Pinkney v. State

JAMES R. EYLER, J.,

Appellant, Walter Pinkney, challenges his first degree murder and child abuse convictions for the brutal killing of his step-grandson, six-month-old Ta’mar Hamilton. Following a four-day trial on the merits, the jury returned verdicts of guilty on the first degree murder and felony child abuse counts, and appellant was subsequently sentenced to a term of life imprisonment for the first degree murder conviction and 30 years imprisonment for the child abuse conviction, to be served consecutively.

On appeal, appellant alleges three errors. First, he argues that the evidence was legally insufficient to sustain a conviction of first degree murder, i.e., that the court erred in failing to grant his motion for judgment of acquittal. Next, he contends that the trial court erred in admitting the prior statements of Renita Pinkney, Ta’mar’s paternal grandmother, who was appellant’s girlfriend at the time and who is now appellant’s wife.1 Finally, appellant claims that the court erred in precluding the defense from pursuing relevant testimony about the actions and behavior of Larry Hamilton, Jr., Ta’mar’s father. Perceiving no error in the trial court’s evidentiary rulings and finding that there was sufficient evidence to sustain the first degree murder conviction, we affirm appellant’s convictions.

Factual Background

On the evening of November 27, 1999, officers of the Baltimore City Police Department went to The Johns Hopkins *315Hospital in response to a call of suspected child abuse of. six-month-old Ta’mar Hamilton. David Peckoo, one of the investigating officers, interviewed Renita Pinkney and appellant, who, he had been told, were responsible for the care and custody of Ta’mar, before Ta’mar was rushed to the hospital earlier that day.

Ta’mar died from his injuries on December 1, 1999. On December 3, 1999, after an autopsy had been performed on Ta’mar, police investigators again interviewed Ms. Pinkney and appellant. On December 14, 1999, appellant was arrested and charged with first degree murder and child abuse.

The evidence at trial portrayed the following chronology of events surrounding Ta’mar’s death. On Thursday, November 25, 1999, Thanksgiving, arrangements were made for Larry Hamilton, Sr., Ta’mar’s paternal grandfather, and appellant to pick up Ta’mar and his brother, Davon Hamilton, then 15 months old, from their mother, Shawntel Rice, and take them to the home of Ms. Pinkney and appellant to stay for the remainder of the Thanksgiving weekend. The men arrived at the home of Ms. Rice and placed both children in their car seats. During the car ride to Ms. Pinkney’s and appellant’s house, Ta’mar was cranky and cried for most of the trip.

Upon their arrival, Larry Hamilton, Sr. instructed his son, Larry Hamilton, Jr., the boys’ father, to remove the children from the car and bring them into the house. There is conflicting testimony about Hamilton, Jr.’s actions following his father’s demand, suggesting varying levels of harshness with which Hamilton, Jr. physically brought the children into the home. According to Ms. Pinkney, Hamilton, Jr. removed the children from the car and, while they still were strapped into their car seats, threw them up several steps into the vestibule of the house. Hamilton, Jr. testified that he retrieved one child at a time and handed the first car seat off to someone before retrieving the second. Finally, another witness described Hamilton, Jr.’s dropping the car seats into the vestibule, after carrying them up the stairs, because his pants *316were falling down. There was undisputed testimony that the car seats were padded, and that they landed upright.

Once the children were inside the house, Hamilton, Jr. and other visitors remained for one to two hours. They then departed, leaving Ms. Pinkney and appellant alone with Ta’mar and Davon. Ta’mar continued to cry and was generally cranky. Before putting the children to bed, appellant gave Ta’mar a bath. Ta’mar slept only a few hours on Thursday night. He awoke at 3 a.m. on Friday morning and required feeding and changing. He did not fall back to sleep until 6 a.m.

On Friday afternoon, after observing Ta’mar’s continued crankiness, Ms. Pinkney took Ta’mar to a clinic. Davon remained in the care and custody of appellant. Ms. Pinkney waited several hours only to be told that the clinic would not treat Ta’mar because he was not covered by insurance. She returned home with Ta’mar late Friday afternoon. When she tried to feed him, Ta’mar would not eat or drink.

Ms. Pinkney and appellant fell asleep on the couch for a few hours with both children. They then took the children upstairs to bed, keeping Davon in the room with them, and putting Ta’mar to sleep in another room. During that night, Ta’mar cried constantly, and Ms. Pinkney and appellant took turns patting his back, walking him around the room, and trying to calm him. Ta’mar briefly slept between the hours of 3 and 6 a.m. Thereafter, he slept only for short periods of time.

At approximately 10 a.m., Ms. Pinkney went to the store for diapers, leaving the children in appellant’s care. She checked and saw that Ta’mar was asleep before she left. According to appellant, while Ms. Pinkney was away, Ta’mar awoke and began crying, so he went into the room where Ta’mar was and picked him up to try to calm him. He tried to feed Ta’mar from a bottle, but Ta’mar only drank a small amount, approximately 3 and a half ounces. Appellant testified that he was changing Ta’mar’s diaper following a suspected bowel movement when Ta’mar gasped for breath and stopped breathing. *317Immediately, he called 911 and began giving Ta’mar CPR. He was still trying to resuscitate Ta’mar when Ms. Pinkney returned home. An ambulance then arrived and transported Ta’mar to The Johns Hopkins Hospital (“Hopkins”).

Ta’mar was admitted to the Pediatric Emergency Department. Dr. Allen Walker, Director of that Department, was contacted to evaluate Ta’mar. Dr. Walker diagnosed Ta’mar as having sustained a severe brain injury. Dr. Walker interviewed Ms. Pinkney and appellant, trying to ascertain what had happened before Ta’mar was brought into the hospital. During the interview, appellant described Ta’mar’s constant crankiness, refusal to eat, how Ta’mar had stopped breathing while he was changing his diaper, how he had immediately contacted 911, and his attempts at CPR. Thereafter, Dr. Walker spoke with the police.

Officer Brian Rice arrived at the hospital and interviewed Ms. Pinkney and appellant. During the interview, appellant again explained that Ta’mar had been cranky and crying all weekend and that he had stopped breathing on Saturday morning.

Devoark Maddox, a clinical social worker at Hopkins, testified regarding her completion of a child maltreatment form, based on her interview with appellant and Ms. Pinkney at the hospital. During the interview, appellant described the events, including his telephone call to 911 and his attempt to resuscitate Ta’mar. Ms. Maddox described appellant as calm and forthcoming during their interview.

Detective David Peckoo also interviewed appellant and Ms. Pinkney at the hospital that day. The interview revealed much of the same information discussed above.

The autopsy revealed that the cause of Ta’mar’s death was blunt force trauma as a result of four injuries to his head. After receiving the autopsy results, Detective Peckoo asked Ms. Pinkney and appellant to come to the police station for a second interview. They did so voluntarily on December 3, 1999, and he took recorded statements from them both. During this second interview, appellant indicated that he might *318have hit Ta’mar’s head on the bed rail while trying to get him to respond after he stopped breathing. He also admitted that he had shaken Ta’mar a few times.

