Conflicting medical expert testimony marks Houston child abuse trial

bpurser@macon.comOctober 30, 2013 

PERRY -- Conflicting opinions from medical experts marked Wednesday’s testimony in the trial of a Warner Robins couple accused of child abuse. The defense says the baby’s multiple fractures were the result of underlying metabolic disorders.

Johan and Nashan Pereira, both 32 and technical sergeants with the 78th Logistics Readiness Squadron at Robins Air Force Base, pleaded not guilty.

Johan Pereira is accused of handling their infant daughter in such a manner as to cause the fractures. Nashan Pereira is accused of failing to intervene. Their daughter, Gabriella, is now about 1 year old.

Dr. Paul Chandler, a pediatric radiologist at The Medical Center of Central Georgia, testified that a skeletal survey of the child when she was nearly 3 months old in November 2012 found multiple fractures and most were consistent with indicators of child abuse.

“Infants don’t normally get fractures,” Chandler told jurors. “They’re not sliding into home plate or jumping out of a tree.”

Chandler said he was particularly troubled by fractures to the ribs that he said could only could be obtained in an infant by an adult “squeezing them forcibly ... and shaking them.”

Dr. Yameika Head, a forensics pediatrician at the Medical Center, testified that a total of 21 fractures were detected in the infant’s body. Most were more than 14 days old and not related to the fractures for which the mother had sought treatment in November, Head said.

The medical experts for the prosecution said they found no evidence of any underlying metabolic disorder such as rickets, a softening and weakening of the bones due to a lack of vitamin D, calcium or phosphate. They also found no evidence of osteogenesis imperfecta, a brittle-bone disease.

But Michael F. Holick, director of the Vitamin D, Skin and Bone Research Laboratory at Boston University Medical Center, testified the infant suffered from a severe vitamin D deficiency that made her highly susceptible to fractures from normal handling, such as getting blood drawn in the pediatrician’s office or having X-rays.

Holick told jurors the child’s mother was vitamin D deficient, and her daughter’s only source of nutrition as an infant was breast milk that had no vitamin D. He said that made the infant not only deficient in receiving Vitamin D but also resulted in her blood stream stealing vitamin D from her bones.

Holick said some of her fractures as an infant were “classic signs of infantile rickets.” He also said a vitamin D deficiency contributes to the brittle bone disease osteogenesis imperfecta.

On cross-examination from prosecutor Clif Woody, Holick acknowledged the fractures found by the X-rays can also be interpreted as “classic child abuse.” But Holick stressed that his opinion was Gabriella suffered from infantile rickets resulting from her severe vitamin D deficiency based on his 40 years of expertise.

Testimony is expected to continue Thursday before Judge Katherine K. Lumsden in Houston County Superior Court.

To contact writer Becky Purser, call 256-9559.

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