Medical professionals outline child abuse diagnosis

Testimony in Witkowski case resumes Wednesday

MANISTEE — Eight witnesses testified on Friday during the Joshua Witkowski first degree child abuse case in Manistee County’s 19th Circuit Court, revealing aspects of the case ranging from family history to the victim’s treatment at two hospitals.

Witkowski, 26, of Manistee, faces up to life in prison if found guilty of knowingly or intentionally causing serious physical harm to a 2-year-old Manistee girl on Dec. 17, 2012. During Thursday’s opening statements, Manistee County assistant prosecutor Jonathan Hauswirth told the jury that Witkowski was the only person alone with the victim immediately before she displayed symptoms of physical trauma.

Joshua Witkowski, 26, of Manistee, faces up to life in prison if convicted of first degree child abuse. His trial resumes at 9:15 a.m. on Wednesday in Manistee County's 19th Circuit Court. (Eric Sagonowsky/News Advocate)

Joshua Witkowski, 26, of Manistee, faces up to life in prison if convicted of first degree child abuse. His trial resumes at 9:15 a.m. on Wednesday in Manistee County’s 19th Circuit Court. (Eric Sagonowsky/News Advocate)

Expert witness Dr. N. Debra Simms, certified child abuse pediatrician, was called to the stand on Friday to outline her consultation with the victim at the Helen DeVos Children’s Hospital in Grand Rapids on the two days after the alleged abuse. She testified about finding bruises to the victim’s forehead, right eye, both cheeks and other areas.

Simms stated that her consultation, as well as an insufficient history of accidental trauma given by victim’s mother, led her to a diagnosis of child abuse.

“We did not see any kinds of symptoms of any kind of underlying disease, disorder or condition,” she said. “We did not see any indication of metabolic disease, genetic disease or other diseases that would explain (these injuries), because there are natural conditions that can give you some of these findings.

“We ruled all of the underlying disorders out,” Simms continued. “In the absence of a credible history of accidental trauma, the only thing that we were left with is nonaccidental trauma, and the diagnosis of pediatric physical abuse was given.”

The victim’s mother told the court on Thursday that her and Witkowski were running errands the day of the alleged abuse. Witkowski and the victim were alone for a period of 30 to 45 minutes, the mother said, and then the group went to Ludington so Witkowski could apply for a job. During that trip, the victim began displaying alarming symptoms and Witkowski called 911 at the mother’s insistence upon their return to Manistee.

The victim was taken to West Shore Medical Center immediately with seizure-like symptoms and a high temperature. Dr. William Weiner treated the victim at WSMC, and he spoke on Friday about her condition and treatment.

He said that by the time he saw the victim, she was continually seizing. He administered anti-seizure medication and completed a CT scan, which showed “massive brain swelling” and a subdural hematoma — bleeding between the brain and an internal membrane called the dura. Additionally, he noticed several external injuries throughout the victim.

“(The victim) was really bruised up,” he said. “She had bruises everywhere. Some of the bruises were old and some of the bruises were newer. They were throughout the body. It was remarkable in that it just wasn’t a bruise in one place (like) a 2-year-old child would have.”

Dr. N. Debra Simms, expert witness and certified child abuse pediatrician, told Manistee County's 19th Circuit Court on Friday that she believed the victim in the Joshua Witkowski case had been physically abused. Witkowski, 26, of Manistee, is pictured in the foreground watching Simms' explanation. (Eric Sagonowsky/News Advocate)

Dr. N. Debra Simms, expert witness and certified child abuse pediatrician, told Manistee County’s 19th Circuit Court on Friday that she believed the victim in the Joshua Witkowski case had been physically abused. Witkowski, 26, of Manistee, is pictured in the foreground watching Simms’ explanation. (Eric Sagonowsky/News Advocate)

Through cross examination, Witkowski’s attorney Mark Otto asked whether the degree of the victim’s injury alone could help doctors determine whether the trauma was accidental or purposeful, and Weiner said that it could not.

When asked about the timing of the victim’s head injuries, Weiner said that they had been sustained that day.

“It’s not there from a week before or a couple days before,” he said. “This was a clinically fresh hemorrhage and her symptoms all were (consistent) with a fresh hemorrhage.”

Due to the extent of the victim’s injuries, Weiner transferred her to Helen DeVos Children’s Hospital, where Dr. Robert Fitzgerald managed her treatment.

When called to the stand on Friday, Fitzgerald explained the victim’s condition, and told the jury that she underwent two neurosurgeries — one to drain fluids in her brain and the other to implant a brain monitoring device. He explained that the pressure inside her skull was abnormally high due to swelling, and that his team was tasked with reducing it.

Fitzgerald added that the victim was placed in a medically induced coma for more than 10 days so she could be treated.

Once again, Otto asked if the doctors could tell whether or not the trauma was accidental or purposeful based on the injuries, and Fitzgerald said they could not. When asked by Judge James Batzer, Fitzgerald said the victim could have died if not treated in a facility similar to the Helen DeVos unit.

The victim’s father, Steve Carey, testified on Friday that he and the victim’s mother split prior to the child’s birth, and that he didn’t see the victim before the alleged abuse.

Now with full custody, Carey gave an update to the court on the victim’s current condition, stating that she is now 4 years old with the cognitive ability between a 12-month-old and an 18-month old.

“Due to the damage, half of her brain ended up dying,” Carey said. “That half controlled the right side of her body, and now she doesn’t have the distinct control that we all do. She can’t quite walk, move or (control) her right arm.”

Carey stated that the victim now attends regular physical, speech and occupational therapy as she continues her recovery. He added that he will have a private conversation with the victim’s mother in the future to determine how the couple should proceed.

Testimony continues at 9:15 a.m. on Wednesday in Manistee County’s 19th Circuit Court.

avatar

Posted by Eric Sagonowsky