Doctors pressured not to make a fuss over Lucy Letby, trial told

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

A consultant has said that doctors were put under pressure by hospital management not to make a fuss when they raised concerns about nurse Lucy Letby.

Dr Ravi Jayaram said his team first raised concerns about unusual episodes involving babies in October 2015.

Ms Letby, 33, is accused of murdering seven babies and attempting to murder 10 others at the Countess of Chester Hospital between 2015 and 2016.

The nurse denies all charges.

Dr Jayaram told Manchester Crown Court his team notified the senior director of nursing in autumn 2015 but nothing was done.

He told the court the matter was raised again in February 2016 and the hospital's medical director was told at this point.

The consultants asked for a meeting but did not hear back for another three months, the court heard.

Ms Letby was not removed from front-line nursing until summer 2016.

Dr Jayaram told jurors that he wished he had bypassed hospital management and gone to the police.

He said: "We were getting a reasonable amount of pressure from senior management at the hospital not to make a fuss."

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

On Tuesday, the court also heard how Ms Letby is said to have attacked a baby girl, referred to as Child K, in February 2016.

The Crown alleges Ms Letby struck at 03:50 GMT, less than two hours after the extremely premature youngster was born.

Child K's designated nurse Joanne Williams said she left the "stable" baby to update her parents on the labour ward.

Dr Jayaram said: "Jo had told me she was going to the labour ward and she told me that Lucy Letby was babysitting, keeping an eye on things.

"At this point, in mid-February, we were aware as a team of a number of unexpected and unusual events and we were aware of an association with Lucy Letby.

"That's all we were aware of. No cause and effect had been ascribed."

He said he felt "extremely uncomfortable" at being told Ms Letby would be there.

"You can call me hysterical, you can call me irrational, but that's how I felt because of this association," he told the court.

"Then the rational part of myself told me to stop being so ridiculous and I kept doing what I was doing but the thought kept coming back into my head."

He said he got up to check on Child K to "prove" to himself that he "needed to stop being ridiculous and irrational".

"I went up to nursery one and walked in."

Phil Astbury, prosecuting, asked: "What, if anything, did you see?"

Breathing tube

Dr Jayaram replied: "As I walked up, I saw Lucy Letby standing by the incubator and the ventilator. She didn't have her hands in the incubator.

"I saw her and then I looked up at the monitor and [Child K's] sats [blood oxygen levels] were in the 80s and they continued to drop.

"The ventilator was not alarming and the incubator was not alarming and the monitor is set to alarm when the sats drop below 90%.

"I recall saying 'what's happening?' and Lucy looked and said something along the lines of 'she is having a desaturation'."

Mr Astbury asked: "What, if anything, was she doing?"

Dr Jayaram said: "Nothing.

"I wasn't aware she was looking at the monitor... She didn't say anything to me until I asked what was happening."

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The consultant said he noticed there was no chest movement with the infant.

The prosecution allege Ms Letby deliberately dislodged the infant's breathing tube shortly before consultant Dr Jayaram walked in the nursery room.

Mr Astbury asked: "Any more conversation between the two of you?"

Dr Jayaram said: "We switched into professional mode.

"It didn't really make sense to me why the tube became dislodged. It had been secured and [Child K] was not a vigorous baby.

Lucy Letby denies all the charges against her

"It's very difficult to dislodge an ET [endotracheal tube] without it being spotted.

"So I then removed the tube, which was not blocked."

Dr Jayaram said he went on to give rescue breaths to Child K and her chest began to move again and her oxygen levels went up.

Child K was transferred later that day to Wirral's Arrowe Park Hospital, where she died three days later.

Jurors were told the Crown does not allege Ms Letby caused her death.

The trial continues.