Doctor ‘felt extremely uncomfortable’ about Lucy Letby being alone with baby girl

A doctor said he was “extremely uncomfortable” at the thought of nurse Lucy Letby being alone with a child, a court heard on Tuesday.

Dr Ravi Jayaram told Manchester Crown Court he was feeling “extremely uncomfortable” and found 33-year-old Lucy Letby doing “nothing” as the baby’s oxygen levels were dropping.

Ms Letby is accused of deliberately dislodging the baby’s breathing tube shortly before Dr Ravi Jayaram entered the nursery.

The alleged assassination attempt is said to have taken place at 3:50am during a night shift in the neonatal unit of the Countess of Chester Hospital two hours after the baby was born prematurely in February 2016.

Miss Letby (pictured) is said to have deliberately dislodged the baby’s breathing tube shortly before Dr Ravi Jayaram entered the nursery.

The baby, known as Child K, was left in “stable” condition before its designated nurse, Joanne Williams, left the nursery to inform the baby’s parents about the delivery room.

But Dr Jayaram said he began to feel “extremely uncomfortable” when Ms Williams informed him that Ms Letby was “looking after” the premature child while she went to inform the parents.

He said: ‘At this point, in mid-February, we were aware as a team of a series of unexpected and unusual events and were aware of an association with Lucy Letby.

That’s all we knew. She had not attributed any cause and effect to it.

I admit that it seemed totally irrational and illogical. Jo told me that she was leaving and Lucy was there, I felt extremely uncomfortable.

‘You can call me hysterical, you can call me irrational, but that’s how I felt because of this association.

“Then my rational part told me to stop being so ridiculous and I kept doing what I was doing, but the thought kept coming back to me.

‘After two and a half to three minutes, I got up to check on Child K and prove to myself that I had to stop being ridiculous and unreasonable and of course everything was going to be okay.

‘They hadn’t called me to check on Child K and I hadn’t gotten up because I heard the alarms go off. I went up to nursery one and went inside.

Prosecutor Phil Astbury asked Dr. Jayaram what he saw once he entered the nursery room.

Dr Jayaram said: ‘As I was walking I saw Lucy Letby standing by the incubator and ventilator. She didn’t have her hands in the incubator.

“I watched her and then I looked at the monitor and Child K’s blood oxygen levels were in the 80s and continued to drop.

‘The fan was not alarming and the incubator was not alarming and the monitor is set to alarm when the satellites drop below 90 percent.

‘I remember saying, ‘What’s going on?’ and Lucy looked over and said something like, “She’s having a desaturation.”

Mr Astbury then asked what he saw Miss Letby doing in reaction to the child’s suffering.

Dr. Jayaram said: ‘Nothing. I didn’t know he was looking at the monitor. He didn’t tell me anything until I asked him what was going on.

Dr. Jayaram, now the unit’s lead pediatrician, said he noticed the baby was not moving at the chest.

At this point, Dr Jayaram said that he and Miss Letby “switched into professional mode”.

He added: ‘It really didn’t make sense to me why the tube dislodged. It had been secured and Child K was not a vigorous baby.

“It is very difficult to remove an endotracheal tube without it being detected. So I removed the tube, which was not blocked.’

Dr Jayaram said he gave girl K mouth-to-mouth resuscitation and her chest began to move again and her oxygen levels increased.

Dr Jayaram said he found Miss Letby (pictured) doing ‘nothing’ when Baby K’s chest was not moving and oxygen levels were dropping.

Questioned by Ben Myers KC, the prosecutor, Dr Jayaram said: “My reasons for entering were not based on clinical indications that Baby K might be at risk of acute deterioration.”

Agreeing that his earlier suspicions about Letby had crossed his mind upon seeing her in the nursery, the lawyer told him: ‘Then you’ve got her!’

Dr. Jayaram replied, ‘No, because I have never seen her do anything.’

He went on to explain that the unit’s senior doctors wanted senior management to investigate the association between Letby’s presence and the fact that “more and more of these events were happening.”

“We wanted this to be objectively investigated in an appropriate way. It wasn’t clear to us how we could properly investigate that.

“There was absolutely no evidence that we could prove anything because that is not our job as doctors.

“As a group of consultants, we had experience or knowledge of unusual events, and there was a particular nurse associated with them.”

Dr Jayaram gave evidence at Manchester Crown Court (pictured) on Tuesday where the case continues.

Asked if he should have confronted Letby as he suspected she had done something to K on purpose, he replied: “Absolutely not.” It’s not my job to do that. It’s my job to take care of the baby.’

He rejected Mr. Myers’ assertion that if the incident had occurred as he told the jury, and as he had previously told the police, he would have confronted her.

The pediatrician had not written a Datix report on the incident because he did not believe that this was the correct way to proceed.

Dealing with a colleague’s problem that might be harming babies was “unfortunately something they don’t teach us in medical school.”

Also, I hadn’t anticipated that several years later I’d be sitting here talking to you.

He told Mr. Myers how his pediatric colleague, Stephen Brearey, had been the first to raise the concerns of the unit’s senior doctors.

“We did everything we could to raise our concerns with senior management. We take it to the senior executive level.

Stephen Brearey raised the concerns prior to this incident and in February before or after this we raised them again.

“We had really big concerns going back in the fall of 2015 and we raised them with the chief nursing officer.

“As doctors, we trust senior management as to how it could be investigated. The initial response was to go ahead and see what happened.

‘We pointed it out again in February to the medical director and the nursing director.

‘My colleague, Dr. Brearey, asked to have a meeting. They didn’t respond to that for another three months. In hindsight, we wish we would have passed them by and gone to the police.’

Child K was transferred the same day to Arrowe Park Hospital, Merseyside, where she died three days later.

Letby, originally from Hereford, denies killing seven babies and attempting to kill 10 others between June 2015 and June 2016.