News

Expert says Lola’s eye injuries suggest abusive head trauma

Published

3 years ago

March 10, 2023

LOLA’S eye injuries are indicative of abusive head trauma, the first medical expert to take to the witness stand told Swansea Crown Court on Friday (Mar 10).

Dr Ian Simmons, Consultant paediatric ophthalmologist gave his opinion on the findings in his report into the retina injuries sustained by the toddler.

Dr Simmons has been an expert in the field since 1999 and has contributed to major studies and literature looking into retinal findings in non-abusive head trauma and abusive head trauma.

Including reviewing and contributing to a review into differential retinal injuries in abusive vs non-abusive head traumas in September 2020.

Swansea Crown Court heard how Lola had multiple haemorrhages in both her right and left eye, which also was evident in all four quadrants; during medical examinations, eyes are split into quarters and referred to as quadrants to locate any significant anomaly.

The injuries were detected through a range of diagnostic methods, including visual, 2d scans, retcams (3d) and the findings during the course of a post-mortem.

These included two large macular haemorrhages to the right eye which were present in all four quadrants, along with multiple other haemorrhages, noted there were too numerous to count.

The court heard how Lola’s left eye had a massive dic haemorrages along with others in all four quardants and macular changes due to retinal splitting. There was also bleeding to the oribital and optical nerve in both eyes.

Dr Simmons went on to say how bi-lateral retinal heamoraghes; those affecting both eyes, are highly indicative of an abusive head trauma as opposed to accidental.

He went on to say that injuries of the retina, such as those sustained by Lola are usually present in children who have sustained a very significant crush injury or a fall from a height such as a house window.

The court heard how the presence of macular folds is more prevalent in an abusive head trauma injury by the tenfold.

Dr Simmons confirmed that before compile his expert opinion report he was privy to reports from all medical professionals who treated Lola, including reports and scans, the autopsy report, police statements and photographs of the family home namely the stairs the defence claim Lola fell down.

The court heard that Dr Simmons bore no knowledge of a child presenting with optical nerve sheath haemorrhages in both eyes ever being presented in an accidental head trauma.

The court heard how Dr Simmons had gone through an extensive exclusion procedure and ruled out any underlying diseases, or anything within the statements from the police that would suggest anything other than abusive head trauma would cause the injuries.

Bevan’s Barrister, John Hipkins KC brought to the court’s attention a case study from 2013, by Dr Adams, another paediatric ophthalmologist, in which a child had a fatal fall down 10 steps, with multiple impacts and noted that the injuries received by that child were similar to that of Lola’s.

He explained that this was a witnessed accidental fall and the injuries were received as a result of accidental head trauma.

Dr Simmons went on to clarify that although those injuries bore a ‘striking resemblance’ to this case, that child did not present with peri-macular folding and sheath haemorrhages that Lola did, and those indicate it is more likely in this case as a result of an abusive head trauma.

In his report Dr Simmons said: “With a combination of extensive bilateral retinal bleeding in all four quadrants affecting multiple layers in both eyes with possible retinal splitting along with evidence of left per-macular retinal fold and presence of bilateral optic nerve sheath haemorrhages, that combination pointed towards abusive head trauma rather than an accidental fall down the stairs.

“Highly unlikely the above combination would have been caused by falling down 10 carpeted stairs.”

Dr Simmons suggested that based on the other injuries Lola had and reading the medical reports it points towards abusive head injury from that such as violent shaking with a possible form of impact.

John Hipkin KC, went on to question Dr Simmon on the language used in his report stating it was all based on medical science which meant they were left to deal with “likelihoods instead of certainties”.

Dr Simmons explained that medical science is not definitive, but certain retinal injuries are highly suggestive towards abusive head trauma based on medical evidence from data collection.

Mr Hipkin KC went on to ask if Dr Simmon had been given Bevan’s statement of his account of the accident, which he confirmed was received and had used that evidence to make his conclusion.

Suggesting that shaking could have been part of Bevans attempts to wake the tot.

However Mr Hipkin went on to say that Bevan’s statement was not included on Dr Simmons summary of evidence documents used to support his claims.

Dr Simmons could not recall whether he had simply forgotten to include them or whether they were together with another set of reports in a bundle which is included on the summary of evidence on the report.

James’ Barrister Mr Elias did not cross examine the witness.

The next medical expert witness is due to take the stand on Monday.

The case was adjourned and will continue on Monday, March 13 at 10am.

