Trial of Mosside couple accused of Child Cruelty continues

A very young child sustained injuries which were so severe he would have died “if it was not for very good, very rapid care,” a jury heard on Tuesday.

The Newry Crown Court jury also heard expert evidence that in addition to an impact injury which caused a fractured skull, there was also evidence suggesting the infant had also been shaken with such force that it injured the other side of his brain.

Giving evidence on the second day of the trial of 35-year-old Amanda Fulton and her husband Christopher (34), consultant paediatric neurosurgeon Jayaratnam Jayamohan described the injuries suffered by the very young boy as “severe and significant.”

He told prosecuting counsel Rosemary Walsh they were so severe that “the injuries would have killed him if it was not for very good, very rapid care” he received.

Amanda Fulton and her husband Christopher (34), from Rockfield Gardens in Mosside near Ballymoney, are jointly charged with four offences including causing grievous bodily harm with intent, causing or allowing the child to suffer significant physical harm and a charge of child cruelty in that they allegedly wilfully neglected the child in a manner likely to cause him suffering, alleged to have been committed on dates between 5 - 8 November 2019.

The couple face a further allegation of child cruelty but this final charge is alleged to have been committed between 17 October and 2 November on the basis that some of the child’s 27 rib fractures had begun to heal so they must have been inflicted on an earlier date.

The jury of six men and six women have heard that when the “very young child” was admitted to the Royal Belfast Hospital for sick children on 7 November, doctors found that he had sustained a fractured skull, associated bleeding on his brain and retinas, a laceration to his liver, almost 30 fractures to his ribs and two fractures to each of his legs.

In order to relieve the pressure in his brain, the little boy had to undergo an emergency craniotomy to remove part of his skull but this morning, the jury heard evidence of the preamble and how doctors and medics first became alarmed.

GP Dr. Stephen McDonnell told the jury that when he spotted the boy’s fontanelle, the soft spot on the top of his head, was swollen, he was not responsive to even painful stimuli and his pupils were not reacting properly to light, he dialled 999 for an ambulance.

The jury heard evidence from the two paramedics who took the child to the Causeway Hospital and then onwards to the Royal Belfast Hospital for sick children where they recounted how Mr Fulton never called the child by his name, continually referring to him as “the baby.”

Tyrone Smith told the jury Mr Fulton “seemed quite cold” towards the stricken infant in that he “didn’t sort of interact with him and just didn’t seem overly worried about him.”

Mrs Fulton was crying and “kissed him” as the ambulance left Coleraine to go to the RVH said Mr Smith.

The jury heard that according to a nurse at the hospital for sick children, Mr Fulton and a relative were “joking and laughing” over a video and passing a mobile phone between them as she was trying to explain the admission process.

Elaine Clarke, ward manager at the paediatric ICU, told prosecuting KC Toby Hedworth that while Mr Fulton “seemed very calm and not really concerned too much” as the boy’s injuries were outlined to the couple, Mrs Fulton was “crying and gasping and puling at her hair” as a doctor told her the boy;’s lacerated liver was akin to an injury sustained in a car crash.

Later this afternoon Mr Jayamohan gave his evidence over a live television link and he recounted how he had been given medical notes and records, scans of the victim and files relating to the police investigation before producing his report and findings on the brain and spinal injuries.

He recounted that according to Mr and Mrs Fulton, the child took his normal bottle at 12 midnight before he was put down to sleep and he slept normally until around 4am when he was “fidgeting” and although he refused another feed, he went to back to sleep.

They claimed he slept until 7am when he was “fidgeting” again, that he was awake, his eyes were open and he was moving his arms and legs before he went back to sleep but they further claimed that by 10am when he next woke, the infant “appeared sleepy” so they contacted the GP.

The couple claim that at no stage was there a traumatic event or incident which would account for the injuries.

Mr Jayamohan told the jury the scans, injuries and his 20 years of experience would suggest that in addition to a traumatic impact injury which caused the skull fracture on the left hand side and the resulting brain clot, there was also evidence of injury to the brain on the other side.

There was also, said the expert, blood found in the infant’s spinal cord and coupled with the fractured ribs, that evidence was indicative of “shaking alongside, not instead of” the incident which caused the fracture.

The jury have hard the CT scan at the RVH was performed just after 6pm and Mr Jayamohan said his view was that the injuries which lead to the emergency hospital admission were likely to have been inflicted within the preceding 12 hours.

The prosecution have opened their case on the basis that one or other defendant caused the catastrophic injuries in circumstances where the other must have been aware of it yet did nothing.

In his testimony Mr Jayamohan said that initially the child would cry but as the injuries worsened “there would be a clear and significant change in his consciousness and behaviour.”

“I think there would have been very clear concerns that this child was not well as soon as he had his injury,” the neurosurgeon told the court, “and not jut a wee bit but very clearly ill.”

Ms Walsh asked him if the severity of the injuries would be noticeable to a person who did not witness the traumatic incident that lead to them and Mr Jayamohan told her yes but it depends on the level of interaction.

He explained while it would be difficult to tell the difference between a sleeping child and one who was unconscious, especially if they were tucked up with a blanket, the seriousness of the situation would be obvious on trying to interact with the child as they would be drowsy, unresponsive and impossible to feed.

“It would be obvious that he was unwell,” said Mr Jayamohan.

The trial continues.

At hearing.