Court Holds Child’s STD-Positive Diagnosis Is Sufficient Evidence For Pediatric Expert Witness To Assume Abuse

    Court: Court of Appeals of North Carolina
    Jurisdiction: Federal
    Case Name: State v. Knolton
    Citation: 2017 N.C. App. LEXIS 332


    The defendant was arrested for allegedly sexually abusing his minor daughter, was tried, and found him guilty of seven counts of sexual offense with a child. The defendant was sentenced to prison for 1220-1593 months.

    The prosecution relied on the expert testimony of the director of medical technology and medical microbiology expert, as well as that of a child abuse pediatric expert, to prove that the child showed signs of having suffered sexual abuse and that the defendant had infected his daughter with chlamydia.

    The Pediatrics Expert

    The pediatrics expert was board-certified in child abuse pediatrics, completed fellowships in general academic pediatrics and child abuse & forensic pediatrics, and had also come across the alleged victim during her work at the Southern Regional Area Health Education Center. The pediatrics expert conducted a pediatric evaluation of the child based on reliable principles and methods used in the field. The expert subsequently expressed the opinion that the child was sexually abused based on medical examination, patient history, lab results, and physical examination of the patient.

    The defendant argued that the expert’s testimony that the child had suffered sexual abuse had been admitted in error. The defendant’ argued that if he did not preserve the issue for appeal, then there should be a reversal on the basis of ‘plain error’. The defendant also contended that even in the event the previous arguments were not successful, effective assistance from his counsel had been denied to him.


    The court noted that in child sexual abuse cases, there must be a proper foundation on which expert testimony is based, “with respect to the characteristics of sexually abused children and whether the particular complainant has symptoms consistent with those characteristics.” Dixon, 150 N.C. App. at 52, 563 S.E.2d at 598 (citing State v. Stancil, 355 N.C. 266, 559 S.E.2d 788 (2002)). Moreover, “an expert medical witness may render an opinion pursuant to Rule 702 that sexual abuse has in fact occurred if the State establishes a proper foundation[.]”

    The court considered the question of whether there was enough physical evidence of abuse to enable the pediatrics expert to testify that the child had been sexually abused or whether she should have restricted her opinion to indicate that the child showed characteristics consistent with that of children who had suffered sexual abuse. The court noted that there was enough physical evidence for the expert to testify that the child had been sexually abused, and thus the trial court did not err in admitting her testimony. The court also noted that the testimony was admissible because the expert had testified that the victim had a sexually transmitted infection, which children of her age do not get without sexual contact.

    The court rejected the defendant’s reliance on State v. Ewell, 168 N.C. App. 98, 606 S.E.2d 914 (2005), “for the proposition that contraction of a sexually transmitted disease is not sufficient physical evidence to provide a foundation supporting an expert’s testimony that an individual had been sexually abused,” considering the present case more akin to Hammet than Ewell. The physical evidence of chlamydia infection in the child provided sufficient foundation for the pediatrics expert to testify that she had suffered from child sex abuse.


    The court held that the trial court had made no error in finding the pediatric expert witness’ opinion that the child had suffered sexual abuse admissible.