A murder trial jury has heard that a doctor admits stabbing her three-year-old autistic son in their south Dublin home and had told gardaí that “a power” had made her go to a drawer and remove a knife.

The Central Criminal Court has heard that the boy was stabbed 20 times, mainly to the trunk of his body. Four stab wounds had penetrated his lungs and heart, severing a vital artery, the court heard.

It was during the opening of the trial of Maha Al Adheem that a prosecuting barrister told the court that expert psychiatrists for both the prosecution and defence are in agreement that the accused fulfils the criteria of not guilty by reason of insanity in this case.

Ms Al Adheem (43), with an address at Riverside, Poddle Park, Kimmage, Dublin 12, is charged with murdering Omar Omran on July 10th, 2017 at the same address. She pleaded not guilty when arraigned before a jury on Monday.

Opening the case for the prosecution, Michael Delaney SC told the court that there will be no “substantial controversy” between the prosecution and defence on the facts of the case. The defence of insanity has been raised on behalf of Ms Al Adheem, the barrister said, and if this is accepted by the jury it would result in a special verdict of not guilty by reason of insanity. “This is not the equivalent of an outright acquittal,” he added.

Arranged marriage

Counsel told the jury that the facts of the case are particularly distressing and profoundly sad so they must strive to be clinical in their assessment of the evidence. “Your deliberations are likely to boil down to what you make of the expert evidence concerning the state of mind of the accused woman at the time she killed her son,” said Mr Delaney.

Outlining the facts of the case, Mr Delaney said Ms Al Adheem spent the early part of her life in Kuwait and lived there until she was 15 years of age. The Gulf War had broken out at this time and the accused’s family moved to Iraq where she remained until 2006. Ms Al Adheem studied medicine between 1994 and 2003 and ultimately qualified as a doctor in Iraq. However, her studies were delayed in part as she was diagnosed with suffering from depression and schizophrenia in 1996.

The barrister said that due to the conflict taking place where Ms Al Adheem had studied and started to practice as a doctor, her family moved to Syria in 2006 and remained there until 2010.

He said the court will hear that Ms Al Adheem came to Ireland in 2010 as part of an arranged marriage to a man called Khalid Omran who was living in Dublin at the time. The pair got married in January 2010 and Ms Al Adheem moved to Ireland in November of that year, he said.

This was not a happy marriage and they separated in May 2014, only a few months after their only child Omar was born. Their son had developmental delay and he was non-verbal, Mr Delaney said, and he was diagnosed with autism when he was just over three years of age. “This all forms part of the background to the case,” he indicated.

Black cat

Although Ms Al Adeem qualified as a doctor she did not practice medicine in Ireland as it was not possible with everything going on in her life.

In March 2017, a month after her son was diagnosed with autism, Ms Al Adheem was admitted to the psychiatric department of St James’s Hospital with suicidal thoughts and was detained there for five days. She was diagnosed with suffering from an “adjustment reaction” and the opinion was that she was under a considerable amount of stress as a single mother who was having difficulty accessing services for her special needs son. The accused was living in her one bedroom apartment in Kimmage with her son at the time, the court heard.

He said the court will hear evidence that in the months prior to the alleged offence based on accounts provided by neighbours, Ms Al Adheem was becoming preoccupied with a black cat with no tail, who was wandering around her apartment complex. “She associated this cat with an evil spirit that was making bad things happen and one of these things was a male presence engaging in sexual acts with her in her bed at night,” said Mr Delaney, adding that the accused told her neighbours about this.

On the day of the killing, Mr Delaney said Dublin Fire Brigade got a 999 call from a female at 6.40pm who stated that her baby was dead and then hung up. The person who took the call phoned the woman back but she hung up again.

Paramedics were dispatched to the scene and were unable to get access to the accused’s apartment on the second floor. There was no answer when they knocked on the door and they went around the side to get access to the balcony but the balcony door was locked and the curtains drawn. They returned to the front door of the apartment and used a sledgehammer to break the door.

Stab wounds

Garda Diarmaid Kelly was the first person to enter the hallway where he saw the accused who began moving back to the living area. She was observed putting her hands up and had blood on her clothing, said Mr Delaney, adding that she held her thigh as if she was injured.

It became apparent at the same time that Omar’s body, which had multiple stab wounds to his chest, was lying on a single bed in the bedroom. Rigor mortis had set in which appeared to suggest the death had occurred sometime earlier. Ms Al Adheem told those in attendance at the scene that she had stabbed her son and then herself and she wanted to die. Medical personnel at the scene tried to examine the accused, she was reluctant at first but eventually allowed this to be done. She had a number of superficial wounds to her abdomen.

Ms Al Adheem was brought to St James’s Hospital where it was confirmed that her injuries were not serious and she was transferred from A&E to the psychiatric part of the hospital where she remained until she was discharged two days later.

Omar’s body was removed from the apartment the following day and a post mortem was conducted by Deputy State Pathologist, Dr Linda Mulligan. Mr Delaney said the evidence will be that Dr Mulligan identified 20 stab wounds, mainly to the trunk of his body. Four stab wounds were significant as they had penetrated his lungs and heart, severing a vital artery. There were also signs of defensive injuries to the boy’s right hand.

Dr Mulligan found that sustaining these injuries was not compatible with life and the child would have had no prospect of survival. The cause of death was massive blood loss as a result of multiple stab wounds. A silver kitchen knife was found towards the head of the bed and Dr Mulligan considered that this knife could have caused Omar’s injuries, the court heard.

Mr Delaney further stated that Ms Al Adheem’s treating psychiatrist said she was fit for interview following her discharge on July 12th and she was then arrested for her son’s death.

Called 999

The accused was taken to Crumlin Garda station where she was interviewed on four occasions and the jury will hear evidence of what was said in the course of those interviews. “In those interviews she spoke of the black cat without a tail wandering around the apartment complex and that a man through the cat was sleeping with her,” said counsel.

The court will also hear evidence, the lawyer said, that Ms Al Adheem gave an account to gardaí concerning what happened that day. The accused told gardaí that she and Omar were in the sitting room at midday when she grabbed a knife and stabbed him in the bedroom and then stabbed herself before she passed out. When she “came around” she called 999.

“She said a power had made her go to a drawer and take out a knife and stab her son,” said Mr Delaney, adding that this was something the accused had been heard to repeat on a number of occasions. Ms Al Adheem was transferred to the Central Mental Hospital in Dundrum shortly after having been charged with the offence.

The court will finally hear evidence, Mr Delaney said, from two psychiatric consultants who are not responsible for Ms Al Adheem’s care but will give independent evidence about her mental state at the time of the alleged offence.

The barrister said the defence of insanity is being raised in this case and both expert psychiatrists are in agreement that the accused fulfils the criteria of not guilty by reason of insanity in this case.

Anne Rowland SC, defending Ms Al Adheem, made a number of admissions of fact to the court on behalf of her client. These included that the accused rang emergency services at 6.40pm on July 10th and reported that her three-year-old son had been killed.

Ms Rowland further admitted that the accused had blood on her right side when gardaí arrived at her apartment on the day of the killing and she told them she had stabbed herself and her son.

Ms Rowland said the body of the deceased was removed to the Mater Hospital and then to the city morgue where an autopsy revealed stab wounds to his trunk. These stab wounds were inflicted by Ms Al Adheem, she said.

The barrister also said her client was interviewed on four occasions by gardaí and during the course of these interviews she made admissions about her son.

The trial resumes on Tuesday before Ms Justice Eileen Creedon and a jury of nine men and three women. It is expected to last three days.