Nurse Lucy Letby's murder trial continues at Manchester Crown Court this morning. We'll be hearing evidence in relation to a baby boy, Child N, who Ms Letby is accused of trying to kill on three occasions in June 2016. She denies all charges.
The prosecution allege Ms Letby made her first attempt on Child N's life on 3 June, before carrying out two more attacks on 15 June. The Crown say Child N's deteriorations were consistent with some kind of "inflicted injury" or him having received an injection of air.
Jury are currently being read statements of agreed evidence from doctors and nurses who worked 15 June. They're in relation to the treatment of Child N, who crashed several times that day
A nurse, who cannot be named for legal reasons, said in her statement that she remembers being 'shocked' at Child N's deterioration that day. She said that he was previously stable and ready to go home that day
Court being read a statement from Independent Nursing Healthcare Advisor Elizabeth Morgan, who was asked by Cheshire Police whether Ms Letby's 'failure' to alert other medics that fresh blood had been aspirated from Child N's mouth that day fits with 'good practice'
Ms Morgan said in her professional opinion, it would be 'standard good practice' to escalate anything unusual - first verbally and then later recoded
Blood expert Prof Sally Kinsey is now in the witness box. She was approached to review Child N's case
Child N has a rare blood disease, Prof Kinsey is explains to the jury that this can cause 'catastrophic' bleeding following minor injury. Child N had a 'moderate' variant of the condition, she tells the court
Prof Kinsey is asked whether the blood seen in Child N's throat that day could have been caused as a result of self injury or a spontaneous bleed due to his blood condition - she says no
Ben Myers KC, defending, is now questioning the witness. He says his questioning will focus on whether a physical act can be established for causing the bleed
Prof Kinsey tells the court that Child N's blood disorder did make him "more likely to bleed", but said: "He won’t just bleed for no reason."
Medical expert Dr Dewi Evans is now in the witness box, he was asked to review the case by Cheshire Police.
Dr Evans’ opinion is that the bleeding in Child N's throat was not caused by the attempts to intubate, but instead some preceding trauma
Dr Evans says Child N's 'progress was pretty uneventful' and was 'making satisfactory progress for a baby that was premature but otherwise well' in the weeks from birth to 15 June
Court being taken back over timeline of Child N's crashes on 15 June - which culminated in CPR and him having six doses of adrenaline, before he was eventually transferred to Alder Hey Hospital
Dr Evans is giving his analysis on Child N's first collapse on June 3. The baby suffered a profound and sudden collapse in the early hours of that day. This was preceded by, what one doctor recalled, as 'screaming' - Dr Evans said that is 'very unusual' for a child of this age
Dr Evans says he went and reviewed scientific research papers on air embolus (injection of air) - these found that in some cases where babies had been injected accidently with air, there was a period of screaming before desaturation an death
He said what happened with Child N was 'repeated' in what we have seen in previous cases
On the 15 June incident, Dr Evans said in his opinion the bleeding 'was a result of trauma to his upper airway'
We're back after a short break. Ms Letby's defence lawyer Ben Myers KC is now questioning Dr Evans
Mr Myers points out that Dr Evans wrote several reports on the collapse of Child N. In his first report written in 2018, the medic didn't mention the incident on 3 June. He tells Mr Myers he 'overlooked' it and later included in subsequent reports
Mr Myers says 'if you considered it significant you would have said so in your first report'
Mr Myers puts it to Dr Evans that there is 'nothing' in the medical notes for Child N 'to support a suggestion that there was an inflicted injury'. Dr Evans disagrees, he says that was his opinion when he authored his report in 2019 and says 'that is my opinion now'
On whether Child N had received an injection of air on 3 June, Mr Myers put it to Dr Evans that there was no evidence of an injection of air and that the medic was attempting "to work a piece of evidence in to support" his theory on air embolus.
He disagreed and said he was "applying standard clinical practice" in his review and said it was written with knowledge of previous babies in this case. "I think that we have to seriously consider that this baby was a victim of air embolus on 3 June", he said.
Mr Myers has jut been questioning Dr Evans about how he was approached to review these cases. He says he was approached. Mr Myers pulls up an email from 2017 that Dr Evans sent to the National Crime Agency telling them the death's at Chester 'sound like my kind of case'
He accuses Dr Evans of 'touting for work' and says he was using his review to 'fit the allegation not the facts'. He puts it to him that air embolus was mentioned to him by Cheshire Police before the review, he denies accusations - accuses Myers of 'going on a wild goose chase'
Dr Sarah Bohin, who also reviewed the case, is now in the witness box. She said the bleeding suffered by Child N on 15 June could have been caused by 'local trauma to the mouth'
On the incident on 3 June, Dr Bohin says she has 'never experienced' a neonatal baby crying for 30mins. She says it is an 'extraordinarily long' time and puts it down to an 'inflicted painful stimulus'
Report from today’s evidence. Back tomorrow https://www.bbc.co.uk/news/uk-...

