State v. Welch is not applicable to the Crystal Mangum case

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Much hullabaloo has been raised recently about the North Carolina Appellate Supreme Court ruling of November 2, 1999 in the case, State v. Welch. This ruling has been twisted and wrangled by a few of the commenters of this blog site in an attempt to essentially place blame for all events occurring at Duke University Hospital on Crystal Mangum.

Yes, Crystal Mangum, the Duke Lacrosse victim/accuser did stab Reginald Daye in the left side of his torso during the wee hours of Sunday, April 3, 2011, but that injury was far from being the proximate cause of his death… nor was it an intervening or contributory cause.

The appellate ruling by Honorable Judge Timmons-Goodson is actually one with which I concur. My position is that the State v. Welch case, though containing a few similarities with that of Mangum’s case, is markedly different with respect to essential conditions. Furthermore, the commenters to this blog site have taken the liberty to stretch far beyond logical bounds the findings and conclusions drawn by the black rober.

To begin with, we’ll acquaint you with the case of the State of North Carolina v. Theondra Ozell Welch, and then draw comparisons and contradictions with the Magnum case.

In the latter part of 1996, Theondra Ozell Welch had shared a residence in Sanford, North Carolina, with his girlfriend Martina Lemmons for approximately nine months… the past few months having been troubled.

On December 17, 1996, according to a report given to police by Mr. Welch, sometime after he arrived home around 5:00 pm, his girlfriend began to repeatedly refer to him using the “n-word” epithet. She then used her cell phone to converse with another man in front of Welch, which, he later admitted to police, made him angry.

He then grabbed a six inch kitchen knife which he stated that he carried for protection and stabbed her… once to his recollection, then shortly thereafter helped transport her to the emergency room for help.

The surgeon observed multiple stab wounds to her upper extremities and torso, which included one to the left chest wall. Ms. Lemmons’ vital signs and other physical findings indicated to the surgeon that she had lost a substantial amount of blood, and the doctor wanted to begin transfusing blood. However, Ms. Lemmons was a Jehovah’s Witness and in compliance with that religion’s mandates, she refused. Physicians waited until she had been placed under anesthesia and then tried to get consent for the transfusion from the patient’s mother and brother. It was unsuccessful as they too belonged to that religion.

Martina underwent surgery to treat her injuries, and following surgery her condition was stable, however she deteriorated as complications set in which the doctor believed were due to the lack of oxygen in her blood stream. Unfortunately, she she eventually passed away.

The surgeon stated that she probably would have survived her injuries had she accepted a transfusion when initially offered, but stated that he could not have made a guarantee on that point.

On February 3, 1997, Theondra Ozell Welch was indicted for first degree murder in the death of his girlfriend Martina Lemmons.

In comparing this case with Mangum’s, the similarities are that both couples were living together, Welch-Lemmons for about nine months, and Daye-Mangum for about one month.

Arguments preceded both acts of violence, and the source being the same… uncontrolled rage because the women had been conversing with another man. Prior to the argument with Daye, Mangum had spoken with a Durham police officer who was in the parking lot on an unrelated call.

Both women were victims of domestic violence with Lemmons being stabbed with a six inch kitchen knife, and Mangum being hit, her hair pulled out of her scalp, fingernail gouges to her face, and a locked bathroom door busted off its frame by Daye. Mangum claims that Daye was choking her when she grabbed a knife lying nearby and stabbed him once.

Although Lemmons received potentially life threatening injuries and sustained serious blood loss, Mangum’s injuries were not life threatening, and the stab wound she inflicted on Daye in self-defense was non-life threatening.

The autopsy report and hospital records of Ms. Lemmons are not available, so I am unaware of any pre-existing health condition or medical malpractice incident that may have contributed to her death.

Reginald Daye, however was a heavy alcoholic, and was heavily intoxicated on his admission to Duke University Hospital. Records show the medical staff recognized the threat of alcoholic withdrawal, and began administering sedatives early in his hospitalization.

Regarding malpractice, there is none related to Ms. Lemmons’ treatment according to the sparse amount of information available. Malpractice is an integral part of Daye’s treatment as esophageal intubation is a gross and life threatening mishap by a health care provider.

There is no doubt that the esophageal intubation led to anoxia, and subsequently Daye’s brain death. Likewise, his dire neurological prognosis without hope of any recovery was the determinant to remove Daye from life support… and it was the removal of life support that was the proximate cause of Reginald Daye’s death.

For purposes of elucidation, the definition of “proximate cause” will be given attention. Simply, it is defined thusly: An act from which an injury results as a natural, direct, uninterrupted consequence and without which the injury would not have occurred.

