Trial commences of young woman accused of manslaughter and child neglect
A TRIAL at Waterford Circuit Criminal Court of a young woman accused of manslaughter of her baby girl, heard how the body of the new born was discovered with bloodstained tissues in a bin in the toilet at Caredoc.
The woman, who cannot be named for legal reasons, pleaded not guilty when arraigned to a charge of manslaughter in 2018 at Caredoc on the Cork Road. She also denied a charge of child neglect on the same date.
Opening the case on Thursday last, Fiona Murphy SC said it was the prosecution’s case that the young woman attended Caredoc with her mother and grandmother sometime after 2am on the day in question complaining of constipation and back pain. Her mother was in the doctor’s office when the issue of her potential pregnancy was raised. The young woman was asked to provide a urine sample and left to go to the toilets. CCTV footage showed that she was in the toilets for approximately 12 to 13 minutes.
She returned to the doctor’s office and indicated that she wasn’t in a position to provide a sample.
The doctor referred her to University Hospital Waterford. The three women left Caredoc and attended at UHW at 3am, where there was a concern about bleeding and a belief was formed that she had recently given birth. On foot of an account given that she had bled into the toilet at Caredoc, a call was made to Caredoc at 7.30am. Gardaí were alerted and the toilet was closed off. Scenes of crime Gardaí arrived at 1pm, and during the course of their search a bin was emptied and the remains of a baby girl was found.
The baby was examined and there was evidence that the baby was a full term child, who breathed after birth. Ultimately, a finding was made that simple management of drying, keeping her warm and feeding her would have kept her alive, Ms Murphy SC said. The prosecution’s case was that by her actions and inactions the mother neglected the baby and ultimately that resulted in her death.
Garda Eugene O’Neill told the court that he attended Caredoc with his colleagues at 1pm on the day in question. A booklet of photographs, handed out to the jury, depicted bloodstains on a number of surfaces, including the toilet seat, sink and a metal bin. Garda O’Neill was present when the contents of the metal bin were checked and the baby’s body was located.
Evidence of defendant’s mother
The mother of the defendant was visibly emotional as she gave evidence. She said that she was suspicious that her daughter was pregnant, but that her daughter denied it, despite being given reassurances that everything would be ok.
After refusing to do a pregnancy test, she brought her daughter to her GP in early January, where she provided a urine sample, which returned a negative result. Three weeks’ later she brought her back for a blood test, but she refused to give one, and nothing could be done as she was over 18. Subsequently, she made her own doctor’s appointment without her mother and stated afterwards that she was “fine”.
Over the following months the mum continued to reassure and speak to her daughter, but she constantly denied being pregnant. Under cross examination she said it got to the stage where both were not speaking.
In the early hours of the day in question the grandmother knocked on the mother’s door to fetch her as the defendant was complaining of back pain and constipation. The mother wanted the defendant to go to the hospital, but she had made an appointment at Caredoc. The mother spoke to the doctor about her suspicions about the pregnancy when the daughter went to the toilet to provide a urine sample. When the defendant came back into the room she handed back an empty sample bottle and said that she couldn’t give one.
Under cross examination, the witness agreed that the defendant couldn’t admit to being pregnant, but she was certain that she was. It was put to her that after the defendant came back from the bathroom her black tracksuit end was wet. The mother said she put her hand on her daughter’s leg and when she took it away there was blood on it, but the defendant said she had got her period. At that point she thought that she was miscarrying and they left.
At the Emergency Department at UHW the mother told a male nurse that she thought her daughter should be in the maternity department, saying that she thought she was pregnant. After being examined the woman was transferred there and the mother and grandmother waited outside. A female member of staff asked them where they had been last, and asked where the baby was. The mother replied, “what baby”, and the staff member informed her that her daughter had given birth. The witness wanted to go back to the Caredoc, but the Gardaí had been called and she went in to see her daughter. When she asked what had happened to the baby the defendant denied that there was any baby.
Taking the stand Dr Adel Abdulrazak confirmed that he had been the doctor on call at Caredoc on the date in question. At 2.17am three ladies attended Caredoc. The grandmother waited outside as the mother and daughter came in to the consultation room. The doctor said the patient complained of lower back pain and constipation. He didn’t directly examine her but asked her to provide a urine sample, to rule out a urinary tract infection. He felt that the patient wasn’t telling him the main complaint. When she left the room he asked the mother if there was anything that she was worried about, and she said she felt her daughter was pregnant. When the patient came back she did not give a sample. He felt there was a necessity to refer her for a blood test at UHW. In his referral letter the doctor said it was difficult to ascertain her real complaint. The patient denied any chance of pregnancy. He noted under reason for referral severe backpain, constipation, and pregnant with a question mark.
The doctor said that he didn’t see any blood on the defendant when she came back from the toilet. He insisted that she should go to hospital.
At 7am he got a call from Dr McNestry in the labour ward who asked him to check the toilet. He found blood stains and looked at the chair that she had been sitting on and also found blood. He brought the chair to the entrance of the bathroom and closed it up.
