Two-year-old Christina Han's life ended when her father plunged a knife into her neck so forcefully that it came out the other side.
Christina's mother, Angela, and 4-year-old brother Nicholas also died from stab wounds to the neck.
All three were bashed in the head with a hammer before being stabbed, and it is likely Nicholas and Angela were unconscious when the fatal stabbings occurred.
The graphic evidence from Auckland forensic pathologist Simon Stables made murder accused Robert Han dry-retch in the dock.
The hearing was adjourned as he was led out of the room, his hands covering his mouth.
Yesterday was the second day of Han's murder trial in the High Court at Auckland.
The 36-year-old has not denied the charges, but is pleading insanity.
The defence says Han was a pathological gambler and was seriously depressed at the time of the murders.
Justice Tony Randerson and a nine-woman, three-man jury are hearing the case.
The court also heard yesterday from Han's sister, Dong Mee Park, who said she and her husband had loaned the accused money before learning of his gambling problem.
Han had borrowed $100,000 to try to start a business in his name, although it would have been owned by the Parks.
Mrs Park said she understood most of that money had been lost at the Sky City Casino, although Angela Han had later borrowed some money from her father to try to repay the debt.
Mrs Park also told how Angela Han had made her husband register as a problem gambler with the casino, and effectively ban himself from the premises.
A police financial analyst testified that the year after Han had been banned, he withdrew $30,000 from cash machines in the casino.
And bank records showed that between January 1996 and March 1999, Han had withdrawn $280,000 from casino cash machines.
On Monday, the court heard that Han's parents, who lived with the family in their Manukau home, found the bodies of their grandchildren and daughter-in-law lying on a bed early on August 9 last year.
Han was lying on the floor beside the bed with stab wounds to the stomach and wrist, but was still alive.
Only days before, he had returned from Korea, where he had gone to get work so he could repay his gambling debts.
Yesterday, Detective Sergeant Stephen Mariu told the court he questioned Han in hospital about the deaths.
He said Han told him:
"He took Angela, he took Christina, he took Nicholas, but he didn't take me.
"I don't know why he didn't take me.
"When I was going to take my life, he told me Angela would have no husband, Christina and Nicholas would have no father. Why didn't he take me?"
Detective Sergeant Mariu later asked who "he" was.
Han did not reply but raised his eyes to the ceiling.
Detective Sergeant Mariu asked if by that motion he meant God, but Han did not reply.
Under cross-examination, defence counsel Robert Fardell asked the officer if he got the impression Han had been "recounting a voice."
Detective Sergeant Mariu replied: "That's what he told me."
Knife-blow killed child, expert says
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