[Cite as State v. Bediako,
2025-Ohio-3169.]
IN THE COURT OF APPEALS
FIRST APPELLATE DISTRICT OF OHIO
HAMILTON COUNTY, OHIO
STATE OF OHIO, : APPEAL NO. C-240567
TRIAL NO. C/24/CRB/7606/B
Plaintiff-Appellee, :
vs. :
JUDGMENT ENTRY
DIANA ASARE BEDIAKO, :
Defendant-Appellant. :
This cause was heard upon the appeal, the record, the briefs, and the
arguments.
The judgment of the trial court is reversed and appellant is discharged for the
reasons set forth in the Opinion filed this date.
Further, the court holds that there were reasonable grounds for this appeal,
allows no penalty, and orders that costs be taxed under App.R. 24.
The court further orders that 1) a copy of this Judgment with a copy of the
Opinion attached constitutes the mandate, and 2) the mandate be sent to the trial
court for execution under App.R. 27.
To the clerk:
Enter upon the journal of the court on 9/5/2025 per order of the court.
By:_______________________
Administrative Judge
[Cite as State v. Bediako, 2025-Ohio-3169.]
IN THE COURT OF APPEALS
FIRST APPELLATE DISTRICT OF OHIO
HAMILTON COUNTY, OHIO
STATE OF OHIO, : APPEAL NO. C-240567
TRIAL NO. C/24/CRB/7606/B
Plaintiff-Appellee, :
vs. :
DIANA ASARE BEDIAKO, : OPINION
Defendant-Appellant. :
Criminal Appeal From: Hamilton County Municipal Court
Judgment Appealed From Is: Reversed and Appellant Discharged
Date of Judgment Entry on Appeal: September 5, 2025
Connie Pillich, Hamilton County Prosecuting Attorney, and Ronald W. Springman,
Jr., Assistant Prosecuting Attorney, for Plaintiff-Appellee,
Cohen, Todd, Kite & Stanford L.L.C., John L. O’Shea and Hailey Martin, for
Defendant-Appellant.
OHIO FIRST DISTRICT COURT OF APPEALS
BOCK, Judge.
{¶1} In this appeal, defendant-appellant Diana Asare Bediako challenges her
conviction for gross neglect of a patient. In two assignments of error, Bediako disputes
the sufficiency and weight of the State’s evidence proving that CPR1 or another
emergency medical intervention would have prevented harm to her patient, or that
her inaction resulted in harm to her patient.
{¶2} We hold that the State’s evidence—the responding officer’s bodycam
footage and testimony—was insufficient to prove that Bediako’s inaction was the
actual cause of harm to her patient. The State offered no proof of when or how
Bediako’s patient died, or any evidence that CPR or other emergency medical
intervention would have prevented her patient’s death.
{¶3} We sustain the first assignment of error, reverse Bediako’s conviction,
and discharge her from further prosecution.
I. Factual and Procedural History
{¶4} After Hamilton County Developmental Disability Services employee
Holly Mott urged police to charge Bediako with a crime based on Bediako freezing in
response to an unresponsive patient, the State charged Bediako with failing to provide
care for a functionally-impaired person in violation of R.C. 2903.16(A) and gross
neglect of a patient in violation of R.C. 2903.34(A)(2).
{¶5} The State’s case against Bediako consisted of the responding officer’s
bodycam footage and testimony from Mott and the responding officer. The underlying
facts are not in dispute.
1 No one defined “CPR” at trial, but the context shows that it means cardiopulmonary resuscitation,
an emergency lifesaving procedure that may increase the chance for survival for a person whose
heart stops beating. See American Heart Association, What is CPR?,
https://cpr.heart.org/en/resources/what-is-cpr (accessed Aug. 27, 2025)
[https://perma.cc/P8QR-JAH4].
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OHIO FIRST DISTRICT COURT OF APPEALS
{¶6} In October 2023, Bediako worked at Graceworks, an “intermediate care
facility” in Wyoming, Ohio. Like all Graceworks employees, Bediako was certified to
perform first aid and CPR, and she was trained to “take emergency action.”
