'Murdered' toddler had older brain injuries - court

A toddler allegedly murdered by his grandparents arrived at hospital in a coma with evidence of older brain bleeds, a court has heard.

Ethan Ives-Griffiths, two, died from a catastrophic head injury in August 2021.

His grandparents, Michael Ives, 47, and Kerry Ives, 46, both of Garden City, Flintshire, are charged with murder, causing or allowing the death of a child and cruelty to a child.

Ethan's mother, Shannon Ives, 28, of Mold, is charged with causing or allowing the death of a child and cruelty to a child. All three deny the charges.

Ethan was taken from his grandparents' home to Countess of Chester Hospital on 14 August, 2021.

Consultant paediatric neurosurgeon Dr Jayaratnam Jayamohan was asked to investigate Ethan's brain injury following his death.

Giving evidence via videolink, Dr Jayamohan said there was evidence Ethan had suffered "repeated assaults... over a prolonged period of time".

"He has more than a head injury... he's surrounded by an environment that causes him to be withdrawn," he said, referring to video footage he had reviewed.

He said Ethan showed signs of decerebrate posturing, which can indicate a brain injury.

Using a scale to measure comas, where 15 is normal and three is the lowest, Ethan scored seven and was "officially counted as in a coma".

He added that the toddler had "poor breathing and irregular heart rhythm... now we have lots of different things telling us his brain is at the centre of this".

"He was anaemic... this reflects in part the fact that he was bleeding into his head," Dr Jayamohan added.

Ethan was then taken to Alder Hey Children's Hospital in Liverpool, where "multiple areas of bruises" were noted on his body.

A plan was made to operate, to try and remove blood and fluid on the right side of his brain but the doctor itted this was "very hopeful" and he was "probably going to die".

"Sadly everything was stacked against him by this point."

Later, a decision was made that further surgery was pointless and Ethan was pronounced dead on 16 August.

Dr Jayamohan said there were potentially two mechanisms which could have been involved - "physical " or being "shaken vigorously".

"It could be a fist, it could be a hand or a knee or it could be a thing," he said.

Analysing a CT scan for the jury, Dr Jayamohan said there were "clear abnormalities" within Ethan's skull, adding that "the whole half of the brain is very, very swollen".

The "very scary" CT scan showed fresh and older blood, some of it "weeks old," the jury heard.

Dr Jayamohan said another doctor analysed the findings and concluded the fresh blood was less than two days old, which was "confirmatory evidence we've got at least two ages of bleeding in there".

The court heard of a previous incident when Ethan was taken out of a Moses basket and dropped by a sibling.

During cross-examination, Dr Jayamohan agreed a re-bleed of an old injury could occur as a result of activity on the trampoline. He also agreed that multiple re-bleeds could increase pressure in the brain.

He added the older blood could be older than 10 weeks.

Asked whether being thrown into a Moses basket could cause injury, he said yes.

But he added Ethan's collapse on 14 August would not have been caused by complications relating to an old bleed.

The trial continues.