Baby had symptoms of abusive head trauma, trial of ex-child minder told

Sandra Higgins (36) has pleaded not guilty to intentionally causing serious harm to baby

A 10-month-old baby girl had “classic” symptoms of abusive head trauma, the trial of her former child minder heard on Thursday.

Sandra Higgins (36), of The Beeches, Drumgola Wood, Cavan, has pleaded not guilty at Dublin Circuit Criminal Court to intentionally or recklessly causing serious harm to the baby at her home on March 28th, 2012.

Paediatric consultant Prof Alf Nicholson told the court he was on call on April 1st, 2012, after the baby was admitted to Temple Street Children's Hospital in Dublin, where the baby girl was transferred for specialist care from Cavan.

The baby was suffering from a number of issues upon admittance, including bilateral retinal bleeding, or bleeding behind the eyes, bleeding along the surface of her brain and two rib fractures on the left side. Some facial bruising was also noted, Prof Nicholson said.


The baby “wasn’t very well”, said Prof Nicholson, and was also experiencing seizure activity and weakness on one side.

The baby’s symptoms – including brain and eye bleeding, as well as rib fractures – were “classic” and “very typical” of abusive head trauma, Prof Nicholson said.

Shaken baby syndrome is now referred to as abusive head trauma, Prof Nicholson said, adding that both he personally and the staff at Temple Street had a great deal of experience in dealing with this condition.

The bleeding in the eyes and the brain were two different bleeds, Prof Nicholson said. When a child was suffering from both “it increases the risk of this being non-accidental”, he told the court.

Prof Michael O’Keefe, a consultant surgeon at Temple Street and professor of ophthalmology at UCD, said the baby came under his care after she was referred by colleagues in Cavan.

Retinal detachment

He said he found the baby was suffering from haemorrhages, or bleeding, behind both eyes. She was also suffering from retinal detachment, with fluid behind one eye, and from bleeding in her brain.

The blood from the eyes most likely came from the vessels at the back of the retinas, Dr O’Keefe said.

The baby was examined by the paediatric team, who decided no intervention was needed.

The baby attended the hospital again on several other occasions and by June of that year the bleeding had gone away, the retinal detachment was resolved and she was using both eyes well.

The prosecution's final witness is expected to give evidence on Friday in the trial before Judge Martin Nolan and a jury.