A doctor told a Supreme Court jury yesterday how he struggled for more than an hour to save the life of ten-month-old baby A'Maya Tamerry after she was rushed to hospital.

Dr. Andrew Spence, director of intensive care at the King Edward VII Memorial Hospital, recalled how the baby was dehydrated, emaciated and vomiting a brown fluid when she was brought into the hospital's intensive care unit on February 28, 2001. She also suffered two cardiac arrests while undergoing treatment.

The baby's parents, Amenemhat Waset Amen-Ra Tamerry, 48, and his wife Maatkai Hatsheput Tamerry, 36, deny unlawfully killing their daughter, who died on March 1, 2001. The Crown alleges that the baby died as a result of severe neglect and malnutrition.

Taking the witness stand yesterday, Dr. Spence said A'Maya was not breathing when she arrived at the hospital. He said that her eyes were cloudy and sunken and that the top of her skull was sunken in.

The baby was also very anaemic, had few platelets, and her temperature was extremely low, he added.

“The child was regurgitating copious amounts of brown fluid,” he said.

A cup full of brown fluid was drained from her stomach and her blood sugar level was extremely low - 13 millilitres in one litre of blood. A normal child of A'Maya's age should have a blood sugar level of between 80 and 100, he said.

Dr. Spence said that, after working on A'Maya for about 45 minutes she sustained a heart beat but then slipped into a second cardiac arrest.

After ten minutes, Dr. Spence said a pulse was detected but at that point A'Maya was brain dead.

At around 2 a.m. on March 1, 2001, Dr. Spence had to tell the defendants that the chances of A'Maya's survival were nil. She was pronounced dead at 8.40 a.m.

Dr. Spence also told the court that the parents informed him that A'Maya's last meal was sea moss and gruel.

He said the parents told him A'Maya had been sick for “some days” and had an infection in her eyes.

“I have never seen a child in this condition before,” Dr. Spence said.

“The child's nutritional state was chronic and it would have taken many weeks to reach the stage of emaciation I saw,” Dr. Spence added.

In cross examination Dr. Spence, told the court dehydration can come on very quickly.

And he described the Tamerrys as being in a state of “obvious distress” while at the hospital.

Earlier in yesterday's proceedings, paediatrician Dr. June Hill told the court that A'Maya should have weighed about 16 pounds at ten months of age but at the time of the autopsy she weighed only eight pounds three ounces.

Defence lawyer Mark Pettingill asked if the child's weight could have dropped between the time of death and the time of the autopsy a day later.

“It would be unusual for the weight to drop from say 11 pounds to eight pounds three ounces,” Dr. Hill said.

Mr. Pettingill also showed Dr. Hill photographs taken of the baby in the months before she died.

He asked Dr. Hill: “Does this photograph appear to show a baby that is well nourished?”

Dr. Hill replied: “It is a normal looking, beautiful baby, but I cannot comment on nutrition from the photograph.”

At this statement, A'Maya's father shook his head in the dock.

Mr. Pettingill suggested to Dr. Hill if she looked at a child from a developing country with bowed legs and distended bellies, could she say the child was malnourished.

Dr. Hill said the images we associate with malnutrition are from commercials about malnutrition.

Shown another photo, Dr. Hill said A'Maya “looks like a cheerful, happy baby”.

“Would you say cheerful, happy babies are not suffering from neglect? ” Mr. Pettingill asked.

“Not usually,” she replied.

Describing another photo to the court, Dr. Hill said: “The baby looks interested and the mother looks caring.”

“If the child was suffering months before its death do you think you'd see a child playing in that manner? ” asked Mr. Pettingill.

Dr. Hill replied: “I don't think you can conclude that.”

Mr. Pettingill then suggested that the condition A'Maya was in on the day of her death could have come on quickly.

“It is possible but unusual,” said Dr. Hill.

Dr. Hill was also asked if congenital conditions - conditions present at birth - could affect failure to thrive, for example, allergies to certain foods or absorption problems.

“Yes,” she said.

But A'Maya's condition when she was admitted to hospital on February 28 would have taken months to develop, she added.

She also said that a doctor may have seen signs of “weakness” in the months before the baby's death.

One sign of malnutrition can be that bones become bowed, she said. Mr. Pettingill asked Dr. Hill if she was aware that A'Maya had a skeletal exam (x-rays) done just before she died and if the result was normal.

Dr. Hill said she was aware the exam was done.

The court also heard yesterday from Dr. Roddy Moore, a general practitioner (GP) who saw A'Maya.

Dr. Moore said that when he first examined her on June 8, 2000, A'Maya showed no evidence of acute illness, was not dehydrated, and had a normal pulse rate.

He said his initial diagnosis was failure to thrive (grow). Dr. Moore also told the court that on four different occasions he told the parents to discontinue feeding A'Maya sea moss and water - a Caribbean drink with an element of condensed milk or cow's milk, herbs and spices.

“I asked them to stop using it because I felt the baby should have breast milk or formula,” said Dr. Moore.

He told the court that at one point A'Maya put on six ounces in five days. But he said the Tamerrys missed one appointment with him because they were “too stressed” to attend.

When the defendants did show up on June 23 - ten days after their previous appointment - A'Maya had not gained any weight, he told the court.

Dr. Moore said he had hoped to see the child gain four to six ounces over that time period.

“I came to the conclusion that the baby needed to be monitored on a regular basis,” he said, adding that he thought, at that point, it was time for “specialist investigation”.

Dr. Moore said he felt he was getting out of his depth as a GP and that A'Maya needed a specialist, so Dr. Hill was called and began seeing A'Maya at the end of June.

“The parents were very upset about the court order and threats of taking the child away,” he said.

Dr. Moore will continue his testimony today before the ten-woman, two-man jury and Chief Justice Richard Ground.