Expert Witness Testimony and Consequences of a Not Guilty by Reason of Insanity Verdict

Facts of the Case

On May 2, 2013, Marina Middlebrooks crashed her car in Columbia County, Georgia. First responders found Ms. Middlebrooks in the driver's seat covered in blood. They also discovered the dead body of Ms. Middlebrooks' two-year-old daughter, Sky Allen, on the rear floor of the car, unclothed, with multiple stab wounds to her neck. The wounds were consistent with having been created by an open pair of scissors that had been found on the passenger seat of Ms. Middlebrooks' car.

Ms. Middlebrooks pled not guilty by reason of insanity to charges of murder and cruelty to children in the first degree. At trial, the defense argued that Ms. Middlebrooks was diagnosed with schizophrenia and was experiencing delusional thought content that prevented her from appreciating right from wrong when she killed her daughter. The defense presented the expert witness testimony of Dr. Geoffrey McKee and Dr. Donna Schwartz-Watts, both of whom supported this conclusion. The defense also had Dr. Donald Evans, a staff psychiatrist at the Veterans Affairs (VA) Medical Center in Augusta, Georgia, testify to his treatment of Ms. Middlebrooks during two previous psychiatric hospitalizations in 2011 and 2012. Dr. Evans was accompanied by an assistant United States attorney who advised the court that the VA's Office of General Counsel “authorized him to testify within boundaries, specifically that Dr. Evans could testify about his personal observations of Middlebrooks, about conversations he had with her, and about the contents of her medical records, but that he could not serve as an expert witness or answer hypothetical questions” (Middlebrooks, p 331). The court ruled that Dr. Evans could testify, but that he could not discuss his diagnosis of Ms. Middlebrooks, as that would constitute an expert opinion. The defense counsel agreed to this stipulation.

The state argued that Ms. Middlebrooks was feigning symptoms of schizophrenia in an attempt to avoid criminal responsibility. The state presented the expert witness testimony of Dr. Michael Vitacco, a forensic psychologist who evaluated Ms. Middlebrooks in June and July of 2013, shortly following her arrest. Dr. Vitacco testified that Ms. Middlebrooks was malingering symptoms of schizophrenia. He stated that Ms. Middlebrooks' observed behavior was not consistent with her reported psychotic symptoms, that she questioned clinical staff about how to build an insanity defense, and that her sudden recollection of detailed psychotic symptoms surrounding the time of the crime after multiple prior reports of diminished memory demonstrated evidence of malingering.

At the end of Dr. Vitacco's testimony, the prosecutor asked him what happens after an individual is found not guilty by reason of insanity. Dr. Vitacco responded that an individual “would come to our hospital for a period of 30 days. And then we would evaluate that individual . . . to determine if they were mentally ill … and dangerous to themselves or others. And then we would have a hearing in 30 days to determine if they could be released, as required by state law” (Middlebrooks, p 326). The prosecutor proceeded to ask, “By law, if that person is not a danger to themselves or others and is not suffering from a mental illness, what is the court obligated to do?” (Middlebrooks, p 326). Dr. Vitacco replied, “According to the Supreme Court, the trial court would be obligated to release that individual” (Middlebrooks, p 326). Ms. Middlebrooks' defense counsel objected to this testimony, arguing that Dr. Vitacco was inappropriately offering a “legal opinion” about the application of the law. The trial court overruled the objection and declined to strike the testimony.

Ultimately, the trial court found Ms. Middlebrooks guilty of both charges and she was sentenced to life without parole. Upon appeal, Ms. Middlebrooks argued that a new trial was warranted because of three main concerns. First, Ms. Middlebrooks claimed the trial court erred in limiting Dr. Evans' testimony by not following correct procedure. Second, she argued that her defense attorney's decision not to object to the limitations placed upon Dr. Evans' testimony constituted ineffective assistance of counsel. Third, Ms. Middlebrooks contended that the court erred in overruling her objection to Dr. Vitacco's testimony. She argued that Dr. Vitacco incompletely paraphrased sections of Ga. Code Ann. § 17-7-131 (2017), which deals with the evaluation and commitment procedures following a not guilty by reason of insanity verdict, and that this unfairly biased the jury.

Ruling and Reasoning

The court first considered the trial court's procedure for limiting the VA psychiatrist's testimony. The court determined that Ms. Middlebrooks' defense attorney appropriately filed a request with the VA for Dr. Evans to testify and that the VA authorized Dr. Evans to testify within their prescribed boundaries. The court concluded that this was in line with 38 C.F.R. § 14.808(a) (1954) and affirmed the trial court's ruling to limit Dr. Evans' testimony.

The court next considered Ms. Middlebrooks' assertion that her defense attorney unfairly prejudiced the outcome of the trial by not objecting to this first ruling. It concluded that defense counsel provided evidence that sufficiently tied Ms. Middlebrooks' mental health symptoms at the time of the crime to her preexisting history of mental illness by presenting two expert witnesses in addition to Dr. Evans. The court ruled, therefore, that they did not believe the defense counsel's alleged error affected the outcome of the trial with a reasonable degree of probability.

Perhaps the main concern pertaining to forensic psychiatric practice was Ms. Middlebrooks' assertion that the state's expert witness unfairly biased the jury. Ms. Middlebrooks argued that Dr. Vitacco provided potentially misleading testimony by insinuating that should she be found not guilty by reason of insanity, she would be evaluated at his home institution during a 30-day commitment, at which point she would likely be released, given his testimony that she was malingering. The court considered Dr. Vitacco's testimony and determined that it was potentially misleading. The court determined that Dr. Vitacco's statements “could have reinforced, rather than corrected, any misconceptions jurors may have had that only a guilty verdict would prevent Middlebrooks's nearly immediate release” (Middlebrooks, p 329).

To determine whether this improper, nonconstitutional, evidentiary ruling warranted a new trial, the court applied a “harmless-error test” as was done in Jones v. State, 880 S.E.2d 509 (Ga. 2022). The court sought to determine whether there was more than a theoretical possibility Dr. Vitacco's testimony contributed to the verdicts. The court concluded that compared with the “substantial evidence that Middlebrooks had the mental capacity to distinguish right from wrong” (Middlebrooks, p 330), it was highly unlikely that Dr. Vitacco's testimony was an important factor for the jury in reaching their guilty verdicts and ruled there was no justification for a new trial.