Lucy Letby trial: Former nurse was ‘caught red-handed’ by doctor, prosecution claims
Convicted multiple murderer Lucy Letby was caught "virtually red-handed" as she attempted to kill a premature baby on the neonatal ward at the Countess of Chester Hospital where she worked, a court has heard. The 34-year-old was discovered by a doctor standing over the cot of an infant, known only as Baby K, having allegedly dislodged her breathing tube and switched off the alarm monitors. As the baby's oxygen levels plummeted, rather than shouting for help or trying to resuscitate her, Letby was observed by a consultant "doing nothing", it was claimed.
Jurors at her retrial at Manchester Crown Court, were told Letby's status as a "multiple murderer and attempted murderer" was an important piece of evidence when assessing whether she was guilty of this single additional offence. The former nurse from Hereford stood trial on the same charge last year but jurors were unable to reach a verdict and were eventually discharged. Opening the prosecution case in the retrial, Nick Johnson KC, explained to the jury: "As you probably already know there was another very long trial about a year ago, In that Lucy Letby was convicted of seven murders and seven attempted murders.
Those seven attempted murders related to six children." He said this case related to a single offence of attempted murder against Baby K, who had been born extremely prematurely at just 24 weeks and six days in February 2016. Mr Johnson said despite being born so prematurely Baby K had been doing "remarkably well" but had required help with her breathing and had a tube inserted into her main airway.
The jury was told that Baby K was being looked after by two nurses in Nursery One, while Letby had responsibility for two other children in Nursery Two. But shortly after 3.40am on Feb 17 2016, the two nurses caring for Baby K had temporarily left the nursery leaving Letby alone with her. "It was about this time that Baby K collapsed," Mr Johnson told the jury.
The court heard that the heavily sedated infant was attached to a ventilator to help her breath and to other machines that monitored her heart and blood oxygen levels. Those machines were alarmed so that if there was an issue the alarms would have sounded, but the jury was told on this occasion they had not. Mr Johnson said: "The reason the alarms did not sound was that somebody had disabled them.
So when Dr [Ravi] Jayaram walked into the nursery he saw Lucy Letby was standing over Baby K. Her saturation blood levels were falling but the alarm was not sounding . Not only that but Lucy Letby was doing nothing."
The prosecutor explained that the reason Baby K's oxygen levels were falling was that her ET tube had become dislodged. He went on: "We suggest the fact Lucy Letby was doing nothing...is evidence you can conclude it was Lucy Letby, the convicted murderer, who had displaced the tube." "We say Lucy Letby was caught virtually red handed by Dr Jayaram."
Arrangements had been made to transfer Baby K to a more specialist hospital, but before that could happen there were two more desaturations, the court heard. Mr Johnson said despite not having responsibility for Baby K, the evidence would show that Letby had been there on both occasions. "Despite having responsibility for two babies in nursery 2, she was very much making Baby K her business," he said.
Mr Johnson suggested that having been "almost caught red handed" Letby had attempted to cover her tracks by suggesting that despite being extremely premature and heavily sedated, Baby K had dislodged her own breathing tube. The jury was told that Baby K had been transferred to Arrowe Park Hospital in Birkenhead where she had died on Feb 20, 2016. Mr Johnson said while it was not the Crown's case that she had died as a result of Letby's actions, it was alleged that she had attempted to murder her.
He told the jury: "Ultimately this case may come down to a single issue. Do you believe what Dr Jayaram says he saw? Are you sure, will you be sure, that he is telling the truth about what he saw?"
Ben Myers KC, Letby's defence barrister also addressed the jury, urging them to put aside "sympathy", "emotional reaction" and "unfair bias" and focus on the evidence before them. He said Letby's multiple murder and attempted murder convictions did not prove this allegation. He said the defence would seek to show that Baby K had been extremely fragile when she was born and the Countess of Chester hospital had not equipped to deal with her.
But he said it would be the evidence of Dr Jayaram and whether the jury believed what he claimed he had seen, that was central to the whole case. Letby denies one charge of attempted murder and the trial continues.
