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Expert says Lola’s eye injuries suggest abusive head trauma

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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.

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Police ask motorists to avoid A44 trunk road due to heavy snowfall

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DYFED-POWYS POLICE have issued an appeal to motorists to avoid a 25 mile section of the A44 trunk road between Aberystwyth and Llangurig due to it being impassable due to heavy snowfall.

In a warning issued at 4am on their social media accounts the police said: “Please avoid the area and find alternative routes for your journey.”

Meanwhile, last night The Nags Head in Lampeter uploaded pictures of the snowy scenes in the area, and were encouraging customers to come in and sit next to their ‘nice warm fire’.

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Egg and farm shop to open at award-winning west Wales farm

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A SCHEME for a self-serve egg and farm shop at an award-winning 32,000-chicken Ceredigion farm, to allow it to receive a UK Shared Prosperity fund grant, has been approved by county planners.

Ben Edkins, of Edkins Eggs, Coed Farm, Cilcennin sought permission to site a self-serve farm shop on an existing yard area at the site.

A supporting letter submitted through agent Morgan & Flynn Architectural Services described it as “a more advanced version of an egg stand, with honesty box, which has been a staple for people producing eggs for centuries”.

It added: “This method of selling eggs has already proven to be a hit with communities in Ceredigion, given the success of the already established egg dispenser located in Aberystwyth town centre.”

Family-owned Edkins Eggs, which supplies multiple businesses across the area with eggs, including Aberaeron’s Y Seler, Hive, Harbourmaster, and Costcutters, has been awarded a grant to cover the cost of part of the proposal, on the condition that planning approval is granted, the statement added.

“The grant, which is a UK shared prosperity fund for the Mid Wales region as part of the ‘Cynnal Y Cardi Fund’ provided by Ceredigion County Council was granted in December 2023.

“For this grant to be claimed, it is required that planning permission is granted, the construction is completed and also the egg dispensers are implemented by December 2024. This gives the applicants a 12-month window from the point of the grant awarded to completion of proposal.”
The building itself will include a solar panel array providing the power for the egg dispensing unit and lighting, and it is hoped to create one extra job at 227-acre Coed Farm, home to 32,000 chickens producing free range eggs, 90 beef cattle and 200 sheep.

A green infrastructure statement by the agent added: “The creation of this building to house the self-serve farm shop to enhance the established family-owned business ‘Edkins Eggs’, which also has provisions to allow for other local companies producing items such as vegetables and honey to sell their products, will provide a facility for the local community to purchase locally produced goods directly from the supplier.

“This will not only provide an enhanced shopping experience in terms of being able to purchase directly from the farm, which could act as an educational benefit especially for children, but also provide the additional facility of a small-scale shop to the local area, whereas currently the community would either have to travel to the service centres of either Aberaeron or Felinfach.”

The application was conditionally approved under delegated powers.

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Entertainment

John Singer Sargent’s ‘Fashion & Swagger’ to light up the Torch

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IN an unparalleled celebration of one of the late 19th century’s most revered portrait artists, the Torch Theatre is set to host “John Singer Sargent – Fashion & Swagger” on Tuesday, 16 April, at 7:30 pm. This innovative exhibition, brought to life by Exhibition on Screen, delves into the remarkable artistry of John Singer Sargent, whose portraits are celebrated for their intricate depiction of his subjects’ persona, attire, and the subtleties of their presentation.

The event promises an insightful exploration of Sargent’s influence on modern art, culture, and fashion, featuring interviews with a diverse group of curators, contemporary fashion icons, and style influencers. Filmed at prestigious venues like the Museum of Fine Arts in Boston and Tate Britain in London, the exhibition unveils Sargent’s extraordinary ability to capture the essence of his subjects’ identities, social standings, and the complexities of gender through his art during a pivotal time of cultural transformation.

Phil Grabsky, one of the producers behind this compelling film, shared his enthusiasm for spotlighting Sargent’s genius, stating, “As filmmakers, both director David Bickerstaff and I have been thrilled to make this film about Sargent, someone I consider a truly astounding artist.” Grabsky further reflected on the curious case of Sargent’s fading recognition despite his once-celebrated status and affirmed Exhibition on Screen’s commitment to revitalizing interest in artists who deserve renewed attention.

The exhibition promises a fascinating juxtaposition of over 50 of Sargent’s paintings with authentic items of clothing and accessories donned by his subjects, offering audiences a unique passage into the artist’s creative realm. It underscores how Sargent’s subjects, often hailing from affluent backgrounds, entrusted him with their public images — a theme that resonates with the ongoing dialogue around the construction of identity in the public eye.

Tickets for “John Singer Sargent – Fashion & Swagger” are available for £13. Those interested can secure their spots by visiting www.torchtheatre.co.uk or contacting the Box Office at 01646 695267.

For further details and imagery, or to arrange press inquiries, please reach out to Anwen Francis (Marketing, Press & Communications) via email at [email protected] or phone at 07854 772640.

ENDS

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