Letby did not intervene when baby became unwell, court told

Lucy Letby denies a single count of attempted murder

A hospital consultant has told a court nurse Lucy Letby was doing nothing to intervene when he saw her standing next to a baby girl who was deteriorating.

It is alleged the baby's breathing tube had been dislodged by the nurse, who has been charged with attempted murder.

Dr Ravi Jayaram told Manchester Crown Court he had helped to deliver the infant, known as Baby K, at 15 weeks premature in February 2016 and it was his "infinite regret" that he did not call the police when he suspected the nurse of wrongdoing.

The 34-year-old denies a single count of attempted murder.

The court heard that in the hours after her birth, Dr Jayaram was overseeing the care of Baby K, who was in an incubator in the intensive care room of the neonatal unit at the Countess of Chester Hospital.

Dr Jayaram told the jury he was sitting at the nurses' station organising the baby's transfer to a more specialised hospital, when he became aware Letby had been left on her own with the two-hour-old infant.

'Letby not intervening'

Baby K died at three days old

"At this time... we had had a number of unusual incidents with babies, and a number of colleagues and myself had noted the association with Lucy Letby being present at these things," he said.

"We had had an external review and we'd not found anything obvious and I was sitting there, and I'll be very honest, I felt very uncomfortable.

"Objectively you could say that was very irrational, but I just had a feeling because of knowing what had happened before.

"My internal dialogue was saying, 'Stop being stupid, get on with your work'.

"And I needed to just go in and reassure myself that everything was OK."

The consultant said when he went into the baby's room, he found Baby K's oxygen saturation levels were dropping and she was deteriorating.

He told the jury that Letby, originally of Hereford, was standing by the incubator and not intervening and the ventilator alarm was not sounding.

Dr Jayaram said he asked what was happening and the nurse replied: "Oh it looks like she's desaturating."

He said he gave the baby breaths with a mask and she quickly improved.

She was transferred to a different hospital later the same day.

She died two days later. Letby is not alleged to have caused her death.

'Fear of retribution'

Defending, Ben Myers KC asked Dr Jayaram why he had not phoned the police if he believed that the nurse was killing babies.

The consultant said he and his colleagues had raised their concerns with senior managers but had been ignored.

"There’s a culture in the NHS of clinicians who raise concerns - there was a strategy to keep us quiet," he said.

"People didn't really want to listen to us or acknowledge problems.

"I can tell you what would have happened if we’d called the police.

"They’d have spoken to the medical director and the chief exec, who’d have said, 'Just ignore them, they’re a bunch of complaining paediatricians'."

Mr Myers asked the consultant why he was prepared to potentially allow the nurse to carry on killing.

"None of us were prepared to do that at all but we were in uncharted territory," he replied.

"There is absolutely no training or precedent for knowing how to deal with this.

"We were meeting big resistance from people from the top.

"Knowing what I know now, I would have challenged it and it’s a matter of regret now that I didn’t."

The defence barrister said the doctor "didn’t call the police because you didn’t see anything worthy of calling the police about".

Dr Jayaram said he disagreed, adding: "I think there was an element of denial, an element of fear of retribution from those above.

"In subsequent weeks and months, we were told it would be inappropriate to call the police.

"We were being advised from the start that the police would be the wrong route and it’s a matter of infinite regret I didn’t handle it differently.

"If we’d actually not had faith in those who were supposed to be guiding us, we’d have gone to the police."

He added that he and colleagues were "explicitly told it'd be the wrong thing to go to the police because it'd be bad for the reputation of the trust and there’d be blue and white tape everywhere".

The jury of six men and six women has been told 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.