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Brain injury played role in boy's death, trial told

Craig Rowland - a still of a man with short brown hair wearing a light blue collared shirt, a skinny grey tie and a black vest jacket. He has one eye closed and is looking at the camera as he walks near a white stone building. A person's face in the background is blurred.Image source, Pacemaker
Image caption,

Craig Rowland, pictured at an earlier hearing, is accused of murdering his son Lewis

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The trial of a County Armagh man accused of murdering his infant son has heard 鈥渃atastrophic brain injuries鈥 played a 鈥渧ery significant role in the development of the pneumonia鈥 the child died from.

Craig Rowland, 29, of Millington Park in Portadown, is charged with the murder and manslaughter of Lewis Oliver Rowland, who died on 20 October 2018.

Lewis was 13 weeks old when he was admitted to Craigavon Area Hospital with 鈥渟erious head injuries鈥 in November 2015.

The infant died three years later after complications arising from surgery.

On Wednesday, the jury at Belfast Crown Court heard evidence from assistant state pathologist Dr Peter Ingram.

The trial heard he conducted a post-mortem examination on the body of the three-year-old on 23 October 2018.

Dr Ingram told the court he determined the child鈥檚 cause of death was 鈥減neumonia following intra-abdominal surgery on a child with a pre-existing brain injury".

The court heard how Lewis had been in foster care in the period following his first admission to hospital as a baby.

The pathologist said he was aware that the boy鈥檚 condition had failed to improve and that there was a 鈥済eneral neurological decline".

鈥淗e was unable to walk or talk, but he could smile at his foster parents鈥, he said.

'Catastrophic' injury

The court heard Lewis underwent surgery on 4 October 2018 to have a nasogastric tube replaced for a longer-term feeding tube.

He subsequently developed a urinary tract infection and a chest infection after returning to the surgical ward.

The pathologist described how the three-year-old had to return to the operating theatre on two further occasions that same month to have the feeding tube mechanism adjusted.

Dr Ingram said that following an operation on 19 October, the infant鈥檚 blood oxygen levels began to drop and that a chest X-ray noted signs of pneumonia.

He added that 鈥渕edical staff were of the opinion this was his final respiratory episode".

The court heard Lewis Rowland died at 13:30 on 20 October 2018.

Dr Ingram said there had been a notable change to the child鈥檚 brain and that 鈥渋t was highly abnormal".

He said a report prepared by a consultant neuropathologist, who鈥檇 examined the child鈥檚 brain, confirmed the finding that he 鈥渉ad suffered a catastrophic brain injury".

Injury 'played significant role'

Reading from his own report, Dr Ingram said: 鈥淭he history indicates this young boy had previously suffered catastrophic brain injuries, resulting in seizures, global development delay, movement disorders and being blind.鈥

The pathologist said there were 鈥渕arked degenerative changes鈥 in the brain which would have rendered the child 鈥渟ignificantly more susceptible to pneumonia鈥 as opposed to a normal healthy child.

Dr Ingram agreed with a prosecution lawyer that the infant was much more susceptible to chest infections and pneumonia, due to the brain injury he had suffered.

鈥淭he head injury played a very significant role in the development of the pneumonia and ultimately his death,鈥 he said.

Mr Rowland, who is on bail, has previously pleaded guilty to a charge of wilfully neglecting his son.

The child鈥檚 mother, Laura Graham, has also pleaded guilty to the same charge.

The trial continues.