The Death of Sanaa Cunningham: Murder or Medical Tragedy?

New Times Illustration/Zac McDonald

This story was originally published on September 19, 2018.

EDITOR’S NOTE: Most of what we know about Sanaa Cunningham’s life and death comes from the autopsy; new courtroom testimony of the lead criminal investigator, Goodyear Detective Noah Yeo; evidence presented in court; other court records; and texts from the phone of her stepmother, Lisa Cunningham. Interviews with people close to the families support claims of both prosecution and defense. Phoenix New Times is withholding the names of Sanaa’s minor siblings and half-siblings to protect their privacy.

On Friday, February 10, 2017, Germayne and Lisa Cunningham found 7-year-old Sanaa draped over the side of her playpen at their Goodyear home. She couldn’t open her eyes. Her body was limp and unresponsive. She drooled.

In two years, they said, they had watched a happy, smiling girl deteriorate into a child who ate dolls’ hair, defecated on the floor, threw rocks at the dog, and heard voices urging her to kill.

The Cunninghams said they feared for the safety of their two shared young children. Sanaa was Germayne’s youngest daughter by his previous marriage.

A stream of social workers and police visited the Cunninghams, amid a string of reports they had mistreated the troubled child.

Doctors had prescribed a strong anti-psychotic to calm Sanaa. Evidence suggests Germayne and Lisa followed the instructions on the label precisely: Give one pill a day, up to three, as needed. Don’t discontinue without consulting a physician.

But now, looking at the vision of horror in the playpen, they wondered if the drug was doing more harm than good.

They called Sanaa’s doctor, whose staff advised the parents to bring her in on Monday. The next day, she turned catatonic. Her body was cold to the touch. Lisa Cunningham couldn’t get a reading from the thermometer.

After waiting 14 hours, the couple took Sanaa to urgent care. Within hours, she died, on Sunday, February 12.

How and why she died lies at the heart of a child-abuse murder case in Maricopa County Superior Court that has attracted international attention. Germayne, a 39-year-old former Phoenix police detective, and his Australian wife, Lisa, 43, are facing the death penalty. Their fate may hinge on what they did or didn’t do in those crucial days and in the last year of Sanaa’s life.

People who think the Cunninghams coldly killed their daughter wonder where the authorities were to protect Sanaa and why the system seemed to cut the couple slack at almost every turn. They question why investigations took so long, and why so much remains secret.

Supporters of the Cunninghams blame prosecutors for excessive zeal. They say the state’s vague, ill-conceived murder theory is built on quicksand, sloppy police work, and a disregard for scientific fact.

The last time the U.S. executed an Australian was during the California Gold Rush.

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The charges against Lisa Cunningham also have gripped the media and the public in her native Australia. The last time the U.S. executed a compatriot was during the California Gold Rush.

Australian media interest in the case spiked after a routine detention hearing last month. It turned into a mini-trial and sent the Cunninghams to jail, facing the death penalty.

The hearing previewed the diametric versions of events that a jury could hear when the real trial starts.

Currently, that is set for July 2020.

Prosecutors with the Maricopa County Attorney’s Office say the Cunninghams abused, confined, and restrained Sanaa for a year and left her to die in a portable playpen called a Pack ’n Play. The child, who weighed only 45 pounds, was covered in cuts and bruises and the couple did nothing to get medical help. Sanaa was an emotional and financial burden. Her death would ease that pressure, the prosecutors implied in court.

Defense lawyers say the couple were overwhelmed, tried their best, but didn’t know what to do. Sanaa suffered a number of rare and severe maladies, and they had to restrain her because she was a threat to herself and her young siblings. They couldn’t find suitable clinical help.

Both Cunninghams pleaded not guilty.

click to enlarge The murder charges against Australian native Lisa Cunningham and her husband have been a big story Down Under. - SCREENSHOT FROM THE ADVERTISER
The murder charges against Australian native Lisa Cunningham and her husband have been a big story Down Under.
Screenshot from The Advertiser
Sanaa came from a fractured and fractious family. Her father, Germayne Cunningham, and mother, Sylvia Cunningham, married in 2007, two weeks before the birth of their first daughter, Sanaa’s older sister. Sanaa was born in December 2009.

