A doctor has told the Circuit Criminal Court that injuries sustained by a ten-month-old baby girl were a significant indicator of a shaking injury and were unlikely to have been caused accidentally.
Registered childminder Sandra Higgins (34) is alleged to have caused the injuries to the 10-month-old baby she was minding at her home by shaking the child.
Ms Higgins of The Beeches, Drumgola Wood, Cavan town, County Cavan has pleaded not guilty at Dublin Circuit Criminal Court to intentionally or recklessly causing serious harm to the baby on March 28, 2012.
On the third day of the trial, consultant paediatrician Dr Alan Finan said her brain injuries could not reasonably have occurred before 9am on that day, prior to her being left by her mother with her childminder.
The court has heard the child was fine that morning and during the day. Around 5pm Ms Higgins brought her to Cavan General Hospital where she presented with active seizures, brain injuries and fractured ribs.
"In my professional view it would not be a reasonable suggestion that she could have been normal for seven hours with those injuries already being incurred. It would not be a reasonable proposal," Dr Finan said.
He told Sean Gillane SC, prosecuting, that he would find a proposal that the injuries could have been caused accidentally to be unacceptable.
"That the combination of injuries could be caused accidentally would not be credible," he said.
He said the injuries clearly indicated the baby had suffered non-accidental injury and that shaking injury was a likely explanation.
The court heard these conclusions were contained in a report provided by Dr Finan to investigating gardai on April 11, 2012.
Under crossexamination Dr Finan agreed that in an earlier report, dated April 2, he stated that "precise dating of [the infant's] injuries is not possible at this time".
In the report he said this dating could be made upon further evaluation and medical imaging.
He denied a suggestion from Remy Farrell SC, defending that he had changed his mind between the first and second report.
"I didn't change my mind. I felt I wasn't in a position to complete a final report, I termed it a preliminary report. On April 11 I felt I had reached a point where I was able to draw conclusions," he said.
Mr Farrell put it to him that nothing had changed between the two reports and suggested that the doctor had "just needed to think about it".
Dr Finan replied: "It was a very serious issue. I needed to be careful about the conclusions drawn. I took the time I needed."
He agreed with a defence suggestion that "lots of babies" - under five per cent of new born babies - have chronic subdural haemorrhaging. He said a chronic condition is ongoing while an acute condition is a very recent event.
He said a chronic subdural haemorrhage may not have significant symptoms.
The trial at Dublin Circuit Criminal Court continues before Judge Patricia Ryan and a jury of eight men and four women.
There is a court order prohibiting publication of the child's name.