Commonwealth v. Walters, P., Aplt.
Supreme Court of Pennsylvania
Todd, Chief Justice Debra
Commonwealth v. Walters, P., Aplt.
Opinion
[J-57-2023]
IN THE SUPREME COURT OF PENNSYLVANIA
MIDDLE DISTRICT
TODD, C.J., DONOHUE, DOUGHERTY, WECHT, MUNDY, BROBSON, JJ.
COMMONWEALTH OF PENNSYLVANIA, : No. 102 MAP 2022
:
Appellee : Appeal from the Order of the
: Superior Court dated April 5, 2022
: at No. 446 MDA 2021 Affirming the
v. : Judgment of Sentence of the
: Wyoming County Court of Common
: Pleas, Criminal Division, dated
PHILLIP DONALD WALTERS, : December 10, 2020 at No. CP-66-
: CR-0000058-2019.
Appellant :
: ARGUED: October 18, 2023
OPINION
CHIEF JUSTICE TODD DECIDED: September 23, 2024
In this appeal by allowance, we consider whether the trial testimony of the
Commonwealth’s expert, a pathologist who opined that the victim’s cause of death was
“strangulation by history,” was offered to a reasonable degree of medical certainty, the
requisite standard for admissibility of this type of expert testimony. We find that it was
not, and, for reasons discussed below, conclude that Appellant Phillip Walters is entitled
to a new trial.
At approximately 5:15 p.m. on December 30, 2018, Appellant called 911 to report
that his girlfriend, 24-year-old Hayley Lorenzen, was missing. Lorenzen had recently
moved into Appellant’s apartment, which Appellant shared with his 10-year-old son.
According to Appellant, the three had stayed up late the prior evening, and, when
Appellant awoke, he discovered that Lorenzen was not in the apartment. Appellant
indicated that, prior to calling 911, he contacted Lorenzen’s father to see if he had heard
from her; when her father stated that he had not heard from her, Appellant decided to
contact the police. Apparently being advised that he needed to wait 24 hours to report a
person missing, Appellant contacted the police at approximately the same time on the
following day, December 31, 2018. On January 1, 2019, the police met Appellant at his
residence to complete a missing person report, and Appellant showed the police several
of Lorenzen’s belongings, such as her clothing.
On January 9, 2019, an attorney for Gabel Bell (“Bell”) contacted the Wyoming
County District Attorney’s Office, indicating that his client had information regarding
Lorenzen’s death. During a subsequent interview with the Pennsylvania State Police,
Bell stated that Appellant killed Lorenzen. Bell explained that she met Appellant online in
September 2018, and they began a sexual relationship, typically communicating through
text messages, although they also met in person. According to Bell, the relationship
involved the infliction of physical pain for sexual pleasure, and dark fantasies, including
the fantasy of Appellant choking and killing Bell. Bell ended the relationship in October,
when Lorenzen moved in with Appellant, but resumed it after a few weeks. However, in
November, Bell told Appellant that she did not want to be in a relationship with someone
who was living with someone else. Appellant told her he was “working on” breaking up
with Lorenzen. N.T., 10/21/20, at 13. On December 27, 2018, Bell and Appellant were
texting each other about a sexual fantasy, and Appellant asked Bell to describe how she
would kill Lorenzen and how they would dispose of her body; Bell claimed Appellant
specifically mentioned throwing Lorenzen’s body into the river. Id. at 17. Bell stated that,
on December 29, 2018, she texted Appellant to end their relationship.
According to Bell, on the morning of December 30, 2018, Appellant sent her a
series of text messages stating that he and Lorenzen had been drinking the night before,
and that he had wanted to hurt her. Appellant asked Bell to stop texting and switch to
[J-57-2023] - 2
Snapchat, so that their messages would disappear after a short period of time. Appellant
then sent Bell a picture of Lorenzen lying on the bathroom floor, suggesting that “she
might be hurt or she might even be dead.” Id. at 21. Appellant asked Bell to come to his
home, and Bell immediately went to Appellant’s apartment and observed that Lorenzen
was dead. She stated that Appellant told her he attempted to choke Lorenzen and break
her neck while she was asleep, but that she woke up and became upset and nauseous
and went into the bathroom, and that, as Lorenzen leaned over the toilet, Appellant struck
her on the back of the head with a hammer and choked her to death. Bell stated that
Appellant instructed her to remove a necktie that he had tied around Lorenzen’s neck and
clean the apartment, and she complied. Appellant then placed plastic grocery bags
around Lorenzen’s hands and face, and placed her body into the trunk of his car, tying
trash bags containing rocks around her body. Bell then rode with Appellant to a nearby
bridge, where Appellant threw Lorenzen’s body into the river. Based on the information
provided by Bell, Appellant was arrested and charged with first-degree murder. 1
On July 20, 2019, Lorenzen’s remains were found in the Susquehanna River, and
the Commonwealth subsequently amended the criminal information to include charges of
strangulation 2 and abuse of a corpse. 3 At trial, in addition to the above-described
testimony of Bell, the Commonwealth presented, inter alia, the testimony of the director
of 911 for Wyoming County, who testified regarding the calls he received from Appellant;
and the testimony of Appellant’s upstairs neighbor, who testified that, while she usually
saw Appellant dressed in shorts and a t-shirt, on the days following December 30, 2018,
she saw him wearing long sleeves, and that Appellant texted her to see if she had seen
Lorenzen. The Commonwealth also presented the testimony of several individuals,
1 18 Pa.C.S. § 2502(a).
2 Id. § 2718(a)(1).
3 Id. § 5510.
[J-57-2023] - 3
including a friend of Appellant and Lorenzen’s father, indicating that Appellant contacted
them on December 30, 2018 to see if they had heard from Lorenzen.
