A nurse accused of murdering seven premature babies – and trying to kill ten more – tracked the families of her alleged victims on Facebook after taking up to three attempts to poison their infants by injecting insulin, milk or air into their tiny bodies, a court heard today.
Lucy Letby, 32, is alleged to have gone on a year-long killing spree while working at the Countess of Chester Hospital – including one child who died less than 90 minutes after being handed into her care.
Children’s nurse Lucy Letby (pictured) appeared in court today accused of murdering seven premature baby and trying to kill 10 more
Today the specially trained ICU nurse was described as a ‘constant malevolent presence’ on the Cheshire children’s unit where she allegedly killed and injured many vulnerable children – including twins.
She is accused of using night shifts to launch many attacks because she knew parents were unlikely to visit the neonatal ward.
Prosecutors claim she showed an ‘unusual interest’ in the families of her alleged victims, with evidence from her computer said to show how she would ‘on occasion’ search for them online ‘in quick succession’.
Several babies were allegedly poisoned with insulin and one child – known as Baby E – was murdered when Letby allegedly injected him with air, Manchester Crown Court has heard.
It caused what doctors call an air embolus, which leads to strokes or heart attacks. Letby is also accused of pumping dangerous levels of milk into the premature children via feeding tubes or veins.
She allegedly targeted twins on more than one occasion – and in some cases one was murdered and their sibling survived. Letby was questioned by police during interviews over why she had tracked the families of her alleged victims on Facebook, with prosecutors saying today that this was an ‘unusual interest’.
Opening the prosecution, Nick Johnson KC, said: ‘Sometimes a baby that she succeeded in killing was not killed the first or even second time she tried’. He added: ‘Sometimes they were injected with air – both intravenously [into the blood] and via the nasogastric tube [into the stomach]. Sometimes they were injected with milk or some other fluid. Sometimes it was insulin. But the constant presence was Lucy Letby’.
Police discovered ‘a poisoner was at work’ on the NHS neonatal unit after a ‘significant rise’ in the number of healthy babies dying or falling ill while a nurse accused of murdering seven children and trying to kill ten more was working on the ward between June 2015 and June 2016, the jury were told on the first day of her trial. She is facing 22 charges concerning 17 babies, some of whom she allegedly attempted to murder multiple times. Letby pleaded not guilty to each charge this morning.
Mr Johnson said Letby was a ‘constant malevolent presence’ at the ‘closely restricted’ neonatal unit. He added: ‘It is a hospital like so many others in the UK but unlike many other hospitals in the UK, and unlike many other neo-natal units in the UK, within the neo-natal unit at the Countess of Chester Hospital a poisoner was at work.’
The prosecutor said two babies – referred to as Baby F and Baby L for legal reasons – were ‘poisoned’ by Letby ‘deliberately with insulin’. They were attacked allegedly eight months apart with each of them from separate sets of twins. Both boys’ blood sugar ‘inexplicably dropped to dangerous levels’ – but both survived ‘because of the skill of the staff in the neonatal unit’, the court heard.
He said both of the twins injected with insulin each had a baby brother, Baby E and Baby M, who were both also allegedly attacked by Letby. The court heard one of the means by which the Baby E was killed and Baby M was harmed, by having air injected into the bloodstream. Baby M had ‘mercifully’ survived.
He said: ‘Babies who had not been unstable at all suddenly severely deteriorated. Sometimes babies who had been sick and then on the mend deteriorated for no apparent reason. Having searched for a cause, which they were unable to find, the consultants found the inexplicable collapses and deaths did have one common denominator. The presence of one of the neonatal nurses. That nurse was Lucy Letby.’
During the time Letby worked on the night shift, there was a rise in babies dying or falling seriously ill, Manchester Crown Court was told, and then when she moved to the day shift there were more ‘inexplicable collapses and deaths’.
