More dispute over timing of toddler's fatal injury

A pathologist, testifying Wednesday for the defense, didn't disagree with state expert witnesses who said 17-month-old Kamryn Schlitter died from blunt force head trauma, but she did dispute an opinion on timing of the injury and that there was more than one brain injury.

Dr. Janice Ophoven, a Minnesota private practice pediatric pathologist, said she only saw evidence of one injury and put the timing of the injury between 24-48 hours or more. She also agreed with the other doctors who testified over the last two weeks that Kamryn was a victim of child abuse but she described the two bruises on her cheeks and a large forehead bruise showed to her in photos as “little spots” because she has seen “far worse.”

Amy Parmer, 29, of Hiawatha, is charged with first-degree murder and child endangerment resulting in death. She is accused of inflicting the physical abuse of Kamryn, along with her ex-boyfriend Zyriah Schlitter, who was also Kamryn's father. Kamryn died March 28, 2010.

Schlitter, 25, of Cedar Rapids, was convicted last December of involuntary manslaughter and child endangerment resulting in death and is serving 50 years in prison.

The defense rested Wednesday and the prosecution will likely have some rebuttal 9 a.m. Thursday. The trial, which started Aug. 19, may wrap up late Friday.

Ophoven, who has only testified for the defense since 2007, said Kamryn's brain injury was days rather than hours old because there was degenerating red blood cells in the sub dural hematoma and it takes time before there is evidence the cells are dying. The aging of the clot isn't fresh or recent, she said.

Ophoven would put the injury as occurring within 24-72 hours.

Dr. Marcus Nashelsky and Dr. Patricia Kirby, both UI Hospitals and Clinics forensic pathologists, testified during trial that there were two injuries, an older one occurring days to weeks or longer, and a recent injury occurring shortly or within 24 hours of when Kamryn was seen at the hospital March 21, 2010.

Dr. Gary Baumbach, also a pathologist with UI, testified two injuries were also possible but he put the timing within 12-24 hours.

Ophoven said there was no scientific evidence to narrow the timing to within 12 hours. She also didn't think there was a more recent injury because there was no evidence of it like a “goose egg” on the outside of her head or bruising to the brain.

Ophoven said Kamryn could have been injured but might not have lost equilibrium or collapsed for two days, according to how the injury impacts the circulation of blood flow to the brain.

Tyler Johnston, Parmer's attorney, asked if the bruises could have been a result of medical intervention such as emergency worker putting resuscitation mask on Kamryn or a neck collar.

Ophoven said it was possible. She had been involved in cases where that happened.

The other doctors who testified said the bruises were not from medical intervention and Nashelsky, who performed the autopsy, said the pattern of bruising on Kamryn was consistent with assault.

First Assistant Linn County Attorney Nick Maybanks on cross asked if Kamryn was put to bed and about 15 minutes later she was having difficulty breathing and was posturing, “wouldn't that show something happened?”

Ophoven said she couldn't say there was a recent injury. She said blunt force trauma doesn't result in immediate unconsciousness.

Maybanks asked if the bruise marks on each side of Kamryn's face could have been finger marks from someone grabbing her and throwing her down on a sofa or crib and if the marks underneath her arms could have been from someone picking her up and throwing her down on a soft surface.

Ophoven admitted both were possible.

Johnston came back and asked if it was possible to cause Kamryn's injury by shaking.

Ophoven said Kamryn wasn't an infant. She was almost 18-months and weighed about 25 pounds, and that would take a lot of force.