CONCORD — Meritel Saintil's appeal of her negligent homicide conviction in connection with her grandmother's death was heard by the state Supreme Court Wednesday.

New Hampshire Assistant Attorney General Elizabeth Woodcock was questioned by Justice Anna Barbara Hantz Marconi over whether 75-year-old Nancy Parker had over-bearing matriarchal control over her daughter Katherine Saintil-Brown and granddaughter Meritel Saintil in repeatedly denying their attempts to call emergency responders for help. Oral arguments were held in front of a three-justice panel.

Woodcock argued in favor of upholding Saintil’s 2- to 4-year prison sentence for negligent homicide and failure to report elder abuse in connection with the 2016 death of her grandmother. Parker spent five days on the floor in her own urine and excrement in her Willow Street home in Exeter beginning Feb. 12, 2016, before emergency crews were called. Parker was diagnosed with a flesh-eating infection and died eight days later in a Massachusetts hospice.

“If you talk to that person and they respond and want to stay (on the floor) what do you do? There was evidence the daughter and the granddaughter were, let’s say controlled by, or the grandmother was the matriarch of this relationship, so does that factor into whether they should go against her wishes,” Hantz Marconi said. “If (the defendant) had offered assistance before and knew that she would refuse it or prohibit them from calling, what are you to do? It sounded like (Parker) was in control of her situation.”

Saintil was convicted on the two charges following a jury trial in December 2017. Saintil-Brown was convicted on similar charges in January 2017. During both trials, it was established Parker instructed her daughter and granddaughter not to open the door for an adult protective services worker and not to call 911 for help to get her off the floor on multiple occasions, the latest instance occurring weeks before her death.

Parker suffered from morbid obesity, bowel control issues and was generally incapable of taking care of herself, both trials outlined. She refused medical treatment and state assistance. Specifically, she struggled with a health issue where she urinated and defecated on herself for most of her adult life, the prosecution and defense said, her mobile home was considered “filth.” Both sides agreed Parker adamantly told Saintil-Brown and Saintil not to call 911 while she was on the floor.

Woodcock said Saintil and her mother had moved in with Parker “ostensibly” to help Parker. A major point of contention in the trials centered on when Parker’s infection would have begun to alter her mental state.

The state argued Parker began losing mental faculties on the second day spent on the floor when Saintil testified her grandmother reported seeing visions of her grandson “dancing on the walls.”

“The concern is it’s apparent anyone would see a 75-year-old obese woman lying on the floor, getting around by rolling around on the floor. She crawls over to the couch, she can’t lift herself up,” Woodcock said. “The two people there couldn’t assist her, at that point you call 911 and get some assistance.”

Justice James Bassett said Woodcock’s arguments were more in line with Saintil’s failure to report elder abuse conviction rather than her negligent homicide conviction.

“It does seem there is some difference there in the knowledge in terms of (the infection) possibly or likely leading to death is a different analysis, both for us and her family members,” Bassett said.

Justice Patrick Donovan served as the third presiding justice.

Saintil’s attorney Wade Harwood argued the state relied on circumstantial evidence in determining when Parker slipped into her altered mental state. He also said the state did not meet the burden to prove negligence because it did not demonstrate Saintil or her mother did not know the act of leaving Parker on the floor could result in her death.

“The question is really when is it reasonable to believe the (altered mental state) may have kicked in?” Harwood said. "We have two physicians who directly stated the altered mental state may have occurred (the morning 911 was called). All of the doctors testified the infection caused the altered mental state … and the infection didn’t happen until 12 to 24 hours before (Parker) was seen.”

The three justices must render a unanimous opinion to uphold Saintil’s prison sentence or not, or decide the case needs to be heard in front of the full five-member court. If the presiding justices do not agree on a decision, the case automatically moves to the full Supreme Court.