As the trial of Lucy Letby got underway today, the court heard:
- Letby, 32, denied murdering seven premature babies and attempting to murder 10 more
- Letby is alleged to have injected babies with insulin, air or pumped with milk to kill them
- The nurse is alleged to have killed babies during night shifts when parents were less likely to visit
- She is said to have searched for the families of her alleged victims families on Facebook
- Prosecutor Nick Johnson KC described Letby as a ‘constant malevolent presence’ at the neonatal unit
- Deaths occurred at the Countess of Chester Hospital between June 2015 and June 2016 where it has been alleged that a ‘poisoner was at work’
- Letby was arrested three years after the death of her first alleged victim on June 8, 2015
- She allegedly targeted twins on more than one occasion – and in some cases one was murdered and their sibling survived
- In some cases, Letby is alleged to have tried to kill the same baby on more than one occasion
- Child A, who was allegedly murdered, died less than 90 minutes after Letby came on night shift
- Mr Johnson said that ‘in all cases Lucy Letby was either responsible for them as their designated nurse or she got involved with them despite not being their designated nurse’
- Her parents and the parents of her alleged victims watched the start of the trial at Manchester Crown Court today
Lucy Letby, 32, is alleged to have gone on a year-long killing spree while working at the Countess of Chester Hospital
Lucy Letby sketched in the dock at Manchester Crown Court with security where she is charged with the murder of seven babies and the attempted murder of another ten, between June 2015 and June 2016 while working on the neonatal unit of the Countess of Chester Hospital
Letby poisoned babies while on the night shift because parents would not be around, court told
Lucy Letby appearing in the dock at Manchester Crown Court
Lucy Letby was today accused of poisoning babies on the night shift.
There tended to be fewer staff on the unit at night, and parents as well tended to visit mostly in the days.
Mr Johnson continued: ‘Many of the events in this case occurred on the night shifts.
‘When upon Lucy Letby was moved on to day shifts, the collapses and deaths moved to the day shifts.’
Mr Johnson said as medics could not account for the collapses and deaths, police were called in and conducted a ‘pain-staking review’.
He said: ‘That review suggests that in the period between mid-2015 and the middle of 2016 somebody in the neo-natal unit poisoned two children with insulin.
‘The prosecution say that the only reasonable conclusion to be drawn from the evidence you will hear is that somebody poisoned these babies deliberately with insulin. This was no accident.’
Letby, 32, allegedly tried to kill one baby girl three times and a baby boy three times – including two attempts in one day.
‘Many of the events in this case occurred on the night shifts,’ said Mr Johnson. ‘Although when Lucy Letby was moved on to day shifts towards the end of this period the collapses and deaths moved to the day shifts’.
Referring to the alleged poisoning of both Baby F and Baby L, he added: ‘Lucy Letby was on duty when both were poisoned. We allege that she was the poisoner’.
This morning she was brought into the dock at Manchester Crown Court, wearing a dark blue suit with a black blouse.
Mr Johnson said: ‘Prior to January 2015, the statistics for the mortality of babies in the neo-natal unit at the Countess of Chester were comparable to other like units.
‘However over the next 18 months or so there was a significant rise in the number of babies who were dying and in the number of serious catastrophic collapses.
‘These rises were noticed by the consultants working at the Countess of Chester and they searched for a cause.’
They were concerned that babies who were dying had deteriorated unexpectedly, despite appropriate medical interventions that would normally have saved them.
He said the collapses ‘defied the normal experience of the treating doctors’.
Mr Johnson said that normally babies might suffer from heart problems, infection or dehydration.
‘Usually when an intervention was undertaken a positive reaction can be expected. But many of the cases you are going to hear about defied those expectations and norms’, he said.
Babies who were stable suddenly deteriorated, and sometimes babies who had been sick but were on the mend suddenly deteriorated for no apparent reason.
Having searched for a cause, the consultants noticed that a single common factor was the presence of a single neonatal nurse.
‘That nurse’ said the barrister, ‘was Lucy Letby’.
‘Many of the events in this case occurred on the night shifts,’ said Mr Johnson. ‘Although when Lucy Letby was moved on to day shifts towards the end of this period the collapses and deaths moved to the day shifts.
Children’s nurse Lucy Letby (pictured) has gone on trial today accused of seven baby murders
Letby is accused of attacking two sets of twins – with insulin and with air – one child, Baby E, would die but his sibling survived
‘Because of the inability of doctors to find genuine medical reasons for the deaths and collapses the police were called in’.
The deaths and injuries of 17 babies were not ‘naturally-occurring tragedies’ – and Lucy Letby was ‘the constant presence’, trial hears
The collapses and deaths of all the 17 children concerned were not ‘naturally-occurring tragedies,’ Mr Johnson said.
‘They were all the work, we say, of the woman in the dock, who we say was the constant malevolent presence when things took a turn for the worse for these 17 children.’
Mr Johnson said the two children poisoned with insulin, who cannot be identified, were two baby boys, both born twins; the first born in summer 2015 and the other born in spring 2016.
Both were poisoned a couple of days after they were born.