{¶7} D.J. was a 60-year-old resident at Graceworks who required “around-
the-clock care.” Before he passed, D.J. lived with “cerebral palsy, organic affective
disorder, GERD, and depressive disorder.” D.J. was also visually impaired and
“[p]rimarily nonverbal.” Notwithstanding those conditions, a routine checkup with
D.J.’s physician revealed that he was “relatively healthy.”
{¶8} Bediako and a senior Graceworks colleague were assigned to handle
D.J.’s care on the day he died. Specifically, Bediako was tasked with administering his
medication and meals. D.J. also needed “full assistance with being changed, being
moved,” and using the bathroom.
{¶9} Wyoming Police Department Officer Sam Gutknecht testified that he
responded to a 911 call made by Graceworks employees for “a male, 60, nonbreather.”
On his way to Graceworks, Gutknecht learned that CPR was “not in progress.” At
Graceworks, Gutknecht found D.J. “facedown” on his bed. The State played
Gutknecht’s bodycam footage, which showed Gutknecht feeling for a pulse and moving
D.J. to the floor with Bediako’s assistance. Gutknecht testified that D.J. had no pulse,
but he did not suspect that D.J. had passed because he “was not cold to the touch.”
Yet, Gutknecht testified that he is “not medically trained to decipher what would be
appropriate” in that situation.
{¶10} The bodycam footage showed D.J. on the floor and Gutknecht shaking
D.J.’s shoulder, shouting, “Sir?” Gutknecht started chest compressions until
paramedics took over. After 30 minutes of CPR, paramedics pronounced D.J. dead.
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OHIO FIRST DISTRICT COURT OF APPEALS
{¶11} Police interviewed Bediako2 on November 16, 2023. Bediako told
officers that D.J. would usually lie in the prone position on his bed, and that she was
instructed to place a plate of food on his bed for him to eat. She recalled bringing D.J.
his dinner as instructed. Bediako returned to D.J.’s room “10 to 15 minutes” later and
“thought that he was sleeping at the time and noticed that he had not eaten much of
his food.” After D.J. did not respond to Bediako, she alerted her senior colleague and
the two called an offsite manager. After talking with the offsite manager, they called
911 and then returned to D.J.’s room “but provided no lifesaving measures.”
{¶12} Gutknecht testified that a Graceworks report stated that someone had
performed CPR on D.J. But, Gutknecht explained, Bediako admitted during her
interrogation that she did not perform CPR on D.J., despite her training. Bediako
explained that she froze when she saw D.J. because this was her first encounter with
an unresponsive person. Gutknecht also recalled that Bediako’s senior coworker
claimed to have attempted CPR but struggled to turn D.J. onto his back. But Gutknecht
later learned that this did not occur.
{¶13} The trial court acquitted Bediako of not providing care for a
functionally-impaired person but found her guilty of gross neglect of a patient. The
trial court sentenced Bediako to a $750 fine and court costs.
II. Analysis
{¶14} Bediako appeals and raises two assignments of error. She alleges that
her conviction is not supported by sufficient evidence and is against the manifest
weight of the evidence.
2 The bodycam footage in the record is stored on a flash drive that includes unadmitted footage of
Bediako’s interrogation. Even more troubling, the State’s flash drive includes bodycam footage
from four other unconnected investigations.
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OHIO FIRST DISTRICT COURT OF APPEALS
A. Bediako’s appeal is not moot
{¶15} As a threshold matter, the State argued in its brief that this appeal is
moot.3 This appeal is not moot.
{¶16} As an appellate court, we lack jurisdiction to entertain moot cases. State
v. Henderson, 2024-Ohio-2312, ¶ 17 (1st Dist.). For misdemeanor cases, a defendant’s
completion of her sentence makes her appeal “moot unless the defendant can show
that the sentence was served involuntarily or will result in an ongoing collateral
disability.”