As part of the investigation, Detective Peckoo removed the bed rail from Ms. Pinkney’s home and tested it for blood, semen, and hair. The test results were negative for those substances and did not reveal any evidence of human contact. On December 14, 1999, appellant was arrested and charged with first degree murder and child abuse of Ta’mar Hamilton.

Following selection of a jury and an unsuccessful pre-trial suppression hearing,2 a trial on the merits began on September 19, 2000. The State presented the testimony of eight witnesses in the following order: Officer Brian Rice, Devoark Maddox, Dr. Allen Walker, Shawntel Rice, Renita Pinkney, Detective David Peckoo, Larry Hamilton, Jr., and Dr. Joseph Pestaner. The defense offered the testimony of Larry Hamilton, Sr., Sheena Watkins, and appellant. These witnesses testified to the following additional information.

Dr. Walker testified in great detail about the extent and cause of Ta’mar’s fatal injuries, explaining that (1) severe brain injury was his initial diagnosis, (2) Ta’mar’s chance for survival was almost non-existent, (3) the injuries were almost everywhere, i. e., the brain and skull had been virtually destroyed, (4) violent force, similar to the force when someone is thrown through the windshield in a car crash or falls from a third floor window, was required to inflict the type of injuries that Ta’mar had sustained to his head, and (5) such violent blows would have rendered Ta’mar immediately unconscious so as to make him incapable of crying or drinking formula. Dr. Walker also described the rest of Ta’mar’s stay at Hopkins, explaining that for a couple of days he was maintained on *319a number of medications and a ventilator because he could not breathe for himself, and that, during that time, his brain died.

During cross-examination, Dr. Walker testified, with the assistance of hospital records, that Ta’mar had been delivered prematurely, requiring assistance with breathing, and that Ta’mar’s mother had a sexually transmitted disease when Ta’mar was delivered. He also testified that Ta’mar was brought into the Hopkins Pediatric Emergency Department when he was three months old for pneumonia and was treated with IV antibiotics and sent home. Finally, Dr. Walker testified that the autopsy revealed that there was a healing rib fracture at the time of his death from an injury suffered prior to November 27, 1999.

Shawntel Rice, Ta’mar’s mother, testified for the State about the events of November 25, when her sons were picked up by appellant and Larry Hamilton, Sr., and about how she learned that Ta’mar had been admitted to Hopkins. She also testified about Ta’mar’s demeanor generally and his behavior prior to being picked up on the 25th.

In addition to testifying about the specific events that occurred between November 25 and 27, 1999, Ms. Pinkney testified generally about the parenting skills of her son and Shawntel Rice. She explained that her son and Ms. Rice, as well as the two boys, had lived in her home for a period of time just after Ta’mar was born. She also explained that, after they left her home, she and appellant continued to watch the two children on a daily basis for a while, but that arrangement ended a few weeks prior to the Thanksgiving weekend visit. According to Ms. Pinkney, Ms. Rice asked her if she and appellant would watch the children for the weekend. Ms. Pinkney reluctantly agreed after Ms. Rice promised to provide a place for Davon to sleep.

Ms. Pinkney further testified that the reason she asked her son and Ms. Rice to leave her home was because they used drugs and did not take good care of their children, neglecting to feed them or play with them. She further testified that they cursed at Ta’mar and Davon and that she witnessed them *320hit both boys on several occasions. The prosecutor challenged Ms. Pinkney’s assertions by pointing out that she had never mentioned any past abuse to anyone prior to her testimony in court.

Finally, Dr. Joseph Pestaner, an expert in forensic and pediatric pathology, was called by the State to testify regarding the autopsy he performed on Ta’mar. His testimony was substantially similar to that of Dr. Walker but was more detailed. He was able to discount other incidents, such as older injuries or being tossed in his car seat, as possible causes of Ta’mar’s fatal injuries, reinforcing what Dr. Walker said about the amount of force that would have been required to cause such serious damage to Ta’mar’s brain and skull. Dr. Pestaner also echoed Dr. Walker’s opinion that Ta’mar would have been rendered unconscious almost immediately after being struck, such that crying and drinking from a bottle would not have been possible.

Larry Hamilton, Sr. and Sheena Watkins were called for the defense and testified generally regarding the events on November 25,1999, when Ta’mar was brought to the home of Ms. Pinkney and appellant. Larry Hamilton, Sr. also testified that he observed his son, Larry Hamilton, Jr., strike Ta’mar in the head on several occasions between September 11, 1999, and the week prior to Thanksgiving of 1999.

Appellant testified in his own defense, describing the events of November 25-27, emphasizing Ta’mar’s continuous crying, as well as his efforts to calm him by walking him, patting his back, attempting to feed him a bottle, and changing his diaper. He also described how Ta’mar stopped breathing and how he immediately called 911 for assistance and tried to resuscitate him by performing CPR.

During cross-examination, the prosecutor asked appellant about his admission during his December 3 statement to Detective Peckoo that he may have accidentally hit Ta’mar’s head when he was shaking him to revive him. Acknowledging that admission, appellant went on to say that after thinking about it for some time after talking to Detective Peckoo, he *321knew that Ta’mar did not hit his head. .In response to the prosecutor’s questions about whether, by Saturday morning, he was tired and frustrated by Ta’mar’s constant crying and crankiness, appellant admitted to being tired from the sleepless nights, but denied that he was frustrated by his failed attempts to quiet the baby. Finally, the prosecutor reviewed with appellant another part of his statement to Detective Peckoo, in which appellant described Ta’mar’s cries as sounding like a child who had been hit, and explained that when he touched Ta’mar’s head, he cried out like someone was beating him. Appellant admitted that he told Detective Peckoo that his first response was to think to himself, “What did I do?”

On the same day that closing arguments were delivered, the jury returned a verdict of guilty on both the first degree murder and child abuse counts. On December 4, 2000, the court sentenced appellant to life imprisonment for the first degree murder conviction, and 30 years incarceration for the child abuse conviction, to be served consecutively.

Appellant filed an appeal to this Court on December 21, 2000. Counsel for both parties argued before a three-judge panel of this Court on February 11, 2002.3 Following that argument, by order dated March 10, 2003, this Court, on its own motion, ordered that an en banc hearing be held on April 29, 2003, to consider whether the theory of the case that the State argued to the jury precluded the jury from convicting appellant of first degree murder.4 Specifically, this Court asked the parties to address whether the State argued that appellant’s intent was to stop Ta’mar from crying as distinguished from arguing that appellant’s intent was to kill Ta’mar, with the desire to stop the crying as a motive for the intent, and if so, the legal effect of the State’s argument. After reviewing the record and considering the arguments, we are satisfied that the State argued that appellant intended to *322kill Ta’mar. Consequently, we need not address the legal issue raised by the Court and will address only the issues raised by appellant.

Additional facts will be set forth as relevant to our resolution of the issues.

