In The
Court of Appeals
Seventh District of Texas at Amarillo
No. 07-25-00367-CR
CATHERINE LYNN JARVEY, APPELLANT
V.
THE STATE OF TEXAS, APPELLEE
On Appeal from the 78th District Court
Wichita County, Texas 1
Trial Court No. DC89-CR2024-1147-1, Honorable Meredith Kennedy, Presiding
August 31, 2026
MEMORANDUM OPINION
Before PARKER, C.J., and YARBROUGH and PRATT, JJ.
A jury convicted Appellant, Catherine Lynn Jarvey, of intentionally or knowingly
causing injury to a child, a first-degree felony, and assessed a sentence of 65 years’
1 Originally appealed to the Second Court of Appeals, this appeal was transferred to this Court by
the Texas Supreme Court pursuant to its docket-equalization efforts. See TEX. GOV’T CODE § 73.001. In the event of any conflict, we apply the transferor court’s case law. TEX. R. APP. P. 41.3. imprisonment and a $10,000 fine. 2 In one issue, Appellant argues that the evidence is
insufficient to support her conviction. We affirm.
BACKGROUND
In September of 2022, a pest control technician was working at the Delux Inn in
Wichita Falls. An occupant of Room 124 granted him entry. The technician found the
room to be in “atrocious” condition, with so much trash and debris that he could barely
walk around. As he sprayed, he noticed what he thought was “a skeleton for a Halloween
decoration.” However, he soon realized that it was not a skeleton, but a child. The child
was curled in a playpen, wearing only a diaper. Alarmed and recognizing that the child
needed help, the technician quickly left the room and contacted his employer. The
Wichita Falls Police Department was called and performed a welfare check at the motel.
Responding officers were concerned by the child’s “very thin,” “very unhealthy,” and
skeletal appearance.
Tracy Anderson, an investigator for the Department of Family and Protective
Services, was called to the scene. Anderson had previously interacted with the family
and knew that the child, “Isaac,” 3 had been born with complex medical conditions,
including alobar holoprosencephaly, hydrocephalus, congenital scoliosis, cerebral palsy,
and developmental delays. As an infant, Isaac was hospitalized, then sent to inpatient
care at a hospice facility. He later went home and received hospice home care for two
years, after which time he was cared for solely by Appellant, his mother. Appellant
2 See TEX. PENAL CODE § 22.04(a)(1).
3 We use a pseudonym to protect the identity of the child. See TEX. R. APP. P. 9.10(a)(3).
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received training on how to properly care for Isaac, who was non-ambulatory and
dependent on a gastronomy feeding tube. When Anderson arrived at the motel, Appellant
was holding Isaac. Anderson observed that Isaac was pale, emaciated, and “just wouldn’t
move.” She could see Isaac’s entire ribcage and all of his veins through his skin.
Because Isaac was so thin, Anderson could also see “the whole shunt” that had been
placed in Isaac when he was a baby. Isaac appeared to Anderson to be “maybe three”
years old, but he was six. Anderson’s familiarity with Isaac’s medical history did not
diminish her concerns about his condition. She testified that in her twenty-five years with
the Department, this was “the worst starvation case” she had ever worked. Isaac was
unable to cry or move his head. Appellant revealed to Anderson that Isaac had not been
seen by a medical professional in more than three years. Anderson concluded that Isaac
was malnourished and not being cared for, so she arranged for him to be taken to the
local hospital.
When he arrived at the hospital, six-year-old Isaac weighed just 15 pounds. He
was treated for hypothermia and fed through his G-tube, then transported to Cook
Children’s Medical Center in Fort Worth for more advanced care. He stayed at Cook’s
for several weeks. Meanwhile, the Department conducted an investigation, made findings
of medical neglect and neglectful supervision against Appellant, and removed Isaac from
Appellant’s care. When Isaac was discharged from Cook’s, he was placed in a medical
needs foster home.
Isaac’s foster mother accepted placement of him in October of 2022. She likened
his appearance to that of a Holocaust survivor. Isaac lived with her for almost two years.
