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Day 7: In murder trial, Juneau physician testifies baby was in "good health" before she died

State to rest case against defendant David J. Paul, 24, on Tuesday

Posted: June 3, 2013 - 11:01pm
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Valley Medical Care family physician Dr. Priscilla Valentine testifies in the David J. Paul trial on Monday.   Michael Penn / Juneau Empire
Michael Penn / Juneau Empire
Valley Medical Care family physician Dr. Priscilla Valentine testifies in the David J. Paul trial on Monday.

The Juneau family physician for a 4-month-old baby whose August 2010 death was ruled a homicide testified Monday the infant was in good overall health the week before she was observed seizing and eventually died at a Seattle hospital.

“She was in good health,” Dr. Priscilla Valentine of Valley Medical Care in Juneau, one of the prosecutor’s witnesses, said from the witness stand in Juneau Superior Court. “She was growing well, (inaudible), developing well, behaving normally, making happy little sounds, not just crying when she’s hungry or uncomfortable, being alert, looking around, moving arms and legs, hands, fingers. ... She was having normal growth and development and behaving like a baby who was catching up well.”

The testimony from Valentine played into the state’s theory that Rian Jambi Orr was a healthy baby until the morning of Aug. 9, 2010, when they say the mother’s live-in boyfriend David J. Paul accidentally dropped Orr in the bathroom then shook her once to make her stop crying. Now 24, Paul is faced with two counts of second-degree murder and manslaughter in connection to her death.

The defense, meanwhile, says Orr did not die from child abuse, but suffered from a chronic brain injury and a clotting problem that went unnoticed until that morning. On Monday, they strived to show the baby was not the perfect picture of health before she died, pointing to the fact that the mother was “risked out” of the natural birth she wanted, as well as complications with the pregnancy and post-fetal growth.

Valentine examined the infant during four out of six visits at the family medicine clinic before Orr’s death on Aug. 15, 2010, the last visit being on Aug. 2, 2010. The physician explained under questioning from Assistant District Attorney Angie Kemp that Orr was born about two weeks early at 5 pounds, 3 ounces, which is small for her gestational age. But the child made gains, albeit initially not as quickly as hoped.

“She started out below the norm and as being small for gestational age and identified as intrauterine growth restricted, which is when the baby is not growing as she should in the uterus,” Valentine said. “But she caught up and got into the normal range by the time she was two months old and continued to grow after that.”

The baby’s mother Jaki Orr was referred to the clinic at the beginning of her third trimester since The Juneau Family Birth Center decided a natural birth was too risky, Valentine said. Valentine said the reason was because the mother had a short cervix, which can be a risk for premature delivery.

Under cross-examination, Valentine said there were other reasons, too. The Birth Center reported Jaki had poor nutrition, didn’t gain enough weight and also smoked during pregnancy, she said.

“Did Jaki smoke?” Hedland asked, broaching the subject for the first time as the trial enters its third week.

“The notes that came with her said she was a recent ex-smoker,” Valentine said. “I don’t know when she stopped or how much she smoked . She was clearly instructed by the midwives ‘cause they don’t accept people who smoke because that’s a risk. ... My understanding is that Jaki was not smoking when she first came to see me. Later in the pregnancy there was a note that she had started up with smoking, a few, I don’t know how many. I think I recall a note that says she has not smoked since whatever day until she delivered.”

Valentine testified that during one of the first visits, Jaki and Paul told her they were concerned about bruises they found on Orr’s chest. Prosecutors have been holding up the bruises found on Orr’s chest at the hospital as evidence of prior child abuse, perhaps from rough handling or squeezing.

Valentine said she did not observe bruising during that visit, but that she observed a small blue-green-gray bruise on Orr’s upper left chest during another appointment, though she can’t remember the date and it’s not documented in her notes. She said the couple told her they thought it may be due to the buckle in the baby’s car seat, which Valentine said on the witness stand “made no sense to me.”

Assistant Public Defender Eric Hedland pressed her on the issue and asked why Valentine never documented observing the bruise or anything about that conversation in medical records. She said she doesn’t know why it’s not in the record, but that she has a clear recollection of it.

“I know that there was a bruise there,” she said. “I talked about it with the parents. Why it didn’t get into the record, I don’t know. A distraction of some kind, but if it’s not there my memory is clear. This is not something I forget.”

Hedland asked, “You are saying today that at some unknown point, you noticed a bruise, a little tiny bruise on Rian’s chest that had three different colors in it and was really important which you’ve never seen before, which you thought was really highly suggestive of something bad. But you never wrote it down or told anybody about it, right?”

“Once I finish the notes, it’s done, I don’t think about it,” she responded. “If I didn’t write something down, that’s it, it’s gone. I’m not going to go back and add information, that’s illegal.”

Valentine, a mandatory reporter who must report suspicions of abuse to authorities, said she did not tell anyone about the bruise because she did not think it was suspicious.

“There was nothing to tell,” she said, adding later, “It was absolutely not normal, I had never seen it before, but it was not by itself diagnostic so that is why I did not report it.”

Police did not contact Valentine for an interview until well after Paul was arrested and charged with murder and manslaughter. Valentine said the first time she was approached by police and interviewed by lead detective Kim Horn was in January 2012. She said she informed Horn of the bruise at that point.

Hedland established that while on the stand, Valentine said the the car seat buckle explanation made no sense to her, but in that in the interview with Horn, she said that the bruise was located right where the car seat buckle would be.

Jurors on Monday also heard testimony from Juneau Police Department Detective Elias Joven, who went to interview Orr’s parents at Harborview Medical Center alongside Detective Kim Horn. Paul, who is not the child’s biological father but raised Orr as his own, denied any wrongdoing, such as dropping or shaking her.

According to testimony thus far, Paul would later admit to Horn that he accidentally dropped the baby, and to JPD Sgt. Paul Hatch that after he dropped her, he gave her “one forceful shove back.” The defense says that admission was a false confession or statement that was untrue and elicited by police tactics.

Prosecutors say they expect to rest their case on Tuesday after putting Dr. Richard Harruff on the stand. Harruff is the chief medical examiner for King County, Wash., who ruled Orr’s death a homicide.

Monday marked the seventh day of testimony in the trial. Jury selection took place for three days before that. Fifteen jurors were selected to hear the case, and one was excused early on due to a family emergency.

Another juror on Monday told presiding judge Philip Pallenberg that a coworker informed him the defense had made a motion for a mistrial. The jurors were unaware of that fact since it was done outside their presence. After consulting with the attorneys who did not raise an objection, Pallenberg allowed him to stay on the jury panel.

Before the jury breaks to deliberate, two of the 14 remaining jurors will be dismissed as alternates, leaving 12 to decide the verdict.

If convicted, Paul could be facing up to 99 years in prison for second-degree murder, plus another 20 years for manslaughter.

• Contact reporter Emily Russo Miller at 523-2263 or at emily.miller@juneauempire.com.

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