Traumatic brain injury caused by blunt force trauma was part of the cause of two-year-old Santina Cawley’s death, the pathologist told the judge and jury on the ninth day of the murder trial today.
Assistant state pathologist, Dr Margaret Bolster, said the cause of the child’s death was traumatic brain injury and upper spinal cord injury together with polytrauma and lower limb injury due to blunt force trauma.
38-year-old Karen Harrington of Lakelands Crescent, Mahon, Cork, denies the murder of Santina Cawley at Elderwood Park, Boreenamanna Road, on July 5, 2019.
Mr Justice Michael MacGrath and the seven men and four women of the jury heard evidence from Dr Bolster. (One juror was excused last week).
The assistant state pathologist found evidence of a severe traumatic brain injury that would have resulted in the child going into a deep coma.
Dr Bolster said the child suffered polytrauma and considerable injuries, and on post mortem examination found injuries throughout the body surface.
Fractures were found to the upper right arm, lower left femur, to ribs close to the backbone and to the skull.
“The pattern of injuries were not consistent with a simple fall or indeed an accident.
“Following inflicting of these injuries – in particular of the head – this child would not have been able to cry,” Dr Bolster said.
The pathologist found that traumatic brain injury and polytraumatic fractures were consistent with blunt force trauma. She said this can be caused by a blunt weapon or being by being struck against a hard surface.
In other words, she was “struck with something or struck against something,” the pathologist stated.
She favoured the view that injuries were caused by impact on to a hard surface rather than with a weapon.
As well as multiple bruising throughout the child’s body from forehead to feet, the pathologist found “a complex fracture of the skull… and a ten-centimetre displaced portion of bone.”
Under cross-examination by defence senior counsel Brendan Grehan, Dr Bolster said of the skull fractures, “There was more that one impact to the head. I cannot count the number of impacts.
“Was it one or two?” Mr Grehan SC asked.
She replied, “Two plus plus.”
Mr Grehan asked the pathologist what she could say about the timing of the fractures.
She replied, “They were all recent. There was no way the child was walking around with these fractures.”
Mr Grehan referred to the pathologist’s evidence about the head injuries making it impossible for the child to cry.
Dr Bolster said, “Once the head injuries were inflicted she would have been in a coma.”
As well as a previous left femur fracture – caused by a fall - which had healed, there were fresh fractures to the same thigh bone.