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Victim, now 2, was "white as a ghost" on night of incident
September 13, 2011 started out like any other day but ended with her infant grandson on a helicopter transport to Denver after suffering a seizure, said Wendi Schuessler, grandmother of the alleged victim, during her testimony in the first day of the State of Nebraska verses Nancy Gipfert.
Gipfert is charged with one count of child abuse causing serious bodily injury, a felony for her alleged part in the incidences leading up to the infant's hospitalization.
Michael Guinan and William Tangeman, both assistant attorneys general, are prosecuting the case, while local attorney Don Miller is representing the defense.
Tangeman questioned Schuessler if she'd ever cared for the infant.
"Yes, I cared for him the Friday night before this happened," Schuessler said.
He was fussy that night, which was typical, she added. He was generally a normal baby, she said, although he was sometimes colicky and suffered from stomachaches.
On Sept. 13, 2011 Schuessler picked up the infant's sister from dance lessons, then his mother brought him to Schuessler's house, after picking him up from daycare at Gipfert's home.
"When she uncovered him, he was just as white as a ghost," Schuessler said.
She described the infant as limp and lethargic. Schuessler called the hospital and was advised to bring the two-month-old to SRMC.
"We couldn't get him to wake up," Schuessler said.
She and her daughter were both hopeful that there was nothing wrong with him. After arriving at the hospital, the infant suffered a seizure. He went stiff and his eyes rolled back in his head, Schuessler said.
After learning of the infant's condition, Gipfert arrived at the hospital and told Schuessler she didn't know what had happened, Schuessler said.
"She was upset," Schuessler said.
She also confirmed that Gipfert was crying upon her arrival at SRMC.
"It appeared to you that Nancy Gipfert was genuinely concerned about [the boy], isn't that true?" Miller asked.
Schuessler said that this was true
The infant was then flown to Denver via helicopter. He was on many medications when he first arrived home in Peetz weeks later, Schuessler said.
"He did an awful lot of sleeping," she said.
The boy is two years old now. He takes seizure medication, attends therapy twice a month and has continued weakness on one side, according to Schuessler. She denied that she'd ever dropped the infant, shook or slammed him or that he was ever in a car accident before the incident in September 2011.
On cross examination Schuessler admitted that she had a difficult time consoling the infant and that her daughter was sometimes frustrated when she encountered the same problem.
"Not only was he fussy when he was hungry but after he ate he also cried?" Miller asked.
Schuessler confirmed this. Miller then questioned Schuessler about whether or not the infant's older sister was allowed to hold him. Schuessler said she was, but only when she was sitting down and with supervision.
Dr. Calvin Cutright took the stand for the prosecution yesterday afternoon as well. Cutright is a veteran medical doctor who's worked at SRMC for the past 15 years.
On Sept. 13, 2011, Cutright responded to a call from the SRMC emergency room that an infant there had suffered a seizure.
"I found a nine-week-old infant who at the time was unresponsive," Cutright said.
The infant had a good heartbeat and respiration despite this.
He was postictal when Cutright arrived, which means that the patient had just come out of a seizure and was temporarily unresponsive. Nurses who witnessed the seizure told the doctor that it lasted between 45-60 seconds. He knew that doctors at SRMC were not prepared to deal with an infant this small so he called for a transport helicopter to take the child to Denver.
"We had not yet established a diagnosis at that point," Cutright said.
The child's eyes were rolling in his head and his pupils were a pinpoint, Cutright said. His fontanelle, or soft spot where a baby's skull isn't yet fused was bulging, which is caused by intracranial pressure, or pressure inside the skull, according to Cutright. He considered the possible causes for a seizure, which could include meningitis, trauma, infection, a tumor or concussion. He began antibiotics in case the cause was meningitis.
A CT scan was performed on the infant which showed that there was a bilateral subarachnoid hemorrhage and a subdural hematoma. A subarachnoid hemorrhage is bleeding in the area between the brain and the thin tissue that covers the brain and a subdural hematoma is a collection of blood on the brain, according to the National Library of Medicine. There was no indication of tumors or fractures present on the scan, Cutright said.
At this point the doctor's concentration turned from infection to trauma. He looked at the birth records, because difficulty with the birth process could cause a subdural hematoma.
The doctor did not see any retinal hemorrhaging, but is aware that doctors in Denver did find some. He was not surprised that he didn't find retinal hemorrhaging, because it's very hard to find on adults and even more difficult to see in children during an undilated exam, he said.
On cross examination Miller asked Cutright if it's always obvious to a lay person that a seizure is occurring in an infant. Cutright admitted that an infant could have a seizure that a non-medical person might not recognize. Cutright explained the possible causes of the infant's injuries.
"A subdural hematoma in an infant generally is caused by some blow or trauma to the head," Cutright said.
Falls or birth trauma could cause them as well, he added. Sometimes these injuries are not accompanied by any symptoms. Regular births with no complications could result in these hematomas on a fairly regular basis, Cutright said. Some of the indications of brain injury in an infant could be fussiness, not eating well and sleeping more than usual, he added.
Also testifying for the state was the helicopter paramedic that flew with the infant from Sidney to Denver. It was a normal air ambulance ride, she said. During the trip the infant was provided with an IV, oxygen and cardiac monitor. Before the ride the infant was awake, fussy and pale but fell asleep soon after take-off. The landing was soft and the infant suffered no seizures during the ride, she said.
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