6:29PM[1]That's all for today
Thank you for following The Telegraph's live coverage which saw the prosecution and defence make their opening statements to the jury at Manchester Crown Court. Here is a summary of today's events:
- Judge reminded jurors to only use evidence before them
- Nick Johnson KC, prosecuting, said Letby searched for parents of babies on social media
- Court heard how Baby K did 'remarkably well for such a premature baby'
- Mr Johnson explained the intubation process and how the tube was moved on 'multiple occassions'
- Jury heard how Letby signed for morphine to be given to Baby K
- Mr Johnson said Baby K 'collapsed' around same time Letby was alone with her
- Vital alarms were 'disabled' and Letby was 'doing nothing' when consultant arrived at the scene, the court heard
- Jury heard how Letby suggested sedated Baby K dislodged intubation tube herself
- Prosecution says the third collapse of Baby K was a 'coincidence too far'
- Court heard how Letby searched Baby K's surname on Facebook years later
- Defence barrister Ben Myers KC, began his opening statement by telling the jury it is vital to avoid 'emotional reaction', 'sympathy' or 'unfair bias' in trying the case
- He outlined three key issues the defence case would be based on
- Mr Myers then concluded his statement by telling the jury: 'Convictions do not prove this allegation'
Opening statements conclude
That concludes the opening statements from the prosecution and defence.
The jury has been sent home until Thursday morning.
4:25PM[3]Defence: 'Convictions do not prove this allegation'
Referring to Letby's convictions from the previous trial, Mr Myers said: "She said she is not guilty of the allegation. The prosecution relies on the convictions from the first trial. She has maintained, always, she is not guilty of that.
She is guilty of nothing. "Well you have those convictions and you will consider them and they are potentially powerful and emotive aspects of this case." But he went on: "Convictions do not prove this allegation."
4:22PM[4]Defence outlines case's three key issues
Mr Myers said the defence case would be based on three key issues, firstly how fragile Baby K was when she was born so prematurely.
He said she should have been born at a Level 3 hospital, rather than the Countess of Chester Hospital, which was not equipped to deal with such a premature baby. Secondly he said the defence would focus on the care and intubation of Baby K, who he said had not been able to breathe by herself during her short life. Thirdly he said was the evidence of Dr Jayaram and what he claimed to have seen, which was key to the whole case.
4:12PM[5]Defence says it is vital jury avoid 'sympathy' in opening statement
Defence barrister Ben Myers KC, who is representing Letby also made an opening statement to the jury and he began by acknowledging sympathy for the family of Baby K.
"Nothing I do or say is intended to diminish that," he said. He said it would be very easy for people to conclude that Letby "must be guilty", but he said it was vital the jury tried the case on the evidence before them, avoiding "emotional reaction", "sympathy" or "unfair bias".
4:08PM[6]Jury told case may come down to whether they believe on-call consultant
Mr Johnson finished his opening statement by saying: "Ultimately this case may come down to a single issue. Do you believe what Dr Jayaram says he saw?
Are you sure, will you be sure, that he is telling the truth about what he saw. And if you do, do you accept what we allege Lucy Letby was trying to do, bearing in mind what we have also proved."
4:00PM[7]Letby searched Baby K's surname on Facebook years later
The court was told that Baby K was transferred to Arrowe Park Hospital in Birkenhead where she sadly died on 20 February. Mr Johnson said the prosecution was not saying her death was the result of what Letby allegedly did, but he added: "We are making it clear she tried to kill Baby K."
Jurors heard that on 20 April 2018, more than two years later, Letby had searched on Facebook for the surname of Baby K. Mr Johnson said: "That in of itself proves nothing but when you take it in conjunction with all the other circumstances that happened to Baby K it has significance."
3:53PM[8]Third collapse of Baby K a 'coincidence too far'
The jury was told that there was a third collapse of Baby K as the night shift was handing over to the day shift at around 7.30am. Mr Johnson said this was a "coincidence too far".
Mr Johnson said: "We say, Lucy Letby was trying to create the impression, of her being caught almost red handed, that this child had a particular problem."
3:49PM[9]Jury hears Letby suggested sedated Baby K dislodged tube herself
Mr Johnson said Lucy Letby after almost being caught "red handed" was seeking to create the impression that Baby K, who was heavily sedated had dislodged her own tube.
3:46PM[10]Intubation tube was dislodged a second time
There was a second collapse at 6.15am and Mr Johnson said Letby was taking a close interest in Baby K's care. He said an x-ray taken of Baby K showed the tube was in the correct position but a short time later it had been dislodged again.
3:42PM[11]Prosecutor: Letby made Baby K 'her business'
The court heard that it was not the only time Baby K had suffered a desaturation. It happened twice more and Mr Johnson said the evidence showed that Lucy Letby was there on each occasion.
He said: "Despite having responsibility for two babies in nursery 2, she was very much making Baby K her business."
3:35PM[12]Prosecutor claims to jury Letby 'caught red handed'
Mr Johnson told the jurors: "We say Lucy Letby was caught red handed by Dr Jayaram."
3:31PM[13]Vital alarms 'disabled' and Letby 'doing nothing' when consultant arrived
The jury was told that Baby K was attached to a ventilator to help her breathe and other machines that monitored her heart and blood oxygen levels. He said those machines were alarmed so that if there was an issue the alarms would have sounded, but on this occasion they did not. Mr Johnson said: "The reason the alarms did not sound was that somebody had disabled them.
