Lucy Letby trial told ‘certain’ babies can dislodge their own breathing tubes
The 34-year-old is accused of trying to murder a newborn, known as Baby K, by displacing her tube.
Babies that are ‘active’ are capable of dislodging their own breathing tubes, jurors in the trial of killer nurse Lucy Letby have been told.
The 34-year-old is accused of trying to murder a newborn, known as Baby K, by displacing her tube while working a night shift at the Countess of Chester Hospital’s neo-natal unit.
She is said to have struck when the infant’s designated nurse left the unit to update her parents on the labour ward about the child’s wellbeing and a pending transfer to a specialist hospital because of her extreme prematurity.
Child K was born less than two hours earlier at 2.12am on February 17, 2016, at 25 weeks’ gestation, weighing just 1lb 8oz (692g).
Dr Ravi Jayaram is said to have caught Letby ‘virtually red-handed’ as he entered the unit’s intensive care room and said he saw Child K’s blood oxygen levels dipping on the monitor screens but no alarms were going off as they should have done.
He has told jurors that he saw ‘no evidence’ of Letby having done anything to help Child K and that he heard no call for help as he sat nearby at a desk at the central nurses’ station.
The consultant paediatrician said he ‘feared retribution’ from hospital bosses if he called police to say he suspected a nurse was killing babies.
On Thursday, Band 6 nurse Joanne Williams told the court that she could not remember if she asked a specific colleague to watch Child K while she was absent but three other registered nurses, including Letby, were on the night shift and the practice was to work as ‘a team’.
Her nursing notes recorded her leaving the unit at 3.30am but she said she could not recall the precise time.
Prosecutor Nick Johnson KC asked: ‘What condition was (Child K) in when you left at whatever time it was?’
Ms Williams said: ‘She would have been stable to the point at what was acceptable for a 25-weeker baby … otherwise I would not have left.’
Mr Johnson said: ‘Would you have been gone long?’
Ms Williams said: ‘No, because I would have been very conscious to come back to (Child K) and support the rest of the nursing staff and the other babies on the unit.’
Door swipe data logged her re-entering the unit at 3.47am when she said she could hear alarms going off from nursery one, the intensive care room.
Mr Johnson said: ‘Can you remember anything you saw when you got to nursery one?’
Ms Williams said: ‘Just that people were in the room and the alarms were going off. I remember Dr Jayaram being in the room and Lucy being in the room.’
Mr Johnson said: ‘Do you remember what was being done by Dr Jayaram or Lucy Letby?’
Ms Williams said: ‘No, not at that time.’
Mr Johnson pointed out that her nursing notes from the night had queried whether the ET (endrotracheal) tube had dislodged.
He asked: ‘Was that the working theory at the time?’
Ms Williams said: ‘If I had written that, then yes.’
Ben Myers KC, defending, asked the nurse: ‘In your experience, is it possible that tubes slip or move?’
‘Yes,’ said Ms Williams.
Mr Myers said: ‘And babies are capable of dislodging tubes, do you agree?’
Ms Williams replied: ‘Certain babies, yes.’
Mr Myers said: ‘If they are active they can dislodge them?’
‘Yes,’ said Ms Williams.
Mr Myers said: ‘Your initial recollection was that Child K was active, and an active baby can dislodge a tube?’
‘Yes,’ she repeated.
Child K was transferred to Wirral’s Arrowe Park Hospital later on February 17 and died there three days later although the prosecution does not allege Letby caused her death.
Letby, of Hereford, denies a single count of attempted murder.
The jury of six men and six women has been told that Letby was convicted at a trial last year of the murders of seven babies – five before February 2016 – and the attempted murders of six other infants at the Countess of Chester between June 2015 and June 2016.
A court order prohibits reporting of the identities of the surviving and dead children involved in the case.
Earlier, Dr Jayaram told the court: ‘I was surprised that the alarm was not going off, although my priority was (Child K) and I didn’t question it at the time. In retrospect I was surprised that help was not called given (Child K) was a 25-week gestation baby and her saturations were dropping.
‘At this time we had had a number of unusual incidents with babies, and a number of colleagues and myself had noted the association with Lucy Letby being present at these things.
‘We had had a thematic external review which had not found any other obvious factors.’
Asked why he did not pass on his suspicions to the police, he said: ‘I think if people were not aware before, people are probably aware now since events in August of the culture for clinicians in the NHS who raise concerns.
‘There was a strategy really to keep us quiet. People didn’t want to listen to us acknowledging problems.
‘All that would have happened had I picked up the phone to police is they would have got in touch with the trust, spoken to the medical director and said “just ignore them, they are a bunch of complaining paediatricians”.
‘If I had known then what I know now I would have found different ways to escalate our concerns.
‘We had spent a lot of time as a group trying to escalate our concerns and were running into walls to the point that I have realised now the risk we were putting ourselves in, in terms of our professions, our careers and our lives, by continuing to raise concerns.
‘Had I had more courage maybe I would have picked up the phone to police.’
Mr Myers said: ‘The easiest thing to do is pick up the phone and say there is a nurse on the unit killing babies – what stopped you doing that?’
He went on: ‘This is your unit, your babies. Patient care is paramount. You didn’t call the police because you didn’t see anything worthy of calling the police about, that’s the truth, isn’t it?’
Dr Jayaram said: ‘No, I disagree.’
The trial continues today.
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