Medical expert 'skeptical' of accidental cause of death

EPHRATA — A medical expert for prosecutors recalled the skepticism and concern he had upon hearing the explanations provided by Rafael "Raffy" Gomez's birth parents to the array of brutal injuries the little boy suffered while in their care.

Dr. Kenneth Feldman, a Seattle-area pediatrician, testified for most of the day Thursday in the trial of 32-year-old Maribel Gomez, the Ephrata mother charged with homicide by abuse and first-degree manslaughter in the death of 2-year-old Raffy in September 2003.

Gomez declared her innocence to the charges in Grant County Superior Court and remains free. She faces a sentence ranging up to 26 years in prison if found guilty of homicide by abuse. The manslaughter charge carries an eight-year sentence, according to Grant County Prosecutor John Knodell.

Gomez's five other children are in foster care, pending the trial's outcome.

For the first 11 months of Raffy's life, spent with foster parents in Royal City, he was healthy, said Feldman, basing his opinions on reports and documents from medical personnel who treated Raffy and CT scans of the boy's head.

The remainder of Raffy's life was spent going back and forth between Gomez's home and the foster family. Signs of abuse sent him to his foster parents, while state social workers reunited Raffy with his birth parents.

Knodell contends Raffy's short life ended with a massive head injury, concluding an escalating pattern of abuse inflicted by Gomez.

Defense lawyer Bobby Moser describes his client as a loving mother, who did everything she could to protect her accident-prone and abnormally-behaving child from injuring himself.

Moser maintains Raffy engaged in self-destructive behaviors, with each previous injury making the child more fragile and susceptible to future injury.

Feldman told the court the serious brain and head injuries Raffy sustained could not be explained by a child throwing its head back during a tantrum, accidentally falling off a bed or bumping his head on a table, as Gomez described to medical providers when she brought him to the hospital on multiple occasions. Raffy suffered four skull fractures during his second year.

The accident scenarios Gomez provided could not generate the force required to explain Raffy's injuries, Feldman said during questioning from Knodell.

"Partly that's common sense, otherwise we wouldn't have a human race here," Feldman said, indicating all kids fall and hit their head.

Gomez told doctors Raffy's last fall came as he was eating in the kitchen, throwing his head back and hitting the floor as he fussed for more food.

"I would expect a different constellation of injuries if he fell," Feldman told Superior Court Judge John Antosz, who's hearing the non-jury trial.

Raffy had brain injuries with a "whiplash component," the doctor said, causing more significant damage than a "focal-point" blow to the head. The fatal head injury was likely a combination of Raffy's head being struck and rapidly whipped around on his disproportionately-small neck, Feldman said.

"The strongest case we can make is it was a combination of the two (injuries)," Feldman told Antosz. He described the end result as "diffuse brain injury."

Feldman, answering questions from Knodell, told the court Raffy's earlier head injuries were not a likely contributing factor to the fatal injury.

On cross examination, Moser emphasized Feldman is not a forensic pathologist, possibly lacking expertise in causes of death.

During Raffy's short life he suffered two broken shoulders, fractured legs and skull, burns on his hand and tongue, pinched flesh, abrasions and a multitude of deep bruises to his head, abdomen and arms. A timeline presented by prosecutors shows the injuries occurred while in Gomez's care.

Separately, the injuries could possibly be accidents, the doctor admitted.

"(But) there were a lot of concerning findings going on," Feldman said. "There was great concern for abuse, but no certainty."

Moser questioned Feldman about behaviors Gomez attributed to Raffy, such as overeating and being irritable.

Feldman said the traits were a matter of perception and were only reported by Gomez, not the foster family.

Trial, expected to last up to another two weeks, resumes Tuesday with more prosecution witnesses.