‘Cold-blooded’ Lucy Letby smiled at a mother after she had murdered her baby girl after four attempts, it was claimed today – as the court heard how infants ‘suddenly recovered’ when they were removed from the hospital where she worked.
The 32-year-old allegedly killed five boys and two girls, and faces a total of 22 charges of both murder and attempted murder involving 17 babies. The offences are said to have taken place between June 2015 and June 2016 while she was working in the neo-natal unit at the Countess of Chester Hospital.
Today, Letby sat in the dock wearing a black jacket as she listened to the prosecution lay out an allegation of murder against Child I, two of attempted murder against Child H, and another of attempted murder against Child J.
Prosecutor Nick Johnson, KC described the case of Child I – who despite being born weighing just 970g (2lbs 2oz) was healthy – as ‘an extreme example even by the standards of this overall case’. Letby tried four times to kill the infant before succeeding on the fourth attempt, Mr Johnson said.
After the third attempt, Child I was transferred to another hospital where she made a dramatic recovery. But after being returned to Letby’s care, the infant collapsed and needed cardiac compressions. ‘Baby I was born very early and very small – but she survived the first two months of her life and was doing well by the time Lucy Letby got her hands on her,’ Mr Johnson said.
After Child I’s death, her parents were taken to a private room and asked if they wanted to bathe her. Mr Johnson said that as the baby’s mother ‘bathed her recently departed child, Letby came into the room and, in the words of the mother, was ”smiling and kept going on about how she was present at Child I’s first bath and how much Child I had loved it”.’
The nurse later sent a sympathy card to the parents, something that was ‘not normal’. In a police interview, she told officers this was the only time she had done it, ‘but it is not often the nurses got to know a family as well as they had known Child I’s’. She admitted to officers that she’d kept an image of the card on her phone.
The case was handed to the coroner and it was found ‘the earlier attempts to kill Child I had caused brain damage’.
Earlier, Mr Johnson told jurors at Manchester Crown Court that Letby twice attempted to murder another baby, Child H, on two successive night shifts in September 2015. The infant suffered two ‘profound’ collapses which required resuscitation by chest compressions with the use of adrenaline, the court heard. No clear cause for either incident was identified at the time but the baby survived.
After the two incidents the baby girl was transferred to another hospital where she showed ‘dramatic improvement’. She later returned to the Countess of Chester and was eventually discharged.
Mr Johnson said: ‘It is a notable fact in the case of (Child H) and others that as soon as children were removed from the Countess of Chester and the sphere of influence of Lucy Letby, it was often followed by their sudden and remarkable recovery.’
Letby’s parents, Susan and John, are supporting her at her six-month trial at Manchester Crown Court.
As the third day of Letby’s trial begins, Manchester Crown Court has heard over the trial so far:
- Letby, 32, denies murdering seven premature babies and attempting to murder 10 more over 12 months. The deaths occurred at the Countess of Chester Hospital between June 2015 and June 2016. Letby was arrested three years after the death of her first alleged victim, Baby A;
- ICU nurse is alleged to have injected babies with insulin, air or pumped with milk to kill them – often during night shifts when parents were less likely to be there;
- Letby allegedly targeted twins on more than one occasion – and in some cases one was murdered and their sibling survived;
- She is said to have searched for the families of her alleged victims’ parents on Facebook and social media, including on Christmas Day;
- In some cases, Letby is alleged to have tried to kill Baby G on up to three occasions, including two times in one shift;
- Nurse was allegedly ‘smiling’ after one child’s death and sent her parents a sympathy card;
Letby denies seven charges of murder and ten charges of attempted murder between 2015 and 2016 at Countess of Chester Hospital
The nurse (pictured) allegedly tried to kill one baby by injecting insulin into his nutrition bag less than 24 hours after murdering his twin brother
The court has heard Letby (pictured) attempted to kill one baby at Countess of Chester Hospital three times in the space of a month
Letby’s parents Susan and John Letby arrive at Manchester Crown Court this morning
Nick Johnson, KC opened today’s hearing by outlining Letby’s first alleged attempt to kill Child H when she was the infant’s designated nurse.
The prosecutor said the ICU chart shows she gave Child H a dose of morphine at 1.25am and saline at 2.50am. The following night, the infant’s oxygen levels began to drop profoundly at 22.53pm and 3.30am after being ‘relatively stable’ during the day shift.
Letby was not her designated nurse at the time, but the nurse who had this role later said she could not recall whether she had taken a break during the shift but confirmed she had been out of the room at least some of the time.