Various law enforcement officials testified regarding their interviews with Appellant,
his son, and Bell, as well as their search of Appellant’s residence. Additionally, a forensic
specialist testified that he tested a red stain found in Appellant’s bathtub, but that it
testified negative for human blood. The forensic specialist explained that he used
“Bluestar,” a substance similar to luminol, to test for blood on other areas of the bathroom,
and that the testing revealed luminescence on the door handle, sink, tub, floor, and some
of the walls. However, the specialist conceded that Bluestar can result in false positives,
particularly if there is an animal present in the area, and he acknowledged that Appellant
had a dog. The forensic specialist also stated that, prior to using Bluestar, he inspected
the bathroom, including the walls, sink, toilet, tub, and plumbing, and it appeared that it
had “been a long time since they were cleaned.” N.T., 10/22/20, at 186.
Finally, the Commonwealth presented the testimony of Dr. Gary Ross, the
pathologist who conducted an autopsy of Lorenzen’s body. Dr. Ross testified that, at the
time Lorenzen’s body was discovered, it was “in a very advanced state of decomposition”;
that there “was almost complete skeletonization of the head and neck organs”; 4 and that
he “didn’t see evidence of any overt injury on the body per se externally when [he]
examined it.” Id. at 18.
Nevertheless, Dr. Ross testified that it was his conclusion that Lorenzen “died by
strangulation which was by history.” Id. at 31. Specifically, he stated:
[t]here was no anatomic indication that she was actually
strangled. If I looked at the body alone without any history, I
could not say that. It would have to be an undetermined
4 “Skeletonization” is defined as extreme emaciation, or the removal of soft parts from the
skeleton. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied
Health (7th ed.).
[J-57-2023] - 4
death. . . . I had no physical actual evidence that a
strangulation occurred other than the history. The history to
me was very important because I saw no other possible cause
of death either.
Id. at 31-32.
On cross-examination, Dr. Ross explained that he “determined the cause and
manner of death by history and the exclusion of everything else from the autopsy.” Id. at
48. He clarified that “somebody else’s statements are the history. And that’s what I refer
to. And that’s what I based my findings largely upon.” Id. at 49. The statements Dr. Ross
relied on were Bell’s. 5 Dr. Ross reiterated that there was “no physical evidence to
support” a determination that Lorenzen’s death was the result of strangulation. Id. at 53.
The jury convicted Appellant of the aforementioned offenses, and he was
sentenced to life imprisonment without parole. Appellant filed a post-sentence motion,
arguing, inter alia, that the trial court erred in allowing Dr. Ross to offer an opinion
regarding Lorenzen’s cause of death because his conclusions were not rendered to a
reasonable degree of medical certainty, and, in fact, were not medical conclusions at all,
as they were based solely on Bell’s account of the events. The trial court denied
Appellant’s post-sentence motion, and, in its opinion in support thereof, stated:
Dr. Ross testified to a reasonable degree of medical certainty
that Ms. Lorenzen’s death was strangulation, by history.
There was certainly adequate testimony from numerous other
witnesses regarding the cause of Ms. Lorenzen’s death and
as such, the jury was able to conclude beyond a reasonable
doubt that the cause of death was strangulation.
Trial Court Opinion, 3/11/21, at 7.
Appellant appealed his judgment of sentence to the Superior Court, arguing, inter
alia, that Dr. Ross’ testimony that the cause of Lorenzen’s death was strangulation by
history was not based on objective medical findings and was not rendered to a reasonable
5 Bell’s testimony was the only testimony stating that Lorenzen had been strangled.
[J-57-2023] - 5
degree of medical certainty; further, he argued that Dr. Ross’ testimony improperly
bolstered the credibility of Bell. The Superior Court affirmed Appellant’s judgment of
sentence in a unanimous, unpublished memorandum opinion. Commonwealth v.
Walters, 2022 WL 1016624(Pa. Super. filed Apr. 5, 2022). In rejecting Appellant’s argument that Dr. Ross’ opinion as to Lorenzen’s cause of death was not rendered to a reasonable degree of medical certainty because it was based solely on Bell’s account of the victim’s death, the Superior Court posited that our precedent permits a medical examiner to rely on case history in formulating an opinion on cause of death, specifically noting that, in Commonwealth v. Bullock,913 A.2d 207
(Pa. 2006), we
wrote with apparent approval of the coroner’s reliance on case
history to arrive at a cause of death: “At trial, the coroner
stated that [the victim’s] cause of death was ‘strangulation by
history,’ which refers to the events immediately preceding the
death, […] this conclusion was apparently based, in part, upon
the occurrences as related by Appellant in his statement to
police.”
Walters, 2022 WL 1016624at *6 (quoting Bullock,913 A.2d at 211
) (alterations original). Thus, the Superior Court rejected Appellant’s argument that, because the trial court allowed Dr. Ross “to consider Bell’s account of the victim’s death,” his opinion as to cause of death did not meet the admissibility standard for expert testimony. Walters,2022 WL 1016624
at *6.
The Superior Court also rejected Appellant’s argument that Dr. Ross’ testimony
improperly bolstered Bell’s credibility. In particular, the court noted that Dr. Ross testified
that he was unable to determine if Lorenzen had suffered neck trauma, and, therefore,
his testimony, in fact, did not corroborate Bell’s claim that Lorenzen had been strangled.
The court further highlighted that Dr. Ross testified that he saw no evidence that
Lorenzen’s bones were broken, which he would expect if, as Bell claimed, she had been
dropped from a bridge, depending on the length of the drop; nor did he observe any
[J-57-2023] - 6
fractures of Lorenzen’s skull, which would corroborate Bell’s testimony that Lorenzen had
been hit on the head with a hammer.
Appellant filed a petition for allowance of appeal with this Court, and we granted
review to consider whether the trial court should have excluded Dr. Ross’ expert
testimony regarding Lorenzen’s cause of death on the basis that it was not offered within
a reasonable degree of medical certainty, and whether Dr. Ross’ testimony improperly
bolstered the credibility of Bell. 6
Preliminarily, we note that the admission of evidence is solely within the discretion
of the trial court, and a trial court's evidentiary rulings will be reversed on appeal only
upon an abuse of that discretion. Commonwealth v. Le, 208 A.3d 960, 970(Pa. 2019). An abuse of discretion is not simply an error of judgment, but is an overriding misapplication of the law, or the exercise of judgment that is manifestly unreasonable, or the result of bias, prejudice, ill-will, or partiality. Commonwealth v. Talley,265 A.3d 485
,
530 (Pa. 2021).
