The injuries that led to the death of six-month-old baby Cassidy Salahuddin could have been caused by a fall, a controversial medical witness testified yesterday.

But prosecutor Kulandra Ratneser threw doubt on the expertise of general practitioner and former emergency room doctor Constance S. Richards, saying she was not qualified to give evidence as a medical expert.

Mr. Ratneser, the former Acting Director of Public Prosecutions, failed to block Dr. Richards taking the stand at the trial of Kareen Salahuddin, who is charged with murdering his daughter Cassidy on May 5, 2003 .

?We cannot have general practitioners coming in to give evidence of injuries which are in the purview of specialists,? Mr. Ratneser told Chief Justice Richard Ground. ?This doctor is not qualified.?

But Dr. Richards, formerly an assistant director of the emergency room at the King Edward VII Memorial Hospital and now a general practitioner, asserted that as an emergency physician/GP she was proficient in the areas, although she admitted she was not a specialist in either area.

Mr. Justice Ground ruled he would accept Dr. Richards as an expert witness, though he added his ruling ?doesn?t go any farther than that?, and warned the jury ?whether or not you accept (her) opinion is a question for you?.

Salahuddin, 27, is on trial for the murder of his daughter, Cassidy.

The defendant, who has maintained he was set up by Police and that his former lawyer Larry Scott did nothing to protect him, claimed he lost his footing while carrying Cassidy in a pumpkin seat on an asphalted hill.

He claimed he fell to the ground and the pumpkin seat, with his daughter still strapped inside, tumbled between 15 and 20 feet down the hill, he said.

However medical experts for the prosecution ? including forensic pathologist Valerie Rao, who examined Cassidy post-mortem, and shaken baby syndrome expert Randell Alexander ? have testified that the infant died of shaken baby syndrome with impact. The infant died in the early hours of May 6, 2003.

And they testified that her injuries were not consistent with a fall. Yesterday, Dr. Richards testified that the five rib fractures received by Cassidy Salahuddin could have been caused by a ?prolonged? CPR procedure. Doctors battled using CPR to save Cassidy for 45 minutes, a length of time Dr. Richards agreed was ?prolonged?.

When cross-examined by Mr. Ratneser, Dr. Richards said she had never performed CPR on an infant for 45 minutes, adding ?most of us don?t do it for that long?.

However, she then conceded that she has done it for 45 minutes ?and longer?. When Mr. Ratneser pointed out that she was contradicting herself, she said: ?Can I retract that ... On rare occasions. Very rare occasions.?

On those rare occasions, however, she said she did not know if the young children had received any rib fractures as no pathology was done.

Earlier in the trial, Dr. Andrew Spence, one of the two doctors who performed CPR on Cassidy, testified that never in his experience had he seen, read or heard of an infant receiving fractured ribs during CPR. However Dr. Richards maintained she knew of an episode that occurred in Bermuda about four years ago.

?Dr. Spence does not know everything that happens at King Edward,? she said.

Finding that case and the radiologist involved would require ?a lot of file searching?, she said.

That case involved the fracture of one rib, she said.

Mr. Ratneser said five of Cassidy?s ribs were fractured, including the first rib below the neck (rib 1). He suggested to Dr. Richards that it was impossible to break the first rib as a result of CPR, where pressure is applied lower on the infant?s chest.

Dr. Richards replied that it was ?not impossible?.

Medical experts had testified earlier in the trail that Cassidy had ?massive haemorrhages? in both eyes ? another trademark sign of shaken baby syndrome.

However, Dr. Richards said such bleeding in the eyes could be caused by other things, and said she did not know why a histopathology had not been done in the case of baby Cassidy to rule out other reasons for the bleeding.

The GP said Cassidy did have injuries consistent with blunt trauma to her head.

Forensic pathologist Valerie Rao found bruises on Cassidy?s forehead, but no abrasions (grazes). Dr. Richards said it was possible the bruises could have come from tumbling down an asphalted hill, however she later said she would expect to find abrasions on the child?s forehead had she come into contact with an abrasive surface.

The GP said she had examined Salahuddin, a Type II diabetic, in 1999. Salahuddin?s blood glucose readings in the days after Cassidy?s death showed he was not caring for his diabetes properly, she said, though she added he would not have gone into a coma.

If Salahuddin was not eating, however, she said he would have been ?lethargic, dizzy, couldn?t be bothered, prefer to sleep?.

The trial continues today before Mr. Justice Ground.