CALGARY -- A British Columbia physician says the parents of a starved teen refused to accept a diabetes diagnosis when the boy was initially admitted to hospital 13 years before his death.
Dr. Laura Stewart, a pediatric endocrinologist, testified Monday that the husband and wife were reluctant to give their son insulin after he was diagnosed with Type 1 diabetes at the children's hospital in Vancouver in 2000.
Emil Radita, 59, and his wife Rodica Radita, 53, are charged with first-degree murder in the 2013 death of 15-year-old Alexandru. The boy, who was one of eight children, weighed less than 37 pounds and died of complications due to untreated diabetes and starvation.
The judge, who is hearing the case without a jury, has yet to decide if the evidence from B.C. will be admitted at trial.
Stewart said Alexandru tested at the severe end of diabetic ketoacidosis, which occurs when the blood becomes acidic and can result in muscle aches, nausea, vomiting and in some cases organ failure. A lack of insulin causes the body to break down muscle and fat cells.
Although their son reacted well to treatment, the parents weren't allowed to take him home until they had proven they were capable of administering insulin and checking his blood sugar.
"What I remember is the mother still not accepting the diagnosis of diabetes and initially did not want to learn how to manage it. Eventually she did comply on how, to get the child home, but never did acknowledge the diagnosis."
Alexandru gained weight and appeared to be a healthy child when he came for an outpatient checkup a few months later in February 2001 just after his third birthday. She said his height was just over three feet and he weighed about 35 pounds, which was normal for his age.
Stewart said she saw Alexandru again in October 2003 when he was readmitted after presenting as "very ill" at a hospital in Surrey, B.C.
"Alexandru was so severely malnourished at the time of admission it was felt by the attending staff at the time that he was not safe to be in the care of his family."
Stewart said children's services in British Columbia was notified and Alexandru was "apprehended" from his parents care while he was still in hospital.
Dr. Paul Korn, an expert in pediatric emergency medicine works at the hospital. He was called to consult on the case by B.C.'s Ministry of Children and Family Development.
Korn said he talked to the parents and was told that Alexandru had been fine two weeks earlier.
"I was already aware that Alex was a very sick boy. It was hard for me to really understand how a child could be totally well and fine and, over the next two weeks, deteriorate to the point where he is going into hypotensive shock," Korn said.
Hypotensive shock occurs when not enough blood and oxygen flow to the body's major organs, including the brain.
Korn said the child was "profoundly malnourished", with a swollen abdomen and fluid in the lining of the lungs and around his heart.
"I have never seen a patient as malnourished as this in my career. I've certainly read about these cases and seen this all on television in terms of countries that have famine."
Alexandru was put into foster care when he was discharged from hospital.
The Raditas moved from B.C. to Alberta in 2009.
The medical examiner in the case said Alexandru was skeletal in appearance when he died, had very little body fat and was severely underweight. His body was covered with ulcers and his teeth had rotted down to the root.
