Physician remembers earlier bruise

Pallenberg, Hedland, and Kemp

Superior Court Judge Philip Pallenberg (left) and assistant District Attorney Angie Kemp (right) listen to public defender Eric Hedland as he makes his point during a sidebar in the David J. Paul homicide trial. Photo by Matt Miller/KTOO News

A family physician who checked on the infant Rian Orr said it wasn’t normal for a baby to suffer from bruising on the upper chest. However, she admitted that she forgot to note what may have been a severe bruise during one of the infant’s check-ups.

Dr. Priscilla Valentine, a family physician and obstetrician at Valley Medical Care, testified on Monday in the David J. Paul homicide trial.

Paul is facing murder and manslaughter charges for the death of four-month old Rian Orr in August 2010.

Before Rian was born in late March, Dr. Valentine said Jaki Orr rarely visited the clinic alone. She first arrived with the biological father and then with David Paul.

“Every single visit or eye contact, said very little. When she did, it was soft-spoken,” described Valentine.

“What about (David Paul’s) demeanor during the visits?” asked assistant District Attorney Angie Kemp.

“Excited, happy, loving, supportive.”

“Was he doing most of the talking between the two?” asked Kemp.

“I would think so since Jaki didn’t say much,” answered Valentine.

Rian Orr was vigorous at birth, but her weight of 5-pounds, 3-ounces was low even for her gestational age of 38 weeks. Valentine remembered that mother Jaki Orr was referred by the Juneau Family Birth Center because a premature delivery was considered risky with a short cervix.

It was also unclear whether Orr followed nutritional advice, or if she was still smoking which was contrary to her earlier claims of quitting.

Later, Valentine said she didn’t believe the explanation from Paul and Orr that the baby suffered from a chest bruise because of a car seat’s straps and buckle. Paul and Orr apparently voluntarily reported a minor bruise during one of the first of about half-a-dozen well-baby check-ups during the spring and summer of 2010.

Car seats did not give bruises. Hundreds, thousands of babies I’ve cared for, never before seen a bruise on baby from a car seat, from anything. It is not usual.”

But then Valentine said on the stand on Monday that she remembered another bruise – possibly more severe and blue-green-gray in appearance – that she did not note in her records. She couldn’t remember when she saw the bruise.

That led to a very tense round of questioning between Valentine and public defender Eric Hedland after he asked whether she, as a health care provider, was obligated to report possible abuse of a child.

“To have what I saw on Rian was not in that realm of being the only thing that could cause it as child abuse,” explained Valentine. “It was absolutely not normal. I’ve never seen it before. But it is not, by itself, diagnostic. So, that is why I did not report it.”

“Maybe you’re misunderstanding my questions.,” said Hedland. “I didn’t say it is about you…”

“You make it sound like I failed,” said Valentine.

“No. I’m asking you… No!”

“…I did wrong.”

“Well, no. What I’m asking is: If it is possible that you conflated your memory?” asked Hedland.

“No!” replied Valentine.

Valentine also testified that sometime after the baby was sent to Harborview Medical Center in Seattle, she wrote ‘shaken baby’ and ‘medivac’ in Rian’s file. She apparently received the latest medical records from the baby’s emergency treatment at Bartlett Regional Hospital, but she said she did not contact investigators nor was she approached by them until later.

She also noted that it’s possible for a baby to be born with subdural hematoma if it’s a difficult vaginal birth that puts a lot of pressure on the brain.

Also on Monday, Juneau Police Officer Elias Joven testified that he interviewed David Paul at Harborview Medical Center in Seattle two days after the baby started suffering from seizures. At that time, Paul continued to deny any knowledge of how the baby suffered from a brain injury that led to the seizures.

Following Joven on the stand was Lt. Kenneth Hoff of Lemon Creek Correctional Center who testified to the regular practice of recording inmates’ phone conversations, including between David Paul and Jaki Orr after he was arrested for Rian Orr’s death. Snippets of two conversations were played for jurors, but the audio quality was so poor that it was difficult to understand the conversations’ contents.