Discussion

We begin with a discussion of appellant’s evidentiary challenges.

Alleged Errors in the Admission of Evidence

Appellant alleges two errors in the trial court’s evidentiary determinations. Appellant’s first challenge involves a recorded statement that Renita Pinkney gave to police on December 8, 1999, a week after the murder. In that statement, Ms. Pinkney denied having seen Ta’mar sustain any abuse or injuries diming the Thanksgiving weekend visit prior to his death. She testified to the same effect on direct examination by the State. During cross-examination, however, she stated that on November 25, 1999, her son, Larry Hamilton, Jr., threw Ta’mar’s car seat up a flight of stairs into the vestibule while Ta’mar was strapped inside. On re-direct, the State challenged the inconsistency by asking Ms. Pinkney questions about her prior statement and later admitted the statement through the testimony of Detective Peckoo.

Appellant argues that the trial court erred in admitting the December 3, 1999, statement because it failed to meet the foundational requirements laid out in Maryland Rule 5-613(a), which requires that the speaker be shown the statement and provided with an opportunity to explain it before its admission. In response, the State first argues that this claim was waived because, when defense counsel stated his basis for the objection to its admission, he mentioned only that Ms. Pinkney had already testified, and thus the jurors should base their deci-. sion on her testimony only. On the merits, the State argues that, if preserved, the court did not err because the statement was properly admitted pursuant to Maryland Rule 5-802.1, which governs the admission of prior statements by witnesses.

*323While we disagree with the State’s preservation argument,5 we agree that the statement was properly admitted under Rule 5-802.1, which governs the admission of extrinsic evidence of a prior inconsistent statement when it is offered as substantive evidence, rather than for impeachment purposes. Specifically, Rule 5-802.1(a)(3) provides that a prior statement is not hearsay if made by a witness who testifies at trial and who is subject to cross examination concerning the statement if that statement is “recorded in substantially verbatim fashion by stenographic or electronic means contemporaneously with the making of the statement!.]” The rule does not contain the same foundational requirements as Rule 5-613; and therefore Ms. Pinkney’s statement meets all of the requirements of Rule 5-802.1 and was properly admitted.

Appellant’s second evidentiary challenge claims that the trial court abused its discretion in excluding relevant testimony regarding Larry Hamilton, Jr.’s treatment of Ta’mar and general behavioral characteristics. Specifically, appellant argues that defense counsel should have been permitted to pursue a line of questioning regarding Hamilton, Jr.’s character, drug use, and abusive treatment of his children, to raise the possibility that Ta’mar’s fatal injuries were not caused by appellant but, rather, were the result of Hamilton, Jr.’s mistreatment of Ta’mar. Appellant acknowledges, however, that both Ms. Pinkney and Larry Hamilton, Sr. were permitted to testify about their observation of Hamilton, Jr.’s neglect and physical abuse of Ta’mar and his brother, Davon.

The State contends that the trial court properly exercised its discretion in precluding certain testimony regarding Larry Hamilton, Jr., arguing that (1) evidence regarding Hamilton, Jr.’s involvement with drugs had no relevance to the issue of whether appellant killed Ta’mar, and (2) Hamilton, Jr.’s al*324leged threats to Ms. Pinkney had no tendency to make it more or less likely that appellant actually killed Ta’mar. Maryland Rule 5-401 defines relevant evidence as “evidence having any tendency to make the existence of any fact that is of consequence to the determination of the action more probable or less probable than it would be without the evidence.” We have stated that a ruling on the relevancy of the evidence is “quintessentially” within the wide discretion of the trial court. See Best v. State, 79 Md.App. 241, 259, 556 A.2d 701, cert. denied, 317 Md. 70, 562 A.2d 718 (1989). In addition, the Court of Appeals has stated that a trial court’s determination as to the relevancy of evidence will not be reversed absent a clear showing of abuse of discretion. See White v. State, 324 Md. 626, 637, 598 A.2d 187 (1991); Hunt v. State, 321 Md. 387, 425, 583 A.2d 218 (1990), cert. denied, 502 U.S. 835, 112 S.Ct. 117, 116 L.Ed.2d 86 (1991).

The trial court did not abuse its discretion in determining that evidence regarding Hamilton, Jr.’s drug use and alleged threats toward Ms. Pinkney was irrelevant to the issue of appellant’s guilt. Thus, the evidence was properly excluded pursuant to Maryland Rule 5^102, which provides that “[e]vi-dence that is not relevant is not admissible.”

Sufficiency of the Evidence

Given our rejection of both of appellant’s evidentiary challenges, we turn to appellant’s main argument—that the evidence was insufficient to sustain a conviction of first degree murder. Specifically, appellant argues that the evidence failed to establish (1) that appellant was the individual who inflicted the fatal injuries upon Ta’mar Hamilton, or (2) that, if appellant did in fact inflict those injuries, he did so with malice or with the premeditation or deliberation necessary for a finding of first degree murder. In support of his second argument, appellant first turns to cases discussing Maryland’s statutory elements for first degree murder, arguing that the evidence does not satisfy the statute’s strict requirements. In addition, appellant reviews other Maryland cases involving abuse inflict*325ed upon a child resulting in death, suggesting that when the fatal act is the result of an emotionally charged situation involving a baby, the accused is, at most, found guilty of second degree murder. Finally, appellant urges us to consider the fact that other jurisdictions have been hesitant to convict a defendant of first degree murder for the death of a child.

In response to appellant’s sufficiency of the evidence argument, the State first argues that appellant’s challenge is not preserved for appellate review. Pointing to Maryland Rule 4-324, which governs motions for judgment of acquittal, the State argues that appellant is bound by the reasons stated when he renewed the motion at the end of appellant’s case, when defense counsel stated: “I renew my Motion for Judgment of Acquittal because there has been no evidence introduced beyond a reasonable doubt to prove Mr. Pinkney guilty.” See Md. Rule 4-324(a) (“A defendant may move for judgment of acquittal ... in a jury trial, at the close of all the evidence. The defendant shall state with particularity all reasons why the motion should be granted.”). Consequently, the State contends that appellant’s claims are not preserved for review because they were not articulated as the basis for his motion for judgment of acquittal at the close of all of the evidence. On the merits, the State argues that, when applying the deferential standard of review for sufficiency challenges, it is clear that there was ample evidence from which the jury could properly conclude that appellant was guilty of first degree murder.

