In the 2004 opinion of the Va. Court of Appeals, Com. v. Correll, Record No. 3387-02-3, the Court held that the relationship of guardian, and the undertaking of care as primary custodian, was sufficient to trigger criminal liability for the death of the guardian's severely malnourished ward (Ms. Paxton, the guardian's mother) under Sec. 18.2-369.

     The Court found that "[t]he evidence in this record, when considered in its totality, demonstrates that Correll was clearly capable of comprehending the seriousness of Paxton’s condition, as well as her need for constant and immediate care. In fact, Correll had cared for Paxton for years prior to her death, and had specifically cared for Paxton in relation to her weight problem and the various bedsores that she had developed over the years. Thus, we simply cannot hold that the trial court’s finding of willful and knowing neglect was plainly wrong. Indeed, testimony given during the trial established that Correll acknowledged Paxton was not being properly cared for prior to her admission to the hospital and that those ' problems' were what prompted the investigation by Bedford County Social Services."

     Va. Code § 37.2-1020, Duties and powers of guardian, provides in pertinent part that a "guardian stands in a fiduciary relationship to the incapacitated person for whom he was appointed guardian and may be held personally liable for a breach of any fiduciary duty to the incapacitated person. A guardian shall not be liable for the acts of the incapacitated person, unless the guardian is personally negligent."