By Janice Morse
The Cincinnati Enquirer

HAMILTON - Bruises and burns on the body of a 13-month-old boy tell a sad story of abuse, says Butler County's coroner, but what he found inside the 23-pound child was worse: the boy's tiny heart that had burst from a devastating blow.

"Somebody really clobbered this kid," Dr. Richard Burkhardt said Thursday, noting a 3/4-inch rupture in the right atrium of the child's tennis-ball-sized heart. "It just takes tremendous force to do that." With a hole that large, the child probably died within a minute or two, Burkhardt said.

In his 23 years as coroner, Burkhardt said this is the first time he has found that a child-abuse victim died from a pericardial tamponade - an accumulation of fluid, usually blood, in the sac surrounding the heart.

The condition, which Burkhardt said he has seen in victims of high-speed automobile crashes, causes the heart to stop beating. It is rarely seen in child abuse cases because the rib cage normally protects the heart, and the ribs of very young children are flexible enough to absorb impact, Burkhardt said.

The youngster was pronounced dead at Fort Hamilton Hospital just after midnight Tuesday. His 13-year-old half-brother, who was baby-sitting at the family's apartment on South Eighth Street, is being held on charges of murder and domestic violence. The Enquirer is not identifying the suspect or his family.

Records show the teen told police he hit the baby across the back with a 2-foot-long piece of metal bed framing; Burkhardt said he found injuries that could be consistent with such an assault. The children's mother has said her son initially reported the baby fell down some stairs. Burkhardt said neither a fall nor resuscitation efforts could have caused the fatal heart rupture.

The child also suffered non-life-threatening injuries: multiple bruises; a cut on his lip; and two healed burns, including one several inches long, Burkhardt said, adding, "This kid had a rough 13 months of life, I suspect."

The Green-Hall & Jordan Memorial Chapel is handling arrangements, the coroner's office said, noting the mother apparently changed her plan to bury the child in Florida.

Hamilton Police Lt. Scott Scrimizzi said the mother was re-interviewed extensively Wednesday, and police were planning to meet with prosecutors next week to determine whether to pursue charges against her if she were suspected of leaving her five children home alone for an extended period.

E-mail jmorse@enquirer.com