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A nurse sat on the witness stand crying today after telling the trial of neonatal nurse Lucy Letby how she felt the last heartbeat of a baby she was trying to resuscitate.
The Countess of Chester Hospital shift director, who cannot be named for legal reasons, performed CPR on Baby A after he suddenly deteriorated in the neonatal ward.
To resuscitate the baby, she reached through a flap at the back of his incubator. Her hands were around the little baby’s chest, her thumbs at his sternum.
The entire time she held him, nurses and doctors stood around the incubator in the last attempts to resuscitate him.
Nurse A recalled that baby A was given small amounts of adrenaline one at a time. After each dose, they listened for a response.
“There was nothing … one more heartbeat,” she told the court.
The nurse testified from behind a screen at Letby’s murder trial.
Letby, 32, denies murdering seven babies and killing ten more at Countess of Chester Hospital in Cheshire between 2015 and 2016.
A colleague of neonatal nurse Lucy Letby (pictured) could not recall the alleged killer going to comfort a baby’s family as he collapsed, a jury heard today
John and Susan Letby, parents of Lucy Letby, arrive at Manchester Crown Court today for their daughter’s murder trial
Sometimes the nurse’s voice dropped to a whisper. Finally, when her proof for the day ended, she could be heard crying.
At the beginning of her evidence, the nurse was asked what Baby A had looked like when he went into a rapid slump.
“I’ve never seen a baby look like that,” she told Simon Driver. ‘He looked very sick. He had a discoloration pattern I’ve never seen before.
“It was white with some purple spots. He looked cyanotic. It was those purple flecks of white I hadn’t seen before, all over his body.”
When asked where in particular on his body, she replied: ‘Everywhere. Maybe more torso… no, I don’t remember well. I just knew it was very unusual.
‘It had come very suddenly. It was just so unusual’.
She had remained in Nursery 1 after the baby’s death.
“It was sudden and very unexpected,” she said.
The nurse recalled a decision made to leave the lines used to treat him “because we didn’t know if the coroner would need them.”
Dr Owen Arthurs (photo arrived at Manchester Crown Court), professor of radiology at Great Ormond Street Hospital, testified today at the murder trial of Lucy Letby
Earlier in the day, the court heard that an X-ray taken the day after baby A died, while in the care of neonatal nurse Lucy Letby, revealed an “unusual” gas line not normally seen in babies.
On day 10 of her murder trial, Dr Owen Arthurs, a radiology professor at Great Ormond Street Hospital, guided the jury through an image displayed on a screen in Manchester Crown Court.
He showed them gas bags in the baby’s stomach and heart. Both were normal.
A court sketch of Lucy Letby at Manchester Crown Court on Thursday, October 20, where she is charged with the murder of seven babies and the attempted murder of a further ten.
Letby, 32, of Hereford, is on trial for the murder of seven babies at Countess of Chester Hospital, Cheshire, and the attempted murder of a further 10 between 2015 and 2016. She denies all charges.
But the doctor then pointed to a third buildup of gas — in a line just in front of the spine, running from the stomach to just beyond the heart.
“That’s an unusual find,” said Dr Arthurs.
His conclusion after conducting a survey of infant deaths was that the gas line was consistent with ‘delivering air’ to baby A.
dr. Arthurs said that after initially noticing the gas near the spinal column, he conducted a large-scale survey of past Great Ormond Street cases, arranging it into a list of possible circumstances for that type of image in deaths reported. attributed to natural causes.
Such accumulations of trapped air can be found in cases such as serious traffic accidents, overwhelming infections of sepsis, or ‘very occasionally’ in cases of ‘sudden unexpected death in infancy’ (SUDI).
Before studying Baby A’s body X-ray, he had never seen such a buildup in a baby.
Nick Johnson, KC, prosecutor, asked, “Have you ever seen this on a baby before?”
The radiologist replied: ‘Only in one other case, I think we’ll discuss that later’.
Mr Johnson: ‘Any other children in this case?’
dr. Arthurs: ‘That’s right’.
He added: ‘My opinion was that this was an unusual experience, not typical of what you would normally see. In the absence of any other explanation, it is consistent with, but not diagnostic of, air administration’.
The court heard that Dr. Arthurs also studied X-rays of Baby A’s surviving twin sister, Baby B, taken on June 8, the day he died, and on June 10.
None of these had shown a buildup of air comparable to the one he’d seen on her brother’s X-rays.
They did not point to a possible diagnosis of air embolism in baby B, nor against it.
But he added: “The absence of air doesn’t mean that hasn’t happened.”
Examined by Ben Myers, KC, who defended, said Dr. Arthurs that his case review was the largest available at the time.
When the lawyer asked if any of the cases involved neonatal babies in the first three or four days of life, he replied, “The vast majority of them don’t die.”
dr. Arthurs agreed that he had initially looked at 500 cases on Great Ormond Street. After refining the criteria, the assessment came to 38 babies under two months of age. Of these, eight had gases in the larger vessels of their bodies.
Causes of death included trauma, a traffic accident, congenital heart disease and sudden expected death in infants.
He agreed with Mr. Myers that “one possibility” that would explain the gas line in the image would have been air delivery. Other possible causes may have been attempts at CPR or post-mortem changes.
The lawyer then asked for an X-ray of baby B on June 10, about 40 minutes after her nonfatal collapse.
“There are no features in that image to support a diagnosis of an air embolism?”
Dr. Arthurs agreed.
Later, another nurse recalled the moment Lucy Letby called her to help with baby A’s collapse.
Senior nurse Caroline Bennion cared for the baby’s twin sister, Baby B, a few feet from the alleged killer at Nursery 1.
The hall was ‘quite full’ because there was a transition between the day and night shifts.
There was no need for an emergency call as doctors were already there – David Harkness and Christopher Wood, an intern. The adviser, Ravi Jayaram, arrived a short time later.
“I remember Lucy asking for help,” said Mrs. Bennion, a Band 6 nurse on the ward. “When it became clear that there was a problem, I switched to help with A.”
She helped her colleague administer some rescue breaths over the Neopuff through a face mask.
When the child deteriorated, she took on the role of preparing the emergency drugs needed to resuscitate him.
She was still there when Baby A was pronounced dead. By then she had returned to care for his sister.
Nurse Bennion told Ben Myers, KC, and defended that there were times when the nationally recommended headcount could not be reached.
She agreed that there was “a lot” to observe and track in a neonatal unit, and that it was entirely possible for a neonate who looked good to suddenly deteriorate.
“These babies are very fragile and there is always the possibility that they will deteriorate very quickly.”
For over 30 years, she had experienced occasional deaths in neonatal wards.
When asked by Simon Driver, the District Attorney, whether the speed and nature of A’s deterioration was typical of those experiences, she replied, “It was very fast. Very suddenly. And sometimes there is an indication that you are going to have a deterioration.
“There was no evidence that he would deteriorate. However, it can happen and it has happened’.
Letby’s parents, John and Susan Letby, supported their daughter during the trial and were seen at Manchester Crown Court earlier today.
The trial continues on Monday.