Nanny's murder trial told of classic injury

The doctor who treated baby Matthew before he died tells the US trial of Briton Louise Woodward there was no earlier injury and the fatal injury took force - it was no accident.

Injuries from which the nine-month-old baby in the care of the British nanny Louise Woodward died showed classic signs of child abuse, her murder trial in the United States was told yesterday.

Defence lawyers for Ms Woodward, 19, of Elton, near Chester, have claimed that the brain damage suffered by Matthew Eappen could have been the result of an old, undetected injury. But on the third day of the trial consultant Dr Robert Barnes yesterday told the Middlesex Superior Court, in Cambridge, Massachusetts: "This is not an old injury. I see no evidence there was any previous injury."

Dr Barnes, neuroradiologist and consultant to the child-protection panel at Boston's Children's Hospital, said the massive injuries were caused close together and "within minutes or hours" of brain scans he carried out shortly after his admission to the hospital. He ruled out a gentle shaking, a tossing on a bed or a fall in the bathroom as a cause of the brain injuries. "It would certainly have required much more force," he said.

He also ruled out a fall on the stairs said to have been suffered by Matthew the day before he was admitted to hospital as a cause of the brain damage. "This is a classic picture of shaken impact head injury seen with non-accidental trauma," he said.

There were angry scenes in the courtroom as Dr Barnes clashed with defence attorney Barry Scheck as he started to cross-examine him. Mr Scheck asked him: "Let us assume on February 4 there was no impact." The doctor said: "That's a hard one to assume."

Mr Scheck then asked him: "To assume there had been some prior bleeding in the brain, causing Matthew to have difficulty breathing." Dr Barnes replied: "That is not what happened."

Mr Scheck shouted at him angrily: "Were you there?", before Judge Hiller Zobel intervened to order both men to be silent.

Two medical experts conceded on Wednesday that the injuries suffered by Matthew could have been days or weeks old from some of the medical evidence. Dr Barnes said there was nothing in the brain scans he carried out to suggest that, but he admitted analysis of a blood clot removed from Matthew's brain which was not kept could have been "helpful".

Ms Woodward denies the charge and faces life without parole if convicted of first-degree murder. The trial continues.