A medical examiner who did the autopsy on 18-month-old Ezekiel Stephan spent a third full day on the stand in the retrial of David and Collet Stephan Wednesday.
The couple is charged with failing to provide the necessaries of life to their son, Ezekiel, who died in March 2012.
In 2016, a jury found the couple guilty, but the Supreme Court of Canada ordered a second trial last year.
The case is being heard by a judge alone in the retrial, with the Crown arguing the Stephans should have sought medical treatment for the boy sooner. The couple opted instead to treat him with natural remedies before he stopped breathing.
Earlier in the retrial, Dr. Bamidele Adeagbo testified via video that it was clear the child had died from bacterial meningitis and a lung infection.
During cross-examination Wednesday, David Stephan, acting as his own lawyer, suggested the pathologist didn’t explore other possibilities that may have led to Ezekiel’s state.
Stephan asked Adeagbo if he took into account whether Ezekiel had hyponatremia, which occurs when there’s low sodium concentration in the blood.
Adeagbo responded that when he reviewed the first available medical record on this information, the child’s “sodium was totally fine.”
Stephan, referring to the medical record, noted that his sodium level was on the lower end of the normal range. Something that, he said, should have been cause for concern for the medical examiner.
Adeagbo responded that in his role as medical examiner, he had “concern about everything.”
“When you look at a number, you look around it,” he explained. “You look at the context of the number.”
When Adeagbo did that, he said he noticed that Ezekiel’s potassium was increasing as well.
Adeagbo told court that this led him to determine the child’s sodium level was at that number not because of hyponatremia, but because Ezekiel was dead — he just hadn’t been officially pronounced at that time.
Stephan also suggested that the pus on Ezekiel’s brain may have been caused by hypernatremia, a high concentration of sodium in the blood, after the administration of saline at the hospital.
When Stephan asked Adeagbo if he had considered in his autopsy whether the pus could have partially or fully been caused by hypernatremia, the pathologist responded that he had.
Adeagbo said that when he sees a patient, he thinks about everything — but that doesn’t mean he’s going to write everything down.
“I can’t write every part of the process or I’d have to write a book on every autopsy,” he said.
Adeagbo’s comments have not yet been admitted into evidence, as the defence is questioning his qualifications as an expert on forensic pathology.
The judge told the court the witness’ comments are difficult to understand in the video call because of delays and feedback from the line, and that if he is to accept Adeagbo as an expert witness, it will be on the basis that the evidence being offered is comprehensible.
The judge added that the Crown should be ready to address this when the time comes.