Shaken baby's injuries would have been 'obvious': expert witness

The baby girl was so badly injured on the morning of December 12, 2020, she has never regained movement or sensation below the waist.

As well as paraplegia, the little girl, who turns four on May 5, lives with cerebral palsy, an intellectual disability, and cognitive, visual and speech issues.

Giving evidence in the Newcastle District Court where the baby's father is on trial, Dr Heather Burnett, a paediatric rehabilitation medicine physician and medical lead for HNEkidsRehab, the paediatric rehabilitation service for Hunter New England, said it was inconceivable that a care giver could have picked that baby up and changed her nappy without realising she had been injured.

You could have seen just by looking at her, if she was not covered by a blanket, a difference in how her limbs were lying, she said.

And if not at that point, then "certainly on picking her up", the difference between holding an infant with normal muscle tone and her abnormal muscle tone would have been "obvious", Dr Burnett said.

Absolutely, she said, a care giver would have noticed if her legs were paralysed while changing her nappy.

The father, identified only as GP, has pleaded not guilty to inflicting grievous bodily harm on his daughter. His defence barrister, Paul Rosser, KC, told Judge Pauline David at the start of the trial two weeks ago that it was either mum or dad who inflicted lifelong injuries on the baby.

The father's evidence, by way of recorded police interviews and what he said at Cessnock and John Hunter Hospitals, was that he went in to get his daughter out of bed that morning, while the baby's mother was still in bed.

She was "perfectly fine when I got her out of bed", she was "normal".

It wasn't until he reached around to some nearby drawers to get some clean clothes to put on her that "everything started" - that she "gasped for air" and then started "breathing funny" and going limp.

Dr Burnett said the symptoms the father described would have emerged immediately after she was injured.

"That would have happened immediately, and quickly, not slowly over many minutes," Dr Burnett said.

When pressed under cross-examination for the longest possible time frame, Dr Burnett said the best range she could give based on published evidence, was that evidence of the injury would be present in a baby's brain within an hour - and also present in the brains of people who die immediately.

"If she had presented to Cessnock Hospital more than an hour or two after this injury had been inflicted she'd be dead," Dr Burnett said.

Further pressed, she agreed there was a window from about 8 am that morning and 9.30 am that the injury could have been inflicted, based on the baby's clinical presentation, CT scans and MRI imaging.

Earlier in her evidence Dr Burnett described some of the child's injuries, which included a long haematoma along her spine ending just below the rib cage at the thoracic or lumbar junction, being likely caused by the baby being shaken.

That same site was commonly where those types of injuries were found in babies who have been shaken, she said.

Consistent with other medical experts' evidence, Dr Burnett said it would have required a great deal of force to generate the degree of spinal injury seen in this baby.

It later became apparent she had suffered what's known as a complete spinal injury, she said, resulting in a complete loss of function and sensation below the waist.

The infant also had a skull fracture with features consistent with being shaken, she said.

"How long would a shake take to create that kind of an injury," Crown Prosecutor Jillian Kelton asked.

"Seconds," Dr Burnett said.

The trial continues.