— Doctors and nurses "feverishly worked" to save the life of 4-year-old Teghan Skiba when her mother's boyfriend took her to Johnston Memorial Hospital more than three years ago, claiming she hit her head while jumping on the bed.

But Dr. Michael Evans, a physician on call when Teghan was brought to the emergency room on July 16, 2010, testified Tuesday in the capital murder trial of Jonathan Douglas Richardson that the child had a faint pulse, strained breathing, dilated eyes and was limp and lifeless.

"The main presentation was that I have a kid here that's been beaten badly, has a head injury and has a bunch of other marks on her, but right now, the problem is the large amount of blood in the brain," Evans said.

As medical workers treated Teghan, nurse Mary Butler – who had seen the more than 60 bite marks, cuts and bruises on the child's arms, legs, back and stomach – confronted Richardson as he abruptly tried to leave the ER waiting room.

"I just couldn't take anymore, and I looked at him and said, 'Oh my God,'" she said. "I took off after him, and I chased him down (the hall). I was running for everything I was worth."

Butler caught up with him and grabbed him from behind at the exit door.

"I caught him by the throat, and I slung him around and was pushing him for everything I was worth," she said, demonstrating on Johnston County Assistant District Attorney Paul Jackson.

She then directed Richardson to a room where he waited until authorities arrived. Fueled by anger and adrenaline, she asked them for a gun.

"I'm going to do what needs to be done, right here, right now," she recalled saying.

Doctors eventually decided to have Teghan transferred to UNC Hospitals in Chapel Hill, where she died three days later.

"She was not conscious. There was no consciousness about her," Johnston County sheriff's investigator Jamey Snipes testified. "All I could see was lacerations. It was just an unbelievable experience – something I've never seen before."

Snipes said Richardson first told him the girl hit her head the night before and later said she used the bathroom in bed and that "he lost it," and whipped her with a drop cord.

Prosecutors say the 25-year-old also tormented, tortured and terrorized Tegahn, who turned 4 just days earlier, for 10 days in a shed behind his grandparents' Smithfield home.

He faces charges of first-degree murder, felony child abuse, kidnapping and sexual offense with a child and, if convicted, could face the death penalty.

Defense attorneys, however, say he didn't sexually abuse Teghan and never meant to kill her. He didn't have the parenting skills or experience to care for her while her mother, Helen Reyes, an Army reservist, attended military training in New Mexico.

Reyes, they say, had other childcare options but chose Richardson – her boyfriend of six months whom she and the child lived with in the small shed.

The child abuse, they say, was happening long before Reyes ever left Smithfield. She also faces a charge of negligent child abuse in the case.

"Helen taught Jonathan that abusing her daughter was appropriate by her actions or by her approval when it happened," defense attorney Jonathan Broun said in opening statements Monday.

That approval, combined with Richardson's own experiences of being abused as a child and undiagnosed mental problems contributed to Teghan's abuse and death.

"Jonathan loved Teghan, but he was as unequipped to care for a 4-year-old as a 21-year-old man could be," Broun said. "He had no idea how to take care of a little girl, and his actions showed it."