In the care of his foster family, Isaac’s condition improved and he steadily gained weight:
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he weighed 25 pounds by December of 2022 and 30 pounds the following January. In
April of 2023, he weighed 39 pounds, was on the growth chart again, and was no longer
considered a failure to thrive case. Isaac’s foster mother took him to school, coordinated
his medical care, and got him “to a place where he was at a maintenance level with his
conditions.” Isaac was eventually adopted by another family. 4
As set forth above, Appellant was charged with injury to a child and convicted. She
was also charged with exploitation of a child, for which the jury found her not guilty.
ANALYSIS
Appellant presents a single issue on appeal, challenging the sufficiency of the
evidence supporting her conviction. The State was required to prove that Appellant
intentionally or knowingly caused serious bodily injury to Isaac by omission, through
failing to provide adequate nutrition, hydration, or medical care. See TEX. PENAL CODE §
22.04(a)(1), (c)(1), (e). Appellant argues that (1) there is insufficient evidence that she
acted with a culpable mental state, (2) the State failed to prove that Isaac suffered a
serious bodily injury, and (3) the evidence on causation fails, given the profound nature
of Isaac’s birth conditions.
Standard of Review
We review Appellant’s sufficiency challenge under the standard enunciated in
Jackson v. Virginia, 443 U.S.307, 318–20, 99 S. Ct. 2781, 61 L. Ed. 2d 560 (1979). See
Brooks v. State, 323 S.W.3d 893, 912 (Tex. Crim. App. 2010). Under that standard, we
4 Isaac’s birth father relinquished his parental rights.
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must determine whether, considering all the evidence in the light most favorable to the
verdict, the jury was rationally justified in finding guilt beyond a reasonable doubt.
Jackson, 443 U.S. at 319; Brooks, 323 S.W.3d at 899. We defer to the jury’s
determinations regarding the witnesses’ credibility and the weight to be given their
testimony. Brooks, 323 S.W.3d at 901.
Culpable Mental State
In her first sufficiency issue, Appellant argues there is insufficient evidence that
Isaac’s malnutrition, dehydration, and lack of medical treatment resulted from her
conscious objective or desire to cause serious bodily injury to Isaac, or that she was
consciously aware that her failures were reasonably certain to cause such injury.
Appellant acknowledges that Isaac “was not healthy and needed medical intervention,”
but asserts that the State did not meet its burden to establish that she “knew” or caused
any “result.”
Appellant was charged with “intentionally or knowingly” committing the offense. A
person acts “intentionally or with intent with respect to . . . a result of [her] conduct when
it is [her] conscious objective or desire to . . . cause the result.” TEX. PENAL CODE §
6.03(a). A person acts “knowingly or with knowledge with respect to a result of [her]
conduct when [she] is aware that [her] conduct is reasonably certain to cause the result.”
Id. § 6.03(b).
When a defendant is charged with injuring a child by omission as Appellant was
here, the evidence is sufficient to support a conviction if the State proves either that a
defendant intended to cause serious bodily injury through her omission or that she was
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aware that her omission was reasonably certain to cause serious bodily injury. Johnston
v. State, 150 S.W.3d 630, 636 (Tex. App.—Austin 2004, no pet.). Intent and knowledge
are fact questions and are almost always proven through circumstantial evidence. Clay
v. State, 390 S.W.3d 1, 8 (Tex. App.—Texarkana 2012, pet. ref’d). A jury may infer
knowledge or intent from any facts that tend to prove the existence of the mental states,
including the defendant’s acts, words, or conduct and the circumstances surrounding the
acts engaged in by the defendant. Turner v. State, 600 S.W.2d 927, 929 (Tex. Crim. App.
1980). Knowledge that failure to obtain medical care is substantially certain to result in
serious bodily injury can be inferred from the circumstances apparent to the defendant,
including the child’s condition and appearance. See Proenza v. State, 471 S.W.3d 35,
46 (Tex. App.—Corpus Christi 2015), aff’d in part and remanded, 541 S.W.3d 786 (Tex.
Crim. App. 2017) (evidence sufficient to support finding defendant knowingly caused
child’s death by omission by failing to feed and failing to seek medical care where baby
had been losing weight, appeared malnourished, and defendant acknowledged baby had
been vomiting); Baldwin v. State, 264 S.W.3d 237, 243 (Tex. App.—Houston [1st Dist.]
