Baby deteriorated after breathing tube displaced - Letby trial

A registrar has told a court that an extremely premature baby's condition deteriorated when her breathing tube became displaced.

Lucy Letby, 34, is accused of deliberately displacing a breathing tube attached to the infant, known as Baby K, within two hours of her birth at the Countess of Chester Hospital.

Letby denies a single count of attempted murder.

Dr James Smith, a locum mid-level registrar, was on duty when Baby K was born at 25 weeks in February 2016, weighing just 1lb 8oz (692g), Manchester Crown Court was told.

Medical records said the baby was initially dusky, floppy with no respiratory effort.

Dr Smith said he had resuscitated the baby before she was then intubated.

The jury heard Baby K's condition deteriorated and the breathing tube had to be re-inserted a further two times .

Dr Smith said it had become displaced - something he said under cross examination "could happen", the jury heard.

Dr Ravi Jayaram - a consultant paediatrician who has worked at the Countess of Chester since 2004 - said the registrar made three attempts to insert the tube but he did not intervene because there was good chest movement and ventilation.

The prosecution said Letby was "caught virtually red-handed" by Dr Jayaram when he entered nursery one on February 17 and saw her standing over Baby K’s cot "doing nothing" as the baby’s blood oxygen levels dipped.

Baby K was eventually transported to Wirral’s Arrowe Park Hospital later the same morning.

She died there three days later although the prosecution does not allege that Letby caused her death.

Dr Srinvasaro Babarao, a doctor from Arrowe Park, told the court that Baby K was very sick and her death was not avoidable or preventable by the time she had been transferred.

Giving evidence on Monday, consultant obstetrician Dr Sara Brigham stood by the decision not to transfer Baby K's mother to Royal Preston Hospital while she was in labour.

She told the court: "It was felt she [the baby's mother] was advancing in labour so it was unsuitable to transfer because of the risk that she could deliver in the back of an ambulance.

"Based on the clinical situation at the time it was the right decision not to transfer her at the time."

Ben Myers KC, defending asked the witness: "As it happened, hindsight being a wonderful thing, (Baby K) was not born for another 35 hours so in fact there would have been time if that decision had not been taken?"

Dr Brigham said: "I don’t think you can say that because she was lying in a bed. The act of transferring to a trolley and into an ambulance may have caused the membranes to rupture."

Letby, of Hereford, denies a single count of attempted murder.

The jury of six men and six women has been told that Letby was convicted at a trial last year of the murders of seven babies and the attempted murders of six other infants at the Countess of Chester between June 2015 and June 2016.

The retrial continues.