Murder trial: Pediatrician says baby's head trauma like that caused by car wreck

Three doctors testified Tuesday in the murder trial of Shane Eric Hinkson, a former Fort Benning soldier charged with fatally injuring his 8-month-old son on Jan. 1, 2012.

Two of the physicians were involved in treating infant Alexander Cabanayan, either here at Columbus’ St. Francis Hospital or at the Scottish Rite children’s hospital in Atlanta, and the third performed the autopsy after the infant died in Atlanta on Jan. 6, 2012.

All said the baby died from abusive head trauma resulting from his being violently shaken or slammed down on a bed or other soft surface, the infant’s brain having been smashed against the inside of his skull, causing swelling and internal bleeding.

After Hinkson called his then-fiance at work at 1:55 p.m. on New Year’s Day 2012 to tell her “something bad had happened” and she needed to come to his Antietam Drive apartment to get their son, she rushed the baby to the emergency room at St. Francis, where records show she arrived at 2:55 p.m.

Emergency room Dr. Mark Anders testified the hospital was not equipped or staffed to handle pediatric neurosurgery, which a CT or commonly called “cat scan” showed the boy needed.

“We’re not a pediatric facility,” Anders said. Such patients in Columbus first should go to the Midtown Medical Center, a level-2 trauma center, after which they may be transferred to a level-1 trauma center in Atlanta, the doctor said.

The protocol at St. Francis when presented so severe a head injury is to stabilize the patient while arranging transport to Atlanta, he said.

Anders said the baby’s first exam showed a “droopy right eye” and two small bruises under his chin. His CT scan showed so much swelling in the right side of the brain that it pressed into the skull’s left side, the doctor said.

“For an 8-month-old infant, that’s a lot of swelling,” he said.

Anders got a grilling from defense attorney David Wolfe, who in his opening statement told jurors the baby likely died as a result of his treatment at St. Francis.

Wolfe particularly hammered on the child’s intubation, the insertion of a tube through the mouth to the trachea to feed oxygen to the lungs, a procedure to ensure the brain gets sufficient oxygen.

Records show the boy was intubated about 4:10 p.m., but the tube was inserted so deeply that its placement was not optimal, so it was pulled back 1.5 centimeters, as hospital workers awaited a level-1 trauma team to come by helicopter from Atlanta.

When that crew arrived about 5 p.m., it found the baby in much worse shape, reporting he was lying on his side instead of his back and had vomited. The team had to clear his airway and reinsert the tube.

Around 5:15 p.m., the baby went into cardiac arrest, as the trauma team found he had no heart rate and his pupils were fixed and dilated. He was given adrenaline and cardiopulmonary resuscitation. At 5:24 p.m., his pulse returned.

But an X-ray showed the intubation still was not optimal: The tube was only in the child’s right lung, not his left, though Anders said the baby could have received enough air through one lung.

That night the child was flown to Atlanta. The next day Dr. Stephen Messner, a specialist in child abuse pediatrics, was called in.

Messner testified a CT scan that day showed the baby had a stroke in the right side of his brain, though surgeons had removed a patch of his skull to relieve pressure from the swelling. Another CT scan the following Jan. 5 showed no improvement.

The head trauma was so severe it resembled injuries from a car crash, Messner said: “This isn’t something an 8-month-old would self-inflict,” he said.

Wolfe pressed Messner on whether the baby should have had bruising on his arms, were he so violently shaken by someone holding him up. “Not necessarily,” Messner replied, and repeated that when asked whether being slammed down on a bed would leave bruises.

Though the baby had bleeding in the veins beneath his skull, that did not cause the extreme swelling, which resulted from injury to the brain tissue, Messner said.

Under questioning from prosecutor William Hocutt IV, Messner said the baby likely would have died even had he gone directly to a level-1 trauma center for surgery.

“With that head CT, it would be very likely to be the same outcome,” the pediatrician said of the baby’s first brain scan at St. Francis.

After the child died Jan. 6, 2012, Dr. Keith Lehman, a forensic pathologist with the Georgia Bureau of Investigation, conducted the autopsy the following Jan. 9.

He found the boy’s brain soft, swollen and bloody. The infant had bled from the retina behind his eyes and from his optic nerve, Lehman said. “He died as a result of abusive head injury,” Lehman testified, like Messner saying the boy’s first brain scan showed lethal damage.

Hinkson’s trial resumes this morning at 10 in Judge Frank Jordan Jr.’s Government Center courtroom.

This story was originally published July 21, 2015 at 6:21 PM with the headline "Murder trial: Pediatrician says baby's head trauma like that caused by car wreck."