“I think that that’s the less likely proposition,” Ryan said on Tuesday. She believed it was more likely Patrick had an unidentified neurogenetic disorder.
Ryan said that if Patrick did suffer a hypoxic ischaemic brain injury,it was possible it happened in the context of a seizure.
A paediatric neurologist had diagnosed epilepsy and cortical blindness in Patrick after the incident in October 1990 when Patrick was found unresponsive in bed.
Ryan was first approached by Folbigg’s lawyers to provide a report to a previous inquiry into Folbigg’s convictions,the inquiry heard,and gave evidence in April 2019.
Post-mortems “failed to establish exactly what had caused the cessation of breathing” in each child,the Court of Criminal Appealsaid in 2005.
“The only conclusion reasonably open is that somebody intentionally caused harm to the children,and smothering was the obvious method,” the previous inquiry into Folbigg’s convictions concluded in 2019.
Peter Fleming,a professor of infant health and development physiology with a background in neonatal and pediatric intensive care,gave evidence earlier on Tuesday from England.
He agreed that “proving suffocation is extremely difficult” but pointed in a report tendered at the inquiry to potential natural causes of death for each of the four children. Fleming was originally engaged by lawyers for Folbigg,the inquiry heard.
Fleming said he had been the medical lead on 200 unexpected child death investigations and,as chair of the UK’s National Child Mortality Database professional advisory group,had overseen local investigations of about 1000 or more deaths.
He said he found it “very hard to believe” there would be no injury caused to the inside of a child’s lip from their front teeth if an adult had smothered them in a fit of rage,and the child had fought for their life,as they “wriggle very,very vigorously” to protect an obstructed airway.
Caleb died aged 19 days and would not have had any teeth,“and that’s why I said I have less certainty about that”,Fleming said. Patrick,Sarah and Laura were aged eight months,10 months and 18 months respectively.
“Would you be ... surprised if one particular person managed to smother three children without leaving a trace?” Bathurst asked.
“Absolutely,I would find that extraordinary. I would find it very,very hard to believe that somebody could suffocate them by putting something over their face ... and leave absolutely no mark,” Fleming said.
Asked if he agreed plastic bag suffocation could be rapid and leave no signs,Fleming said:“I believe that’s correct.”
The inquiry continues.
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