The deaths of a mother's three babies were likely to have been caused by an acute metabolic disorder and not suffocation, a leading expert in sudden infant death told a court yesterday.
Professor Peter Fleming, a paediatrician at Bristol Royal Children's Hospital, said all the evidence suggested that Trupti Patel's two sons Amar and Jamie and her daughter Mia, had died because their bodies could not metabolise properly and they became very ill, while appearing to be well.
He told the trial at Reading Crown Court that he could find "no clear evidence" to suggest that any of Mrs Patel's babies had been smothered or deliberately suffocated. "I can find considerable evidence that points in the direction of a metabolic disorder, which is compatible with the picture that occurred in all three cases. The most likely explanation is that these children died as a consequence of a metabolic disorder," he said.
Mrs Patel, 35, a pharmacist, denies murdering the babies. All three collapsed suddenly in separate incidents at the Patels' family home in Maidenhead, Berkshire, between 1997 and 2001. Professor Fleming told the hearing that he had seen three other families in which there had been three unexplained deaths of babies.
He said the high level of ammonia found in Jamie, who died aged 15 days, was "extraordinary" and highly unlikely to be consistent with him having died as a result of a lack of oxygen. He said that the bleeding in his bowel and low body temperature were consistent with an acute failure of his metabolic system. He said evidence also strongly suggested that a metabolic disorder was to blame for the death of Mia, who died aged 22 days.
He said that taken in isolation the death of Amar, when he was aged three months, had to be considered as a typical case of sudden infant death.
Professor Fleming, appointed a CBE for his research into infant deaths, said it was extremely difficult to detect acute metabolic disorders, and that a child might appear to be well right up to the time of their sudden collapse.
The case continues.