Forensic doctor explains her lice-related diagnosis at negligent homicide trial

Nov. 16—The negligent homicide trial of Christian Cummings enters its fourth day on Thursday with a doctor from the state's largest health care corporation expected to explain whether lice are dangerous or not.

Dr. Resmiye Oral, the head of Dartmouth Health Child Advocacy and Protection Program, will likely be asked to address the organization's guidance on lice.

Lice have become a key focus in the trial, where a jury will decide if Cummings, 24, is guilty in the negligent homicide death of his 1 1/2 -year-old daughter Kamryn Cummings in February 2019.

Authorities say she was a victim of neglect, and an autopsy determined lice infestation was a contributing cause, said Dr. Christine James, a former New Hampshire deputy medical examiner who performed the autopsy. James testified Wednesday at Hillsborough County Superior Court in Manchester.

During her testimony, Cummings' defense attorney Ted Lothstein introduced as evidence the Dartmouth Health post-care instructions involving lice. The instructions state that lice are not dangerous, don't spread disease and have nothing to do with how clean a child is.

A Dartmouth-Hitchcock spokeswoman said they had no comment.

On Wednesday, James testified that when she sees a child with iron-deficiency anemia, she looks for blood loss. There was no sign of internal bleeding in Kamryn.

"I had no internal explanation for blood loss, just the external source of lice," said James, whose work on Kamryn's autopsy has been criticized by her former boss, New Hampshire Medical Examiner Jennie Duval. James now lives in Kansas.

James said the only other cause would be nutritional deficiency, and she does not know if post-mortem tests for vitamin levels are possible.

"I don't even know how you would start testing for nutritional deficiency," she said.

The state has said the toddler died of dehydration, electrolyte imbalance and/or a blood infection that started with an untreated infection of the girl's urinary tract.

In her testimony, James said she is certain of her diagnosis of the cause of death — probable urosepsis.

James said the source of the infection is evident by its spread, but she cannot definitely call it sepsis because it does not meet all criteria.

"I am certain of the diagnosis," James said.

Also expected to testify Thursday is Dr. Thomas Andrew, the retired chief New Hampshire medical examiner. Andrew, who held the post for 20 years, is expected to attribute the child's death to Sudden Unexplained Death in Childhood.

Similar to Sudden Infant Death Syndrome, SUDC hits children above the age of 1 and kills them in their sleep.

The testimony phase of the trial is expected to wrap up late Friday morning.

The child was found dead around 1 a.m. on Feb. 14, 2019, in the Cummings family home on Colby Road in Weare. Both Cummings and the child's mother, Mikayla Cochran, face a charge of negligent homicide, child endangerment and reckless conduct.

The negligent homicide charge carries a maximum possible sentence of 10 to 30 years in prison.

Cochran isn't expected to go to trial until next year.