A doctor told a jury how he asked for Lucy Letby to be taken off shift after the death of two baby brothers on consecutive days.
A senior paediatrician at the Countess of Chester Hospital told an executive he and his consultant colleagues were "not happy" with the defendant continuing to work on the neo-natal unit. Dr Stephen Brearey said he raised the matter with nursing chief Karen Rees following the deaths of two brothers on successive days in June 2016.
The prosecution say the infants, Childs O and P, were the 15th and 16th victims of Letby, 33, who denies the murders of seven babies and the attempted murders of 10 others between June 2015 and June 2016. On Tuesday, Dr Brearey, head consultant on the unit, told Manchester Crown Court he held a staff debrief following the deaths of Childs O and P on June 23 and June 24.
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Nurse Letby was present at the debrief, he said, and he asked her how she was feeling.
Dr Brearey said: "I can remember suggesting to her she would need the weekend off to recover from the traumatic events. She didn't seem overly upset in the debrief, or upset at all, and she told me she was on shift the next day, which was a Saturday.
"I was concerned about this because we had already expressed our concerns to senior management about the association with nurse Letby and the deaths we had seen on the unit. So, following the staff debrief, I phoned the duty executive on call, Karen Rees, senior nurse in the urgent care division.
"She was familiar with our concerns already. I explained what had happened and I didn't want nurse Letby to come back to work the following day or until this was all investigated properly.
"Karen Rees said 'no' to that and that there was no evidence. I put it to her was she happy to take responsibility for this decision in view of the fact that myself and my consultant colleagues all wouldn't be happy with nurse Letby going to work the following day.
"She responded she was happy to take that responsibility. We had further conversations with executives the following week and action was taken."
On June 25, Letby is accused of attempting to murder Child Q during a day shift by injecting him with air. Letby, originally from Hereford, denies all the allegations.
In June 2015, Dr Brearey conducted a review into the circumstances of the death of Child D that month. An "association" with Letby and her presence at a number of collapses up to that point were noted, the court heard.
Dr Brearey told the court a meeting followed with director of nursing Alison Kelly in late June or early July 2015.
He said: "I think my comment at the time during the meeting was 'it can't be Lucy, not nice Lucy'."
Ben Myers KC, defending, said: "I would suggest that once Ms Letby had been identified as someone, or a factor, that caused concern there was naturally a bias against her in the way she behaved and the way it was interpreted, do you agree?"
Dr Brearey replied: "I disagree."
A further review of collapses at the unit from a neonatologist based at Liverpool Women's Hospital took place in February 2016, the court was told. Dr Brearey said he sent a report of those findings to the director of nursing and the hospital's medical director as he asked for another meeting.
He confirmed that during this period there was no formal complaint made to the police.
Mr Myers asked: "If somebody hurt a baby on your unit and you believed you had the identity of the person responsible, you'd report it to the police wouldn't you?"
Dr Brearey said: "I think you are making it a bit more simplistic than it was. It was not something that anyone wanted to consider, that a member of staff is harming babies.
"Actually, the senior nursing staff on the unit didn't believe this could be true up until the point and beyond when the triplets (Child O and P) died. None of us (the consultants) wanted to believe it either.
"This all became very exceptional and it took a step back to think about it. The nature of these collapses, the unexpected nature of them, the lack of response to resuscitation, the unusual rash noted on a number of occasions and each time the association with Nurse Letby."
He said he wanted to "escalate" concerns within the hospital management rather than go directly to the police. He said: "I needed executive support and that was what we were after."
Dr Brearey said there were "no more events" after Letby left the neo-natal unit.
He said: "It was the same staff doing the same job and there were no sudden collapses."
The consultant told Simon Driver, prosecuting, that between the deaths of Child D and Child O he was unaware that two other babies had returned blood results which showed abnormally high insulin levels.
The trial continues.
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