Baby allegedly murdered by nurse had ‘extraordinary’ discoloured patches on skin, trial told

A baby allegedly murdered by nurse Lucy Letby had “extraordinary” discoloured patches on his skin which a doctor had never seen before, a court has heard.

The newborn twin died at the Countess of Chester Hospital just over 24 hours after his premature birth.

Manchester Crown Court heard that Child A and his sister, Child B, were moved to the hospital’s neo-natal unit on the evening of June 7 2015.

Child A is one of seven babies that Letby, 32, is said to have murdered at the unit, and Child B is one of 10 that she allegedly attempted to murder.

Giving evidence on Wednesday, registrar Dr David Harkness told the jury of eight women and four men of the moment he was alerted to a rapid deterioration of Child A on the evening of June 8, 2015.

Despite efforts to resuscitate him, Child A was pronounced dead at shortly before 9pm.

Dr Harkness said: “It was incredibly unexpected. This was a completely stable, well baby who had no reason to deteriorate. I was very surprised to be called back.

“There was very unusual patchiness on his skin which I had not seen before. There were patches of blue/purple colour, patches of red and of white that didn’t fit.

“This was bright red patches… that means you have blood going round your body.”

He said the patches were all over the body and were “there from shortly after the event started”.

“It didn’t come and go,” said Dr Harkness. “It came. It was there. He had a cardiac arrest.

“Unfortunately I have seen lots of babies who have had the pattern that fits with death or dying and I have not seen these.”

The Crown say Letby injected a fatal amount of air into Child A’s bloodstream within 90 minutes of coming on duty. The defence do not accept an air embolus, or air bubble, was the cause of death and say the care given to Child A on the unit – not by Letby – was “suboptimal”.

Dr Harkness agreed with Ben Myers KC, defending, that the discoloured patches struck him personally as “something quite extraordinary”.

But the medic accepted he did not make a recorded note of those particular skin colour changes at the time.

He said it was “something I only picked up later” when similar further incidents with babies took place at the hospital.

Mr Myers said: “Certainly by the time you came to make your police statement in July 2018, you talk about the colour changes then?”

“Yes,” said Dr Harkness.

Mr Myers said: “I am going to suggest that you have been influenced in that recollection by conversations that have taken place about skin colours?”

“No,” said the medic. “This was worth mentioning because it was a pattern recognition.

“At the time this was one of my first neo-natal deaths I had to deal with as a registrar. I was in tears. I required time off work.”

The doctor accepted he also did not mention the “striking” skin patchiness in a statement to the coroner ahead of Child A’s inquest in October 2016 when he said he thought he was “still upset”.

Mr Myers said: “I am going to suggest there is a possibility that by this point the discussions had set in your mind about this colour when it really had not been there at all.”

Dr Harkness replied: “No.”

Asked by junior prosecutor Simon Driver if he was sure about Child A’s “unusual” skin discolour, he said: “Categorically yes. There was skin discolouring.”

The jury has been told Child A did not have intravenous fluids for up to four hours on June 8 before he received glucose through a “long line” plastic tube at 8.05pm, co-signed by Letby and fellow nurse Melanie Taylor.

Earlier on the shift, a cannula to a blood vessel stopped working, followed by two failed attempts to correctly insert a catheter in the belly button.

Dr Harkness fitted the long line but removed it shortly after Child A’s sudden deterioration, the court was told.

He later queried in his contemporaneous notes whether the procedure could be linked to Child A’s death.

He told the court: “It was a knee-jerk reaction because in my mind this is the last thing that changed so should be the first thing to go.

“But there is no evidence then or since to support that as being the cause.”

Dr Harkness said he initially thought the line’s position was less than perfect but revised his opinion after a review with his consultant colleagues the next day.

Ms Taylor told jurors she could not remember whether she or Letby administered the glucose.

The court also heard from Lisa Walker, a neonatal nursery assistant who had worked at the unit for about seven years.

She said she had only known a “couple of deaths” during that time.

“I remember coming in to work to see another baby had died and remember thinking, ‘What on Earth is happening?’ she said.

A court order prohibits  reporting of the identities of surviving and dead children allegedly attacked by Letby, and also prohibits identifying parents or witnesses connected with the children.

Letby, originally from Hereford, denies all the offences said to have been committed between June 2015 and June 2016.

The trial continues on Friday.