Two days after she was admitted to hospital, a two-year-old toddler was shown to have sustained a severe brain injury, a court has heard.
Chief State Pathologist Dr Linda Mulligan told Judge Orla Crowe and a jury at Dublin Circuit Criminal Court that a scan showed Heidi Douglas had a “devastating brain injury”, having been admitted to Our Lady's Children's Hospital in Crumlin on April 14th, 2016.
Dr Mulligan was giving evidence on Friday, the second day of the trial of Heidi's mother, Sadie Douglas, who is charged with child neglect leading to death.
Ms Douglas (39) of Rathsallagh Drive, Shankill, Co Dublin has pleaded not guilty.
The trial heard Ms Douglas' partner, who is not before the court, was a recovering heroin addict and was taking daily doses of methadone - a heroin substitute obtained on prescription from a local chemist - in quantities to cover a week's supply.
Heidi was found apparently unconscious on her parents' bed in the middle of the afternoon on April 14th and was subsequently taken to hospital by ambulance.
Dr Mulligan told the court that Heidi's brain had swollen so much it was pushing down onto the spinal column.
Clincally dead
Her condition continued to deteriorate and, on April 19th, she was assessed to be clinically dead. Life support was withdrawn and her death was confirmed at 6.34pm that day.
Dr Mulligan said that as a result of a post-mortem examination which she carried out, she concluded the child had acute cerebellitis, an inflammation of the brain, which was "most likely" caused by her having ingested methadone, resulting in her death.
She added that because the child had been comatose for a number of days, she had also developed bronchial pneumonia which would also have been terminal.
She said Heidi had otherwise been a "normal healthy two-year-old girl".
A pharmacist, Richard Geoghegan, who worked at Lloyds Pharmacy in Shankill at the time, gave evidence of Ms Douglas' partner obtaining his weekly supply of methadone every Thursday.
The first 70ml dose of his weekly 490ml supply was always taken in a special room at the pharmacy, while the remainder of the drug was taken away by the patient in a bottle that had a childproof top.
Pharmacies supplied a measuring cup for patients, each of whom signed service agreements, governing the relationship between patient and chemist, behaviour at the pharmacy, and use of the methadone, Mr Geoghegan said.
The agreement contained three warnings, one of which was: “Be aware that 5 mls of methadone can kill a child,” the court heard.
The trial continues on Monday.
