Testimony continued Thursday in the murder trial of the former Mid-State pediatrician charged with killing her adopted daughter nearly two years ago in Wilson County.
Prosecutors called several witnesses to the stand including the pediatric doctor at Vanderbilt University Medical Center who examined Deborah Mark's daughter Kairissa on July 1, 2010, the day she died.
Dr. Paul Hain said the four-year-old girl was already comatose and being kept alive by machines when she arrived at Vanderbilt.
He told jurors the girl had suffered severe brain trauma within 24 hours prior. He compared the brain damage to that caused only by a car wreck or falling two to three stories, for example.
"This is not and ‘I slipped and bonked my head injury.' That does not happen," he said.
Hain said Kairissa had a total of 13 fractures in various stages of healing, including nine rib fractures ranging from two months to less than a week old.
In his expert opinion, the doctor said Kairissa was "tortured" over a span of months and deliberately killed.
"This child wasn't abused just once. This child was abused over the course of time, multiple times. Painful skin issues, painful broken bones and was never brought for medical attention. This child was tortured and then killed," Dr Hain said from the stand.
A doctor from Summit Medical Center also testified Thursday that he also suspected abuse after examining Kairissa.
Dr. David Lien said the little girl was at Summit for only about 30 minutes before she was taken by helicopter to Vanderbilt.
Prosecutors also showed jurors a picture of Kairissa's on the day she died. Witnesses in the courtroom called the photo "hard to look at."
Deborah Mark, for the first time, was visibly emotional in court during the doctor's testimony.
The prosecutions' last witness, Medical Examiner Dr. Thomas Deering, took the stand Thursday afternoon and testified the autopsy found Kairissa had multiple blunt force trauma injuries.
Deering said the little girl had extensive bleeding in her brain and down to her spine, in addition to multiple rib fractures of varying ages.
He said an adult had to have put their hands around the child and squeeze "very hard" to cause the injuries.
The autopsy determined Kairissa's cause of death to be acute blunt force trauma that was not accidental and in his opinion, homicide.
Mark's husband, Steven, who also faces child abuse charges in the case, took the stand Thursday and was asked if he contacted the couple's adoption agency just before his daughter's death as testimony revealed he did on Wednesday.
He replied, "From the advice of my attorney Alan Poindexter, I am exercising my right under the 5th amendment of the United States constitution against self incrimination I respectfully decline to answer."
Deborah Mark is charged with first degree murder and several counts of child abuse in the case. She has pleaded not guilty to all counts.
Steven Mark also pleaded not guilty and is out of jail on bond while awaiting trial.