A profoundly disabled teenage girl allegedly killed by her grandparents had suffered severe internal injuries, a court heard last Friday.
Rebecca McKeown's nappy was found to be “covered in blood” after she was collected from the home of the two accused, according to a medical report.
David Johnston (87) and his wife Sarah Johnston (84) have each been charged with manslaughter and cruelty towards the 14-year-old, who died in March 2001.
The couple, of Carwood Drive, Glengormley, Co Antrim, deny causing any harm to their grandchild.
A post-mortem revealed that Rebecca, who was born blind and unable to speak, died from shock and extreme blood loss.
During a hearing to decide if the Johnstons should stand trial for the alleged offences, Belfast Magistrates Court heard Rebecca had been taken to their home days before she died.
When she was collected a round, red mark was noticed on the cushion of a settee she had been on, it was claimed.
A forensic medical report recorded how Rebecca's mother later changed her nappy and discovered it was “covered in blood, with a very big clot”.
The child was medically examined and taken to the Royal Belfast Hospital for Sick Children after her condition deteriorated, but subsequently died.
Dr Deborah Rogers, who compiled reports on the case, told the court Rebecca's injury would have been painful when caused.
She said she was unable to determinate precisely what caused the injury, but she suggested several possibilities.
Dr Rogers said the injury was consistent with having been caused within a few hours of the child being admitted to hospital, but was unable to give a precise time.
During cross-examination by James Gallagher QC, for David Johnston, she agreed that the medical evidence provided no definite answer as to how the injury was caused.
The pair are jointly accused of unlawfully killing Rebecca and with having “willfully ill-treated, neglected or exposed Rebecca McKeown in a manner likely to cause her unnecessary suffering or injury to health”.
The case continues.