Rule 702 of our Rules of Evidence provides that expert testimony is generally
admissible if: the witness has a specialized knowledge beyond that possessed by the
6 Although Justice Dougherty agrees with our determination that Dr. Ross’ opinion that
the victim was strangled “was not offered within a reasonable degree of medical certainty
and should have been excluded at trial,” he indicates that he is unable to join our holding
that Dr. Ross’ testimony impermissibly encroached upon the jury’s determination of Bell’s
credibility because Appellant waived this claim as he did not raise it at trial. Concurring
and Dissenting Opinion (Dougherty, J.) at 2. However, as Justice Dougherty observes,
the Commonwealth does not argue that Appellant waived this claim. Id. at 4. Further, in
his brief on appeal to the Superior Court, Appellant included this specific argument in his
challenge to the admission of Dr. Ross’ testimony, and the Superior Court addressed this
claim. Finally, in response to Appellant’s petition, this Court granted review to determine
whether the Superior Court erred in admitting Dr. Ross’ testimony “which was devoid of
any objective medical findings and did not comport with a conclusion or opinion ‘within a
reasonable degree of medical certainty’ thereby not only improperly bolstering the
credibility of Gabel Bell but depriving [Appellant] of his right to due process and a fair trial.”
Commonwealth v. Walters, 286 A.3d 710 (Pa. filed Oct. 18, 2022) (order). Accordingly,
we are disinclined to sua sponte find this issue to be waived.
[J-57-2023] - 7
average layperson; such knowledge will help the trier of fact to understand the evidence
or determine a fact in issue; and the expert’s methodology is generally accepted in the
relevant field. Pa.R.E. 702; 7 see also Commonwealth v. Maconeghy, 171 A.3d 707, 712(Pa. 2017). An expert may not, however, opine on issues relating to the credibility of witnesses, as the determination of witness credibility is exclusively for the finder of fact.Id.
(holding that doctor’s expert opinion that a child was sexually abused, which was
based solely on witness accounts and not physical findings, was inadmissible because
his opinion invaded the jury’s province as the sole arbiter of witness credibility).
In addition to meeting the above general requirements for expert testimony, in
order for a medical opinion regarding an individual’s cause of death to be considered by
the trier of fact, it must be shown that the expert “entertained a reasonable degree of
medical certainty for his conclusions.” Commonwealth v. Williams, 316 A.2d 888, 891(Pa. 1974). An expert’s opinion regarding cause of death is offered within a reasonable degree of medical certainty when it is based on medical observations and conclusions. See, e.g., Commonwealth v. Spotz,756 A.2d 1139, 1160
(Pa. 2000) (as pathologist
7 Rule 702 provides:
A witness who is qualified as an expert by knowledge, skill,
experience, training, or education may testify in the form of an
opinion or otherwise if:
(a) the expert’s scientific, technical, or other specialized
knowledge is beyond that possessed by the average
layperson;
(b) the expert’s scientific, technical, or other specialized
knowledge will help the trier of fact to understand the evidence
or to determine a fact in issue; and
(c) the expert’s methodology is generally accepted in the
relevant field.
Pa.R.E. 702.
[J-57-2023] - 8
“clearly explained the medical basis for all of his conclusions . . . it is clear that his opinions
were based upon a reasonable degree of medical certainty”); Commonwealth v. Davido,
106 A.3d 611, 628-29 (Pa. 2014) (in holding appellant failed to demonstrate
ineffectiveness of counsel based on counsel’s failure to challenge pathologist’s expert
testimony as unreliable, we observed that pathologist’s determination as to cause of
death, offered within a reasonable degree of medical certainty, was based on a number
of “observable factors”).
Appellant maintains that Dr. Ross’ expert opinion as to Lorenzen’s cause of death
was not offered within a reasonable degree of medical certainty, and, thus, was
inadmissible, because it was not based on objective medical findings, and, further, “could
not be drawn from even the process of elimination . . . due to decomposition” of
Lorenzen’s body. Appellant’s Brief at 31. In this regard, Appellant highlights Dr. Ross’
testimony that, in light of the body’s advanced stage of decomposition, he was unable to
detect from an external examination any signs of overt injury, such as knife or gunshot
wounds, or needle marks; that he was unable to observe any signs of bleeding or trauma
to the brain because it was necrotic and liquified, so much so that, although he took tissue
samples, they would not have been interpretable; that, although he suspected, based on
his internal examination of the body, that Lorenzen did not suffer from heart, lung, liver,
or other such diseases, his findings were “questionable” due to the necrotic state of the
organs; and that he was unable to observe any sign of injury to the head and neck area
because they were skeletonized and the cartilage structures were missing due to
decomposition. Id. at 32.
Appellant further emphasizes that, in explaining the basis for his opinion that
Lorenzen’s cause of death was “strangulation which was by history,” Dr. Ross conceded:
[t]here was no anatomic indication that she was actually
strangled. If I looked at the body alone without any history, I
[J-57-2023] - 9
could not say that. It would have to be an undetermined
death. . . . I had no physical actual evidence that strangulation
occurred other than the history. The history to me was very
important because I saw no other possible cause of death
either.
N.T., 10/26/20, at 31-32.
Appellant additionally challenges the Superior Court’s reliance on this Court’s
decision in Bullock. In Bullock, the appellant went to the police department and reported
that, approximately one week earlier, he strangled his pregnant girlfriend to death and
placed her body in a closet in their apartment. The appellant was charged with third-
degree murder and voluntary manslaughter. At trial, the coroner testified that, based on
the autopsies of the victim and her unborn child, the victim’s cause of death was
“strangulation by history,” a conclusion that “was apparently based, in part, upon the
occurrences as related by Appellant in his statement to police.” 913 A.2d at 211. The
appellant was found guilty but mentally ill, and was sentenced to an aggregate term of 20
to 60 years imprisonment. He appealed to the Superior Court, which affirmed. On further
review, we affirmed; we did not, however, address the admissibility of the coroner’s
testimony. Appellant avers that Bullock is distinguishable from the instant case because
the appellant therein admitted to strangling the victim, whereas Appellant denies harming
Lorenzen; further, he notes that the admissibility of the pathologist’s opinion in Bullock
was neither raised by the appellant, nor addressed by this Court.
