Clarifying Plain Error and Jury Instructions: Permissible Alternative Causation Theories in Negligent Homicide – State v. Cummings (2025 N.H. 15)

Introduction

State v. Cummings, 2025 N.H. 15, is a seminal decision by the Supreme Court of New Hampshire issued on April 1, 2025. The defendant, Christian Cummings, was convicted by a jury in Hillsborough County of negligent homicide in the death of his 17-month-old daughter, K.C. The child, born with a single kidney, suffered from lice, dehydration, and a urinary tract infection that developed into probable urosepsis. On appeal, Cummings challenged three rulings: (1) the trial court’s instruction allowing the jury to convict on any one or combination of the three alleged causes of death despite one count having been dismissed; (2) his trial counsel’s failure to object to that instruction (ineffective assistance of counsel); and (3) the sufficiency of the evidence to support negligent homicide. The Supreme Court of New Hampshire rejected all three arguments and affirmed.

Summary of the Judgment

The Court held that:

No plain error: Even assuming the trial court erred in its instruction regarding alternative causation theories, any error did not affect substantial rights because overwhelming evidence showed that K.C. died from a combination of dehydration, iron‐deficiency anemia, and probable urosepsis.
No ineffective assistance of counsel: Trial counsel’s failure to object to the jury instruction fell short of prejudicing the outcome; the evidence of combined causes was so compelling that the verdict would have been the same.
Sufficient evidence: Viewing all evidence in the light most favorable to the State, a rational jury could find beyond a reasonable doubt that Cummings’ gross deviation from reasonable child‐care standards caused his daughter’s death.

Analysis

1. Precedents Cited

State v. Rawnsley, 167 N.H. 8 (2014): Defines the narrow scope of plain error review, emphasizing that relief is granted only when a miscarriage of justice would result.
State v. Leroux, 175 N.H. 204 (2022): Clarifies the four-part plain error test: error, plainness, effect on substantial rights, and threat to judicial integrity.
State v. Mueller, 166 N.H. 65 (2014): Holds that prejudice under plain error requires inability to say the outcome would be the same.
State v. Thompson, 161 N.H. 507 (2011): Permits direct review of ineffective-assistance claims when the record plainly shows counsel’s failure (e.g., to object to jury instructions).
State v. Collins, 166 N.H. 210 (2014): Sets forth the Strickland test’s first prong (deficient performance measured against an objective standard).
State v. Littlefield, 152 N.H. 331 (2005): Defines negligent homicide and the standard for sufficiency of evidence in criminal cases.

2. Legal Reasoning

The Court’s reasoning proceeded in three parts:

a. Plain Error Review: Under Rawnsley and Leroux, the Court assumed, without deciding, that instructing the jury on an alternative theory (urosepsis alone) was error and that the error was plain. It then analyzed prejudice under Mueller, concluding that overwhelming testimony from the State’s expert, Dr. Christine James, established death only as the product of multiple factors. No juror could reasonably have found that urosepsis alone, standing in isolation, killed K.C. Therefore, the instruction did not affect substantial rights.

b. Ineffective Assistance of Counsel: Employing the two-pronged Strickland test (Collins), the Court recognized direct appellate review of the failure to object to jury instructions (Thompson). Because the error would not have changed the verdict, counsel’s omission was nonprejudicial and thus not constitutionally deficient.

c. Sufficiency of the Evidence: Under the familiar standard (Littlefield), the Court viewed every inference in the light most favorable to the State. Cummings knowingly exposed his daughter to squalid, lice-infested conditions, ignored her signs of illness for weeks, and refused to seek medical attention despite obvious dehydration, heavy breathing, and dark urine. The evidence of gross deviation from a reasonable parent’s care established criminal negligence causing death.

3. Impact

State v. Cummings provides the following important guideposts for future cases:

Jury Instructions on Alternative Theories: A court may, by agreement of the parties, instruct that jurors may convict on any one or a combination of alternative causation theories so long as each theory is adequately supported by evidence.
Limits of Plain Error: Even clearly erroneous instructions will not overturn a verdict where unchallenged instructions do not prejudice the defendant’s substantial rights.
Direct Review of Ineffective Assistance: When the record plainly shows counsel’s omission (for example, failure to object), appellate courts may decide the claim without remanding for an evidentiary hearing.
Negligent Homicide Standards: Reinforces that criminal negligence entails a gross deviation from the standard of care, particularly where obvious child welfare threats persist over time.

Complex Concepts Simplified

Plain Error: A rare appellate remedy reserved for unpreserved errors so obvious that they affect a defendant’s substantial rights and threaten the fairness or integrity of judicial proceedings.
Ineffective Assistance of Counsel: Under the Sixth Amendment, a defendant must show both (1) substandard legal performance and (2) a reasonable probability that, but for that performance, the result would differ.
Urosepsis: A bloodstream infection arising from a urinary tract infection; in living patients, diagnosed via systemic inflammatory response criteria. In autopsy contexts, pathologists refer to “probable” urosepsis based on tissue and fluid findings.
Negligent Homicide (RSA 630:3, I): Causing death by criminal negligence—failure to perceive a risk so grave that ignoring it constitutes a gross deviation from how a reasonable person would act.

Conclusion

State v. Cummings solidifies New Hampshire law on three fronts: the proper scope of jury instructions when multiple causation theories are indicted, the narrow availability of plain error relief, and the contours of appellate review for ineffective-assistance claims. In negligent homicide prosecutions, trial courts and counsel must carefully frame causation options to the jury, but appellate courts will not overturn convictions absent demonstrable prejudice. The decision underscores that parents who flout obvious health risks—especially to vulnerable children—face criminal liability when a gross deviation from care results in tragedy.