## Facts

- A 12-year-old boy, J.C., visited a friend’s home where a 4-year-old girl, A.W., was present.
- Earlier that day, J.C. engaged in sexualized conduct toward an older child in the home, including attempts to photograph her chest, show images of his penis, and a prior note asking to have sex.
- A witness unexpectedly entered a bedroom and saw J.C. pulling down A.W.’s underwear while positioned over her; the witness intervened, and J.C. fled.
- Two additional witnesses ran upstairs after hearing A.W. scream and reported seeing J.C. on top of A.W. while removing her clothing.
- After police were contacted, A.W. was forensically interviewed at a child advocacy center, and later evaluated by a physician who conducted a medical assessment and generated a written report.
- A.W. did not testify at J.C.’s juvenile delinquency adjudication hearing.
- Over J.C.’s Confrontation Clause objection, the juvenile court admitted the physician’s written report and allowed testimony from the physician and the forensic interviewer describing A.W.’s out-of-court statements.
- The juvenile court adjudicated J.C. delinquent for assault with intent to commit sexual abuse; the court of appeals affirmed.

## Issues

1. Whether admitting A.W.’s out-of-court statements through the physician’s testimony and written medical report, when A.W. did not testify, violated the Sixth Amendment Confrontation Clause.
2. Whether admitting A.W.’s out-of-court statements through the forensic interviewer’s testimony, when A.W. did not testify, violated the Sixth Amendment Confrontation Clause, and if so whether the error was harmless beyond a reasonable doubt.
3. Whether any distinct analysis was required under the Iowa Constitution where the respondent did not propose a separate state constitutional standard.

## Decision

- The Iowa Supreme Court affirmed the delinquency adjudication.
- The court held that A.W.’s statements made during the physician’s medical assessment, and the physician’s related testimony and written report, did not violate the Confrontation Clause because the statements were non-testimonial.
- As to the forensic interviewer’s testimony, the court assumed without deciding that admission may have been error, but held any error was harmless beyond a reasonable doubt given other overwhelming evidence.
- The court declined to develop a separate Iowa constitutional confrontation analysis because J.C. did not argue for a distinct state standard.

## Legal Principles

- The Confrontation Clause bars admission of testimonial hearsay unless the declarant is unavailable and the accused had a prior opportunity for cross-examination.
- Whether a statement is testimonial turns on its primary purpose, assessed objectively in context.
- Child-victim statements made primarily for medical diagnosis or treatment are generally non-testimonial and may be admitted without live testimony from the child.
- Even if Confrontation Clause error occurs, the adjudication may be affirmed if the error is harmless beyond a reasonable doubt based on independent evidence supporting the finding.

## Conclusion

The Iowa Supreme Court held that a child’s statements to a physician during a medical assessment for diagnosis and treatment were non-testimonial and admissible without the child’s testimony, and that any assumed error from admitting forensic-interview statements was harmless beyond a reasonable doubt in light of strong eyewitness evidence.


In re Interest of J.C., 877 N.W.2d 447 (Iowa 2016)