Instead, Appellant suggests that this case is “more akin” to the Superior Court’s
decision in Commonwealth v. Passmore, 857 A.2d 697 (Pa. Super. 2004). Appellant’s
Brief at 39. In Passmore, the appellant, charged with the kidnapping and murder of his
ex-girlfriend, pled guilty to murder generally. At a subsequent degree of guilt hearing, a
pathologist testified that, although she was unable to observe any evidence of traumatic
injury due to the advanced decomposition of the body, she was able to eliminate various
causes of death and, based on information from the crime scene, her examination of the
[J-57-2023] - 10
body, the toxicology report, and the discovery of a pillow case containing blood and saliva
that matched the victim’s DNA, opined that the victim’s cause of death was “most likely”
and “probably” asphyxia. Passmore, 857 A.2d at 713. The trial court convicted the
appellant of second-degree murder, and he appealed to the Superior Court, challenging,
inter alia, the weight of the evidence for his kidnapping conviction. 8 Relevant herein, the
appellant argued that the trial court should not have considered the pathologist’s opinion
as to the victim’s cause of death because it was not offered within a reasonable degree
of medical certainty.
The Superior Court agreed with the appellant that the pathologist’s use of the term
“probably” to qualify her medical opinion directly contravened her claim that her opinion
was rendered with “reasonable certainty.” Id.(citing Commonwealth v. Stoltzfus,337 A.2d 873
(Pa. 1975) (holding admission of medical expert’s testimony as to cause of death was proper because expert testified emphatically and without qualification as to cause of death); Commonwealth v. Radford,236 A.2d 802
(Pa. 1968) (holding medical
expert’s testimony as to cause of death was insufficient to establish legal causation
because he stated defendant’s assault on victim “probably” caused his death)). Notably,
however, the court in Passmore determined that the admission of the pathologist’s
testimony was harmless error in light of the fact that the appellant admitted to killing the
victim, and that the method of the victim’s murder was immaterial to the appellant’s
conviction for second-degree murder.
Appellant also discusses at length the Iowa Supreme Court’s decision in State v.
Tyler, 867 N.W.2d 136 (Iowa 2015), wherein the court held, inter alia, that an expert’s
opinion on the cause and manner of a newborn baby’s death was inadmissible because
8 The appellant’s conviction for second-degree murder was based on his conviction for
felony kidnapping.
[J-57-2023] - 11
it was not sufficiently based on objective medical findings, but on the defendant’s
conflicting statements to police. The appellant in Tyler hid her pregnancy from her family
and gave birth in a hotel room. Housekeeping staff eventually discovered the deceased
newborn in a trash can. When interviewed by police, the appellant gave inconsistent
statements, first stating that the baby was stillborn, and then stating that it was born alive,
crying and moving, at which time she placed him in the bathtub and drowned him. At the
appellant’s trial, a pathologist testified that the cause of the newborn’s death was
drowning, and the manner of death was homicide. However, the pathologist admitted
that his opinion on the cause and manner of death was based primarily, if not exclusively,
on the appellant’s uncorroborated statements to police, as opposed to objective medical
findings. See id. at 164 (noting pathologist’s statement that “without the witness
statements, I could not have diagnosed drowning in this case”). The Iowa Supreme Court
concluded that the pathologist’s opinion was not sufficiently based on objective medical
findings, and, further, that his testimony amounted to impermissible commentary on the
appellant’s credibility.
Along these lines, Appellant likewise contends that Dr. Ross’ opinion improperly
bolstered and vouched for the credibility of Bell. He submits that this Court has
consistently prohibited such testimony on the basis that it “encroaches upon the province
of the jury and improperly and unfairly enhances the credibility of the witness.” Appellant’s
Brief at 53 (citing Commonwealth v. Seese, 517 A.2d 920(Pa. 1986); Commonwealth v. Balodis,747 A.2d 341
(Pa. 2000); and Commonwealth v. Hernandez,615 A.2d 1337
(Pa.
Super. 1992)). With respect to the Superior Court’s determination that, because Dr. Ross
admitted he found no objective evidence to substantiate Bell’s claim that Lorenzen was
strangled, his testimony did not impermissibly bolster Bell’s credibility, Appellant suggests
that the court overlooked the fact that Dr. Ross admitted that he relied on Bell’s
[J-57-2023] - 12
statements for his opinion that Lorenzen was, in fact, strangled. Id. Thus, Appellant
submits that, under this Court’s decision in Maconeghy, Dr. Ross was precluded from
offering an opinion that was based solely on information provided by Bell, rather than his
objective physical findings.
In response, the Commonwealth, highlighting the liberal standard for qualification
of expert witnesses, argues that the admission of Dr. Ross’ testimony was proper
because it was “based on both historical data as well as objective findings through
autopsy and the process of elimination,” which the Commonwealth suggests is “standard
practice in the field of forensic pathology, and falls outside the ken of the average lay
person.” Commonwealth’s Brief at 13 (emphasis omitted). The Commonwealth further
submits that, on several occasions, Pennsylvania courts have approved the admission of
expert testimony regarding the cause of death that was based on anecdotal history. Id.at 14-15 (citing Bullock and Williams). 9 9 In Williams, the appellant was charged with the first-degree murder of a wheelchair- bound woman with whom she lived. The victim’s remains were discovered in the residue of a fire. At the appellant’s trial, a medical pathologist testified that, “in his opinion based on a reasonable degree of medical certainty, death was caused by burning and asphyxiation.”316 A.2d at 891
. The pathologist stated that “he arrived at this conclusion by the absence of any other evidence of major trauma sufficient to cause death except the fire.”Id.
