A Northern Ireland pathologist's failure to identify numerous bone fractures during a post mortem examination led to the child's body being exhumed, the British General Medical Council heard today.
It also left the Romanian boy's twin brother vulnerable to serious injury, the Professional Conduct Committee in Manchester was told.
Dr Michael Curtis, assistant state pathologist for Northern Ireland, denies serious professional misconduct.
The hearing heard Dr Curtis carried out a post mortem exam after the death of Romanian David Briggs in October 2000. David, who was 14 months old, was buried but Dr Curtis had failed to identify and explain multiple rib fractures.
Just 13 days later the boy's twin was admitted to hospital with a fractured skull.
The twins had been legally adopted by former missionary Mr Geoffrey Briggs, from Portadown.
Briggs admitted punching David's brother and was convicted of grievous bodily harm and sentenced to two years in jail. The surviving child is no longer in Briggs's care.
David's body was exhumed and a further post mortem was ordered. Up to 16 fractures were discovered on his torso. There has never been any explanation for the injuries and the police investigation is continuing.
Hugh Davies, acting for the GMC, said: "The presence of rib fractures of this number and of this distribution strongly suggests abuse."
He added: "If Dr Curtis had carefully examined the X-rays the fractures would have been evident to him."
Dr Curtis's alleged failure led to the exhumation of David's body for a second post mortem and left his surviving brother at risk of serious injury, Mr Davies said.
The GMC hearing will inquire into allegations that Dr Curtis "failed to exercise reasonable care and competence in the conduct of a post mortem examination and produced reports which were inadequate".
It is alleged that Dr Curtis's actions were "unprofessional, inappropriate, and liable to bring the medical profession into disrepute".