A two-year-old girl known as Baby L was severely disabled because of the horrific head injury she allegedly suffered at the hands of her mother's boyfriend, the High Court in Pretoria heard on Tuesday.
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Baby L could not walk, roll over, eat or communicate coherently, Dr Paul Stevens, a surgeon at the Steve Biko hospital in Pretoria who performed emergency surgery on her on December 30 last year, testified.
She was discharged to a Tshwane place of safety after weeks in hospital.
"She had a severe head injury... which is the cause of her being confined to a wheelchair, and she cannot eat by herself. Her life expectancy will depend on the standard of care she gets on a day-to-day basis.
"It is not possible for her to live at a normal home. She requires constant care in order to prevent pressure sores from developing.
"She is unable to change positions herself and she requires assistance with her feeding tube. She cannot do anything for herself," Stevens testified.
Stevens said Baby L's injuries did not fit with the mother and boyfriend's explanation that she fell off a washing machine.
The toddler's 20-year-old mother and her 36-year-old boyfriend pleaded not guilty to charges of attempted murder, child abuse and failing to provide medical attention.
They allegedly absconded from the Steve Biko hospital without the toddler receiving medical attention three days before she was admitted in a coma.
They denied ever assaulting or neglecting Baby L, claiming she fell down a flight of stairs and off a washing machine.
Stevens testified that Baby L was critically ill and in need of emergency surgery when she was admitted.
She had an extended abdomen, low blood pressure, a weak pulse and low blood oxygen levels.
She was breathing through a ventilator and there was frothy pink fluid coming from her lungs, which was indicative of fluid in the lungs.
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This could either have been caused by inhaling fluid as in a near-drowning, or by a severe head injury.
She only opened her eyes when stimulated with pain and had multiple bruises all over her body in various stages of healing.
Stevens found old blood in her abdomen, a big bruise over her kidney, a tear in the vein between the colon and stomach, a fractured hip and a severely bruised pancreas.
"In children the most common cause for such an injury to the pancreas is a direct blow to the pancreas. It takes a lot of force to injure the pancreas because it's a well protected organ and lies behind other organs."
He said it would have taken a large amount of force to cause a fracture to the pelvic bone, which was also not a fresh injury.
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Stevens operated on Baby L again in January, when a tube was placed in her throat for her to breathe and a feeding tube into her stomach.
The trial continues.
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