GP mum weeps in court as trial for unlawful killing of daughter begins
GP mum 'gave toxic level of drug to daughter'
A GP gave her young, severely disabled daughter sedatives at a 'toxic' dosage up to 10 times the correct limit, a manslaughter trial has heard.
Dr Bernadette Scully was found unresponsive by paramedics, having taken an overdose of anti-depressants.
The doctor, of Emvale, Bachelors Walk, Tullamore, Co Offaly has pleaded not guilty of the unlawful killing of her daughter Emily Barut (11) at their home on September 15, 2012.
She has pleaded not guilty to charges that she caused her daughter's death by gross negligence, involving the administration of an excessive dosage of chloral hydrate, a sedative.
Dr Scully wept in court as State Pathologist Professor Marie Cassidy gave details of the post mortem examination.
Opening the trial at the Central Criminal Court, Tara Burns SC for the State said Emily was born in 2000 with profound mental and physical disabilities, with microcephaly and epilepsy.
Her mother acted as her GP throughout her life and the evidence was that Emily was very well cared for, Ms Burns said.
On September 15, 2012, Dr Scully sent her partner to the chemist with a prescription for anti-depressants and sedatives.
Later that afternoon, Dr Scully went for a sleep.
Her partner checked her at 7pm and found her still asleep.
At 9pm, he checked Emily and found her cold.
He called an ambulance and mother and daughter were taken to hospital where Emily was pronounced dead.
Dr Scully was found to have taken an overdose of anti-depressants.
Two weeks before, Emily underwent a procedure to fit a new feeding peg in her stomach and was subsequently in a lot of pain and sleeping poorly.
Dr Scully had her own medical difficulties, the court heard. She was sleeping badly because she had to care for her daughter and had recently returned to work, having taken some time off.
The court heard Dr Scully had given an account of what had happened on the night in question, saying Emily was very upset, crying, and was in pain.
She awoke at 2am and Dr Scully administered a dose of chloral hydrate and similarly at 6am when another dose was given.
At 11am, Emily had a "very significant fit" and again chloral hydrate was given, with the court later hearing that the sedative is used in the treatment of epilepsy.
In all, between 27 and 32ml of chloral hydrate was given by Dr Scully between 2am and 11am.
Dr Scully "accepts she gave her too much," said Ms Burns.
She said a toxicology report would show the level found in Emily's blood was 200 micrograms per millilitre.
If the correct amount of the drug had been administered, the level of the metabolised chemical should be in the range of only 10 to 20 micrograms.
Ms Burns told the jury this was without doubt an "extremely sad case" and said there wasn't a doubt that Dr Scully had loved her daughter and cared for her highly.
However, she said this case was about the events of a specific day, when chloral hydrate was administered to Emily to a level within the toxic range.
Dr Scully would have realised there was a high degree of risk of causing a substantial personal injury to her daughter, Ms Burns argued.
Prof Marie Cassidy told the court the post mortem had shown Emily to have been disabled from birth.
The skull was poorly developed, the cerebellum was smaller than normal and the brain also showed damage from multiple seizures.
One severe seizure had occurred some six to eight hours before death, she said.
Emily had been "extremely well cared for", Prof Cassidy said.
She noted Emily had been prescribed treatment for epilepsy but initially said drugs were not present in her body and that she was "at risk of suffering a severe seizure at any time".
However, a note to her report after additional toxicology screening said three drugs for epilepsy were found in Emily's system at "normal or low levels" but she still remained at risk of a fatal seizure at any time.
Dr Cassidy said there had been a special request for screening for chloral hydrate which showed a level of 220 micrograms - a level within the fatal range.
The post mortem showed no specific anatomical cause of death but Prof Cassidy said this did not exclude epilepsy.
She concluded death was due to chloral hydrate intoxication, with microcephaly, epilepsy and local acute inflammation of the lungs present.
Asked by Ken Fogarty SC for Ms Scully if Emily "could have had a terminal seizure", Prof Cassidy agreed that she could.
And asked whether chloral hydrate was taken out of the equation, if there was 'still sufficient there to cause her death'.
"Yes," Professor Cassidy said.
The trial continues.