Lucy Letby: Baby had unusual skin mottling, trial hears

A doctor saw "unusual" skin mottling on a baby girl allegedly murdered by nurse Lucy Letby, a jury has heard.

She is accused of trying to kill the premature baby three times before succeeding on a fourth attempt.

Manchester Crown Court heard Ms Letby is accused of injecting air into the youngster's stomach via a feeding tube.

The 33-year-old denies murdering seven babies and attempting to murder 10 others at Countess of Chester Hospital between 2015 and 2016.

Registrar Dr Matthew Neame said the baby, referred to as Child I, was "stable" when he examined her at 22:05 on 13 October 2015.

He said he thought Ms Letby asked him to see Child I at 05:55 on 14 October as her oxygen requirements had increased.

On examination, Dr Neame noted her abdomen was "distended", "mottled" and with "some tenderness".

He said he noticed Child I's eyes were open and she "grimaced".

Dr Neame said: "I don't recall it clearly but it's unusual to see mottling on the abdomen.

"My impression was the increase in abdomen distension may have caused [Child I's] lungs to be squashed, making it hard for her to breathe," he told the jury.

The court heard Ms Letby retrospectively noted that at 05:00, Child I's abdomen was "more distended and firmer in appearance with area of discolouration spreading on the right side".

Ms Letby, who was the baby's designated nurse, noted she gave antibiotics at 05.05.

She also retrospectively noted that at 05.30 Child I's "abdo distended ++".

Jurors were told that at 07:00, Child I had a "significant" drop in blood oxygen levels and heart rate.

At 07:45, her heart rate fell "dangerously low" to below 60 beats per minute, said Dr Neame, which prompted CPR to begin.

Thirteen minutes of resuscitation from medical staff followed before she recovered.

The court has heard evidence of various babies having a "mottled, discoloured" appearance before collapsing.

Ben Myers KC, defending, asked Dr Neame: "Your view is mottling normally means circulation is not as good as it should be?"

Dr Neame replied: "That's right."

Mr Myers went on: "And the underlying cause could be infection in some cases?"

Dr Neame said: "Yes [but] when seen, infection is usually accompanied by other signs."

Mr Myers said: "Or low oxygen levels?"

The witness said: "It can be."

In WhatsApp messages read to the court, Ms Letby asked a colleague on the afternoon of 14 October if Child I was staying on the unit.

She added: "I'd like to keep her please."

Her colleague, who cannot be identified for legal reasons, replied: "Yes. Staying for now. OK re keeping."

An hour later the colleague messaged: "I've had to re-allocate. Sorry."

Ms Letby said: "Has something happened?"

The colleague replied: "No. Was just asked to reallocate so no one has her for more than one night at a time. Or one shift. Not just night."

Ms Letby responded: "Yeah that's understandable."

The prosecution alleges Ms Letby, originally from Hereford, murdered Child I in the early hours of 23 October after earlier bids on 30 September, 13 and 14 October.

The trial continues.

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