PROVO -- A medical expert testified Thursday that 13-month-old Austin Pierce died from complications of an old injury, not as a result of Battered Child Syndrome.
Dr. Janice Ophoven, a pediatric forensic pathologist, testified at Christopher Thunborg's child abuse homicide trial that Pierce had no evidence of a fresh injury.
"I attribute the death to blunt force trauma to the abdomen some weeks prior," she said.
Ophoven said she would have investigated the baby's death as a homicide, but as a result of an event occurring nearly two months before he died. The boy likely had a traumatic abdominal injury around January 2008, and his body was healing in the months before his March 11 death.
The injury to the boy's intestine behind his abdominal wall was a "time bomb," she said, that could have led to a medical emergency at any time while it was still healing.
An autopsy after Pierce's death found that he had scarring on his small intestine, and the intestine was torn completely apart. The chief medical examiner for the state of Utah, Todd Grey, testified Monday that Pierce had a prior injury to his abdomen, but ultimately died as a result of a blow to the abdomen hours before his death.
Ophoven, however, said she found only evidence of old, healing injuries in Pierce's abdomen. There was no fresh blood in his abdomen or in his small intestine, indicating his intestine was torn after he died, she said, possibly as a result of CPR.
"I don't know for certain what happened," she said. "I just know there's no fresh blood there."
An injury that occurred within 24 hours of death and sufficient to cause death, Ophoven said, would have fresh blood associated with it. If an intestine was bruised and healing, it is possible the area would be quite fragile as the body tried to fix the injury, she said. In autopsies in the past, such tissue could literally "fall apart in your hands," she said. As such, it is quite possible Pierce could have suffered a fatal injury if Thunborg tripped and fell with the baby as he told investigators, she said.
Children often suffer such injuries in normal activities when an area is healing, she said. It can also be difficult to diagnose an injured intestine behind the abdominal wall when a child is too young to speak. It is common for the baby's symptoms to be incorrectly diagnosed as the flu, she said.
"He doesn't have a lot of skills to tell you why he doesn't feel good," Ophoven said.
Unlike an injury inside the abdominal cavity, one behind the cavity does not spread infection as quickly and the symptoms do not manifest as dramatically, she said. Instead, the injury often does not become apparent and deadly until the effects spread inside the abdominal cavity. That is why Pierce may have lived and not seemed drastically injured for two months until he died, she said. He may have been uncomfortable and was seemingly ill, losing weight and vomiting on and off, but those symptoms still may have seemed like the flu.
Though Grey also testified that various bruises on the child's body were suspicious and indicative of abuse, Ophoven said the bruises on the child's body told her nothing about his death. Most bruises on the arms and legs of a child learning to walk are normal, she said, and a cluster of bruises on his back correspond with bones beneath.
"You have to be very careful in identifying anything as a pattern when it's really close to the bony surface," she said.
All of the injuries Ophoven identified in Austin Pierce were of the same age, and probably two to three weeks old, she said. Defense attorney Dusty Kawai asked her whether it was possible the injuries occurred the night of the baby's death, but she said it could not have.
"Absolutely no," Ophoven said.
Thunborg's trial is scheduled to finish today.
Posted in Local, Orem, Provo on Friday, November 20, 2009 12:45 am Updated: 4:05 pm. | Tags: Orem, Provo, Thunborg
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