A radiologist told the Lucy Letby trial today ‘it stands to reason’ a deliberate injection of air was the most likely explanation for a baby’s stomach to become ‘massively’ swollen.
Dr Owen Arthurs, who practices at Great Ormond Street Hospital, was called in by the prosecution to view x-rays taken of Baby I both before and after she died at the Countess of Chester Hospital.
These showed that the infant’s stomach had become so strikingly swollen that it was pushing up towards her diaphragm and therefore affecting her breathing.
Baby I’s designated nurse has already recalled her ‘very loud’ and ‘relentless’ crying during two unexplained collapses on the neonatal ward in October, 2015.
Today Professor Arthurs said two-dimensional images of the baby’s body showed a ‘massive’ level of swelling in her stomach.
Lucy Letby is accused of killing the premature-born infant, known as Child I, in the early hours of October 23, 2015
He added: ‘It is quite unusual to see babies with this degree of dilation of the stomach’.
Such an enlargement could cause splints in the diaphragm that would then lead to respiratory complications.
Nick Johnson KC, prosecuting, asked how much air it would have taken to produce the images being viewed on a screen by the jury at Manchester Crown Court.
He replied: ‘The truthful answer is we don’t know, and I don’t think anyone really knows, because experiments can’t be carried out. We can’t experiment on babies, giving them 50 or 100mls of air and taking x-rays’.
Professor Arthurs was aware of instances when medical staff had drawn out 15-20mls of air.
Asked how much air he believed had been injected into Baby I, he said: ‘I’m guessing it would be more than that.’
Mr Johnson then asked whether it followed, in the absence of infection, that ‘one is left with the inference that someone has deliberately injected air?’
He replied: ‘I think that stands to reason.’
The prosecution alleges Letby made three attempts on the life of Baby I before finally succeeding in killing her in an attack launched on October 22, 2015. The infant died in the early hours of October 23.
Letby, 33, originally from Hereford, is on trial accused of murdering seven babies and attempting to murder 10 others. She denies all the charges.
Baby I’s designated nurse has already recalled her ‘very loud’ and ‘relentless’ crying during two unexplained collapses on the neonatal ward in October, 2015. This is the cot belonging to Baby I during her hospital stay
Paediatrician Rachel Chang also took the stand today, breaking down in tears as she told the jury that seven years later she could still recall the desperate attempts to save Baby I’s life.
She had been in the Countess of Chester Hospital’s maternity suite when Baby I’s final collapse began in Nursery 1 of the neonatal unit.
She was called to the emergency by a nurse, Ashleigh Hudson, who ran the 50 yards to fetch her because it would be quicker than putting out a crash call.
Dr Chang took over the lead role in the resuscitation attempt by controlling the baby’s airway while Nurse Hudson carried out chest compressions.
‘I can still see it in my mind’s eye,’ she told the jury. ‘I have a very unwell looking baby in front of me, and Ashleigh’s face.
‘She was delivering the compressions and I’m concentrating on the airway’.
Asked whether there was any improvement in the baby’s condition, she momentarily broke down before saying that there hadn’t been.
The lead paediatrician at the hospital, John Gibbs, took over when he arrived at 00:25 on October 23, 2015.
‘I’d been doing the job and leading, but he’s now the most senior and so the responsibility fell to him if he wants to, and that would normally be the case.
‘He mostly observed, but carried out intermittent examinations and checked the positioning of the tubes.’
She recalled the baby’s coming into the room as the resuscitation attempts continued. ‘I remember (Baby) I’s mum touching (Baby) I as we were trying to revive her’.
Dr Gibbs eventually made the decision to stop the procedure ‘because we’d worked for a period of time and there had been no sign of improvement at all’.
Dr Chang recalled the ‘awful’ experience, but felt the team – including Lucy Letby – had done all they could to save her.
‘I knew we’d done everything. I trusted everyone around me,’ she said.
Caroline Oakley, who had been Baby I’s designated nurse on the day shift, recalled her having been unsettled at times and very hungry. But she settled with a dummy and her abdomen was fine.
She said the infant’s parents were ‘really angry’ because staff at Alder Hey Hospital hadn’t gone through with a planned transfer so she could have a barium test.
Dr Owen Arthurs, who practices at Great Ormond Street Hospital, was called in by the prosecution to view x-rays taken of Baby I both before and after she died at the Countess of Chester Hospital
‘I just remember her as a lovely, beautiful but problematic baby. She was a bit older and (so) more responsive, with eye contact,’ she said.
Nurse Oakley found it distressing to see Baby I awake in her cot and obviously hungry. She recalled a little of the bereavement process that came after the baby had died.
‘I remember that the cold mattress we’d put her on kept heating up and alarming. At times like that you want everything to run smoothly, not being made to look incompetent by a piece of machinery.’
Nurse Christopher Booth recalled the baby being wrapped in a blanket and handed to her grieving parents by Ashleigh Hudson.
In a written statement read to the court, he said: ‘In those 10 weeks we’d got to know the family, and got to know (Baby) I because she was a character herself. We were very fond of her and had high hopes for her.
‘It was gut-wrenching and we were all heartbroken. We were an amazing team at that time. If we hadn’t been we’d have crumbled.’
The trial resumes on Monday.
