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YOKOSUKA NAVAL BASE, Japan — It took Capt. James Caruso a “difficult” six months to declare 2-month-old Kylie Delgado’s death a homicide.

But the U.S. Naval Hospital Okinawa regional medical examiner defended his autopsy report Monday in the fourth day of testimony in the court-martial of the baby’s father.

Kylie’s “constellation” of injuries — a brain hemorrhage, three fractured ribs and bleeding in her retinas — couldn’t be explained any other way, he said.

“I looked at the whole picture,” Caruso said. “I put everything together and arrived at the conclusion that it had to be a homicide.”

Sailor Seaman Recruit Jonathan Delgado, 22, is accused of killing his daughter by shaking her.

But Caruso stopped short of using the phrase “shaken baby syndrome,” or SBS, preferring instead to say “brain injury” was the cause of death. SIDS is a controversial diagnosis, he explained, and a different pathologist might conclude there wasn’t enough medical evidence.

“Another pathologist could say the manner of death was ‘undetermined,’ and I would not criticize that person as incompetent,” Caruso said. “But this is my opinion, established with a reasonable degree of medical certainty.”

Caruso’s testimony prompted rigorous debate on medical studies and citations, as defense lawyers maintain the baby died of SIDS.

Kylie wasn’t breathing when Jonathan Delgado awoke July 15, 2006, in his Misawa Air Base apartment where he lived with his wife, Petty Officer 2nd Class Michelle Delgado, according to the defense.

Delgado was sleeping with Kylie in the bed while his wife worked the late shift at Naval Information Operations Command, where both sailors were assigned.

A former coworker, David Kan, was at the apartment that morning and tried to revive the baby using cardiopulmonary resuscitation while the father called 911, Kan testified Monday.

“I did my best, but I did it wrong,” Kan said, adding that he did the chest compressions with his hand, not the proper two-finger method used for babies.

The baby regained a heartbeat after 26 minutes in Misawa’s emergency room, but she couldn’t breathe without a respirator and was flown to the Navy’s neo-natal intensive care unit on Okinawa. Kylie died July 17, 2006, after she was declared brain dead and life support was withdrawn.

Lt. Cmdr. Dave Epstein, the staff neurologist at U.S. Naval Hospital Okinawa, said he examined Kylie for brain activity. SIDS wasn’t on his short list of causes, he said, but he acknowleged he wasn’t a SIDS expert.

Also testifying Monday was Naval Criminal Investigative Service Special Agent Rodney Beshears, who said Jonathan Delgado cooperated with NCIS but initially lied about his activities the night before the incident.

The sailor had left the baby in the care of two baby sitters while he went to find an off-base card game with Chief Petty Officer Ever Browning — a fact Delgado omitted from his first NCIS interview but included the second time around, Beshears said.

“He thought an E-4 playing cards with an E-7 had the appearance of looking inappropriate,” Beshears said. “He also knew it wouldn’t look good for him to be out playing poker when he was watching his daughter.”

Delgado denied harming the child in any way in both interviews, Beshears said.

“He said she was perfectly healthy and had no accidents,” Beshears said. “He said maybe during the night he rolled over on her. ... He didn’t remember doing that, but that was the only explanation for it.”

The court-martial at Yokosuka Naval Base is expected to last though this week.

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