Lucy Letby: Doctor could find no clear cause for baby girl's death

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

A consultant paediatrician said he could not understand why a premature baby collapsed and died, nurse Lucy Letby's murder trial has heard.

The 33-year-old is accused of murdering the girl, referred to as Child I, at Countess of Chester Hospital in October 2015.

Dr John Gibbs said he had written in his medical notes that he could not assign "a clear cause of death".

Ms Letby denies murdering seven babies and attempting to murder 10 others.

It is alleged the neonatal nurse attempted to kill the infant on 30 September and again during night shifts on 12 and 13 October.

The prosecution claim she harmed the baby by injecting air into her feeding tube and bloodstream before she eventually died in the early hours of 23 October 2015.

Manchester Crown Court heard how Dr Gibbs was called in urgently after Child I had rapidly deteriorated, arriving on the neonatal unit at 00:06 GMT.

'Abnormal cry'

"The nurses were telling me that she suddenly seemed very distress and was making an abnormal cry and that was about 10 minutes before I arrived," he said.

Child I required chest compressions but these were no longer needed by the time Dr Gibbs arrived on the unit.

He told the court Child I was "fighting" the ventilator, which meant she was resisting and was a "good sign".

But he told the court he "could not understand what natural disease could have affected her that she would have recovered so quickly".

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

In his medical notes, he had written: "Likely generalised lung collapse - very stiff, small vol [volume] lungs due to distress and crying".

"My suspicion was that she had cried in distress and her lungs had become much smaller and it was hard for her to breathe," he told the court.

But he added: "I admit I was struggling to understand exactly what had happened to [Child I]."

He said he returned home once Child I seemed stable, adding she was "settled, sucking her dummy [and] looking like a well baby when I left".

But within 30 minutes, he had been urgently called back to the neonatal ward as Child I had collapsed again, arriving at 01:23.

The court heard Child I was given CPR and repeated adrenaline but at 02:10 resuscitation efforts were stopped.

"We had been trying to help Child I vigorously for 50 minutes and she still had no pulse of her own, no breathing on her own and we had tried I think eight doses of adrenaline. It's often futile to continue," he said.

Child I was pronounced dead at 02:30.

Lucy Letby denies all the charges against her

"I didn't know or couldn't understand why she had collapsed and died," he said, adding he had reported her death to the coroner's office because of this.

"I felt [Child I] needed a post-mortem but it was the coroner's decision," he said.

The court also heard how Dr Dewi Evans, who has been called as a medical expert by the prosecution, believed the baby had been subjected to an infusion of air into the stomach via a feeding tube on the first three occasions.

However, he told the court he believed the baby had been subjected to a different method of harm before her final fatal collapse.

"I think she was the victim of having air injected into her blood circulation and this probably explains her crying and distress and the failure of the medical team second time around to save her life," he added.

During cross examination by Ms Letby's defence team, Dr Evans said there was "compelling evidence" to support his findings and denied that he had shown "prosecution bias".

The court heard Dr Evans was asked to provide a medical report for another unrelated case in June 2021.

The judge presiding over the case later described the report as "worthless", said it contained "partisan expressions of opinion" and stated Dr Evans made "no effort to give a balanced opinion".

Dr Evans told the court the case had nothing to do with Ms Letby's trial and was a "one-off" and something he found "quite upsetting".

He said it was the "only judgement that went against me in a family court in 30 years" and there was "huge demand for my opinion in the family court because of my track record as a witness and an independent witness".

He added that the "persistent fiction that I am a prosecution person" was "pure fantasy".

"It is incorrect, it is incorrect in all of these cases," he said.

The trial continues.