The defendant, who has interim name suppression, is on trial before the Dunedin District Court after pleading not guilty a charge of injuring with reckless disregard (and an alternative count of assault).
The alleged incident took place on July 18, 2023 during a brief period when the child’s mother was at the gym and days later the infant was diagnosed with 13 broken ribs and a fractured collarbone.
Both the defendant and the child’s mother have been adamant they did nothing which could have caused the damage and were confused as to how it could have occurred.
Counsel Anne Stevens KC, at the trial’s opening, told the jury there were other possibilities as to how the injuries occurred, pointing to the boy’s severe vitamin-D deficiency.
This morning, paediatric endocrinologist Professor Ben Wheeler told the court an ongoing lack of the vitamin could lead, in the most extreme circumstances, to rickets.
Rickets, he said, led to fractures in about 10% of cases, but that was usually in toddlers, who suffered breaks to longer bones in the arms or legs.
“Rib fractures are unusual, multiple rib fractures are extremely, extremely unusual,” Prof Wheeler said.
In any case, he was confident having reviewed x-rays, biochemical testing and other evidence that the baby did not suffer rickets.
Prof Wheeler said there was no research to say multiple rib fractures could be caused by simple vitamin-D deficiency – something that was a common issue among babies born in the south.
He also pointed out it was “highly unlikely” the injuries were caused at birth.
“If [the child] had severe bone fragility you’d expect to see ongoing fractures after first admission,” Prof Wheeler said.
But since the 2023 admission to hospital, there had been no further issues, the court heard.
The witness was critical of the statements of defence medical expert witnesses, one of which he said made “a massive assumption”, putting the baby’s state down to bone weakness.
“I don’t know what caused these fractures but in my opinion it’s not vitamin-D or bone fragility,” Prof Wheeler said.
“There’s absolutely nothing that supports he’s got abnormal bones.”
X-rays taken two weeks after the bone breaks showed evidence of healing, which he said supported the theory that vitamin-D was not an issue.
Prof Wheeler said the child’s presentation was consistent with non-accidental injury caused by “substantial force”.
In cross-examination, Mrs Stevens suggested there was evidence of rickets in the “flaring” of the ribs seen in x-rays.
Prof Wheeler said he had not seen those images.
He will continue to give evidence this afternoon.
