The prosecutor in the trial of a doctor charged with the manslaughter of her profoundly disabled daughter has said Bernadette Scully broke all the rules by giving her child too much sedative.
However, her defence lawyer said there is a clear indication in the autopsy of a possibility of a terminal seizure.
The barristers were giving their closing speeches yesterday in the 58-year-old’s trial at the Central Criminal Court.
The Offaly GP is charged with unlawfully killing 11-year-old Emily Barut, who was profoundly disabled, at their home at Emvale, Bachelor’s Walk, Tullamore.
It is alleged that Ms Scully killed Emily by an act of gross negligence involving the administration of an excessive quantity of chloral hydrate on Saturday, September 15, 2012. She has pleaded not guilty.
Emily had microcephaly, severe epilepsy and could not speak or move. She had been in pain for the last eight days of her life, having had a medical procedure to replace the tube into her stomach, through which she received fluids and medication.
Ms Scully said she had administered chloral hydrate when her daughter became upset at 2am and 6am that day. She said her daughter then had a massive fit after 11am and she administered more.
Tara Burns SC, prosecuting, noted that 10 times the therapeutic level of chloral hydrate’s metabolite was found in Emily’s system.
“My submission to you is that in itself establishes gross negligence,” she said.
She pointed out that the State pathologist, Marie Cassidy, had given the cause of death as chloral hydrate intoxication.
She said that, although Prof Cassidy agreed that Emily’s illnesses could have caused her death, she had not demurred from her opinion that the intoxication was a substantial cause.
“The law says the prosecution doesn’t have to prove it was the only cause,” she said.
Ms Burns noted that Ms Scully had a rule that she would not administer more than 15 ml of chloral hydrate in a 24-hour period and an absolute rule that she would never administer more than 20 ml. This was also the expert view of the safe levels, she said.
“But on the 15th of September, 2012, Ms Scully broke all those rules,” she said.
She said that, by 6am, Ms Scully had already exceeded her first rule, pointing to her account of having given 17ml by then.
She said her next absolute rule was well exceeded by 11am, when 34ml had been administered, according to Ms Scully’s own evidence.
Ms Burns also suggested that there was a question mark over what the accused said she administered. She said she was not suggesting that Ms Scully had lied, but said that she had been exhausted, emotional, and in a very fretful situation.
“I’m not sure how much. It was just pandemonium,” Ms Burns read from one of Ms Scully’s garda interviews.
Ms Burns described Ms Scully as a holy person, noting evidence of a Padre Pio medal and prayer said with Emily every night.
Ms Burns said that, in light of that knowledge and the dignity and respect she had wished for Emily, Ms Scully’s two suicide attempts after Emily’s death did not equate with a belief that she had died of natural causes.
Ms Burns asked the jury to look carefully at any suggestion that giving more chloral hydrate at 11am was the only thing she could do. She asked if it was not time to seek other medical help at 6am when the chloral hydrate was not working.
“I suggest that, if she had acted as a reasonable doctor with her knowledge and her experience, she wouldn’t have administered that much,” said Ms Burns.
“She was grossly negligent on the night, and I have to urge upon you to return a guilty verdict in this case.”
Emily was ‘minded like a little princess’ by a mother who did all she could
Kenneth Fogarty addressed the jury on behalf of Bernadette Scully.
He said that the only thing his client could use that morning was the medicine she had to hand.
“The only one ready, available, and that had worked previously was chloral hydrate,” he said.
He noted that his client had been standing by Emily, her own daughter, who was in a seizure the likes of which she’d never seen before.
He asked if the prosecution was alleging that she could either stick with what she’d already administered and let Emily scream it out or give other medications that had previously made her vomit, in which case she would aspirate and choke. If Emily’s fit continued, he said, she was going to die.
“In the human condition, people do make mistakes,” he said, giving an example of confusion about the number of adrenaline shots administered by medics trying to save Emily’s life.
“They’re trying to make the person’s life better. Anybody who has looked at somebody in pain, would you not, as a human being, do anything to solve that problem of pain?”
He also said it was beyond his understanding that eyewitness evidence of Emily suffering a colossal fit at around 11am was being ignored.
“There’s a clear indication in the post-mortem of a possibility of a terminal seizure,” he said. “But nobody investigates it.”
“Prof Cassidy said the underlying medical conditions could give rise to death at any time.”
Mr Fogarty also noted that tests had found toxic levels of the drug in Emily’s system.
“Toxic does not mean fatal,” he said.
He noted that the experts had all found that Emily had been cared for extremely well during her life. Witnesses had noticed how well her hair, nails, and teeth were looked after.
“She was minded like a little princess,” he said.
He mentioned that Ms Scully, who the trial heard had burnout, had sought help; she had called her professional body and gone to a psychiatrist but had not got the help she needed.
“She’d gone beyond crying for help,” he said.
“My friend says she was a holy woman,” he said of prosecutor Tara Burns. “I don’t know what people who don’t believe in God have to say. But you can’t look after a child like Emily without believing that there’s a God and if He’s there I suggest to you, it’s not lost on Him when somebody decides ‘I can’t go on without her’.”
He said Ms Scully’s attempt to take her own life was not a recognition that she did something wrong. “That means you’re at the end of your tether,” he said.
He told the jurors they would probably have the hardest job that had ever been done by a jury.
“I’d say there isn’t a person in the country that would envy the position you’re in,” he said. “I guarantee you this, you’ll never come across a case like this again. The emotional roller coaster we went through as a group is nothing compared to the position that Bernadette Scully finds herself in. You don’t have to be a genius to work out that she’s an incredible woman.
“It’s not just my privilege to represent her.
“But it’s an eye-opener in a country like this that you can get somebody who goes to the extraordinary lengths to look after a child and when the child passes away, the instantaneous response is: ‘You killed her.’
“I believe, in the coverage that this case has got, that maybe there’ll be a debate, depending on your decision.
“I believe it will be the right decision but it’s just a pity it’ll just be down to one word or two.”
He asked for a verdict of not guilty.
Mr Justice Patrick McCarthy has now begun charging the jury of seven women and five men and will continue his charge this morning.
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