Swansea baby was 'thriving' on the day she died, murder jury told
A baby poisoned with an adult painkiller was "thriving" when seen by health visitor on the day she died, a jury has heard.
Toxicologist Dr Stephen Morley told the trial 42-day-old Amy Smith could have been drugged just minutes before the health visitor called in Swansea.
Her mother Michelle Smith, 34, denies murder in 2007.
She also denies causing or allowing the death of a child. The Swansea Crown Court trial continues.
Two-and-a-half hours after the health visitor saw her, paramedics were forced to give up resuscitating the baby, the court was told.
A post-mortem examination found the pain killer dihydrocodeine (DHC) in Amy's blood, Swansea Crown Court was told.
Dr Stephen Morley said she might have been drugged just minutes before the health visitor saw her.
The drug was also found in Amy's urine more than a fortnight before her death when she was rushed to hospital with breathing problems.
When tests found the opiate in the baby's urine the sample had been sent to a specialist lab for further testing but the results were never passed on.
A health visitor on the day of Amy's death recorded her as being "immaculate" and "thriving" at 11.50am, the jury heard.
Her mother told police she bottle-fed Amy after the visit and took her up to bed at 1pm. She said she found her daughter dying one hour later.
"It appears that Amy Smith was well and caused no concern to the health visitor at 11.50am, but was found collapsed two-and-a-half hours later," Dr Morley told the court.
"Therefore, the history suggests that the dihydrocodeine had been administered either after the health visitor has left or just before the health visitor has arrived.
"It may have taken some time for the effects of the dihydrocodeine to manifest itself."
He said if the drug had been given to Amy some time before the visit the effects would have been visible.
"I would have expected there to have been drowsiness. I would have expected her to be drowsy and floppy when the health visitor was present," he said.
Earlier he ruled out that finding DHC in Amy's blood was the same dose previously found in her urine weeks before.
"That is almost impossible as far as I am concerned. It is my opinion that there had been two separate administrations of dihydrocodeine."
He stressed that because the drug is never given to babies no clinical tests exist to show how long DHC takes to work through the system.
But in adults DHC would still test positive for three days after having been taken.
Dr Morley said the drug can cause people to become "unconscious and go into a coma".
"It may cause drowsiness and it may cause sickness."
He said that in the case of Amy "there has been a history of blue lips and that is a sign of poor breathing and that can be due to a slow breathing rate or a very shallow breathing rate.
"There was a history of floppiness and drowsiness which is consistent with DHC toxicity," he added.
Sasha Wass QC, defending, later questioned Dr Morley, pointing out: "As far as the cause of death is concerned you have not given evidence that Amy died of dihydrocodeine."
Mrs Wass added that all he could say was that "Amy had this drug in her system. This drug may cause these effects and these effects may have caused her to die."
Dr Morley: "I am saying that dihydrocodeine contributed to the death. From the evidence that I have seen there has been no other mechanism of death discovered."
Mrs Wass also suggested that sudden infant death syndrome (SIDS) could theoretically also explain Amy's death.
She said that could be another explanation of the death since it was not known what part DHC played.
Dr Morley said that that was "speculating" SIDS was responsible which was only possible if the evidence of HDC was discounted.
The trial has already heard that a crucial test more than two weeks before Amy's death found dihydrocodiene in her system.
The court heard the potentially life-saving information was never passed to her doctors and the baby girl lived to suffer at least one more dose.
The painkiller is rarely used on children and never on a baby.
Ms Smith denies the charge of murder and an alternative charge of causing or allowing the death of the child.