Tuesday 11 October 2022 07:31 PM Lucy Letby returned to kill baby whose twin brother she murdered just 24 hours ... trends now

Lucy Letby returned to kill a baby whose twin brother she had murdered just 24 hours earlier and attempted to murder a baby girl who was born weighing just over 1lb three times in the space of a month, a court has heard.

The nurse, who is accused of murdering five boys and two girls, left the girl 'severely disabled' after overfeeding her with milk and injecting her with air, prosecutors said today. 

A jury at Manchester Crown Court was told that the 32-year-old tried to kill the girl, known as Baby G, on September 7, 2015, the day after she passed the 'significant date' of 100 days since her birth.

The court heard that staff had put up a banner and cake to mark the occasion, but in the early hours of the next morning the girl collapsed and projectile vomited so forcefully it went onto the carpet and a chair next to the cot.

While the child was moved to a different hospital a day later, she was returned to Countess of Chester Hospital a week later, at which point Letby allegedly tried to kill her two more times in one shift on September 21.

It is claimed that the nurse also undertook Facebook searches of the child's parents, including one on that day, something Letby told police she had no recollection of. 

Prosecutors also told the jury that Letby had tried to kill a child known as Baby F, less than 24 hours after murdering his twin, Baby E, who was found 'acutely distressed' and found bleeding from the mouth in his cot on August 3, 2015.

Earlier the court was told how the mother of the twins interrupted her attacking Baby E in the hospital's neonatal unit, but the alleged baby killer 'got rid' of the panicked parent by telling her: 'Trust me I'm a nurse'.

The trial heard that after Baby E's death the following morning on August 4, 2015, the nurse would attempt to kill his brother by injecting insulin into nutrition bag just a day later.  

The nurse went on to show a 'very unusual interest' in the family of the twins, the court heard, with social media searches on them two days after the baby's death and again on seven occasions, including on Christmas Day. 

Letby denies murdering seven babies - five boys and two girls - and attempting to murder 10 more infants by injecting insulin, milk or even air into their tiny bodies. Her parents Susan and John are supporting her at her six-month trial at Manchester Crown Court.

As the second day of Letby's trial continues, Manchester Crown Court has heard: 

This afternoon prosecutors told a jury at Manchester Crown Court that Letby left Baby G 'severely disabled' after making multiple attempts to kill her in September 2015. 

It is claimed she targeted the baby after she was moved to Countess of Chester from Arrowe Park Hospital in Merseyside, where she had been born extremely prematurely at the age of 23 weeks and six days, and a weight of just 535 grams.

After spending 10 weeks in Arrowe Park, she was well enough to be transferred to the Countess of Chester on August 13.

The date of Letby's first attempt on the infant's life was a significant one, said prosecutor Nick Johnson, KC. She was 100 days old, and to mark the occasion staff had put up a banner and baked a cake.

At 2.15am Letby was sitting with the shift leader at the nursing station when both women heard Baby G vomiting. She had suffered a collapse and was not breathing.

The infant's projectile vomiting was so forceful that it went onto the carpet and an adjacent chair (to the cot).

A registrar noted that the baby appeared uncomfortable and her abdomen was 'purple and extended'. Her blood/oxygen levels had fallen to 80 per cent.

He later noticed bloodstained fluid from her trachea – a phenomenon that had also been evident in the case of Baby E.

Baby G was returned to Arrowe Park in the early hours of September 8. By September 16 she had recovered so well that she was transferred back to the Countess of Chester.

On the day Letby allegedly attacked her twice she was said to be well and due her immunisations.

At 9.15am Letby, the infant's designated nurse, fed her 40ml of milk via an NG tube. Just over an hour later, at 10.20am, Baby G had two projectile vomits and went apnoeic 'for 6-10 secs'. She suffered brief colour loss and her blood saturations fell to 30 per cent.

'So she suffered the same problem that she had had on September 7,' said Mr Johnson. This time it had followed a documented feed by Letby.

That afternoon a consultant was called to cannulate the infant. Baby G's mother left the nursery, privacy screens were erected and the infant was placed on a trolley still attached to her Masimo monitor.

Letby remained with the baby after the doctors had gone. A short time later the nurse overseeing Baby G's care heard Letby shout for help.

'When she attended she noticed that G's monitor had been switched off,' said Mr Johnson. 'She was dusky and struggling to breath, and Letby was giving her ventilation breaths. She responded to the treatment'..

That evening Letby sent another nurse on the unit a text saying that G 'looked rubbish when I took over this morning, then she vomited at 9 and I got her screened…mum said she hasn't been herself for a couple of days'.

Mr Johnson reminded the jury that the infant had been due her immunisations that day – 'something that would not have been contemplated if she had not been in good condition.

'There had been no significant issues with G at all. She had vomited because she had been given excessive milk and air'.

Mr Johnson told the court that an MRI scan taken in August 2016 confirmed that Baby G had sustained irreversible brain damage.

He said there was only one conclusion to draw in this case: that somebody had put extra milk and air into her system.

'That does not happen by accident. There are parallels here with the previous case of Baby C and the subsequent cases of Baby I, Baby P and Baby Q.

The prosecution alleges the attacks came just over a month after Letby killed one baby and attempted to murder his twin brother the very next day.

It is claimed that Letby murdered Baby E with an injection of air into the bloodstream on August 4 and tried to kill Baby F using insulin on August 5, 2015.