Germayne worked as a corrections officer in state prisons from 2000 to 2004 and again in the first half of 2005. He left for a job at the Phoenix Police Department. During his 12-year career, he had been a beat cop and a robbery detective, and had worked for a time in the evidence room.

Sylvia is from a large, prominent family in Phoenix’s African-American community, her lawyer Quacy Smith said. She worked as a cashier and a hotel valet.

By the time Sanaa was 4 months old, the couple had already separated. Germayne moved out of the house on North 32nd Avenue in Phoenix to an apartment across town on South 50th Street, taking the kids.

Sylvia filed for divorce, but the case was tossed out. So, too, was her restraining order request in 2011. She complained in court documents that Germayne threatened and bullied her.

“He is keeping my children away from me and I am afraid to go visit my children where he lives,” she wrote, to no avail.

click to enlarge Sylvia Norwood had a contentious divorce from her husband, who is accused of murdering their daughter. - SEAN HOLSTEGE
Sylvia Norwood had a contentious divorce from her husband, who is accused of murdering their daughter.
Sean Holstege
The courts treated Germayne differently. He received a restraining order against Sylvia in September 2011, telling the court his estranged wife had been calling his boss and harassing him at work. He filed for divorce the same day, and won sole custody of the two girls. Sylvia was ordered to pay child support.

Now Sylvia Norwood again, she met a man and moved to Texas.

In 2011, Germayne Cunningham began seeing Lisa Anderson, a single mom from Australia.

Lisa had grown up in a tough house, in a blue-collar suburb of Adelaide, according to people close to the family.

Her parents were heavy drinkers. He father died young. Her mother reacted by staying out partying, leaving Lisa to take care of a sister with special needs. One brother died of an overdose. The other was in and out of jail.

Some family members say Lisa grew resentful and bitter by taking care of her sister Katie. But her cousin, Donna Roesler, who still lives in the town where they grew up, said Lisa is “the most kind, caring, thoughtful person you’d ever meet.” She cited Lisa’s treatment of Katie.

When Lisa was young, she married a U.S. airman, Russ Anderson. They moved to Japan, had two children, and bounced around the globe until Anderson transferred to Luke Air Force Base in Glendale.

Lisa got a job as a guard at the Arizona State Prison Complex-Lewis in Buckeye, where she met Germayne Cunningham.

She divorced Anderson and later married Germayne in August 2015.

The couple had two children together, adding to Germayne and Sylvia’s two girls, and Lisa’s two kids. The new couple and six kids crammed into the 2,300-square- foot, four-bedroom stucco house on South 152nd Avenue in Goodyear.

Norwood said she last saw Sanaa alive in December 2015, recalling that until then she seemed a normal, healthy girl.

Photos from before show a young Sanaa as a smiling, happy girl who “made you feel good probably on your worst day,” as her obituary later read.

The mother’s description also fits what a half dozen people at Sanaa’s preschool told Goodyear Detective Noah Yeo. They told him they had never seen symptoms of abuse, trauma, or behavioral disorders before she left the school, he testified.

“Stuff started happening when he married Lisa,” Norwood said in a recent interview. Sanaa’s life deteriorated, she said.

Photos, interviews with family members, and court filings by prosecutors also bear that out.

“In August of 2015, (Lisa Cunningham) began to claim that the victim had behavioral issues,” Deputy County Attorney Joshua Clark wrote in a pretrial motion.

In April 2016, the Cunninghams took Sanaa out of school and began homeschooling her, according to Clark’s motion, which noted, “This marked (taking her out of school) the decline in mental and behavioral health.”

But the Cunninghams’ claims about Sanaa’s condition at the time, according to Clark, were “not verifiable.”

click to enlarge Sanaa Cunningham, who died at age 7. - COURTESY OF SYLVIA NORWOOD
Sanaa Cunningham, who died at age 7.
Courtesy of Sylvia Norwood

The first official warning sign that Sanaa Cunningham
could be in danger came on March 4, 2016, when somebody called the Arizona Department of Child Safety.

The anonymous caller alleged that the Cunninghams were neglecting Sanaa. A DCS investigator visited the house. Sanaa and her siblings denied any neglect or abuse, according to a DCS statement.

