11:33am
Medical expert Dr Dewi Evans said Child Q's collapse was due to 'inappropriate care', and he had been injected with air via the NGT.
The significant amount of air aspirated from his stomach 'could not have arisen in any other way'.
Dr Sandie Bohin noted Child Q was well up until June 25 and believed something happened between 9am and his collapse.
He was only being fed what Dr Bohin describes as “tiny” amounts of milk yet he had taken in “copious amounts of air” from the NGT. This was abnormal.
The effect of a large volume of air in the stomach would “squash” the lungs leading to desaturation and instability. Although a baby may recover quickly after such an event, he may remain unstable for some time thereafter.
She agreed with Dr Evans’ conclusion that events were consistent with the introduction of a large amount of air via the NGT.
A professor reviewed brain imaging of Child Q taken in November 2019 - more than three years later. He found evidence of abnormalities which whilst they were not diagnostic of him having suffered a brain injury as a result of being given excessive air and liquid via his NGT, they could be explained.
11:34am
In Letby's home search, officers recovered the handover sheet from the morning of June 25 whic included Child Q's name. This was a document which should not have left the hospital.
When interviewed by police, Letby agreed Child Q had been well enough for her to leave him on the morning of June 25.
When asked about the excess air aspirated from his stomach, she suggested babies sometimes gulp air when they vomit. She denied putting excess air down the NGT.
11:37am
Mr Johnson: "Following those events, the consultants suspected that the deaths and life-threatening collapses of these 17 children were not medically explicable and were the result of the actions of Lucy Letby.
"No doubt they were acutely aware that making such an allegation against a nurse was as serious as it gets.
"They, at the time, did not have the benefit of the evidence that you will hear and the decision was taken by the hospital took the decision to remove Lucy Letby from a hands-on role. She was moved to clerical duties where she would not come into contact with children.
"The police were contacted and began a very lengthy and complex enquiry.
"This involved the police contacting independent paediatricians and other specialists to review many cases which had passed through the NNU at the CoCH. Following that review, the decision was taken to arrest Lucy Letby – the first arrest came in July 2018.
"On July 3 she was arrested at her home, where the house was searched.
"In addition to some of the paperwork, they found sme other interesting items.
"There were some Post-it notes with closely written words on them, some of which included the names of some of her colleagues.
"On some of the notes were phrases such as “Why/how has this happened – what process has led to this current situation. What allegations have been made and by who? Do they have written evidence to support their comments?"
11:37am
"In her writings, she expressed frustration at the fact that she was not being allowed back on the neonatal unit and wrote 'I haven’t done anything wrong and they have no evidence so why have I had to hide away?'
"Her notes also expressed concern for the long-term effects of what she feared was being alleged against her and there are also many protestations of innocence."
11:39am
"On another piece of paper, she wrote: 'I don’t deserve to live. I killed them on purpose because I’m not good enough”.
“'I am a horrible evil person' and in capital letters, 'I AM EVIL I DID THIS'.
"That, in a nutshell," Mr Johnson tells the court, "is your case."
11:40am
That is the conclusion of the prosecution opening.
The defence, led by Benjamin Myers KC, will give a defence statement after a short adjournment.
THE prosecution in the trial of Lucy Letby, accused of murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to…
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