While there is some merit to the State’s preservation argument, because we conclude that the evidence was legally sufficient and appellant’s conviction will not be disturbed, we shall resolve the uncertainty as to preservation in favor of appellant and reach the merits. Accordingly, we begin by reviewing the standard of review for sufficiency of the evidence challenges. Most recently, the Court of Appeals, in State v. Smith, 374 Md. 527, 823 A.2d 664, 2003 Md. LEXIS *326251 (Md. May 9, 2003),6 discussed the standard of review in great depth, stating:

The standard for appellate review of evidentiary sufficiency is whether, after viewing the evidence in the light most favorable to the prosecution, any rational trier of fact could have found the essential elements of the crime beyond a reasonable doubt. See Jackson v. Virginia, 443 U.S. 307, 313, 99 S.Ct. 2781, 2785, 61 L.Ed.2d 560, 569 (1979); Moye v. State, 369 Md. 2, 12, 796 A.2d 821, 827 (2002); White v. State, 363 Md. 150, 162, 767 A.2d 855, 861-62 (2001); State v. Albrecht, 336 Md. 475, 478-79, 649 A.2d 336, 337-38 (1994). “Weighing the credibility of witnesses and resolving any conflicts in the evidence are tasks proper for the fact finder.” State v. Stanley, 351 Md. 733, 750, 720 A.2d 323, 331 (1998). See McDonald v. State, 347 Md. 452, 474, 701 A.2d 675, 685-86 (1997), cert. denied, 522 U.S. 1151, 118 S.Ct. 1173, 140 L.Ed.2d 182 (1998) (quoting Albrecht, 336 Md. at 478, 649 A.2d at 337); Binnie v. State, 321 Md. 572, 580, 583 A.2d 1037, 1040-41 (1991); Wright v. State, 312 Md. 648, 541 A.2d 988 (1988). “We give ‘due regard to the [fact finder’s] findings of facts, its resolution of conflicting evidence, and, significantly, its opportunity to observe and assess the credibility of witnesses.’ ” Moye, 369 Md. at 12, 796 A.2d at 827 (quoting McDonald v. State, 347 Md. 452, 474, 701 A.2d 675, 685 (1997) (quoting Albrecht, 336 Md. at 478, 649 A.2d at 337)). See the following recent cases quoting Albrecht: Anderson v. State, 372 Md. 285, 291-92, 812 A.2d 1016, 1020 (2002); Deese v. State, 367 Md. 293, 305, 786 A.2d 751, 758 (2001); Galloway v. State, 365 Md. 599, 649, 781 A.2d 851, 880 (2001); White, 363 Md. at 162, 767 A.2d at 861-62. We do not re-weigh the evidence, but “we do determine whether the verdict was supported by sufficient evidence, direct or circumstantial, which could convince a rational trier of fact of the defendant’s guilt of the offenses charged beyond a reasonable doubt.” White, 363 *327Md. at 162, 767 A.2d at 862. A valid conviction may be based solely on circumstantial evidence. Wilson v. State, 319 Md. 530, 537, 573 A.2d 831, 834 (1990). The same standard applies to all criminal cases, including those resting upon circumstantial evidence, since, generally, proof of guilt based in whole or in part on circumstantial evidence is no different from proof of guilt based on direct eyewitness accounts. See Eiland v. State, 92 Md.App. 56, 607 A.2d 42 (1992) , rev’d on other grounds, 330 Md. 261, 623 A.2d 648 (1993).

Id. at 533-34, 823 A.2d at 667-68.

Noting some confusion regarding the amount of deference that an appellate court should give to the fact finders’ ability to draw inferences from the evidence, the Court went on to explain:

The following cases further emphasize a trial judge’s or a jury’s ability to choose among differing inferences that might possibly be made from a factual situation and the deference we must give in that regard to the inferences a fact-finder may draw. Jackson, 443 U.S. at 319, 99 S.Ct. at 2789, 61 L.Ed.2d at 573 (noting the responsibility of the trier of fact to fairly resolve conflicts in testimony, to weigh the evidence, and to draw reasonable inferences from basic facts to ultimate facts); Jones v. State, 343 Md. 448, 460, 682 A.2d 248, 254 (1996) (Involving a probable cause issue the Court stated “it is the trier of fact that must draw the inferences.... Consequently, absent clear error in its fact-finding, an appellate court is required, in deference to the trial court, to accept those findings of fact.”); In re Timothy F., 343 Md. 371, 379-80, 681 A.2d 501, 504-05 (1996) (in criminal cases the appropriate inquiry is not whether the reviewing court believes that the evidence established guilt beyond a reasonable doubt, but, rather, whether, after viewing the evidence in the light most favorable to the prosecution, any rational trier of fact could have found the essential elements of the crime beyond a reasonable doubt); McMillian v. State, 325 Md. 272, 281-82, 600 A.2d 430, 434-35 (1992) (stating that “The trial court’s findings as to *328disputed facts are accepted by this Court unless found to be clearly erroneous”); see also Riddick v. State, 319 Md. 180, 183, 571 A.2d 1239, 1241 (1990).

In State v. Raines, 326 Md. 582, 590-93, 606 A.2d 265, 269-70 (1992), the Court stated:

“This analysis indicates that the Court of Special Appeals ■ credited the Raines’s version of the events, one that necessarily mitigated his culpability. Of course, the credibility of the witnesses was a matter for the trial court, as fact finder, not the appellate court, to resolve. Furthermore, the determination of an accused’s intention is, in the first instance, for the trial judge, when sitting without a jury, and this determination will not be disturbed on appeal unless clearly erroneous. As noted, the trial court discounted Raines’s version of the events. Instead, the court drew an inference based on other evidence offered at trial that the killing was intentional, deliberate and premeditated. This, the trial court, as fact finder, has the exclusive right to do. The Court of Special Appeals erred in conducting its own independent credibility analysis and in rejecting the trial court’s finding of facts.
“... This Court has noted that the trier of fact may infer the intent to kill from the surrounding circumstances: “[S]ince intent is subjective and, without the cooperation of the accused, cannot be directly and objectively proven, its presence must be shown by established facts which permit a proper inference of its existence.”
"... Raines’s actions in directing the gun at the window, and therefore at the driver’s head on the other side of the window, permitted an inference that Raines shot the gun with the intent to kill. Relying upon that inference, the trial judge could rationally find, beyond a reasonable doubt, that the killing was wilful, deliberate and premeditated so as to render Raines guilty of first degree murder.
“Although a different trier of fact may have viewed the evidence as establishing second degree murder instead of *329first degree murder, the trial court’s decision was not clearly erroneous. The Court of Special Appeals erred in substituting its judgment for that of the trial court on the evidence.” [Citations omitted.]

While in Raines, and in some of the other cases, the exact issues relate to the proof of intent in respect to the type of homicide, we, and the Court of Special Appeals, have held that even in murder cases, intent may be established by the use of rational inferences from the underlying evidentiary facts.

Id. at 534-35, 823 A.2d at 668-69.

The Court’s articulation and explanation of the standard emphasizes three important principles: (1) we must give great deference to the trier of facts’ opportunity to assess the credibility of witnesses, weigh the evidence, and resolve conflicts in the evidence, (2) circumstantial evidence alone can provide a sufficient basis upon which a trier of fact can rest its determination of guilt, even for first degree murder, and (3) we do not re-weigh the evidence or substitute our own judgment, but only determine whether the verdict was supported by sufficient evidence to convince the trier of fact of the defendant’s guilt beyond a reasonable doubt. These principles were summarized by the Smith Court when it stated:

The primary appellate function in respect to evidentiary inferences is to determine whether the trial court made reasonable, i.e., rational, inferences from extant facts. Generally, if there are evidentiary facts sufficiently supporting the inference made by the trial court, the appellate court defers to the fact-finder instead of examining the record for additional facts upon which a conflicting inference could have been made, and then conducting its own weighing of the conflicting inferences to resolve independently any conflicts it perceives to exist. The resolving of the conflicting evidentiary inferences is for the fact-finder.

