Court hears doubts over baby's injury

Doctor questions estimated time of fatal head trauma

March 03, 2001|By Lisa Goldberg | Lisa Goldberg,SUN STAFF

The head trauma that killed 15-month-old Alexa Shearer could "clearly" have occurred before she was in the care of North Laurel day-care provider Kathleen A. Butcher the day she stopped breathing, and symptoms caused by the injury could have been masked by chronic illness, a defense expert testified yesterday.

Washington medical examiner Jonathan Arden's decision to time the child's injuries close to when she went into cardiac arrest - and while she was in Butcher's care - was made before he had all the facts, said Dr. Jack Daniel, a former Virginia medical examiner who now does consulting work. Arden had not finished his medical analysis when he told detectives his findings the day of the autopsy, Daniel said.

That analysis should have included a microscopic examination of brain tissue, which Arden never performed, Daniel said yesterday, at the end of the second week of testimony in Butcher's murder trial.

"To narrow the time frame down to say that the injuries might have occurred after 7:30 or 8 in the morning ... would have been, in my view, clearly premature," Daniel testified on the first full day of testimony in the defense case.

Alexa was dropped off at Butcher's day care at 7:30 a.m. on Nov. 16, 1999, the day she stopped breathing, according to testimony. The little girl was declared brain dead two days later. Arden determined that she died of blunt-force trauma to the head caused by both shaking and impact.

Defense attorneys, who have tried to paint both Arden's autopsy and the police investigation as sloppy, offered Daniel yesterday to rebut prosecution experts' assertions over the last several days. Those experts said Alexa's injuries were so severe that the child would have been symptomatic almost immediately. Butcher told police that the child was acting normally and ate two meals at the Sewall Avenue day care before she went into cardiac arrest.

But Daniel said yesterday that while he found medical evidence that was "consistent" with shaken baby syndrome, it was far from conclusive.

And, he said, medical records showed that Alexa was sick - suffering, at a minimum, an ear infection and more likely a chronic infection.

Under cross-examination, Daniel said he did not review the microslides, autopsy photographs or statements of witnesses or the defendant before rendering his opinion and that some of the medical records are "inconsistent."

Oldham asked if he, then, rendered his opinion without all the information - as the defense had accused Arden of doing. Daniel said that information about "context" helps give a medical examiner an idea of what he's working with.

Daniel also said he agreed with Arden that Alexa died of blunt-force trauma and that her death was a homicide.

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