Baby P was seen 60 times by health or social workers during that period, around twice a week. However, close to his death, he became unrecognisable, with more than 50 injuries or bruises, and an attempt had been made to cover up the crime. A postmortem examination revealed the boy had a broken back, eight fractured ribs, missing fingernails and toenails, multiple bruises and an injury to the inside of his mouth. He had also swallowed one of his own teeth. The court heard that his back had been broken by slamming him down over a bent knee or a bannister, which would have left him paralysed. It is claimed he was taken to hospital three times in the months before his death after being repeatedly beaten and abused. The child was last seen by social services on July 30 - when his mother and her boyfriend had smeared him with chocolate to cover up his injuries, according to Owen - and by a paediatrician two days before his death. Sally O'Neill QC, prosecuting, told the jury that the boy was taken to a child development clinic at St Ann's hospital, Haringey, on August 1. By that time he is said to have had eight fractured ribs and a broken back, injuries that would have left him in terrible pain and unable to move his legs. He was examined by a consultant paediatrician, Dr Sabah al-Zayyat, who noted that Baby P appeared "cranky" and "miserable" but was said not to have found any indication that he had fractured ribs or a broken back. However, two medical experts told the court they believed those injuries would have been evident. At 11.35am on August 3 2007, an ambulance was called to the house. Its crew found Baby P already stiff and blue in his cot. He was taken to North Middlesex hospital where he was pronounced dead at 12.20pm. The Old Bailey heard he should have been protected by social workers, police and health professionals, but his mother had manipulated them with lies. Gillie Christou, in charge of social workers looking after children on the register in Haringey, told the court she had agreed to keep the baby with his mother. She said: "I made the decision at the time based on the material in front of me and based on the background to the case." A detective in the case told the court the boy had more than 50 injuries, 15 of them to the mouth. He added that the boyfriend was "sadistic - fascinated with pain". The mother was "completely divorced from reality. She was living in a dream world and put her lover before her child. She closed her eyes to what was going on.