Id. To decide whether this case is moot, we may consider “extrinsic
evidence.”
Id.
{¶17} In Henderson, this court reviewed caselaw from around Ohio holding
“that an appeal of a misdemeanor conviction is not moot even if the defendant has
served the sentence when fees, costs, or fines remain unpaid.” Id. at ¶ 18 (collecting
cases). If “‘the record does not affirmatively demonstrate’ that a defendant has paid
the court costs, fines, or fees” imposed by the trial court, courts will presume that those
financial obligations are still unpaid and that the appeal is a live controversy. Id. at
¶ 19, quoting State v. Tsibouris, 2014-Ohio-2612, ¶ 17 (1st Dist.).
{¶18} Here, the State does not suggest that Bediako paid her fine or court
costs. And the Hamilton County Clerk of Court’s website confirms that Bediako still
owes court costs and fines, which are “Due Now!” So, Bediako’s appeal is not moot.
B. Insufficient evidence supported causation
{¶19} In her first assignment of error, Bediako challenges the sufficiency of
evidence underlying her conviction for gross neglect of a patient. Specifically, she
3 The State appeared to have abandoned this argument at oral argument.
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OHIO FIRST DISTRICT COURT OF APPEALS
argues that the evidence does not prove that CPR was necessary or that her panic-
induced inaction caused physical harm to D.J.
1. The State must present sufficient causation evidence
{¶20} The Due Process Clause of the Fourteenth Amendment to the United
States Constitution requires the State to present “proof beyond a reasonable doubt of
every fact necessary to constitute the crime with which [the defendant] is charged.” In
re Winship, 397 U.S. 358, 364 (1970). When determining if the evidence is legally
sufficient to sustain a conviction, we must decide if, after viewing the evidence in a
light most favorable to the State, any rational trier of fact could have found the
essential elements of the crime proven beyond a reasonable doubt. See State v. Hinton,
2025-Ohio-2249, ¶ 8 (1st Dist.); see also State v. Walker,
2016-Ohio-8295, ¶ 12.
{¶21} The trial court convicted Bediako of gross neglect of a patient under R.C.
2903.34(A)(2). The statute provides, “no person who . . . is an . . . employee of[] a care
facility shall . . . commit gross neglect against a resident or patient of the facility.”
Bediako’s inaction constitutes “gross neglect” if the evidence proves that she
“knowingly fail[ed] to provide a person with any treatment, care, goods, or services
that is necessary to maintain the health or safety of the person when the failure results
in physical harm or serious physical harm to the person.” R.C. 2903.33(C)(1).
{¶22} A failure to provide necessary care to a patient rises to gross negligence
under R.C. 2903.33(C)(1) only if that failure “results in” harm to the person. In Ohio,
the “‘law generally defines “cause” in criminal cases identically to the definition of
“proximate cause” in civil cases.’” State v. Pitts, 2022-Ohio-4172, ¶ 19 (1st Dist.),
quoting State v. Carpenter,
2019-Ohio-73, ¶ 51 (3d Dist.). A defendant’s failure to act
“results in” harm if that failure “was both the actual and legal cause of the result.”
Pitts
at ¶ 19. To support a conviction, a defendant’s conduct must be “the cause in fact of
7
OHIO FIRST DISTRICT COURT OF APPEALS
the result, meaning that the result would not have occurred ‘but for’ the conduct.”
State v. Lovelace, 137 Ohio App.3d 206, 216 (1st Dist. 1999). Conduct may be the
“actual” cause of a result even if it was not the only cause.
Pitts at ¶ 19, citing
Carpenter
at ¶ 52.
