The defendant was convicted in a bench trial of first-degree murder and negligent child abuse inflicting serious injury for starving and failing to provide medical treatment to his four-year-old disabled stepson, Malachi. The defendant appealed, and the Court of Appeals affirmed. The Supreme Court granted discretionary review.  The defendant argued on appeal that: (1) the trial court erred by failing to dismiss the first-degree murder charge because the record failed to contain sufficient evidence to support a finding that Malachi’s death was proximately caused by starvation; (2) the State was required to make a separate showing of malice in order to prove defendant’s guilt of murder on the basis of starvation; (3) if malice is implied, then starving must be defined as the complete deprivation of food and water; and (4) his conviction for negligent child abuse inflicting serious bodily injury rested upon findings that Malachi suffered from bedsores, ulcers, and diaper rash, which differed from the indictment’s allegations that he failed to provide the child with medical treatment and proper nutrition. The Supreme Court rejected each of the defendant’s arguments and affirmed his convictions.

(1) The Supreme Court determined that the trial court had ample justification for concluding that Malachi died as a proximate result of starvation, despite findings in an amended autopsy report attributing Malachi’s death to asphyxia caused by strangulation. Witnesses who were responsible for providing treatment to Malachi and his sibling during the last two years of his life testified that Malachi was not fed even though he was ravenously hungry and looked considerably thinner in the months leading up to his death. Emergency medical technicians who responded to the 911 call for Malachi’s death noticed the malnourished state of Malachi’s body, which some of them initially mistook for a doll. The physical evidence in the autopsy report demonstrated that Malachi was severely malnourished and dehydrated. A pediatric neurologist who had treated Malachi testified that the only thing that “‘would cause Malachi or any child to look like’” the child described by the emergency medical technicians and depicted in the autopsy report and related photographs was “‘starvation.’” Slip op. at ¶ 44. Although the autopsy was amended to attribute Malachi’s death to asphyxia secondary to strangulation, the record demonstrates that the forensic pathologist made those amendments based on the defendant’s statements to a detective that he had strangled Malachi, statements that the trial court found not credible.

(2) The Supreme Court concluded that the trial court did not commit plain error or err by failing to (a) instruct itself concerning the issue of malice or (b) make a separate finding that defendant acted with malice in connection with killing Malachi. The Court reasoned that the intentional withholding of the nourishment and hydration needed for survival resulting in death when the victim is unable to provide these things for himself or herself shows a reckless disregard for human life and a heart devoid of social duty. Thus, the malice necessary for guilt of murder is inherent in the intentional withholding of hydration or nutrition sufficient to cause death. As a result, the Court held that the act of starving another person to death for purposes of G.S. 14-17(a), without more, suffices to show malice, so that the trial court did not commit plain error by failing to instruct itself to make a separate finding of malice or err by failing to make a separate determination that defendant acted maliciously in its findings of fact and conclusions of law.

The Court further held that the record and the trial court’s findings demonstrated that the defendant proximately caused Malachi’s death by intentionally depriving him of needed hydration and nutrition, a showing that supported the conviction of murder by starvation. Witnesses testified that there was food in the house and that Malachi’s siblings received sufficient nutrition and hydration to survive. The evidence depicted Malachi as hungry and dehydrated during the months leading to his death; yet the defendant, who was Malachi’s primary caregiver, did not seek medical attention for Malachi and fed Malachi, at the most, no more than once each day.

(3) The Supreme Court rejected the defendant’s argument that starvation for purposes of G.S. 14-17(a) required proof that the defendant subjected the victim to a complete deprivation of food and hydration. The Court explained that the discussion in State v. Evangelista, 319 N.C. 152 (1987) did not suggest otherwise; instead, Evangelista simply indicated that murder by starvation occurs in the event that the defendant completely deprives the victim of food and drink. The Court reasoned that the adoption of the defendant’s definition of starvation for purposes of G.S. 14-17(a) would produce the absurd result that a person who kills another by withholding virtually all, but not all, food and drink would not be guilty of murder by starvation.

(4) The Supreme Court held there was no fatal discrepancy between the allegations of the indictment charging defendant with negligent child abuse inflicting serious injury and the trial court’s factual justification for convicting defendant of that offense. The indictment charged the defendant with negligent child abuse inflicting serious injury for failing to provide Malachi “‘with medical treatment’” for over one year, “‘despite the child having a disability,’” and with failing to “‘provid[e] the child with proper nutrition and medicine, resulting in weight loss and failure to thrive.’” Slip op. at ¶ 50. The Court deemed the trial court’s determinations that defendant “‘allow[ed] the child to remain in soiled diapers until acute diaper rash formed on the [child’s] groin and bottom,’” resulting in “‘open sores and ulcers,’” and that defendant kept “‘the child in a playpen for so long a period of time that bed sores formed on [his] legs and knees’” to be  fully consistent with the allegations in the indictment. Slip op. at ¶ 50.