A Crown medical expert in the trial of a man accused of murdering a Tauranga toddler says the girl's injuries were more likely to be the result of an "abusive head trauma".
Adrian Colin Clancy, who is on trial in the Rotorua High Court, has denied murdering 17-month-old Sadie-Leigh Gardner in Tauranga on March 27, 2019.
The Crown has alleged Clancy violently assaulted Sadie-Leigh while she was in his sole care.
His jury trial began on March 15.
Sadie-Leigh was admitted to Tauranga Hospital in a critical condition on March 27, 2019, before being transferred to Starship hospital. She died two days later.
In an opening address earlier this week, Crown prosecutor Richard Jenson described her injuries, to her head and shoulder, as unsurvivable.
The Crown alleges a frustrated or angry Clancy caused the injuries then sought help from a neighbour after realising the toddler was unconscious.
Clancy's lawyer Kerry Tustin, however, has argued there is no evidence linking her client to the alleged assault.
Dr Jeanine Nunn, a paediatric consultant at Starship Hospital's child protection unit, gave evidence for the Crown on day four of the trial yesterday.
She had reviewed medical reports from Tauranga Hospital and Starship and statements from those who had contact with the child in the days leading up to injury.
Nunn said in the absence of any medical history of trauma such as a significant fall or car accident, the toddler's injuries were "more likely to be from an abusive head trauma".
"Someone has injured the child and significant force has been applied to her head."
Witness reports suggested the child had fallen in the shower days before or may have been hit over the head with a toy but Nunn said these incidents would not carry sufficient force to cause the injuries.
"Not this type of sudden decomposition requiring CPR... it just doesn't make sense."
Nunn said Sadie-Leigh had an unsurvivable brain injury and she was likely to have been blind soon after sustaining the head injury.
The child had injuries that might be seen after a serious car crash or from a significant fall from a height, she said.
During questioning by defence lawyer Tustin, Nunn said there was no evidence that Sadie-Leigh had suffered a significant fall.
"We are talking about falling more than a metre, a complex fall such as in playground with significant momentum or what we sometimes see in a car crash," she said.
Nunn said there was no clinical history or evidence of a significant accidental fall.
Dr Paul Blackmore also gave evidence. He was the team leader in charge of managing Sadie-Leigh's care after she arrived at Tauranga Hospital's emergency department on March 27.
He said the toddler was "profoundly unconscious" and she was posturing with rigid movement of her arms and legs which were "ominous signs" of a serious brain injury.
Blackmore also said a quick physical examination of Sadie-Leigh revealed a boggy haematoma on the right-hand side of the back of her head.
The toddler's eyes were "fixed and forced to one side" and she was critically unwell, he said.
Blackmore said in the absence of any history of a significant fall or traumatic injury, he was "overwhelmingly confident" this was traumatic blunt force brain injury, with an underlying skull fracture.
He said he quickly ruled out any septic infection or accidental type of injury.
When interviewed at Tauranga police station by Detective Andrew Veysey and Detective Sergeant Darryl Brazier on March 27, 2019, Clancy denied he had harmed the baby.
The Crown previously told the court a CT scan revealed Sadie-Leigh sustained significant bilateral subdural brain bleeds and a fracture to the right side of her skull just below the right ear.
As well as the fractured skull, the post-mortem revealed brain swelling and bleeding and a fracture to her right shoulder, Jenson said.
Further tests confirmed the toddler also had significant retinal haemorrhages to both eyes and was unable to see, he said.
The trial continues today.