Giving babies in cardiac arrest adrenaline was 'uncommon', Lucy Letby murder trial told

Lucy Letby, 32, denies going on a killing spree at the Countess of Chester's neonatal unit between June 2015 and June 2016 when she allegedly murdered seven babies and attempted to murder 10 others.

Medics could find no reason why one of those infants, Child H, suddenly collapsed in the early hours of September 26 2015, Manchester Crown Court was told.

The baby girl, who cannot be identified for legal reasons, needed full resuscitation again the following night shift in the early hours of September 27 in similar circumstances.

Chest compressions from nursing staff were under way when consultant paediatrician Dr John Gibbs arrived to the first collapse.

Three doses of adrenaline were administered to help stimulate the heart of the youngster and her heart rate eventually rose to a safe level after 22 minutes of resuscitation.

Philip Astbury, prosecuting, asked the now retired doctor: "Was the use of adrenaline in those circumstances a commonplace occurrence?"

Dr Gibbs replied: "No. It was becoming more common as events continued on the unit with repeated collapses of babies. Until 2015, uncommon."

Earlier on the shift, Child H received emergency treatment for a tension pneumothorax where air accumulates between the chest wall and lung which causes it to collapse.

A chest drain - a tube inserted to drain air - was fitted by Dr Gibbs and was the third drain to have been fitted after a number of pneumothoraxes had been detected in the preceding days.

A number of invasive needle treatments were also required to treat the issue, while Dr Gibbs said he could not explain why pneumothoraxes had occurred on three consecutive nights.

Dr Gibbs said it was the first and only time in his career that three chest drains were needed with one patient.

The court heard that usually only "two or three" such procedures would be carried out at the unit in a whole year.

Ben Myers KC, defending, asked if it was possible that the collapse in the early hours of September 26 could be attributable to the cumulative effect of all the medical interventions on Child H.

Dr Gibbs said he did not believe that was "tenable".

He said Child H was "stable" and in a "good condition" after he inserted the third chest drain - about an hour before the sudden collapse.

Dr Gibbs said he told Child H's parents at the time she was in a "precarious" position because he did not know why her heart rate and blood pressure had plummeted.

Child H was then transferred to Wirral's Arrowe Park Hospital where she improved. She was moved back to the Countess of Chester before she was discharged the following month with no ill effects.

Dr Gibbs recalled Child H's final outpatient clinic appointment when she was aged 16 months old.

He said: "She was doing very well by that stage. Her early development was normal, which was very reassuring given all the problems she had."

Earlier another medic, consultant paediatrician Dr Ravi Jayaram, denied the defence's suggestion he had inserted Child H's second chest drain in the "wrong place".

Dr Jayaram said: "You are focusing on the process, Mr Myers, and you need to look at the outcome and we drained the pneumothorax. We succeeded and actually made (Child H) more stable."

Mr Myers has previously told the jury that Child H's collapses were the result of "suboptimal care" and had "nothing to do with Lucy Letby".

The trial continues on Monday.