A mother walked in on Lucy Letby trying to murder her baby but was told “trust me, I’m a nurse”, a court was told.
Nurse Ms Letby, 32, is on trial at Manchester Crown Court charged with murdering seven babies and attempting to murder 10 others in the neonatal unit in the Countess of Chester Hospital.
She denies all the charges against her.
On Tuesday, Nick Johnson KC continued the prosecution opening after telling the jury on Monday that Ms Letby was a “constant, malevolent presence” when children died or fell seriously ill on the maternity ward.
He told jurors that in August 2015 she murdered a baby known as Child E, before attempting to murder his twin brother, Child F, by insulin poisoning the following day.
The decision not to give Child E a post-mortem examination was described by Mr Johnson as a "big mistake", as it stopped the true cause of his death being discovered.
Jurors were told that on the night of Child E’s death, Ms Letby was the designated nurse in charge of caring for the twins in the neonatal unit.
The twin’s mother decided to visit her sons in the unit shortly after 9pm, the court was told.
“We say (the mother) interrupted Lucy Letby who was in the process of attacking Child E,” the prosecutor said.
“She did not realise it at the time.”
Child E was said to have been “acutely distressed and bleeding from his mouth” and Ms Letby attempted to reassure the mother that it was due to a stomach tube irritating his throat.
The prosecutor told the court Ms Letby was trying to “fob off” the mother by giving her reassurances. He continued: “Trust me, I’m a nurse, that's what she told (the mother).”
The mother agreed to return to the postnatal ward but was so concerned she phoned her husband. Call records indicate this was at 9.11pm and lasted around four minutes.
Mr Johnson said: "What concerned her so much that she rang her husband?"
He continued: “The next time (the mother) recalls seeing Child E was when he was in terminal decline later that night.
Ms Letby, however, submitted a “fraudulent timeline” of the treatment saying the mother had visited between 7.30pm and 8pm, before returning at around 10pm, the prosecutor alleged.
There was no mention of the blood around Child E’s mouth at 9pm, nor of the mother’s visit at around that time, he said.
Mr Johnson told the court: “Nine o’clock was a very important time in the life of Child E - it was the time he was due to be fed and he was being fed by his mother’s express breast milk.
“That is the reason she went down at nine o’clock.”
Child E's condition continued to deteriorate over the hours that followed.
The doctor noticed the infant's skin developing a discolouration which, the prosecutor has previously alleged, was present on many of the infants who fell ill or died in Ms Letby's presence and was consistent with air being injected through a tube into his stomach.
The baby died early the next morning.
Mr Johnson said the parents did not wish a post-mortem examination to be carried out on Child E because they would find it too distressing. The doctor concluded that it was not "necessary" and the coroner's office "agreed.
"Subsequent reviews have established that was a big mistake," he said.
Ms Letby searched repeatedly for the family of Child E and Child F on social media in the months that followed, including on Christmas Day 2015, the court heard.
Her “unusual interest” in the family began just two days after the death of Child E, with six further searches for them in 2015 found in her internet history, Mr Johnson said.
There were then further searches in January 2016, he told jurors.
Mr Johnson said police had also asked Ms Letby in Nov 2020 about a text she had sent about Child E “that queried whether he had Downs Syndrome”.
“She said she could not remember whether there had ever been any mention of Downs in the medical notes,” he added.
Nurse killed baby in same room she murdered another days earlier, court told
A nurse killed a baby in the room she murdered another infant days earlier, after telling a colleague it would be “cathartic” to see “a living baby” in the same space, a court has been told.
On Tuesday, Nick Johnson KC continued the prosecution opening after telling the jury on Monday that Ms Letby was a “constant, malevolent presence” when children died or fell seriously ill on the maternity ward.
Her third alleged victim, like the previous two, was targeted in the first half of June 2015, Manchester Crown Court was told.
A medical expert who reviewed the case concluded that the "only feasible explanation" Child C could have died was by having air "deliberately" injected into his stomach through a tube, according to the prosecutor.
Child C weighed less than 2lbs when he was born and was taken into the neonatal unit after falling ill in the first few days of his life.
On the night he died, Ms Letby had been assigned to look after another child - referred to as JE - who was “of more concern and appeared to be deteriorating” in what the prosecutor called Room 3 in the unit.
Child C was in Room 1 receiving care from another nurse and Ms Letby was reprimanded by a colleague for “ignoring” the close attention she was supposed to be paying to the welfare of JE, Mr Johnson said.
