BELFAST — The medical examiner who performed an autopsy on Maddox Williams testified Monday that the 3-year-old died from “battered child syndrome.”

Testimony in the trial of Jessica Trefethen of Stockton Springs, charged with “depraved indifference murder” in her son’s death, picked up Monday in Waldo County Superior Court after being delayed last week because the lead prosecutor tested positive for COVID-19.

Deputy Chief Medical Examiner Liam Funte testified that based on his medical experience, while he found older injuries during the autopsy, Maddox’s death was caused by an “acute” injury that occurred hours before he was pronounced dead at Waldo County General Hospital on June 20, 2021.

Funte performed the autopsy the next day and said he found a hemorrhage in the boy’s abdominal cavity, a cut across his pancreas, a tear in his small bowel and fractures to his L2 and L3 vertebrae, all consistent with non-accidental or inflicted trauma such as a car accident, a fall from a great height or someone stomping on the child.

Funte said the injuries would result in severe abdominal pain. Prosecutors had played a recorded interview with Trefethen earlier in the trial in which she told police Maddox had complained of stomach pain on the day he died.

The autopsy also revealed several older injuries that had started to heal, including a hemorrhage inside Maddox’s skull, three missing front teeth and several cuts inside his mouth. Funte also said he found several blunt force injuries to Maddox’s forehead, cheeks and chin, as well as other injuries to his stomach, back, arms and legs. He told the jury that he could not determine the exact number of injuries because there were so many, and that they were not consistent with the normal activities of a 3-year-old.

Maddox Williams was one of 25 children whose deaths were reported last year to the Office of Child and Family Services. That doesn’t include at least four deaths that were classified as homicides but haven’t been added because the criminal cases have not been resolved.

Trefethen’s defense attorneys say Maddox was playing outside when he was knocked over by a dog, and that then his older sister kicked him. Trefethen also goes by the names Jessica Williams and Jessica Johnson.

Her attorney, Jeffery Toothaker, cited a trampoline in the family’s yard as a potential cause of an accidental fall, and said detectives never looked for another explanation for Maddox’s death.

Maine State Police Detective Hugh Landry, the lead investigator in the case, testified Monday that he did see the trampoline, but that Trefethen had told him Maddox had fallen off it the week before his death. He said Trefethen mentioned nothing about him falling from it the day he died.