7) Considerable violence was used

7) Considerable violence was used. Most definitely against evidence Judge Stevens was well aware of. Det.Snr.Sgt T (M12) To C, prosecutions barrister 28/4/06 (when withdrawing my assault charge saying there was no suspicious circumstances and no further charges would be laid.) “The pathology has revealed that Melissa Sale had at some stage in the three months preceding the fatal injury received a head injury and brain bleed. The enquiry was unable to date that injury. Unfortunately, the first brain bleed meant that the degree of force required to cause the second and fatal brain bleed was nowhere near as great as that which would have been required to cause the fatal injury in the absence of the earlier bleed”. Mr B, neurosurgeon, (trial 132, 135) no fractures. (Trial 135) I am ‘not qualified to interpret radiologist’s findings’. (When Mr HJ, crown prosecutor tried to get him to say the CT did not show evidence of a prior). The radiologist’s report of the CT done at Tauranga (that was not disclosed to defence prior to the assault charge being withdrawn) detected a prior subdural haemorrhage. It was the radiologist’s with the expertise to conclude this as he correctly did so. Despite this, the judge let Dr K, crown specialist paediatrician be the expert to say it was not. Dr Z, Crown forensic paediatric pathologist, (trial 471): size of haematoma not related to force. (Trial 472): no fractures. (Trial 468) “I think it very unlikely that such an action would cause a unilateral large subdural haemorrhage that was seen in Melissa”. (when giving her opinion to how I shook Melissa to get a response from her when she went comatose) Dr M, defence specialist paediatrician (equal standing to Dr K except that he is professional, objective and scientifically minded). (Trial 538) “pattern of massive subdural bleeding and same sided brain swelling is well recognized to be due to impact from a significant, but not extreme force. It’s a rare but well documented event after a relatively short fall”. (553 Trial) “It is now shown that even short falls can have significant rotational acceleration associated with them”. (In other words the initiating applied force is magnified with such a fall. So a significant applied force can end up being a considerable reactive force. It does not mean the force applied was “considerably violent”). Dr F defense forensic pathologist, (M35) The evidence indicates that there was prior episode of head impact injury and it is not possible to exclude such an injury from having contributed to or predisposed to her fatal subdural haemorrhage. (Trial 485) forces required are the field of a bioengineer. The crown did not have a biomechanical engineer at trial. Dr V defence biomechanical engineer, (trial 581) force to rupture a bridging vein causing a subdural depends upon the nature of the fall. (Trial 586) falls are never totally linear. (Trial 608) if a rotational element is involved, can easily exceed adult limits of risk of bridging vein rupture. (Trial 585) based upon what we know about children, they may be even more susceptible then adults. (Trial 616) a child could have a subdural haematoma and not necessarily have symptoms and if that progresses or re-bleeds, you have this catastrophic event. (Trial 573) short falls can result in subdural haemorrhages, retinal haemorrhaging and death. (Trial 585) “shaking does not result in very large acceleration. The accelerations are in the more benign level. It’s unlikely they’re going to result in subdural haematoma. By this method, it would be chest and neck injury”. This would explain why Dr K crown specialist paediatrician and the judge wanted it accepted as fact that the chest scratch was fresh and Melissa had cervical cord injury. (Judge Stevens saying “that’s simply not on” cut of defence when this expert was on the stand as defence had not given something he began to say to the crown in advance, so Dr K could argue it outside of his area of expertise. Very shortly afterwards Mr HJ, crown prosecutor bought up material defence had never been given and the judge was fine with it) Dr F, defence forensic pathologist, (trial 484) force that resulted in a carpet burn that is on the cheek is enough to have caused a subdural haemorrhage also. (Trial 481) said “the size of the haemorrhage is to some extent dependent upon two things. One is the size of the blood vessel that tears and two how long it takes for the blood to accumulate. So it’s a question of time as well as the size of the vessel. But neither of these relate well to the amount of force involved. So we really don’t know the amount of force involved”. Dr M2 original crown ophthalmologist (trial 157) “It’s highly unlikely that the forces required to produce retinal haemorrhage in a child less than two years of age would be generated by a reasonable person in an attempt to rouse an apparently unconscious child” Dr K, crown specialist paediatrician, significant element of rotation in a complex fall can tear a bridging vein, and the forces can be significant but not extreme if these two conditions apply. Low level falls can result in these injuries, but extreme force was used on Melissa as she had no underlying medical factors that made her susceptible (He often brought up things in court to appear objective then would shoot it down in flames). ((This explains why it was hidden from the jury that Dr B, neurosurgeon said all of Melissa’s blood vessels had a susceptibility to bleed and that Melissa had a prior subdural haemorrhage seen macroscopically and at surgery). Melissa’s head had grown from ‘normal’ size to in the 98th percentile rapidly for unknown reason well before her latest fall. Dr K used a child’s large head of a defence example of an all but identical case, to say that child would have an underlying medical issue that would have made them susceptible, which wasn’t ruled out). No-one knows exactly if a bridging vein was ruptured with the impact. It was assumed as it is a large main blood vessel, and it was a large haemorrhage. Greater force would be required to rupture it than more fragile smaller vessels. The neurosurgeon did not find a source of the bleed. Eliminated as evidence from trial was Mr B’s, neurosurgeon (operation note) finding that “no single obvious bleeding point was identified, but the brain and surrounding dura were inclined to bleed”. In other words, it could well be that the blood came from a number of small vessels rather than one large one. Dr S, crown forensic neuropathologist, (Trial 417) “A large haematoma like this is likely to need a largish blood vessel or vessels to be torn to produce the clot”.