WOBURN — Dr. Alice Newton, a prominent specialist on child abuse cases, Friday defended her conclusion that the 1-year-old girl under the care of Aisling Brady McCarthy was the victim of abusive head trauma, a cornerstone of the murder case against McCarthy.
In a daylong hearing in Middlesex Superior Court, Newton said the girl, Rehma Sabir, sustained massive brain trauma in the hours before she was rushed to the hospital, injuries that were consistent with a "violent shaking injury."
"It is my opinion that Rehma was subjected to violent force," Newton said. "I believe she was shaken and slammed."
A child could not have sustained such severe injuries and appeared normal, said Newton, who diagnosed Sabir when she was head of the child protection team at Boston Children's Hospital. Prosecutors say McCarthy, who is from Ireland, was baby-sitting the child when the fatal injuries occurred.
McCarthy has maintained her innocence, and her lawyers have noted that the child had suffered bone fractures — including compression fractures to her spine — several weeks before her death in January 2013, when she was out of the country and not in McCarthy's care.
But Newton said Friday the bone injuries did not change her conclusion. "Rehma Sabir was a victim of abusive head trauma and died from abusive head trauma,'' Newton said.
McCarthy's lawyers are seeking to have Newton's testimony excluded from McCarthy's upcoming trial, saying her diagnosis of the child was flawed and did not fully consider other possible causes of death.
In court documents, McCarthy's lawyers said thee is no evidence that Newton or other specialists "spent any meaningful time" looking at diagnoses other than abusive head trauma, also known as shaken baby syndrome.
"She diagnosed SBS so quickly . . . that it is difficult even to pretend for argument's sake she engaged in any serious differential diagnosis," the lawyers wrote.
The judge did not issue a decision Friday. The trial is expected to begin this fall.
McCarthy's lawyers have also raised questions about Newton's role in the case of Geoffrey Wilson, a former Massachusetts Institute of Technology employee charged in 2010 with killing his 6-month-old son. They contend the charges were based in part on Newton's conclusions about what caused the child's death.
The state medical examiner's office recently changed the cause of death in that case from homicide to undetermined.
"The opinions expressed by Dr. Newton in the Wilson case are strikingly similar to those expressed by her in this case,'' McCarthy's lawyers wrote.
On Friday, Newton detailed how she arrived at her diagnosis, saying that scans showed bleeding in the brain and eyes. She said she reviewed the child's medical history but found nothing that could have caused such a traumatic injury.
"She was a healthy, normal child," Newton said. "These are injuries that happened at the hand of an adult."
One of McCarthy's lawyers, Melinda Thompson, said Newton did not follow protocol in making her diagnosis and failed to fully review the child's medical history, including concerns about eating and weight.
"Dr. Newton did not do a proper differential diagnosis to determine what was going on with this child," Thompson said. Her testimony on Friday made it "completely apparent" she had not followed proper procedures," she added.
But Newton said she and others conducted a careful review, and the evidence showed the child died from "a major traumatic injury."