Doctor ‘confident’ baby’s injuries not accidental

A consultant paediatrician told a jury she was as “confident as she can be” that severe injuries suffered by a six-week-old boy were not the result of an accident.

Dr Elizabeth Myercough, 57, based at the Royal Aberdeen Children’s Hospital, said the injuries she saw in the baby could have been caused by shaking, or someone obstructing the boy’s breathing.

The High Court in Livingston heard that the baby was taken to the hospital after sustaining injuries while his mother was away on her first night out since giving birth.

Raymond McPhee, 23, who had been caring for the baby, told police that the baby had fallen down the side of the bed when he fell asleep.

The court heard that the baby was now brain damaged, and the mother was told by doctors that he was permanently impaired, profoundly retarded, hypertonic and suffering from cerebral palsy.

Dr Myercough was shown footage of the baby, taken by the mother of the baby on her mobile phone, the day before the incident.

She said: “He looks a very nice, health happy baby. There is not a mark on him. He looks completely different to the child that I saw the next day.”

Dr Myercough – who has worked in child protection for 13 years – told the jury that after seeing the baby in the high dependency unit in the hospital, she called police and social workers immediately.

She said: “I called police and social work after seeing the baby. If we didn’t share information on a child protection issue we would be severely criticised. We don’t have to be definite that it’s a non accidental incident, but in this case it appeared more likely that not.”

She said staff found the baby with bruising to the right ear lobe, ‘rashing’ to the upper face, haemorrhaging across the right eye, bruising and swelling around both eyes, swelling across the lips, bruising on the abdomen, right forearm and right wrist, as well as on the forehead.

Dr Myercough said: “The baby was fitting repeatedly. He was literally on the threshold of life or death.”

Alison Di Rollo, prosecuting, asked Dr Myercough for her medical opinion on how some of the injuries were caused.

Dr Myercough said: “The ear is a very unlikely area to be injured, particularly in an infant. The likely cause of this is pinching or a firm grip of the ear.

“The rash on the face could be caused by a rise in pressure on the face. This injury is associated with obstruction of the breathing. The haemorrhage on the right eye could be down to a blow to the eye but is also a sign of shaking.

“The torn frenum on the lip is well reported in shaking injuries, and also a sign in direct injuries to the mouth, when someone has put a bottle or a spoon in. It’s more likely to be caused by direct impact.

“I’m not happy that this was an accident. If you were to fall on your face you would hit your chin or nose, not the mouth.

“The bruise to the abdomen is not an accidental injury. It’s not clear how the mark came about but what you could see suggests a hand mark.

The advocate-depute asked Dr Myercough what her overall conclusion was to the external injuries.

She replied: “Looking at all the injuries it is very suspicious. Some are less suspicious but when you put it all together we have a non accidental injury. I’m as confident as I can be on that.”

The advocate-depute asked: “Could the injuries have been caused by a single short fall from a bed?”

Dr Myercough replied: “No. I’m as confident as I can be on that. I can’t create an understanding in my mind how all those injuries could have been caused by a single fall.”

Dr Myercough added that it was later found that the baby had a fractured rib on the right side.

She said: “Rib fractures in young children are heavily associated with abuse and shaking of young children.”

McPhee, of Moir Crescent, Aberdeen, denies attempted murder.

He is alleged to have pinched the baby repeatedly on the head and body, struck him on the head, face and body, forced something into his mouth, squeezed the child and shook him, as well as restricting his breathing with a pillow, or by other means on August 25 2008, to his severe injury, permanent disfigurement, permanent impairment and the danger of his life.

He further denies a second charge, of failing to get the baby medical attention.

The trial before Lord Uist continues. The jury were told that the prosecution case was expected to conclude on Friday.