2008, pet. ref’d) (defendant’s failure to obtain medical care or provide adequate
nourishment in light of child’s obviously malnourished condition was sufficient to support
reasonable inference that defendant consciously desired or was aware that her conduct
was reasonably certain to cause serious bodily injury). Moreover, a jury is “free to apply
common sense, knowledge, and experience gained in the ordinary affairs of life in
drawing reasonable inferences from the evidence.” Eustis v. State, 191 S.W.3d 879, 884
(Tex. App.—Houston [14th Dist.] 2006, pet. ref’d).
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Several witnesses testified to Isaac’s observably frail and emaciated condition at
the time of his hospitalization in September of 2022. Photographs of Isaac at the time
were admitted into evidence, and they show an extremely thin child with no muscle
development, curled into a contracted fetal position. The evidence also indicated that
Isaac had not been fed adequately and that Appellant did not seek medical treatment for
him. Frank Cook, a nurse who treated Isaac at the hospital in Wichita Falls, testified that
the hospital staff experienced “quite a bit of shock” at Isaac’s appearance. Cook
described Isaac as “frail, emaciated, cold,” and “scared.” He stated, “You could tell it had
been a while since [Isaac] had any care.” Cook testified that Isaac’s stomach was
checked for residual contents, but nothing came up, indicating he had not been fed
recently. Cook stated that Isaac’s condition would “definitely not” be caused by just one
missed feeding.
Kasey Robertson, a nurse practitioner, also treated Isaac at the emergency
department in Wichita Falls. She said his condition was “pretty shocking” and described
him as “the thinnest human being I have ever seen in my life.” She could see all of Isaac’s
ribs and all of his spine through his skin. Robertson recognized that Isaac would need to
receive hospital care for a while. She testified that he was “exceedingly skinny, just very,
very thin, frail looking, [and] pale,” and that “anybody,” not just health care workers, would
be able to tell that he was not healthy. Both Cook and Robertson testified that Isaac had
hypothermia, which was an indication of his malnutrition.
Anderson, who accompanied Appellant and Isaac to the hospital, testified that a
nurse asked them for Isaac’s formula. Anderson returned with Appellant to the motel to
retrieve formula. She testified that Appellant “had to find” Isaac’s feeding supplies by
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digging through and climbing over items in the cluttered room; the feeding machine,
tubing, and formula were not readily available. Appellant opened a case of formula, and
they took a can back to the hospital. The formula was not usable because it had expired.
An investigator later searched the motel room for opened or used cans of formula, but did
not find any.
Dr. Elizabeth Peeler, a pediatrician who treated Isaac at Cook’s, testified that Isaac
presented one of the worst cases of neglect she had ever seen. She was initially
concerned that he would not survive. The “vast physical improvements” Isaac made in
the hospital were largely due to proper nutrition. Dr. Peeler noted that when Isaac last
saw a medical provider in 2019, he weighed 21 pounds, compared to the 15 pounds he
weighed in 2022. There was evidence that Isaac had been gaining weight when he was
under a physician’s care. Appellant told Dr. Peeler that she regularly fed Isaac, but Dr.
Peeler concluded this was “not possible” based on Isaac’s condition. She said this case
involved “chronic malnutrition long term,” which landed Isaac below the first percentile on
the growth chart. Dr. Peeler made findings of severe malnutrition, failure to thrive, and
medical neglect, which she explained means “not attending and following through with
basic medical recommendations that result in harm to the patient or the child.”
