Belfast Telegraph

Judge halts inquest into young girl's salt death because 'an offence may have been committed'

By Paul Higgins

An inquest into how a four-year-old died from salt poisoning has been dramatically halted after a judge said he "felt an offence may have been committed".

Coroner Jim Kitson said he was "duty bound" to stop the inquest into how Filipino girl Lindsey Angela Alvarez died and that as a result of the evidence he had heard this week, he will be filing a report to the PPS.

Yesterday's decision came after he heard a doctor's evidence that Lindsey must have been "forced" to ingest more than seven- and-a -half teaspoons of salt.

Giving evidence at the inquest into the death of Lindsey in August 2009, sodium expert and consultant paediatric pathologist Dr Duncan Coulthard described how the little girl had "extremely high sodium levels in her blood" when she was admitted to the Ulster Hospital.

"The only mechanism I believe that could have caused that was by ingesting an excess of salt and the only mechanism I can postulate was that that was forced upon her," declared Dr Coulthard.

He told Coroner's lawyer David Sharpe: "I cannot accept the possibility that she took this voluntarily."

Severely autistic Lindsey was rushed to the Ulster Hospital suffering from breathing difficulties, vomiting and diarrhoea on July 29, 2009 before being transferred to the intensive care unit at the Children's Hospital where she died from hyponatraemia as a result of salt poisoning on August 4.

The inquest being conducted by Coroner Jim Kitson has already heard evidence that on the day she fell ill, Lindsey was being looked after by her uncle Michael Valderama at his flat at Ardara Mews in Dundonald after her mother Amelda Alvarez and aunt Mylin Valderama went to work at the nearby Ulster Hospital, where they were nurses.

All three adults have denied giving the little girl either salt or a salty drink.

The court also heard evidence from pathologist Dr Peter Ingram that when he examined Lindsey's body, he found multiple rib fractures and fingertip-type bruises at the back of her neck, as though she had been firmly grasped. He also found bruising to her chest, arm and abdomen consistent with being "poked" by a finger.

There has also been evidence that Michael Valderama told police that Lindsey's father Angelito, also known as Jojo and who has returned to the Philippines, beat both his only daughter and his wife.

On July 29 the first call to emergency services came at 1.55pm and yesterday Dr Duncan said that the salt in Lindsey's system was given to her within four hours of that call. Coulthard told Mr Sharpe that he and another professor had searched through the literature worldwide into salt poisoning and did not find any cases of salt being ingested voluntarily by a child.

A normal sodium plasma level is around 140 but Lindsey's level was measured at 180, the court heard. Dr Coulthard commented that that was "unbelievably high".

"I think people need to understand that this isn't just a bit high," said the doctor, adding that even with the "excellent care" Lindsey received in the Ulster, her chances of survival were still only 50/50.

The inquest has also heard evidence that Lindsey sustained eight fractured ribs when she fell down the stairs at her uncle's flat a week before she fell ill and that in 2005, when she was around 14 months old, she was put on the child protection list when she suffered a broken ankle.

Bone expert Professor Archibald Malcolm said the rib fractures were consistent with her having fallen down the stairs around two weeks before she died.

However the previous witness, consultant paediatrician Dr Dewi Evans, said they were equally consistent with "deliberate impact trauma" such as her having "been thrown down the stairs".

He said that despite her autism, which caused massive communication problems and left her with a very "blank expressionless face", Lindsey would still have had "self preservation". As such, he would have expected to have found other injuries such as a broken wrist from the fall so "concerns regarding these injuries remains."

Dr Evans added, however, that given the evidence of bruises to her arms, neck and abdomen, while the fractures were "worrying," he could not rule out that the fall was an accident or that "there was more to it than that".

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