‘Lucy Letby was on duty when both were poisoned and we allege she was the poisoner,’ Mr Johnson said.
‘There’s a very restricted number of people who could have been the poisoner, because entry to a neo-natal unit is closely restricted.’
Officers from Cheshire Constabulary commissioned a detailed review by experienced doctors with no connection to the Countess of Chester Hospital.
‘That (review) suggests that from the middle of 2015 to the middle of 2016 somebody in the neonatal unit poisoned two children with insulin.
‘The prosecution say that the only reasonable conclusion from the evidence will have been that somebody poisoned these babies deliberately with insulin. This was no accident’.
If the prosecution was right about that, the fact that there were two deliberate poisonings would help the jury decide whether other crimes had been committed or whether they were ‘just tragic coincidences’.
Mr Johnson went on: ‘We say the collapses and deaths of the 17 babies were not naturally occurring tragedies.
‘They were all the work, we say, of the woman in the dock, who we say was the constant malevolent presence when things turned to the worst for these 17 children’.
Nick Johnson KC, prosecuting, said in the case of the two babies injected with insulin, identified only as child F and child L, their blood sugar levels dropped to dangerous levels.
But both survived due to the skill of medical staff who appreciated low blood sugar can have natural causes.
Mr Johnson added: ‘What the medical staff did not realise was that in both cases, was the result of someone poisoning them with insulin.’
The prosecutor said nobody would think somebody would be trying to kill babies in a neo-natal unit.
He said both of the twins injected with insulin each had a baby brother, child E and child M, who were both also allegedly attacked by Letby – one of which did not survive.
The court heard one of the means by which the child E was killed and child M was harmed, was by having air injected into the bloodstream – what the doctors call an air embolus.
Mr Johnson added: ‘As we go through my introduction of the case, we will see that similar events repeated themselves. The means by which the children in this case were harmed and killed varied.’
John and Susan Letby, parents of Lucy Letby, are at Manchester Crown Court for their daughter’s murder trial (pictured last week)
Prosecutor Mr Johnson said sometimes babies were injected with air and on other occasions they were fed with insulin or too much milk.
He told the court: ‘So varying means by which these babies were attacked but the constant presence when they were fatally attacked or collapsed catastrophically was Lucy Letby.’
Jurors were shown a chart showing nurses who were present on duty when the alleged criminal incidents were said to have taken place.
Pointing out, as examples, the first three alleged offences in time he said the chart showed the only person that was present on all three occasions was the defendant.
Mr Johnson said: ‘If you look at the table overall the picture is, we say, self-evidently obvious. It’s a process of elimination.’
Mr Johnson went on: ‘It is a complicated case by any measures. It concerns seven allegations of murder and allegations of attempted murder of 10 other children.
‘We allege that sometimes Lucy Letby tried to kill the same baby more than once.
‘Sometimes a baby that she succeeded in killing she did not manage to kill the first time she tried, or even the second time, and in one case even the third time.’
Judge warns jury to be ‘dispassionate’ in ‘case bound to provoke an instinctive reaction of horror’
The trial judge, Mr Justice Goss, told the empanelled jurors that all the charges relate to babies.
‘Any anxiety or apprehension you may have about your role as jurors in this case. You will have apprehensions about what is to follow, but in relation to the nature of the case and your role’.
Other juries up and down the country were trying very serious cases, so they should not to be anxious. They would soon become familiar with the details of the case.
The judge added: ‘The case is bound to provoke an instinctive reaction of horror. It is part of our characteristics as a human being.
‘Whilst retaining your knowledge and understanding of human behaviour, you must put your emotions to one side and consider the evidence calmly, rationally, fairly and dispassionately’.
He said the defendant was born on January 4 1990 and was originally from Hereford.
Letby studied for her nursing degree at the University of Chester, he said, and at the time of the alleged events was a nurse at the Countess of Chester Hospital and had been since she had qualified a few years earlier.
She worked throughout the period in consideration at the neo-natal unit and prior to her arrest was living at an address in Chester, the court heard.
Mr Johnson told the jury: ‘As you know we have 22 charges, 17 children. In all the cases Lucy Letby was either responsible for them as their designated nurse or she got involved with them despite not being their designated nurse.’
Mr Johnson then turned to the individual cases of each child, starting with Child A, which the court heard was the first to be attacked and murdered at just a day old, on June 8, 2015.
Child A, a baby boy, was born just a minute behind his twin sister at 8.31pm the previous day.
