12:28pm
A 35ml feed at 4pm for Child I has an aspirate of 3ml, with Child I 'asleep'. It is signed by Letby's initials.
Letby notes: 'did not wake for feed at 1600 therefroe NG Tube feed given'.
Child I then suffers a deterioration at 4.30pm.
12:28pm
4.30pm on the feed chart records, for Child I, 'large vomit and apnoea - nil by mouth'. It is not signed by anyone.
12:32pm
Letby notes: 'At 1630 [Child I] had a large vomit from mouth and nose++ suction given. Became apnoeic with bradycardia and desatuartion (30s). Help summoned and IPPV given for approx 3min in 100% oxygen to recover. Drs were crash called.
'Transferred to nursery 1...'
A doctor [who cannot be named] records he is crash called. He notes 'Chest clear... Abdomen distended, active bowel sounds all zones'
2:35pm
Letby's mentor replies to a message Letby had sent earlier, expressing birthday wishes, at 5.23pm: 'Ah thank you so much. You ok? x'
12:37pm
An x-ray is taken of Child I at 5.39pm, with the radiologist recording: 'There is splinting of the diaphragm due to bowel distension...there is moderately severe bowel distention which is thought to involve both large and small bowel.
'The appearances are suspicious of NEC...'
12:39pm
Medication of glucose and sodium chloride is co-signed by Letby at 5.45pm and 6pm.
A CRP blood reading for Child I is 'less than 1'.
12:47pm
Child I suffered another deterioration at 7.30pm.
Letby's notes, written in retrospect at 8.26pm, record: 'At 1930 [Child I] became apnoeic - abdomen distended++ and firm. Bradycardia and desaturation followed, SHO in attendance and registrar called...
'Nil by mouth. NG tube on free drainage. Cannula inserted but tissued during saline bolus (5mls given).
'Colour appears pale but improved from earlier in shift. Abdomen appears full and distended. Veins more prominent. Not further vomits. Responsive but quiet on handling.'
For the family communications: 'Mummy present when reviewed by Drs. Had left unit when [Child I] had large vomit and transferred to nursery 1. [Mother] up to date with current plan...'
Nurse Bernadette Butterowrth, who took over care of Child I for the night shift, records: 'During handover [Child I] abdo became more distended and hard she had become apnoeic nad bradycardiac and sats had dropped. IPPV given and despite a good seal with Neopuff there was still no chest movement...'
12:48pm
The doctor records 'ticks' for temperature instability and apnoea for Child I at 8pm.
12:50pm
Letby's final note from 8.26pm: '[Child I] is now very pale and quiet.
12:52pm
Letby responds to her mentor: 'Yes thank you. Hope you are rnjoying your celebrations. X'
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…
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