The family doctor who assessed the Kahui twins says it was so obvious the twins were unwell he asked their parents if they had been dropped on their heads.
Dr Gopinath Nayar told the High Court in Auckland today he examined the three-month old twins Chris and Cru about 1pm on June 13, 2006, the day after the crown says they were injured by their father Chris Kahui.
Kahui, 22, is charged the twins' murder. They died five days later, within about 14 hours of each other, at Auckland Starship Hospital.
Dr Nayar said it was clear the twins were neurologically unwell but both Kahui and their mother, Macsyna King, denied at his south Auckland medical centre that the babies had been dropped on their heads.
The evidence came as the trial is being forced to take a recess tomorrow due to the junior doctors' strike, with many of the senior medical experts for the crown being rescheduled to cover for their striking junior counterparts.
Dr Nayar said he did not ask the couple anything more about the twins' injuries as he did not want any further confrontation but rather focus on the babies.
Chris had an "obvious bruise" on one cheek and Cru was in respiratory distress, he said.
Dr Nayar said as he was very surprised by Chris' condition and an examination of Cru confirmed his diagnosis that both needed immediate specialist medical attention.
Dr Nayar said he told them they needed to go to Middlemore Hospital straight away and they seemed to agree.
"I think the obvious implication was the twins were sick."
Earlier two nurses at Middlemore Hospital gave accounts of Ms King arriving about 2.30pm at the emergency department swinging the babies in their car seats. One of the nurses, Claire Dillon, said Ms King was "quite elated".
The evidence was in stark contrast to Ms King's testimony last week when she said she had been upset and demanded medical attention.
Ms Dillon, a staff nurse was on duty when the twins were brought in, first saw Ms King as she entered into the emergency corridor swinging a baby capsule in each hand, she said,
Ms King appeared "quite elated" and showed "no distress signs at all".
There were bruises on both babies going down the side of their faces, she said.
When asked how the twins had been hurt Ms King said her toddler had put his hands into their cot and hit their heads together.
Ms King told her she was not home when the injuries had happened, having only arrived home at 11am that day, but three adults were.
Ms Dillon spoke with Ms King four hours later and explained both Chris and Cru were critically ill.
Ms King responded "That's terrible isn't it?" and left the room.
Ms Dillon said Ms King did not cry but was "obviously saddened".
Under cross-examination, Ms Dillon said Ms King's mood was almost elated and she did not made any demands for immediate medical attention.
Fleur Paulsen, a charge nurse at Middlemore Hospital, was working at the triage desk and met Ms King when she brought the twins in.
Ms Paulsen was given a referral letter from Dr Nayar, with "query NAI" written on the side, standing for non-accidental injury.
Ms King said she had brought the twins in because they had not been feeding, had a cold and one had stopped breathing.
Ms Paulsen said she saw a small crescent shaped bruise around the eyesocket on the left hand side of one of the twins.
Ms King told her she was unsure what had happened to either of the boys because she had not been at home but was told the cause by a female relative caring for the boys overnight, she said.
Ms Paulsen said there was "no sense of her being concerned for the children's condition".
"It struck me as quite unusual, given if I had been sent into hospital with my two premature babies I would have been concerned."
Ms Paulsen said Ms King seemed "unconcerned and relaxed".
It was clear the twins were not well, she said.
"It's just a feeling I had, they just didn't look right."
Ms Paulsen said Ms King was very calm and polite during the five minutes she dealt with her.
