The nurse denies attacking a baby to gain the attention of a doctor she allegedly “had a crush on”.
Image source, SWNSTwo babies died and a third collapsed within 72 hours of Lucy Letby telling a colleague she would be “back in with a bang” after her holiday, a court heard.
The neonatal nurse, 33, is charged with murdering seven babies and attempting to murder 10 others at Countess of Chester Hospital between 2015 and 2016.
Manchester Crown Court heard Child O and P, two brothers in a set of triplets, died in June 2016.
Ms Letby, from Hereford, denies all of the allegations against her.
Jurors were told the accused was on holiday in Ibiza with friends when the triplets were born.
In a text message to a fellow nurse ahead of her return to work, Ms Letby said she would “probably be back in with a bang”, the court heard.
Prosecutor Nick Johnson KC said “within 72 hours of that text” Child O and P had both died and Child Q – who was unrelated to them – had collapsed.
Ms Letby accepted there were no health concerns about the triplets, who cannot be named for legal reasons, when they were born.
She agreed their birth was “big news” on the neonatal unit and that it was the first time she had ever come across naturally conceived triplets in her career.
Image source, PA Media
Ms Letby denied attacking Child O on her first day back at work in order to gain the attention of a doctor who prosecutors have suggested she “had a crush on”.
She has previously told jurors she was not in love with the registrar – who cannot be named for legal reasons – and they were just friends.
Jurors were told Ms Letby texted him that morning: “Bit rubbish that you couldn’t stay on nnu (neonatal unit).
“You may get time for lunch though if on clinic.”
Mr Johnson asked her: “Were you disappointed he was not there?”
She said: “Yes, I enjoyed working with [the doctor].”
Mr Johnson said: “Were you missing him?”
Ms Letby said: “No, this was my first day back at work.”
Mr Johnson said: “Did you want to get his attention?”
“No,” the nurse said.
Mr Johnson asked: “Is that the reason you sabotaged [Child O]?”
“No,” the defendant repeated.
Image source, Helen Tipper/BBC
Jurors were told that up to 90 minutes later, Ms Letby called for help from the registrar, who was working in a neighbouring nursery.
The prosecutor asked her: “Were you trying to get his attention?”
Ms Letby said: “Yes, I wanted him to be with (Child O).”
Mr Johnson said: “Personal attention as well?”
Letby said: “No, he was the registrar on the unit that day.”
Ms Letby, who was Child O’s designated nurse, called for the doctor’s assistance at about 13:15 BST after the infant vomited following a milk feed 45 minutes earlier.
Medical entries showed the accused signed for the feed but, giving her 13th day of evidence, Ms Letby told the court that the child was actually fed by a student nurse she was mentoring.
Mr Johnson said: “You deliberately overfed [Child O], didn’t you?”
Ms Letby replied: “No I didn’t. I was not feeding this baby.”
The court was told Ms Letby had noted Child O’s appearance was “mottled” and his abdomen was “red and distended”.
Mr Johnson reminded the nurse the unit’s head consultant Dr Stephen Brearey had recalled an “unusual rash” on the right side of Child O’s chest wall, which later disappeared.
The prosecutor asked her: “Is that what you saw as well?”
Ms Letby said: “No.”
Mr Johnson told the court that Child O’s mother had noticed “changing” skin discolouration and “prominent veins”, while Child O’s father observed “something oozing through his veins”.
He asked the accused: “Do you agree with the descriptions?”
Ms Letby replied: “I didn’t see anything like that.”
Mr Johnson said: “You saw a sort of blotchy, purply/red rash?”
“Yes,” Ms Letby said.
The defendant agreed a liver injury sustained by Child O – discovered after his death – must have been inflicted during the shift.
She told the court: “I don’t know how that has happened.”
Mr Johnson said: “You injected [Child O’s] stomach with gas down the [nasogastric tube], didn’t you?”
The nurse said: “No, I didn’t.”
Mr Johnson said: “You injected air into his circulation.”
Ms Letby said: “No.”
Mr Johnson said: “And through some violent mechanism, you inflicted that liver injury on him.”
“No,” the nurse replied.
Child O continued to decline throughout the afternoon and died at 17:47.
Mr Johnson accused Ms Letby of then turning her attention to Child O’s brother, Child P, who was also in her care.
The prosecutor said: “You had already put your plan into motion by pumping [Child P] before you left, hadn’t you?”
“No,” Ms Letby said.
Mr Johnson went on: “You overfed [Child P] some time between 6pm and handing him over at 8pm, didn’t you?”
Letby said: “No.”
The defendant is alleged to have murdered Child P the following day with more injections of air.
Child P suffered an acute deterioration five minutes after a doctor examined him on the morning ward round, the court heard.
Again, Ms Letby’s alleged love interest was among medics to respond to an emergency crash call, the court heard.
Mr Johnson asked the defendant: “Were you trying to attract [the doctor’s] attention?”
“No,” said the accused.
Mr Johnson said: “Did you enjoy being in these crisis situations with [the doctor]?”
She said: “No.”
Mr Johnson said: “Did it give you something to talk about and message about?”
The nurse said: “No, [the doctor] and I were friends.”
Mr Johnson said: “The reason you crash called was because you had injected air down his [nasogastric tube]?”
“No,” said Ms Letby.
A further deterioration happened just before 12:30 when the registrar and another doctor were in a tea room and they heard a call for help from the accused.
The second doctor – who also cannot be identified for legal reasons – has previously told the jury that Ms Letby went on to say to her: “He’s not leaving alive is he?”
The accused said she could not recall the conversation.
Mr Johnson said: “Did you enjoy making predictions when you knew what was going to happen?”
“No,” said the defendant.
Child P continued to decline and was pronounced dead at 16:00.
Mr Johnson put it to the defendant that she was “falling over yourself” to message a colleague about the boy’s death later that evening.
Ms Letby said: “No, I told her out of respect.”
She added it was “common practice” to try and make nursing staff aware of such outcomes before they walked on to the unit and found out.
Mr Johnson said: “She was at the races. Why didn’t you just leave her alone?”
The accused said: “She was asking me.”
Mr Johnson said: “Did you enjoy the drama?”
“No,” said Ms Letby.
The nurse also denied she attempted to murder Child Q, a baby boy, the following day by “pumping him with a clear fluid”.
The trial continues.
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