Day 9
Warning graphic details
Read bottom up…
TW medical evidence!!!
3:57pm08/07/26
Case adjourned
The hearing has been adjourned for the evening and Dr Hoggard will conclude his evidence tomorrow morning.
3:51pm08/07/26
Internal examination
The jury hears how the pathologist was able to rule out any natural cause of the toddler's death.
Dr Hoggard says a dense bruise were discovered in Isabelle's intestinal tract measuring 11cm by 8cm on the fatty tissue underneath the intestines.
He says the bruising could be the result of a 'very forceful' punch but can't provide a more accurate measurement than that.
Dealing with the toddler's bruising on her scalp, the doctor says there were three injuries on the right hand side of her head.
He says there was a large area of dense bruising covering almost the entire left side of her scalp.
"It will have been significant force to cause bruising across almost the entire of the left side of the scalp," he says.
The image of Isabelle's head showed a fracture running down the centre of the head and was 5cms long, he says.
He says some of the bruising to the right side of head could be associated with the fracture but the bruising to the left side was not associated with the fracture of the skull.
The final injury was to the left knee joint of the toddler which showed large internal bruising measuring 5cm by 2.5cm.
3:33pm08/07/26
Injuries to limbs
Dr Hoggard says there were a series of bruises on Isabelle's shoulders and arms.
On her left leg, there were a series of bruises near her knee and one on her ankle with a large red abrasion on her foot.
Dealing with Isabelle's right leg there are another series of bruises around her knee and a large bruise below her kneecap with a further bruise on her calf.
3:25pm08/07/26
Rear torso injuries
The hearing has resumed after a short break for the jurors.
Dr Hoggard is now dealing with injuries to Isabelle's rear torso.
He is taking the jury through the ten areas of bruising or scratching across the toddler's back, including a series of circular bruises consistent with gripping.
The jury hears how there were signs of some of the injuries starting to heal with scabs forming on the skin.
The doctor confirms that all of the bruising was 'very obvious' to the eye.
2:50pm08/07/26
Bottom injuries - warning graphic details
Jurors are now looking at a computer generated image of the bruising discovered around Isabelle's bottom.
Dr Hoggard says there were a series of five separate injuries in an around her
mole, including a tear in her skin.
He says he conducted further investigations in the same area which will be dealt with later in his evidence.
The jury hears that the tear would have been 'extremely painful'.
2:45pm08/07/26
Torso injuries - warning graphic details
Jurors are now looking at computer generated images of the marks and bruising recorded on Isabelle's torso.
The image shows several large bruises on the front of her chest including nine separate scratches measuring up to 9cm long.
Dealing with injuries on the lower section of Isabelle's torso, Dr Hoggard says there were multiple bruises on the right side of her body around the abdomen area, including circular bruises which are often caused by forceful gripping of the torso.
Dr Hoggard tells the jury that all of the injuries were 'very obvious, immediately'.
On the left side of Isabelle's abdomen were another eight injuries including ones close to the pubic area of her body.
Mr Wright asks the pathologist about the bruising to the abdomen and whether they were caused by a single incident or more than one.
He says each bruise is a singular injury, 'the impression I formed was there was forceful gripping of the abdomen' - he says those type of injuries are always concerning as signs of physical abuse.
He says there is one set of marks which are likely to have been caused by medical intervention.
The pathologist says there were four areas of bruising around the toddler's
tina, with haemorrhages in the area, he says they could be a marker of trauma but they are of no significant meaning to them.
He says he believes the bruising is separate but they are almost merging together. "They indicate there has been some blunt force trauma to the pubic area," he says.
2:12pm08/07/26
Facial injuries
Dr Hoggard tells the jury that he records all of the injuries discovered on Isabelle's body.
He says there is no relevance to the numbering of the injuries and jurors are now looking at computer generated images of the toddler's injuries.
Jurors are shown an image of the four injuries recorded on her head, including large bruises on her forehead and a scab on the left side of her scalp.
He says that the positioning of the three bruises indicates there was more than one impact.
Jurors are hearing details about further injuries to her face and neck.
The image shows five separate injuries including a large bruise on the left cheek and jawline which were orange in colour.
When asked about the bruising to Isabelle's ear, he says it is always concerning to a pathologist because it is difficult to injury your ear accidentally and could be a sign of physical abuse.
On the right side of her face, there was more bruising around her nose.
Returning to the left side of her face, the pathologist is describing further bruising and abrasions around her mouth area.
Isabelle also had red and blue bruising with further abrasions - together it could be caused by contact with a rough surface, he says.
In total there were 24 visible injuries on the toddler's head and neck.
