I don't believe Poppi was assaulted before death, pathologist tells inquest

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A pathologist told the inquest into the death of Poppi Worthington he did not believe she was assaulted before her death.

Dr Nat Carey said he disagreed with the interpretation of findings from the post mortem on the 13-month-old, that the girl had been "penetrated" in the bottom.

Poppi collapsed at her home in Barrow, Cumbria, in the early hours of December 12 2012 and was pronounced dead in hospital an hour later.

Her father Paul Worthington, 49, was ruled to have probably sexually assaulted her, according to a judge during family court proceedings.

Poppi Worthington's father, Paul Worthington (Owen Humphreys/PA)
Poppi Worthington's father, Paul Worthington (Owen Humphreys/PA)

Home Office pathologist Dr Alison Armour, who carried out the post mortem, has told the inquest she is "sure" the girl was injured by penetration before her death with evidence of tears and bruising to her bottom.

But Dr Carey, who was asked by Cumbria Police to review the case and give a second opinion, disagreed, Kendal Coroner's Court heard.

He said: "I see no convincing evidence of a laceration. I don't see clear cut evidence of trauma in that zone."

Leslie Thomas QC, representing Paul Worthington, asked him if Poppi had been penetrated would he have expected to see more injuries.

Dr Carey replied: "Usually the findings are not subtle and seldom get debated in this manner in court because they are abundantly obvious."

The double bed where Poppi Worthington was placed at the time of her collapse (Cumbria County Council)
The double bed where Poppi Worthington was placed at the time of her collapse (Cumbria County Council)

Mr Thomas asked if there was any evidence he had seen so he could be sure or even on a balance of probabilities that there was anal penetration in this case.

Dr Carey replied: "No. Not in my opinion."

He said blood reportedly seen coming from Poppi's bottom may have been the result of the body "purging" after death as a result of a natural process of the breakdown of blood vessels or oozing from congested vessels.

And he said bleeding could also result from prolonged resuscitation attempts.

But Gillian Irving QC, representing the mother, reminded Dr Carey that Poppi woke up screaming around 5.45am and her father put her in his bed, then went to get a fresh nappy.

When he returned she had settled but five or 10 minutes later he reached over and she was limp or floppy and he ran downstairs and the mother called an ambulance, shortly before 6am.

The cot where Poppi slept on December 11 and 12, 2012 (Cumbria County Council)
The cot where Poppi slept on December 11 and 12, 2012 (Cumbria County Council)

Paramedics carried out a "scoop and run" delivering the apparently lifeless toddler at Furness General Hospital at 6.11am but she never regained consciousness and was pronounced dead shortly after 7am.

During the journey, paramedic Nicola Lynn noticed "bright red blood" on the ambulance sheet coming from Poppi.

Ms Irving said this was a "critical piece of evidence" - and suggested it was not evidence of blood being purged from the girl after death.

She said: "The speed of which the blood was seen points to the fact that on the balance of probabilities that something happened to this child, in life, in the home?"

Dr Carey replied: "Or something natural happened. I don't think the evidence is there to support penetration."

Dr Nat Carey in 2010 (Katie Collins/PA)
Dr Nat Carey in 2010 (Katie Collins/PA)

He suggested Poppi's gastroenteritis virus may have caused the bleeding.

Ms Irving said: "This was a death that was extremely rapid. The evidence is, save for a few snuffles, this child was well.

"It is indicative of something having happened to this child in life?"

"Well, it's supportive," Dr Carey replied.

Ms Irving continued: "This is an extremely important point in the family proceedings, the presence and timing of that blood, lends itself to the conclusion, it is suggestive something happened to this child?

"It is your sticking point then, and it is your sticking point now?"

Dr Carey replied: "That's true, but I would not read too much into it."

The child's exact cause of death remains "unascertained" and the inquest will try to determine how she died.

Court artist sketch of Poppi's father, Paul Worthington (Elizabeth Cook)
Court artist sketch of Poppi's father, Paul Worthington (Elizabeth Cook)

Mr Worthington, who is now in hiding, has never been charged with any offence and strongly denies any wrongdoing.

The inquest was adjourned until Thursday morning.