Decina was convicted of criminal negligence in operating an automobile in the Supreme Court of Erie County and appealed. The Supreme Court of New York granted a new trial and both Decina and the prosecution appealed. The Court of Appeals (New York’s highest court) affirmed. At about 3:30 p. m. on March 14, 1955, a bright, sunny day, defendant was driving, alone in his car, in a northerly direction on Delaware Avenue in the city of Buffalo. The portion of Delaware Avenue here involved is 60 feet wide.
At a point south of an overhead viaduct of the Erie Railroad, defendant's car swerved to the left, across the center line in the street, so that it was completely in the south lane, traveling 35 to 40 miles per hour. It then veered sharply to the right, crossing Delaware Avenue and mounting the easterly curb at a point beneath the viaduct and continued thereafter at a speed estimated to have been about 50 or 60 miles per hour or more. During this latter swerve, a pedestrian testified that he saw defendant's hand above his head; another witness said he saw defendant's left arm bent over the wheel, and his right hand extended towards the right door.
A group of six schoolgirls were walking north on the easterly sidewalk of Delaware Avenue, two in front and four slightly in the rear, when defendant's car struck them from behind. One of the girls escaped injury by jumping against the wall of the viaduct. The bodies of the children struck were propelled northward onto the street and the lawn in front of a coal company, located to the north of the Erie viaduct on Delaware Avenue. Three of the children, 6 to 12 years old, were found dead on arrival by the medical examiner, and a fourth child, 7 years old, died in a hospital two days later as a result of injuries sustained in the accident. After striking the children, defendant's car continued on the easterly sidewalk, and then swerved back onto Delaware Avenue once more. It continued in a northerly direction, passing under a second viaduct before it again veered to the right and remounted the easterly curb, striking and breaking a metal lamppost. With its horn blowing steadily apparently because defendant was ‘stopped over’ the steering wheel the car proceeded on the sidewalk until if finally crashed through a 7 1/4-inch brick wall of a grocery store, injuring at least one customer and causing considerable property damage.
When the car came to a halt in the store, with its horn still blowing, several fires had been ignited. Defendant was stooped over in the car and was ‘bobbing a little’. To one witness he appeared dazed, to another unconscious, lying back with his hands off the wheel. Various people present shouted to defendant to turn off the ignition of his car, and ‘within a matter of seconds the horn stopped blowing and the car did shut off’.
Defendant was pulled out of the car by a number of bystanders and laid down on the sidewalk. To a policeman who came on the scene shortly he appeared ‘injured, dazed’; another witness said that ‘he looked as though he was knocked out, and his arm seemed to be bleeding’. An injured customer in the store, after receiving first aid, pressed defendant for an explanation of the accident and he told her:
‘I blacked out from the bridge’.
When the police arrived, defendant attempted to rise, staggered and appeared dazed and unsteady. When informed that he was under arrest, and would have to accompany the police to the station house, he resisted and, when he tried to get away, was handcuffed. The foregoing evidence was adduced by the People, and is virtually undisputed defendant did not take the stand nor did he produce any witnesses . . . . On the basis of this medical history, Dr. Wechter made a diagnosis of Jacksonian epilepsy, and was of the opinion that defendant had a seizure at the time of the accident.
. . . We turn first to the subject of defendant's cross appeal, namely, that his demurrer should have been sustained, since the indictment here does not charge a crime. The indictment states essentially that defendant, knowing ‘that he was subject to epileptic attacks or other disorder rendering him likely to lose consciousness for a considerable period of time’, was culpably negligent ‘in that he consciously undertook to and did operate his Buick sedan on a public highway’ (emphasis supplied) and ‘while so doing’ suffered such an attack which caused said automobile ‘to travel at a fast and reckless rate of speed, jumping the curb and driving over the sidewalk’ causing the death of 4 persons. In our opinion, this clearly states a violation of section 1053-a of the Penal Law. The statute does not require that a defendant must deliberately intend to kill a human being, for that would be murder. Nor does the statute require that he knowingly and consciously follow the precise path that leads to death and destruction. It is sufficient, we have said, when his conduct manifests a ‘disregard of the consequences which may ensue from the act, and indifference to the rights of others. No clearer definition, applicable to the hundreds of varying circumstances that may arise, can be given. Under a given state of facts, whether negligence is culpable is a question of judgment.’
Assuming the truth of the indictment, as we must on a demurrer, this defendant knew he was subject to epileptic attacks and seizures that might strike at any time. He also knew that a moving motor vehicle uncontrolled on public highway is a highly dangerous instrumentality capable of unrestrained destruction. With this knowledge, and without anyone accompanying him, he deliberately took a chance by making a conscious choice of a course of action, in disregard of the consequences which he knew might follow from his conscious act, and which in this case did ensue.
How can we say as a matter of law that this did not amount to culpable negligence within the meaning of section 1053-a?
To hold otherwise would be to say that a man may freely indulge himself in liquor in the same hope that it will not affect his driving, and if it later develops that ensuing intoxication causes dangerous and reckless driving resulting in death, his unconsciousness or involuntariness at that time would relieve him from prosecution under the statute.
His awareness of a condition which he knows may produce such consequences as here, and his disregard of the consequences, renders him liable for culpable negligence, as the courts below have properly held. To have a sudden sleeping spell, an unexpected heart or other disabling attack, without any prior knowledge or warning thereof, is an altogether different situation, and there is simply no basis for comparing such cases with the flagrant disregard manifested here . . . Accordingly, the order of the Appellate Division should be affirmed.

Questions:-

1. Did Decina commit a “voluntary act” that resulted in the car accident?
2. Is it relevant that Decina knew he was subject to seizures? If so, why?
3. Is Decina’s case different from a driver who suffers a heart attack or a stroke while driving? If so, why?