Id. at 547-48, 823 A.2d at 676.

Appellant’s sufficiency argument presents two separate issues; first, whether there was sufficient evidence to prove that *330appellant was the individual who caused the fatal injuries suffered by Ta’mar; and second, whether there was sufficient evidence to demonstrate that appellant killed Ta’mar wilfully, deliberately, and with premeditation. Appellant’s first claim is primarily premised on his theory that evidence that was both admitted and excluded tended to show that Ta’mar’s father, Larry Hamilton, Jr., may have been the responsible party. We previously held that the court did not abuse its discretion by excluding certain evidence regarding Larry Hamilton, Jr. In addition, we do not think that any of the evidence that was admitted precluded the jury from finding that appellant was the individual who inflicted the fatal injuries to Ta’mar’s head.

In Deese v. State, 367 Md. 293, 786 A.2d 751 (2001), a ease with similar facts to ours, the Court of Appeals affirmed the defendant’s second degree murder conviction7 based on its application of the rule that “[i]t is well settled that a conviction may be sustained on the basis of circumstantial evidence.” Id. at 308, 786 A.2d 751 (citing Hebron v. State, 331 Md. 219, 228, 627 A.2d 1029 (1993)). Applying the above rule to the facts of the case, the Court explained that

the evidence most favorable to the State is that (1) Kyle was alive on the morning of February 8, (2) Kyle was under Deese’s exclusive supervision for a period of time on that day, (3) Kyle was found dead a few hours after that period, (4) death was due to blunt force injuries to the head [caused by force of a magnitude at work in car crashes and falls from significant heights] and possibly due to shaking, and (5) no one had contact with Kyle after the period described in (2) and before the event described in (3). From these circumstances, a rational jury could have inferred, beyond a reasonable doubt, that Deese inflicted the fatal injuries.

Id. (reasoning that other cases have affirmed convictions based on circumstantial evidence when a defendant, during the commission of the crime, exercised exclusive control or custo*331dy over the premises where the crime occurred). The similarity between the facts in Deesa and those in the present case support our application of the Deese Court’s reasoning to hold that there was sufficient evidence from which the jury could have concluded beyond a reasonable doubt that appellant was the individual who inflicted the fatal blows to Ta’mar’s head.

Appellant was convicted under section 407 of Article 27 of the Maryland Code, which provides that “[a]ll murder which shall be perpetrated ... by any kind of wilful, deliberate and premeditated killing shall be murder in the first degree.” Md.Code, art. 27 § 407 (1957, 1996 RepLVol., 2000 Supp.).8 As appellant properly recognized, the State has the burden of proving each element of the crime beyond a reasonable doubt. Bane v. State, 327 Md. 305, 311-12, 609 A.2d 313 (1992) (citing State v. Evans, 278 Md. 197, 206-07, 362 A.2d 629 (1976)). We are reminded that, on appellate review, we are not asked to re-weigh the evidence or substitute our judgment for that of the jury, but instead, we must simply determine “whether, after viewing the evidence in the light most favorable to the prosecution, [the jury] could have found the essential elements of the crime beyond a reasonable doubt.” See Jackson v. Virginia, 443 U.S. 307, 313, 99 S.Ct. 2781, 61 L.Ed.2d 560 (1979); Moye v. State, 369 Md. 2, 12, 796 A.2d 821 (2002); White v. State, 363 Md. 150, 162, 767 A.2d 855 (2001); State v. Albrecht, 336 Md. 475, 478-79, 649 A.2d 336 (1994).

Having determined that there was sufficient evidence upon which the jury could have found that appellant caused Ta’mar’s death, we turn our focus to the additional three elements of first degree murder—wilfulness, deliberation, and premeditation. The Maryland Criminal Pattern Jury Instructions 4:17 (2001), which were used by the trial judge in this case, define those three elements by stating:

Wilful means that the defendant actually intended to kill the victim. Deliberate means that the defendant was conscious of the intent to kill. Premeditated means that the *332defendant thought about the killing and that there was enough time before the killing, though it may have only been brief, for the defendant to consider the decision whether or not to kill and enough time to weigh the reasons for and against the choice. The premeditated intent to kill must be formed before the killing.

The Court of Appeals has reinforced the application of those definitions by stating that first degree murder requires “that the defendant possess the intent to kill (willful), that the defendant have conscious knowledge of the intent to kill (deliberate), and that there be time enough for the defendant to deliberate, i.e., time enough to have thought about that intent (premeditate).” Willey v. State, 328 Md. 126, 133, 613 A.2d 956 (1992) (holding that the jury instructions adequately distinguish between first and second degree murder).

Despite these seemingly clear definitions, we are mindful that it is often difficult to understand these concepts in the abstract,9 and even more difficult to determine whether each is satisfied when faced with a specific set of facts. Fortunately, a body of case law has developed to guide our interpretation and application of these definitions.

First, examining the wilfulness requirement, we have stated that “[flor a killing to be ‘wilful’ there must be a specific purpose and intent to kill[.]” Snyder v. State, 104 Md.App. 533, 549, 657 A.2d 342 (1995) (quoting Tichnell v. State, 287 Md. 695, 717-18, 415 A.2d 830 (1980)); see also Faulcon v. State, 211 Md. 249, 126 A.2d 858 (1956); Hounshell v. State, 61 Md.App. 364, 486 A.2d 789 (1985). Given the fact that most defendants do not announce their intent to kill to witnesses or other third parties, we are forced to look to other factors as reflecting the defendant’s intent to kill.

*333For example, in Cummings v. State, 223 Md. 606, 165 A.2d 886 (1960), the Court of Appeals reasoned that the trial judge was justified in finding that the defendant had “a specific purpose and design to kill,” based on the fact that “he shot the deceased seven times with a deadly weapon at point-blank range, and then, calmly, laid the pistol on her dead body, stating: ‘I might go to jail, but I am glad I done it.’ ” Id. at 611-12, 165 A.2d 886 (involving a scorned lover who shot his paramour after a heated argument). Even if Cummings had not made the statement after shooting his victim, his actions reflected those of an individual who intended to bring about her death. The Court’s reasoning, therefore, demonstrates that the circumstances of the death, i.e., the defendant’s actions, often speak for themselves when they so clearly involve actions that are likely to bring about death.