The state agency noted a “severe eating disorder.” Pathologists later said she binged and purged. Undigested food would come back up, and she’d chew it again and swallow. She defecated and urinated uncontrollably. She had pica, a mental disorder that compelled her to eat indigestible objects. She ate her dolls’ hair.

The DCS agent interviewed the Cunninghams and reviewed medical appointments and bills. Investigators concluded the couple were trying to provide Sanaa treatment “for her very special needs,” and consulted a gastroenterologist.

DCS determined the allegations had no merit and closed the case.

Social workers returned on October 27, 2016, in response to a report that Sanaa had been sexually abused. Sanaa denied it and the state ruled it unsubstantiated.

In court records, Germayne Cunningham blamed his mother, Valerie Cunningham, for calling DCS as part of an ongoing feud she had with Lisa. He called the allegation “unfounded” and “based on malicious intent.” Family members said Valerie was trying to force DCS to pay attention to Sanaa’s worsening condition. Valerie could not be reached for comment.

No evidence of sexual trauma emerged from the autopsy.

In December, one of the psychiatrists who had evaluated Sanaa told Cunningham his daughter had reported voices telling her she’d feel better if she killed somebody. He diagnosed schizophrenia.

On December 20, 2016, Sylvia Norwood came to the house demanding to visit Sanaa on her birthday. She says Germayne slammed the door in her face.

In a new restraining order petition that day, Germayne wrote that Sylvia tried to kick in the door, after making no effort in two years to see her kids.

In December, one of the psychiatrists who had evaluated Sanaa told Cunningham his daughter had reported voices telling her she’d feel better if she killed somebody. He diagnosed schizophrenia.

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The next day, DCS opened a third investigation, looking into allegations that Germayne abused Sanaa and that both parents neglected her.

Goodyear Police Officer Reagan McCarthy went to the house wearing a body cam on an unannounced check of Sanaa’s well-being.

He saw Sanaa, partially clothed, sitting in a lawn chair in the closed laundry room. Her knees were badly skinned and bandaged. A camera was mounted in the small room.

Sanaa told him she was okay.

Germayne Cunningham explained that she had “dug the skin off both knees” with her hands. Police said Cunningham let McCarthy tour the house, as he explained how Sanaa was severely disturbed and he needed to take measures to protect her.

Goodyear Police called DCS, which came out on December 23.

DCS said the case was open, and agents were preparing a recommendation substantiating the claims of neglect and abuse, when Sanaa died.

“In each instance that DCS investigated, there was not sufficient evidence to legally justify removing Sanaa from her home or to mandate court-ordered services,” DCS stated.

That evidence only surfaced after her death.

click to enlarge Germayne and Lisa Cunnigham may face the death penalty. - COURTESY OF MARICOPA COUNTY JAIL
Germayne and Lisa Cunnigham may face the death penalty.
Courtesy of Maricopa County Jail

Over the holidays and into the New Year,
Sanaa got worse.

Psychiatrists prescribed the anti-psychotic risperidone on January 17, 2017.

In late January, Lisa texted someone that her son was “stressed out about Sanaa being strapped down. It’s making everybody nervous.”

By early February, Sanaa shook violently. She struggled to stand or walk. She fell face first and smashed her head on the tile floor. Her father said her self-harming had waned, but she had entered a “zombie-like” state.
“From now on, Sanaa remains in the playpen, strapped down,” Germayne Cunningham texted his wife on February 6.

The next day, Sanaa’s condition apparently grew severe. The Cunninghams described her as catatonic, shaking, drooling, and unable to eat. They recorded her state in cellphone videos. In texts, the couple decided not to consult doctors until some of her visible wounds healed, prosecutors allege.

On February 10, the couple stopped giving Sanaa risperidone, according to court evidence. They called Sanaa’s doctor for advice. The call lasted several minutes. His staff set an appointment for Monday, February 13. Germayne Cunningham described Sanaa as “despondent.”

At 1:30 a.m., doctors recorded her body temperature at 89.6 degrees Fahrenheit. Normal temperature for healthy children her age is between 97 and 100 degrees.

