HILO, Hawai'i — Hyacinth L. Poouahi, caregiver for an abused 10-year-old Big Island girl who nearly died from her injuries in 2005, pleaded guilty to four felony charges in the case yesterday.

Poouahi's lawyer Keith Shigetomi said Poouahi was responsible for the girl, knew the girl was being hurt and failed to rescue her, but said Poouahi did not actually inflict the severe injuries the child suffered.

Shigetomi declined to say who did assault the girl, other than to say that "there were a number of people who caused the injuries." He said at least one other person has been charged in the case, but declined to elaborate.

Court records show that one of Poouahi's daughters alleged in 2005 after the 10-year-old was hospitalized that Poouahi's underage son had been hurting the girl, and in one instance the youth allegedly stabbed the girl in the ankle with a steak knife.

Shigetomi and Poouahi, 40, said they are subject to a Family Court "gag order" and could not answer questions about Family Court proceedings. Poouahi is the only adult who has been charged in the case.

Yesterday, Poouahi pleaded guilty to first-degree assault, first-degree unlawful imprisonment, terroristic threatening and endangering the welfare of a child. In exchange for those guilty pleas, Deputy Prosecutor Rick Damerville agreed to drop a charge of attempted murder.

Poouahi entered the pleas "because she wants to acknowledge responsibility for what she did, but not for what she didn't do," Shigetomi said after the hearing. "We acknowledge that the child was seriously harmed, but at the same time it's also clear that the charges that were brought against (Poouahi) were overblown and exaggerated."

Poouahi sobbed in court as she read aloud from a prepared statement in which she said she was "extremely sorry" and admitted that "I knew that (the girl) was suffering from serious harm, and I failed to obtain proper and timely medical attention for her."

That delay caused some of the girl's wounds to become infected, leaving her in critical condition, Poouahi said.

"Due to my fear of someone finding out, I told (the girl) not to tell anyone what was happening to her," Poouahi said in her statement. "On more than one occasion, I threatened to punish (the girl) if she told anyone what was happening to her."

The girl and her family are not being identified by The Advertiser to protect the girl's privacy.

Poouahi faces up to 10 years in prison for the assault charge and up to five years in prison for each of the other charges when she is sentenced by Hilo Circuit Court Judge Glenn Hara on Aug. 27.

The plea agreement makes Poouahi eligible to be sentenced to probation, but Shigetomi would not say what sentence he will request.

Had Poouahi been convicted of the original charge of attempted murder by omission, she would have faced a sentence of up to life in prison with the possibility of parole.

Police became involved in the case after Poouahi finally called an ambulance to her 'Ainaloa home on Feb. 7, 2005, when the girl could not be roused.

The girl was not related to Poouahi's family, and police and neighbors have said the girl had been dropped off in November 2004 at the Woodrose Drive home by her mother, who was a friend of Poouahi.

Acquaintances of the injured girl and her mother have said the child had an unstable life and had been left with a series of caregivers over the years.

Court records say the ambulance crew found the girl lying on a couch on the lanai of the home with a cut on her head that was "decomposing and containing maggots."

She also had injuries to her upper lip and other areas of her body that showed "signs of decomposition," according to court records.

A doctor at Kapi'olani Medical Center for Women & Children who treated the girl later told police that marks on the girl's body suggested she had been bound, and that "she had several areas of dead tissue about her body as a result of pressure ulcering (often called bedsores) and burns that appeared to be from a cigarette and cigarette lighter," according to a district court affidavit.

The girl also was suffering from severe dehydration and malnutrition, and had broken bones in her left hand and left foot, the doctor reported.

The girl went into cardiac arrest at the hospital and had to be revived, and was in a coma at the hospital for a time.

Poouahi claimed in a 2005 interview she suspected that the girl cut herself and picked at her wounds, causing a severe infection.

Poouahi said in that interview that the girl's condition suddenly deteriorated on Feb. 6, prompting her to call an ambulance the following day.

The girl, now 13, is living with family on the Big Island.

Deputy Prosecutor Damerville said the state's position from the beginning was that "the individual injuries that were caused by whoever were not that serious, but became serious because they didn't seek medical treatment."

He said Poouahi used threats to prevent the child from telling what was happening to her, and Poouahi had to be pressured by another person to finally call for help for the girl after her wounds became severely infected. The bystander threatened to call for help if Poouahi didn't, Damerville said.

He said the infection was so serious it caused the girl's heart to stop twice and left her with "profound deafness."

Shigetomi said Poouahi was suffering from postpartum depression and a condition called "borderline intellectual function," a condition that affects a person's ability to adapt to personal and social circumstances, and limits his or her ability to respond in stressful situations.

She also suffered from "paralyzing fear in terms of what was happening in the house and her inability to totally prevent it," Shigetomi said. "She intervened, but was unable to prevent it."

Shigetomi said the assault charge Poouahi admitted to was actually "assault by omission" because Poouahi knew someone was hurting the girl, and did not stop it.

The unlawful imprisonment charge was for not allowing the girl to leave the house or attend school, in part to conceal the fact that she was being mistreated. The terroristic threatening charge stems from threats Poouahi made to the girl to try to control her.

"As she said before, she is extremely sorry," Shigetomi said after the hearing. "This is someone who called her auntie, and she took into her home willingly, and tried her best. Unfortunately, her best wasn't good enough in this case."