A FORMER registered nurse and midwife accused of injecting her daughter with urine while she was in hospital and secretly giving the young girl laxatives to make her constantly ill allegedly told detectives she missed being a nurse and liked being involved in decision making with doctors.
The girl was repeatedly hospitalised with renal failure, unexplained constant diarrhea and vomiting and other serious conditions until hospital staff raised concerns with detectives in 2015 and the girl was taken out of her mother's care.
Since being separated from her mother there had been a "dramatic improvement" in the girl's condition, Crown prosecutor Wayne Creasey said at the outset of the woman's trial in Newcastle District Court on Monday.
The woman, who cannot be named because it would identify her daughter, stood in the dock and softly replied not guilty to two counts of administering a noxious thing with intent to injure and one count of administering a noxious thing to endanger life. The woman will face a two-week judge-alone trial focusing on complex medical evidence from a raft of experts and specialists.
During his opening address, Mr Creasey told Judge Christopher Robison that the case against the woman was circumstantial, but the prosecution contended she had interfered with her daughter's intravenous line by introducing urine while the girl was a patient at Westmead Children's Hospital in March, 2015.
It was the girl's fourth admission for renal failure since January, 2014, and came despite the girl being discharged from John Hunter Children's Hospital with normal kidney function just 10 days prior.
It is during that hospital stay that the girl's central line was dislodged and she suddenly became unwell with fever and renal failure despite no obvious cause, Mr Creasey said.
"I expect the evidence will establish that those changes were consistent with the introduction into the blood steam of an extraneous substance such as urine," Mr Creasey said. "Which may also have contained a substance such as an infectious microorganism."
Mr Creasey said the young girl had presented to John Hunter Children's Hospital on a number of occasions in 2013 and 2014 with unexplained diarrhea and vomiting, which the prosecution allege was likely caused by the "surreptitious administration of a laxative agent".
Mr Creasey said tests conducted on the girl's stools showed the samples were being tampered with and diluted with water prior to being handled by hospital staff.
He said the woman was "almost always" by her daughter's bedside during her admissions.
The trial continues.