The pathologist admitted that the condition of the body “did not permit him to exclude all possible causes of death unrelated to trauma but reasoned that the attempt to conceal the body suggested a cause of death other than one of natural means.”Id.
The trial court excluded the testimony on the basis that the pathologist “had not testified to the cause of death using the standard of reasonable doubt.”Id.
In the instant case, the trial court cited Williams in support of its denial of Appellant’s post-sentence motion. The Superior Court concluded, however, that our opinion in Williams was dicta, as the trial court in that case had excluded the pathologist’s testimony, and it further opined that Williams is factually distinguishable from the instant case because, in Williams, “there was some physical evidence to support the pathologist’s conclusions,” whereas, “in contrast, the only evidence of [Lorenzen’s] cause of death came from Bell.” Walters,2022 WL 1016624
, at *6 n.7. Notwithstanding its observations, the Superior Court, as noted
above, affirmed the trial court’s decision.
[J-57-2023] - 13
Additionally, the Commonwealth disputes Appellant’s suggestion that Dr. Ross’
testimony was qualified in a manner similar to the testimony in Passmore. Id. at 16. It
further avers that Tyler is “inapposite,” noting that the Iowa Supreme Court itself later
cautioned that the factual circumstances in Tyler were “unique.” Id. (citing State v.
Stendrup, 983 N.W.2d 231, 239 (Iowa 2022)). 10 Instead, the Commonwealth suggests the instant case is more analogous to the South Carolina Supreme Court’s decision in State v. Commander,721 S.E.2d 413, 415
(S.C. 2011) (finding no error in the admission
of a pathologist’s testimony that the cause of death of a victim, whose mummified and
partially decomposed body was found covered by a blanket on a sofa in her home, was
asphyxiation, based on a lack of other evidence of trauma and “anecdotal history relayed
by officers at the scene”).
The Commonwealth further maintains that Dr. Ross’ testimony did not improperly
bolster or vouch for the credibility of Bell, particularly since Dr. Ross stated that he was
unable to corroborate several of Bell’s statements, including that Lorenzen had been
struck by a hammer prior to her death, and that her body had been dropped from a great
height. 11 The Commonwealth emphasizes that, “[t]he only facts Dr. Ross and [Bell]
agreed upon were that [Lorenzen] had died, the manner was homicide, and the cause
was strangulation.” Commonwealth’s Brief at 22. The Commonwealth suggests that
those facts “were also evinced by the location and disposition of the body upon being
10 Although the court in Stendrup characterized the case of Tyler as “unique,” it expressly
declined the State’s request to overrule Tyler, and, in fact, reiterated that the pathologist’s
opinion in Tyler was inadmissible because “it was not based on objective, scientific, or
medical evidence” but, rather, “solely on his belief in the mother's statements.” 983
N.W.2d at 239.
11 In light of the fact that Dr. Ross testified that, due to the decomposition of Lorenzen’s
body, he could not confirm whether she had been struck by a hammer, but, at the same
time, opined that she had been strangled, Appellant suggests that Dr. Ross “cherry-
picked his conclusion.” Appellant’s Brief at 35.
[J-57-2023] - 14
found, i.e., in a river tied to a bag, decomposing, with no evidence of any other cause of
death discernable from the corpse.” Id.
The Commonwealth also asserts that the cases relied on by Appellant for the
proposition that expert testimony implicating the credibility of a witness is inadmissible,
including Seese, Balodis, and Hernandez, are distinguishable because, in those cases,
the expert testified that the victim of a sex crime or domestic violence crime was credible,
despite the lack of physical evidence of the crime, whereas here, “Dr. Ross offered no
testimony regarding the credibility of any other witnesses.” Id. The Commonwealth
further submits that Maconeghy is distinguishable because there was no physical
evidence in that case, whereas here, “Dr. Ross was provided with a physical finding in
the form of a dead body that had been found decomposing in a river with a bag tied to its
arm, which is evidence independent from the statement of another witness indicating that
a murder has occurred.” Id. at 23.
Finally, the Commonwealth argues that, if this Court determines that Dr. Ross’
opinion as to Lorenzen’s cause of death was not offered within a reasonable degree of
medical certainty, and that it improperly vouched for Bell’s credibility, such error was
harmless because a process of elimination of other causes of Lorenzen’s death left
strangulation as the only reasonable explanation. The Commonwealth further states in
its brief that it “respectfully echoes the Superior Court’s characterization of the evidence
in the instant case as ‘voluminous,’” see id. at 21, although it fails to identify that evidence.
As noted above, for an expert’s medical opinion regarding an individual’s cause of
death to be admissible at trial, it must be shown that the expert’s opinion was offered
based on a “reasonable degree of medical certainty.” See Webb, 296 A.2d at 737;
Williams, 316 A.2d at 891; Stoltzfus,337 A.2d at 879
. Our thorough review of the record
in the instant case reveals that Dr. Ross’ expert opinion did not meet this standard.
[J-57-2023] - 15
At Appellant’s trial, Dr. Ross testified that, at the time Lorenzen’s body was
discovered, it was “in a very advanced state of decomposition. It was almost complete
skeletonization of the head and neck organs. The feet and the hands were absent.” N.T.,
10/26/20, at 18. Dr. Ross further stated: “I didn’t see evidence of any overt injury on the
body per se externally when I examined it. But there was more decomposition obscuring
any type of injuries that may have been present.” Id. When asked to identify several
autopsy photographs of Lorenzen, Dr. Ross explained:
The first photograph it shows the upper jaw and the
base of the skull of the body . . . . And basically it shows the
teeth within the jaw and almost complete skeletonization of
the head and neck organs and the loss of all anterior soft
tissue and boney tissue of the neck organs. That’s critically
important for me to find those in an autopsy because I
examined those to determine if there is any signs of trauma
about the neck.
But the problem is, all that tissue rotted away over the
six-month period that she was absent – or in the water. And
all the soft tissue of the head and neck were gone.
