Doctors saw blood in baby's throat, nurse trial told

Doctors saw blood and "unusual" swelling at the back of a baby boy's throat after he was allegedly attacked by nurse Lucy Letby, a court has heard.

Ms Letby is accused of trying to kill the boy, referred to as Child N, on three occasions at the Countess of Chester Hospital in June 2016.

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

The 33-year-old, originally from Hereford, denies 22 charges.

The prosecution allege Ms Letby made her first attempt on Child N's life on 3 June, before carrying out two more attacks on 15 June.

Child N's deteriorations were consistent with some kind of "inflicted injury" or him having received an injection of air, the court has heard.

A doctor, who cannot be named for legal reasons, told Manchester Crown Court that Child N crashed several times throughout the early hours and morning of 15 June.

He said at 08:00 the boy suffered a "profound desaturation" and required breathing support.

The medic told the court that he made three unsuccessful attempts to intubate the child with a breathing tube.

Asked about his recollection of that morning, he said: "I saw blood at the back of the throat, blood that prevented me seeing where the entry to his airway was.

"I also recall that the back of the throat looked unusual, there was a degree of swelling."

After three attempts to intubate, the doctor abandoned the procedure. His note from that morning, shown to the court, stated: "Intubation abandoned due to blood present at oropharynx and likelihood of trauma due to repeated attempts".

Child N was placed on non-invasive breathing support, via a mask, but later that day another doctor made an attempt to intubate after a further collapse.

Dr Huw Mayberry, giving evidence via live link from Australia, told the court that he was crash called to attend the neonatal unit at around 15:00 on 15 June.

Dr Mayberry told jurors he was "unable to get a very clear view because there was substantial swelling within the airway" of Child N.

He said that the swelling was "unlike anything I had encountered previously."

Dr Mayberry said the infant's epiglottis, which is a flap of tissue at the back of the throat, was "quite swollen". He added: "It looked quite large and reddy pink in colour. I had not seen this in my practice before, only in textbooks."

The head of the neonatal unit, Dr Stephen Brearey later told the court that he could think of "no normal, natural cause" for the swelling and collapses.

Ben Myers KC, defending, asked Dr Mayberry if he could give a professional opinion for the cause of the blood.

Dr Mayberry told the court that he had told Cheshire Police it could have been a result of gastric irritation or necrotising enterocolitis, a condition that effects newborns.

He said it could also have been a result of Child N's blood disorder, which resulted in a deficiency of an essential blood-clotting protein.

In cross-examination of the doctor, who cannot be named, Mr Myers quoted his comments to Cheshire Police in 2018. In his statement the medic said he was "not sure" if the bleeding had been caused by his repeated attempts to intubate Child N.

In his opening address last October to the jury, Mr Myers said Child N was another baby who received "sub-optimal care" - not from the defendant - and should have been treated elsewhere at a specialist "tertiary" unit.

The trial continues.

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