Dr Melissa Pearson was a senior resident medical officer in pediatrics at Tamworth hospital in 2013 when she first encountered 22-month old Baylen Pendergast.

She fought back tears on Wednesday in Tamworth Coroner’s Court as she offered condolences to the boy’s family for their loss, after the child’s life support was switched off in a Sydney hospital.

He died from severe brain damage and had a fractured skull.

Deputy State Coroner Derek Lee is examining the cause of, and nature of, the injuries to Baylen, and how he suffered them; the treatment at Tamworth hospital; and whether there was a “failure to properly diagnose head injuries” after he presented on November 22, 2013.

He will also examine whether clinical staff took appropriate measures including notification to authorities, as well as what caused Baylen to lose consciousness on November 28, two days before his death.

Dr Pearson initially treated Baylen on his first visit to the hospital on November 22, and suspected a brain injury after the delayed representation and ongoing symptoms.

“Certainly at that time you were concerned about a brain injury,” Counsel Assisting the Coroner Hamant Dhanji SC asked.

“I was,” Dr Pearson replied.

The inquest earlier heard Baylen’s mother told staff she believed he had hit his head on the end of his racing car bed, about five days prior.

“If there was a brain injury, the mechanism didn’t fit,” she said, adding she needed the child to be admitted, and needed to “ascertain imaging” and further testing.

Dr Pearson said when she handed over the care of Baylen she said more testing was needed.

“My handover was that I had concerns that if there was an injury that was greater than a skin injury … this child … requires a report to child protection services,” Dr Pearson said.

When Baylen was rushed to hospital on November 28 unconscious, Dr Pearson was there again.

She called the DOCs helpline, and “it was not short”.

“The reason I called is because I now had a child that I seriously considered brain injury for,” she said.

The court heard Baylen was discharged from hospital after the first presentation because he breached the gate-pass timing allowing him to leave for a number of hours with family, not because he was given the all clear.

THE officer-in-charge of investigating Baylen Pendergast’s death believed the injuries inflicted were suspicious.

The homicide squad was called in to help Oxley Detective Graham Goodwin’s investigation in early-December, 2013, following the death.

Detective Goodwin told the inquest he was first alerted to a Tamworth child who “was in a critical condition and not expected to live” on November 29. 

The alarm was raised by Dr Melissa Pearson who “expressed some concern” that the child had been admitted on November 22 with “significant facial bruising and head injuries”.

Detective Goodwin detailed the investigation in the initial weeks, detailing how both parents’ phones and the mother’s current partner were analysed and the house was combed as a crime scene by police.

He said he was suspicious how Baylen suffered the injuries and a post-mortem revealed a “large and significant fracture at the rear of the skull”, and subsequently formed a strike force to investigate, interviewing Baylen’s mother’s partner, who” believed Baylen must have fallen from his bed”.

He said there was evidence on the man’s phone that “he feels he is a suspect”, when police investigated any evidence of foul play at a search of the home on December 2.

He said based on his investigation, he was of the opinion that the treating medical staff “that they should, community services or the police should be informed … especially in relation to skull fractures”.

DOCTORS thought Baylen Pendergast needed an MRI scan to determine the extent of a suspected brain injury which couldn’t be performed in Tamworth but the young boy was never transferred to Newcastle for the specialist imaging.

Dr Amit Kshatriya was the pediatric registrar who took over from Dr Melissa Pearson, examining the 22-month-old on November 23.

He said when he handed over the care of Baylen, he noted the child had “significant head injury” that “needs further investigation”.

He said he “observed mother and child” to have a “secure attachment”, but did not make any notification to authorities when he was unable to rule out if the “significant head injury” was from a deliberate injury or “non-accidental injury”.

When questioned why he didn’t make the automatic referral under the mandatory guidelines, Dr Kshatriya said “I thought that further information was needed”.

He said he had a “a significant concern of head injury and hand over patient” to another doctor and left his shift, believing that an MRI was needed.

The inquest continues.