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A Lakeville woman has been indicted on two counts of manslaughter in the smothering death of her infant grandson after Dakota County Attorney James Backstrom took the unusual step of asking a grand jury to make the call.

It was a case that presented a challenge for prosecutors. The Lakeville police wanted manslaughter charges, saying Tina Louise Miller-Steiner, 45, was negligent when she mixed alcohol and prescription drugs -- against her doctor's advice -- and then fell asleep atop her six-week-old grandson in May.

But nationwide, few such cases are charged as crimes, because prosecutors find it hard to prove that a parent or caregiver intended to harm a child or acted recklessly. Medical examiners nearly always rule such deaths accidental or undetermined.

The grand jury, in a decision delivered last week and unsealed Tuesday, indicted Miller-Steiner on two felony counts of manslaughter in the death of six-week-old Evan Michael Berney.

Miller-Steiner was caring for Evan in her mobile home on May 9 when she placed him on an adult bed to nap between 7 and 7:30 p.m. She prepared a bottle for him and lay down beside him. Miller-Steiner's younger daughter, age 12, later awoke Miller-Steiner after discovering her lying with the baby, who was not breathing.

Her physician had warned her not to drink alcohol while taking her prescription drugs for depression, anxiety and hypertension, but she drank two martinis and some wine between 5 and 7 p.m. on the night of Evan's death, she told police.

Miller-Steiner has said in an interview that her grief and suffering are punishment enough. Her attorney could not be reached for comment on Tuesday.

Grand juries are convened to hear the evidence in a case, presented by prosecutors without rebuttal, to make a determination about charges. The overwhelming majority of grand juries return an indictment after hearing the evidence, which is subject to looser standards than for criminal trials.

Such juries are required to review all first-degree murder charges. But Backstrom said he wanted the citizens of the county to make the call in this case, even though it was a lesser charge.

"They've reviewed it, they've made their decision, and we're going to pursue the indictment that's been returned," Backstrom said.

He declined to discuss what elevated this case from a tragedy to an alleged crime, including whether knowingly defying a doctor's orders constitutes negligence while caring for a child.

Evan was the child of Miller-Steiner's daughter, Davina Louise Miller, 23, and Nathan Berney, 22. Davina had asked her mother not to drink while baby-sitting with Evan, court papers say.

A laboratory analysis determined that Miller-Steiner's blood alcohol level almost four hours after she called police was still .08, which would be illegal for driving a motor vehicle, the indictment says.

Lab tests also found a therapeutic dosage of Prozac in her blood but no other drugs.

Backstrom said his office had contacted Miller-Steiner's attorney and allowed her to come to court on Tuesday rather than be arrested.

District Judge Tim Wermager set bail at $20,000 with conditions that prohibit her from taking care of children younger than 12. She is not allowed to consume alcohol and must submit to alcohol-sensor testing once she is released from treatment for alcohol abuse, Backstrom said.

Miller-Steiner's next court appearance is set for Aug. 25.

Joy Powell • 952-882-9017