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The next day, February 11, video taken at 10 a.m. shows Sanaa hunched over the side of the Pack ’n Play, too wobbly to stand, drooling, struggling to breathe.

That morning, Germayne Cunningham went to work providing security at a Peter Piper Pizza restaurant.

Lisa Cunningham noticed Sanaa was cold to the touch. She surrounded the girl with warm water bottles. When she tried to take her temperature, she was so cold the thermometer didn’t work.

But she never called 911 or a doctor. Instead, she waited until around 1 a.m. Sunday to tell her husband Sanaa was cold and unresponsive, records show.

He came home and rushed Sanaa to a nearby urgent care clinic three miles away. At 1:30 a.m., doctors recorded her body temperature at 89.6 degrees Fahrenheit. Normal temperature for healthy children her age is between 97 and 100 degrees.

From urgent care, she was taken and admitted to Banner Thunderbird Medical Center, and given intravenous fluids and an oxygen mask. By 3:30 a.m., her temperature had climbed to 95 degrees. The ER doctors thought she was dehydrated, anemic, and suffering from septic shock.

She was airlifted to Phoenix Children’s Hospital. Upon arrival, she was unresponsive and cold. Her breathing was raspy. She went into cardiac arrest at 5:18 a.m. and was pronounced dead at 5:30 a.m.

“DCS took my kids away and said they were unsafe with me because texts were found in my phone planning Sanaa’s death? Really? How do you do that with the way our girl died?” – Lisa Cunningham

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Right away, doctors considered the death suspicious. A Goodyear police sergeant dispatched Detective Yeo to Phoenix Children’s Hospital to talk with the physicians and the Cunninghams.

Lisa Cunningham told him she had worried for two years about Sanaa’s mental health. She described to him the self-harming and efforts to protect her by restraining her with a makeshift straitjacket.

Two days after Sanaa died, on February 14, 2017, the Maricopa Medical Examiner’s Office conducted an autopsy. Pathologists counted more than 100 cuts, bruises, and scrapes from her head to her toes. Some were healing, some fresh, some infected, and some had scarred over. On her foot was an open septic wound. There were wounds to her wrists and ankles, consistent with restraints.

State law requires DCS to “promptly provide … information to the public regarding a case of child abuse, abandonment or neglect that has resulted in a fatality or near fatality.”

That did not happen. Not promptly.

DCS placed the Cunninghams’ shared kids, the two youngest, in foster care. The rest went to relatives.

“DCS took my kids away and said they were unsafe with me because texts were found in my phone planning Sanaa’s death? Really? How do you do that with the way our girl died?” Lisa texted her cousin, Donna Roesler. “No texts were ever shown in juvenile court to a judge, so how could my kids be taken away without evidence?
And why didn’t the judge ever demand to see them?”

Germayne Cunningham took bereavement leave.

Yeo began gathering evidence in a criminal probe. He interviewed members of the family, visited the house, spoke with Sanaa’s doctors and psychiatrists, gathered medical records, and interviewed people at Sanaa’s preschool and neighbors down the street.

A more troubling account of Sanaa’s life emerged.

Goodyear police combed through 23 garbage bags at the house on South 152nd Avenue for evidence. They found plenty. They collected medical documents in the Cunninghams’ name and plastic twisty-ties, like the kind police use to detain protesters.

They sent the ties to the Arizona Department of Public Safety crime lab and waited for forensic and DNA evidence.

Police accessed Lisa Cunningham’s cellphone, but not her husband’s. They sent the phone to two private labs to retrieve and organize the contents.

One neighbor reported noticing in the summer of 2016 that Sanaa would be alone in the backyard for hours. There, she would rake rocks or pick up dog feces with her bare hands.

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Neighbors and doctors painted a harrowing picture of Sanaa’s life, according to court filings.

One neighbor reported noticing in summer 2016 that Sanaa would be alone in the backyard for hours. There, she would rake rocks or pick up dog feces with her bare hands. She wore only a diaper, they told detectives.

They also allege that in the fall, Sanaa’s parents confined her with plastic zip-ties, police RIPP restraints, and handcuffs, none of which Lisa Cunningham mentioned in her initial interview with Yeo, he later testified.

