Accused nurse found it 'quite hard' after baby boy suddenly stopped breathing, court told

The newborn boy stopped breathing without warning just days after his premature birth, weighing just 800 grams, at the Countess of Chester Hospital in June 2015.

The infant, referred to as child C, is one of seven babies allegedly killed by the 32-year-old who is also said to have attempted to murder 10 others at the hospital's neo-natal unit.

Lucy Letby, who denies the charges, is said to have caused the collapse of child C at about 11.15pm on June 13 by inserting air into the boy's stomach via a nasogastric tube.

Jurors at Manchester Crown Court have heard medics failed to revive him and that "token resuscitation" took place until the arrival of a Church of England vicar to baptise the boy and a Catholic priest to perform a blessing.

However, signs of life reappeared during the wait for the ministers with "occasional gasps of breathing" and "feeble heart beats" noted as the parents cuddled their son.

An on-call consultant could not explain the "fairly minimal" signs of life but explained to child C's parents the chance of him recovering was "remote" and the prospect of him not suffering profound brain damage was "extremely remote".

Palliative care was provided and no further gasps or heartbeat were heard some five hours after the christening and child C was pronounced dead at 5.58am on June 14, the court heard.

When interviewed about child C, the defendant said she remembered him because he was a small baby.

Letby recalled he deteriorated not long after his first feed by one of the nurses but said she had no involvement in that.

Her only involvement with child C was when she was asked to help with the resuscitation attempt, she told police.

She added she had a "vague recollection" of taking child C's hand and foot prints for a memory box while the infant was sat with his parents but "couldn't be certain".

Letby went on to say she found the boy's death "quite hard because he lived several hours (after the collapse)" and she had "not seen that before".

Detectives also asked her about a conversation in which a nurse was said to have asked child C's parents if they wanted him to be taken away in a ventilator basket while he was still alive.

She replied she had no recollection of making that comment and questioned whether the parents had said she was the nurse who said that, the court heard.

She said it was "very sad" for the parents.

Letby, originally from Hereford, denies administering air to child C.

She accepted she made Facebook searches for his parents about 10 hours after their son died but could not remember doing the searches or why.

The court has previously heard Letby messaged a colleague during the night-shift of June 13 that it was "eating her up" she was not allocated to work in the intensive care unit (ICU) room just days after the fatal collapse of another baby.

Letby told police she agreed she wanted to go the room "as it can be hard to go back into an ICU environment after having a sick baby so she preferred to go straight back in".

Giving evidence, expert medical witness Dr Sandie Bohin said Child C was "potentially at risk of complications" after birth.

But she told the court: "Actually, in his early days he managed very well indeed. A couple of times he had skin-to-skin contact with his parents and that is something you would not do if you had concerns.

"He was not only doing well but was actually improving. This was not a baby who was ill."

She agreed Child C developed pneumonia but said he received the standard treatment of antibiotics.

Dr Bohin said: "My conclusion was, yes, he had pneumonia, but that was not what caused him to collapse.

"I think the pneumonia contributed to not surviving the resuscitation."

Asked to explain a build-up of gas in Child C's abdomen detected on a X-ray on June 12 - the day before his fatal collapse - Dr Bohin said air could have accumulated via respiratory support he was receiving. The alternative explanation is a deliberate introduction of air down a fitted nasogastric tube, she said.

Prosecutor Nick Johnson KC asked: "When you looked for a reason for (Child C's) collapse on June 13, can you find an explanation?"

Dr Bohin replied: "No. Babies like this should not collapse. You get prior warning that something is amiss.

"They don't go from being stable into a cardiorespiratory situation within minutes. They rarely collapse in this way but they are usually responsive to resuscitation and he was not."

Mr Johnson said: "In your view, did the infection that (Child C) had, was that the cause of his catastrophic collapse?"

Dr Bohin said: "I think he died with his pneumonia, not because of his pneumonia."

Ben Myers KC, defending, noted Child C's markers for infection rose in the last 24 hours of his life.

His blood platelet count fell below acceptable levels, his weight was low and he had not been fed, he said.

Notes were also recorded of dark bile being produced and an incident of vomit with bile, he added.

Mr Myers asked: "If you put things together they might be a matter for concern?"

Dr Bohin said: "I say there was not."

Mr Myers said: "It's not a question of you minimising the seriousness of (Child C's) condition, is it?"

"Absolutely not," said Dr Bohin.

Mr Myers previously told the jury Child C was vulnerable, especially to infection, and should have been at a specialist children's hospital rather than the Countess of Chester.

The trial continues.