The family of Sophia Acosta cried while nurse, Teresa Pardee, described the toddler’s injuries the day she was rushed to the emergency room.
On May 7, 2011, Pardee was the lead nurse in Kaweah Delta Medical Center’s ER in Visalia. Paramedics contacted the staff letting them know there was an incoming code blue. The patient was a 3-year-old girl.
Pardee prepared nurses and staff for what was to come.
Sophia was rushed into the emergency room by paramedics just after 4 p.m. that Saturday. While transporting the small child from the ambulance gurney to the hospital gurney, Pardee remembers seeing a grapefruit size pool of blood under the toddler.
While trying to intubate Sophia, nurses checked her temperature.
READ MORE: Witnesses set the scene of toddler’s death
“She was cold,” the nurse said.
Pardee took deep breaths in between questions by the prosecution.
The girl’s temperature was below 90 degrees. She did have a faint pulse but she wasn’t breathing on her own, Pardee said.
“She presented almost like a drowning,” she added.
Paramedic Michael Simonian, who testified in court last week, remembers walking into the apartment where the child was lying. She soaking wet and unresponsive, Simonian said.
“From what I had experienced, she looked like drowning victim,” he said. “But I thought that was weird because there was no pool.”
In an attempt to revive the small child, Cheary placed her in a cold shower and removed her clothes, said the paramedic.
After her death, Acosta's brain was delivered to Stanford University, ABC30 reports.
Dr. Hanns Vogel is the director of the neuropathology department there, and he examined Acosta's brain and then came to some startling conclusions. "The history we have, along with the general autopsy findings and so forth, were completely consistent with many forms of trauma to this deceased person."
Pardee’s statements echoed those of many others who saw Sophia that day.
The veteran nurse, though, noticed visible injuries on the child. There was bruising around her buttocks and bleeding to the girl’s genitals.
She remembers watching while detectives with the Exeter Police Department photographed the toddler’s injuries.
Dr. Vogel found Acosta suffered bleeding under the thick coverings of the brain. He also noted significant brain swelling and found evidence of extensive bilateral retinal hemorrhages and optic sheath hemorrhages -- in other words, bleeding in the back of the eyes.
"A fall would not account for the injuries in this child."
Defense attorney Angela Krueger asked how common it was for medical staff to check those areas on an unresponsive child.
The prosecution has argued that's how Acosta died at the hands of Christopher Cheary, the boyfriend of Acosta's mother.
Prior to being hired at Kaweah Delta, Pardee worked as a nurse at a suspected child abuse center.
“I’ve been a nurse for 13 years,” Pardee said. “I’ve seen a half dozen incidents of children who were unresponsive. She was the only one with rectal bleeding.”
Prosecutor David Alavezos wondered if a medical examination could have caused Sophia’s injuries.
“I’ve never seen an injury to the rectum or vagina caused by a medical exam,” Pardee said.
Neuropathologist Hannes Vogel also testified that the child’s injuries was consistent with ‘inflicted’ and ‘non-accidental’ trauma.
Vogel explained that Sophia suffered from severe brain trauma. He compared her injuries to those of someone who fell from a three-story building.
“Do these things happen without cause?” Alavezos asked.
“No, that’s literally impossible,” Vogel responded.
Most often, the kind of injury he observed is caused by blunt force trauma and is not found outside of the spectrum of “simple accidents”, he said.
The defense has said the death was caused by a rare blood clotting condition.
“There is no way on God’s green earth this pattern of injury could be explained by a clotting disorder,” the doctor said.
Cheary was arrested on June 2, 2011, on suspicion of homicide with a special allegation that the death was caused by a sexual assault. The charges include one count of first-degree homicide, torture while engaged in rape with a foreign object, and that the acts were intentional.
If convicted, he faces the death penalty or life in prison without the possibility of parole.