A Tamworth toddler who was taken to hospital with a "suspicious" head injury had experienced "multiple episodes of trauma" before he died in 2013, medical experts have told an inquest in Sydney.
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Baylen Pendergast, 22 months, died of severe brain damage after his life-support was turned off in a Sydney hospital on November 30 in 2013.
An inquest previously heard Baylen’s mother told hospital staff on November 22 she believed he had hit his head on the end of his racing car bed about five days earlier.
Baylen was discharged from hospital because he breached the gate-pass timing that let him leave with family, not because he was given the all-clear, the inquest heard.
He was rushed to hospital when his mother found him unconscious at her Westdale home on November 28.
The inquest is examining the cause and nature of Baylen's injuries, his treatment at Tamworth hospital, and whether there was a failure to properly diagnose head injuries after he first presented.
It will also look at whether clinical staff took appropriate measures, including notifying authorities, as well as what caused Baylen to lose consciousness two days before his death.
The inquest began earlier this month in Tamworth and heard evidence on Baylen's injuries from a series of medical experts when it continued at the NSW Coroner's Court in Glebe on Wednesday.
Pediatric radiologist Kristina Prelog said a CT scan performed on Baylen on November 22 showed a bleed on the right side of his brain and a skull fracture.
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The inquest heard a scan taken during his second hospital admission a week later showed more recent bleeding, or re-bleeding, in that same area, as well as another bleed on the left side and a tear to part of the brain.
Under questioning from counsel assisting the coroner Hament Dhanji, SC, five medical experts agreed those fresher injuries were likely caused by an additional trauma, or traumas.
The experts also agreed the two sets of injuries indicated "multiple episodes of trauma" at separate times.
Baylen's cause of death was brain injury from at least two acts of trauma, both caused by significant force, the inquest was told.
When asked if a second trauma ruled out the possibility he died as a result of the first trauma, neurosurgeon Professor Michael Besser said: "I don't think you can say that."
Dr Isabella Brouwer, who performed Baylen's autopsy, said he had "quite extensive" bruising to the back of his head over the skull fracture, and "recent bruising" on his forehead.
She said it was difficult to say exactly when those bruises had been caused.
Pediatrician Dr Ahmed Khan, who was involved in treating Baylen on November 22, said he presented at hospital experiencing lethargy, nausea, vomiting, and black-outs.
Doctors at the hospital had described Baylen's head injury as "suspicious" and suggested a "social investigation" and MRI, the inquest heard.
Dr Khan said he didn't think at the time the injury was suspicious as the boy's mother had explained he had fallen out of bed.
The inquest continues in front of Deputy State Coroner Derek Lee and is scheduled to sit until Friday.