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Doctor Testifies Toddler Massive Brain Swelling was Caused by "Shaken" Incident

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CEDAR RAPIDS - Two University of Iowa Hospitals and Clinics pediatric emergency care doctors said 17-month-old Kamryn Schlitter's chances for survival were low when she was brought in with massive head injuries and significant brain swelling.

Dr. Alexandra Volk, who works in the pediatric intensive care unit, testified she was concerned about Kamryn's brain swelling on the left side because it was cutting off her blood flow.

"She was dying, Volk said. "There were different ages of blood in the brain that indicated multiple abusive (incidents)."

Volk said Kamryn had a "shaken event" with acceleration and deceleration of force on the brain that led to her death and occurred within minutes to hours of the 911 call March 21, 2010.

The murder trial of Zyriah Schlitter, who is accused of killing Kamryn March 28, 2010, continues 9 a.m. Tuesday in Linn County District Court. Schlitter is charged with first-degree murder and child endangerment resulting in death.

The trial started last week and is expected to go another week and a half.

Amy Jo Parmer, 29, of Hiawatha, Schlitter's ex-girlfriend, is also charged with first-degree murder and child endangerment resulting in death. Her trial is set Jan. 14, 2013.

Gazette reporter Trish Mehaffey continues her live coverage from the courtroom where viewers can ask questions and provide comments.

Dr. Charles Jennissen, testified he asked Schlitter what Kamryn was like before he left her with Parmer March 21, 2010 because he knew the injuries were non-accidental, but Schlitter wouldn't tell him. Schlitter talked about what she had been like during the week but he wouldn't say what she was like that day.

"I thought that was odd," Jennissen said. "I asked several times. He said she had been sleepy that day."

Tom Gaul, Schlitter's attorney, repeatedly questioned Jennissen and later Volk on cross examination about why they didn't talk to Parmer, since she was the last one with Kamryn that night.

Jenniessen said more than once that Parmer wasn't at the hospital and he knew someone would investigate this incident but it wasn't his job. His job was to provide emergency care to Kamryn.

Jennissen said Schlitter also told him Parmer's son, who was there that night, was gentle and wouldn't have hurt Kamryn but Jennissen never asked him about the son.

Jennissen and Volk both testified about number of bruises on Kamryn's body. She had bruises on her forehead, cheeks, underneath the chin and "suspicious grab" marks on her arms.

Jennissen said the bruises were inflicted at different times because they were in various stages of healing.

Volk said the chin or jaw area bruises, which could indicate a strangulation incident, were not common injuries for a toddler. Volk said that's not what caused her death but she couldn't rule out that Kamryn wasn't strangled at some time. When she talked to the family about this everybody started accusing each other.

Volk said Kamryn's mother Nicole King blamed Parmer and Schlitter defended Parmer.

Gaul on cross asked Volk wasn't it difficult to determine when a bruise is inflicted because medication, genetics and other things can affect them.

Volk agreed.

First Assistant Linn County Attorney Nick Maybanks asked Volk about how Kamryn's behavior changed she became withdrawn, lethargic and was even pulling out her hair - and if it was consistent with her condition.

Volk said reduced blood flow from the brain swelling could account for her being withdrawn or not interacting with others and being lethargic.

"I was told about her pulling out her hair," Volk said. "It's a sign of how much stress she was under. That's what you do when you're being tortured."

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