Babies deaths not 'naturally occurring tragedy' but work of 'poisoner' nurse Lucy Letby, court told

Granada Reports correspondent Elaine Willcox reports on the first day of the trial

The collapses and deaths of 17 children at a hospital neonatal unit were not "naturally-occurring tragedies" but the work of a "poisoner", a court has heard.

Lucy Letby, 32, allegedly used various means to attack the youngsters, including insulin poisoning and injecting air into the bloodstream, while working at a neonatal unit.

It is claimed she went on a year-long killing spree while working at the Countess of Chester Hospital.

Letby, of Arran Avenue, Hereford, denies murdering five boys and two girls and attempting to murder another five boys and five girls between June 2015 and June 2016.

She is said to have tried to kill some of the babies more than once before she succeeded.

Manchester Crown Court heard the deaths of five girls and two boys, and the sudden deterioration of another 10 babies, in the short space of time were referred to police as medics "could not account" for them.

Officers were called in and conducted a "pain-staking review", prosecutor Nick Johnson KC told the court.

He said: "Having searched for a cause, which they were unable to find, the consultants noticed that the inexplicable collapses and deaths did have one common denominator.

"The presence of one of the neonatal nurses and that nurse was Lucy Letby.”

Lucy Letby denies all the charges against her. Credit: Cheshire Live

Opening the case, Mr Johnson said the Countess of Chester Hospital was a "busy general hospital" which included a neonatal unit that cared for premature and sick babies.

He said: "It is a hospital like so many others in the UK but unlike many other hospitals in the UK, and unlike many other neonatal units in the UK, within the neonatal unit at the Countess of Chester Hospital a poisoner was at work."

"Their concern was that babies who were dying had deteriorated unexpectedly," he continued.

"Not only that, when babies seriously collapsed they did not respond to appropriate and timely resuscitation.

"Some of the babies who did not die collapsed dramatically but then - equally dramatically - recovered.

"Their collapse and recovery defied the normal experience of treating doctors."

Lucy Letby appearing in the dock at Manchester Crown Court. Credit: Elizabeth Cook / PA Images

He continued: "Babies who had not been unstable at all suddenly deteriorated.

"Sometimes a baby who had been sick but then been on the mend suddenly deteriorated for no apparent reason.

"Having searched for a cause, which they were unable to find, the consultants noticed that the inexplicable collapses and deaths did have one common denominator.

"The presence of one of the neonatal nurses and that nurse was Lucy Letby."

He told jurors at Manchester Crown Court that at the relevant time the number of nursing staff at the Countess of Chester’s neonatal unit was between 25 and 30 nurses, along with about 15 nursery nurses.

Mr Johnson continued: "Many of the events in this case occurred on the night shifts.

"When upon Lucy Letby was moved on to day shifts, the collapses and deaths moved to the day shifts."

Mr Johnson said as medics could not account for the collapses and deaths, police were called in and conducted a "pain-staking review".

He said: "That review suggests that in the period between mid-2015 and the middle of 2016 somebody in the neonatal unit poisoned two children with insulin.

"The prosecution say that the only reasonable conclusion to be drawn from the evidence you will hear is that somebody poisoned these babies deliberately with insulin. This was no accident."

The collapses and deaths of all the 17 children concerned were not "naturally-occurring tragedies," Mr Johnson said.

"They were all the work, we say, of the woman in the dock, who we say was the constant malevolent presence when things took a turn for the worse for these 17 children."

Mr Johnson said the two children poisoned with insulin, who are only identified as child F and child L, were two baby boys, both born twins; the first born in summer 2015 and the other born in spring 2016.

Both were poisoned a couple of days after they were born - with their blood sugar levels dropping to dangerous levels.

"Lucy Letby was on duty when both were poisoned and we allege she was the poisoner," Mr Johnson said.

"There’s a very restricted number of people who could have been the poisoner, because entry to a neonatal unit is closely restricted."

Both children survived due to the skill of medical staff who appreciated low blood sugar can have natural causes.

Mr Johnson added: “What the medical staff did not realise was that in both cases, was the result of someone poisoning them with insulin.”

The prosecutor said nobody would think somebody would be trying to kill babies in a neonatal unit.

He said both of the twins injected with insulin each had a baby brother, child E and child M, who were both also allegedly attacked by Letby – one of which did not survive.

The court heard one of the means by which the child E was killed and child M was harmed, was by having air injected into the bloodstream – what the doctors call an air embolus.

Mr Johnson added: “As we go through my introduction of the case, we will see that similar events repeated themselves. The means by which the children in this case were harmed and killed varied.”

Prosecutor Mr Johnson said sometimes babies were injected with air and on other occasions they were fed with insulin or too much milk.

He told the court: “So varying means by which these babies were attacked but the constant presence when they were fatally attacked or collapsed catastrophically was Lucy Letby.”

Jurors were shown a chart showing nurses who were present on duty when the alleged criminal incidents were said to have taken place.

Pointing out, as examples, the first three alleged offences in time he said the chart showed the only person that was present on all three occasions was the defendant.

Mr Johnson said: “If you look at the table overall the picture is, we say, self-evidently obvious. It’s a process of elimination.”

Prosecutor Nick Johnson went on: “It is a complicated case by any measures. It concerns seven allegations of murder and allegations of attempted murder of 10 other children.

“We allege that sometimes Lucy Letby tried to kill the same baby more than once.

“Sometimes a baby that she succeeded in killing she did not manage to kill the first time she tried, or even the second time, and in one case even the third time.”

He said the defendant was born on January 4 1990 and was originally from Hereford.

Letby studied for her nursing degree at the University of Chester, he said, and at the time of the alleged events was a nurse at the Countess of Chester Hospital and had been since she had qualified a few years earlier.

She worked throughout the period in consideration at the neo-natal unit and prior to her arrest was living at an address in Chester, the court heard.

Mr Johnson told the jury: “As you know we have 22 charges, 17 children. In all the cases Lucy Letby was either responsible for them as their designated nurse or she got involved with them despite not being their designated nurse.”

Letby, wearing a blue jacket over a black shirt, earlier pleaded not guilty to seven counts of murder and 15 counts of attempted murder.

Family members of some of her alleged child victims sat in the public gallery listening as the names of the children were read out during her not guilty pleas.

On the other side of the public gallery sat the defendant’s parents, John, 76, and Susan, 62.

A court order prohibits reporting of the identities of surviving and deceased children allegedly attacked by Letby, and prohibits identifying parents or witnesses connected with the children.

The trial continues.