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The trial of a County Armagh man accused of murdering his infant son has heard “catastrophic brain injuries” played a “very significant role in the development of the pneumonia” the child died from.

Craig Rowland, 29, of Millington Park in Portadown, is charged with the murder and manslaughter of Lewis Oliver Rowland, who died on 20 October 2018.

Lewis was 13 weeks old when he was admitted to Craigavon Area Hospital with “serious head injuries” in November 2015.

The infant died three years later after complications arising from surgery.

On Wednesday, the jury at Belfast Crown Court heard evidence from assistant state pathologist Dr Peter Ingram.

The trial heard he conducted a post-mortem examination on the body of the three-year-old on 23 October 2018.

Dr Ingram told the court he determined the child’s cause of death was “pneumonia following intra-abdominal surgery on a child with a pre-existing brain injury".

The court heard how Lewis had been in foster care in the period following his first admission to hospital as a baby.

The pathologist said he was aware that the boy’s condition had failed to improve and that there was a “general neurological decline".

“He was unable to walk or talk, but he could smile at his foster parents”, he said.

'Catastrophic' injury

The court heard Lewis underwent surgery on 4 October 2018 to have a nasogastric tube replaced for a longer-term feeding tube.

He subsequently developed a urinary tract infection and a chest infection after returning to the surgical ward.

The pathologist described how the three-year-old had to return to the operating theatre on two further occasions that same month to have the feeding tube mechanism adjusted.

Dr Ingram said that following an operation on 19 October, the infant’s blood oxygen levels began to drop and that a chest X-ray noted signs of pneumonia.

He added that “medical staff were of the opinion this was his final respiratory episode".

The court heard Lewis Rowland died at 13:30 on 20 October 2018.

Dr Ingram said there had been a notable change to the child’s brain and that “it was highly abnormal".

He said a report prepared by a consultant neuropathologist, who’d examined the child’s brain, confirmed the finding that he “had suffered a catastrophic brain injury".

Injury 'played significant role'

Reading from his own report, Dr Ingram said: “The history indicates this young boy had previously suffered catastrophic brain injuries, resulting in seizures, global development delay, movement disorders and being blind.”

The pathologist said there were “marked degenerative changes” in the brain which would have rendered the child “significantly more susceptible to pneumonia” as opposed to a normal healthy child.

Dr Ingram agreed with a prosecution lawyer that the infant was much more susceptible to chest infections and pneumonia, due to the brain injury he had suffered.

“The head injury played a very significant role in the development of the pneumonia and ultimately his death,” he said.

Mr Rowland, who is on bail, has previously pleaded guilty to a charge of wilfully neglecting his son.

The child’s mother, Laura Graham, has also pleaded guilty to the same charge.

The trial continues.