A 15-month-old girl whose parents belong to a congregation that shuns doctors appeared to be malnourished after her death from pneumonia, a medical examiner testified Tuesday in the manslaughter trial of her parents.

Raylene and Carl Brent Worthington of Oregon City are members of the Followers of Christ Church and are accused of manslaughter and criminal mistreatment in the March 2008 death of their child, Ava, who didn't get a doctor's care.

The state medical examiner said she could easily have been treated with antibiotics for her pneumonia.

The trial opened on Monday, with the lawyers for her parents saying they thought the girl was getting better as they and other members of the church went through faith healing rituals — such as anointing her with oil and the laying on of hands.

After the girl's death, her body was examined by Clackamas County Deputy Medical Examiner Jeffrey Mayer.

On Tuesday, Mayer said he went to the girl's bedroom and saw a humidifier and fan running and a TV tray containing a red liquid he assumed was wine and olive oil. He said both are commonly used by members of the congregation.

Mayer said the girl appeared to be malnourished, with protruding ribs and weight "not consistent with peer weight." Mayer also testified about a cyst-like growth found on the girl's neck, which prosecutors say was caused by her lymphatic system struggling against the infection.

"I have never seen anything like that in my experience," he said.

Mayer testified that his office had a good relationship with the church, dealing frequently with the members because they do not have attending physicians present when they die. It's up to his office to sign the death certificate, he said.

He said about 200 people, whom he assumed to be church members, had gathered at the home just east of Oregon City when he arrived to examine the body.

Also at the court hearing, Mayer played taped interviews he had with the Worthingtons the night their daughter died. The parents told him the girl had never seen a doctor and not been given any over-the-counter medication.

In the interview, Raylene Worthington said she noticed the swelling on Ava's neck getting substantially larger during her daughter's final days. She also said Ava developed a cough and it worsened.

Carl Brent Worthington said his wife was with their daughter on the bed when Ava died.

"I ran to the bedroom," he said. "They said she had quit breathing."

Asked during the taped interview if he called 911, he said he did not. When asked why, he said: "She was already gone. I anointed her."