Lucy Letby trial: Air was injected into baby's blood

A line of gas in front of the spine was a "striking" finding on a post-mortem X-ray of a baby allegedly murdered by nurse Lucy Letby, her trial has heard.

Paediatric radiologist Dr Owen Arthurs told Manchester Crown Court that its appearance was "consistent with, but not diagnostic of, air administration".

It is alleged Ms Letby injected air into the bloodstream of the baby at the Countess of Chester Hospital in 2015.

Ms Letby, 32 and originally from Hereford, denies 22 charges.

She has been charged with murdering seven babies and attempting to murder 10 others at the hospital between 2015 and 2016.

Jurors were told that Dr Arthurs, professor of radiology at London's Great Ormond Street Hospital, had been instructed to review X-rays taken of the baby, known as Child D, when alive and after death, as well as other babies in the investigation.

Dr Arthurs said the amount of gas present in Child D's X-rays was consistent with babies that had died of sepsis, complications with a breathing support system, a severe trauma such as a road traffic collision or the direct administration of air into the body.

Dr Arthurs said he had never come across a child dying in such circumstances where there was no such explanation.

He told jurors the most plausible conclusion was, in the absence of any other explanation, "external intravenous air administration".

Dr Arthurs added that he knew of only two other babies dying in similar circumstances, both of whom also form part of this case.

When cross-examined, the expert did later agree that in one of the X-rays there were signs of "infection" in Child D's right lung, which contained less air.

The court had previously heard that Child D's mother was left waiting more than 50 hours for treatment after her waters broke early.

A pathologist's report into the death of Child D deemed the cause of death was pneumonia.

Expert medical witness Dr Sandie Bohin told the jury that despite having pneumonia at birth, Child D was "improving" and was "stable".

She said there was "nothing to indicate that death was imminent".

She added: "I would be surprised if an infection alone could cause that catastrophic a collapse."

Asked to give an assessment of Child D's fatal collapse, she said: "Taking into account the suddenness of the collapses and quick recovery, I was clear that this was not the infection.

"I was looking at something else and that something else had to be unusual, something odd."

She concluded: "(Child D) had air administered to her and that was the cause of the collapses."

The medic said this was administered either through the umbilical venous catheter line or the cannula in her hand.

Ben Myers KC, defending, later pressed Dr Bohin on her diagnosis and noted that she had been searching for something "unusual" and "odd".

Mr Myers said: "Are you just trying to find any evidence to support your air embolus conclusion?"

Dr Bohin said: "No, absolutely not."

A court order bans the reporting of the identities of the children allegedly attacked by Ms Letby, while identifying parents or witnesses connected with the children is also banned.

The trial continues.

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