Student slapped by teacher apparently died after brain swelling; expert says non-traumatic causes possible

Metro Manila (CNN Philippines, October 4) — The death certificate of the 14-year-old student from Antipolo City, who died days after being slapped by his teacher, showed that the immediate cause of death was “global brain edema,” or a swelling of the brain.

The document stated that a hemorrhage was found in the brain of Grade 5 student Francis Gumikib, whose family accused his teacher of having a hand in the death.

Suspected pulmonary tuberculosis and physical abuse could have also contributed to the loss of life, based on the death certificate.

However, Dr. Raquel Fortun, a forensic pathologist, described as “vague” the details in the document, saying a lot of questions were left unanswered.

The expert told CNN Philippines’ News Night that an important detail — the underlying cause of the death — was left blank. It failed to explain where the hemorrhage came from, she said.

“Tapos blangko 'yung part on manner of death, 'yung linya diyan na death by external causes," she added. "Kasi kung wala kang nilagay diyan, ibig sabihin you think natural, due to disease."

[Translation: And the part on the manner of death, the line pertaining to death by external causes, was also blank. Because if you don’t put anything there, that means you think the death is natural, due to a disease.]

According to the student's family, the boy informed them that he was slapped by his teacher on Sept. 21.

Over a week later, they said Gumikib begged to be brought to the hospital due to intolerable headache and ear pain.

They said he went into a coma before he died on Monday.

Death possibly due to rare condition?

Fortun said there are a number of things to consider to help determine if the slapping incident indeed led to the death, including how exactly he was slapped.

“I don't see any contrary description of the method," she explained. "‘Yung usual na sampal is ‘yung palm ng kamay mo itatama mo sa mukha. It’s not really effective or strong kasi malambot ‘yan eh, and it can only go so far in terms of velocity, gaano kabilis, ‘yun ‘yung delikado."

[Translation: I don't see any contrary description of the method. In a usual slap, you hit one's face with the palm of your hand. It's not really effective or strong, because the palm is soft, and a slap can only go so far in terms of velocity, which is what's dangerous.]

The medical examiner said there is a need to “keep an open mind,” as there could be other causes – such as a rare condition called meningoencephalitis.

“It might not even be trauma, because this presentation is also consistent with inflammation from an infection of the brain and the surrounding meninges, or 'yung covering niya [or the covering of the brain]. So, pwedeng pwede ‘yan [so it’s really possible that it is] meningoencephalitis,” she said.

Gumikib’s remains were brought to Camp Crame in Quezon City on Wednesday for an autopsy, a critical piece of evidence in the investigation.

According to Fortun, the computerized tomography or CT scan done on Gumikib may not be enough to ascertain that there was hemorrhage in the brain.

Results of the autopsy, which is a more comprehensive process, may provide more clarity, she said.

“And one thing that struck me is nu'ng una, may usap-usapan na masakit daw yung tenga [at first, they said his ear hurt]…It is really common to have an ear infection and it goes to the brain, and that's one cause of meningoencephalitis,” Fortun said.

Police earlier said they are looking at filing a homicide complaint against Gumikib’s teacher.

However, even if it is later determined that the teacher did not cause the student's death, authorities and Gumikib’s family said they will still pursue criminal charges against her for the slapping incident.

READ: Homicide case eyed vs. teacher accused of slapping Grade 5 student who later died