Images and texts pulled from Lisa Cunningham’s cellphone told detectives that by December 2016, she was locking her stepdaughter outside, wearing only a diaper. She was being disciplined for making a mess.

A cellphone photo taken that month shows Sanaa wearing goggles. The Cunninghams made her wear them because she would rub her eyes raw.

One video from that period shows the festering wound on her foot, untreated. The wound was open down to the bone, had turned septic, and was treated only with Neosporin and gauze, prosecutors claim.

In December 2016, police said, the Cunninghams zip-tied Sanaa “spread eagled” to a water heater in the laundry room, which could be locked only from the outside.

When she wasn’t there or outside, she would be bound in the garage or put in the playpen, which was designed for a child 10 pounds lighter.

The Cunninghams always insisted, and their attorneys argue, that all these measures were to protect Sanaa from herself, and to stop her harming her smaller half-siblings.

Medical records suggested why.

One of the psychiatrists had produced a report with 16 recommendations. One suggested that Sanaa might need to be involuntarily confined to residential treatment at some point.

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Psychiatrists who examined Sanaa in fall 2016 reported her saying that she hallucinated. She saw figures in the room with her and felt things crawling on her skin.

Sanaa said she also heard voices telling her to hit her little sister over the head, that “killing someone would make her feel better,” and that she liked to hurt things that couldn’t fight back.

Sanaa told doctors she had thrown a rock at her 2-year-old sister’s head and tried to kill her. She attacked the dog and felt better.

One of the psychiatrists had produced a report with 16 recommendations. One suggested that Sanaa might need to be involuntarily confined to residential treatment at some point.

“She had never recommended this in 20 years of practice,” Yeo testified. “She felt the Cunninghams were incapable of treating Sanaa and they recommended inpatient care.”

Detectives and prosecutors were not convinced by the Cunninghams’ efforts.

Many of Sanaa’s symptoms were not witnessed by doctors, only reported by her parents. The couple would seek advice, ignore it, and keep looking for experts, prosecutors said. They were doctor-shopping until they found somebody to confirm their views.

“The only evidence they put forward” of Sanaa’s illness “they used to trick the Goodyear Police Department, DCS, and doctors,” Yeo testified.

They were suspicious because texts between the couple suggested they were withholding information about their efforts to discipline or restrain Sanaa.

Her older half-brother, prosecutors allege, told detectives about the abuse he witnessed. Yeo testified that the Cunninghams told the boy to lie to CPS investigators because they would split up the family.

As the investigation tightened, Germayne quit his police job on September 11, 2017.

Finally, on October 12, eight months after Sanaa died, the Medical Examiner’s Office released findings. Police said pathologists needed time to sift through the “complicated medical history.”

Pathologists ruled that the cause of Sanaa’s death was sepsis, stemming from a bout of bronchitis and pneumonia. But they listed the manner of death “undetermined,” rather than homicide.

“It is unclear if the scars, blunt force injuries, and healing wounds and ulcerations are the result of self-harming behaviors, inflicted injuries or restraint, or a combination of both,” pathologists wrote.

Yeo and prosecutors concluded, after talking with pathologists and emergency room doctors, that Sanaa died because the restraints prevented her from expelling infected fluid from her lungs.

It took authorities almost two months more to assign blame.

On December 1, DCS concluded Sanaa died because of abuse or neglect. The state didn’t publish that finding until December 12.

Five days later, a Maricopa County grand jury indicted the Cunninghams on 10 counts of felony child abuse and one count of murder.

Despite the gravity of the crime and the horrors of what was alleged, police never arrested the Cunninghams. Instead, they were ordered to appear in court on January 2, 2018.

Germayne Cunningham arrived late and Lisa Cunningham not at all. Prosecutors wanted $1 million bond for him and an arrest warrant for her. Judges routinely issue bench warrants when defendants fail to show up. Murder defendants are routinely jailed awaiting trial.

But court commissioner Thomas Kaipio instead ordered Germayne Cunningham released with an ankle monitor and conditions not to contact Lisa’s older children, who were witnesses.