The nurse looking after Child C briefly left Room 1 to go to the nurse’s station, only to hear the alarm from Child C’s incubator sounding.
When she returned, she saw Ms Letby standing by his cot, the court heard.
Mr Johnson said: “Lucy Letby, who should have been in Room 3, had no business, we say, with Child C and yet when the alarm went off, there was Lucy Letby.”
He added: “Here, we have the third baby who suffered a serious deterioration in the neonatal unit in less than a week and there at the incubator’s side was Lucy Letby.”
As the infant’s situation deteriorated, Ms Letby is alleged to have said to her colleague: “He’s going.”
Mr Johnson told the court: “She was right.”
The baby was declared dead after lengthy efforts to resuscitate him which lasted into the following morning.
The prosecutor then referred to evidence retrieved from a mobile phone seized from Ms Letby, which “gives us and you an insight into what Lucy Letby actually was doing immediately before Child C's collapsed”.
He continued: "You already know Lucy Letby was supposed to be looking after JE in Room 3, but she didn’t want that, she didn’t want to be looking after JE in Room 3.
“She texted an off-duty colleague saying that she had wanted to be in room 1 because it would be cathartic for her – in other words it would help her wellbeing, she was saying - to see a living baby in the space previously occupied by a dead baby (Child A), the baby who had died a few days earlier under her care.”
But the nurse had put her in Room 3, Mr Johnson said, adding: “She didn’t like it.”
Just seven minutes before Ms Letby had said “he’s going”, she had sent another text to a friend saying: “Sleep well xx”
Nurse 'looked up parents of children on social media'
Ms Letby looked up the parents of Child C on social media as soon as she woke up on her first day off after the alleged attack, Mr Johnson told the court.
He said: “At 3.52pm, Lucy Letby had searched on Facebook for Child C’s parents.
“That was the first of her days off, having come off duty at about 8am. The timing may well suggest that, having just done a night shift, that was one of the first things she did having woken up.”
The prosecutor told the jury that “there was a pattern emerging”.
He continued: “So far as the nursing staff were concerned, Lucy Letby was the only person working when Child C died who had also been working when Child A died and Child B had collapsed.
“She was the only person in the room when Child C collapsed – just as she had been by the side of Child A when he collapsed and had been one of two in the room when Child B collapsed.
“Not only did she have no reason for being in the room when Child C had collapsed, but she was supposed to be keeping an eye on JE having already been told off for failing to do so.”
Ms Letby was found to have searched for Child D's parents on Facebook in the aftermath of her death, the court heard.
When asked about this by police in November 2020, she said she could not remember why she had done so.
Mr Johnson said: "We suggest if, as a nurse, you search for a family whose baby you had seen die, you would know and remember why you had done it."
Ms Letby was also asked about another text in which she referred to an "element of fate" being involved in the death, but told police "it was fate that babies get ill sometimes, but she would have to know the context", according to the prosecutor.
He continued: "We say, tragically for Child D, her bad luck, or 'fate', was that Lucy Letby was working in the neonatal unit that night."
'Lucy Letby was the only constant presence'
The next alleged victim of Ms Letby, Child D, was born less than a week after the death of Child C.
She had been unwell in the days after her birth and at various stages required intubation and ventilation to keep her alive.
“Although she was ill, she was responding well to treatment and was not expected to deteriorate,” the prosecutor said.
During a night shift, Child D collapsed three separate times and then died when Ms Letby was in the same room, but not directly responsible for the infant’s care.
The designated nurse was “out of the room” and was “called back by Lucy Letby” when the child first began to deteriorate, Mr Johnson said.
She had an unusual discolouration, which the prosecutor told jurors on Monday was present on several of the babies allegedly attacked by Ms Letby.
“The prosecution say this is another case of injecting air into the bloodstream, the same mode of attack that had been deployed with the twins Child A and Child B,” he said.
Child D was resuscitated and collapsed, before being resuscitated again, the court heard.
“But Lucy Letby did not leave things there,” the prosecutor said.
“In Child D’s records, timed at 3.20am, there is record of Lucy Letby starting an infusion after which she appears to have remained in the room.”
Just 25 minutes later, Child D suffered her third and final collapse, Mr Johnson told jurors.
“In a two-week period, three children had died and one had suffered a life-threatening episode in the neonatal unit of the Countess of Chester hospital,” he continued.
“Lucy Letby was the only constant presence.”
The trial continues.
