I'm back at Manchester Crown Court this week for the murder trial of nurse Lucy Letby. This morning we're expecting to hear evidence from former colleagues in regards to the death of Child D in June 2015.
Dr Andrew Brunton, who is now a consultant neonatologist but was a trainee doctor in 2015, is in the witness box. He is running the jury through is notes from June 20. He notes at the start of his shift that Child D was in 'respiratory distress'
His notes from around 21:45 that evening state: 'Explained (to father) that safest option at present would be to intubate and ventilate her now with the hope of weaning her off the ventilator quickly'
Child D was deemed 'clinically stable' at around 23:15 after being placed on a ventilator. At that time, parents were told 'if prolonged ventilation is required or a deterioration, we may have to think of transferring to Arrowe Park Hospital or Liverpool Women's Hospital'
Another note from 01:50 on 21 June, 2015 shows an improvement in Child D's condition. Dr Brunton took the decision around this time to wean her off the ventilator.
Later that day, Child D was taken off a ventilator and placed back on a less invasive form of respiratory support (continuous positive airway pressure or CPAP therapy). Dr Brunton's notes from that night state that she was 'clinically improving' and 'well enough' to take milk
Four hours later at around 01:40 on June 22, Dr Brunton was called 'urgently' to attend to Child D. His note from that morning states:'Called urgently to review baby. Nurses noted that became extremely mottled also noted to have tracking lesions dark brown/black across trunk'
Dr Brunton tells the court that a consultant was called as 'this was a completely unusual situation that I hadn’t seen before', he said he 'couldn’t explain' the discolouration of Child D's skin