He went on to describe ‘interesting Facebook searches’ by Letby after the incidents.
He told the court that about a week after Child H’s second collapse, at about 1.15am, within about three minutes she searched for Child H’s mother, the father of twin children E and F and the mother of Child I. At the time she was on her day off.
Introducing the case of Baby I, Mr Johnson said: ‘There were four separate occasions on which we allege Lucy Letby tried to kill Baby I. She was resilient, but ultimately, at the fourth attempt, Lucy Letby succeeded in killing her’.
Baby I weighed 970 grams when she was born in Liverpool Women’s Hospital on August 7, 2015. She was transferred to the Countess of Chester on August 18.
By September 29, the infant was eight weeks old and the clinical concerns about her had diminished.
She had no breathing problems, was ‘in air’, gaining weight and being fed both by bottles and a tube.
Full indictment against Lucy Letby
Lucy Letby is charged as follows:
Count 1 – Charged with murder of Baby A on June 8, 2015
Count 2 – Charged with attempted murder of Baby B between the June 8, 2015 and June 11, 2015
Count 3 – Charged with murder of Baby C on June 14, 2015
Count 4 – Charged with murder of Baby D on June 22, 2015
Count 5 – Charged with murder of Baby E on August 4, 2015
Count 6 – Charged with attempted murder of Baby F on August 5, 2015
Count 7 – Charged with attempted murder of Baby G on September 7, 2015
Count 8 – Charged with attempted murder of Baby G on September 21, 2015
Count 9 – Charged with attempted murder of Baby G on September 21, 2015
Count 10 – Charged with attempted murder of Baby H on September 26, 2015
Count 11 – Charged with attempted murder of Baby H on September 27, 2015
Count 12 – Charged with murder of Baby I on October 23, 2015
Count 13 – Charged with attempted murder of Baby J on November 27, 2015
Count 14 – Charged with attempted murder of Baby K on February 17, 2015
Count 15 – Charged with attempted murder of Baby L on April 9, 2016
Count 16 – Charged with attempted murder of Baby M on April 9, 2016
Count 17 – Charged with attempted murder of Baby N on June 3, 2016
Count 18 – Charged with attempted murder of Baby N on June 15, 2016
Count 19 – Charged with attempted murder of Baby N on June 15, 2016
Count 20 – Charged with murder of Baby O on June 23, 2016
Count 21 – Charged with murder of Baby P on June 24, 2016
Count 22 – Charged with attempted murder of Baby Q on June 25, 2016
Mr Johnson alleged that Letby carried out her first attack on Baby I the following day, September 30 – ‘a couple of days after she had tried to kill Baby H and a week or so after events two and three for Baby G.
Letby was on a 12-hour shift that began at 8am, and she was Baby I’s designated nurse.
She had two other babies to look after in Room 3, yet despite this she was also involved that shift with G and H.
According to Baby I’s mother, Letby expressed some concern to her and indicated that the infant would be reviewed by a doctor.
Mr Johnson said: ‘When she made the requisite note, Letby reversed the concern, saying that it was Baby I’s mother who had raised an issue about her abdomen, writing ‘Mum feels it is more distended to yesterday and that I is quiet…not on monitor but nil increased work of breathing’.
He asked the jury: ‘Was it Lucy Letby trying to cover for what she was going to do?’
She fed the sleeping baby 35mls of expressed breast milk via the NGT at 4pm. Half an hour later an emergency ‘crash call’ was put out.
Baby I had vomited, desaturated, her heart rate had dropped and she was struggling to breath. Her airway had to be cleared and she was given breathing support before being moved to Room 1.
X-rays revealed a massive amount of gas in her stomach and bowel, and her lungs appeared ‘squashed’ and of small volume. It was the prosecution case that this air had been injected into the baby’s stomach.
The crisis passed, but medical notes record that Letby adjusted the infant’s glucose infusion and gave her an injection of saline.
‘Within moments, Baby I deteriorated again. However, as I have said, Baby I was resilient and overnight her condition’.
Thereafter the baby enjoyed a period of such stability that she did not even need a monitor.
In the early hours of October 13, Baby I was well and being bottle-fed every four hours. At about 3am her designated nurse briefly left the room and asked Letby and another colleague to listen out for the infant.
Mr Johnson told the court: ‘When she returned to Room 2, at about 3.20am, Lucy Letby was stood in the doorway. The room was darkened because it was night time. But as soon as she came in Lucy Letby told her Baby I looked pale.