Id. at 19-20.
Although Dr. Ross indicated that he did not observe any knife wounds, gunshot
wounds, or track or needle marks on Lorenzen, he continued: “But again, the body was
so decomposed that I could easily have not seen those due to the decomposition.” Id. at
21. Dr. Ross testified that he also conducted an internal examination of the victim, but
when asked to describe his findings with respect to her organs, including her heart and
lungs, he stated:
I have to preface this by saying all the internal organs
like the external portions of the body were in advanced state
of decomposition. So basically they were all necrotic, rotten,
basically - - and I hate to say this when the body is out in the
elements it basically rots and it decomposes. And all the
internal organs were in that very advanced state of
[J-57-2023] - 16
decomposition. So examination of the autopsy was limited
because of the decompositional changes.
Id. at 24. Dr. Ross reiterated throughout his testimony that his examination was “very
limited” due to the decomposition of the body. See, e.g., id. at 24 (“But again, my
examination was very limited because of the decomposition.”); id. at 25 (“And again, I
must caution you that examination was very limited because of the decomposition
changes”; “Again, [the pancreas, spleen and adrenals] were very necrotic.”).
Dr. Ross further explained that he examined Lorenzen’s brain and skull, and did
not see any evidence of trauma to the skull or fractures, but again stated that “the brain
was extremely decomposed.” Id. at 27. In fact, he testified that, although he took a
sample of Lorenzen’s brain, he “[knew he] wasn’t going to analyze it. And I suggested it
not be analyzed because the results would basically be uninterpretable.” Id. When asked
whether he analyzed Lorenzen’s musculoskeletal system, Dr. Ross stated that “[t]here
were no fractures to the skeletal system. There were no injuries noted on the skeletal
system of the head and neck. And most importantly the bone structures and cartilaginous
structures of the neck were absent due to decomposition.” Id. at 29 (emphasis added).
Notwithstanding all of the above, when asked for a conclusion as to Lorenzen’s
cause of death, Dr. Ross offered the following:
The conclusion my cause of death [sic] was that she
died by strangulation which was by history. There was no
anatomic indication that she was actually strangled. If I looked
at the body alone without any history, I could not say that. It
would have to be an undetermined death.
What I look for in an autopsy is basically injury to the
neck organs, a fractured hyoid bone which is a small bone in
the neck, hemorrhage within the muscles of the neck,
crushing of the larynx of the laryngeal cartilages and none of
that was present because all that tissue was gone. It was all
rotted away and necrotic. So all the tissue of the head and
neck was absent.
[J-57-2023] - 17
I also look for petechial hemorrhages which are small
blood vessels which are burst on the skin of the cheeks. But
all that was gone. And I look for hemorrhages within the
conjunctiva of the eyes which are typical in strangulation. But
eyes were absent. The conjunctiva was absent all due to
decomposition. So I had no physical actual evidence that a
strangulation occurred other than the history. The history to
me was very important because I saw no other possible cause
of death either.
Id. at 31-32 (emphasis added).
Moreover, on cross-examination, Dr. Ross confirmed that he “determined the
cause and manner of death by history and the exclusion of everything else from the
autopsy,” id. at 48, and explained that “somebody else’s statements are the history. And
that’s what I refer to. And that’s what I based my findings largely upon.” Id. at 49. Finally,
Dr. Ross reiterated that there was “no physical evidence to support” a determination that
Lorenzen’s death was the result of strangulation. Id. at 53.
It is abundantly clear from Dr. Ross’ own testimony that his opinion that Lorenzen’s
cause of death was strangulation was not offered to a reasonable degree of medical
certainty. Dr. Ross’ opinion was not based on any objective medical observations or
findings, as he repeatedly acknowledged that he was unable discern any trauma to
Lorenzen’s neck because the tissue, cartilage, and organs in her neck and head were
missing. Dr. Ross also explained that he was unable to determine whether there were
other potential causes of death, such as knife or gunshot wounds, or drugs, because he
“could easily have not seen those due to the decomposition.” Id. at 21. Thus, the
Commonwealth’s contention that Dr. Ross’ opinion as to Lorenzen’s cause of death was
properly admitted because it was “based on both historical data as well as objective
findings through autopsy and the process of elimination,” Commonwealth’s Brief at 13
(original emphasis omitted, italics added), is unsupported. Dr. Ross repeatedly conceded
[J-57-2023] - 18
that there was no physical evidence to support his conclusion that Lorenzen was
strangled, and that the only basis for his opinion in this regard were Bell’s statements. 12
Moreover, with respect to the Superior Court’s reliance on this Court’s decision in
Bullock for the proposition that a medical expert is permitted to consider the case history
in arriving at a cause of death, we agree with Appellant that Bullock is inapplicable to the
instant case. First, the appellant in Bullock admitted to strangling the victim, whereas
Appellant denies harming Lorenzen. Most critically, as noted by Appellant, the
admissibility of the pathologist’s opinion in Bullock was neither raised by the appellant
therein, nor addressed by this Court.
We need not decide in this case the extent to which an expert may rely on case
history in formulating his or her opinion as to cause of death, because it is clear that an
expert’s opinion cannot be based solely on case history; rather, it must also be supported
by objective medical findings. As Dr. Ross’ testimony regarding Lorenzen’s cause of
death was not based on any objective medical findings, it did not meet the standard for
admissibility, and should not have been admitted at trial. 13
12 Justice Mundy asserts that we are “turn[ing] a blind eye” to “the defense’s deficient
attempt at issue preservation,” specifically, a Frye challenge to Dr. Ross’ methodology, in
favor of resolving the issue of “whether a medical expert can issue an opinion to a
reasonable degree of medical certainty based solely on case history.” Dissenting Opinion
(Mundy, J.) at 1. However, for the reasons aptly explained by Justice Wecht in his
concurring opinion, Appellant is not challenging the admission of Dr. Ross’ testimony
based on Frye, and, as such, there is no issue of waiver. See Concurring Opinion (Wecht,
J.) at 6 n.15.
