During his testimony for the defense, a former Suffolk County medical examiner said 7-year-old Nixzmary Brown was not killed by child abuse syndrome but by a single blow. In spite of her malnourished state and various injuries battering her body, Dr. Charles Wetli said, "If you take away the head injury from this child, there is no reason that the child should have died in that time and place."

The NYC Medical Examiner's office said the blow to Nixzmary's head was "the straw that broke the camel's back," because of all the abuse and neglect she had suffered. Prosecutors charged stepfather Cesar Rodriguez and mother Nixzaliz Santiago with murder for the girl's January 2006 death. The two are being tried separately, and Rodriguez's attorney has argued Santiago dealt the fatal blow. However, Rodriguez has admitted to beating, tying up and starving Nixzmary.

Wetli also questioned the NYC ME's timeline of events as well as claiming Nixzmary, who weighed 36 pounds - which is what 3- or 4-year-olds weigh - was not starved based on her fat cells. Defense lawyer Jeffrey Schwartz told reporters Wetli's testimony was a "huge step forward."