Serenity's mother says autopsy report doesn't bring 'clarity'

An autopsy report says four-year-old Serenity died of blunt trauma to her head, but the cause of that trauma was never confirmed.

Warning: This story contains graphic details that may be disturbing to some readers

Serenity was four years old when she died of severe head trauma in an Edmonton hospital. (Supplied)

Editor's note: On Jan. 4, 2023, a justice of the Alberta Court of King's Bench released her report into Serenity's death. In that report, Justice Renee Cochard reviewed information, including the results of subsequent investigations, and outlined various "misconceptions" about the girl's condition at the time she was admitted to hospital. The report includes findings that there was no sexual abuse, and that an interpretation of a nurse's note which read "?0 hymen observed during catheter insertion" indicated her hymen was missing is incorrect. 

An autopsy report shows that four-year-old Serenity died from blunt head trauma and its complications, but the cause of that trauma was never confirmed.

The Office of the Chief Medical Examiner provided the report to Serenity's mother on Friday, who in turn shared it with CBC.

Though she had made previous attempts to access the report, the mother said police and prosecutors told her she wasn't allowed to have the document while the criminal case was still active. 

CBC is not publishing Serenity's surname, or identifying her mother or her caregivers in order to protect the identities of Serenity's siblings.

The little girl died in 2014, following injuries sustained while she was living in a kinship care arrangement on a central Alberta reserve. Her guardians claimed she fell off a tire swing, but some of her medical reports, leaked to the media, indicated she had bruising in her genital and pubic areas and a missing hymen.

Those reports were erroneous and inaccurate, the guardians argued in an amended statement of defence in response to a $1.6-million lawsuit filed by Serenity's mother.

The couple had faced a criminal charge of failing to provide the necessaries of life to Serenity. That charge was stayed by the Crown last month.

According to the autopsy report, Serenity's hymen was intact. Dr. Bernard Bannach, who was the assistant chief medical examiner at the time, performed the autopsy on Sept. 30, 2014.

Bannach did record bruising all over the little girl's body: in addition to the bruise on her head, there were bruises and abrasions found on her limbs and torso, above the pubic bone on her lower abdomen, as well as next to her anus. She had no internal injuries to her vagina or anus.

The autopsy also noted Serenity's weighed 11.5 kg at the time of her death, which is below the third percentile for weight. 

Bannach finalized his report two years later, on Sept.9, 2016, after receiving the results of an examination of Serenity's brain by Calgary neuropathologist Dr. Leslie Hamilton. 

Hamilton confirmed that "blunt head trauma and its complications" caused the death, but found no evidence of a cause, a fall from a swing or otherwise.

"There are no specific features identified at neuropathological examination to indicate the nature of the blunt trauma that occurred to cause the injuries identified," she wrote.

The conclusion brought no comfort to Serenity's mother, who said she asked police and prosecutors for a copy of the autopsy report multiple times before she was told she could have it.

"No, it doesn't bring clarity to me at all," she said Monday, adding that she's frustrated by the differing information in her daughter's medical reports and the autopsy's findings.

The autopsy report also revealed that Serenity's heart had been removed for transplant. Her mother said she made the decision to donate her daughter's heart

She said she has received a letter thanking her, and informing her that Serenity's heart tissue and valves helped save the lives of two babies.

"Those two babies who are living today have a shot at life. I'm thankful for that," she said.

Serenity's case prompted public outrage and an emergency debate in the Alberta legislature. Her death led to the creation of a panel looking into the province's child-intervention system.

The provincial government later revamped its system for child intervention, based on recommendations from the panel.