The Palestine Herald, Palestine, Texas

February 26, 2013

Doctors testify in murder trial of woman accused in toddler's death

By MARY RAINWATER
Palestine Herald-Press

PALESTINE — The state continued testimony Monday with two physicians taking the stand in the capital murder trial of a local woman accused in the 2010 death of a 16-month-old girl.

Jennifer Jill Whitehead, 41, is charged with capital murder for the May 5, 2010 death of her stepgranddaughter, Emma Nicole Whitehead, who died at a Dallas hospital one day after being transported to Palestine Regional Medical Center for head and other injuries.

First to testify for the state was Dr. Heidi Knowles, an emergency room physician at Palestine Regional Medical Center who treated Emma when she arrived at the hospital.

“I remember how impressive (bad) the injuries were,” Knowles testified. “She came in intubated, with no spontaneous response.

“She was essentially in a coma,” she added. “We made the decision when she came in intubated that she would have to go to Children’s (Medical Center in Dallas).”

The doctor testified that she had been told that Emma had fallen out of a playpen, eventually concluding that the child would need a CT scan.

“She appeared to have a skull fracture and bleeding in the skull,” Knowles testified. “Her pupils were fixed and dilated, which means her brain was not sending out the signal to her pupils to react.”

According to Knowles, the CT scan showed an occipital skull fracture and a suspected subdural hematoma that would need to be confirmed with additional scans.

Next to testify for the state was Dr. Matthew Cox, a board certified pediatrician at Children’s Medical Center with a subspecialty in child abuse pediatrics.

He also serves as clinical director the hospital’s REACH (Referral and Evaluation of At Risk Children) Clinic, which provides inpatient and emergency room consultations in cases of suspected child abuse.

In evaluating patients, Cox testified that he gathers background information, family history and medical history up to the time of the evaluation and then looks at all the patient’s medical results including scans, lab results and x-rays, etc.

“(Emma) was covered in bruises from her head to her feet,” Cox said, explaining that Emma had extensive bruising on her forehead and cheeks, her torso, on her side and back, both sides of her hips and upper thighs.

“Some of the injuries on her legs showed extensive repeat trauma with a strait object,” he explained. “They had straight-line edges, which indicates those bruises were not the result of a single fall.”

Other injuries Cox found in evaluating Emma included an internally busted lip and a bare spot on the back of her head with hairs of different lengths remaining.

The fatal injury, Cox testified, was a brain injury that resulted from a fracture of Emma’s occipital bone. Emma’s CT scans, taken at both PRMC and at Children’s, showed a hemorrhage in the back of her skull and swelling in the brain, which over time had increased.

“Her entire occipital bone was broken down to the base of the skull, which is a sign of severe blunt force trauma,” the doctor said. “Young children can tolerate brain swelling easier as kids’ skull bones are softer. So when a kid hits their head, it would require significant trauma to break that bone.

“A neurological exam also is part of that evaluation,” Cox added. “Physicians do several exams to gauge reflexes, including to the gag reflex and a test done on the bottom of the foot. Early on, Emma was showing no signs of brain function.”

His findings, Cox said, showed that Emma’s injuries were indicative of physical injuries in child physical abuse.

A slight change-up took place in Monday’s proceedings, as the state agreed to allow defense attorneys to present one of its expert witnesses to testify due to availability issues.

Dr. Thomas William Young is a forensic pathology consultant hired by the defense to evaluate the findings of the medical examiner, physicians, medical reports and more to determine what he felt was the cause of Emma’s death.

Young refuted the findings of Cox and the medical examiner (who has not yet offered testimony for the state), stating that the ME’s determination of homicide as cause of death and Cox’s finding of abuse-related injuries were not accurate.

“She calls it a homicide thinking it is the only explanation and with child abuse, it is only a guess,” Young testified. “But there can be multiple explanations.”

Young reported that from his evaluation he determined that the skull fracture was not new, but could have been there at the time of Emma’s “collapse.”

Previous indications of the injury included reports from family members that Emma had been throwing up — a certain sign of head trauma.

“Her demise was a product of that break, but when that break occurred is the issue,” he said. “I do believe that Emma was on the precipice of brain death at the time of the (911) call.”

The trial, held in the 369th District Court with Judge Bascom W. Bentley III presiding, is set to continue at 9 a.m. today on the second floor of the Anderson County Courthouse.

Representing the state is Anderson County Assistant District Attorney Elizabeth Watkins, with assistance from District Attorney Doug Lowe.

The defendant is being represented by Palestine attorney Stephen Evans and Dallas attorney Clipper Peale.

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Mary Rainwater may be reached via e-mail at mrainwater@palestineherald.com