The woman's trial opened in the High Court at Nelson today. Photo / Tracy Neal
A mother accused of medically abusing her child “wanted to be seen as the medical mother of a sick child”, the Crown has alleged.
The woman has denied all charges against her in a trial which opened before Justice Lisa Preston in the High Court at Nelson today.
The mistreatment was alleged to have required hospital and medical treatment over a 19-month period before it was discovered.
The Crown described it as a “complex medical case” and said the offending constituted “medical child abuse”, which was a diagnosis from a doctor when the child was discharged from a North Island hospital in January 2021.
The woman, who has name suppression to protect the identity of the child, was charged in April 2023. Today she reiterated her not guilty pleas to four charges of ill treatment of a child and three charges of infecting with disease.
Medical child abuse was described by Crown prosecutor Mark O’Donoghue as a recognised form of child abuse where a child received “unnecessary, potentially harmful medical care” at the instigation of a caregiver.
He said the Crown case revolved around two key phrases: deliberate contamination and deliberate tampering.
The defence case, led by Marie Dyhrberg, KC, was built around interpretation, hindsight and what someone might expect to find, and how that might influence recollections of what happened.
“The existence of risk does not prove deliberate harm,” Dyhrberg said.
It is alleged the offending occurred at various locations around New Zealand.
A witness today described how many people gave money to the family to help during times they had to travel for care.
The first charge alleged that between February 28 and September 10, 2019, the woman intentionally engaged in conduct likely to cause adverse effects to the health of the child.
The particulars of the charge included exaggeration and fabrication of the child’s signs and symptoms of illness and inducing illness by stopping feeds.
It was alleged this happened through the woman disconnecting a TPN line and filter (a bag holding liquid nutrients), disconnecting the central line from the hub (external connection point of the catheter), severing the central line, removing the jejunostomy (surgical opening from the abdominal wall into the small intestine), and removing the positive pressure device (PPD) on the central line.
The second charge of ill-treating a child alleged that between August 10, 2019, and September 23, 2019, she intentionally engaged in conduct likely to cause adverse effects to the child’s health by exaggerating and fabricating their illness and by inducing the child’s illness by piercing and causing a hole in the central line.
The particulars of the third charge alleged that between February 10, 2020 and July 31, 2020, the woman exaggerated and fabricated the child’s signs and symptoms of illness, and induced illness by stopping feeds, disconnecting the TPN line, tap and filter, tampering with the TPN line and piercing, and causing a hole in the PICC line (tube to deliver medications).
Charges four and five alleged that between July 7-9, 2020, and between September 15 and October 2, 2020, she wilfully and without lawful excuse caused a disease, namely polymicrobial sepsis, by deliberately contaminating the child’s central line.
The sixth charge alleged ill-treatment between October 7 and November 30, 2020. The woman allegedly caused adverse effects to the health of the child by exaggerating and fabricating the child’s signs and symptoms of illness, by introducing an unknown substance into the PICC line.
The seventh charge alleged that between November 11-27, 2020, the woman wilfully caused a disease in the child, namely polymicrobial sepsis by deliberately contaminating the central line.
O’Donoghue said the Crown would argue the “gross contamination” was most likely deliberate rather than accidental, based on several points, including recurrences while the child was in hospital where cross-contamination was less likely, and the multitude of bacterial organisms found on occasions that one expert described as being “like a jungle”.
O’Donoghue said sepsis was life-threatening, and at one point it could be said the child was fighting for their life.
He said events leading to the defendant’s arrest were triggered by a doctor who made a “big and very difficult decision” to make a report of concern to Oranga Tamariki to exclude the defendant from her child’s care.
Dyhrberg said in her opening statement that now was “not the time” to critique the evidence.
“This is about a very sick child who was medically fragile at a very young age and who required constant management,” she said.
The trial is set down for six weeks. The Crown intends to call 58 witnesses, half of whom will provide evidence in person to the court and the remainder by video link.
Tracy Neal is a Nelson-based Open Justice reporter at NZME. She was previously RNZ’s regional reporter in Nelson-Marlborough and has covered general news, including court and local government for the Nelson Mail.