Coroner's jury finds babysitter responsible for toddler's death

UPDATE:
A coroner's jury today found that babysitter Alicia Stepp caused the death of Ginny Rose Hughes, saying the child died as a result of "extreme indifference to life."

The inquest had begun today with the playing of 911 tapes and a host of doctors testifying about the child's unexplained ailments.

Doctors from Medical University Hospital testified that they were concerned that child abuse played a role in Ginny's April 30 trip to the emergency room for seizures and a stroke.

Among other things, doctors noted unexplained bruising, bleeding on her brain and hemorrhaging on her eyes. Her head was also larger than normal, though she had not been born that way, they said.

The hospital's social worker also discovered some history of drug use and domestic violence in her home, Dr. Mia Amaya said in videotaped testimony.

Doctors notified the state Department of Social Services, who removed Ginny and her two siblings from the home. But medical teams, despite their suspicions, could never find conclusive explanations for her ailments or definitive proof that abuse had played a role, Amaya said.

Back home on July 2, Ginny returned to the hospital after her babysitter found her unresponsive in bed. She died on July 4 after doctors declared her brain dead.

An autopsy noted signs of bloody fluid on the brain and signs that oxygen to her brain had been cut off, but no further explanations as to what had caused this to happen.

Charleston County Coroner Rae Wooten said she hopes to unravel these mysteries though today's inquest, determine the manner of Ginny's death and whether someone should be held responsible.

A six-member panel of jurors will heard additional testimony in the afternoon and deliberated until about 9:30 p.m. before arriving at a conclusion.

Ginny was born with a defect that left her without feet, but she managed to get around by crawling on her knees. Other than her birth defect, “she was a healthy normal 2-year-old,” her pediatrician, Dr. Mary Kate Tillman, testified. Ginny checked out fine during a wellness visit in March, but she returned in late April with strep throat, Tillman said. The doctor noted bruising on the toddler's nose and forehead, but it seemed consistent with her mother's explanation that she had fallen off a couch, she said.

Soon after, however, Ginny was hospitalized after suffering a seizure at home.

“The left side of her body is twitching,” her mother, Amanda Montagu, told an emergency dispatcher on a 911 tape played for the jury. “I have no idea what is going on.”

Doctors discovered that a stroke had affected the right side of Ginny's brain. She spent nearly three weeks at Medical University Hospital as specialists ran batteries of tests, but doctors could not come to an agreement as to what had caused the ailments, Amaya testified.

Though some signs pointed toward abuse, doctors found no evidence of broken bones or internal injuries, and a specialist who examined her eye hemorrhages noted that they didn't look like those normally seen in abuse cases.

“Unfortunately, we couldn't put it all together and say there was definitive evidence of child abuse,” Amaya said.

Social workers were called in and Ginny was placed in a foster home. But without any proof of abuse, she was returned to her Brossy Circle home in early June.

Stepp, Ginny's 17-year-old live-in babysitter, testified that she returned home at 5:30 a.m. on July 2 after a night out but was up and ready to care for Ginny and her siblings when Montagu left for work.

After breakfast and playing with toys, Ginny, who was sleepy, went to bed to take a nap, Stepp said. Stepp told the jury she went to check on Ginny a short time later, ran her fingers through Ginny's hair and called her name, but the toddler just lay there.

“That's when I knew something was wrong,” she said. “I realized she wasn't breathing and I couldn't hear her heartbeat when I checked.”

The jury heard a 911 call Stepp placed for help, speaking in a calm voice but telling dispatchers she was “freaking out” over Ginny's condition. Dispatchers walked her through the steps to perform CPR as paramedics rushed to the scene.

Emergency crews initially detected no pulse but got her heart beating again in the ambulance. Paramedics also noted bruising on her face and what appeared to be bite marks on the toddler's arm.

Images of Ginny's brain showed a complete stroke throughout the brain, leading to massive death of brain tissue. “It's a very ominous finding and represents a patient that is not going to recover,” Dr. Donna Roberts told the jury.

Roberts, who had examined earlier scans after Ginny's April admission, said the damage was more extensive and brought on by a trauma likely caused within 24 hours of the brain imaging.

Ginny died two days after arrival at the hospital. An autopsy determined that oxygen to the brain had been cut off and there was bloody fluid on her brain, but it couldn't pinpoint exactly what caused those things to happen, Dr. Lee Marie Tormos, a pathologist, testified.

Ginny's head started growing larger than normal somewhere between four and nine months, possibly due to trauma or infection, but the exact cause is unknown, Tormos said.

Tormos said she also found bruising on the body and a fading bite mark that appeared to have been made by a child. She also noted two parallel bruises that ran along Ginny's lower back, injuries that were not consistent with a fall and unusual for a child to receive, she said.

Those bruises might have been inflicted by someone, but they were not lethal wounds, Tormos said.

“In this case, I cannot explain why this child died,” she said.

The inquest proceeding, in which Wooten acts as a judge, is relatively rare but was the second this year. In early August, a jury found that the dog-mauling death of Mount Pleasant toddler Ja'Marr Tiller was accidental.