AN EMERGENCY room doctor who assessed a man who was allegedly beaten to death on the City Walls has told a court how he had suffered "multiple bruising and bleeds" on his brain and a fractured skull.
Dr Alex Gorton was working at the Accident and Emergency Unit at the Countess of Chester Hospital when Christopher Garwell was admitted following an alleged attack on June 3.
Dr Gorton told Chester Crown Court that the 23-year-old was “unresponsive” when he was initially assessed by a nurse and was admitted after being found in a collapsed state by two students on the City Walls by King Charles Tower.
It is alleged that Mr Garwell, from Connah’s Quay, suffered the head injuries after he was jointly attacked by David Tushingham, 20, Kieran Cunnah, 18, both of Blacon and two youths who cannot be named for legal reasons. All of the accused deny a charge of murder.
Prior to the alleged attack the deceased had travelled to Chester with a friend and had spent the day with the four accused and a larger group of people at Grosvenor Park, Chester where he is said to have drunk vodka, taken six ecstasy pills and smoked cannabis.
Mr Garwell was taken to the Countess by paramedics and he was admitted shortly before 8.30pm. Because he was heavily intoxicated, he was given intravenous fluids and samples of his blood and urine were also taken. He had vomitted several times.
When Mr Garwell was seen by a nurse at 9.15pm he scored 10 on the Glasgow Coma Scale (GCS) which rates three to 15 in terms of responsiveness – with three being totally unresponsive and 15 being fully awake and alert.
Mr Garwell’s girlfriend at the time attended A&E with him and told a nurse that he had been involved in an altercation that night.
Dr Gorton said: “When I saw him I noted evidence of external bruising to three main areas – the left eyelid, the left ear and at the back of the left-side of the head.”
He said the signs of injury “did not ring alarm bells enough” to conduct a CT scan.
The court was told that during his time on A&E Mr Garwell did rise to a GCS of 13 and walked to the toilet.
When Dr Gorton carried out his first proper assessment of Mr Garwell shortly after 11pm, he noted an increased swelling and bruising to the face and head and recorded a GCS of 11.
He told the court: “Christopher Garwell was not improving in line with alcohol intoxication.”
An emergency CT scan was ordered and found “multiple bruising and bleeds” within the skull on the brain tissue and a possible fracture to one of the skull bones was found.
Dr Gorton contacted the neurological team at Walton Hospital in Liverpool and Mr Garwell was transferred before 5am on June 4.
The victim died six days after the alleged attack.
The prosecution alleges the four accused repeatedly kicked and punched the victim to the head, setting upon him for his money and drugs.
The trial continues.