Doctors are able to "re-feed" children in Andrew's emaciated state and within hours to a few days stabilize their condition, said Dr. Allen R. Walker, an associate professor of pediatrics at the Johns Hopkins School of Medicine and head of the hospital's child-protection team.
Walker testified at length for the prosecution in Baltimore County Circuit Court on the fourth day of a trial in which Susan Griffin and her husband, John, both 39, of Rodgers Forge are accused of first-degree murder and child abuse.
Prosecutors said Andrew, who was almost 3 years old at the time of his death, weighed about 13 pounds, the weight of a normal 3-month-old. He was almost as tiny. His body was severely bruised, and his internal organs were at least half the normal size for a child his age, Walker said.
"All that indicates that he was denied the appropriate nutrition for life," Walker said.
Walker reviewed the medical examiner's report and more than 140 autopsy photos as well as the birth, pediatric and emergency room records of the child, who died Dec. 26, 2007, at St. Joseph Hospital in Towson.
Walker found no evidence of intestinal abnormality or a problem with the absorption of food.
"There was no organic basis for his starvation," he said. "This was nonorganic failure to thrive."
When asked if that terminology meant Andrew had not been properly fed, Walker answered, "The bottom line is yes." Although the defense pressed him, he said he could not assume that the child had eaten within a week of his death.
In his review, Walker also found evidence of a brain injury, a subdural hematoma, although, he said, it was difficult to ascertain its severity or cause. Typically, such injuries in children stem from force applied to the skull, a fall or shaking, he said. When defense attorneys asked if that injury could impair the child's ability to swallow or absorb nutrition, Walker said no.
Prosecutors also concluded yesterday the playing of a nine-hour digital video recording of the police interview with a pregnant Susan Griffin on the day her son died. During the interrogation, Detective Al Barton said, "Something killed him." Susan Griffin replied loudly, "No. He died from something."
Barton said he has reviewed the tape several times during the investigation.
"She talks very fast and changes topic very quickly," he said.
She repeated many times that she wanted to be with her four other children, that she had no idea what happened to Andrew and that she never meant to harm him.
She frequently alluded to a fear that her other children would have been taken away had she sought medical attention for him. "They'd remove all my kids," she said. "It looks like they're doing that anyway." Throughout the questioning, she did not ask for a lawyer.
The prosecution is expected to present the remainder of its case, including testimony of the medical examiner, on Monday.
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