Lucy Letby: Baby's catastrophic bleed not spontaneous, trial told

A baby's "catastrophic" bleed was "not spontaneous" or caused by any pre-existing condition, a jury has heard.

Manchester Crown Court heard Child E died while being cared for by nurse Lucy Letby at the Countess of Chester Hospital's neonatal unit in 2015.

Ms Letby denies murdering seven babies and attempting to murder 10 others.

Blood expert Prof Sally Kinsey said it was "striking" how much blood the child lost but agreed her observations did not help establish a cause of death.

The court has previously heard that Child E lost 25% of his blood volume before his death on 4 August 2015.

Jurors have also been told the bleed could have been as a result of an "inappropriate" use of a medical tool.

Prof Kinsey, who was asked to review the case by Cheshire Police, told the court it was "striking" how much blood Child E lost in a two-and-a-half-hour period.

She said a 30g per litre drop in his haemoglobin rate between 22:21 BST on 3 August and 01:05 on 4 August was "considerable" and the bleeding was "not spontaneous".

Ben Myers KC, defending, said her comments on Child E established only that the bleed was not a result of "a blood abnormality" and did not rule out the possibility that he could have had a gastro-intestinal haemorrhage.

He added her observations did "not assist with what the cause of death actually was".

The professor agreed that all three suggestions were correct.

Prof Kinsey was also asked to review the cases of Child A and B.

It is alleged Ms Letby, 32, and originally of Hereford, injected air into the bloodstream of Child A in June 2015, just over 24 hours after his premature birth, and used the same method to attack his sister, Child B, a day later.

Prof Kinsey told the court the skin discolorations observed on Child A had "cemented" her concerns that he had suffered an air embolus.

She said it was a very "rare" condition and that she had not seen it herself, but had read about it in medical literature.

"It was a pretty stark description of what sounded to be air embolus to me," she said.

She told the court that no blood disorder would account for the sudden deterioration suffered by Child A.

Questioned about their deaths by Mr Myers, she agreed that air embolus did not feature in her expertise and she had drawn parallels between a 1989 medical journal review of the condition and what had been observed by doctors and nurses in the case of Child A and B.

She also agreed that the babies' medical notes made no mention of the indicative "bright pink" patches which were mentioned in the review.

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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