Quacy Smith, Sylvia Norwood’s family lawyer, expressed shock afterward. He said in 20 years he had never seen a murder case handled this way. Smith said Cunningham kept “getting a pass” because he was an officer. Smith would know. He once was one.

Lisa Cunningham showed up for a rescheduled arraignment two weeks later, and got the same release conditions as her husband.

Last month, prosecutors accused the Cunninghams of violating their release terms, by letting Lisa’s oldest daughter, now 21, live with them.

Defense attorneys countered with a letter from a county probation officer informing Germayne Cunningham he was in full compliance.

The other motions, among a flurry filed in August 2018, will define the case.

The county attorney’s office now sought the death penalty and wanted the couple jailed without bond. Defense lawyers argued the nonsensical murder charge should be dismissed or sent back to a second grand jury for a fresh look.

The stakes soared. Everything was on the line. All or nothing.

The Cunninghams were heading back to court.

The morning of Friday, August 24, Maricopa Superior Court Judge Michael Kemp settled into his chair and opened what he scheduled as a routine, 30-minute hearing. He had to decide if there was sufficient evidence to jail the Cunninghams and proceed with the death penalty.

Germayne Cunningham arrived in a dark suit, Lisa Cunningham in a pink sweater.

Detective Yeo took the stand, recounted the evidence, and laid out the theory of the case.

“Based on texts that she was in a Pack ‘n Play zip-tied to an object, it made it impossible for her to expel fluids in her lungs,” Yeo said, summarizing what doctors told him.

Defense lawyers objected repeatedly, saying the state never claimed in the indictment that the restraints led to her death.

“This has nothing to do with the capital offense,” defense attorney Eric Kessler told Kemp.

Kemp let Yeo continue to describe the abuse, conflicting statements by the Cunninghams, incriminating texts between them, Sanaa’s myriad medical problems, medical testimony, and what the Cunninghams said about all of it.

He testified Lisa worried Sanaa’s treatment would hurt her career and Germayne feared the financial strain. He wanted to help his daughter on his own.

On the day Sanaa turned catatonic, it was obvious she needed urgent medical care and there was no evidence her parents sought it, Yeo testified.

But when Kessler began questioning the detective, cracks opened in the case.

Yeo said text messages were key to his investigation, the autopsy, and doctors’ findings.

Then Kessler showed Yeo a text between Germayne and Lisa that had been entered into evidence but was dated four years before Sanaa was born. The attorney also showed Yeo an entire page of incorrect dates from a forensic report.

Yeo testified that Lisa Cunningham’s children by her previous marriage told police they never said they saw Sanaa tied or cuffed on the weekend she died.

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Yeo acknowledged the mistakes, adding, “That was an oversight on my part.”

As the cross examination continued, Yeo conceded that the Cunninghams followed the prescription guidelines for the antipsychotics and the only day they stopped giving them to Sanaa was the day before she died.

Yeo also admitted that he told the grand jury Sanaa had died at 2:30 a.m., three hours earlier than she had.

“So you had a child in care of emergency medical staff for four hours before she died,” Kessler said.

The fireworks continued on the second day of the hearing, when another attorney on the defense team, Taylor Fox, volleyed more questions at the detective.

Yeo testified that Lisa Cunningham’s children by her previous marriage told police they never said they saw Sanaa tied or cuffed on the weekend she died. It was the same story the parents gave.

Then Fox asked Yeo if any witness said she was placed in the playpen unable to breathe. He couldn’t recall. He flipped through his own report for a few tense minutes.

“Sir, I don’t see anything in there that says she was zip-tied, shackled or confined to the playpen,” Yeo admitted.
Fox turned to the recommendation to put Sanaa in residential care. Yeo admitted that the recommendation was to institutionalize her in the future, not right away.

He admitted that he never interviewed the doctor who prescribed the antipsychotics. He sent questions by email.

Yeo testified that detectives had searched the trash bags at the family home in mid-March, weeks after Sanaa died. “Anybody could put a trash bag there,” he conceded, before testifying that the DNA results from the zip ties were still not in, 18 months on.

Fox pointed out that the staph infection on the festering, but healing, foot wound was a different kind than the one that plagued her lungs. The state’s allegation that the untreated foot wound led to the sepsis that killed her was bogus, the defense said.

