A nutritional expert testified this morning that it would have been apparent that Chandler Grafner was very ill before he died and that the emaciated 7-year-old might even have been comatose in his final days.
Dr. Nancy Krebs, a professor of pediatric nutrition at the CU School of Medicine and director of nutrition at Children’s Hospital, testified that the degree of dehydration found in Chandler’s body would have taken one to two weeks without fluid intake.
If he had been vomiting or suffering from diarrhea, it would have taken him two or three days to reach the level of severe dehydration he was in before he died on May 6, 2007.
Krebs said Chandler showed all the classic signs of dehydration and starvation, including a severe deficiency of vitamin C, which caused his fingernail beds to bleed. The condition is known as scurvy, she said. Autopsy photos showed Chandler’s nails to be black, which Krebs said was blood coming from broken capillaries.
Chandler also suffered from a severe deficiency of niacin or vitamin B3, known as pellagra, which caused his skin to flake off or develop lesions.
“It is quite apparent that he was quite ill,” she said. “I can’t say if he was able to walk or not, but if he could, it wouldn’t be very fast or very far because of the loss of muscle in his legs.”
“His hands and feet would have been cold because his body was trying to conserve energy. He would have had very little desire to move around.”
She said his body had consumed nearly all of its fat under the skin and around his organs. His body weight was 62 percent of what it should have been, a condition known as marasmus, or severe protein calorie malnutrition.
“His fat had been all used up by his body,” she said.
Earlier in the morning, during the first-degree murder trial of Chandler’s guardian, Jon Phillips, a child-abuse expert testified that the bruises and skin abrasions on the boy’s body were consistent with child abuse or inflicted trauma, rather than from accidents or from horsing around.
Dr. Kathryn Wells of Denver Health Medical Center said the locations and patterns of bruises or skin abrasions tell her much about the causes.
“The ear is one of the areas I always check first” when looking for signs of child abuse, she told the jury.
Chandler’s plight first came to light when he showed up at Holm Elementary School with a severely bruised right ear on Jan. 17, 2007. He first told his teachers, “My dad clobbered me,” but later changed his story to having slipped and fallen in the bathtub.
“Chandler was bruised only on his ear,” Wells said. “He had no linear bruising or any other bruises. That’s not consistent with hitting a large object (such as a bathtub).”
She also said it’s difficult for children to bruise their ears from playing around because of the protective triangle formed by the shoulder and the head. She said that frequently, a child will hit a shoulder or the top of their head in a fall but rarely only their ear.
Viewing photographs taken of Chandler after he died, she said the numerous skin abrasions — particularly over the areas where the emaciated boy’s bones were pressing against the skin — were caused “over a period of time,” not just within a few hours. Chandler’s body had skin abrasions on his shoulder blades, spine and hips.
In other testimony this morning, David Hageman whose job is to pick up corpses in the city and deliver them to the coroner’s office, said he was incensed when he saw the condition of Chandler’s body.
“I became very angry,” he said, adding that he has picked up “thousands of corpses.”
“I can’t seem to let go of this one. It keeps returning to me,” Hageman said.
He said one of his duties is to weigh the bodies as he delivers them. He said Chandler’s corpse weighed 31 pounds, 3 pounds lighter than had been previously reported. He didn’t explain the difference.
Mike McPhee: 303-954-1409 or mmcphee@denverpost.com