13 In her dissenting opinion, Justice Mundy states that Dr. Ross “testified that based on
his independent examination and understanding of the case’s history, he could determine
to a reasonable degree of medical certainty that Lorenzen’s cause of death was
strangulation by history.” Dissenting Opinion (Mundy, J., dissenting) at 6. Justice Mundy
further submits that Dr. Ross’ testimony was proper under Pa.R.E. 702, which permits
expert opinion testimony if, inter alia, the expert’s methodology is generally accepted in
the relevant field, because Dr. Ross indicated that “it is ‘common’ in his ‘practice to utilize
information provided by the police in reaching [his] conclusions[.] . . . In fact, the
(continued…)
[J-57-2023] - 19
We now turn to the question of whether Dr. Ross’ erroneously admitted testimony
improperly bolstered Bell’s credibility. As noted above, in Maconeghy, this Court held
that an expert’s opinion that a child victim was sexually assaulted, which was based on
the expert’s apparent acceptance of the child’s report of the abuse and not on any
physical evidence of abuse, impermissibly invaded the province of the jury in determining
the child’s credibility. Similarly, in Tyler, the Iowa Supreme Court held that a pathologist’s
opinion regarding a newborn baby’s cause of death, which was not based on objective
medical findings, but, rather, on the defendant’s conflicting statements to police,
constituted improper commentary on the defendant’s credibility. Like the testimony in
Maconeghy and Tyler, Dr. Ross’ opinion as to Lorenzen’s cause of death was not based
on any objective medical findings, but, instead, was premised on his acceptance of Bell’s
pathologist confirmed that he has consulted the relevant history to render an opinion on
cause of death in other cases.” Id. at 7 (emphasis added).
Notably, in the instant case, the information “utilized” by Dr. Ross to reach his
conclusion was not provided by the police. Rather, his opinion was based solely on the
statements of Bell, who offered that she assisted Appellant in cleaning up after the murder
and disposing of the victim’s body. Moreover, in addition to meeting the requirements of
Rule 702, including that the expert’s methodology is generally accepted in the relevant
field, for an expert’s medical opinion regarding an individual’s cause of death to be
admissible at trial, the expert’s opinion must be offered to a reasonable degree of medical
certainty. See Webb, 296 A.2d at 737; Williams, 316 A.2d at 891; Stoltzfus,337 A.2d at 879
. An expert’s opinion regarding cause of death is offered within a reasonable degree
of medical certainty when it is based on medical observations and conclusions. Spotz,
756 A.3d at 1160. As detailed above, Dr. Ross’ testimony was not based on any objective
medical observations or findings, and Dr. Ross repeatedly admitted that there was no
physical evidence to support his conclusion that Lorenzen was strangled; rather, the only
basis for his opinion in this regard were Bell’s statements. Accordingly, the totality of Dr
Ross’ testimony demonstrates that his opinion as to Lorenzen’s cause of death was not
offered within a reasonable degree of medical certainty, notwithstanding his single
affirmative reply when asked by the prosecution at the conclusion of his direct testimony
whether the “conclusions [he] made today [are] within a reasonable degree of medical
certainty.” N.T., 10/26/20, at 36.
[J-57-2023] - 20
statements. 14 Thus, we hold that his testimony impermissibly encroached on the jury’s
determination of Bell’s credibility.
Although the Superior Court opined that Dr. Ross’ testimony did not improperly
bolster Bell’s credibility because he conceded that he was unable to determine if
Lorenzen had suffered neck trauma, and, therefore, his testimony did not corroborate
Bell’s testimony that Lorenzen had been strangled, as Appellant emphasizes, this
reasoning ignores the fact that Dr. Ross testified that, without relying on Bell’s statements,
he could not have offered an opinion as to Lorenzen’s cause of death. Indeed, in opining
that Lorenzen’s cause of death was “strangulation . . . by history,” Dr. Ross testified that,
without Bell’s testimony, he would have ruled Lorenzen’s cause of death “undetermined.”
Id. at 31. He admitted that he had “no physical actual evidence that a strangulation
occurred other than the history.” Id. at 32. He explained that he “based [his] findings
largely upon” Bell’s statements. Id. at 49. Indeed, he conceded there was “no physical
evidence to support” a determination that Lorenzen’s death was the result of
strangulation. Id. at 53. In repeatedly stating that that he relied on Bell’s testimony to
reach his determination as to Lorenzen’s cause of death, and that he could not have
reached his determination without her statement, Dr. Ross indisputably placed his
imprimatur on Bell’s testimony.
Further, while the Superior Court reasoned, and the Commonwealth argues, that,
because Dr. Ross stated that he could not corroborate several of Bell’s specific
statements (for example, being hit on the back of the head with a hammer) based on his
14 The Commonwealth attempts to distinguish these cases, suggesting that, in
Maconeghy, there was no physical evidence, whereas in the instant case, there was
physical evidence in the form of Lorenzen’s dead body. However, as we discuss infra,
while the existence of Lorenzen’s decomposed body may have supported Dr. Ross’
determination that the manner of death was homicide, it did not establish that she was
strangled. While the Commonwealth submits that Tyler is inapposite, it offers no
argument as to why it is distinguishable from the instant case.
[J-57-2023] - 21
examination of Lorenzen’s body, his testimony did not bolster her credibility, the record
testimony undermines this reasoning. For example, when asked by the prosecutor if it
was “fair to say that there’s no medical evidence that anyone applied a hammer to the
skull” of Lorenzen, Dr. Ross replied, “there’s no physical evidence to support that fact”;
critically, however, he continued: “I’m not saying it didn’t happen. And certainly,
somebody could be struck with a hammer without fracturing the skull or causing bleeding
within the brain.” Id. at 51.
Additionally, the Commonwealth’s assertion that Dr. Ross’ conclusion that
Lorenzen had been strangled was supported “by the location and disposition of the body
upon being found, i.e., in a river tied to a bag, decomposing, with no evidence of any other
cause of death discernable from the corpse,” Commonwealth’s Brief at 22, is incorrect.
