Updated at 6pm
THE PROSECUTOR IN the trial of a doctor charged with the manslaughter of her profoundly disabled daughter has said she broke all the rules by giving her child too much sedative.
Her defence said there was a clear indication in the post-mortem of a possibility of a terminal seizure.
The barristers were giving their closing speeches this evening in 58-year-old Bernadette Scully’s trial at the Central Criminal Court.
The Offaly GP is charged with unlawfully killing 11-year-old Emily Barut, who was profoundly disabled, at their home at Emvale, Bachelor’s Walk, Tullamore.
It’s alleged that she killed her by an act of gross negligence involving the administration of an excessive quantity of chloral hydrate on Saturday 15 September 2012.
She has pleaded not guilty.
Severe epilepsy
Emily had microcephaly, severe epilepsy and couldn’t speak or move. She’d been in pain for the last eight days of her life, having had a medical procedure to replace the tube into her stomach, through which she received fluids and medication.
Ms Scully said she had administered chloral hydrate when her daughter became upset at 2am and 6am that day. She said her daughter then had a massive fit after 11am and she administered more.
Tara Burns SC, prosecuting, noted that ten times the therapeutic level of chloral hydrate’s metabolite had been found in Emily’s system.
“My submission to you is that in itself establishes gross negligence,” she said.
She pointed out that the State Pathologist had given the cause of death as chloral hydrate intoxication.
She said that, although Professor Marie Cassidy agreed that Emily’s illnesses could have caused her death, she had not demurred from her opinion that the intoxication was a substantial cause.
“The law says the prosecution doesn’t have to prove it was the only cause,” she explained.
Ms Burns noted that Ms Scully had a rule that she would not administer more than 15 ml of chloral hydrate in a 24-hour period and an absolute rule that she would never administer more than 20 ml. This was also the expert view of the safe levels, she said.
“But on the 15th of September, 2012, Ms Scully broke all those rules,” she said.
She said that by 6am, Ms Scully had already exceeded her first rule, pointing to her account of having given 17 ml by then. She said her next absolute rule was well exceeded by 11 o’clock, when 34 ml had been administered on Ms Scully’s evidence.
Ms Burns also suggested that there was a question mark over what the accused said she administered. She said she wasn’t suggesting that Ms Scully had lied, but said she was exhausted, emotional and in a very fretful situation.
“I’m not sure how much. It was just pandemonium,” Ms Burns read from one of her Garda interviews.
She described Ms Scully as a holy person, noting evidence of a Padre Pio medal and prayer said with Emily every night.
Ms Burns said that in light of that knowledge and the dignity and respect she had wished for Emily, her two suicide attempts after her death didn’t equate with a belief that she had died of natural causes.
Chloral hydrate
Ms Burns asked the jury to look carefully at any suggestion that giving more chloral hydrate at 11 o’clock was the only thing she could do. She asked if it was not time to seek other medical help at 6am when the chloral hydrate wasn’t working.
“If it was your child and you had the luxury of having access to a GP throughout that night and your child passed away, would you feel the doctor did all they could or breached their duty of care that night?” she asked.
“I suggest that if she had acted as a reasonable doctor with her knowledge and her experience, she wouldn’t have administered that much,” she said. “She was grossly negligent on the night, and I have to urge upon you to return a guilty verdict in this case.”
Kenneth Fogarty SC then addressed the jury on behalf of Ms Scully.
He said that the only thing his client could use that morning was the medicine she had to hand.
“The only one ready, available and that had worked previously was chloral hydrate,” he said.
He noted that his client had been standing beside her own daughter, who was in a seizure, the likes of which she’d never seen before.
He asked if the prosecution was alleging that she could either stick with what she’d already administered and let her scream it out or give other medications that had previously made her vomit, in which case she would aspirate and choke.
If the fit continued, he said, she was going to die.
“In the human condition, people do make mistakes,” he said, giving an example of confusion about the number of adrenaline shots administered by medics trying to save Emily’s life.
“They’re trying to make the person’s life better,” he said. “Anybody who has looked at somebody in pain, would you not as a human being do anything to solve that problem of pain?”
He also said it was beyond his understanding that eyewitness evidence that Emily had suffered a colossal fit around 11am was being ignored.
“There’s a clear indication in the post-mortem of a possibility of a terminal seizure,” he said. “But nobody investigates it.”
“Professor Cassidy said the underlying medical conditions could give rise to death at any time,” he said.
He also noted that tests had found toxic levels of the drug in her system.
“Toxic does not mean fatal,” he said.
He noted that the experts had all found that Emily had been cared for extremely well during her life. Witnesses had noticed how well her hair, nails and teeth were looked after.
“She was minded like a little princess,” he said.
He mentioned that Ms Scully, who the trial heard had burnout, had sought help; she had called her professional body and gone to a psychiatrist but had not got the help she needed.
“She’d gone beyond crying for help,” he said.
“My friend says she was a holy woman,” he said of Ms Burns. “I don’t know what people who don’t believe in God have to say. But you can’t look after a child like Emily without believing that there’s a God and if He’s there I suggest to you, it’s not lost on Him when somebody decides I can’t go on without her.”
He said that leaving a man like Ms Scully’s partner behind when she tried to take her life was not a recognition that she did something wrong.
“That means you’re at the end of your tether,” he said.
He told the jurors they would probably have the hardest job that had ever been done by a jury.
“I’d say there isn’t a person in the country that would envy the position you’re in,” he said. “I guarantee you this, you’ll never come across a case like this again,” he continued.
“The emotional roller coaster we went through as a group is nothing compared to the position that Bernadette Scully finds herself in.”
“You don’t have to be a genius to work out that she’s an incredible woman,” he said of his client.
“It’s not just my privilege to represent her,” he said. “But it’s an eye opener in a country like this that you can get somebody who goes to the extraordinary lengths to look after a child and when the child passes away, the instantaneous response is: You killed her.”
He described it as extraordinary.
“I believe in the coverage that this case has got, that maybe there’ll be a debate, depending on your decision,” he concluded. “I believe it will be the right decision but it’s just a pity it’ll just be down to one word or two.”
He asked for a verdict of not guilty.
Mr Justice Patrick McCarthy has now begun charging the jury of seven women and five men and will continue his charge tomorrow morning.
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