HAMILTON — Two doctors testified Wednesday that tests showed a Hamilton baby suffered bleeding or fluid collection inside his head that went undetected after his vacuum- and forceps-assisted birth.

        But they said a more recent injury — only hours to “several days” old — was what threatened Draven Howard's life on April 4, 2000, and indicated abuse.

        Dr. Richard Brilli and Dr. Elena Duma of Children's Hospital Medical Center in Cincinnati were among key witnesses Wednesday in the prosecution's case against James Neil Howard, 28, who is accused in a controversial case of alleged “shaken baby syndrome.”

        Mr. Howard's son, now 21 months, was diagnosed with brain and eye injuries last year — leading to two felony child-endangering charges against Mr. Howard.

        In a trial that began Monday in Butler County Common Pleas Court, Mr. Howard is accused of hurting Draven on or around April 1 and April 4 last year, when the child was 2 1/2 months old. The child's potential to see and learn are uncertain, and he takes anti-seizure medicine as a result of his injuries.

        Both Dr. Brilli and Dr. Duma said it was impossible to give exact times when Draven's injuries happened, but both also said that, in their opinion, only a recent injury could have caused the breathing difficulties and signs that were detected in tests on April 4 and April 5 last year.

        They also said the most likely cause of the more recent injuries was violent shaking. They didn't know the cause of the older injuries, and said there was a possibility that they could date back to the child's difficult birth, which culminated in an urgent Caesarean section after failed forceps and vacuum extraction attempts.

        Dr. Duma said Draven's injuries were so extensive, “It looked like almost all of (his) brain had been damaged.” That damage, she said, most likely resulted from lack of blood flow and lack of oxygen as a result of a severe shaking incident.

        Two other medical incidents during 2000 — a Feb. 8 collapsed lung and a June 30 “rebleed” of a previous head injury — were not considered evidence of abuse, Dr. Duma said. Mr. Howard was originally charged with causing those, but prosecutors dropped those charges in September and proceeded to trial on the two charges relating to April 2000.

        The trial, in recess while Judge Keith Spaeth hears other cases today, resumes Friday, when the prosecution is expected to conclude its case and the defense intends to begin calling witnesses.

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