D was indicted on one count of felonious assault and one count of involuntary manslaughter for allegedly causing the death of Bryan Biser by a closed-fist punch to the head. Biser was socializing with neighbors. He and Shanna Knapp had split a six-pack of beer with her while watching the children playing in a playground just across the parking lot. Two of the kids around the age of five got into a fight. One of the children was a distant relative of D. D walked over to the playground and screamed obscenities at the children. D encouraged his five-year-old relative to beat up the other child. Knapp told D to stop yelling obscenities and encouraging the children to fight. Knapp then got into an argument with D's nephew, John Rawlings. Biser approached Knapp and Rawlings in the parking lot and attempted to stop the arguing by asking everyone to calm down. D then walked around a car towards Biser, yelled an obscenity at him, and hit him with a closed fist on the left side of his head while Biser stood with one hand to his side and one hand holding a beverage cup. Biser never raised his arms, squared to fight, or said a threatening word. The right side of Biser’s face hit a parked car, and then his head hit the pavement. D 'danced' over Biser, as he lay unconscious, taunting him to get up and fight and challenging everyone else to fight him. A neighbor, Twila Jones, called 911. One of the children alerted Amy Preston, the apartment complex manager, who was also a nursing assistant, to attend to Biser. Biser regained consciousness, and the EMTs began treating his wounds and transported him to Adena hospital. Biser stated to the EMTs that he was diabetic and had taken his insulin that day. However, the EMTs were not able to take his blood-glucose level. One of Biser's pupils was bigger than the other, which was not noted in the EMT report. Dr. Kashubeck noted that Biser's pupils were round and equal in size and that Biser denied any pain anywhere. Biser complained of a laceration to his right eye and a bump to the back of the head, and that he answered questions and followed commands appropriately. Biser refused emergency room treatment for his head injuries and his diabetes, despite an elevated blood-glucose level of 465. Biser had insulin to treat diabetes at home and did not want to purchase more at the hospital. He refused a CAT Scan, which the doctor had recommended. The doctor discharged Biser from the hospital but ordered him to return immediately if he experienced any vomiting, confusion, or vision problems. Ms. Preston and Ms. Jones went to check on Biser that same day, April 15, 2005. Ms. Preston testified that Biser seemed confused and did not remember being involved in a fight, but, instead, told her he had been singing karaoke that night. The next day, Ms. Preston and Ms. Jones went again to check on Biser. Ms. Jones testified that Biser did not invite them in, but cracked the door and told them he felt sick to his stomach, and asked them to leave him alone. Biser's cousin, Spangler testified that she visited Biser on three separate occasions on April 16, 2005. Biser wanted everyone to go away. On the last check, she testified that Biser told her he had taken his insulin that day. She also testified that there were two bottles of insulin in the refrigerator. Preston testified that on Tuesday, April 19, 2005, she received a voicemail from one of Biser's family members, who had been unable to contact him. Ms. Preston found Biser lying on the floor, unconscious struggling to breathe, and his feet and left arm had turned black. An ambulance arrived within seven to eight minutes to transport Biser to the hospital. A CAT scan indicated that he had a possible skull fracture, a small subdural hematoma, and subarachnoid hemorrhage. Biser's blood-glucose level was 1,169, and he was in severe diabetic ketoacidosis, a lethal condition resulting from a diabetic's failure to take prescribed insulin. Biser underwent exploratory surgery in his abdomen at a different hospital. The surgeons discovered that his right bowel and a portion of his right colon were necrotic, a condition from which no one could survive. Biser died several hours later. Deputy Coroner Trent ruled the cause of death to be homicide due to blunt force craniocerebral injuries. Dr. Glenn Roush testified that Biser had a skull fracture and brain injury that had occurred recently. Dr. Roush testified he has 'never seen anyone with this sort of injury be able to function.' Dr. William Cox testified that the punch Biser received and subsequent fall to the ground caused him to suffer contusions to his brain that damaged his frontal lobes. That damage affected his cognitive ability and caused him to become apathetic, uninhibited, and disinterested. He testified that Biser's head injury substantially contributed to his death, and the damage to his frontal lobes 'clearly would have adversely affected [Biser's] ability to look after himself.' D was found guilty of involuntary manslaughter. D appealed.