N.E.2d 218 (Ind. 2007).

[21] In any event, the nature of Ragan's offense alone supports an above-advisory sentence. The trial court put it best when it said “what [S.W.] had to endure during the fifty (50) some days in the care of Defendant was jarring, it was unimaginable, it was sad, and it was criminal.” Tr. Vol. 5 p. 35. S.W. had cuts, scratches, and bruises of varying ages all over his body, compression fractures in his spine, bilateral subdural hematomas, a concussion, a liver injury, and a laceration under his tongue so deep that air went through the wound and “into the subcutaneous tissues of his left-sided jaw and neck.” On the night of the incident, when Ragan saw S.W. unalert and turning blue, she tried to shake him, but he didn't move. She didn't call 911 or perform CPR even though she knew how. Instead, she waited in the front yard for Ankrom and Nunnelly to come over, leaving S.W., her three-year-old step-grandson, unconscious on the floor inside alone. As the trial court put it, S.W. “was in the care of someone who should've been keepin[g] him the safest, a grandparent.” Id. But rather than keeping S.W. safe, Ragan all but left him for dead. Nothing about the nature of Ragan's offense makes her sentence inappropriate.

[22] The only facet of her character Ragan addresses is that she has no criminal history. The trial court recognized as much. And while we agree that Ragan's lack of criminal history is mitigating, given the egregious nature of the offense, Ragan has failed to persuade us that her 15-year sentence is inappropriate.

[23] Affirmed.

FOOTNOTES

1.   Although the charging information didn't specify the basis for the neglect charge, the State argued during closing that Ragan committed Level 3 felony neglect of a dependent resulting in serious bodily injury both when she came home and saw S.W.’s injuries but “left [him] in that condition” and when she “left [S.W.] unconscious” and “[f]ailed to render aid to him.” Tr. Vol. 4 p. 146. And both domestic-battery charges were based on B.R.’s disclosure that Ragan “threw” S.W. See id. at 143-44, 147.

2.   In November 2024, Ragan pled guilty to Level 3 felony domestic battery resulting in serious bodily injury to a person under 14, and the State dismissed the remaining count for Level 6 felony domestic battery. The trial court sentenced Ragan to 10 years in the Department of Correction to be served concurrent to Ragan's sentence for Level 3 felony neglect of a dependent resulting in serious bodily injury. See Cause No. 74C01-2401-F3-46 (Nov. 20, 2024 CCS entry).In December 2024, the State charged William with two counts of Level 3 felony neglect of a dependent resulting in serious bodily injury for the events of July 2023 based on his testimony in his deposition, at trial, and at the sentencing hearing in Ragan's case. See Cause No. 74C01-2412-F3-653; see also Cause No. 62C01-2507-F3-502 (change of venue). Trial is set for November 2025.

Vaidik, Judge.

Judges Tavitas and Felix concur. Tavitas, J., and Felix, J., concur.