Baby J's injuries could have been caused by shaking says doc

FRACTURES to a baby's arms and legs could have been caused by "violent shaking" a court heard today.

Dr Karl Johnson said when he examined the x-rays of three-month-old Jack he discovered at least five and possibly six fractures to arms and legs.

Dr Johnson, a paediatric radiologist at Birmingham Children's Hospital, said the fracture to the child's upper arm must have occurred within two days of the child being rushed to Basildon Hospital on February 13 2006 and could have been caused by a "blow to the arm, a "bending or snapping action" or "the arm could have impacted against a hard surface."

Dr Johnson said three further fractures to his arm and legs must have happened around a week earlier and could have been caused by a "pulling or twisting force applied to the bone.

Giving evidence at the trial of Jack's mother Joanne Mallinder, 37, who is alleged to have inflicted the fractures and severe brain damage which led to his death 13 months later, Dr Johnson said: "Alternatively if a child was violently shaken so the child was flaying around that could have caused the fractures."

He also told the jury at Basildon Crown Court that a fifth fracture to the leg, which must have occurred one to two weeks earlier, could have been caused by a "blow or impact or some sort of leverage or bending type of action."

On cross examination by Sally O'Neill QC, defence counsel for Mallinder, Dr Johnson accepted some children were prone to fractures and although there was no evidence from the x-rays that Jack had brittle bone disease, there were "rare" cases when it didn't show up.

Dr Johnson said he didn't believe the fractures to Jack's legs were caused when paramedics screwed a needle into his leg so they could administer Adrenalin as he travelled to hospital in the ambulance but accepted it was possible if the paramedics had "inappropriately" restrained him.

Dr Cheryl Hemmingway, a consultant paediatric neurologist at Great Ormond Street Hospital said when she examined Jack's brain scans on February 14 2006 she discovered he had suffered recent bleeding and swelling to his brain and there was also bleeding behind his eyes.

Dr Hemmingway said Mallinder and Jack's father Gareth Cox told her they were not aware of Jack having fallen and said: "I felt they (the injuries) were most likely to be the result of trauma.

"We do know from similar situations that normally trauma occurs shortly before they become significantly unwell.

"We know in the case of Jack he was found not to be breathing by his mother. One would assume that the incident had happened shortly prior to his being found not breathing."

She also said a "significant" amount of shaking or impact injury could have caused the brain damage, which was usually seen in children who had been involved in a serious car accident or who had fallen from a first floor window.

On cross examination by Ms O'Neill QC Dr Hemmingway admitted children could be born with bleeding on the brain and there were other causes of such injuries.

She also accepted that if a child had stopped breathing and there was a significant delay in the child receiving oxygen, this would result in swelling and damage to the brain.

Mallinder, of Leicester Road, Tilbury, denies murder.