{¶23} The State may establish causation through direct or circumstantial
evidence that demonstrates the cause of a person’s harm. State v. Klotz, 2024-Ohio-
2864, ¶ 32 (11th Dist.). Circumstantial evidence is “‘proof of facts or circumstances by
direct evidence from which [the factfinder] may reasonably infer other related or
connected facts that naturally and logically follow according to the common
experience of people.’” State v. Shabazz, 2016-Ohio-1055, ¶ 18, quoting Ohio Jury
Instructions, CR § 409.01(4) (Rev. Aug. 17, 2011). With that said, the State must
present evidence of circumstances establishing, with some degree of certainty, that the
defendant’s actions or inaction caused the harm. Mills v. Best W. Springdale, 2009-
Ohio-2901, ¶ 20 (10th Dist.), quoting Woodworth v. New York Cent. RR. Co.,
149 Ohio
St. 543, 549 (1949). Speculation and conjecture are inadequate to prove actual
causation. Id. at ¶ 20.
2. The State’s evidence is insufficient to prove causation
{¶24} Bediako asserts that the State produced no evidence linking her inaction
to D.J.’s death. We agree. The State failed to present any evidence showing D.J.’s
official cause of death or whether lifesaving efforts like CPR could have affected D.J.’s
chance of survival.
{¶25} At oral argument, the State acknowledged that “we don’t know” what
physical harm resulted from Bediako’s inaction. Instead, the State contended that
Bediako’s inaction “possibly could have been a cause of death.” And while the State
recognized that showing a nexus between Bediako’s inaction and D.J.’s death is the
8
OHIO FIRST DISTRICT COURT OF APPEALS
“difficult aspect of the case” and would require “medical evidence,” it urged us to draw
a “common sense” inference—that Bediako’s failure to administer lifesaving measures
like CPR caused D.J.’s death.
{¶26} But even when viewed in a light most favorable to the State, the limited
evidence in the record does not prove, beyond a reasonable doubt, that Bediako’s
failure to administer CPR or other lifesaving efforts could have or would have
prevented D.J.’s death. We have no way of knowing whether CPR—or any
intervention—would have prevented harm to D.J. The success rate of CPR after a ten-
to-15-minute delay is beyond the scope of “common knowledge.”4 Gutknecht correctly
suggested at trial that medical training was necessary to “decipher” the proper action
in response to D.J.’s condition. And “where an issue involves a question of scientific
inquiry that is not within the knowledge of lay witnesses or jurors, expert testimony is
required.” Mills at ¶ 22, quoting Ramage v. Cent. Ohio Emergency Servs., Inc., 64
Ohio St.3d 97, 102 (1992).
{¶27} We hold that no rational trier of fact could find that the State proved
beyond a reasonable doubt that Bediako’s inaction was the actual cause of physical
harm to D.J. Therefore, we sustain Bediako’s first assignment of error. Because the
State’s evidence is insufficient to prove causation, an element of the offense, the
Double Jeopardy Clause bars any further prosecution of Bediako. See Henderson,
4 As one Virginia Court of Appeals recently explained,
Despite what some may believe, under the best of circumstances CPR is not always
effective, even when properly performed. And in some circumstances, CPR may be
particularly ineffective. In other words, the EMTs’ failure to apply CPR or other
therapeutic efforts only destroyed a substantial possibility of [a decedent’s]
survival if he had a substantial possibility of surviving the underlying condition
causing [the] medical distress, in this case, diabetic ketoacidosis. This is a question
that falls beyond the realm of the common knowledge and experience of a lay jury,
for which the assistance of expert testimony is required.
(Cleaned up.) Stoots v. Marion Life Saving Crew, Inc., 2025 Va. App. LEXIS 118, *14 (Feb. 25,
2025).
9
OHIO FIRST DISTRICT COURT OF APPEALS
2024-Ohio-2312, at ¶ 33 (1st Dist.), citing Greene v. Massey,
437 U.S. 19, 24 (1978).
Our disposition of the first assignment of error renders Bediako’s second assignment
of error moot.
III. Conclusion
{¶28} We sustain Bediako’s first assignment of error, reverse her conviction,
and discharge her from further prosecution.
Judgment reversed and appellant discharged.
KINSLEY, P.J., and MOORE, J., concur.
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