The court was told he was born early, by C-section, at 31 weeks, and admitted to the intensive care room at the neo-natal unit of the hospital.
He was in good condition and did well and by the following morning was breathing ‘in air’, that is, without extra oxygen and was given expressed breast milk, Mr Johnson said.
Letby came on to work on the night shift at 7.30pm for the handover from another nurse looking after Child A during the day shift, it was heard.
At 8pm Letby became the designated nurse for Child A but at 8.26pm she called a doctor to the baby’s incubator and the on-call consultant was also alerted, the court was told.
Both doctor and consultant noted an ‘odd discolouration’ on the child’s skin, patches of pink over blue skin that appeared and disappeared, which became a ‘hallmark’ of the some of the cases in which Letby had allegedly injected air into the bloodstream of a victim, the court was told.
Despite resuscitation attempts, Child A was said to have been pronounced dead at 8.58pm, within 90 minutes of Letby coming on duty.
The infant’s death was referred to a coroner who recorded the cause of death as ‘unascertained’.
The court heard that four medical experts reviewed the case. The first said Child A was a ‘well infant’ before their death.
He said the fatal event was consistent with a deliberate injection of air or something else into the boy’s circulation a minute or two before his collapse.
A second expert said Child A’s collapse was not a natural event and added the ‘most likely reason’ was air administered deliberately, ‘by someone who knew it would cause significant harm’.
A pathologist concluded it would be reasonable to conclude that air in Child A’s circulation was most likely caused by air administration through one of two tubes already attached to the baby’s body.
In her November 2020 interview it was put to Letby that she had tracked the family of Child A on Facebook. She said she had no memory of doing so but accepted it if there was evidence from her computer.
Mr Johnson told the jury: ‘Her interest in the families of the children who we say she attacked is another feature of this case which we will see more of as the evidence emerges in more detail.
‘We suggest it is an unusual interest and we will see in due course that on occasion she searched in quick succession for several of the families of babies whose names appear on the indictment.
Child A’s twin sister, Child B, needed some resuscitation at birth but recovered quickly and stabilised.
By June 9, the day after her brother’s death, she was managing periods of independent breathing. All observations were normal and she remained stable, the court heard.
According to prosecutors, around 28 hours after Child A had died, Child B was found ‘blue’ and ‘limp’ on the ward.
‘She was blue, she wasn’t breathing and she was limp,’ said Mr Johnson.
Child B ‘recovered quickly’ once resuscitated and survived the incident – without suffering any further consequences.
A doctor concluded she was ‘subjected to some form of sabotage before or after midnight on the night of June 9/10 2015’.
Mr Johnson told jurors: ‘Here you can see we have a pair of twins who were born prematurely but in pretty good condition. No-one expected them to face grave problems, yet both suffered unusual symptoms within a short time of each other.’
A second doctor observed the sudden discolouration, profound collapse and ‘relatively quick recovery is rare and only explained by a dose of air administered into the bloodstream’.
Family members of some of her alleged child victims sat in the public gallery listening as the names of the children, who cannot be named for legal reasons, were read out.
Earlier, three members of security staff surrounded her as she stood up to enter her pleas as her parents John and Susan watched on. Her trial could last up to six months.
Letby quietly repeated the words ‘Not guilty’ as each of the charges was read out to her by a clerk at Manchester Crown Court.
She was standing stock still in the glass-panelled dock of Court 7, her once blonde hair, now darkened, let down over her shoulders.
Fourteen jurors were sworn in to hear the trial. However, two of them will act as substitutes while the prosecution opening is being heard. Once that point has been reached the trial will continue with 12 jurors.
According to the indictment she tried to kill one baby girl three times and another twice. And she tried to claim the life of a baby boy on three separate occasions – two of them on the same day.
In addition to the seven murder charges, Letby faces a further 15 charges of attempted murder relating to 10 premature babies being cared for in the hospital’s neonatal unit.
All of the alleged murders and attempted murders took place in a 12-month period between June 2015 and June 2016.
Letby’s parents, John, 76, and Susan, 62, watched as proceedings were relayed to annexe courtrooms attended by families of the children involved and members of the press and broadcast media.
A court order prohibits the media from reporting the identities of either the surviving infants or those who died.
A court order prohibits reporting of the identities of surviving and deceased children allegedly attacked by Letby, and prohibits identifying the parents or witnesses connected with the children.
The children, who cannot be named for legal reasons, will be referred to as Child A to Q.
The trial, which is expected to last six months, continues.