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Seven-year-old Aaliyah Rosa’s death was caused by a combination of factors, including drowning, drugs, possible strangulation, and blunt trauma to her head, pathologist Dr. Lisa Steele testified Monday in a New Westminster courtroom.
Steele was resuming her testimony in the trial of Langley’s KerryAnn Lewis, Aaliyah’s mother, who has pleaded not guilty to a charge of first-degree murder in the July 22, 2018 death.
“This case is incredibly difficult and there are a lot of findings that aren’t a slam dunk, for lack of a better word,” Steele noted at one point during her testimony.
Steele testified that there were multiple signs indicating that Aaliyah had suffered lack of oxygen to her brain, and that she had likely breathed in water before her death. Water was found in her lungs and stomach, as well as in a sinus cavity connected to her nose.
A toxicology report prepared by the RCMP also showed the presence of both lorazepam, commonly sold as Ativan, and diphenhydramine, better known as the over-the-counter allergy medication Benadryl, in Aaliyah’s stomach.
The girl had a fairly high concentration of Benadryl in her system, according to the toxicology report, Steele said.
Crown prosecutor Christopher McPherson also asked Steele about other injuries to Aaliyah, including one to the muscles in her neck, and a couple of blows the girl appeared to have taken to the back of the head.
Steele said it was possible that the drugs alone could have caused Aaliyah’s death, and the other injuries could have contributed as well.
“There’s no way to really tease out one and only one thing that’s responsible for Aaliyah’s death,” Steele said.
Either the drugs or the drowning, alone, could have caused death, she said.
A significant amount of the cross-examination of Steele focused on injuries or damage to Aaliyah’s brain.
Defense lawyer Marilyn Sandford tried to suggest that Aaliyah did not drown at all.
Steele had testified that Aaliyah had swelling in her brain, which could have been caused by drowning, other forms of asphyxiation, or a blow to the head.
Sandford asked if the brain swelling, could have been a pre-existing condition for Aaliyah.
“I highly disagree with that,” said Steele.
The pathologist then went through a litany of technical factors suggesting why it was unlikely that the brain swelling took place before the injuries leading to Aaliyah’s death.
She also said it was very likely that a child of seven with hydrocephalus – often known as water on the brain – would have symptoms that would have been apparent to others.
Sandford also asked about how difficult it was to prove 100 per cent that drowning was a cause of death.
Steele agreed that it was very difficult to show drowning as a definitive cause. Water was found inside one of Aaliyah’s sinuses, which is an indicator that she tried to take a breath while under water, but it’s not the only possible reason, Steele agreed.
Sandford zeroed in on Steele’s testimony that there were “red neurons” in Aaliyah’s brain. These are neurons that are damaged and changed in colour due to a lack of oxygen.
But Sandford said that such damage takes time, and is associated with a lack of oxygen and then resuscitation and survival for at least four to six hours after that, not a rapid death.
“It depends on how quickly you drown,” Steele said.
She agreed that four to six hours is a rule of thumb, but there has been no research on children.
Finally, Sandford suggested that Aaliyah had actually died of a blow to the head, combined with a pre-existing issue of brain swelling.
Steele did not believe that had happened.
“The blunt force head trauma that she sustained was in my opinion not severe, and in and of itself may have been survivable,” Steele said.
The drugs in her system would have meant she could have been submerged in water and died from that, Steele said.
“I do think that she drowned.”
McPherson followed up and asked whether it was possible for someone to be immersed in water, suffer lack of oxygen, survive for a time afterwards, but still die, thus creating the “red neurons.”
“That doesn’t necessarily mean the person will survive the original deprivation, is that right?” McPherson asked.
“Correct,” said Steele.
“They could still die?”
“They could still die, yes,” she said.
The court has already heard from witnesses who found Aaliyah’s body, as well as multiple police investigators and emergency responders.
Steele is the last witness scheduled to testify in the trial, which began in October and has been plagued by delays linked to the health of witnesses – several of whom have either contracted COVID-19 or been exposed to it and forced to isolate – and of the accused.
Lewis collapsed in the courtroom in early December on one occasion.
Following Steele’s testimony, the Crown and defence lawyers are expected to make their final arguments before Justice Martha Devlin renders her verdict.