So, too, was the situation in the present case. Even though appellant did not use a deadly weapon like the pistol in Cummings, the fragile nature of the victim, a six-month-old baby, transformed appellant’s hands, and other ordinary objects in the room, into potential deadly weapons given the likelihood of harm that they could cause to the victim. The jury, therefore, could have rationally concluded that appellant’s use of his hands or other objects to deliver the fatal blows to Ta’mar’s head reflected a “specific purpose and intent to kill.” 10

Similarly, in Dunn v. State, 226 Md. 463, 174 A.2d 185 (1961) (involving a man who bludgeoned to death his wife and *33418-month-old baby and was tried for the murder of his wife), the Court of Appeals, in determining whether there was sufficient evidence to demonstrate that Dunn had a wilful design to murder, considered the fact that the evidence reflected a clear motivation on Dunn’s part for the murder of his wife. Id. at 476, 174 A.2d 185. Noting that Dunn was involved with another woman whom he planned to marry, the Court reasoned that it was reasonable for the trier of fact to have concluded that Dunn intended to kill his wife. Id.

Although perhaps not as strong a motivation as that involved in Dunn, here, the State argued, and appellant concedes in his brief, that appellant’s actions could have been motivated by his desire “to quiet the baby.” While appellant argues that this phraseology reflects an innocent or innocuous goal on the part of appellant, the jury could have rationally inferred that appellant was tired and frustrated by the sleepless nights and continuous crying, such that he wanted to quiet Ta’mar permanently, ie., kill Ta’mar.11

Finally, in Faulcon v. State, 211 Md. at 249, 126 A.2d 858, in which the defendant ran over the victim with a car and dragged him eight blocks to his death, the Court of Appeals affirmed Faulcon’s first degree murder conviction, reasoning that the intent to kill could be inferred in part from the fact that the defendant’s version of events was contradicted by other witnesses. Id. In Faulcon, the contradiction centered on whether the defendant had been threatened by the victim before he ran over him. Id. The Court concluded that if the trial judge discredited the defendant’s version, the existence of legal justification vanished. Id.

Like the Court in Faulcon, we think that it would have been reasonable for the jury to consider the fact that appellant’s *335story contradicted the other evidence. In the present case, if the jurors disbelieved appellant’s version of events, they could have rationally concluded, based on the medical evidence, that the only possible explanation was that appellant intended to kill Ta’mar when he inflicted the four fatal blows to his head.

The task of demonstrating that appellant acted deliberately and with premeditation is often treated as a single endeavor.12 Summarizing the principles espoused in earlier cases, the Court of Appeals, in Willey v. State, 328 Md. at 133-34, 613 A.2d 956, explained that, “[i]f the killing results from a choice made as the result of thought, however short the struggle between the intention and the act, it is sufficient to characterize the crime as deliberate and premeditated murder.” Id. (quoting Colvin v. State, 299 Md. 88, 108, 472 A.2d 953 (1984) and Tichnell, 287 Md. at 718, 415 A.2d 830); see also Houn-shell, 61 Md.App. at 373, 486 A.2d 789 (explaining that the time between the intention to kill and the act of killing “may be as instantaneous as successive thoughts of the mind”) (quoting Smith v. State, 41 Md.App. 277, 317, 398 A.2d 426 (1979)). Deliberation and premeditation have also been clarified by the principle that

in order to justify a conviction of murder in the first degree, the trier of facts must find the actual intent, the fully formed purpose to kill with enough time for deliberation and premeditation to convince the trier of facts that this purpose is not the immediate offspring of rashness and impetuous temper, but that the mind has become fully conscious of its own design.

Cummings, 223 Md. at 611, 165 A.2d 886 (followed by Willey, 328 Md. at 133, 613 A.2d 956).

*336A review of other cases provides support for the conclusion that the evidence presented in this case justifies a finding of deliberation and premeditation, as well as the element of wilfulness. For example, in Mitchell v. State, 363 Md. 130, 767 A.2d 844 (2001), the Court of Appeals, discussing the difference between first and second degree murder, explained:

Although it is true that a murder committed solely on impulse—the “immediate offspring of rashness and impetuous temper”—is not one committed with deliberation and premeditation, the law does not require that deliberation and premeditation be the product of clear and rational thought; it may well result from anger or impulse. The test for first degree murder is whether there was the deliberation and premeditation—sufficient time to reflect— not the quality or rationality of the reflection or whether it may have been emotionally based.

Id. at 149, 767 A.2d 844. While appellant argues that the killing, at best, reflects the actions of an emotionally drained and sleep deprived care giver, whose only goal was to have the crying cease, Mitchell teaches us that the jury could still have found that appellant acted deliberately and with premeditation despite the fact that he may not have been thinking clearly or rationally because of a lack of sleep and emotional stress, as long as he had time to reflect on his actions.

Another helpful tool for making this determination comes from this Court’s review of a first degree murder conviction in Hounshell v. State, 61 Md.App. at 374, 486 A.2d 789. In Hounshell, in which the defendant strangled his victim to death, we expressly recognized that “[premeditation may be established circumstantially from the facts of a particular murder.” Id. (citing Bieber v. State, 8 Md.App. 522, 261 A.2d 202 (1970)). This principle is especially important given the fact that, “[o]rdinarily, premeditation is not established by direct evidence. Rather, it is usually inferred from the facts and surrounding circumstances.” Hagez v. State, 110 Md.App. 194, 206, 676 A.2d 992 (1996) (citing Snyder v. State, 104 Md.App. 533, 549, 657 A.2d 342 (1995) and Traverso v. State, 83 Md.App. 389, 395, 574 A.2d 923 (1990)).

*337More specifically, Hounshell teaches us that “the brutality of the murder act may, in and of itself, provide sufficient evidence to convict for first degree murder.” 61 Md.App. at 375, 486 A.2d 789 (citing Kier v. State, 216 Md. 513, 523, 140 A.2d 896 (1958) (in which the Court of Appeals focused on the brutal manner in which the victim was beaten about the face and head with certain objects, indicating a protracted period of time during which the assault continued)). Pointing out that “death by strangulation does not in and of itself establish first degree murder,” the Hounshell Court emphasized that the “jury ... may consider that some time element is necessarily involved between the onset of squeezing the throat and death resulting therefrom.” Id. at 372, 486 A.2d 789 (“Whether the time required to produce death by strangulation is sufficient for the assailant to reflect upon his actions before death ensues is a matter for the jury to determine.”). Ultimately, the Court affirmed the defendant’s first degree murder conviction, reasoning that “[t]he time period in which the strangulation of [the victim] must have occurred, and the brutality with which the act was committed, were such that a reasonable juror could have concluded that appellant committed the act with premeditation and deliberation.” Id. at 376, 486 A.2d 789.