Charity

Toy Story fans fill charity toy box at Haverfordwest cinema

Published

1 hour ago

June 20, 2026

Tom Sinclair

Donations pour in for SNAP Specialist Play as families embrace Toy Story 5 launch

A TOY STORY-themed charity appeal at a Haverfordwest cinema has got off to a flying start, with families donating toys to support children with additional needs across Pembrokeshire.

The Palace Cinema has teamed up with local charity SNAP Specialist Play to collect new and pre-loved toys during screenings of the newly released Toy Story 5.

The appeal centres around an “Andy’s Toys” donation box, inspired by the beloved Pixar films, which has already been filled by generous filmgoers.

***Toy Story magic: The Palace Cinema foyer has been transformed with themed decorations to celebrate the film’s release***

Cinema manager Hannah Cramp said the response from the community had exceeded expectations.

Families attending opening screenings have arrived carrying bags of toys, with many children keen to share their own treasured items to help others.

The cinema has transformed its foyer into a colourful Toy Story-themed experience, complete with hand-painted decorations, character silhouettes, bunting and famous film slogans including “Reach for the Sky” and “To Infinity and Beyond”.

Many visitors have also embraced the spirit of the occasion by attending in costume as their favourite Toy Story characters.

***Specialist support: SNAP’s sensory facilities help children with additional needs learn and develop through play***

The toys are being donated to SNAP Specialist Play, a charity based within the Child Health Department at Withybush Hospital.

SNAP supports pre-school children with additional and complex needs through specialist play sessions designed to encourage communication, physical development and sensory learning.

Its facilities include sensory rooms, therapeutic play spaces and bespoke equipment used by speech and language therapists, occupational therapists and physiotherapists.

Project manager Cindy Jenkins said the charity was delighted by the partnership and grateful for the generosity shown by local families.

She said every toy donated would be put to good use, either during specialist play sessions, at family events, or through seasonal initiatives such as Christmas gift boxes for children and their siblings.

The appeal will continue until mid-July, with organisers hopeful that even more donations will be received over the coming weeks.

Anyone attending Toy Story 5 at the Palace Cinema is invited to bring along a new or good-quality pre-loved toy to support the appeal.

Cover photo:

Fancy dress fun: Palace Cinema manager Hannah Cramp helping launch the Toy Story charity appeal.

Health

Medicine shortages now ‘most severe on record’, health leaders warn

Published

1 hour ago

June 20, 2026

Tom Sinclair

PATIENTS are facing some of the worst medicine shortages ever seen in the UK, with pharmacists warning the situation now poses a serious risk to safety.

The National Pharmacy Association said shortages affecting commonly used medicines are becoming more frequent, lasting longer, and causing increasing disruption for patients, GP surgeries and pharmacies.

The warning comes as Serious Shortage Protocols for Creon, used by people with pancreatic cancer and cystic fibrosis to help digest food, have been in place since May 2024 and have now been extended until July 10, 2026.

HRT treatment Estradot has also been under a Serious Shortage Protocol since December 2024, with the current extension also running until July 10.

Patients travelling between pharmacies

A survey by the National Pharmacy Association found that 98 per cent of pharmacies had encountered patients who had visited several pharmacies in one day to find a prescription.

It also found that 96 per cent of pharmacies believed the current situation posed a serious risk to patient safety, while 89 per cent said they had been unable to dispense a medicine at least once a day because of supply problems.

Some pharmacy teams have also faced anger and abuse from patients unable to obtain medication.

Olivier Picard, Chair of the National Pharmacy Association, said: “Medicine shortages are becoming more frequent, lasting longer and causing increasing disruption for patients.

“These shortages are some of most severe the UK has experienced.

“It is deeply distressing to find patients who have travelled from pharmacy to pharmacy to find the medicines they need without success.”

Calls for urgent taskforce

The NPA is calling on the government to convene an emergency taskforce involving manufacturers, wholesalers, clinicians and pharmacists.

It also wants changes to rules which currently stop pharmacists from making simple substitutions, such as changing a tablet to a capsule or a cream to an ointment, even where a safe alternative is available.

Professor Victoria Tzortziou Brown, President of the Royal College of GPs, said medicine shortages were frustrating for patients, GPs and pharmacists, and added pressure to already stretched services.

She said the College supported pharmacists being able to make limited changes to prescriptions where a medicine is unavailable and a safe alternative exists.

She added: “The most important thing is that patients are able to access the medication they need safely and without delay.”

The Cystic Fibrosis Trust and Pancreatic Cancer UK have also raised concerns about the impact of shortages of pancreatic enzyme replacement therapy, including Creon, on people who rely on the medication to digest food, maintain weight and stay well enough for treatment.