Rare scalp bleed, not abuse, caused Keene toddler’s death, doctor tells court

A pathology expert told jurors in Cheshire County Superior Court on Tuesday that 23-month-old Luca Hudson died in January 2024 from an unusual scalp hemorrhage.

A pathology expert told jurors in Cheshire County Superior Court on Tuesday that 23-month-old Luca Hudson died in January 2024 from an unusual scalp hemorrhage linked to a minor blow to the head, rejecting the state’s theory that the child was abused.

Dr. Elizabeth Laposata, a Brown University Medical School professor who testified by video conference, said the bleeding under the scalp led to swelling in the brain and ultimately caused Luca’s death. She said the injury could have occurred during ordinary play or routine caregiving, even though cases like this are uncommon.

The testimony came in the second-degree murder trial of Annthoni Bliss, 24, of Lyndeborough, who is accused of fatally injuring Luca while dating the boy’s mother, Lydia Marrotte. The New Hampshire Medical Examiner’s Office previously determined the death was a homicide caused by blunt force trauma.

Laposata said her opinion was shaped by both Luca’s medical records and the postmortem findings. She argued that the medical picture fit a subgaleal hematoma, a bleed beneath the scalp, rather than inflicted injury. She also said the eye hemorrhages described by treating specialists could be explained by pressure from brain swelling affecting veins connected to the eyes.

During questioning, Assistant Attorney General Peter Hinckley pointed to the contrast between Laposata’s pathology background and the experience of doctors who treated Luca at Dartmouth Hitchcock Medical Center in Lebanon. Those clinicians had testified earlier that the injuries reflected serious head trauma caused by someone in the child’s life.

Hinckley also challenged the medical studies Laposata relied on, pressing her on whether they supported her conclusion. Laposata said the literature included rare examples of similar hemorrhages, sometimes tied to abuse or underlying illness, but she maintained Luca showed neither. She said her review found no evidence of inflicted injury.

She told the court that a scalp bleed spread by friction or dragging along the head usually looks different from the localized bruising and small skull fracture more often seen with blunt force. Asked for another case that matched Luca’s condition, she said she could not name one, but added that each case must be judged on its own facts.