An emergency medicine consultant who examined a four-year-old boy after he was brought to hospital unconscious has said she had very significant suspicions that his injuries were non-accidental.
The consultant was giving evidence at the Central Criminal Court, in the trial of a woman charged with the murder of the boy, who was her partner’s son.
The court also heard the boy’s brain injuries were like those caused by a high speed road traffic accident or a fall from a big height, and that he was covered in extensive bruising from previous injuries for which the boy’s father could not give a satisfactory explanation.
The woman has admitted the manslaughter of the boy in 2021 and has also pleaded guilty to two counts of assault, but she has denied murder. She cannot be named due to legislation protecting the identity of child witnesses in criminal proceedings.
Emergency call taker, Niamh O’Brien, told the court she received an call from a man who said his son had fallen from the top bunk of his bed and banged his head.
The man said his son was unresponsive and it was as if he was asleep. He said the fall had happened around an hour previously.
Ms O’Brien said normally if they were dealing with a child who had lost consciousness, they would get a call within a few minutes of the incident happening.
Advanced paramedic Dan New said when he arrived at the house, the child was lying in the middle of the bedroom floor in the foetal position with his head on a pillow. He did not have a blanket over him.
He noticed the child had bruising on his face and around his eyes. He said from his experience the bruising was at least five days old.
He asked the child’s father about the injuries and was told they were from a previous incident where the child had run into a door.
Mr New said the child was described to him as bold, and acting up and had been “grounded and confined to his bedroom”.
He said, given the clinical severity of the situation, he picked the child up and carried him to the ambulance.
In the ambulance, he assessed the child’s pupils which were fixed and dilated and not responding to light. He said the child’s limbs were going stiff, which suggested a head injury.
Mr New said he passed on his concerns about the child’s bruising immediately on arrival at the hospital.
Mr New’s colleague said she saw a woman downstairs in the house. Later in hospital, she asked the father of the child where the bruises came from.
He said the child had been playing soccer earlier in the week and had bruises on his eyes after running into a door the previous day. He said the boy bruised easily.
She asked if she could call the child’s mother, but the man said she was not in their lives any more.
The jury has been told the child was living with his father and his father’s partner, after the mother suffered from mental health issues.
A clinical nurse manager told the court it became clear after a CT scan that the child needed urgent neurosurgery and was to be transferred.
He told the father this and the father again said he would not be contacting the child’s mother. The nurse manager said he asked gardaà to contact the child’s mother. She rang a short time later, hysterical and upset.
Dr Niamh Mitchell, a doctor at the emergency department, said she clearly saw multiple bruises to the child’s forehead, eyes, his right arm, both his legs and his inner thighs.
She said she was concerned as she knew from her training that bruising on the inner thighs don’t come from “normal play”. The doctor said the bruises were all different colours and it looked as if he had been hit on more than one occasion.
A consultant at the emergency department said the child had an “acute subdural haematoma”. She said this was a very severe brain injury.
She said she spoke to the child’s father who told them the boy had been “grounded”, which she said she found a little unusual in a child of that young age.
The consultant said she didn’t get a satisfactory explanation for the bruises from the father.
She said the fall from a bunk bed was not consistent with what she saw on the scan. She said the scan showed a very significant brain injury and her suspicion was that it was non-accidental.
She said such an injury is normally seen in high velocity road traffic cases or a fall from a big height.
She said once she saw the child’s CT scan, she had very significant anxiety about the cause of his injury.
The trial is expected to last up to five weeks.