They pointed out that the forensic analysis of Lisa Cunningham’s phone was done by a retired detective from the Phoenix Police Department, where Germayne had worked.

Kessler told the judge the president of the lab was ready to testify that he never would have released the report had he known about all of the errors in the investigation. The attorney read an email from the lab owner, saying,

“Any error in the data would taint the entire report.”

“This was more than reckless behavior, more than failure to provide care, and it led to the death of a child.” – Judge Michael Kemp

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In their summation for the judge, prosecutors showed horrific images, photos and videos of Sanaa’s last month on earth. Here, a skinny, frail, half-naked ball on the back porch. There, an image of her festering foot. Finally, Sanaa clinging like a punch-drunken prizefighter to the side of the playpen. And clinging to life.

In the gallery, her mother, Sylvia Norwood, gently wept.

The Cunninghams sat as they had throughout: stone-faced.

“Neither defendant rushed the victim to the hospital for more than half a day. This was abuse that led to pneumonia that killed Sanaa,” prosecutor Clark concluded.

Kessler followed a very different line.

“The state has never explained: At what point in time should the Cunninghams have taken Sanaa to the emergency room?” he said, adding there is no way to know from the indictment what caused Sanaa’s death.

“This was a child who had bizarre physical and psychological symptoms. They sought help everywhere they could. They were not predisposed to not seek care or hide it,” Kessler added. “It’s unfair to say they were on notice that she was near death. She was not a normal child.”

Kemp wasn’t buying.

“This was more than reckless behavior, more than failure to provide care, and it led to the death of a child,” he said as he ruled there was sufficient evidence to continue with the death-penalty case.

Sheriff’s deputies handcuffed the couple, who left the courtroom without fuss, few words, and nary a glance back.

click to enlarge Australia native Lisa Cunningham, accused of murdering her stepdaughter, at a recent hearing. - CAITLIN O’HARA / NEWS CORP AUSTRALIA
Australia native Lisa Cunningham, accused of murdering her stepdaughter, at a recent hearing.
Caitlin O’Hara / News Corp Australia

During the hearing, Kemp had said it
had resembled a mini-trial. It had.

The case hinges on whether Sanaa died by neglectful, uncaring human hands, or from a tragic medical emergency. A jury has to decide if the Cunninghams abused the frail 7-year-old and caused her maladies, or if they acted out of despair to protect their children, including Sanaa.

On October 12, Kemp will determine if a jury will hear the same evidence. That’s when he hears arguments on the motion to dismiss the murder charge or send it back to the grand jury.

It could be returned to the grand jury. That’s what happened in a similar case, which Kemp settled as well.
In 2007, the mother of 4-month old Dillon Uutela dropped the toddler off at a Peoria day care. Lisa Randall had been babysitting for 25 years. She was licensed with an unblemished record and stellar customer reviews.

When she turned her back on Dillon, he stopped breathing. She tried to revive him, failed, and called paramedics. He died at Children’s Hospital. Doctors noticed a swollen, bleeding brain and a cracked skull and called police.

Months later, police arrested Randall. Prosecutors took the case to a grand jury, which refused to indict. A judge dismissed it. Prosecutors tried again with a grand jury. This time they wanted to hear from Randall, an unusual step.

A judge released her from jail, but then-county attorney Andrew Thomas filed a direct complaint, seeking the death penalty. He said Randall killed the boy with a blow to the head.

Another judge warned county prosecutors they didn’t have enough evidence to convince a jury.

Two years later, Kemp heard new evidence, which showed that pneumonia had caused Dillon’s brain to swell, cracking his skull from the inside. It was a medical tragedy, not a murder. Prosecutors knew it and withheld it.

Kemp dismissed the case with prejudice, which means it could never be brought to court again.

Thomas was later disbarred after being found guilty of prosecutorial misconduct and abuse of power, in unrelated matters. Randall sued the county, but lost.

