A Westmoreland County judge ruled Thursday that prosecutors have enough evidence to bring a New Kensington man to trial and seek the death penalty for the alleged first-degree murder of a 2-year-old boy in 2020.

Common Pleas Judge Scott Mears rejected defense claims that medical evidence was insufficient to prove allegations that Keith Dale Lilly Jr., 34, caused the injuries that led to the death nearly four years ago of Mikel Fetterman. Mikel was weeks shy of his third birthday when he was hospitalized for serious head injuries following an incident in the family’s New Kensington home.

Prosecutors contend Lilly was left alone to care for the child while the boy’s mother was asleep in another room. Police said they found the child unresponsive and in cardiac arrest as Lilly attempted to resuscitate the toddler. The boy’s mother, Teresa Fetterman, stood nearby and cried, investigators said.

Lilly was charged with first-degree murder, multiple counts of aggravated assault, involuntary deviate sexual intercourse, child endangerment and drug offenses.

The doctor who treated the child at a Pittsburgh hospital testified during a hearing last spring that the toddler was physically and sexually abused, suffered serious head injuries and suffered other medical issues as a result of being violently shaken.

Lilly claimed the boy fell off a couch and was assaulted by unnamed other people on prior occasions, according to police.

Mears ruled prosecutors presented enough medical evidence to allow the first-degree murder case to proceed to a jury trial.

The judge dismissed the felony sex charge, saying the prosecution’s evidence cannot support allegations that the child suffered serious bodily injury as a result of the alleged molestation. Mears said prosecutors could refile another, lesser version of the sex count that was supported by the evidence.

“We are disappointed in the decision … because we sought relief to the most significant charge — first-degree murder,” said defense attorney Tim Dawson. “The bigger issue is the death penalty. We are going to defend against that with our own experts.”

Prosecutors contend that Lilly, if convicted, should be condemned to death by lethal injection because of a lengthy criminal record, the violent nature of the killing and that it occurred during the commission of another felony.

District Attorney Nicole Ziccarelli did not respond to a request for comment.

A date for Lilly’s trial has not been set.

Teresa Fetterman, 27, of Lower Burrell is awaiting trial on charges of involuntary manslaughter, aggravated assault, child endangerment and related offenses, and is cooperating with authorities in Lilly’s prosecution.

Meanwhile, a lawsuit filed in 2022 by the child’s maternal grandparents against Lilly, Fetterman and the Westmoreland County Children’s Bureau continues to be litigated. The lawsuit contends the county agency failed to intervene and protect the child from continued sexual abuse before his death.

Pennsylvania’s Commonwealth Court currently is weighing an appeal filed by the Children’s Bureau challenging a ruling issued last fall that allowed lawyers for the child’s grandparents to review internal county records of its investigation into allegations the boy’s parents mistreated the child before his death.

Rich Cholodofsky is a Tribune-Review staff writer. You can contact Rich by email at rcholodofsky@triblive.com or via Twitter .