Lucy Letby trial: Consultant tells of baby post-mortem decision regret

A senior paediatric consultant "now regrets" not recommending a post-mortem examination for a baby allegedly killed by nurse Lucy Letby, a court has heard.

Ms Letby is accused of injecting air into the bloodstream of the baby, referred to as Child E, at Countess of Chester Hospital in June 2015.

She has denied murdering seven babies and attempting to murder 10 others.

The consultant, who cannot be named, said she had suspected a bowel disorder was the cause of the baby's death.

Turning to the child's parents, who attended the hearing at Manchester Crown Court, she apologised to them for not insisting on a full examination.

Ms Letby is accused of murdering Child E and attempting to murder his twin, Child F, the following day.

The jury was told the twins had been born prematurely and Ms Letby was the designated nurse for both boys.

The consultant was on call on the night of Child E's death and went to the ward after the infant suffered a "sudden" deterioration, the court heard.

Doctors used five doses of adrenaline and tried two rounds of resuscitation during a 45-minute battle to save the baby, beginning at 00:37 BST and ending at 01:23 BST, when he was handed to his parents.

In medical notes recording the events, observations indicated the child had been stable earlier in the night before suffering a gastro-intestinal bleed.

The consultant said she suspected the severe intestinal disorder, necrotising enterocolitis, was the cause of death.

She said the baby was deemed at "high risk" of a variety of complications and a post-mortem examination was not arranged, but she now felt she did not give enough weight to the fact that the infant's x-rays had been normal and he had been largely stable before the sudden collapse.

Vital signs including heart-rate, oxygen levels and blood pressure, had previously been good, the court heard.

The consultant said the boy's parents were "understandably devastated" their baby had died and were "not keen on a post-mortem".

"I didn't want to make what was a terrible situation any worse, so I didn't push, which is something I now regret," she said.

Ms Letby's defence lawyer Ben Myers KC put it to her that it had been "precisely the situation" where a post-mortem examination would have been appropriate.

She replied that she felt necrotising enterocolitis was the "most likely" cause of death, but added: "I regret not pushing for a post-mortem at the time.

"I was keen to avoid that to avoid any further distress to [Child E's] parents."

She denied "steering" the parents into not having a post-mortem examination.

She also conceded that she "wished" she had gone to the neonatal unit sooner.

Mr Myers went on to suggest that a blood transfusion was given too late during the resuscitation efforts, something the consultant also denied.

He added gastro-intestinal bleeds could happen when babies are under stress, but the consultant said that had not been the case and Child E was "making excellent progress" before his sudden decline.

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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