Criminal Liability for Unprescribed Drug Administration in Childcare: Standards for Negligence and Willful Cruelty

Introduction

In State v. Stacey Lynn Vaillancourt, 2025 VT 20, the Vermont Supreme Court confronted the tragic death of a six-month-old child, H.B., in a home daycare. The defendant, Stacey Vaillancourt, operated the daycare for over 26 years and was the sole caregiver on the day of H.B.’s death. The State charged her with involuntary manslaughter and cruelty to a child resulting in death after the medical examiner determined that diphenhydramine intoxication caused the infant’s death. The key issues on appeal were:

Whether the evidence was sufficient to support convictions for involuntary manslaughter and cruelty to a child with death resulting;
Whether dual convictions were logically inconsistent or violated double jeopardy;
Whether the admission of short video clips of the victim was unduly prejudicial.

We examine the Court’s decision affirming both convictions, its legal reasoning, and the broader implications for caregivers and criminal law.

Summary of the Judgment

The Vermont Supreme Court unanimously affirmed the trial court’s denial of defendant’s motions for judgment of acquittal and rejection of her double‐jeopardy and evidentiary challenges. Key holdings:

Sufficient evidence supported involuntary manslaughter: an experienced caregiver administered a non‐prescribed, dangerous dose of diphenhydramine, a risk she should have appreciated.
Sufficient evidence supported cruelty to a child (death resulting): defendant willfully administered a drug she knew endangered an infant’s health.
The convictions are not inconsistent; one offense addresses reckless disregard, the other willful exposure to harm.
Double jeopardy was not violated—legislature expressly permits multiple punishments for separate statutes arising from the same conduct.
Admission of brief videos showing the child’s developmental abilities was relevant to causation and not unduly prejudicial.

Analysis

Precedents Cited

State v. Viens (2009 VT 64): Defined involuntary manslaughter and criminal negligence as a gross deviation from reasonable care.
State v. Brooks (1995): Clarified awareness of a substantial and unjustifiable risk.
State v. Robitille (2019 VT 36): Upheld involuntary manslaughter conviction based on circumstantial evidence of gross negligent alcohol administration to a disabled child.
State v. Amsden (2013 VT 51): Explained “willful” exposure under cruelty to a child statute: conscious decision plus knowledge of risk.
State v. Durenleau (1994): Distinguished speculative evidence insufficient for conviction.
State v. Crepeault (1997): Reversed inconsistent sexual assault convictions—contrast to this case’s independent statutes.
Federal precedents on inconsistent verdicts (Daigle, Vastine) and double jeopardy jurisprudence.

Legal Reasoning

The Court’s reasoning unfolded in four parts:

Sufficiency of Evidence for Involuntary Manslaughter:
- Causation conceded by defendant at trial, forfeiting appellate challenge.
- Circumstantial evidence showed defendant was the only person who could have administered diphenhydramine shortly before death; the dose was many times a therapeutic level.
- An experienced childcare provider should have known the federal-mandated warnings against infant use—constituting a gross deviation from reasonable care.
Sufficiency of Evidence for Cruelty to a Child, Death Resulting:
- Statute requires willful exposure with knowledge of endangerment.
- Defendant intentionally administered a known CNS depressant to an infant without prescription; federal labeling warns against such use under age two.
- Knowledge of risk was inferable from her training and label warnings; meeting the statute’s subjective-awareness requirement.
Consistency and Double Jeopardy:
- Embraced the view that a single act can support both reckless and intentional mental states so long as each pertains to a distinct offense element.
- Legislature expressly authorized multiple punishments for cruelty and manslaughter arising from the same conduct (13 V.S.A. § 1304(c)), defeating double-jeopardy claims.
Admissibility of Video Evidence:
- Rule 403 balancing: brief videos of the infant’s coordination were probative to eliminate alternative causes (self-medication or self-strangulation) and not unduly prejudicial.
- The trial court conducted a record balancing and limited cumulative or overly emotional footage, thus properly exercising discretion.

Impact

State v. Vaillancourt establishes clear boundaries for criminal liability when caregivers administer non-prescribed medications:

Experienced care providers will be held to a high standard; warning labels and professional experience inform the “should‐have‐known” inquiry.
Both reckless and intentional mental states may coexist in a single act, permitting concurrent manslaughter and cruelty convictions if each element is satisfied.
Evidentiary admissions of short, relevant videos will survive Rule 403 challenges when tied to causation or ability to self-protect.

Future prosecutions for drug‐related child fatalities may rely on circumstantial evidence of administration, label warnings, and caregiver roles to establish negligence or willfulness.

Complex Concepts Simplified

Criminal Negligence: Acting without awareness of a serious risk that a reasonable caregiver would recognize (e.g., dosing an infant with a sedating antihistamine).
Willfulness (Cruelty to a Child): A conscious, purposeful act that one knows will expose a child to harm, even if harm is not the actor’s direct objective.
Concurrent Mental States: The law allows a single deed to be both reckless (manslaughter) and intentional (cruelty) if different elements hinge on different mental states.
Rule 403 Balancing: Courts weigh probative value against prejudice; brief, factual videos aimed at proving causation rarely cross the line into unfairness.

Conclusion

State v. Stacey Lynn Vaillancourt crystallizes Vermont’s approach to drug‐related child fatalities in childcare settings. By affirming both involuntary manslaughter and cruelty convictions, the Court underscored that:

Caregivers cannot escape liability by claiming ignorance of well-known pharmacological dangers.
Separate offenses with different mental states may validly coexist when supported by the evidence.
Short, illustrative videos are admissible when they serve a clear evidentiary purpose.

The decision sends a strong message: professional responsibility and statutory labeling requirements carry criminal weight when a child’s life is at stake.