The sister of a woman accused of deliberately harming her child during medical treatment says it’s possible bacterial infections in the child’s feeding tube were caused by outdoor activities on their semi-rural property.
The sister, who has been caring for Child X since their removal from the mother’s care, said it was a “huge responsibility”, but one she wanted to do.
She gave evidence in the High Court at Nelson today, as the first of two witnesses to be called by the defence, after the Crown case closed on Friday.
The mother is defending charges of ill-treating a child and infecting with disease during lengthy and complex diagnosis and treatment for what was considered to be a gastrointestinal disorder.
Child X required treatment in hospitals around the country and was then under a strict management regime when at home.
The sister said she knew about the risk of infections of central lines and that she and her sister had been vigilant about strict hygiene standards but Child X enjoyed time outside while at home.
She said Child X and a sibling, Child Y, were outdoor children and there were no specific restrictions placed on the family in terms of keeping Child X isolated or indoors.
The sisters were part of what the witness described today as a close-knit family who lived on a semi-rural lifestyle property in a town in the South Island.
She and the mother of Child X also shared childcare duties around work commitments, including that of the child’s father, who was said to work long hours in a primary sector role.
The Crown case sought to prove deliberate contamination and deliberate tampering of the child’s feeding tubes and IV lines as explanations for the child’s chronic condition and occasions of sepsis.
The defence case was built around what was described as a “medically fragile child living with complicated medical devices” and the actions of a desperate mother trying to help her child.
At the time, Child X was fed and administered medicine via an array of different lines and surgically inserted tubes, which were also alleged to have been deliberately tampered with in ways which caused them to break or come out.
The sister alleged Child X was strong and dexterous, with “quite scary” use of hands, having spent a long time in a crib fiddling with toys.
She claimed the child could write and hold a pencil early, and on one occasion in hospital, while she was away having a shower, she returned to find Child X had disconnected a liquid nutrition line, having shown signs earlier of wanting to do this.
She said on another occasion, the child disconnected the entire total parenteral nutrition (TPN) central line, although she had not seen that occur.
Another time, she said a feeding tube came “straight out” as she was putting the child to bed.
The child initially presented at the family’s local hospital in 2019 with symptoms of failing to gain weight and thrive, resulting in multiple admissions and interventions by many doctors, specialists and nursing staff in hospitals around the country over the next 19 months.
The sister said the more Child X drank from a bottle, the worse it would be, and that it appeared the child had no ability to digest food from an early age.
“It was like [the child’s] stomach didn’t know what to do with it – didn’t know how to digest it,” she said.
It was during multiple admissions and interventions by many doctors, specialists and nursing staff in hospitals around the country that suspicions were raised over the cause of the child’s ongoing and at times serious symptoms.
The first specialist children’s doctor to treat Child X said, despite what amounted to 26 clinic appointments, 28 hospital admissions and discharges, 13 operations, 44 imaging tests and more than 1000 lab tests, specialists struggled to get to the bottom of what was going on.
In January 2021, consultant paediatric gastroenterologist Dr Amin Roberts diagnosed medical child abuse. It triggered a police investigation and the mother was arrested in April 2023.
The sister said in response to allegations of line breakages that equipment provided for home care was different from that in hospital, including the TPN pump, which was smaller and ran a smaller, more “flimsy” line.
She said Child X was also prone to tossing and turning a lot, and tubes and lines would become occluded, or get air in them, and alarms would go off.
The sister said lines would also come loose on the child’s drainage bags during tossing and turning and would drain into the bed, requiring frequent bed changes.
The child was said by medical witnesses to have improved once removed from the mother’s care.
Crown prosecutor Abigail Goodison asked the witness if Child X, who was now at school, took part in after-school activities, but was told it was not possible as the child was too tired.
Goodison asked the sister to provide a photo of how the child looked today, which the judge allowed.
