IT IS impossible to say whether the catastrophic injuries inflicted on a five-month-old baby at the centre of a criminal trial were caused by shaking, an expert witness says.
Dr Catherine Skellern said the injuries, which included a skull fracture to the back of the head and extensive brain damage, may have been caused by an impact.
"High force energy impact, given the skull fracture," Dr Skellern said.
That could have been an impact into something hard, but padded.
The consequences were the same, regardless of whether the injuries were caused by shaking, or a blow, she said.
The doctor gave evidence at the trial of a 29-year-old man, identified only as GP, accused of inflicting grievous bodily harm on his infant daughter.
She was brought to Cessnock Hospital about 9.30am on Saturday, December 12, 2020, unconscious and limp.
The little girl would have died without medical intervention, Dr Skellern said.
It was impossible to say exactly when the injuries were inflicted, due to the neuropathological cascade of a range of things having an impact on the brain, Dr Skellern said.
The injury would have triggered seizures, as well as bleeding on the brain and swelling, and some of those symptoms may have developed over hours, even days.
A care-giver might not be immediately aware of the extent of injury, she said.
In the judge-alone trial, the baby's mother has given evidence, saying she never hurt her baby.
Her recorded interviews with police, and those of the baby's father, show both parents saying they had no idea how the injuries were sustained.
Both have also said they were not convinced the child's condition was due to an injury, as opposed to a medical reason.
The baby's injuries included both new and old rib fractures, and the loss of movement below the waist.
The trial, before Judge Pauline David, continues.