'Massive blow' caused boy's death

Brandon Muir died after his intestine ruptured

A "massive blow" would have been needed to cause the injury which killed a Dundee toddler, a court has heard.

Brandon Muir, who was 23 months old, died on 16 March last year after his intestine ruptured.

A surgeon told the High Court in Glasgow that the boy's chances of survival would have been "quite high" if the injury had been treated.

Robert Cunningham, 23, denies murdering the toddler. Brandon's mother, Heather Boyd, denies culpable homicide.

The trial earlier heard that Brandon suffered acute peritonitis brought on by a ruptured intestine, which had been caused by blunt force abdominal trauma.

Professor Robert Karachi, a consultant paediatric surgeon, was asked what sort of force would have been needed to cause the rupture.

Blunt object

"A very forceful injury by any blunt instrument. It would have been quite a massive blow to cause this injury to a child," he said.

He added: "This is because of the position of the duodenum [part of the small intestine], it would have been crushed against the spine and the other object."

Prosecutor James Wolffe QC then asked: "What about a fall into a blunt object?"

He replied: "Yes, this would cause that."

The prosecutor asked: "To simply fall over?"

The child would be in severe pain. He would be very miserable indeed

Professor Robert Karachi
Consultant paediatric surgeon

Prof Karachi replied: "Absolutely not. You are talking about falling [from] one or two storeys high onto a blunt object."

Mr Wolffe later asked how Brandon would have been affected up until his death.

Professor Karachi told the court: "The child would be very irritable, crying, would not want to eat or drink and would soon start vomiting.

"In addition to clear fluid, there would be blood from the stomach - red or brown in nature.

"The child would become more and more unstable. The pulse would be rapid and the blood pressure would drop.

"He would not be playing or laughing or acting normally after the event. He would gradually have gone into a state of coma and the shock would come later."

He added: "The child would be in severe pain. He would be very miserable indeed."

Professor Karachi was also asked about the success in treating such an injury.

He told the jury: "If one gets it early, then the prospect of success is quite high indeed."

He added that there comes a point when treatment no longer becomes "viable" after the child goes into "irreversible shock."

Denied charges

Mr Cunningham is accused of murder by assaulting Brandon so severely on 15 March last year at two flats in Balunie Crescent that he died the following day in hospital.

Mr Cunningham and Ms Boyd, 23, also face a charge of repeatedly and wilfully ill-treating Brandon between October 2007 and March 2008.

Ms Boyd is accused of assaulting her son at Douglas Family Centre in Dundee on 5 March last year.

Mr Cunningham is also charged with repeatedly and wilfully ill-treating another young boy at properties in Dundee between October 2007 and March 2008.

The pair deny all charges.

The trial, before Judge John Morris QC, continues.