Baby F who had been born at the Countess of Chester Hospital on July 29, 2015, was prescribed a tiny dose of the substance to help combat his high blood sugar. That was between 3.40am and 6.20am.

He was moved out of Room 1, where his brother had previously died, and from there went to Room 2 where Letby was looking after a single baby.

Letby and another nurse signed the prescription chart to record that a fresh bag of TPN (total parenteral nutrition), known as Babiven, had been started and administered via a long-line at 12.25am on August 5.

The prosecution alleges that Letby added insulin to this bag with the intention of killing Baby F. It was also possible, said Mr Johnson, that she put insulin into a second bag that had been put in the fridge.

At 3am the baby suffered an unexpected drop in his blood sugar, along with a surge in heart rate.

Although she was not his designated nurse, Letby signed the observation charts at 5am. Three hours later she went off shift.

At 5.56pm a blood sample returned a blood glucose level so low that if had remained untreated it could have caused Baby F to suffer convulsions, coma, apnoea, irreversible brain damage or even death.

The medical team was sufficiently concerned by the infant's hypoglycaemic episode that a check was ordered on his plasma insulin level and the level of another hormone called C-peptide.

This revealed an extremely high insulin level and very low C-peptide levels – 'conclusive evidence of Baby F having received exogenous insulin. Someone gave him insulin. Someone poisoned him'.

At the time no other baby in the neonatal unit had been prescribed insulin, so he could not have received a supply intended for another baby through negligence.

'He was given it intentionally – though it may be relevant that his dead brother had been prescribed insulin for a short period and Lucy Letby had co-signed for administering it'.

Mr Johnson added: 'To give insulin to F, the perpetrator would have had to access the locked fridge, use a needle and syringe to remove some insulin from the ampoule in the fridge, and either inject it into a TPN bag kept in the same locked fridge or return to the cot-side and inject the insulin into the infant's intravenous system'.

Alternatively, it could have been given by intramuscular injection or by mixing the insulin with the other content of the TPN.

He told the jury: 'F could not have received the insulin as a result of some oversight or accident. You know that it was Lucy Letby who hung the bag'.

When police interviewed the nurse in July 2018 she confirmed giving the infant glucose, but 'had no independent recollection of having had any involvement with administering the contents of the TPN.

Baby E, her fourth alleged murder victim, was born on July 29, 2015 and by August 3 was feeding well. At about 9pm that evening, his mother decided to make her way from the postnatal ward to visit him in the neonatal unit, where he was in the care of Letby with his brother Baby F.

Mr Johnson told the jury that the boys' mother 'interrupted Lucy Letby who was in the process of attacking Baby E' but 'she did not realise it at the time'. He added: 'When she arrived Baby E was acutely distressed and bleeding from his mouth'.

The little boy's mother said that Letby 'tried to reassure her' that the blood was due to a feeding tube 'irritating his throat'. Mr Johnson claimed that whilst telling the mother to return to the postnatal ward she had implored her: 'Trust me, I'm a nurse'.'  

Mr Johnson told Letby's trial: 'We suggest she was fobbed off by Lucy Letby.  However, she [the mother] was so concerned by what she had seen that she telephoned her husband when she got back to the labour ward'. 

Following Baby E's death in the early hours of August 4, the Crown said Letby made 'fraudulent' nursing notes which were 'false, misleading and designed to cover her tracks'.  The little boy also had 'striking' white and purple rash on his abdomen – seen on several other of Letby's alleged victims, which doctors claimed was consistent with an injection of air.

Letby's notes failed to mention that Baby E was bleeding at 9pm, and yet she claimed there had been a meeting between the registrar and the mother. Neither recalled such a meeting, said prosecutor Mr Johnson.

Mr Johnson said that Letby had made a note in Baby F's records which she timed at 9.13pm – 'after she had got rid of (the mother)', he added.

Child E went on to suffer significant blood loss, say the Crown, later in the evening, with a treating registrar saying he had never encountered such a large bleed in a small baby.

Following Child E's death in the early hours of August 4, the Crown said Letby made 'fraudulent' nursing notes which were 'false, misleading and designed to cover her tracks'.

At 11.40pm Baby E's blood oxygen levels and heart rate dropped and his abdomen developed a striking discolouration with flitting white and purple patches that reminded a registrar who saw them of the distinctive skin discolouration on the body of Letby's first alleged victim, Baby A, who medics believe suffered a fatal injection of oxygen in the June.

Full CPR began on Baby E at just after midnight on August 4 and he died at around 1.27am. The court also heard today that Baby E's brother, Baby F, is alleged to have been the victim of one of two insulin poisonings carried out by Letby on August 5.

The court heard that Letby wrote a note in the nursing records at 4.51am, in the aftermath of E's death.

Written in capital letters, it read: 'Mummy was present at the start of the shift attending to cares. Visited again approx. 10pm. Aware that we had obtained blood from his NG tube and were starting some different medications to treat this.

'She was updated by (a registrar) and contained E. Informed her that we would contact her if any changes'.

The court heard earlier today that Letby was found with a premature child moments after administering a fatal injection of air in the same room where she had poisoned and killed another newborn just six days earlier.

The jury was told that she was stood next to the cot of Baby C, who was just five days old and weighed 2lbs, when his monitor alarm went off and she told the colleague who rushed in: 'He's going, he's going'. 

Baby C died because the air injected into his stomach made him unable to breath and he suffered a

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