FARMINGTON — The obvious injuries to 4-year-old Ethan Stacy did not cause his death.

Instead, his death was classified a homicide due to a combination of scalding injuries, drug toxicity and aspiration pneumonia, Utah deputy chief medical examiner Edward Leis testified Friday.

The boy suffered some obvious second- and third-degree burns, bruising to his head and legs and lacerations to his head, but Leis said those injuries did not cause his death. The lacerations were caused after he died and the bruises were not serious.

The burns, however, could have led to dehydration, of which the boy showed signs. Leis said the burns were on the boy's feet and thighs, as though he had been crouching in scalding water. The burns would have been caused by either exposure to temperatures of 150 degrees or more or lower temperatures for a longer period of time.

Ethan would not have simply stepped into scalding water and received such injuries, he said, adding that the burns he received would have required medical treatment.

The doctor's testimony came during the third day of a preliminary hearing for Nathan Sloop, 34, the boy's stepfather who is accused of killing him. One more witness, a burn expert, is scheduled to testify on April 19 and a judge will likely decide then whether he's heard enough evidence to order Sloop to stand trial for capital murder and other charges.

Leis said aspiration pneumonia is caused by an inhalation of foreign materials into the lungs, potentially vomit, or as prosecutors suggested, fecal matter that the boy allegedly was forced to eat, according to prior police testimony.

That also may have caused dehydration, Leis said, which was exacerbated by a lack of food in the boy's stomach. Defense attorney Scott Williams argued that the lack of food could have been caused by vomiting, as Nathan and Stephanie Sloop contended that they thought Ethan was ill.

Williams also questioned Leis about the drugs found in the boy's system, most of which, Leis said, could be found in over-the-counter children's medications. However, there was also evidence of alprazolam, or the drug found in Xanax, in the boy's body.

David Andrenyak, a toxicologist from the University of Utah, listed the substances found in Ethan's system, including Xanax and substances indicative of Benadryl and Tylenol. The medications appeared to have been administered in adult doses.

Still, Andrenyak said none of the drugs, on their own, would have caused the boy's death.

"There was no one single drug detected in the blood samples from Ethan where the concentration was high enough to say it was a clear-cut drug overdose," Andrenyak said.

He said the boy had other medical issues that would have played a part in the child's death. "There were other factors ... in addition to the drugs," Andrenyak said. "Those things would definitely have to be considered as we look at the whole picture of how Ethan may have died."

Prosecutor David Cole questioned whether Benadryl seemed like an appropriate medication to address Ethan's burned skin, which at some point he said was described as "falling off."

"I would suspect that if someone was seriously injured, they would take other action and not administer over-the-counter medication," Andrenyak said.

Defense attorney Richard Mauro also talked to the toxicologist about the prescriptions given to Nathan Sloop — totaling more than 4,000 pills in 11 months for drugs such as Lortab, Percocet and Xanax — and how those medications could affect his general behavior and responses in police interviews. But Andrenyak said he could not know how many of the pills Sloop had taken or what his tolerance to the medications may be.

Afraid of going to prison, Sloop has contended that he and his wife, the child's mother, Stephanie Sloop, found the boy dead the morning of May 8 and decided to disfigure and bury the boy's body. Days later, they called police and reported Ethan as missing. Nathan Sloop ultimately led police to where the boy was buried in the Powder Mountain area of Weber County.

Prosecutors believe the boy was abused beginning shortly after he came to Utah to visit his mother on April 28, 2010, until his death days later on May 8. Cole said Ethan died of severe abuse, was scalded, beaten, overmedicated and not given the medical care that he needed.

Defense attorneys argued that the boy's death was an accident caused by an overmedication of over-the-counter drugs.

The boy had been sent to visit his mother for the summer as part of a custody agreement.

In phone calls with his mother and ex-wife played in court Thursday, Nathan Sloop said he believed Ethan's father had taught the child to misbehave in an effort to hurt Stephanie Sloop. He told police that Stephanie Sloop thought that her ex-husband, Joe Stacy, "destroyed my boy." He also said his wife told him to "teach him (Ethan) to be a man" by beating him or "whatever it took to get her boy back."

Sloop told police he would discipline the boy, usually by slapping or spanking him, but didn't think it amounted to abuse. He also told police that Ethan's death was an accident.

But prosecutors have pointed to conversations in which Nathan Sloop called the boy "poison" and also said that after Ethan arrived, his relationship with Stephanie Sloop went down "like a battleship." Sloop told his mother in one recorded phone call from jail that he destroyed two women's lives, apparently referring to his mother and Stephanie Sloop, "because I wanted to get laid more."

Prosecutors also pointed to a timeline — shown in text messages, surveillance videos and other evidence — that showed that the couple buried the child on May 8, then sent each other messages about their sex life, visited their favorite restaurants and cleaned up their apartment. Stephanie Sloop called to report that her son was missing May 11.

Prosecutors have indicated their intention to seek the death penalty against Nathan Sloop, who is also facing charges of obstructing justice and intentionally inflicting serious injury on a child, second-degree felonies; desecration of a dead body and damaging a jail, third-degree felonies.

They have not stated whether they will also seek the death penalty against the boy's mother. Stephanie Sloop, 30, is facing identical charges except for the damaging a jail charge.

E-mail: emorgan@deseretnews.com

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