Lucy Letby: No explanation for baby collapse, nurse trial hears

A doctor had "no clear explanation" why a baby girl allegedly attacked by nurse Lucy Letby suffered a second significant collapse within 24 hours, her murder trial has heard.

Ms Letby is accused of attempting to murder the baby, referred to as Child H, on two occasions at the Countess of Chester Hospital in September 2015.

The nurse is charged with murdering seven babies and attempting to murder 10 others between 2015 and 2016.

Ms Letby, 32, denies 22 charges.

The prosecution claim she first attacked Child H in the early hours of 26 September 2015 and then again the following morning after infant's designated nurse had temporarily left the intensive care room.

Registrar Dr Matthew Neame told Manchester Crown Court about his involvement with the second incident and how he was twice summoned by nurses on the shift.

The first emergency bleep was received after a "profound" drop in Child H's blood oxygen levels and heart rate as medics discovered her breathing tube was blocked with secretions, the court heard.

Several hours later at 00:55 BST on 27 September, Child H suffered more profound desaturations while on a ventilator - but this time her breathing tube contained no secretions.

Child H's heart rate plunged to 40 beats per minute at 01:07 BST and full resuscitation, including chest compressions and doses of adrenaline, was needed for six minutes before she recovered.

Asked how the second crash call was different, Dr Neame said: "The distinction is the lack of clear explanation for the event at this time and the fact that it has happened again in a relatively short space of time.

"Both those things would have made me more concerned about [Child H's] condition."

Dr Neame said he thought Ms Letby was the nurse who he first spoke to upon his arrival to the second crash call.

Soon after Child H was transferred to Wirral's Arrowe Park Hospital where she "came on in leaps and bounds", her parents said, before she was discharged the following month.

In his discharge letter to Arrowe Park, Dr Neame wrote: "Thank you for accepting this baby who has had two significant episodes of bradycardia [low heart rate] requiring resuscitation, adrenaline and CPR in the last 24 hours with no clear precipitating factors.

"Her care has been complicated by the development of respiratory distress syndrome and pneumothoraces [collapsed lung] but the acute episodes with desaturation and bradycardia do not seem to be directly related to the respiratory problems."

Nurse Shelley Tomlins, Child H's designated nurse on the nightshift beginning 26 September, said she would not have been in the baby's presence throughout. She said she would have been covered by a colleague while on a break or if she had temporarily left the room.

She told the court: "Given that she was unwell, I don't think we would have left her in her room alone but I can't be sure."

Ms Tomlins said she she could offer no explanation why Child H's blood oxygen levels dropped at 00:55 BST on 27 September.

She told Ms Letby's defence barrister Ben Myers KC her recollection of Child H was that she was a "very poorly baby".

Fellow nurse Christopher Booth, who was on duty on both nightshifts, told Mr Myers that Letby had completed an overtime shift that week.

He said: "That was not unusual for her. She was very conscientious."

Mr Myers went on: "Was she someone willing to work extra or have shifts changed at short notice?"

"Yes," replied Mr Booth.

Mr Myers said: "Did you find her to be a hard worker?"

Mr Booth said: "Without doubt, yes."

Asked if Ms Letby became upset as events involving babies continued, Mr Booth said: "Oh definitely. It was a harrowing time. We were all upset. Without doubt, Lucy as well."

The trial continues.

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