Experienced nurse ‘had never seen’ rash that appeared on baby ‘murdered’ by Lucy Letby

An experienced nurse says she had “never seen before” the “unusual” rash that appeared on a baby allegedly killed by Lucy Letby, a court has heard.

Caroline Oakley, who has more than 20 years of experience, told how colleagues at Countess of Chester Hospital were “beaten” by the dark rash after it started showing up in other babies in the neonatal ward.

The baby girl, dubbed Child D, is said to be the third newborn to be killed by Nurse Letby in two weeks, along with another youngster who had a life-threatening collapse during the same time.

Ms. Oakley was the designated nurse for Child D in the neonatal unit for the June 21, 2015 night shift, the judges heard.

Meanwhile, Letby, 32, was assigned to two other babies in the same intensive care room.

Ms Oakley said Child D was in a ‘stable condition’ from the time she entered service at 8pm until 1:30am the following morning.

She told the court today, “I remember being very happy with her.”

However, she was called to daycare at 1:30 a.m., a jury heard.

Testifying from behind a screen, Ms. Oakley said, “I remember I had a break, I had only been gone for half an hour. I remember going to the nursery and saying, “What’s happening?”

Her nursing notes stated that Child D’s oxygen levels had dropped and she had lost color.

She also recorded: ‘Skin discoloration observed. Trunk, legs, arms, chin.’

Ms Oakley told the court: ‘I don’t exactly remember the exact result, but I remember not seeing it before. It was dark, it was unusual.

“The result hit me. I hadn’t seen that result on a baby I’d cared for.’

She added: ‘I struggled to describe it. I remember it as a deep red/brown but other than blotchy.

“Sometimes when a baby is sick, they lose their color and have a mottled appearance, where this was just a rash, specifically in those places.

‘I remember that. You don’t really get a rash with babies.’

A doctor was called and Child D ‘responded quickly’ to the treatment, with the rash clearing up.

Mrs. Oakley said, “Everything was back to normal I’d say in about an hour and we had made some changes as she was pretty stable again.”

But she noticed that child D was “crying” at 3 a.m. and her oxygen levels had dropped again.

The baby “picked up well” after receiving respiratory support, adding: “The skin discolored again, but less than before.”

Asked about her memory of this note of child D’s complexion, Mrs Oakley told Prosecutor Simon Driver: ‘I just remember it wasn’t that pronounced. It wasn’t that bad, but I didn’t expect her to be bad again.’

The court heard Child D’s monitor alarm go off at 3:45 am and the newborn stopped breathing.

CPR began immediately, but Child D was pronounced dead at 4:25 am. Ms Oakley said her memory of the alarm was “just a blur.”

She added: “I remember it was very busy. I don’t know exactly where I was. I could have been in the room or just outside the room in the nursing station. I don’t have a clear memory.’

Ben Myers KC, who was defending Letby, asked the nurse, “Was there any discussion in the ward around the time this happened that people had seen an unusual rash on one or more other babies?”

Mrs Oakley said she remembered such discussions. before Mr. Myers then asked, “What about people comparing their memories of what they’d seen in other babies?”

Mrs Oakley replied, “I can’t remember the details, but people had recently noticed a different rash.”

The Crown says Letby injected a deadly amount of air into Child D’s bloodstream.

Mr Myers previously told the jury that there was more evidence that infection played a role in her death and that the hospital was not providing adequate care.

Ms Oakley also told Court A today of her surprise when she was recalled to a ‘stable and happy’ newborn who suddenly deteriorated shortly after leaving her – and died just two hours later.

Ms Oakley said Baby D was doing so well in the neonatal unit at Countess of Chester Hospital that she was about to get her first expressed milk feed from her mother.

But on September 22, 2015, at 1:30 a.m., she was recalled by Letby – who was accused of murdering seven babies – and another nurse on duty.

‘I was like,’ ‘Why are you calling me back?” Mrs Oakley told Manchester Crown Court. “I had only been gone for half an hour and had been happy with her before I left. I was just wondering what was going on.’

She found that the previously “stable” baby had suddenly lost color and had saliva from her mouth. There were also discolorations to her torso, legs, arms and chin.

“It was unusual, and the result struck me,” Mrs. Oakley told the judges. “I had never seen that rash on a newborn baby I’ve cared for for over 20 years.

“I hadn’t seen it before and I probably had a hard time describing it. I remember it as a deep reddish brown – unlike speckles, unlike anything I’d seen before.

“Sometimes when a baby is sick, they can look generally white, have a mottled appearance, whereas this was just a rash in those places.

“It was just different from what I’d seen before. That has stayed with me’.

Baby D responded very quickly to the treatment and her notes indicated she was “back to normal” within half an hour.

“As she was stable again and the doctors were busy, we decided to let the parents rest and informed them in the morning,” Ms Oakley told the court.

But at 3:45 a.m., Baby D had a second, fatal collapse that continued until a doctor pronounced her dead at 4:25 a.m. She was 36 hours old.

Ms Oakley told the jury that her memory was now “just a blur” in her head. But when the monitor sounded over D’s bed, she’d either been in the nursery itself or just outside.

“I remember it was very busy, and just when it was good, D had misbehaved again – turned bad –.”

When she reached the child, she lost oxygen and had stopped breathing.

Mrs Oakley called Letby to help. The two nurses tried to resuscitate her by tickling her feet and touching her ears “because sometimes that’s enough to get them around again.”

Then they tried the Neopuff device, but that also failed. With the child still unresponsive, they called the senior house officer and crashed Dr. Brunton.

Ms. Oakley continued to help with the CPR attempts until the team realized there was nothing more they could do.

Letby, 32, from Hereford, denies the murder of seven babies and the attempted murder of a further ten.

Her trial is expected to take up to six months.