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Pretoria - A 2-year-old girl known as Baby L was not injured accidentally but was the victim of child abuse, a medical expert testified in the North Gauteng High Court in Pretoria on Tuesday.
Dr Lorraine Du Toit-Prinsloo, a forensic pathologist, testified in the trial of a 20-year-old Pretoria North woman and her 36-year-old boyfriend who denied trying to kill the woman's daughter, abusing the toddler and depriving her of medical care.
The couple claimed Baby L had fallen down a flight of stairs and off a washing machine.
She was already in a coma when she was rushed to the Akasia hospital on 30 December last year.
She had bleeding in her brain, a fractured hip, blood in her abdomen, a bruised kidney, a serious injury to the pancreas and bruises all over her body.
A pathologist earlier testified that she was in a vegetative state because of severe brain damage.
Prinsloo said bruises on the skin were the first sign of child abuse.
Three doctors testified that Baby L had bruises of markedly different colours, which Prinsloo said showed that the bruises could not have been inflicted at the same time.
Bruises to the buttocks (as Baby L had) were frequently a sign of bruises caused by hand slaps or beating with a strap and was a sure sign of abuse.
The small red bruises on the chest of Baby L were from finger point pressure on the chest and was also one of the tell-tale signs of child abuse, she added.
The history provided by the accused was that Baby L had tumbled down stairs on 15 December, but Prinsloo said falling down stairs was likely to cause superficial injury and involve only one body area, most commonly the head and neck.
"I'm of the view that the explanation of a fall down stairs does not explain the number of bruises on this child.
"I'm also of the opinion that bruises sustained on 15 December when she allegedly fell down the stairs could not still have been on the body on 30 December," she said.
"If she fell off a washing machine onto the back of her head, I would have expected a bruise on the back of her head but bleeding to the front part of the brain.
"Another worrisome finding is a bruise behind the child's ear. You would not expect that from a fall because it's a protected area," Prinsloo testified.
In her 10 years doing autopsies on children she had only seen pelvic fractures caused by falling from a great height such as a building or in a car accident, she testified.
She said the pancreas was a very protected organ in the abdomen and the injury sustained by Baby L was very rare.
"In my view the injury to the pancreas was caused by a directed blow with an object such as a broom stick that injured the abdomen," she added.
Prinsloo described the fluid found in Baby L's lungs as possibly indicating a near-drowning while the blood in her abdomen showed that the toddler had lost nearly 20% of the blood in her body.
The trial continues.
