A nurse accused of murdering seven premature babies – and trying to kill ten more – took up to three attempts to poison infants by injecting insulin, milk or even air into their tiny bodies, a court heard today.
Lucy Letby, 32, is alleged to have gone on a year-long killing spree while working at the Countess of Chester Hospital – including one child who died less than 90 minutes after being handed into her care.
Today the specially trained ICU nurse was described as a ‘constant malevolent presence’ on the Cheshire children’s unit where she allegedly killed and injured many vulnerable children – including twins. She is accused of using night shifts to launch some attacks because parents were off the neonatal ward.
Several babies were allegedly poisoned with insulin and one child – known as Baby E – was murdered when Letby allegedly injected him with air, Manchester Crown Court has heard. It caused what doctors call an air embolus, which leads to strokes or heart attacks. Letby is also accused of pumping dangerous levels of milk into the premature children via feeding tubes or veins.
Opening the prosecution, Nick Johnson KC, said: ‘Sometimes a baby that she succeeded in killing was not killed the first or even second time she tried’.
He added: ‘Sometimes they were injected with air – both intravenously [into the blood] and via the nasogastric tube [into the stomach]. Sometimes they were injected with milk or some other fluid. Sometimes it was insulin. But the constant presence was Lucy Letby’.
Police discovered ‘a poisoner was at work’ on the NHS neonatal unit after a ‘significant rise’ in the number of healthy babies dying or falling ill while a nurse accused of murdering seven children and trying to kill ten more was working on the ward between June 2015 and June 2016, the jury were told on the first day of her trial. She is facing 22 charges concerning 17 babies, some of whom she allegedly attempted to murder multiple times. Letby pleaded not guilty to each charge this morning.
Mr Johnson said Letby, 32, was a ‘constant malevolent presence’ at the ‘closely restricted’ Chester neonatal unit. He added: ‘It is a hospital like so many others in the UK but unlike many other hospitals in the UK, and unlike many other neo-natal units in the UK, within the neo-natal unit at the Countess of Chester Hospital a poisoner was at work.’
The prosecutor said two babies – referred to as Baby F and Baby L for legal reasons – were ‘poisoned’ by Letby ‘deliberately with insulin’. They were attacked eight months apart with each of them from separate sets of twins. Both boys’ blood sugar ‘inexplicably dropped to dangerous levels’ – but both survived ‘because of the skill of the staff in the neonatal unit’, the court heard.
He said both of the twins injected with insulin each had a baby brother, Baby E and Baby M, who were both also allegedly attacked by Letby. The court heard one of the means by which the Baby E was killed and Baby M was harmed, by having air injected into the bloodstream. Baby M had ‘mercifully’ survived.
Lucy Letby sketched in the dock at Manchester Crown Court with security where she is charged with the murder of seven babies and the attempted murder of another ten, between June 2015 and June 2016 while working on the neonatal unit of the Countess of Chester Hospital
Children’s nurse Lucy Letby (pictured) has gone on trial today accused of seven baby murders
Letby poisoned babies while on the night shift because parents would not be around, court told
Lucy Letby appearing in the dock at Manchester Crown Court
Lucy Letby was today accused of poisoning babies on the night shift.
There tended to be fewer staff on the unit at night, and parents as well tended to visit mostly in the days.
Mr Johnson continued: ‘Many of the events in this case occurred on the night shifts.
‘When upon Lucy Letby was moved on to day shifts, the collapses and deaths moved to the day shifts.’
Mr Johnson said as medics could not account for the collapses and deaths, police were called in and conducted a ‘pain-staking review’.
He said: ‘That review suggests that in the period between mid-2015 and the middle of 2016 somebody in the neo-natal unit poisoned two children with insulin.
‘The prosecution say that the only reasonable conclusion to be drawn from the evidence you will hear is that somebody poisoned these babies deliberately with insulin. This was no accident.’
He said: ‘Babies who had not been unstable at all suddenly severely deteriorated. Sometimes babies who had been sick and then on the mend deteriorated for no apparent reason. Having searched for a cause, which they were unable to find, the consultants found the inexplicable collapses and deaths did have one common denominator. The presence of one of the neonatal nurses. That nurse was Lucy Letby.’
During the time Letby worked on the night shift, there was a rise in babies dying or falling seriously ill, Manchester Crown Court was told, and then when she moved to the day shift there were more ‘inexplicable collapses and deaths’.
Letby, 32, allegedly tried to kill one baby girl three times and a baby boy three times – including two attempts in one day.
‘Many of the events in this case occurred on the night shifts,’ said Mr Johnson. ‘Although when Lucy Letby was moved on to day shifts towards the end of this period the collapses and deaths moved to the day shifts’.
Referring to the alleged poisoning of both Baby F and Baby L, he added: ‘Lucy Letby was on duty when both were poisoned. We allege that she was the poisoner’.
This morning she was brought into the dock at Manchester Crown Court, wearing a dark blue suit with a black blouse.
Mr Johnson said: ‘Prior to January 2015, the statistics for the mortality of babies in the neo-natal unit at the Countess of Chester were comparable to other like units.
‘However over the next 18 months or so there was a significant rise in the number of babies who were dying and in the number of serious catastrophic collapses.
