6 days ago
Ethan Ives-Griffiths murder trial day three: Flintshire
Michael Ives (47) and Kerry Ives (46) - Ethan's grandparents - from Garden City, stand accused of murdering Ethan Ives-Griffiths, who died on August 16, 2021.
They have also been charged with: Causing or allowing a child to suffer serious physical harm, and Causing the assault / ill treatment / neglect / abandonment of a child to cause unnecessary suffering / injury.
Shannon Ives (28), Ethan's mother, also standing trial, has been charged with: Causing or allowing a child to suffer serious physical harm, and Causing the assault / ill treatment / neglect / abandonment of a child to cause unnecessary suffering / injury.
At Mold Crown Court on Tuesday (June 10) Mr Jayaratnam Jayamohan, a Paediatric Neurosurgeon for more than 20 years, gave evidence.
Mr Jayamohan confirmed that Ethan was unresponsive on arrival at the Countess of Chester hospital on August 14, adding that after examinations, medical professionals would classify Ethan as being in a coma at the time.
Mr Jayamohan said there is a way of looking at verbal responses, motor responses and whether the eyes were open or closed. He stated that Ethan's PERMA score was 7/15. Fifteen being the highest and three being the lowest.
Following a CT scan, Ethan was transferred to Alder Hey hospital. At the stage of being transferred to Alder Hey for surgery, Mr Jayamohan described Ethan as being "desperately ill".
The court heard that Ethan had a "large amount of fluid" pressing on brain and the operation was aimed at removing fluid.
When asked by Caroline Rees KC, prosecuting, about the state of Ethan at this point, Mr Jayamohan said it was a "very hopeful operation" and he "was probably going to die".
He added: "He was a young boy, so we were always going to give him every opportunity. Everything was stacked against him at this point."
When asked by Ms Rees whether there were "clear abnormalities inside the skull", when discussing Ethan's CT scan, Mr Jayamohan replied: "Yes".
Reviewing the scan, Mr Jayamohan said: "It tells me there is very significant abnormality on right side causing pressure and would not be working at all right. It is essentially having a stroke to whole half of brain and reflects how desperately unwell he was."
He states there were areas of fresh blood (less than 10 days old) within the subdural space, in addition to the fresh blood within the brain. Mr Jayamohan said the bleeding suggests at least two episodes to cause bleeding in brain, but it "could be more".
Mr Jayamohan said he hasn't seen any evidence or history that Ethan had hit his head, adding that Ethan collapsed and went straight into a "comatose situation", which was consistent with the findings of his CT scan
Mr Jayamohan said the injuries caused to Ethan's head could come from two mechanisms, and that both could happen rather than one or the other.
The first is an "impact" or physical contact with an object moving to hit the right side of Ethan's head or Ethan's head moving to hit object. The second mechanism is that of a shaking injury, which doesn't involve an impact.
'Either way is involving trauma that is abnormal', he said.
Mr Jayamohan said in his view it is clear that the brain injury suffered by Ethan that led to his collapse must have occurred "pretty much straight away" on August 14.
He said that once Ethan had sustained the injury he was "always likely to die".
Mr David Elias KC, defence for Michael Ives asked Mr Jayamohan whether the pressure on Ethan's brain prior to August 13 may have caused changes in behaviour such as weakness and withdrawal. Mr Jayamohan said it was possible but couldn't say that it definitely could have caused the changes.
Mr Elias asked whether there may have been bleeding in Ethan's brain in the lead up to August 13, which Mr Jayamohan confirmed.
"That bleeding could lead to gradual build up of pressure on brain and skull," said Mr Elias.
Mr Elias asked whether an increase in pressure could lead to seizures, which Mr Jayamohan confirmed, but added that he would be "exceptionally surprised" if the subdural bleeding found in Ethan caused a seizure.
When asked about the injuries suffered by Ethan on August 14, Mr Jayamohan said that collisions can occur with a hard surface, without sustaining a fracture, as was the case with Ethan.
Mr Elias asks about lucid intervals within children suffering non accidental lethal head injuries.
For some head injuries you can have a period of 'complete normality', states Mr Elias, which Mr Jayamohan states was not in the case of Ethan.
Mr Jayamohan said: "Lucid means behaving neurologically normally. In general that is correct, for various reasons not applicable to Ethan."
Owen Edwards KC, defence for Kerry Ives, said that Ethan was "subject to substantial head injury close to time of collapse", with Mr Jayamohan stating that the use of force wouldn't have been lowered because of Ethan's presentation at the time.
The court was also shown police body worn footage of Shannon Ives' first interview, which took place at 1.30am on August 15 at Alder Hey.
When asked how Ethan had got in that position, Shannon Ives replied: 'I don't really know to be honest".
She said that Ethan wasn't really interacting with anybody, but was still eating and drinking. She claimed Ethan was "in his own little world" and wouldn't play with anyone, despite encouragement.
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Shannon Ives continued, stating that Ethan was "completely fine" on Friday, August 13, before collapsing at around 10am.
When discussing the events of August 14, Shannon Ives said that he had collapsed and it was "worse" than the Friday.
She gestured that she and Michael Ives were doing CPR but Ethan wouldn't wake up. In the footage, Shannon was seen crying and saying "I don't know what's caused it".
In the video, Shannon said that Ethan was "not the same child as he used to be".
Phone and text messages from Shannon Ives and Kerry Ives to other friends and family were also read out to the court.
The trial continues.