Although commonly used in reference to injuries due to alleged negligence in tort cases, we will use its application in the criminal case regarding Reginald Daye’s death.

The proximate cause of Daye’s brain death was clearly the errantly placed endotracheal tube that was introduced into his esophagus instead of trachea. Its wrong placement was the direct cause of lack of oxygen to the brain cells and cells throughout his body… and it was the lack of oxygen to the brain cells that resulted in his brain death. Consequently, the mis-positioned tube was also the direct cause of Daye’s cardiac arrest.

Had the initial intubation been tracheal instead of esophageal, then Daye would not have become brain dead and would not have lapsed into cardiac arrest. Both events were due to the wrongful placement of the endotracheal tube.

The stab wound was the proximate cause of injuries to Daye’s colon and spleen. Injuries from the stabbing were not considered to be fatal… as his stable condition provided the trauma surgeons with the luxury of performing CAT scans and other diagnostic examinations preoperatively. The surgery was a success and Mr. Daye had a prognosis for a full recovery.

To review, the proximate cause of Daye undergoing surgery on April 3, 2011, was the stab wound inflicted by Mangum.

The proximate cause of Daye’s brain death and cardiac arrest on April 6, 2011, was the esophageal intubation by Duke University Hospital staff.

The proximate cause of Reginald Daye’s actual death was his removal from life support on April 13, 2011, by Duke University Hospital staff.

Finally, the proximate cause of Reginald Daye’s transfer to the Surgical Intensive Care Unit was delirium tremens… a result of his alcoholic intoxication on admission and his history of alcoholism.

Mangum’s actions in stabbing Daye were responsible only for him undergoing surgery on April 3, 2011, which was uneventful and successful. The wound she inflicted to Daye had nothing to do with circumstances that occurred later in his hospitalization and included his lapsing into delirium tremens and transfer to the SICU, his brain death, his cardiac arrest, his removal from life support, and his actual death. For these events, Mangum is without liability.

Now, let’s apply law to the cases. In State v. Welch, the defendant alleges that his stabbing of Ms. Lemmons was not the act that was responsible for her death. He claims that she died because she refused to accept blood transfusions, and he cites the statements made by the surgeon. Defendant Welch claimed that had the victim accepted the transfusions early on, she would have survived… defining her refusal of this potentially life saving treatment as an intervening cause which led to her death. Put another way, had she allowed the transfusion of blood to take place, she would have lived.

In response to this argument, Judge Timmons-Goodson replied, “But for the defendant’s act of stabbing the victim, she would not have been in need of a transfusion.”

I full heartedly agree with the judge’s statement which is direct and limited. Specifically, it is noted that the defendant’s action of stabbing the victim was directly related to the treatment she required and refused. In Mangum’s case, however, the stabbing had nothing to do with the events that transpired later in Daye’s hospitalization, such as the esophageal intubation.

Commenters have also tried to broaden the scope of the judge’s statement. Keep in mind, the black rober did not state, “But for the defendant’s act of stabbing the victim, she would not have required hospitalization.”

Therefore, the commenter’s argument that claims that Mangum is responsible for every action and event that takes place during Daye’s hospitalization is not supported by this case. The ruling is specific and limited to the transfusion, as the defendant Welch is arguing that Ms. Lemmons’ refusal of the procedure was responsible for her death.

Also, neither the defendant nor judge state or suggest that malpractice had a role in the transfusion not being given… the word “malpractice” not even mentioned in Judge Timmons-Goodson’s decision.

Malpractice during the intubation of Daye, however, was an intervening and proximate cause of Daye’s brain death. This completely relieves Mangum of culpability in Daye’s brain death by Judge Timmons-Goodson’s statement that, “To escape responsibility based on an intervening cause, the defendant must show that the intervening cause was the sole cause of death,” or in Mangum’s case, “brain death.” Daye’s brain death would not have occurred without the esophageal intubation by Duke University Hospital staff.

Another argument used by the judge in the Welch case is that the doctor stated that he could not have guaranteed that the stabbing victim would have survived had she received a timely transfusion.

In Mangum’s case however, Daye’s prognosis by surgeons was for a full recovery. It was the independent and intervening act of an esophageal intubation that was the proximate cause of Daye’s brain death, and his elective removal from life support that was the proximate cause of his actual death.

Too many differences exist between the Mangum and Welch cases for there to be applicable case law. The Welch case decision is far more restrictive, defined, and limited than commenters to this blog site want to recognize.

I concur with the findings and decision of the State Supreme Court on State v. Welch, and believe it only strengthens the argument that Crystal Mangum is neither responsible for Reginald Daye’s brain death nor his actual death. 