Abused Girl Died Slowly, Doctor Testifies

Seven-year-old Nixzmary Brown slipped into unconsciousness more than 13 hours before her stepfather and mother sought medical help for her, a medical examiner testified Thursday at her stepfather’s murder trial.

For more than seven hours of that time, the doctor said, Nixzmary was dead.

The timeline offered in State Supreme Court in Brooklyn by the medical examiner, Dr. Barbara A. Sampson, contrasts with the accounts that the stepfather, Cesar Rodriguez, gave the authorities on Jan. 11, 2006, the day that Nixzmary’s body was found in her family’s apartment in Bedford-Stuyvesant, Brooklyn.

In his written and videotaped statements, Mr. Rodriguez described an evening of shopping at Target on Jan. 10, followed by snacks for Nixzmary’s five siblings, a confrontation with Nixzmary over a container of yogurt or pudding that had disappeared, and another confrontation over a computer printer that Nixzmary confessed to jamming. This was followed, Mr. Rodriguez said, by a punishment session in which he beat Nixzmary, then held her head under a running tub faucet. When he left her naked on a bedroom floor, she was awake and moaning, he said.

According to Dr. Sampson, the city’s first chief deputy medical examiner, who presented the results of Nixzmary’s autopsy on Thursday, none of that could have happened when Mr. Rodriguez said it did.

Nixzmary, Dr. Sampson said, lost consciousness around 2:30 p.m. on Jan. 10, from a blow to the right side of her head sustained two days earlier.

“At least several hours before her death she was not receiving oxygen,” Dr. Sampson said, describing a microscopic exam of the girl’s brain cells.

“She was unconscious at least several hours before she ultimately died,” she said. Nixzmary died between 8 and 9 p.m., Dr. Sampson said.

This would make Mr. Rodriguez’s efforts to resuscitate Nixzmary — which he said he began briefly before sending his wife to summon help around 4 a.m. on Jan. 11 and was still doing when paramedics arrived — pointless, said Ama Dwimoh, the lead prosecutor.

“Cesar Rodriguez was doing C.P.R. on a dead body,” she said.

Dr. Sampson said the blow inflicted Jan. 8 caused a subdural hematoma, or bleeding on and around Nixzmary’s brain.

She described the symptoms of a slow death by subdural hematoma: “headache, nausea, confusion,” after which the victim grows “sleepy, somnolent and gradually slips into a coma, followed by respiratory depression.”
Typically, without medical attention, Dr. Sampson said, “respiration would be so depressed that she would die.”
Dr. Sampson said that Nixzmary, who weighed 36 pounds when she died, was killed both by the blow and by a history of starvation and abuse.
“The cause of death was child abuse syndrome, including blunt impact to the head with subdural hematoma,” she said. Child abuse syndrome, she explained, is a clinical term for prolonged physical abuse, malnutrition and neglect. “That subdural hematoma is the straw that broke the camel’s back,” she said.
Mr. Rodriguez’s lawyer, Jeffrey T. Schwartz, contends that Nixzmary’s mother, Nixzaliz Santiago, dealt the fatal blow while Mr. Rodriguez slept on the night of Jan. 10-11. Ms. Santiago is also charged with murder and will be tried after Mr. Rodriguez.
Dr. Sampson also said that Nixzmary’s two black eyes — huge raccoonlike circles surrounding the whole eye socket, photographs of which were shown to a tearful jury again on Thursday — were inflicted in the last few days of her life. Mr. Schwartz, noting that Ms. Santiago told investigators that Nixzmary sustained at least one black eye in late November when she fell after Ms. Santiago pushed her, has said that the black eyes shown in the photograph long predated Nixzmary’s death.
Dr. Sampson disputed that contention. “Black eyes that occurred six weeks ago would be gone,” she said.
In his videotaped statement, Mr. Rodriguez says of the black eyes, “she managed to do that to herself.”
Mr. Schwartz told reporters outside the courtroom that Dr. Sampson’s version of events was not just at odds with the accounts of Mr. Rodriguez and Ms. Santiago, but also at variance with the impression that the prosecution had elicited from its own witnesses as it presented its case. That testimony, based in part on Mr. Rodriguez’s statements, seemed not to question at least Mr. Rodriguez’s contention that Nixzmary was alive and well enough to misbehave on the night of Jan. 10.

“The pathologist’s testimony is disproving the people’s theory that this happened on January 10-11,” Mr. Schwartz said. “The whole setup has been shown by their own witness to be false.”
In her opening statement, though, Ms. Dwimoh was vague about the timeline, saying that the shopping trip to Target occurred on Jan. 9; that “hours later,” Mr. Rodriguez beat Nixzmary; and that after that, “hours later,” in the early hours of Jan. 11, her parents finally sought help.
Surveillance video from the Target store near Downtown Brooklyn, played earlier in the trial, shows Mr. Rodriguez, Ms. Santiago and five of the six children — all except Nixzmary — at the store at 7:30 p.m. on Jan. 9.
Outside court on Thursday, Ms. Dwimoh was asked if that meant that while the family was out shopping, Nixzmary was at home slowly dying from the brain injury she had suffered the day before.
“It sure seems that way from the evidence,” Ms. Dwimoh said.
Mr. Schwartz began his cross-examination of Dr. Sampson on Thursday by seeking, without success, to elicit the opinion that Nixzmary, who weighed only as much as a normal 4-year-old, was not dangerously underweight. His cross-examination is to continue on Friday.

Abused Girl Died Slowly, Doctor Testifies - New York Times