So when Dr Jayaram walked into the nursery he saw Lucy Letby was standing over Baby K. Her saturation blood levels were falling but the alarm was not sounding . Not only that but Lucy Letby was doing nothing."
He went on: "We say that in those circumstances the only reasonable thing for a nurse to have done is either or both, to call for help or use the Neopuff to breathe for the child. "The reason Baby K was desaturating was that the ET tube had become displaced. We suggest the fact Lucy Letby was doing nothing...is evidence you can conclude it was Lucy Letby, the convicted murderer who had displaced the tube."
3:17PM[14]Prosecutor details events leading to Letby being alone with Baby K
Mr Johnson told jurors: "The allegation we make against Lucy Letby we say is very straightforward.
Nurse Joanne Williams, who was the designated nurse for Baby K, will tell you that she left, having stabilised Baby K, and went to see Baby K's mum in the delivery suite and so she left the ventilated and very premature Baby K for that sole purpose and could not have been gone long and she was not gone long. "Dr Jayaram was distracted, and the other nurse had been out of the unit that would leave another nurse and Lucy Letby covering four nurseries. While nurse Williams was out of nursery one, Lucy Letby was in there with Baby K.
She was in there on her own and Baby K collapsed."
3:06PM[15]Jury told Baby K 'collapsed' around same time Letby was alone with her
Mr Johnson explains that there were two other nurses in the nursery with Baby K, but at 3.40am door swipe data showed that one of the nurses had left the unit. At 3.41am Dr Jayaram was on the telephone at the nurses unit, speaking to the transfer department. The jury was told that around this time Letby was alone in the nursery with Baby K
Mr Johnson went on: "It was about this time that Baby K collapsed."
2:54PM[16]Letby signed for morphine to be given to Baby K
The jury is told that at 3.30am Letby signed for morphine to be administered to Baby K to sedate her because she had been intubated and it would stop her interfering with the tube.
2:50PM[17]On-call consultant arranged transfer for Baby K
Going through the sequence of events, Mr Johnson explained that at 3.15am, Dr Ravi Jayaram, who was the on-call consultant, made a call to the transport service to arrange Baby K's transfer to a Level 3 hospital elsewhere in the North West. At the same time Letby was administering medicine to one of the other babies she was looking after.
2:47PM[18]Baby K admitted to separate nursery from one Letby was working in
The court is told that Baby K was admitted to nursery one and Letby was in nursery two, where between 3.02am and 3.12am, she was making notes on one of the other babies she was looking after.
2:38PM[19]Baby K admitted after intubation
Mr Johnson said after being intubated, Baby K was admitted to the neonatal unit at 2.40am.
2:35PM[20]Prosecutor explains tube used for intubation moved on 'multiple occassions'
Pausing the video, Mr Johnson explained that the tube is secured in place and a measurement is taken to show how far it was inserted. He said the reading for Baby K was 6.5cm.
He told jurors this was an important detail because during the trial they would hear that the tube had moved on "multiple occasions". He went on: "This is really what this case is all about."
2:24PM[21]Proceedings resume
Mr Johnson is resuming his opening address following the lunch break. He is telling jurors about the care of Baby K immediately after her birth.
He explained that she was intubated, which means a tube was inserted into the main airway of the baby so that the lungs can be inflated. To explain the procedure, jurors are being shown a video which demonstrates how it works.
2:21PM[22]Trial set to begin
The trial is set to restart soon, following a break for lunch.
1:08PM[23]Court breaks for lunch
Mr Johnson is now pausing his opening address and the court is breaking for lunch. Jurors have been told to return to court at 2.15pm.
1:07PM[24]Baby K did well for premature child
The court heard that Baby K was born at 2.12am on February 17 2016 and did "remarkably well for such a premature baby".
1:05PM[25]Mother transferred to Countess of Chester Hospital
The jury was told that given how premature she was the original intention had been to transfer the mother to another better equipped hospital, either Liverpool Women's Hospital or Arrowe Park hospital in Birkenhead.
But Mr Johnson said medics had to balance the risk between moving her to another hospital and her giving birth in an ambulance on the motorway and so the decision was taken to keep her at the Countess of Chester Hospital.
Countess of Chester Hospital in ChesterCredit: Peter Byrne/PA1:00PM[26]
Mother of Baby K called hospital over 'worrying symptoms'
Turning to Baby K, Mr Johnson explained that just after 9am on February 15 2016, her mother had called the hospital with "worrying symptoms" She arrived at the hospital just before 10am in labour despite being very premature at just 24 weeks and six days gestation.
