A “cold-blooded” nurse was trying to kill a 98-minute-old baby when she was interrupted by a doctor who had started to link her to unexplained deaths, a court heard.
Lucy Letby, 32, was standing over the incubator of a newborn girl whose oxygen levels had fallen “dangerously” low when a colleague walked in, a jury was told.
Ravi Jayaram, a paediatric consultant, had been “uncomfortable” that Letby was alone with the 12-week premature baby because he had “started to notice a coincidence between unexplained deaths, serious collapses and the presence of Lucy Letby”, the trial at Manchester crown court heard.
Jayaram rushed to help the infant and found that her chest was not moving and her breathing tube had been dislodged, it was alleged.
Letby was “making no effort to help” the baby and had not called for assistance, jurors were told, while an alarm connected to the infant appeared to have been silenced.
Jayaram was “troubled” because Letby was the only person in the room, the court heard. He did not make a contemporaneous note of his suspicions or about the alarm failing to activate, the trial before judge Sir James Goss was told.
The baby, who can be named only as Baby K, died three days later but Letby is not charged with her murder.
She was one of 10 babies that Letby allegedly attempted to murder on the neonatal unit of the Countess of Chester hospital between June 2015 and June 2016.
Letby is accused of murdering seven babies in the same period. She denies all 22 counts.
Nick Johnson KC, prosecuting, told the jury that three months after the death of Baby K, in April 2016, Letby had been moved to day shifts “because the consultants were concerned about the correlation between her presence and unexpected deaths and life-threatening episodes on the night shifts”.
On the third day of the trial, jurors were also told Letby had sent a sympathy card to the grieving parents of a baby she murdered at her fourth attempt.
Johnson told the jury that Letby’s attempts to kill the infant, Baby I, were “extreme … even by the standards of this overall case”.
Jurors were told that although Baby I was born 10 weeks premature, weighing 970 grams (just over 2lb), she was progressing well until she arrived on Letby’s ward from Liverpool Women’s hospital, where she was born.
Johnson said: “[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.”
He added: “It was persistent, it was calculated and it was cold-blooded.”
Letby is accused of repeatedly pumping Baby I with a “massive” amount of gas over a period of two months when she had to be resuscitated by Letby’s colleagues.
On one occasion the University of Chester graduate was seen standing in the doorway of the girl’s darkened room “coolly watching [a baby] who was in crisis”, the jury was told.
A nurse turned on the light and saw Baby I “at the point of death” and unable to breathe.
On a separate occasion, the infant’s monitor alarm sounded and a colleague rushed to help and found Letby standing beside the incubator.
Letby’s fellow nurse wanted to intervene as Baby I was “distressed” before Letby placated her colleague, saying “they would be able to sort it”, it was alleged. The baby, 11 weeks old, then collapsed and died.
The baby’s mother said that as she bathed her dead daughter, the alleged murderer was “smiling and kept going on” about how she was present at the girl’s first bath “and how much [the baby] had loved it”, the trial heard.
During a police interview four years later, Letby was asked about a sympathy card she had sent to the girl’s parents.
Letby apparently agreed that it was “not normal” for a nurse to send a card and that this was the only time she had done it, but she said “it was not often the nurses got to know a family as well as they had known [Baby I’s family]”.
Letby accepted that she had kept an image of that card on her phone, the jury was told.
She was also asked about medical records for twin boys, who she had allegedly tried to kill, at her home. She denied this was “a souvenir” and said she must have taken them home by accident.
The trial continues.
• This article was amended on 13 October 2022. Letby is charged with the attempted murder of Baby K, not her murder as an earlier version said.