Posted 30 March 2023 - 13:35
Posted 30 March 2023 - 13:35
News
Lucy Letby trial: baby had ‘impact-type’ injuries to liver
Child O’s death was partly due to injuries similar to those caused by a road traffic collision, paediatric pathologist tells court
Child O’s death was partly due to injuries similar to those caused by a road traffic collision, paediatric pathologist tells court
A baby boy allegedly murdered by nurse Lucy Letby suffered a liver injury that was similar to the damage caused by a road traffic collision, her trial has heard.
Ms Letby is said to have harmed the baby, a triplet known as Child O, on a day shift on 23 June 2016 at the Countess of Chester Hospital’s neonatal unit.
Paediatric pathologist said Child O’s death was partly caused by ‘impact-type’ liver injury
Manchester Crown Court heard how the baby was in a good condition when he was born, but suddenly collapsed two days later while he was in the care of Ms Letby. His condition became progressively worse and medics could not revive him.
Ms Letby, who is accused of the murder of seven babies and the attempted murder of 10 others, denies the charges.
On Wednesday 29 March, paediatric pathologist Andreas Marnerides told the court that Child O died partly due to an ‘impact-type’ internal liver injury, discovered after the baby’s death.
Jurors were shown post-mortem examination photographs that showed two separate sites of bruising, as well as areas with a blood clot.
Prosecutor Nick Johnson KC asked the consultant: ‘How does that injury come to be in a child of (Child O’s) age?’
Dr Marnerides, who works at St Thomas’ Hospital in London, said: ‘The distribution, the pattern and the appearance of the bruising indicates towards impact-type injury. I’m fairly confident this is an impact-type injury.’
He explained the photograph showed ‘extensive haemorrhaging into the liver,’ which he had only seen previously in road traffic collisions and in non-accidental assaults by parents or carers.
Traumatic internal injury may not be visible externally, says consultant
Mr Johnson said: ‘Looking at this sequence of photographs, can you rule out the possibility that these injuries were caused by cardiopulmonary resuscitation (CPR)?’
Dr Marnerides said: ‘I cannot convince myself that in the setting of a neonatal unit this would be a reasonable proposition to explain this. I don’t think CPR can produce this extensive injury to a liver.’
Mr Johnson asked: ‘In so far as you have spoken about an impact-type scenario for causing that internal injury, would you necessarily expect to see any outside sign on the skin itself?’
The consultant replied: ‘You can have the most devastating injury internally and nothing can be observed externally. That is very common.’
When then asked what he believed was the cause of death of Child O, Dr Marnerides said: ‘In my view, the cause of death was inflicted traumatic injury to the liver, profound gastric and intestinal distension following acute excessive injection/infusion of air via a nasogastric tube and air embolism due to administration into a venous line.’
Reviewed evidence relating to other babies’ deaths
The consultant was approached by Cheshire Police in late 2017 to review the deaths of a number of babies at the hospital, the court heard. He gave his opinion on their causes of death after having reviewed the pathological evidence as well as information received from clinical and radiological reviews.
Dr Marnerides said it appeared Child A, a twin boy, died as a result of an injection of air into his bloodstream. Child C, a boy, was subjected to an excessive infusion/injection of air into his nasogastric tube, he said. The ‘likely explanation’ for the death of Child D, a girl, was an air embolism into her circulation. Another girl, Child I, received an excessive injection of air into her stomach, he said.
He told the court he could offer no opinion on the death of Child E, a twin boy, because no post-mortem examination took place.
The trial continues.
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