A doctor who stabbed her three-year-old autistic son to death in their south Dublin home has been found not guilty of his murder by reason of insanity.

Kuwaiti national Maha Al Adheem (43) told gardai who arrived at the scene: “I did it, I stabbed my son and then stabbed myself”. A large amount of blood was observed on Ms Al Adheem's hands and clothing before the boy's body was found lying in the middle of a bed in the one bedroom apartment.

Omar Omran was stabbed 20 times, mainly to the trunk of his body. Four stab wounds had penetrated his lungs and heart, severing a vital artery. His cause of death was multiple stab wounds to his chest, abdomen and trunk as well as to his right thigh.

There were signs of defensive injuries to the boy's right hand and a silver stainless steel knife was found at the top of the bed. Ms Al Adheem told gardai in her interviews that “a power” had made her go to a drawer and remove the knife.

Ms Al Adheem, with an address at Riverside, Poddle Park, Kimmage, Dublin 12 had pleaded not guilty to murdering Omar Omran on July 10, 2017 at the same address.

Two consultant psychiatrists gave evidence during the Central Criminal Court trial that Ms Al Adheem was suffering from paranoid schizophrenia in July 2017. The defendant was unable to appreciate that what she did at the time was morally wrong and would have been unable to refrain from her actions, they said. The doctor met the requirements for the special verdict of not guilty by reason of insanity, the court heard.

On the first day of the trial, defence counsel Anne Rowland SC made a number of admissions on behalf of her client including that Ms Al Adheem had inflicted stab wounds to the deceased and rang emergency services at 6.40pm on July 10 reporting that her son was dead.

Patrick Gageby SC, also defending, told the court this morning that he would like to repeat and add to one of the section 22 admissions which his colleague Ms Rowland had previously made. The body of Omar Omran was removed to the Mater Hospital and then to the city morgue where an autopsy revealed stab wounds, which were inflicted by Ms Al Adheem who had the requisite intention required by the Criminal Justice Act of 1964, Mr Gageby said.

The jury of nine men and three women spent one hour and 46 minutes deliberating today before bringing in a unanimous verdict of not guilty by reason of insanity.

After they had delivered their verdict, Ms Justice Eileen Creedon thanked the jury for their care and attention to this very difficult case.

The judge exempted them from jury service for the next five years and wished them a happy Christmas.

Ms Justice Creedon then made an order committing Ms Al Adheem to go to the Central Mental Hospital today and to be brought back before the court tomorrow morning at midday.

The judge also directed the preparation of a psychiatric assessment by an approved medical officer.

Evidence in trial

During the four-day trial, former garda Diarmaid Kelly, from Sundrive Road Garda Station, gave evidence that he was the driver of an official patrol car on the Crumlin Road on July 10. He said that at 6.52pm he was informed by Dublin Fire Brigade that a child was in cardiac arrest at an apartment in Kimmage.

Members of the fire brigade were preparing to leave the scene when Mr Kelly arrived as they had tried to gain access to Ms Al Adheem’s apartment but there was no response.

Mr Kelly and some members of the fire brigade went to the second-floor apartment and made several attempts to knock on the door.

Mr Kelly rang Ms Al Adheem’s mobile number, as she had previously called 999 at 6.40pm saying her baby was dead before hanging up. The person who took the call had phoned her back but she hung up again.

The witness said there was a “red smudge mark” on the left-hand side of her apartment door which he believed was blood.

The fire brigade used a ladder to look through the balcony window but the curtains were drawn and the balcony door was locked.

Mr Kelly said two firefighters breached Ms Al Adheem's apartment door using a sledgehammer which activated an intruder alarm.

The witness testified that Ms Al Adheem was standing in the hall directly in front of him and looked panicked.

“Ms Al Adheem held her hands up and said ‘no, no, no’ and backed away into the living area where she sat on a couch,” he said.

Mr Kelly said he observed a large amount of blood on her hands, her right hip and her clothing. He called for the assistance of paramedics and a doctor who had accompanied them to the scene.

The witness said he soon became aware of a “degree of commotion” coming from the bedroom of the apartment and went to see what the cause was. He observed the body of a young male lying on his back in the middle of a bed in the bedroom. “There was a substantial amount of blood at the scene and paramedics had connected an ECG monitor to the child,” he said.

The witness said he noted several puncture wounds to his torso and legs. A silver stainless steel knife was also on the bed.

Paramedics informed Mr Kelly that the child was unresponsive and had no pulse before he returned to Ms Al Adheem in the living area.

Mr Kelly said he asked the defendant repeatedly what had happened and she replied: “I did it, I stabbed my son and then stabbed myself”.

Ms Al Adheem was initially reluctant to be examined by staff and held a cushion to her side where her injuries were. Eventually, she allowed a doctor to examine her before she was brought by ambulance to St James’s Hospital at 7.40pm.

Detective Garda Riana O’Sullivan gave evidence that she attended St James’s Hospital with Ms Al Adheem as she had three small puncture wounds on her abdomen.

Det Gda O’Sullivan said the defendant told her that she had killed her son and her bed was full of blood. “She said ‘the spirit goes to bed with me, at 12 o’clock I take the knife and start hitting him and myself, I want to die',” Det Gda O’Sullivan testified.

