A medical expert called to give evidence at a murder trial said a non-accidental brain injury sustained by a 13-week-old baby was “one of the most severe” he has seen in 10 years of practice.
The paediatric neuroradiologist, who specialises in brain and spinal injuries in children, said today that it was his view that the injury sustained to Lewis Oliver Rowland in November 2015 was likely caused by “a forceful shaking episode”.
He also revealed that the brain injury was akin to being sustained in a road traffic accident or a fall from “an enormous height”.
Lewis was admitted to Craigavon Area Hospital at around 1.30pm on November 20, 2015, by his parents Craig Rowland (29) and Laura Graham (31).
Whilst the pair, both with an address at Millington Park in Portadown, have admitted a charge of wilfully neglecting their son by failing to obtain timely medical treatment, Rowland has been charged with both the manslaughter and murder of his son, which he denies.
Lewis passed away aged three following complications arising from surgery on October 20, 2018, and it’s the Crown’s case that the catastrophic brain injuries he sustained in November 2015 played a significant role in his death.
During today’s sitting at Belfast Crown Court, the paediatric neuroradiologist said that in the aftermath of Lewis’s death he was asked to examine a number of images relating to the brain injury which were taken during both CT and MRI scans.
The doctor was also provided with the child’s medical history.
The jury of eight men and four women heard him describe Lewis’s brain injury as “severe” and one caused by “traumatic force”.
Answering questions posed by a Crown barrister, the doctor was asked about Lewis’s “level of functioning” after he suffered the injury.
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The medic responded by saying: “Once a child sustained a brain injury this severe, there would have been an abrupt and sudden change in their behaviour and demeanour.”
This, he said, included changes in levels of consciousness, seizures and initially becoming “floppy” but as the injury progressed they “could go stiff”.
When he was asked his opinion on how Lewis sustained the brain injury, the doctor said that after examining all the evidence including the level of bleeding on the brain and no swelling associated with an impact with a hard surface, it was his opinion it was likely to have been caused by a “forceful shaking injury”.
After being asked about the degree of force used, the doctor said it would have been “inappropriate” and added: “If it happened in front of the jury now, they would be immediately concerned for Lewis’s wellbeing, or any child, if they saw this degree of force being used.”
Describing the level of injury caused by shaking as “one of the most severe” he has seen in his 10 years of practice, the doctor determined it was sustained within a 24-hour period prior to Lewis being admitted to hospital.
The doctor also told the court that Lewis was “in serious trouble by the time he presented to hospital” and said “he needed urgent treatment to preserve life and his brain injury, if not treated promptly, would almost certainly have resulted in his death”.
The paediatric neuroradiologist was also questioned by a defence barrister representing Rowland, who asked if the term ‘non-accidental injury’ indicated an injury caused intentionally or deliberately.
The doctor replied, “no it is not… most of these types of cases and most of these types of injuries are sustained in a momentary loss of control… and not a pre-meditated desire to inflict injury”.
The defence barrister then asked if a person who had not witnessed a baby being shaken would be able to recognise the signs of a brain injury.
Saying a “lay person” may not associate abnormal behaviour with a brain injury, the doctor said that due to a lack of visible injuries, this abnormal behaviour would be “confusing”.
After the doctor’s evidence concluded, the Crown barrister addressed both Mr Justice O’Hara and the jury and said the prosecution case was now concluded.