Medical Examiner Testifies in Cartagena Trial

June 11, 2014 Updated Jun 11, 2014 at 5:53 PM EDT

By WKBW News

June 11, 2014 Updated Jun 11, 2014 at 5:53 PM EDT

BUFFALO (WKBW) Most of Wednesday inside court was spent questioning one expert witness, Dr. Dianne Vertes, the former Erie County Medical Examiner and the person who performed the autopsy of 8 year old Bianca Cartagena the day after she was found dead.

Dr. Vertes testified to blunt force injuries to Bianca, evidence that something put pressure on the girl's nose and face, and specific hemorrhaging found in the autopsy, all contributing to her ruling the case a homicide via asphyxiation.

"This case is simple. Bianca's cause of death is and always was asphyxiation," Assistant District Attorney Kristin St. Mary said during opening arguments Monday.

Doctor Vertes also reaffirmed her belief that Bianca did not die of any natural cause.

But the main focus of the defense was to counter that point, arguing that Bianca suffered from an undiagnosed heart condition that led to her death.

"Bianca Cartagena had a previously undiagnosed dialated cardiomyopothy. Which by the way, Dr. Vertes noted, but didn't understand," defense attorney Joseph Terrenova said Monday.

But according to Vertes, that condition is extremely rare for children and nothing was found in the autopsy to support that claim. She went on to say it would have been "impossible" for Bianca to suddenly die from it without any prior symptoms.

Both sides are each expected to call another medical examiner to help prove their case. The trial is expected to will continue Thursday morning.