A toddler who died of head injuries after being rushed to Victoria General Hospital on April 9, 2008, had high levels of a drug commonly found in over-the-counter cold medications, a forensic toxicologist testified Monday in B.C. Supreme Court.
Dr. William Schreiber, who is also an expert in clinical pathology, was testifying at the trial of Bradley Ryan Streiling. The 30-year-old Victoria man is charged with the second-degree murder of Noah Cownden, who died just three days short of his second birthday. At the time of Noah’s death, Streiling was living with Noah’s mother, Meadow Dykes.
Noah’s death was originally deemed an accident. Five years later, on April 5, 2013, Streiling was arrested and charged with the boy’s death. Blood taken from Noah before his death showed the presence of pseudoephedrine at 1.6 milligrams per litre, Schreiber testified. Pseudoephedrine is a decongestant that many people take for a runny nose, sneezing and other symptoms of a cold, he said.
“We found 1.6 milligrams per litre,” said Schreiber. “That is an elevated value. The therapeutic level for adults is anywhere from 0.2 to 0.8 milligrams per litre. … If you look at 1.6 milligrams per litre, that’s in the range where you might expect toxic symptoms would be present.”
Pseudoephedrine is not recommended for children under the age of two, Schreiber said. There’s no therapeutic range for young children, because studies have not yet been done. Normal amounts of pseudoephedrine do not cause side effects, but elevated levels can cause restlessness, rapid breathing and a rapid or irregular heart rate. At high enough levels, it can cause seizures, said Schreiber. “At very high levels, it is considered to be causative of death,” the doctor told defence lawyer Martin Allen.
The court did not learn why Noah had such high levels of the decongestant.
Forensic odontologist Dr. David Sweet also testified on Monday, saying he was present at Noah’s autopsy and examined a bite mark on Noah’s left shoulder, a suspected bite mark on the boy’s cheek and a suspected bite mark on his thigh. Sweet testified that the police gave him a sample of the bite marks of five people, including Streiling; Sweet was able to exclude Streiling as a suspect for the bite mark on Noah’s shoulder, he told the court.
Dr. Richard Little was the trauma team leader at Victoria General Hospital on April 9, 2008. He testified that Noah was unconscious with a low heart rate and slow respiration when he arrived in the emergency room. He said Noah had a bruise on his right front scalp and a dilated right front pupil that was unresponsive to light.
“It was fairly obvious he had a severe head injury,” testified Little, who said he asked that a neurosurgeon be paged to emergency.
Noah was so ill, there was no time for a full examination, he said. Little recalled that at the time, he was told the baby had fallen out of the bathtub, but he said he was suspicious that the injury did not match the history he was given. “I did not observe any other injury on the child to tell what happened. However, we had a life-threatening and fatal brain injury that is unlikely to occur from a low-level fall,” Little testified.