The following is the medical evidence that was printed in the Star Democrat.
EASTON A sentencing hearing is set for 1:30 p.m. Friday, Oct. 29, for Gail Dobson, the former daycare provider convicted in August of second-degree murder, second-degree child abuse: death, and second-degree assault in the death of 9-month-old Trevor Ulrich.
Dobson is being held without bond at the Talbot County Detention Center while awaiting sentencing. Talbot County Circuit Court Judge Broughton M. Earnest ordered a pre-sentence investigation.
At trial, Dobson testified she did not harm Trevor Ulrich.
Dr. Carolyn Revercomb, a Washington, D.C. deputy medical examiner, ruled the death a homicide by blunt impact head trauma. Revercomb testified she could not rule out shaking as well.
"This is one of the worst cases of abusive head trauma that I have seen," said Dr. Tonya Hinds, a pediatrician who examined Trevor at Children's National Medical Center in Washington, D.C., where Trevor was taken Sept. 2, 2009, for his injuries. Trevor died the next day. Earnest struck the comment from the record after an objection from Dobson's attorney, Raymond H. Simmons.
Dr. Allen Walker, an expert witness offered by Dorchester County Deputy State's Attorney Maurice S. Nelson, is board certified in pediatrics and pediatric emergency medicine. Walker said he reviewed Trevor's records, including his prematurity, childhood illnesses (which Walker characterized as minor) and his autopsy and wrote an opinion letter based on his findings.
He said Trevor died as a result of blunt trauma to the head, as well as shaking of the brain.
Based on the records, Walker said, Trevor's injuries occurred "shortly before 911 was called."
Dobson called 911 at about 3:03 p.m., after calling White Marsh Elementary School, where Trevor's mother, Kelly Ulrich, was teaching.
Revercomb said Trevor's head was swollen and showed evidence of subdural and subarachnoid bleeding, as well as bleeding between the hemispheres. Trevor could not have received the injuries accidentally, she testified.
The trauma causing the brain injuries also caused extensive bleeding in both eyes and detachment of the right retina, Revercomb testified.
Revercomb's testimony reflected much of the information provided by Hind's testimony. Revercomb's exam also showed bruising under the scalp, which were hidden from the outside by skin and hair, she testified.
Revercomb found a bruise about halfway up Trevor's scalp from his right ear, which also was noted by Hinds. She said she found five additional scalp bruises. On the right side of Trevor's head, she found three bruises, each about one-quarter inch in diameter and a spot on the surface of Trevor's skull, associated with those marks.
Additionally, Revercomb said, Trevor's head was bruised on the right side of the back of his head.
Hinds testified, based on Trevor's medical history, that Trevor's prematurity nine months before his death was not an issue. She said he had caught up and was a healthy, well-developed little boy. She said records from his pediatrician indicated he had caught up, developmentally, by six months of age.
With a reasonable degree of medical certainty, based on literature and mainstream pediatrics and ophthalmology, Hinds said, the "cause of Trevor's death was vigorous, repetitive shaking with impact." Hinds is board certified in pediatrics and child abuse pediatrics.
She said Trevor arrived at her hospital "neurologically devastated," and "I had several concerning findings on his physical examination."
Trevor, who was connected to a lot of life-sustaining equipment, had scalp bruising, bleeding in both eyes, fixed and dilated pupils and was unresponsive during the entire exam, Hinds said.
Opthalmological screenings later showed diffuse, widespread, multiretinal bleeding in both eyes, Hinds said.
Despite medical intervention, Trevor effectively had no blood flow to his brain, meaning the brain was getting no oxygen or nutrients, Hinds said. Tests showed he had no vitamin-K deficiency and no evidence of infection or underlying medical conditions, Hinds testified.
It is not physically possible for a baby to injure himself so severely accidentally, she said. Outside of a crushing injury (such as a widescreen television falling on a child), which would have been immediately obvious, Hinds said, the injuries Trevor had are caused by "nothing else other than vigorous, repetitive shaking trauma, with or without head impact."
She said the force that led to Trevor's death was extensive.