Detective Andrea Young, who began the criminal investigation, testified that she
interviewed Appellant in connection with the investigation. Videos of the interviews were
played for the jury. Appellant acknowledged that Isaac needed to be under a doctor’s
care and that he required more medical care than a typical child. She also conceded that
she noticed Isaac was not gaining weight and she had become concerned. Appellant
stated that taking Isaac to a doctor was on her “to-do” list and she agreed that more
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should be done for him. However, she claimed doctors would not see him because of his
complex conditions. 5
The testimony and medical evidence established that Isaac was obviously
emaciated. Appellant recognized that he needed medical care. Reviewing the evidence
in the light most favorable to the verdict, we conclude a rational jury could have
reasonably inferred Appellant was aware of Isaac’s malnourishment and his need for
medical attention, and that her failure to provide them would be reasonably certain to
cause serious bodily injury. See Proenza, 471 S.W.3d at 46; Baldwin, 264 S.W.3d at
243; see also Guerrero v. State, No. 04-15-00762-CR, 2016 Tex. App. LEXIS 9632, at
*25–26 (Tex. App.—San Antonio Aug. 31, 2016, no pet.) (mem. op.) (circumstantial
evidence sufficient to prove intentional or knowing omission that caused serious bodily
injury to child by malnourishment).
Causation of Serious Bodily Injury
In her second and third sufficiency issues, Appellant asserts there is insufficient
evidence that Isaac suffered serious bodily injury and that she caused such injury.
Appellant posits that malnutrition, dehydration, and lack of medical care could cause
serious bodily injury, but the State did not establish that they actually caused serious
bodily injury to Isaac, who was already suffering from complex medical conditions.
“Serious bodily injury” includes bodily injury that creates a substantial risk of death
or that causes death, serious permanent disfigurement, or protracted loss or impairment
5 This assertion was disputed by more than one witness, including the pediatrician who treated
Isaac in October of 2019.
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of the function of any bodily member or organ. TEX. PENAL CODE § 1.07(a)(46). “Whether
an injury constitutes serious bodily injury is determined on a case-by-case basis.” Wade
v. State, 663 S.W.3d 175, 184 (Tex. Crim. App. 2022). Further, serious bodily injury may
be established without a physician’s testimony when the injury and its effects are obvious.
Carter v. State, 678 S.W.2d 155, 157 (Tex. App.—Beaumont 1984, no pet.).
There is ample evidence in the record to support the inference that Isaac’s
condition constituted a serious bodily injury and that Appellant caused it. Isaac was
severely malnourished and dehydrated. Medical providers testified to the gravity of his
condition and to its detrimental effects, including stunted growth, compromised organ
function, and impaired cognitive function. Moreover, Dr. Peeler testified that Isaac was
suffering from refeeding syndrome when he was hospitalized. She explained that
refeeding syndrome is a dangerous condition that can develop in someone who is
severely malnourished. Dr. Peeler testified that people with refeeding syndrome have
been starved for so long, their bodies have trouble processing food. When food is
reintroduced to their system, they can become sicker. They are at risk of “severe
complications such as cardiac arrhythmias and even death.” Dr. Peeler testified that
Isaac required blood draws “around the clock” when he was in the Intensive Care Unit to
ensure that nutrients were safely and gradually reintroduced. Thus, there was sufficient
evidence that Isaac’s starvation and refeeding syndrome constituted serious bodily injury.
The jury also heard evidence that Isaac’s emaciated state was caused by
inadequate nutrition, not his underlying conditions. Dr. Peeler stated that Isaac’s “medical
neglect and physical neglect resulted in severe malnutrition and refeeding syndrome,
which was life[-]threatening.” She testified that Isaac improved and was able to gain
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weight “simply by obtaining proper nutrition . . . .” Isaac’s foster mother also testified that
his malnourishment resolved with proper care.
Viewing the evidence in the light most favorable to the verdict, we conclude that
the jury could reasonably have found that Appellant put Isaac at substantial risk of death
when she failed to provide adequate nourishment or medical care. See, e.g., Estrella v.
State, 546 S.W.3d 789, 797–98 (Tex. App.—Houston [1st Dist.] 2018, pet. ref’d)
(evidence supported guilty verdict of injury to child by omission when child was chronically
malnourished); Guerrero, 2016 Tex. App. LEXIS 9632, at *22–23 (evidence supported
guilty verdict when mother did not seek medical treatment for child’s malnourished and
weakened condition). The evidence was sufficient to establish the essential elements of
serious bodily injury to a child by omission beyond a reasonable doubt. We overrule
Appellant’s second and third issues.
CONCLUSION
Having overruled Appellant’s issues on appeal, we affirm the trial court’s judgment.
Judy C. Parker
Chief Justice
Do not publish.
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