Sergeant Brendan O’Halloran told the trial that he arrested Ms Al Adheem at 10.05pm in the psychiatric unit of St James’s Hospital on July 12 and conveyed her to Crumlin Garda Station where four interviews were conducted with her. When the murder charge was put to her she replied: “Yes it was my knife, my hand, it was not me, the power.”

In her first interview, Ms Al Adheem told gardai: “How can I kill my son, the only thing in my life I lost”.

She told gardai that her son had been playing the ipad on the couch and she was reading before she grabbed a knife and stabbed him the bedroom.

The defendant said she did not answer the door to gardai as she thought they were “fake people” and she knew Omar was already dead.

When gardai informed her that a post-mortem had been carried out on her son and the results showed he died of multiple stab wounds, including those to the heart and lungs, she replied: “I want to die, I want to die.”

Prosecution counsel Michael Delaney SC tendered two witnesses during the trial at the request of the defence.

Siobhan Murray told Patrick Gageby SC, defending, that she was Ms Al Adheem's neighbour and found her bubbly and a bit hyper as well as “beyond” a caring mother to her son. “She was amazing, she did everything for him morning and night. I never heard her raise her voice once or correct him,” remarked Ms Murray.

The witness gave evidence that a black cat with no tail hung around their apartment complex and Ms Al Adheem did not want her calling the cat over. Ms Murray agreed with Mr Gageby that the defendant thought the cat was an evil spirit and the cause of a lot of bad things that were happening to her.

The witness said that Ms Al Adheem gave her “a blow by blow” account about a smashed mirror in her apartment on July 7, which she maintained the cat had caused. “She thought that when anything was not going right the cat seemed to be there. It was a worrying thing for her,” she said.

Aingle Ni Cheallaigh told defence counsel Anne Rowland SC that she also lived at Riverside and found Ms Al Adheem “so friendly” when she first met her in 2010 but could see the defendant's difficulty with her son being demanding. However, the witness said her "best friend" was extremely caring and protective of Omar.

Ms Rowland put it to Ms Ni Cheallaigh that her client had devoted herself to her son’s care. “She was his only care that I knew. The only time she got to put out the bins was when he was asleep," she replied.

The witness said she had noticed Ms Al Adheem become paranoid a few months before the incident and told the court that her friend was afraid the spirits of dead people would inhabit the cat and use this cat to hurt her.

Ms Ni Cheallaigh further agreed with the defence that the defendant was a kind, good and decent mother.

The statement of Deputy State Pathologist, Dr Linda Mulligan was read into the record by the prosecution. Dr Mulligan conducted a post-mortem examination on July 12 and gave the cause of the child's death as multiple stab wounds to his chest, abdomen and trunk as well as to his right thigh.

There were 20 stab wounds in total and four of the stab wounds had been fatal as they had penetrated his heart and lungs, severing a vital artery. The remaining stab wounds to his back, abdomen and right thigh contributed to overall blood loss and death. Dr Mulligan added that two incised wounds to his hand were consistent with defensive type injuries.

Two psychiatrists from the Central Mental Hospital in Dundrum told the trial that Ms Al Adheem fulfilled the criteria for a special verdict of not guilty by reason of insanity.

Dr Paul O'Connell and Dr Lisa McLoughlin were in agreement that the defendant was suffering from paranoid schizophrenia in July 2017. The Kuwaiti woman was unable to appreciate that what she did at the time was morally wrong and would have been unable to refrain from her actions, they said.

Dr O’Connell told defence counsel Patrick Gageby SC that Ms Al Adheem qualified as a doctor in Iraq in 2003 but it took her nine years to complete a six-year medical degree as she was diagnosed with depression and schizophrenia while she was a medical student in 1996.

Ms Al Adheem told the psychiatrist that she had seen an “out of this world” black cat with no tail from her apartment balcony in Kimmage and as a result prayed on the Quran day and night over three days to “ward off” its spirit.

Dr O’Connell said Ms Al Adheem seemed to be deluded that her life was being “laid bare” on Facebook by a previous suitor who was keeping her under surveillance and had hacked her account.

Ms Al Adheem told Dr O’Connell that her ex-husband had a limited ability to learn English and he had sensitivities which meant he could not tolerate loud noises including the sound of their baby crying. Her son Omar was born on January 9, 2014 through assisted conception treatment. Their marriage ended when Omar was four months old and Ms Al Adheem applied for a legal separation that year which came into effect in 2016.

She told Dr O’Connell that developmental problems became apparent in Omar when he was two and a half years old and there were issues finding a crèche for him as he was non-verbal, needed one to one attention and his special needs were evident.

Ms Al Adheem said she felt very depressed in the months prior to the event because of her child's autism and because she said schools were refusing to take her son. On March 14, 2017 she felt suicidal and attended her GP with suicidal thoughts and was admitted to the psychiatry department in St James’s Hospital for five days, said Dr O’Connell.

According to notes generated from St James’s Hospital, Ms Al Adheem was not presenting with any psychotic phenomena or psychotic ideation when she was discharged from St James’s Hospital.

Ms Al Adheem said a power took over her on the day of the killing which made her stab herself and her son and she felt her wrists being twisted, recounted Dr O’Connell.

The second forensic psychiatrist, Dr Lisa McLoughlin told Mr Delaney that the defendant retains the delusional belief about the black cat, although she does not currently see it, and there has been a substantial deterioration in her level of functioning.

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