Although the location and disposition of Lorenzen’s body may have supported Dr. Ross’
determination that the manner of death was homicide, it did not, as revealed by Dr. Ross’
testimony that he relied on the case history provided by Bell, establish that Lorenzen was
strangled to death. Accordingly, we find that Dr. Ross’ testimony improperly bolstered
Bell’s testimony. 15
15 Justice Dougherty disagrees with our conclusion that Dr. Ross “placed his imprimatur
on Bell’s testimony,” noting that Appellant’s counsel “disclaimed” this theory at trial by
arguing, in his closing, that Bell’s story “was never corroborated,” and that counsel
highlighted how Dr. Ross’ testimony undercut Bell’s testimony in several respects, for
example, by stating that there was no physical evidence that Lorenzen had been
strangled. Concurring and Dissenting Opinion (Dougherty, J.) at 5-6. First, in our view,
counsel’s assertion, in his closing argument, that Bell’s testimony “was never
corroborated” is distinct from a concession that Dr. Ross somehow rejected her
strangulation testimony. Justice Dougherty’s position essentially ascribes to Appellant’s
counsel an intent to abandon an objection to the admission of Dr. Ross’ testimony – which
was clearly and expressly preserved on the record – based on counsel’s general
assertion in his closing argument that Bell’s testimony “was never corroborated.”
However, Appellant’s counsel did not specifically reference Dr. Ross’ testimony, and his
statement that Bell’s testimony “was never corroborated” arguably was directed at the
lack of additional physical evidence and/or fact witnesses. Moreover, the Commonwealth
(continued…)
[J-57-2023] - 22
Finally, we address the Commonwealth’s suggestion that, if this Court determines
Dr. Ross’ opinion as to Lorenzen’s cause of death was not offered within a reasonable
degree of medical certainty, and, further, that it improperly vouched for Bell’s credibility,
such errors were harmless because the process of elimination of other causes of
Lorenzen’s death left strangulation as the only reasonable explanation. As detailed
above, however, Dr. Ross testified that, due to the decomposition of the body, he was
unable to determine whether there were other potential causes of death, such as knife or
gunshot wounds, or drugs. N.T., 10/26/20, at 21. Thus, Dr. Ross’ opinion as to
Lorenzen’s cause of death was not based on the process of elimination. Further, beyond
its statement that it agrees with the Superior Court’s characterization of the evidence as
“voluminous,” see supra, the Commonwealth makes no attempt to demonstrate that the
overwhelming evidence of Appellant’s guilt renders any error in the admission of Dr. Ross’
testimony harmless. See Commonwealth v. Holt, 273 A.3d 514, 540 (Pa. 2022) (an error
may be found harmless if: (1) the error did not prejudice the defendant or the prejudice
was de minimis; (2) the erroneously admitted evidence was merely cumulative of other
untainted evidence which was substantially similar to the erroneously admitted evidence;
or (3) the properly admitted and uncontradicted evidence of guilt was so overwhelming
did not assert, either before the Superior Court or this Court, that Appellant, through
counsel’s isolated statement, abandoned his claim that Dr. Ross’ testimony improperly
bolstered Bell’s testimony. Thus, there is no basis on which to conclude Appellant
abandoned his challenge to the admissibility of Dr. Ross’ expert testimony. To Justice
Dougherty’s second point, regardless of what else in Bell’s testimony Dr. Ross disputed,
in specifically stating that he could not have reached a determination as to the cause of
death without Bell’s statement, Dr. Ross necessarily indicated to the jury that he believed
her strangulation testimony, a central focus of the case. Therefore, Dr. Ross improperly
bolstered Bell’s testimony.
[J-57-2023] - 23
and the prejudicial effect of the error was so insignificant by comparison that the error
could not have contributed to the verdict). 16
In summary, Dr. Ross’ expert opinion that Lorenzen’s cause of death was
strangulation was inadmissible because it was not offered within a reasonable degree of
medical certainty and, therefore, constituted inadmissible testimony that vouched for the
credibility of Bell. As the Commonwealth failed to prove that the error was harmless
beyond a reasonable doubt, we are constrained to hold that Appellant is entitled to a new
trial.
Judgment of sentence vacated. Case remanded. Jurisdiction relinquished.
Justices Donohue, Wecht and Brobson join the opinion.
Justice Wecht files a concurring opinion.
Justice Dougherty files a concurring and dissenting opinion.
Justice Mundy files a dissenting opinion.
16 In her dissent, Justice Mundy avers that we are “summarily reject[ing]” the
Commonwealth’s suggestion that any error in the admission of Dr. Ross’ testimony was
harmless. Dissenting Opinion (Mundy, J., dissenting) at 8. She submits that, given Dr.
Ross’ disclosures regarding the limitations of the autopsy, “the jury was still required to
assess Bell’s credibility,” and Bell’s testimony, “[i]f believed, . . . along with other properly
admitted evidence, would have been sufficient to find Appellant guilty of the charged
crimes.” Id. at 9. As noted above, and as Justice Mundy recognizes, harmless error exists
if the record demonstrates that the error did not prejudice the defendant or the prejudice
was de minimis; the erroneously admitted evidence was merely cumulative of other
untainted evidence which was substantially similar to the erroneously admitted evidence;
or the properly admitted and uncontradicted evidence of guilt was so overwhelming, and
the prejudicial effect of the error so insignificant by comparison, that the error could not
have contributed to the verdict. See Holt. Not only does Justice Mundy fail to identify
which prong she relies on to conclude that the admission of Dr. Ross’ testimony, if
erroneous, was harmless error, her determination that the evidence was “sufficient” to
support Appellant’s conviction is not a relevant factor in a harmless error analysis. Finally,
and importantly, the dissent ignores the fact that, by conceding that he could not have
reached a determination as to the cause of death without Bell’s statement, Dr. Ross
placed his expert imprimatur on her testimony, and thereby necessarily and improperly
bolstered her credibility.
[J-57-2023] - 24
Reference
- Status
- Published