When asked what he saw during the facial examinations, he says: "It was covered in bruises and abrasions. They were very obvious."
2:00pm08/07/26
Pathologist report
Dr Hoggard, a Home Office pathologist, carried out the post mortem of Isabelle Welsh on September 16 last year at the Sheffield Children's Hospital.
He says he didn't need to go to the scene in Thornaby but was given a lot of the toddler's medical history in the time leading up to her death.
The court hears how he listened to the police interview of Isabelle's mother, Alexandra Walker.
Mr Wright, prosecuting, is taking the pathologist through his evidence for the jury.
Dr Hoggard recorded all the marks of medical intervention as well the multiple other injuries found on the two-year-old's body.
12:28pm08/07/26
Early lunch
The trial has adjourned for an early lunch after the conclusion of Dr McPartland's evidence.
The next witness to give evidence is pathologist Dr Sam Hoggard.
12:03pm08/07/26
Report conclusion
Dr McPartland says there was no history of accidental trauma which could explain the skull fracture in this case.
She says: "There was no history provided of an accidental fall that could explain the skull fracture in this case.
"In the absence of an underlying medical cause the finding of multiple haemorrhages in both eyes, the severe optic nerve haemorrhages in both eyes and orbital soft tissue haemorrhages.
"In combination with the brain injury, it is indicative of a severe traumatic head injury. In the absence of a history of an accidental head trauma of appropriate severity - it is highly suggestive of an abusive head trauma."
11:50am08/07/26
Injury cause
Dr McPartland tells the jury she has seen the report provided by Dr Daniel Duplessis, a neuropathologist.
She says he identified two head injuries - one around four days old and a significant trauma at the time of Isabelle's death.
The doctor says the damage to Isabelle's eyes was caused during the significant trauma.
She says the injuries could have been caused by shaking but also could involve impact damage.
Dr McPartland says there is a timeframe of within 24 hours of death but cannot give a definitive time the injuries were suffered.
She says there was a tiny area on one eye which could have occurred at the same time as a previous injury.
11:41am08/07/26
Major findings
Dr McPartland says she applied a number of specialist dyes to the eyes to carry out further investigations into healing responses in an attempt to age the injuries.
She says there was no evidence that the injuries were beginning to heal.
In summary, she says Isabelle's eyes appeared to be normal prior to the injuries being suffered.
Dr McPartland concludes that the multiple haemorrhages were linked to abusive head trauma rather than accidental head trauma.
11:25am08/07/26
Microscopic examinations
Closer examination revealed that both eyes suffered multiple haemorrhages.
Dr McPartland says there was damage to her retinas and the haemorrhages were present throughout her eyeballs.
She says: "The presence in both eyes is a pattern that is seen in abusive head injury rather than accidental head injury."
Dealing with the level of force needed to cause the injuries, she says: "A forceful and repetitive movement on the neck and impact."
She confirms that the injuries could have only been caused accidentally by a fall from height, a car crash or having the head crushed.
Mr Wright asks the doctor what the consequences could have been for Isabelle is she had survived the head injury. She says it is difficult to predict unless she regained consciousness.
11:12am08/07/26
Injury details
Dr McPartland says there was evidence of haemorrhaging from the blood vessels in Isabelle's eyes.
The jury hears how the left eye had suffered bleeding to the optic nerve sheath which would not occur in a healthy person.
She says there were numerous haemorrhages in the toddler's eye - too many to count.
The doctor says there was evidence of blood clotting which indicates that there had been a survival period of some hours but it is impossible to give a definitive time period.
Dealing with Isabelle's right eye, the doctor says she found she had suffered bleeding to the optic nerve sheath and multiple retinal haemorrhages - again too numerous to count.
She says the injuries are consistent with infliction rather than accidental.
10:53am08/07/26
Eye damage
Richard Wright KC, prosecuting, is taking the witness through her evidence.
The doctor tells the jury that there are a limited number of eye specialists working in the pathology field and has carried out 150 investigations since she trained almost a decade ago.
She confirms that she has worked alongside all the other medical experts involved in the post mortem of the toddler.
The jury hears how an initial examination is carried out before dissection is carried out and microscopic examination is performed.
Dr McPartland examined both of the toddler's eyes as part her investigations.
10:42am08/07/26
First witness
Dr Jo McPartland is a pathologist who works in the Alder Hey Children’s hospital in Liverpool. She has developed a particular specialism in ophthalmic pathology.
She will be taking the jury through the eye injuries Isabelle Welsh suffered.
10:39am08/07/26
Trial resumes
The jury did not sit yesterday but here is a round up of the evidence they listened to on Monday -
Thornaby mother denied murdering her two-year-old daughter
www.gazettelive.co.uk
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