11:29am
He says some tasks would have required him to work with Dr Christopher Wood, his colleague on the night, and some would have been done solo.
He says his tasks would have included speaking to nurses and seeing the neonatal unit babies.
He says if there was nothing outstanding happening on the neonatal unit, he would be there at 10-10.30pm.
He says for this night he was called over at 10pm, having been called over because Child E had blood in his vomit.
'Small amounts of blood' - minuscule blood flecks - were spotted when the NG Tube was brought out of Child E, he recalls.
11:42am
The court is shown Dr Harkness's note from 10.10pm on August 3, which says 'asked to see patient [Child E] regarding gastric bleed.
'Large, very slightly bile-stained aspirate 30mins ago.'
The note adds: 'Sudden large vomit of fresh blood and 14ml aspirate.'
The doctor is given the opportunity to look through his clinical notes, and Lucy Letby's nursing notes from that shift, to see the chronology of events that night.
11:47am
The court is now shown the 10.10pm note.
He says it is not clear, from his note, how much of the 14ml aspirate contained 'fresh blood'.
He says the fresh blood was what he had witnessed, having been called over to see it. The court hears he did not see the child vomit, but saw the fresh blood as a product of it.
11:51am
He notes Child E's blood pressure was 'very good', a CRT reading was good, the heart rate was 'normal' and saturation rates were good, with minimal oxygen support.
"At that point in time, everything is fine, except for the blood in the aspirate," he tells the court.
Child E was also 'pink, well perfused', the lungs were 'clear', the abdomen was 'soft, not distended'.
11:54am
Dr Harkness notes 'GI bleed ? Cause', and tells the court that is a possible diagnosis for the bleeding, and a plan of action with administration of antibiotics is made.
The note 'close observation' is made, emphasising the designated nurse - Lucy Letby - was to monitor Child E closely in room 1.
1:28pm
Mr Myers asks about the sequence of events.
He refers to a police statement Dr Harkness made, where the doctor says: "I was asked to review [Child E] by Letby [following the finding of a dirty aspirate].
'Looking at the notes it was 10pm-10.30pm...I only came on at 9pm'.
He described, in the statement, the aspirate which was largely mucus-y.
He said he could not be sure if there was a fleck of blood around Child E's face [on examination].
'[Child E] looked relatively settled and there was nothing to suggest that was ging to change'.
1:30pm
The statement adds: 'However, around half an hour to an hour later there was a large amount of fluid which came up the tube.
'From memory it was 12-14ml of blood which for a baby was a substantial amount'.
Child D brought up further 'fresh blood' in quantities which he had 'not seen [in sudden cases] since'.
1:38pm
Mr Myers asks about the initial stages from the first clinical note, at 10.10pm.
Dr Harkness confirms he has been asked to review Child E, following the bile-stained aspirate '30 mins ago'.
Mr Myers said all of what had happened in the 10.10pm note, had happened by 10.10pm.
Dr Harkness says this was a 40-minute period of several year ago. He said this was potentially a period of 9.30-10.10pm.
He said it would 'match up' with the note.
In the police statement, Dr Harkness said he would have been 'bleeped' by Lucy Letby.
He says that would have been the most common approach to be alerted to the nursery room 1.
He said he had seen 'a dirty aspirate which may have contained blood flecks and bile'.
Mr Myers says the police statement said Child E had 'nothing dramatic' around the baby's face, and could not be sure if there were any blood flecks.
Child E was 'not in distress' and 'appeared fine'.
1:39pm
Mr Myers asks if Dr Harkness had 'any particular concerns' from the first reading. Dr Harkness says there wasn't. He agrees the second note, with blood vomit, was 'more concerning' and suggested a gastrointestinal bleed.
Mr Myers asks if such a bleed was 'serious'.
"Potentially," Dr Harkness replies.