‘These rises were noticed by the consultants working at the Countess of Chester and they searched for a cause.’
They were concerned that babies who were dying had deteriorated unexpectedly, despite appropriate medical interventions that would normally have saved them.
He said the collapses ‘defied the normal experience of the treating doctors’.
Mr Johnson said that normally babies might suffer from heart problems, infection or dehydration.
Letby is accused of attacking two sets of twins – with insulin and with air – one child, Baby E, would die but his sibling survived
The deaths and injuries of 17 babies were not ‘naturally-occurring tragedies’ – and Lucy Letby was ‘the constant presence’, trial hears
The collapses and deaths of all the 17 children concerned were not ‘naturally-occurring tragedies,’ Mr Johnson said.
‘They were all the work, we say, of the woman in the dock, who we say was the constant malevolent presence when things took a turn for the worse for these 17 children.’
Mr Johnson said the two children poisoned with insulin, who cannot be identified, were two baby boys, both born twins; the first born in summer 2015 and the other born in spring 2016.
Both were poisoned a couple of days after they were born.
‘Lucy Letby was on duty when both were poisoned and we allege she was the poisoner,’ Mr Johnson said.
‘There’s a very restricted number of people who could have been the poisoner, because entry to a neo-natal unit is closely restricted.’
‘Usually when an intervention was undertaken a positive reaction can be expected. But many of the cases you are going to hear about defied those expectations and norms’, he said.
Babies who were stable suddenly deteriorated, and sometimes babies who had been sick but were on the mend suddenly deteriorated for no apparent reason.
Having searched for a cause, the consultants noticed that a single common factor was the presence of a single neonatal nurse.
‘That nurse’ said the barrister, ‘was Lucy Letby’.
‘Many of the events in this case occurred on the night shifts,’ said Mr Johnson. ‘Although when Lucy Letby was moved on to day shifts towards the end of this period the collapses and deaths moved to the day shifts.
‘Because of the inability of doctors to find genuine medical reasons for the deaths and collapses the police were called in’.
Officers from Cheshire Constabulary commissioned a detailed review by experienced doctors with no connection to the Countess of Chester Hospital.
‘That (review) suggests that from the middle of 2015 to the middle of 2016 somebody in the neonatal unit poisoned two children with insulin.
‘The prosecution say that the only reasonable conclusion from the evidence will have been that somebody poisoned these babies deliberately with insulin. This was no accident’.
If the prosecution was right about that, the fact that there were two deliberate poisonings would help the jury decide whether other crimes had been committed or whether they were ‘just tragic coincidences’.
Mr Johnson went on: ‘We say the collapses and deaths of the 17 babies were not naturally occurring tragedies.
‘They were all the work, we say, of the woman in the dock, who we say was the constant malevolent presence when things turned to the worst for these 17 children’.
John and Susan Letby, parents of Lucy Letby, are at Manchester Crown Court for their daughter’s murder trial (pictured last week)
Family members of some of her alleged child victims sat in the public gallery listening as the names of the children, who cannot be named for legal reasons, were read out.
Judge warns jury to be ‘dispassionate’ in ‘case bound to provoke an instinctive reaction of horror’
The trial judge, Mr Justice Goss, told the empanelled jurors that all the charges relate to babies.
‘Any anxiety or apprehension you may have about your role as jurors in this case. You will have apprehensions about what is to follow, but in relation to the nature of the case and your role’.
Other juries up and down the country were trying very serious cases, so they should not to be anxious. They would soon become familiar with the details of the case.
The judge added: ‘The case is bound to provoke an instinctive reaction of horror. It is part of our characteristics as a human being.
‘Whilst retaining your knowledge and understanding of human behaviour, you must put your emotions to one side and consider the evidence calmly, rationally, fairly and dispassionately’.
Three members of security staff surrounded her as she stood up to enter her pleas as her parents John and Susan watched on. Her trial, which is due to begin this afternoon, will last up to six months.
Letby, 32, quietly repeated the words ‘Not guilty’ as each of the charges was read out to her by a clerk at Manchester Crown Court.
She was standing stock still in the glass-panelled dock of Court 7, her once blonde hair, now darkened, let down over her shoulders.
Fourteen jurors were sworn in to hear the trial. However, two of them will act as substitutes while the prosecution opening is being heard. Once that point has been reached the trial will continue with 12 jurors.
According to the indictment she tried to kill one baby girl three times and another twice. And she tried to claim the life of a baby boy on three separate occasions – two of them on the same day.
In addition to the seven murder charges, Letby faces a further 15 charges of attempted murder relating to 10 premature babies being cared for in the hospital’s neonatal unit.
All of the alleged murders and attempted murders took place in a 12-month period between June 2015 and June 2016.
Letby’s parents, John, 76, and Susan, 62, watched as proceedings were relayed to annexe courtrooms attended by families of the children involved and members of the press and broadcast media.
A court order prohibits the media from reporting the identities of either the surviving infants or those who died.
A court order prohibits reporting of the identities of surviving and deceased children allegedly attacked by Letby, and prohibits identifying the parents or witnesses connected with the children.
The children will be referred to as Baby A to Q.
The trial is expected to last six months continues.