But Sanaa’s case also resembles another capital murder child abuse case with a very different outcome.

click to enlarge Greenwood Memory Lawn Cemetery in Phoenix, where Sanaa is buried without a headstone. - SEAN HOLSTEGE
Greenwood Memory Lawn Cemetery in Phoenix, where Sanaa is buried without a headstone.
Sean Holstege

Ame Deal was 10 when her relatives locked her in a plastic storage tub in the garage, during the height of summer. She died hungry, soaked by her own sweat and urine. She was in the box because she took a Popsicle without asking.

She had lived, and been tormented, in an overcrowded home. Relatives made her walk barefoot on hot pavement, forced her to eat dog feces, and paddled her with the “butt-buster.”

Kids in the family told a rehearsed tale to police that Ame got in the box during a game of hide-and-seek and nobody knew she was in there.

Neighbors suspected things were wrong, but none called police. State child welfare agents were never called to the house, but Ame’s death became a rallying cry for all that was wrong with how Arizona protected vulnerable kids. State case workers didn’t know about Ame because counterparts in Utah and Texas never told them about their dealings with family.

Juries convicted several family members on child abuse counts. They got long sentences. Two were convicted of murder. They are on death row.

Somewhere in between the two extremes, perhaps, lies the sad case of Sanaa Cunningham. It raises familiar, troubling questions. Why did she have to die? Who’s to blame? Could anybody have prevented it? What does justice look like?

Outside of court recently, Sylvia Norwood was philosophical. She said it didn’t matter if the Cunninghams get convicted of murder if they are found guilty of abuse. Family members don’t often say that.

“They were mean individuals. They knew what they were doing to Sanaa. What she needed was medical treatment. She didn’t do all that to herself,” Norwood said.

Lisa Cunningham, in her texts to her cousin, expressed a different outrage.

“This child never got the medical or mental health care she should have,” she wrote. “After six mental health experts and $100,000 in bills searching, it was the drug that we didn’t choose that took her life. No one cared about her quality of life or what being and feeling psychotic felt like to a child.

“In spite of the judgment we have endured, the injustice, the loss of everything we had, our children, we wake up every day and we can’t bring her back. The rage I feel for what happened to our girl is crippling,” she wrote.

“I didn’t think it would ever get this far. I believe the justice system over there is corrupt.” – Donna Roesler, Lisa Cunnigham's cousin.

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Her cousin in Australia, Donna Roesler, is outraged by the U.S. legal system.

“I didn’t think it would ever get this far. I believe the justice system over there is corrupt,” she said in a recent telephone interview. She and another cousin allege that the state only prosecuted Lisa Cunningham after she threatened to sue DCS.

Questions linger about the system, its fairness, or its effectiveness, and why so much about this case is unorthodox.

Three times DCS agents visited the house in the last, troubled year of Sanaa’s life. A Goodyear police officer was there two months before she died. None of them reported signs of abuse in time to save her life.

DCS waited 10 months to “promptly” report her suspicious child abuse death.

Police took weeks to gather evidence from the house. The state crime lab has had that evidence for 19 months and still hasn’t produced results.

Pathologists took eight months to finish an autopsy report.

That delayed the finding that the death was suspicious, and still an indictment took another two months.

After the charge, the suspects were released without bond, despite the horrific nature of the accusations. A witness, their adult daughter, moved in with them.

Authorities have released none of the police or DCS case reports, or last month’s courtroom exhibits, all sealed by court order. The parties are subject to a gag order.

There is no way to independently verify what state and local investigators saw, heard, or did in the last month of Sanaa’s life. No way to independently verify who’s telling the truth, or if the investigations were conducted properly.

DCS Director Greg McKay was once a Phoenix detective, then the man who blew the whistle on 6,000 dormant and ignored state child welfare investigations. But now he is defending the agency he was later tapped to lead.

He said DCS bore no blame in Sanaa’s death, noting its investigations often last months.

“This is absolutely not something that DCS missed, leading to a death,” McKay said. “There are two people’s names on that indictment, and it’s nobody from our organization.”

That’s not what Sanaa’s mother, her lawyer, and others in the family say.

“This is not going to look like justice as we’re accustomed to it,” lawyer Quacy Smith said. “Something in this room stinks. Either you have a cop who’s a killer, or you have an absolute failure of DCS to protect this child. Or both.”

He added, “Who do we hold accountable for a failure to act?”