In addition to considering the type of actions involved in committing the murder, it is well established in Maryland that “the firing of two or more shots separated by an interval of time may be viewed as evidence of premeditation.” Tichnell v. State, 287 Md. 695, 719-20, 415 A.2d 830 (citing Wilson v. State, 261 Md. 551, 276 A.2d 214 (1971); Cummings; and Chisley v. State, 202 Md. 87, 95 A.2d 577 (1953)).13 In Braxton v. State, 123 Md.App. 599, 720 A.2d 27 (1998), we clarified this rale by applying it to a specific set of facts, stating:

*338Appellant complains that the evidence of four bullet wounds, including a wound to the head, “cannot standing alone, support a reasoned decision to kill.” This assertion is refuted by several cases, including State v. Raines, 326 Md. 582, 606 A.2d 265 (1992).
The case of Willey v. State, 328 Md. 126, 613 A.2d 956 (1992), is also instructive. There, the Court observed “that the delay between firing a first and a second shot was enough time for reflection and decision to justify a finding of premeditation and deliberation.” Id. at 134, 613 A.2d 956 (citing Tichnell v. State, 287 Md. 695, 719-20, 415 A.2d 830 (1980) and Gladden v. State, 273 Md. 383, 387, 330 A.2d 176 (1974)).
In noticeable contrast to Raines, in which only one shot was fired at the victim’s head, three out of the four shots fired at Mr. Alexander were directed to. a vital part of the body. Thus, the jury could easily infer premeditation and deliberation. The jury -also was entitled to consider appellant’s fingerprint on the outside of the victim’s car door, and ballistic tests showing that the bullets recovered from the victim’s body were fired from the gun found in appellant’s bedroom.
In essence, Braxton’s complaint is that “the jury did not draw the inferences that he wished it to draw.” Hagez, 110 Md.App. at 205, 676 A.2d 992. He overlooks that it is the function of the jury to decide what inferences to draw from proven facts. McMillian v. State, 325 Md. 272, 290, 600 A.2d 430 (1992); Hagez, 110 Md.App. at 205, 676 A.2d 992. The jury was certainly entitled to infer from the facts that “the defendant possessed the intent to kill (wilful), that the defendant [had a] conscious knowledge of that intent (deliberate), and that there [was] time enough for the defendant to deliberate, i.e., time enough to have thought about that intent (premeditate).” Willey, 328 Md. at 133, 613 A.2d 956.

Id. at 658-59, 720 A.2d 27.

Our discussion in Braxton reminds us that our task is not to determine whether there were other permissible inferences *339that the jury could have made. Instead, we must ensure that the evidence supports a finding that the elements of the crime existed beyond a reasonable doubt. See also Tichnell, 287 Md. at 719, 415 A.2d 880 (explaining that the jury is not obligated to believe the defendant’s version of events, but is permitted to draw its own conclusions based on the other evidence presented).

Before applying these rules to the facts of the present case, we are mindful of one final guiding principle, that being that the existence of the three elements necessary to support a first degree murder conviction must be “discerned from the facts of the case.” Id. at 718, 415 A.2d 830; see also Hyde, 228 Md. at 216, 179 A.2d 421; Faulcon, 211 Md. at 258, 126 A.2d 858.

Applying these principles to the facts of this ease leads us to hold that there was sufficient evidence presented from which the jury reasonably could conclude that appellant acted with deliberation and premeditation in killing Ta’mar. The jury was not required to accept appellant’s version of events, especially given that much of the evidence presented by the State demonstrated how his story was inconsistent with the medical evidence. Nor was the jury obligated to conclude from the testimony of other witnesses and from the medical evidence that appellant’s actions could not have been done with the deliberation and premeditation necessary to support a conviction for first degree murder.

Like the defendant in Braxton, appellant argues that evidence about the nature of the injury suffered by the victim is insufficient to support his first degree murder conviction. We disagree. The medical testimony presented by Dr. Walker and Dr. Pestaño clearly established that Ta’mar suffered four fatal blows to his head, involving violent force similar to the force involved when a person is thrown through the windshield in a car crash or falls from a third floor window. Both doctors also discounted other possible causes of his fatal injuries, emphasizing that such injuries were not likely to be the result of an accidental knock on the head during attempts to resusci*340tate or even the alleged mishandling of Ta’mar by his father when he arrived at Ms. Pinkney’s home in his car seat.

Accepting that it was permissible for the jury to use circumstantial evidence to establish the elements of first degree murder, the nature and number of the deadly blows to Ta’mar’s head, in the context of all other evidence, supports a finding of deliberation and premeditation. Like the Court of Appeals in Hyde v. State, we believe that the evidence supports the jury’s conclusion that appellant possessed the necessary mental state and amount of time to reflect on his actions in a manner consistent with a deliberate and premeditated killing.

Even though our decision to affirm rests on our application of case law discussing Maryland’s first degree murder statute, we take a moment to briefly address appellant’s alternative argument that his first degree murder conviction should be reversed because there is no Maryland case in which an otherwise caring, responsible care giver has been convicted of the premeditated, deliberate, first degree murder of a child, when death resulted from a single incident. Appellant attempts to support his argument by highlighting cases involving child abuse death in which the defendants were convicted of second degree murder, at worst,14 suggesting that second *341degree murder was the appropriate verdict here given that the killing of Ta’mar was no worse than those murders where the defendant was convicted of second degree murder.

Appellant does acknowledge at least one first degree murder conviction stemming form the physical abuse of a child but tries to distinguish it from the present case on its facts. Appellant’s discussion of White v. State, 318 Md. 740, 569 A.2d 1271 (1990), a case in which a mother was convicted of first degree murder and child abuse after she and her boyfriend caused the death of her four-year-old daughter by beating her over a five-day period, resulting in 40 to 50 separate blows to her body, focuses solely on the fact that the death did not result from a single incident. The case does not have prece-dential effect in any event because the defendant in White did not challenge the murder conviction in the Court of Appeals but only argued that the child abuse conviction should have merged into the murder conviction. This Court, in an unreported opinion, affirmed both convictions.

We also note that there are at least two other examples in which Maryland appellate courts affirmed first degree murder convictions for parents’ murder of their children. Both of the cases involved a single, violent episode resulting in the child’s death.15 In neither case was sufficiency of the evidence raised *342and addressed in a reported opinion, however. As previously-discussed, we reach our conclusion that the evidence in this case was legally sufficient by applying the elements of the crime to the evidence. The cases just discussed are by no means authority to support a contrary conclusion.

Finally, we comment on appellant’s attempts to argue for reversal of the first degree murder conviction by attempting to demonstrate that courts in other jurisdictions have been hesitant to convict a defendant of first degree murder in the death of a child.16 For the following reasons, we do not find appellant’s argument to be persuasive.

Appellant’s conviction was based on Maryland’s first degree murder statute, just as our review is governed by Maryland cases interpreting that statute. Courts from other jurisdictions are not bound by our statutes or case law, and thus, their analyses of similar issues may vary based on those differences. Additionally, with respect to legal sufficiency, cases turn on their facts. We have made no attempt to research and compare cases from other jurisdictions because we believe Maryland case law- supports our conclusion. We are always cognizant of the fact that every jury is different, and that, in the end, it is our job, “after viewing the evidence in the light most favorable to the prosecution, [to determine whether] any rational trier of fact could have found the essential elements of the crime beyond a reasonable doubt.” Jackson v. Virginia, 443 U.S. 307, 313, 99 S.Ct. 2781, 61 L.Ed.2d 560 (1979). That *343is exactly what we have done here, and we conclude that there was sufficient evidence from which the jury could have determined that appellant was guilty of first degree murder. We reach this conclusion based on the totality of the evidence, including permissible inferences.

