“I already mentioned the bruising to the sternum…”

“Yes, you did. But isn’t it possible that the bruising might also be consistent with vigorous, medically necessary CPR?”

“It is,” he concedes.

“Is it possible that there might be other scenarios—other than foul play—that might have led to the death of this baby?”

“It’s possible.”

Kennedy asks him to review the neonatal screening results she entered into evidence earlier. “Doctor, would you mind taking a look at exhibit forty-two?”

He takes the file and thumbs through it.

“Can you tell the jury what you’re looking at?”

He glances up. “Davis Bauer’s newborn screening results.”

“Did you have access to this information while you were performing your autopsy?”

“I did not.”

“You work at the state lab where these tests were performed, don’t you?”

“Yes.”

“Can you explain the highlighted section on page one?”

“It’s a test for a fatty acid oxidation disorder called MCADD. The results were abnormal.”

“Meaning what?”

“The state would return these results to the hospital nursery, and the doctor would have been immediately notified.”

“Do infants with MCADD show symptoms from birth?”

“No,” the medical examiner says. “No. That’s one of the reasons the state of Connecticut screens for it.”

“Dr. Binnie,” Kennedy says, “you were aware of the fact that the infant’s mother had gestational diabetes, and that the baby had low blood sugar, correct?”

“Yes.”

“You stated earlier that the diabetes was what caused the hypoglycemia in the newborn, didn’t you?”

“Yes, that was my conclusion at the time of the autopsy.”

“Isn’t it also possible that hypoglycemia might be caused by MCADD?”

He nods. “Yes.”

“Isn’t it possible that a newborn’s listlessness and lethargy and poor appetite might be caused by MCADD?” Kennedy asks.

“Yes,” he admits.

“And an enlarged heart—is it potentially a side effect not only of maternal gestational diabetes…but also of this particular metabolic disorder?”

“Yes.”

“Dr. Binnie, did you learn from the hospital records that Davis Bauer had MCADD?”

“No.”

“Had these results come in in a timely manner, would you have used them to determine the cause of death and manner of death in your autopsy results?”

“Of course,” he says.

“What happens to an infant who has the disorder yet has gone undiagnosed?”

“They are often clinically asymptomatic until something happens to cause metabolic decompensation.”

“Like what?”

“An illness. An infection.” He clears his throat. “Fasting.”

“Fasting?” Kennedy repeats. “Like the kind of fasting done prior to a baby’s circumcision?”

“Yes.”

“What happens to a baby who is undiagnosed with MCADD, and who suffers one of these acute episodes?”

“You might see seizures, vomiting, lethargy, hypoglycemia…coma,” the doctor says. “In about twenty percent of cases, the infant can die.”

Kennedy walks toward the jury box and turns so that her back is facing them, so that she is watching the witness with them. “Doctor, if Davis Bauer had MCADD, and if no one at the hospital knew it, and if the medical protocol was to have him fast three hours prior to his circumcision like any other infant without the disorder, and if an acute metabolic episode occurred in his little body—isn’t there a chance Davis Bauer would be dead even if Ruth Jefferson had performed every conceivable medical intervention?”

The medical examiner looks at me, his gray eyes soft with an apology. “Yes,” he admits.

Oh my God. Oh my God. The energy in court has changed. The gallery is so quiet I can hear the rustle of clothing, the murmur of possibility. Turk and Brittany Bauer are still gone, and in their absence, hope blooms.

Howard, beside me, breathes a single word. “Day-umm.”

“Nothing further, Your Honor,” Kennedy says, and she walks back to the defense table, winking at me. I told you so.

—

MY CONFIDENCE IS short-lived. “I’d like to redirect,” Odette says, and she gets up before Dr. Binnie can be dismissed. “Doctor, let’s say that this abnormal result had come into the nursery in a timely fashion. What would have happened?”

“There are some abnormal results that require a letter to be sent to the parents in due course—suggesting genetic counseling,” the medical examiner says. “But this one—it’s a red flag, one any neonatologist would consider emergent. The baby would be monitored closely and tested to confirm the diagnosis. Sometimes we send the family to a metabolic treatment center.”

“Isn’t it true, Doctor, that many children with MCADD are not formally diagnosed for weeks? Or months?”

“Yes,” he says. “It depends on how quickly we can get the parents in for a confirmation.”

“A confirmation,” she repeats. “Then an abnormal result on the newborn screening is not a final diagnosis.”

“No.”

“Did Davis Bauer ever come in for more testing?”