12:58PM[27]Letby searched for parents of babies on social media
Mr Johnson said after murdering and attempting to murder a number of babies, Letby had carried out Facebook searches for their parents. He explained that she had also searched for parents of other children who had not featured in any criminal case.
He told the jury: "So we are not saying that the simple fact of searching proves anything but she undoubtedly murdered these children and then searched for their parents."
12:54PM[28]Prosecutor speaks about alleged attempted murders
Mr Johnson told jurors Letby had also attempted to murder a baby twice on June 9 and 10 of 2015, had attempted to murder another child on August 5 2015 and had twice attempted to murder another baby on dates between September 7 and 21 2015. The prosecutor went on: "After what we allege she did to Baby K, Lucy Letby went on to murder two of three triplets on consecutive days on 23 and 24 of June 2016. By then she had tried to murder two other children, a pair of twins on April 9 2016 and finally so far as this case is concerned a baby boy on June 3 2016."
12:50PM[29]Jury told of critical date
"The critical date as far as this case is concerned is the 17th February 2016," Mr Johnson explained.
He added: "What you will hear in due course is that by this stage Lucy Letby had murdered five children." He said she had murdered one child on June 6 2015, another child on June 14 2015, another baby on June 22 2015, a further baby on August 4 2015 and another on October 23 2015.
12:21PM[30]Morphine features in case
In the video Mr Johnson pointed out the secure cupboard where controlled drugs were kept. He said drugs such as the painkiller morphine were kept in the cupboard and explained that drug features in this case.
12:18PM[31]Letby sitting in glass walled dock
Letby is sitting in the glass walled dock at the back of the court listening to proceedings.
12:15PM[32]Jury shown video of neonatal unit
The jury is now being shown a walkthrough video of the neonatal unit as it would have been in 2016.
The purpose is so that the jury have a clear understanding of the ward where the alleged offence took place.
12:04PM[33]Jurors shown hospital neonatal unit floor plan
The jurors are also being shown a floorplan of the neonatal unit at the Countess of Chester Hospital, where Letby worked when the alleged offence took place in 2016.
12:01PM[34]Jury shown documents related to case
Mr Johnson is taking the jury through the large volume of documents they will be required to refer to throughout the case. This includes the sequence of events, the indictment and the medical glossary.
11:59AM[35]Prosecutor tells jury about previous convictions
The case relates to an infant who can only be identified as Baby K, who Letby allegedly attempted to murder in February 2016. Mr Johnson said he was telling the jury about her previous convictions, not because they should convict her of this offence on the basis of what she had previously been found guilty of.
But he explained: "We are suggesting the relevance gives you significant evidence as to what her intention was at the time we allege she did something to Baby K. "We are saying that her status as a multiple murderer and attempted murderer is an important piece of evidence you can, if you wish, take into account when you are considering whether we have made you sure she attempted to murder Baby K."
11:48AM[36]Prosection opens case
Nick Johnson KC, the prosecutor in the case, has begun his opening by telling jurors that Lucy Letby is charged with a single offence of attempted murder. He said: "As you probably already know there was another very long trial about a year ago in that Lucy Letby was convicted of seven murders and seven attempted murders.
"Those seven attempted murders related to six children."
11:42AM[37]Trial to begin shortly
The trial is set to begin.
11:21AM[38]Proceedings delayed
There will be a slight delay to proceedings while the jurors are given a tutorial on using iPads which are going to be used to show some of the evidence related to the case.
10:41AM[39]Prosecution to open its case
Nick Johnson KC will open the case on behalf of the Crown by outlining the prosecution evidence. Letby's barrister Ben Myers KC is also expected to make an opening statement on behalf of the defendant.
10:34AM[40]Judge has reminded jurors to only use evidence before them
Mr Justice Goss has explained to jurors that Letby had faced the same charge at the previous trial last year but that jury had been unable to agree on a verdict. However he reminded them that their task was to try the defendant on the evidence in this case alone and to ignore anything they had read or heard about previously.
He explained: "Anyone accused of a crime is innocent until proven guilty, it is for the prosecution to prove the case. "You know the defendant has been tried by another jury. You are to try the defendant on a charge of attempted murder upon which that jury could not agree and were discharged from giving a verdict.
"I repeat it will be for you to decide this case on the evidence placed before you as to whether the defendant is guilty or not." He went on: "It is highly likely you know something about the case last year when the verdicts were announced that is something we accept that you will know about "You can only make the decisions on the evidence placed before you in the trial and not what you may have read or heard about in any media reports."
10:32AM[41]Letby trial to begin in Manchester
Lucy Letby's will begin at Manchester Crown Court on Wednesday with statements expected from the prosecution and defence.
We will be covering the case throughout the day - you can follow all the latest in this blog.
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