Nanny Trial: Exact causes of death still unclear

No one disputes that eight-month-old Matthew Eappen died on 9 February this year from a brain haemorrhage. But, as the trial of Louise Woodward progressed, it seemed that was all we could be sure of. Glenda Cooper, Social Affairs Correspondent examines the medical evidence.

British experts supported the prosecution's case, saying Matthew Eappen's injuries could not have been inflicted accidentally and gone unnoticed for three weeks. A neurosurgeon at Great Ormond Street Hospital said that to diagnose shaken-baby syndrome a number of things must be looked for: other injuries, fractures, other evidence of abuse and bleeding at the back of the eye.

The prosecution made the case that the injury that killed Matthew had been sustained on 4 February, when he was alone with Woodward and could not have been an accident, such was the force required - equivalent to falling 15 feet. Evidence from brain scans and of retinal bleeding proved this, they said.

Robert Barnes, a neuroradiologist, said the injuries were caused "within minutes or hours" of brain scans he did shortly after Matthew's admission to hospital. Lois Smith, an ophthalmologist said she had seen signs of recent retinal bleeding which showed extreme force had been used on him - equalling nine on a scale of severity from one to 10. The type of bleeding found in nine-month-old Matthew's eyes, she added, was "very, very rarely" seen in accident cases.

Brain scans can help date injuries, said the Ormond Street neurosurgeon, because the blood found between the brain and brain lining - the dura - changes colour with the length of the injury. Recent injuries would show up red, whereas older ones would change colour to grey and clear.

During the trial, Joseph Madsen, a paediatric neurosurgeon at Boston Children's Hospital, said that when he started to operate first a clearish, yellowish liquid, followed by blood, spurted from Matthew's skull. He agreed it had the appearance of serum - which the defence claimed is indicative of an old injury.

Jan Leestma, a neuro-pathology specialist, also said his examination showed evidence that a blood clot existed between the brain and the dura - before 4 February and there was evidence of re-bleeding in the area. The defence also called America's leading expert on shaken-baby syndrome, Lawrence Thibault, who raised the fact that there appeared to be no other injuries. Any violent shaking, he said, would have produced "injury to the neck, the structure surrounding the spinal cord and the cord itself". None of these was found.

But experts in Britain said the injuries were so severe they could not have been caused accidentally. Brian Neville, a paediatric neurologist at the Institute of Child Health/Great Ormond Street said: "The impact would have to be pretty immediate. There could well have been a previous injury that was partially resolved but the idea of building up pressure over three weeks - they wouldn't really do this. It would just make the baby ill. Something occurred of some severity."

A Home Office pathologist, Paula Lannas, agreed: "From my assessment of the evidence this is a tragedy for this little girl but in my opinion I believe her to be guilty. This sort of case arises all the time but she was unlucky because she got captured by the system. I couldn't accept that the injuries were three weeks old, as the parents were both doctors, and a child sustaining that extent of injury could not have appeared to be normal for three weeks leading up to his death. It would be apparent that something was wrong."

Start your day with The Independent, sign up for daily news emails
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA special investigation by Andy McSmith
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Tradewind Recruitment: English Teacher

Negotiable: Tradewind Recruitment: My client is an excellent, large partially ...

Tradewind Recruitment: Science Teacher

£90 - £140 per day: Tradewind Recruitment: I am currently working in partnersh...

Tradewind Recruitment: Year 3 Primary Teacher

£100 - £150 per day: Tradewind Recruitment: Year 3 Teacher Birmingham Jan 2015...

Ashdown Group: Lead Web Developer (ASP.NET, C#) - City of London

£45000 - £50000 per annum + Excellent benefits: Ashdown Group: Lead Web Develo...

Day In a Page

Isis hostage crisis: The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power

Isis hostage crisis

The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power, says Robert Fisk
Missing salvage expert who found $50m of sunken treasure before disappearing, tracked down at last

The runaway buccaneers and the ship full of gold

Salvage expert Tommy Thompson found sunken treasure worth millions. Then he vanished... until now
Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

Maverick artist Grayson Perry backs our campaign
Assisted Dying Bill: I want to be able to decide about my own death - I want to have control of my life

Assisted Dying Bill: 'I want control of my life'

This week the Assisted Dying Bill is debated in the Lords. Virginia Ironside, who has already made plans for her own self-deliverance, argues that it's time we allowed people a humane, compassionate death
Move over, kale - cabbage is the new rising star

Cabbage is king again

Sophie Morris banishes thoughts of soggy school dinners and turns over a new leaf
11 best winter skin treats

Give your moisturiser a helping hand: 11 best winter skin treats

Get an extra boost of nourishment from one of these hard-working products
Paul Scholes column: The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him

Paul Scholes column

The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him
Frank Warren column: No cigar, but pots of money: here come the Cubans

Frank Warren's Ringside

No cigar, but pots of money: here come the Cubans
Isis hostage crisis: Militant group stands strong as its numerous enemies fail to find a common plan to defeat it

Isis stands strong as its numerous enemies fail to find a common plan to defeat it

The jihadis are being squeezed militarily and economically, but there is no sign of an implosion, says Patrick Cockburn
Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action

Virtual reality: Seeing is believing

Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action
Homeless Veterans appeal: MP says Coalition ‘not doing enough’

Homeless Veterans appeal

MP says Coalition ‘not doing enough’ to help
Larry David, Steve Coogan and other comedians share stories of depression in new documentary

Comedians share stories of depression

The director of the new documentary, Kevin Pollak, tells Jessica Barrett how he got them to talk
Has The Archers lost the plot with it's spicy storylines?

Has The Archers lost the plot?

A growing number of listeners are voicing their discontent over the rural soap's spicy storylines; so loudly that even the BBC's director-general seems worried, says Simon Kelner
English Heritage adds 14 post-war office buildings to its protected lists

14 office buildings added to protected lists

Christopher Beanland explores the underrated appeal of these palaces of pen-pushing
Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

Scientists unearthed the cranial fragments from Manot Cave in West Galilee