Two experts at odds over when teen fatally injured

3 Dec 2008
The Irish Independent

Two senior medical experts disagreed yesterday on when a 14-year-old schoolboy received a head injury that killed him.

An inquest has been hearing evidence about the death of Brian Rossiter, who had been the victim of an assault on September 9, 2002. He was found unconscious in a garda cell on September 11 and died on September 13.

Yesterday the Cork City Coroner's Court heard that a third doctor, State Pathologist Professor Marie Cassidy, could not give any specific time beyond a three-day period for when the teenager sustained a blunt force trauma blow to the head that fractured his skull and caused a fatal Extra-Dural Haematoma (EDH).

The revelation came on the fifth day of the re-opened coroner's inquest into the death of the Clonmel, Co Tipperary boy six years ago.

Unconscious

Brian Rossiter died on September 13, 2002 -- two days after being found unconscious in a Clonmel Garda Station cell.

However, on September 9, Brian had been the victim of a serious street assault where he was head-butted repeatedly, punched and 'kneed' in the head.

Yesterday, two consultants -- neuro-surgeon Charles Marks and pathologist Christopher Milroy -- differed over precisely when the fatal injury was most likely to have been inflicted.

The teen was found to have a hairline fracture to the left side of his skull near his temple. A corresponding abrasion mark on his face indicated he may have been pushed or propelled into a wall or a hard surface.

The skull fracture had caused a tear in an arterial blood vessel in Brian's dura, the membrane that lies between the brain and skull. Blood began to leak and clot in a cavity between Brian's brain and his skull, gradually exerting fatal pressure on the brain -- the condition known as the EDH.

Prof Milroy -- who was previously retained by the Rossiter family for the Hartnett Inquiry and worked for 17 years as a Home Office pathologist in the UK -- said he believed Brian's fatal injury was most likely to have been sustained sometime between September 10 and September 11.

"If you take the medical evidence in its entirety -- based on the way Extra-Durals behave, based on the histology and the other findings -- it is more likely that the injury which caused the Extra-Durals occurred after (September 9) -- assuming there wasn't an incident before," he explained. But Prof Milroy warned that the assault which Brian suffered on September 9 could not be ignored.

"Based on the totality of the evidence, you cannot exclude the attack," he said. "It could have occurred anytime from the incident on the ninth to the time shortly before he was found -- but I favour the shorter period," he said.

Prof Milroy also said that the fatal injury was not inflicted by a kick, a punch or a head-butt.

However, Mr Marks, who was the neuro-surgeon who performed an emergency operation on Brian Rossiter, said he believed the fatal injury was sustained 56 hours beforehand.

That timeframe would pre-date the teenager being taken into Clonmel Garda Station after being arrested on a public order offence.

Mr Marks confirmed to the inquest that he performed emergency surgery on Brian Rossiter on September 11.

"We accepted him to Cork [from St Joseph's Hospital, Clonmel] while acknowledging that things were desperate. There was a large blood clot between the brain and the skull. Things were rather hopeless -- but we took out the brain clot," he said.

However, Brian failed to respond and was later ruled to be brain-dead.

"I concluded on the balance of probabilities that the trauma he sustained 56 hours before was the most likely cause of his Extra-Dural Haematoma and his death," Mr Marks said.

Deterioration

"I didn't think there was a further significant trauma," he said. "(The) trauma and headaches is enough for me to explain his deterioration on that morning," he added.

Prof Cassidy told the inquest that she performed a post- mortem on Brian Rossiter on September 14.

But she told the inquest that she did not believe there was sufficient scientific evidence for saying anything beyond that the fatal injury could have occurred anytime between September 9 and 11.

The inquest continues today.

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