SINGAPORE — A Singapore General Hospital doctor has testified that an alleged five-year-old murder victim was skinnier than anyone she had seen when the girl was taken to the hospital’s emergency department. It later emerged that she was already dead.

Dr Tess Teo Lin was giving evidence on Friday (Sept 22) on the fourth day of the trial of a 43-year-old father accused of murdering his five-year-old daughter.

Dr Teo saw the girl at the emergency department on Aug 12, 2017.

The accused cannot be named to protect the identity of his surviving children.

Before her death, the girl was allegedly ill-treated and living naked in a toilet with her brother and only let out when her father or stepmother needed to use the toilet.

The man was arrested on Aug 12, 2017, the same day as the hospital visit, and has been remanded since then.

GIRL LOOKED SKINNY AND UNKEMPT

Responding to Deputy Public Prosecutor (DPP) Derek Ee’s question about the state of the girl’s body, Dr Teo said that what she mostly remembered was how she looked “very, very skinny” when she first saw her.

“At that point, I had not seen a child that skinny,” she added. “Even until now.”

She also said that she was able to see some sores on her toes, as well as red spots on her limbs, which could mean that an infection process had occurred.

When asked if Dr Teo or her team knew that the girl was dead at the time they first saw her, she said the initial information that they got was that she was “unresponsive”, so they attempted resuscitation and intubation.

However, a decision was made to terminate these procedures after 20 minutes. The girl was then pronounced dead.

Referring to the medical report that Dr Teo had prepared on Aug 30 in 2017, DPP Ee asked her to elaborate on the head injuries that she had observed on the girl.

These injuries included bruising over her left forehead and over the back of her head, darkish discolouration on the upper, outer side of her left skull, and scabs over the right side of her forehead.

Dr Teo’s report also stated that the girl was observed to be “cachectic” and was asked by DPP Ee to explain.

She said: “It is usually used to describe a patient who has cancer as they lose a lot of muscle mass so there was a lot of soft tissue wasting of her body, which basically meant that she was very skinny.”

During cross-examination, defence counsel Mervyn Cheong asked Dr Teo what the significance was for noting that there was a “foul odour” coming from the girl’s body.

Dr Teo then said she observed that the girl was “unkempt”.

During re-examination, DPP Ee asked Dr Teo what she meant. She said that the girl did not look like she was in a very good state when she was in the hospital.

“I remember thinking that the clothes didn’t look clean and what I remember most was that there were a lot of open sores over her toes and the skin was peeling, so in general, she looked dishevelled and unkempt.” 

Dr Teo was one of four witnesses scheduled for Friday’s hearing, including Health Sciences Authority’s analyst Leong Hsiao Tung who was asked about the toxicology report that she had prepared.

The report stated that at the time of the girl’s death, substances from anti-vomiting drugs and anti-histamines were detected in the girl’s blood and urine samples.

When asked by the defence counsel to explain the significance of these phenomena, Ms Leong said that when a drug is detected in a urine sample, it meant that there were traces of past consumption.

If it is detected in a blood sample, it meant that the drug was still circulating in her body before the girl’s death, she added.

The lawyer then asked if Ms Leong was able to tell the court what the toxic level would be for the substance but she was unable to answer since it was not her area of expertise.

As the prosecution had examined all witnesses set aside for this part of the trial, the accused is scheduled to return to High Court on March 19 next year for the continuation of the trial.