Doctors testify Kamryn Schlitter was victim of child abuse

Two doctors testified Tuesday that 17-month-old Kamryn Schlitter's fatal head injuries were the result of child abuse and could have happened within 24 hours of when Amy Parmer called 911 March 21, 2010.

Both doctors said Kamryn was near death and would require “heroic” measures to save her when she was airlifted from St. Luke's to the University of Iowa Hospitals and Clinics that day.

Dr. Charles Jennissen, emergency room physician and associate professor with UI, said Kamryn had severe retinal hemorrhaging which is typical of a child that has been “viciously shaken.” Her pupils were fixed, which indicated serious neurological problems, and she had sub-dural bleeding in her brain and the cranial pressure had caused the brain to shift.

The head injury, that couldn't be explained by an accidental trauma, along with bruises on Kamryn's forehead, cheeks, jaw area, arms and chest, indicated she was the victim of child abuse, Dr. Gwen Erkonon, pediatric critical care physician with UI, said.

Parmer, 29, of Hiawatha, is charged with first-degree murder and child endangerment resulting in death. Parmer is accused in the death of Kamryn, her ex-boyfriend Zyriah Schlitter's daughter, who was babysitting her when she died from a blunt force head injury March 28, 2010.

Zyriah Schlitter, 25, of Cedar Rapids, was convicted of involuntary manslaughter and child endangerment resulting in death last December. He is serving 50 years in prison.

The prosecution continues its case 9 a.m. Wednesday in Linn County District Court.

Both doctors also said they believed the fatal head injury occurred within 24 hours of the 911 call. They both cited that a video Karmryn's father Zyriah Schlitter took March 20, 2010, helped them come to that opinion because she was functioning normally, talking and being playful, and displayed no neurological problems like the next day, March 21.

Jennissen said he believed the head injury occurred March 21. Besides the video, he also considered history of the child. He talked to Zyriah Schlitter who said there had been no trauma and only cited her being more sleepy that day.

Jennissen said initially Zyriah Schlitter wouldn't tell him how Kamryn was that day, which he thought was odd. He said Kamryn had been clingy all week and kept talking about how she acted that week but wouldn't answer his question about how her condition was March 21.

Zyriah Schlitter also didn't mention much about Parmer, only that she stayed with Kamryn that night when he left to attend a financial meeting, Jennissen said. He said Parmer's 6-year-old son was there that night but made a point to defend him, saying the boy wouldn't hurt Kamryn.

Erkonen said the doctors on Kamryn's case ruled out everything except inflicted trauma. The retinal hemorrhaging indicated she had been shaken, causing the acceleration-deceleration injuries to the brain, which resulted in severe brain swelling and shifting of the brain.

Erkonen said the pattern of bruising, in different stages of aging, also indicated she was a battered child. The marks on her cheeks were like someone squeezing her face and the location of the forehead bruise wasn't typical for a child. She also had unusual bruises on her chest. When a child falls, they typically put their arms out to protect themselves, she said.

“A shin bruise would be normal if a child fell,” Erkonen. “The bruising on the arms is also consistent with someone grabbing her arm.”

Both doctors admitted they couldn't estimate timing on when the bruises occurred.

Tyler Johnston, Parmer's attorney, trying to put doubt in the juror's minds that the fatal head injury occurred while Kamryn was in Parmer's care March 21, challenged Erkonen on her timing of the injury.

“This is just based on a ballpark notion of your experience?” Johnston said.

Erkonen said it wasn't a “ballpark notion,” it was based on Kamryn's condition and her training and experience.

“It's inflicted trauma that's acute and occurred within 24 hours,” Erkonen said.

Johnston challenged her with studies and papers from other experts in the field regarding timing of inflicted head trauma and some said this kind of trauma could occur as far out as 36 or 72 hours.

Erkonen stayed with her 24 hours estimate.

Dr. Gregory Albert, a neurosurgeon with the Arkansas Children's Hospital in Little Rock and a former UI neurosurgeon, also testified about performing surgery on Kamryn to relieve pressure of the subdural hematoma in her brain. He removed the hematoma and part of her skull to allow the brain to swell and preserve the functioning portion.

The surgery didn't improve her condition and there was no other surgical procedure they could do for her.

Kamryn was taken off life support and died March 28, 2010.