LISBON - Miranda Todd was unable to maintain composure Wednesday when photos of her dead baby were shown.
The 24-year-old Salem woman is on trial here in Columbiana County Common Pleas Court for the murder of 7-month-old Derek Dennison.
Todd cried often during testimony by two investigators, although she never looked as photographs were shown in court.
Her chair was behind, not facing, the large television used to show photographs taken by then-coroner's investigator Brian Fullum both at Salem Community Hospital and Eells-Leggett Funeral Home. She maintained the same position later in the afternoon as the forensic pathologist Dr. Joseph Felo of the Cuyahoga County coroner's office went over numerous injuries he found while doing an autopsy the morning after the baby's death.
Todd wiped her eyes several times, buried her face in her hands for long periods of time and even sobbed as Fullum testified about the photographs of the baby lying on a hospital gurney. At least twice during testimony, defense attorney Jennifer Gorby reached over to put an arm on Todd's shoulder to comfort her and once Gorby asked for a brief recess when Todd seemed unable to regain composure.
Photographs depicted numerous bruises and injuries to the baby. Fullum, called shortly after the death, took photographs of the hospital room with the baby still lying inside after medical personnel were unable to revive him following 30 to 35 minutes of resuscitation efforts.
They depicted bruises to Dennison's forehead, which Felo testified happened about a week before death. He said the child had suffered several blows over time. Additional bruising was visible in photographs on the left side of the head, behind the ear and on the chest in the area of the liver. Additionally, Fullum showed photos he took at the funeral home, which showed even more pronounced bruising.
Both Felo and Fullum testified it is not unusual for bruising to become darker or more pronounced after embalming. Felo added the bruises would have been there all along, just sometimes too light to see until time elapsed or the body was embalmed.
Gorby had objected to jurors seeing photos from the funeral home, but Washam allowed it.
Due to the numerous different colors of bruising, Fullum testified, "When I look at this child, I know this is not an isolated incident."
Felo, who has done 2,770 autopsies, testified the 11 rib fractures Dennison suffered happened between five and 10 days or at the most 14 days prior to his death. They had begun to heal. Two new breaks found on the ribs, he said, could have been the result of resuscitation efforts at the hospital. Additionally, the baby had bruising along its back, which would appear to be from squeezing the child. He suggested the four bruises spaced over a three to three and a half-inch area may have been caused by four fingers. He noted the bruising would not have occurred after the heart was no longer beating. The baby's liver was found to be torn, which Felo said was more of a squeezing injury.
A deep purple bruise visible behind the baby's ear was caused about five hours or less before Dennison's death, according to Felo. He suggested it could be from three different causes, such as someone pulling on the ear or a blow to the back of the head. His investigation showed the bruises were caused from trauma to the outside, not from the inside such as a shaken baby.
Most significant in the baby's death, Felo said, were the two skull fractures which happened an hour or less before death. The first to the left side of the baby's head caused a bruise to the brain and bleeding on the surface of the brain and swelling on the outside of the skull. The bleeding is believed to have caused the fracture to expand. Blood trying to escape began to build up behind the eyes.
"There was a huge amount of bleeding on the surface of the brain," Felo said. "More than enough to kill an adult."
The second skull fracture was to the back of the head. Felo testified it was sometime after the first, but he was unable to give an exact time reference.
When asked if a quick response to the hospital would have saved Dennison, Felo responded medically the head could have been drained of the bleeding. Although the child would have suffered at least some neurological damage, he may have survived, Felo said.
Felo was asked if the injuries could have been self-inflicted by the child using a toy or striking his head on his crib bars.
"These are not self-inflicted," Felo said, adding the toys could have caused it "only if they were falling on the child repeatedly."
He also confirmed a woman would have the strength to cause the injuries to Dennison, including the blunt force trauma he listed as the cause of death.
Defense attorney Charlie Kidder questioned if Felo could tell by performing the autopsy who killed the baby.
"We just heard two hours of testimony and saw 30 heartbreaking photos and at the end of the day all we know is the child died of blunt force trauma, Kidder said. "We are no closer to knowing who did it."
"I don't know any more than I did the day of the autopsy," Felo responded. "I don't know who did it. I know Derek did not do it to himself."
In addition to Fullum and Felo, assistant prosecutors Timothy McNicol and Tammie Riley Jones started their case with testimony from hospital staff.
The receptionist from that night, Deanna Gartrell, testified Todd was hysterical when she entered the doors, wearing no shoes and carrying a limp baby without correctly supporting or cradling his head. Gartrell immediately got the child to a nurse.
Dr. Lisa Bennett, the physician in the emergency room, testified about how they worked on Dennison, who was "limp and lifeless." He never showed signs of life despite more than 30 minutes of effort by staff.
Two nursing supervisors were also on duty, Brenda Chengales and Steven Snyder. Snyder testified Todd never came into the room while they worked on the baby. While Bennett testified it was not unusual according to Salem hospital policy, Snyder said in his experience it is often difficult to keep them out.
"A lot of times you cannot keep a mother out of the room," he said. "It's like a mamma bear and her cub, you can't get between them. Not in this case."
Chengales testified she went out to get more information from Todd about how long the baby had been unconscious, determining he may have been out for as long as 30 minutes before he arrived.
"She said she had laid him down in the other room and she said she heard him scream, very, very loudly and then it was quiet. She thought he fell asleep. She went to check on him 15 minutes later."
After the baby was declared dead at 12:05 a.m. on July 23, 2010, the doctor and nurses testified they then stood back and noticed the bruises and other injuries to the baby's head.
"The left side of his head was mush," said Chengales. "It was very swollen."
They found the side of the baby's head was distorted, Chengales said, and hospital staff began to decide this was not the case of a baby striking its own head off the side of the crib, which was the story Todd reportedly gave when she came to the hospital.
Chengales, Snyder and Bennett all testified about Todd's reaction after being told her baby died. She reportedly started crying and put her arms around a man she knew seated in the family consultation room. Chengales responded the man, identified to her as the biological father, was just looking straight down at the floor.
All three testified that Todd, shortly after the notification, asked if it could have been caused by someone hitting the baby.