ITV Granada Reports correspondent Elaine Willcox has the latest from Manchester Crown Court
A concerned doctor walked in on nurse Lucy Letby as she allegedly attempted to kill a newborn baby girl, a court heard.
Dr Ravi Jayaram, a paediatric consultant, decided to check on the nurse after he noticed a "coincidence between the unexplained deaths, serious collapses and the presence of Lucy Letby".
He was aware Letby was alone in a room with the baby - identified as child K - who he had helped deliver at just 25 weeks on 17 February 2016 at the Countess of Chester Hospital.
Nick Johnson KC, prosecuting, told the jury at Manchester Crown Court: "We allege she was trying to kill child K when Dr Jayaram walked in."
The 32-year-old nurse, originally from Hereford, is accused of the murder of seven babies and attempting to murder 10 more, between June 2015 and 2016.
She denies all the allegations.
Despite weighing just 692g, child K was considered in as good a condition as possible for a baby born that early and was booked into the neonatal unit by Letby.
Around 90 minutes later, as arrangements were being made for the baby’s transfer to a more specialist hospital on Merseyside, Dr Jayaram was at the nurses’ station writing up his notes about the birth.
He could not see into room one, where child K was.
Nick Johnson KC, prosecuting, told the jury: "Feeling uncomfortable with this because he had started to notice the coincidence between the unexplained deaths, serious collapses and the presence of Lucy Letby, Dr Jayaram decided to check on where Lucy Letby was and how child K was.
“As he walked into room one, he saw Letby standing over child K’s incubator.
“She did not have her hands inside the incubator, but Dr Jayaram could see from the monitor on the wall that child K’s oxygen saturation level was falling dangerously low, to somewhere in the 80s.
“But the alarm was not sounding as it should have been and Lucy Letby had not called for help, despite child K’s oxygen levels falling.
“We allege she was trying to kill child K when Dr Jayaram walked in.”
Dr Ravi Jayaram found child K’s chest was not moving and asked Lucy Letby if anything had happened.
Letby was said to have replied: “She’s just started deteriorating now.”
Nick Johnson KC said Dr Jayaram found child K’s breathing tube had been dislodged.
The prosecutor said it is possible for this to happen in an active baby, but child K was very premature, had been sedated and was inactive.
The jury heard the breathing monitor in use will activate if readings fall outside normal ranges and should have sounded, but this can be over-ridden by pressing a pause button.
Prosecutor Mr Johnson said despite his concerns at the time, Dr Jayaram did not make a note of his suspicions or the alarm failing to activate.
Child K was transferred to another hospital later that day but remained unwell and died two days later. Letby is not accused of her murder.
One independent medical expert said it was “very likely” the dislodgement of the breathing tube was a deliberate act.
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.