News

Lucy Letby trial: ‘a physical chill that went down my spine’

Consultant Ravi Jayaram recalls the moment he linked the cause of babies’ deteriorating health with a possible air embolism
Court artist sketch of Lucy Letby appearing in the dock at Manchester Crown Court: Consultant Ravi Jayaram recalls the moment he linked the cause of babies’ deteriorating health with a possible air embolism

Consultant Ravi Jayaram recalls the moment he linked the cause of babies’ deteriorating health with a possible air embolism

Court artist sketch of Lucy Letby appearing in the dock at Manchester Crown Court: Consultant Ravi Jayaram recalls the moment he linked the cause of babies’ deteriorating health with a possible air embolism
Court artist sketch by Elizabeth Cook of Lucy Letby appearing in the dock at Manchester Crown Court Picture: Alamy

A doctor said a ‘chill went down my spine’ when he found a possible explanation for numerous collapses of babies, the murder trial of Lucy Letby has heard.

Resuscitation attempts took more than 30 minutes

Ravi Jayaram said a number of ‘unusual and inexplicable events’ at the Countess of Chester Hospital’s neonatal unit led to a meeting of consultants at the end of June 2016.

Ms Letby, who was working at the unit at the time, is accused of murdering seven babies and attempting to murder ten others on various dates between 8 June 2015 and 25 June 2016.

On Wednesday, 22 February, consultant Dr Jayaram told Manchester Crown Court how he saw ‘bright pink patches’ that ‘flittered’ around the abdomen of one infant he treated in April 2016.

Jurors were told how he responded to an emergency call from nurses to attend Child M, a twin baby boy who had stopped breathing as his heart rate and oxygen levels plummeted. He said it was a prolonged resuscitation that lasted ‘close to 30 minutes’ and at one point he thought of stopping the efforts to revive him.

Unusual skin discolouration was also seen in Child A

However, Child M ‘suddenly recovered’ as his heart rate rose and he started breathing again, Dr Jayaram said. He later stated to police that he witnessed Child M’s ‘unusual’ skin discolouration when he arrived during the resuscitation.

He told the court: ‘They were patches of very bright pink on his torso that flittered around. They would appear and disappear. Once circulation was restored and his heart rate came up above 100 beats per minute they vanished.’

He said the discolouration was ‘very similar’ to what he had seen in his treatment of Child A, the first alleged murdered child.

Other colleagues had spoken of seeing skin discolouration in other babies who had also collapsed on the unit, he said.

A meeting of a consultants was held on 29 June 2016, the court heard.

Dr Jayaram said that one thing that came up in discussions was air embolism – when gas bubbles enter a vein or artery and can block blood supply. He said it prompted him that evening to conduct a literature search in which he found a research paper which described the effects of air embolism.

‘I remember sitting on my sofa at home with the iPad and reading that description and the physical chill that went down my spine because it fitted with what we were seeing,’ he said. He emailed colleagues a link to the research paper the next day.

Ms Letby is said to have attacked several of the babies by injecting air into their bloodstream.

Bright pink patches were not noted in Child M’s notes

Jurors have heard Dr Jayaram did not refer to skin discolouration in his clinical notes concerning Child M. Dr Jayaram disagreed with Ben Myers KC, defending, that it was because he had not seen such an appearance.

He said: ‘There were far more important things. The important thing was dealing with his cardiac arrest.’

Mr Myers said: ‘I am going to suggest it would be incompetent to leave that out of the clinical note if you saw it.’

The consultant replied: ‘I disagree. In many ways I wish I had written it down. At that time I had no knowledge or suspicion that the discolouration could have been related to something else that could have caused cardiorespiratory arrest, which is probably why I didn’t specifically put it in the notes.’

Mr Myers said that given his previous similar observations about Child A, then there was ‘all the more reason’ to note changes in skin colour. Mr Jayaram agreed with Mr Myers that he had also failed to mention skin discolouration in his clinical notes on Child A, or in his subsequent statement to a coroner.

The court went on to hear that Stephen Brearey, head of the neonatal unit, reviewed the circumstances surrounding the case of Child D shortly after her death in June 2015.

Dr Jayaram said it was not a formal review and he discussed the findings with Dr Brearey who had looked at case papers and files. Mr Myers said: ‘He identified Lucy Letby as a person of interest.’

Dr Jayaram replied: ‘I think he noticed that Lucy Letby was the nurse looking after these babies and that was it.’ Mr Myers asked if the fact that Ms Letby was present on these occasions was raised, to which Dr Jayaram replied ‘yes’.

Lucy Letby was mentioned in an informal review of Child D’s death in June 2015

Mr Myers said: ‘With that in mind, she became the focus of interest as events unfolded. She had been flagged up as linked in some way.’

Dr Jayaram said: ‘There was an association with her being present. Nothing more.’

Mr Myers said: ‘You and Stephen Brearey were already talking about Lucy Letby in June 2015, weren’t you?’

The consultant replied: ‘In terms of association, but as clinicians we have to think about all possibilities… we don’t generally consider unnatural causes or deliberate things.

‘Nothing like that was being contemplated at that stage. It was simply an association.’

Jurors heard the defendant continued to work in the unit for the following 11 months.

Ms Letby denies the murders of seven babies and the attempted murders of ten others between June 2015 and June 2016. The trial continues.


In other news

Jobs