‘When the other nurse turned on the light, she saw that Baby I appeared at the point of death and was not breathing.
‘When she reconsidered later she thought that perhaps I was breathing once at least every 20 seconds, because if she hadn’t been the apnoea alarm would have sounded’.
Turning to the jury, Mr Johnson said: ‘You might want to consider how it was that Lucy Letby could see that I was pale from the door of a room in which there was minimal lighting.
‘And you may want to consider the possibility that someone had silenced the alarm or turned it off’.
The third incident happened on October 14 when Baby I suffered desaturation caused by gas in her abdomen. Again she needed to be resuscitated. She was ‘brought back from the brink of death’ at 7.48am.
‘So I had the same problem as she had had before,’ said Mr Johnson. ‘And yet again there was Lucy Letby who was her designated nurse. Same nurse, same problem – a problem that doesn’t happen when she isn’t around’.
Baby I was transferred to Arrowe Park on October 15 and quickly stabilised before returning to Letby’s hospital on October 17.
Baby I became unsettled just after midnight on October 23. Letby and the designated nurse went to her, but the infant collapsed and needed cardiac compressions.
Both an on-call registrar and an on-call consultant were called in. The latter noticed a mottled blue appearance in her trunk and peripheries. After five minutes of CPR the infant’s saturation rate picked up to 100 per cent.
An x-ray showed massive dilation of the bowel and this was noted by the medics as ‘large stomach bubble’. Baby I was successfully resuscitated and recovered.
At 1.06am the infant’s designated nurse left the nursery temporarily, but then responded to the alarm. She returned to see Letby at the incubator.
Letby sketched in the dock at Manchester Crown Court with security as she was charged with the murder of seven babies and the attempted murder of another ten
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’
Realising the infant was very distressed, the nurse wanted to intervene. But Letby assured her that they would be able to settle the baby.
‘Baby I then collapsed,’ said Mr Johnson, before adding: ‘This exchange foreshadows what was to happen when Child O collapsed six or so months later’.
The same on-call registrar arrived at 1.12am and led the attempts at resuscitation. She was joined by the registrar at 1.25am and he noted purple and white mottling.
‘All resuscitative efforts were unsuccessful and treatment was withdrawn at 2.10am,’ Mr Johnson said. ‘Baby I was pronounced dead at 2.30am on October 23.’
Immediately after her death the infant’s parents were taken to a private room. The mother was asked if she wanted to bathe her daughter.
‘As [the mother] bathed her recently-deceased child, Lucy Letby came into the room and in the mother’s words ”was smiling and kept going on about how she was present at Baby I’s first bath and how much Baby I had loved it”.’
A post mortem revealed that all the loops in the infant’s bowel were significantly dilated due to increased air content. ‘In layman’s terms they were expanded like a partially-inflated balloon,’ Mr Johnson said.
Dr Dewi Evans, the expert paediatrician later called in by Cheshire Police, said he thought the apnoea monitor must have been tampered with or switched off.
He also believed an IV bolus of air had been injected into her bloodstream around midnight on October 22-23. ‘In support of that, he points to Baby I screaming – followed quickly by her collapse,’ Mr Johnson said.
The court heard that Letby had sent a sympathy card to the parents.
‘She said that to send a card was not normal – indeed this was the only time she had done it; but that it was not often the nurses got to know a family as well as they had known Baby I’s,’ Mr Johnson said.
‘She accepted that she had kept an image of the card on her phone. She denied giving Baby I air via the NGT.
She challenged her colleague’s account of Baby I’s collapse in the darkened room, claiming that because she was more experienced she might have ‘spotted something that she wasn’t able to spot’.
Mr Johnson told the jury: ‘Baby I was born very early and very small. But she survived the first two months of her life and was doing well by the time Lucy Letby got her hands on her.
‘What happened to Baby I followed the pattern of what had happened to others before and what was yet to happen to others., All of a sudden, out of nowhere, came vomiting, breathing problems and critical desaturations’.
In the first incident there had been a vomit followed by lots of air and some milk; in the second Letby had been seen ‘coolly watching Baby I who was in crisis’; in the third the infant pumped with air; and in the fourth the designated nurse returning in response to the alarm and finding Letby standing over her.
‘It was persistent, calculated and cold-blooded,’ said Mr Johnson.
Letby is accused of attacking two sets of twins – with insulin and with air – one child, Baby E, would die but his sibling survived
The prosecution claims that a single common factor in the babies’ deaths and collapses was Letby’s presence