Baby died after suffering liver injury akin to road traffic collision, Lucy Letby murder trial told

A triplet baby boy allegedly murdered by nurse Lucy Letby suffered a liver injury akin to a road traffic collision, her trial has heard.

The 33-year-old, who is originally from Hereford, is said to have attacked the new-born boy, known as Child O, on a day shift on 23rd June 2016 at the Countess of Chester’s neo-natal unit following her return from a holiday to Ibiza.

Child O is alleged to have been one of 17 babies she targeted between June 2015 and June 2016.

He was born in good condition, Manchester Crown Court heard, until he suddenly collapsed two days later in the care of Lucy Letby and went progressively downhill as medics failed to revive him.

On the following day shift, the prosecution says she murdered Child P, one of Child O’s triplet brothers.

Paediatric pathologist Dr Andreas Marnerides told the court that Child O died partly due to an “impact-type” internal liver injury – discovered after the baby’s death.

Jurors were shown post-mortem examination photographs which showed two separate sites of bruising, as well as areas of a blood clot.

Prosecutor Nick Johnson KC asked the consultant: “How does that injury come to be in a child of (Child O’s) age?”

Dr Marnerides, who practises at London’s St Thomas’ Hospital, said: “The distribution, the pattern and the appearance of the bruising indicates towards impact-type injury. I’m fairly confident this is impact-type injury.”

He explained the photograph showed “extensive haemorrhaging into the liver”, which he had only seen previously in a road traffic collision and in non-accidental assaults from parents or carers.

Mr Johnson said: “Looking at this sequence of photographs, can you rule out the possibility that these injuries were caused by CPR?”

Dr Marnerides said: “I cannot convince myself that in the setting of a neonatal unit this would be a reasonable proposition to explain this. I don’t think CPR can produce this extensive injury to a liver.”

Mr Johnson said: “In so far as you have spoken about an impact-type scenario for causing that internal injury, would you necessarily expect to see any outside sign on the skin itself?”

The consultant replied: “You can have the most devastating injury internally and nothing can be observed externally. That is very common.”

Mr Johnson went on: “What in your view was the cause of death of (Child O)?”

Dr Marnerides said: “In my view, the cause of death was inflicted traumatic injury to the liver, profound gastric and intestinal distension following acute excessive injection/infusion of air via a naso-gastric tube and air embolism due to administration into a venous line.”

Who are the children alleged to have been murdered by Lucy Letby?

The consultant was approached by Cheshire Police in late 2017 to review the deaths of a number of babies at the hospital, the court heard.

He gave his opinion on their causes of death after having reviewed the pathological evidence as well as information received from clinical and radiological reviews.

Dr Marnerides said it appeared Child A, a twin boy, died as a result of an injection of air into his bloodstream.

He told the court that Child C, a boy, was subjected to an excessive infusion/injection of air into his nasogastric tube and the “likely explanation” for the death of Child D, a girl, was an air embolism into her circulation.

Another girl, Child I, received an excessive injection of air into her stomach, he said.

He told the court he could no offer no opinion on the death of Child E, a twin boy, because no post-mortem examination took place.

Lucy Letby denies the murders of seven babies and the attempted murders of 10 others between June 2015 and June 2016.