A nine-year-old boy died in hospital after his mother spiked his food with salt in an attempt to mislead doctors about his illness, the Old Bailey was told today.

Petrina Stocker used salt to make her son appear ill as the climax of a campaign to hoodwink doctors looking after her son David, alleged Nicholas Hilliard, prosecuting.

But the levels of salt she used were "extremely high" and David died in Great Ormond Street children’s hospital in August 2001, after his brain swelled.

Mr Hilliard said David had been treated since February 2001 in the central London hospital and also at Oldchurch Hospital, in Romford, Essex. His symptoms included weight-loss and lethargy but doctors could not find out what was wrong with him. He was on a salt-free milk diet which was being given via a nasal tube.

Mr Hilliard said two milk bottles were probably tampered with whilst in the ward kitchen to which staff and parents had free access. The bottles were examined after blood tests showed high levels of salt two days before David died.

They showed one had contained four-and-a-half level teaspoons of salt. David had absorbed two teaspoons o salt from the other bottle.His condition deteriorated rapidly and he died in the intensive care unit.

Mr Hilliard said: "Although no one saw the salt being added to the feed, all the evidence establishes that she was responsible.

"The whole picture of what was happening whilst David was in hospital demonstrates that the salt poisoning was the last event in a series designed to produce misleading symptoms in him. This was sadly quite deliberate."

He said while David was in hospital, Mrs Stocker contaminated samples of his urine, samples of vomit and interfered with drips being used to give him drugs.

David had been a "fit and healthy child" until February 2001 when he went into a dramatic decline. His karate teacher had noticed he was unwell. He was seen at hospital with abdominal pains and was admitted to Oldchurch Hospital on March 1.

Doctors could not find any cause for the severe stomach pains. His appendix was removed but his symptoms continued.

He was transferred to Great Ormond Street Hospital where doctors thought he might be suffering from a psychiatric illness. He was sent home but re-admitted to Oldchurch Hospital where he continued to lose more weight.

After some improvement, he was sent home again but was re-admitted to Great Ormond Street when he deteriorated.

Mr Hilliard said there was no suggestion Mrs Stocker was responsible for David's illness before the salt was administered.

He said David’s post mortem showed wasted muscles consistent with chronic anorexia or chronic natural disorders. But neither had caused his death. The cause was sodium chloride poisoning, "in other words salt poisoning".

"The question was, who had added the salt to his feed and why? If it was deliberate, why would anyone do such a thing to a nine-year-old child in hospital?

"It cannot be for any of the usual reasons. David had done no harm to anyone. The prosecution say that this incident was the last in a series of incidents at Oldchurch and Great Ormond Street hospitals.

"In each, the defendant tried to fabricate aspects of David’s illness, either manufacturing false symptoms or inducing symptoms which would not otherwise be there.

"It may seem extraordinary, but these are typical examples of behaviour known as fabricated illness where one person seeks to fabricate symptoms of illness in someone else."

Mr Hilliard alleged that in 1987, Mrs Stocker worked for a pharmaceutical company and was referred to a doctor by her boss as she had missed work and claimed to have diabetes. She had allegedly produced a urine sample with a high sugar content but other samples taken showed normal levels.

Mr Hilliard asked: "Is this an instance of her doing then just what she was doing in 2001 - adding to a urine sample?"

Mrs Stocker, 42, of Romford, Essex, denies manslaughter. The trial was adjourned until Wednesday.

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