Medical examiners disagree on case

By JENNIFER SICKING
Register Staff Writer

While two medical examiners agreed on the cause of 2-year-old Jorden Saager's death, they disagreed on the stand Tuesday in the 235th District Courtroom as to whether the child had been chronically sexually assaulted during her short life.

Jurors continued hearing evidence in the case in which Kim Stevens is on trial for allegedly murdering and causing injury to Saager, whom she was babysitting.

Dr. David Dolinak took the stand first for the prosecution, which is handled by Lisa Tanner, with the state's Attorney General office.

Dolinak, a forensic pathologist now working in Cleveland County, Ohio, previously worked at the Southwestern Institute of Forensic Sciences (Dallas County medical examiner's office) and performed the Saager's autopsy on Jan. 5, 2005.

Saager died Jan. 4, 2005, at Gainesville Memorial Hospital, where she was transported by Cooke County Emergency Medical Services from Dr. Mark Gibbs office on Grand Avenue. According to testimony, Stevens took the child to the doctor's office because she wasn't feeling well.

Dolinak read off a list of bruises he found externally on Jorden's eyes, arms, head, back and abdomen. Later, he would testify he saw a non-accidental pattern of injuries.

"They appear abusive to me," he said. He also testified the injuries were not consistent with the child falling forward on her face.

Under questioning by Tanner, he said, he also examined the girl's genitalia, which he does in every case.

"The external genitalia looked normally developed," he said. "I saw no external injuries."

When questioned further by Tanner, he said he saw no signs of sexual abuse.

Tanner then moved the questioning to what internal injuries he found when he began the autopsy. He said he found a four to five-inch fracture in the 2-year-old's skull.

He also testified Saager would have been immediately affected by it and it could have made her lose consciousness.

"I didn't see any healing attempts of the bone so I would say it was fairly recent," he said. He also added because there wasn't much inflammation in the brain tissue, it led him to think it was recent. Also the lack of bleeding on the surface of the brain showed him the brain didn't have time to react to the fracture.

In the young girl's abdomen, he said he removed a 1/2 liter of bowel contents that had escaped into the abdomen cavity. After he removed the fluid, he said he discovered two tears in the tissue around the small bowel. While that would have caused pain and irritation, Dolinak said it wouldn't have led to her death.

He listed the cause of death as the separation of the stomach from the duodenum -a small, C-shaped part of the small intestine linking it to the stomach. That separation, he testified, would lead to shock and sepsis.

"It was transected, completely torn in part," Dolinak testified about the internal injury.

He said a severe impact to the abdomen would have caused the tear. Later, Tanner would place on the floor a child-sized doll, which she would stomp and kick. Stevens' 11-year-old daughter, of whom she no longer has custody, testified Monday she saw her mother step on Jorden. The daughter's counselor also testified the child enacted stomping on and kicking a doll in the head during therapy and said she saw her mother do so.

Dolinak agreed those actions could have caused the injuries.

However, Dolinak said he could not pinpoint a time of when those injuries could have occurred.

"If I can pinpoint it to a precise time that can certainly help the investigation," he said. "Most commonly, I don't know when an injury was inflicted. We rely on the police investigation to tell us when the child was injured."

He said bowel injuries can be difficult to put into a time frame because people can react differently to them.

While Dolinak testified, Tanner entered autopsy photos, which she had the medical examiner explain to jurors.

Roger White, defense for Stevens, asked Dolinak under cross-examination if stomping would have been severe enough to injury Saager. Dolinak said it would depend upon what was used.

"A small heel would take less force than a flat surface like a tennis shoe," he said.

White then queried Dolinak if he was familiar with a book titled "Child Maltreatment," to which he said he wasn't. He then continued to question Dolinak about signs of sexual abuse.

It is the Register's policy not to publish graphic descriptions.

White also questioned Dolinak about a possible time frame for the injuries.

"I could just give an estimate," he said. He listed a range of time between eight to 12 hours up to 48 hours, but added it could have occurred outside of that time frame.

Under repeated questioning about the time frame from White, Dolinak replied, "I'd like to be able to tell you exactly when the injury occurred, but science doesn't allow that."

Branden Saager, 11, also testified Tuesday morning he saw Stevens throw his sister on a bed.

"She shut the door. I heard a smack and heard Jorden scream," he said. He said he didn't remember what Jorden did before being taken into a bedroom. After he heard his sister scream, he said he heard another smack and more screaming.

"I went and hid behind the house," he said. He added under questioning he didn't tell his parents because he was scared.

He also testified to seeing Stevens put Jorden's hand into an ostrich cage at the Frank Buck Zoo and seeing an ostrich peck her. On Monday, two of Stevens children testified to the same incident.

Under cross-examination by White, Branden testified Stevens did not baby-sit him very often. White also asked Branden, isn't it true there weren't any bedroom doors in Stevens' house, to which he replied no.

White also asked the boy if his parents told him bad things about Stevens and if he was angry with Stevens, to which he replied yes.

Former Gainesville resident Robbie Manthei proved to be the last witness for the prosecution when it rested shortly after noon.

Manthei said she and her now estranged husband rented a house to Stevens on Magnolia Street. During the renting process, Manthei said Stevens told her she was a pharmacist, which she said she later found to be untrue when she referred her for a job with a pharmacy in town.

On the day Jorden died, Manthei said Stevens telephoned and asked her to pick up her children because she had to take a girl she was babysitting to the doctor's office. Manthei said she picked up Stevens' two older children from school and later took Stevens' baby to her house as well.

She went to the house on Magnolia Street that night at Stevens' request after being told police officers were going to search the house for toxins.

Manthei said Stevens told her the baby died. However, Manthei said she had learned of that previously when her husband went to the hospital at her request and saw Stevens sitting in a police car.

"I had company and her children were fairly unruly," Manthei said.

Standing in the yard with Stevens, Manthei said the Stevens told her the baby had been sexually abused as well and the child had a concussion and a ruptured spleen.

"She said she took the baby to McDonald's and she (Saager) fell down and had a cut on her head and a scratch on her lip," Manthei said about the child's activities before the child's condition deteriorated. "She said the little girl walked to the car."

When questioned by White, Manthei said Stevens' bedroom, which had been the dining room, did not have doors, but other bedrooms in the house did.

In the afternoon, the defense began putting on its witnesses by first calling Dr. Roberto Bayardo, who is the chief medical examiner in Travis County, to the stand.

He testified he didn't think the skull fracture occurred on the day Jorden died, but possibly 24 hours before because blood adhered and stuck to the bone.

He also testified from examining the autopsy photos and various hospital documents he saw signs of chronic sexual abuse.

"It was something quite suspicious that would have to be investigated further," he said.

Under cross-examination, Tanner asked Bayardo if a witness saw the child with red, watery eyes and blue around the face if that would be indicative of something happened to the child.

"Yes, she was crying before," he replied.

When Tanner questioned him if people turned blue around the mouth when they cry, he replied his son did.

He also described the duodenum injury as like being kicked by a mule.

"Or being stomped on?" Tanner asked.

"No, more than that," he said.

Bayardo also put the injury occurring 12 to 18 hours before the child died. Tanner asked if she would then be acting normally 12 to 18 hours afterward.

"No, but children are resilient," he said.

She also questioned Bayardo about the alleged sexual abuse.

"You are aware all of this literature shows you should be very careful about a diagnosis of sexual abuse because there could be a lot of reasons," she asked.

"I would be derelict in my duties if I didn't do that (report the alleged abuse)," he replied.

The defense will continue with its witnesses at 9 a.m. today.