To break a baby's ribs would need “incredible force”, a neurosurgeon has testified in the High Court trial of a Pretoria couple accused of murdering their baby.
Dr Peter John Samuels, one of the neurosurgeons who treated two-month-old baby Wade at the Steve Biko hospital before his death in April 2009, testified that medical intervention at another hospital would not have caused the baby's 22 broken ribs, head injuries or bruises.
Baby Wade's parents Marissa Rudman, 36, and her boyfriend Nolan Schoeman, 32, pleaded not guilty to charges of murdering and abusing their son and another young boy.
Rudman admitted discharging the baby from the Pretoria West Hospital, where he was admitted with pneumonia about two weeks before his death, against medical advice.
She claimed she had only noticed bruises on the baby's head six days later, but thought it had been caused by the struggle to insert a drip into his head.
Dr Samuels earlier testified that the baby was in a critical condition with convulsions, an eye swollen shut and visible bruises on his head and body when he was admitted to the Steve Biko Hospital early in April 2009.
X-rays revealed that baby Wade had two broken forearms and various broken ribs that were a few weeks old.
The baby's lung was also bruised, his brain was bleeding in several places and there was such massive swelling that the bones of the skull had pulled apart and parts of the brain had already started to die.
Dr Samuels and the doctor who admitted the baby to the Pretoria West Hospital were called by the court to testify, after suggestions by the accused that some of the baby's injuries might have been sustained at Pretoria West.
Dr Lee Pillay of Pretoria West testified that the baby's massive head injuries, bruises and rib fractures could not possibly have been caused by inserting a drip into his head.
He said one did not go through the skull when inserting a drip in a baby's head, and the drip could not interfere with the brain at all.
Although he could not remember the specific patient, it was clear from the notes that the baby had been seriously ill and had been discharged prematurely.
Dr Pillay said it was possible that the baby could already have had broken ribs at that stage, as this could also have caused his symptoms of pneumonia, but it was unlikely that anyone would have picked up the rib fractures unless there were severe bruises.
He conceded that babies usually struggled and that it was difficult to insert a drip into a baby's head, but said it was highly unlikely that the insertion of the drip or the nurse restraining the baby would have caused bruises which were only visible six days later.
He said Rudman's claims that an adult needle had been used was also unlikely - one would not even try to use it on a baby, because it did not fit.
Dr Samuels also testified that it was extremely unlikely that bruises would only appear six days later.
He thought it extremely unlikely that holding a baby down to insert a drip would have caused the massive bruises to the baby's forehead, as the baby was acutely sick and no great force would have been necessary.
Pushing the baby onto the bed while inserting the drip would also not have broken ribs, as a baby's ribs were soft and one would need sudden, incredible force to break the ribs, he testified.
Dr Samuels was adamant that anyone caring for the baby would have noticed two broken forearms, as it would have been incredibly painful and the baby would not have used his arms.
The trial will resume on July 10. - Sapa