We expressly do not adopt a bright line rule of legal sufficiency for first degree murder, based solely on the number of blows delivered. We merely hold that the evidence was legally sufficient to convict appellant of first degree murder for the death of a six-month-old child based on the totality of the evidence, including evidence as to the number, severity, and brutality of the blows, the circumstances leading up to the beatings, and appellant’s version of events.

JUDGMENTS AFFIRMED.

COSTS TO BE PAID BY APPELLANT.

. At the time Ta’mar died, Renita Pinkney's last name was Williams, as she had not yet married appellant. Ms. Williams and appellant were married on December 9, 1999, eight days after Ta’mar’s death. She will be referred to as Ms. Pinkney for purposes of this appeal.

. Prior to the trial, appellant argued that his statements to police made on December 3, 1999, should be suppressed based on physical coercion by the interviewing officers, making the statements involuntary. After hearing testimony and finding appellant's version of events to be incredible, the court denied the motion.

. The sole issues argued before the panel were the three issues set forth at the beginning of this opinion.

. The parties were given an opportunity to submit memoranda addressing the issue for the Court to review prior to the en banc argument.

. We think that the State's reading of defense counsel's basis for objecting is too narrow. Although defense counsel initially focused on the fact that Ms. Pinkney's testimony should speak for itself, he went on to argue that the statement was inadmissible because Ms. Pinkney was not given an opportunity to read it and determine whether there was an inconsistency.

. The following quotes are from the plurality opinion. There were two concurring opinions and a dissenting opinion. Six judges concurred in the result and, effectively, in the standard of review.

. First degree murder was never discussed in the opinion.

. Maryland’s first degree murder statute now appears in section 2-201(a)(1) of the Criminal Law article of the Maryland Code.

. Much of this difficulty is likely based on the fact that the definition of "deliberate” includes the language from the "wilful" definition, just as the definition of “premeditation” includes the phrase "time enough to be deliberate.” See Tichnell v. State, 287 Md. 695, 717, 415 A.2d 830 (1980).

. Appellant, in his brief, recognized that intent to kill is often proved through the use of a deadly weapon, citing Hyde v. State, 228 Md. 209, 179 A.2d 421 (1962) (stab wounds); Cummings, 223 Md. 606, 165 A.2d 886 (1960) (seven point-blank range shots from a pistol); and Faulcon, 211 Md. 249, 126 A.2d 858 (1956) (dragging a victim under a car). Appellant argues that here, however, intent cannot be proven by means of an implement used to bring about the victim’s death. As noted in the text above, we are not persuaded that the absence of a recognized deadly weapon negates the intent element. Instead, we are satisfied that the medical evidence demonstrates that appellant could have used his hands and surrounding objects to inflict the fatal blows, and that if the jurors believed that that was what happened, they could infer an intent to kill from those actions.

. On this point, appellant argues in his brief that the lack of evidence of past abuse or threats to kill Ta’mar by appellant means that he could not have intended that result on the day in question. As discussed, the evidence supports a finding that appellant’s actions on that day were influenced by his lack of sleep and inability to stop Ta’mar's crying, such that it was reasonable for the jury to conclude that he intended to kill Ta'mar by inflicting the four fatal blows.

. There is also some overlap between the wilfulness element and deliberation, as the Court of Appeals has also used the dangerousness of the instrumentality as a factor in determining whether the defendant acted deliberately. See, e.g., Faulcon, 211 Md. at 259, 126 A.2d 858. In the present case, a jury could find that an adult man’s hands are just as dangerous as an automobile when the victim is a six-month-old baby.

. This rule has also been extended to other types of murder acts, such as stabbing. See, e.g., Hyde, 228 Md. at 216, 179 A.2d 421 (“[T]he nature and number of the deadly blows and the time necessarily required for their infliction amply support a finding appellant had time for premeditation.”).

. See Fisher v. State, 128 Md.App. 79, 736 A.2d 1125 (1999) (affirming the defendants’ second degree murder and child abuse convictions when the evidence indicated that the nine-year-old girl died from dehydration and malnutrition, but also revealed numerous severe injuries such as bruises, abrasions, bleeding of the brain, and rib fractures); Simpkins v. State, 88 Md.App. 607, 596 A.2d 655 (1991) (affirming parents' second degree murder convictions when their two-year-old daughter died of starvation); Duley v. State, 56 Md.App. 275, 467 A.2d 776 (1983) (affirming a father’s child abuse and involuntary manslaughter convictions when the evidence suggested that the defendant hit his infant baby hard enough to break her ribs and shook her hard enough to rupture the blood vessels in her brain); Moore v. State, 15 Md.App. 396, 291 A.2d 73 (1972) (affirming the second degree murder conviction of a step-father for killing his step-daughter during what he claimed was a spanking incident, but where the medical evidence showed that she died from a direct injury or blow to the head); Dyson v. State, 6 Md.App. 453, 251 A.2d 606 (1969) (affirming a second degree *341murder conviction of a father for maliciously inflicting corporal punishment upon his three-year-old daughter).

. See Pouncey v. State, 297 Md. 264, 465 A.2d 475 (1983) (involving a mother who was convicted of first degree murder for killing her five-year-old son, when the evidence disclosed that she drowned him because she thought that the devil was pursuing him and the only way to prevent him from going to hell was to kill him); State v. Johnson, 143 Md.App. 173, 794 A.2d 654 (2002) (a father, who had a history of drug abuse, stabbed and decapitated his 13-month-old child and was convicted of first degree murder). In Pouncey, the defendant argued, on appeal, that she could not be found guilty of first degree murder and insane. 297 Md. at 265, 465 A.2d 475. The Court of Appeals affirmed, reasoning that a finding of insanity simply relieved the defendant of criminal liability but did not mean that the court could not enter a guilty verdict and impose other non-criminal consequences. Id. at 269-70, 465 A.2d 475. In Johnson, a post conviction proceeding, we had *342affirmed the defendant’s conviction on direct appeal, in an unreported opinion. 143 Md.App., at 175, 794 A.2d 654.

. Appellant cites Commonwealth v. Woodward, 427 Mass. 659, 694 N.E.2d 1277 (1998) (the court affirmed the trial judge's reduction of the defendant’s conviction from second degree murder to involuntary manslaughter, reasoning that the evidence did not support a finding of malice), and State v. Brown, 836 S.W.2d 530 (Tenn.1992) (holding that the evidence was insufficient to support a first degree murder conviction when the defendant's four-year-old son suffered two or three skull fractures during a fight between the defendant and his wife, reasoning that evidence of the repeated blows was not sufficient, by itself, to establish first degree murder, given the fact that they could have been delivered in the heat of passion).