A TOTTENHAM GP who examined Baby P eight days before his death failed to spot the toddler was probably suffering from eight broken ribs, the General Medical Council heard on Tuesday.

Family doctor Jerome Ikwueke saw Peter Connelly on July 26, 2007, at which time an expert pathologist said it was likely the 17-month-old would have felt "acute pain" from his injuries if he had been picked up.

It is also likely that the toddler had a mouth injury known as a classic sign of abuse, normally caused by a blow to the mouth.

Dr Ikwueke, 63, suspended in February 2009, is accused of failing to carry out an adequate examination of Peter or make an urgent referral to hospital despite knowing the child was on the at-risk register and noting his behaviour had changed.

Eight days after the GP's examination, Baby Peter was found dead in a blood-spattered cot at the family home in Penshurst Avenue, Tottenham.

Paediatric forensic pathologist Professor Rupert Risdon told the hearing of the extensive injuries found on Peter's body at a post-mortem examination.

Referring to the broken ribs, Prof Risdon said: "I was of the opinion, having looked at these sections through the microscope, that fracturing had occurred approximately one to two weeks before death."

The expert was asked how much suffering broken ribs would cause a child.

He said: "I would say that rib fractures are painful when they are initially inflicted, but children are surprisingly resilient and often a couple of days later they may be back to playing normally. However, if you pick them up or touch the fractured rib, then it will become acutely painful."

Prof Risdon told the hearing that the pain could make a child withdrawn. Dr Ikwueke, who qualified as a doctor at the University of Ibadan in Nigeria in 1974, observed that Peter had changed from his usual happy self and pulled away from him on his last visit.

The GMC's Fitness to Practise Panel said: "His conduct was not in the best interests of his patient, was below the standard expected of a reasonably competent general practitioner and was a serious breach of his professional duty towards the child."

He denies misconduct.

Dr Ikwueke previously referred Baby Peter to hospital specialists after becoming concerned about suspicious marks on his face and body on two separate occasions.

It was his referral, in October 2006, that led the 17-month-old to be placed on Haringey Council's at-risk register.

Peter was tortured to death by those who were supposed to care for him despite receiving 60 visits from social workers, doctors and police over the course of his short life.

His mother Tracey Connelly, her boyfriend Stephen Barker, and his brother Jason Owen were jailed at the Old Bailey in May last year for causing or allowing his death.

The inquiry, expected to last six weeks, continues.