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Doctors: child may have died from physical abuse

died as a result of physical abuse, three medical doctors indicated yesterday.The doctors, testifying at the inquest into the 1991 death of Cannice Joann White, said it was highly unlikely the girl died by accident.

died as a result of physical abuse, three medical doctors indicated yesterday.

The doctors, testifying at the inquest into the 1991 death of Cannice Joann White, said it was highly unlikely the girl died by accident.

Father Mr. Daniel Cann brought Cannice into King Edward VII Memorial Hospital on May 30, 1991 where doctors discovered she was without a pulse and not breathing.

Although her heart was successfully resuscitated, Cannice was pronounced "brain-dead'' that same day. The infant was pronounced dead four days later after her life-support system was disconnected.

Each of the doctors who appeared yesterday attributed the severe brain-damage to a medical condition known as "shaken baby syndrome''.

They said the syndrome occurs when a young child is violently shaken and its head is whipped back and forth. This causes the delicate bridging veins surrounding the brain to rupture, resulting in substantial bleeding within the enclosed area of the skull.

Because the blood is unable to drain into another part of the body, the brain becomes compressed and the victim suffers respiratory and cardiac arrest within half an hour. Coma and death usually follow.

Dr. Valerie Rao, a pathologist with Miami's Dade County Medical Examiners Office, said Cannice's death was " a classic case'' of the syndrome. She said there was no doubt in her mind that the child's injuries were non-accidental.

Dr. Rao prepared a consultation report on behalf of Bermuda Police, using a case file of witnesses' statements, the KEMH autopsy report, photographs of the girl, tissue samples taken from the body and Cannice's hospital chart.

Using a photograph taken during the autopsy, Dr. Rao pointed out the extensive pooling of blood in back of the girl's skull. She said that in the absence of external injuries, such clotting was a definite sign of shaken baby syndrome.

No bumps, bruises or fractures were found on the girl's head.

In later testimony, the director of emergency services at KEMH, Dr. Edward E.

Schultz, and consulting paediatrician Dr. Peter Perinchief, said they had come to the same conclusion.

"In my opinion, these injuries could not have been caused by anything accidental,'' said Dr. Schultz, who examined the child soon after she was brought into the hospital.

At the request of the attending physician, Dr. Schultz confirmed retinal haemorrhaging in both of Cannice's eyes -- a sign of severe bleeding in the brain.

Dr. Perinchief, who was asked to assist in the child's care, said there was "no other explanation'' for her condition. He insisted the head injury'' could not be explained away by a fall down a few steps.

The child's father told medical staff she had fallen down several stairs at his home and struck her head on the floor.

Dr. Perinchief confirmed there are "extremely rare'' cases where blood vessels in the brain suddenly burst, but said if this had happened, Cannice's medical record and autopsy would have shown evidence of it.

In the course of testimony, it was also revealed Cannice had a fracture just above one armpit. This type of injury, said Dr. Rao, is often the result of an adult's hand applying strong pressure to a child's chest while in the act of shaking it.

Two symmetrical fractures found on both lower leg bones were judged by Dr. Rao and Dr. Schultz to be bi-lateral. They could only be the result of a "rotational force'' they said, such as a twisting of the legs.

The doctors also called burns on the girl's hands and chest area "suspicious''.

All three said the burns were definitely unlike those which would be sustained from a falling clothes iron, as claimed by the child's father. Dr. Rao said she made film "overlays'' of the irons' bases, but was unable to match any of them with the wounds found on Cannice. She could not say what instrument might have caused the burns.

Before the last of the day's witnesses could be called, Mr. Cann asked for an adjournment so he could confer with legal counsel.

Coroner the Wor. Will Francis and Crown Counsel Mr. Mark Pettingill told him the inquest was not a trial, and that no-one was being accused of any crime, but Mr. Cann insisted he wanted a lawyer present during the remainder of the inquiry.

"I'm the so-called prime suspect,'' Mr. Cann told the coroner. "Don't I have the right to have a lawyer?'' Mr. Francis told Mr. Cann legal aid was open to him and adjourned the inquest until this morning.

Mr. Daniel Cann.