Lucy Letby: Insulin not ordered for any babies in unit, trial hears

Lucy Letby is accused of murdering seven babies and trying to kill 10 others

No babies were being prescribed insulin at the time nurse Lucy Letby allegedly poisoned a child with the medicine, a doctor has told her murder trial.

Ms Letby is accused of attempting to kill the boy, referred to as Child F, at Countess of Chester Hospital in August 2015.

She has denied murdering seven babies and attempting to murder 10 others.

The doctor, who cannot be named for legal reasons, said "accidental administration" could be ruled out.

Ms Letby, 32, is alleged to have intentionally added insulin to the infant's intravenous feed bag during a night shift, less than 24 hours after she allegedly murdered his twin brother, Child E.

The twins had been born prematurely and Ms Letby, originally of Hereford, cared for both boys, the jury has heard.

'Synthetic insulin'

Giving evidence at Manchester Crown Court, the paediatric consultant described medical notes made by a colleague following tests made on Child F after his condition deteriorated.

They showed high levels of insulin alongside low levels of a hormone called C-peptide, something she said "strongly suggests" he had been given insulin as a medicine, rather than it being naturally produced by the body.

"This is something we found very confusing at the time," she said.

The babies were being cared for on the neonatal ward at Countess of Chester Hospital

She said Child F had been given a small dose of insulin to help regulate his blood sugar shortly after his birth, but this would have "long gone" by that time.

The court later heard from consultant paediatrician Dr John Gibbs, who said Child F was given "a very small dose" of insulin which was "carefully controlled".

He said the baby "responded very well" and the insulin was stopped.

Jurors have heard how Child F's heart rate surged and his blood sugars dropped dangerously low after a feed bag was started shortly after midnight on 4 August.

No babies in the unit were being prescribed insulin on either 4 or 5 August, the court heard.

Reviewing notes from the period, Dr Gibbs said infection was initially suspected but it was "still unusual to have such a sudden change in observations".

The child's blood sugar remained persistently low despite treatments to raise it, he said.

Lucy Letby denies all the charges

In retrospect, given later tests, Dr Gibbs said it was "likely" his symptoms were due to very low blood sugar caused by a large dose of insulin being given to him.

He did not suspect this at the time as "there was no reason why he should have had a high dose of insulin prescribed to him", he said.

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Referring again to test results, Dr Gibbs said: "This isn't natural insulin. This is synthetic insulin made by a drug company."

Child F recovered in the following days, but his twin brother, who was born a minute earlier, died after air was allegedly injected into his bloodstream by Ms Letby.

After Child F's alleged poisoning Ms Letby messaged a colleague to say something was "not right" about the infant, the court has heard.

She also arranged to go salsa dancing the following evening.

The trial continues.