Ciaran O’Loughlin, SC, pointed out that everything in the toilet was covered in blood and said he must have been “truly alarmed” at what he saw. He said that Dr McNestry expressed surprise that he didn’t mention heavy vaginal bleeding in his referral letter, but the doctor stated that the patient didn’t mention anything about bleeding. Mr O’Loughlin put it to him that Dr McNestry shared her suspicion that the defendant had recently given birth, but the doctor denied this. In relation to the bathroom, he said that he didn’t want to disturb anything in the room until the Gardaí arrived.
James Hennessy, retired Garda and Caredoc employee, gave evidence of a call from Caredoc head office later that morning. He stated that a lady told him to check the ladies’ toilet and he saw bloodstains and spatters. He was instructed to seal the bathroom off until Gardaí arrived. He put up a sign and a chair against the door. He did not open the bin.
Via video link from the UK, Dr Annie O’Leary confirmed that the woman was transferred from the ED to the maternity ward at around 6am. Dr O’Leary spoke with the patient who told her that she believed she was pregnant and somewhere between 20-25 weeks gone, but she had not had a positive pregnancy test. She said she was bleeding and came to the hospital after Caredoc.
The doctor recollected, under cross examination, that the patient had told her that she had planned on hiding the pregnancy and giving the child up for adoption. However, the doctor wasn’t sure she had been pregnant until receiving the results of a hormone pregnancy test. Evidence was heard that when the patient was being scanned the doctor couldn’t see a baby in the womb.
After seeking senior support, Dr O’Leary carried out an external examination and noticed signs of a perineal tear, an indication of recent childbirth.
When the patient was told she had recently given birth she became upset and stated that she wanted to go home.
Also giving evidence via video link from Dublin, Dr Catherine McNestry confirmed she was working a specialist registrar based in the maternity department of UHW in 2018.
Brid Walsh, staff midwife, expressed concern that the woman had concealed the delivery of a baby. The patient had been examined by Dr O’Leary and the staff midwife when she arrived. Dr McNestry said the patient spoke to her about pains and haemorrhaging into the toilet at Caredoc, which resulted in a relief of pressure.
Dr McNestry asked about her first positive pregnancy test and the patient told her that she had given her mum a fake sample of urine to fabricate a negative pregnancy test, as she didn’t want her mum to know that she was pregnant.
During examination she also noticed tearing and what would be consistent following delivery. The patient denied suggestions of recent child birth and repeated a history of vaginal bleeding.
At some point Dr McNestry received a return call from Caredoc. She was surprised that the doctor was not aware of the heavy bleeding the patient described. Dr McNestry asked him to check the bathroom and informed him of her suspicions that she had delivered a baby. He refused and would leave the scene to be checked by the Gardaí. Under cross examination, she said that she became quite upset when he wouldn’t check the toilet.
She later phoned the Gardaí as the patient needed stitches but she wanted to know if they needed evidence of the tear. She said there wasn’t any facility in the hospital to document anything photographically, and not to deny her medical care the doctor sutured two lacerations and a perennial tear using local anaesthetics.
A number of other medical staff members gave evidence of their interactions with the patient from the time she presented at UHW. CCTV evidence of the defendant’s movements at Caredoc was shown to the jury.
Dark-haired baby girl
Dr Sean McBrinn of Waterford Medical Centre attended the scene at Caredoc. He was asked to confirm the baby was deceased. The baby girl had dark hair and seemed to be full term. There was no heartbeat or breathing, and he pronounced the baby dead. Dr McBrinn confirmed that he didn’t see any signs of trauma.
Dr Michael Curtis, former Deputy State Pathologist, was asked to conduct a joint forensic and paediatric pathology report with Dr Peter Kelehan.
Dr Curtis noted that the baby was inside a yellow plastic bin bag on top of which Gardaí had placed a white disposable blanket. Multiple bloodstained tissues were present with the baby. Measurements were consistent with that of a full term baby. She weighed approximately eight pounds and two or three ounces. There was slight bruising in keeping with a difficult delivery or birth trauma. There was no evidence of a blow or being struck. There was no evidence that the baby inhaled water into the major airways, for instance from a toilet bowl.
The baby hadn’t been fed and mucoid fluid hadn’t been washed out. Samples were taken for toxicology and DNA testing.
In conclusion, Dr Curtis said the baby appeared to be full-term and healthy. There was evidence that she breathed after birth with air present in the lungs and stomach. Her death was attributed to inattention at birth.
Professor Naomi McCallion, Professor of Neonatology and Consultant Neonatologist, was asked to give her opinion on the findings of the post mortem. She said all she could determine was that the baby established breathing over the first few minutes of life. She stated that once breathing was established it would be very unusual for it to stop. Professor McCallion was of the opinion that all would be required would be stimulation, feeding to prevent hypoglycaemia and keeping the baby warm.
The trial continues this (Tuesday) morning.