'Tremendous force' caused optic nerve bleeding in Kamryn Schlitter, doctor testifies

An ophthalmologist testified Thursday that based on the optic nerve hemorrhages found in Kamryn Schlitter's eyes the force to cause such an injury was “tremendous.”

Dr. Nasreen Syed, ophthalmologist with University of Iowa Hospitals and Clinics who performed the autopsy on the 17-month-old's eye, said there were hemorrhages in both eyes too numerous to count, but there was also something unusual – hemorrhages in the optic nerve sheath. The sheath protects the optic nerve and it would “take a tremendous amount force” to cause this bleeding.

The optic nerve bleeding, along with other retinal injuries, is consistent with non-accidental trauma that could be caused by a violent head movement or slamming, Syed said.

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

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

More medical experts testify starting 9 a.m. Friday in Linn County District Court. The prosecution should wrap up its case sometime next week.

Dr. Marcus Nashelsky, a forensic pathologist with UI Hospital and Clinics, conducted the rest of the autopsy on Kamryn. He identified autopsy photos for the jury as he pointed out numerous bruises that were in different stages of healing on her head and body. She had bruises on the right and left sides of her face – cheeks, forehead and jawbone area.

Kamryn also had bruising on her shoulder, along both arms, inside and outside area of her knees, hip and thigh area.

“Individually, some of these bruises could be attributed to normal childhood falls but there are several all over her body, which isn't,” Nashelsky said.

Kamryn also had an injury on the inside of her mouth, the frenum, the piece of skin that connects upper lip to gums, was torn, which could have resulted from being hit or pulled on, Nashelsky said.

The distribution of the injuries is consistent with non-accidental trauma and what Nashelsky referred to as “homicidal” injuries.

His examination of the brain revealed two separate “leading” trauma incidents, one recent and one older. He determined the different incidents based on how the blood looked. The older blood was a golden brown in the membrane area, which was a few weeks old from the time Kamryn died March 28, 2010.

The more recent one, over both sides of the brain, is difficult to date, Nashelsky said. The injuries were inflicted within a short time before Kamryn started having severe symptoms March 21, 2010.

Nashelsky said a head injury that is fatal will likely produce symptoms soon after it occurs.

“How soon,” First Assistant Linn County Attorney Nick Maybanks asked.

“Could be seconds or minutes or could be longer,” Nashelsky said.

Nashelsky did say it's “extremely unlikely” Kamryn's head injury occurred before the video was made about 4 p.m. March 20, 2010, which showed her active, talking and playing.

The timing of the injury is crucial to the state's case to help prove Parmer could have been responsible for inflicting the fatal injuries. Parmer was with Kamryn the night she was taken to the hospital March 21, 2010.

Christoher Palenik, employed by Microtrace in Elgin, Ill., was the only non-medical doctor who took the stand Thursday. He conducted forensic analysis on the substance that was removed from Kamryn's face with a wipe or tissue by a Apple Kids Daycare teacher March 8, 2010 in Cedar Rapids. The teachers said the substance covered up some of the bruises on Kamryn's face.

Palenik, who conducts the analysis using electron microscopes, determined the sample contained materials like glitter, starch grains and mica – a mineral, all found in cosmetics or make-up.