12:07pm
Letby's notes for that day are shown to the court.
They include... 'at 1015 x2 large projectile milky vomits, brief self resolving apnoea and desaturation to 35% with colour loss. NG tube aspirated - 30mls undigested milk discarded. Abdomen distended, soft. Drs asked to review. Temperature remains low, tachycardiac >18bpm since vomit. Mum states that [Child G] does not appear as well as she did yesterday...'
The court is shown a feeding chart for Child G. A 40ml feed of expressed breast milk was given at 9.15am, signed by Letby.
After the feed, there were 'two projectile milky vomits', Letby noted. Child G also had a large bowel motion.
Letby says she would have tested the stomach pH level prior to a feed, but would not have aspirated the contents. She says that would not have been needed as Child G was a '40-week baby', and would be treated as a full-term baby by this stage.
Mr Myers asks if it would be known how much milk would be in a baby's stomach. Letby says she would not, as there would only be an aspiration to check for the pH levels.
This projectile vomit "did not leave the cot space", Letby tells the court. She says that would have amounted to 10mls.
Letby says she cannot be sure, but believes Child G's mother would have been present at the time. Letby says she, herself, would have been in the room but not at the cotside of Child G when the vomit happened, and would have been alerted to it by the monitor going off.
She says Child G stabilised after that. Letby said she asked if Child G could be seen 'sooner' than usual on the ward round, as room 4 would normally be the last to be seen.
Letby says there was no large-scale medical response to the incident.
Letby explains care was transferred to another nurse as it was identified Child G required a higher level of care, and Letby was already looking after three babies that day.
12:17pm
The court hears evidence about the second incident on September 21.
Letby says parents would be allowed and in the unit at about 3pm that day. Letby says for this incident, she remembers being 'conscious there were other parents' in the room.
Screens were put up as "normal practice" for privacy, as Child G was having cannulation following her event.
The note records: 'Numerous failed attempts then at cannulation. Finally inserted by Dr Gibbs. Without fluid for 6 hours, as [nil by mouth]. Blood sugars were stable throughout....further significant apnoea/brady/desat following cannulation requiring Neopuff and 100% oxygen. Help summoned...'
Letby says she discovered the desaturation, and called for help. She said Child G had been behind the screen for some time, and had been looking after her other designated babies. She says she was aware the cannulation process took some time, but was not present to see it taking place as it was behing the screens.
A long line chart is shown to the court, which noted the cannula was inserted at the 7th attempt.
Letby said she cannot recall why she went in, but saw behind the screen that she was alone. She was 'dusky and blue and not breathing'.
The monitor was "not on".
Letby says Child G was on the 'procedure trolley' - used for procedures such as cannulation. Letby says the baby should not have been left alone on the trolley like that.
She says she picked up Child G and put her back in her cot, applied Neopuff and called for help.
Letby says she did not know why the monitor was off.
The nurse colleague "froze" and got someone else to help. Another nurse, Caroline Bennion, came in.
Letby said she was "very concerned" about three issues - a baby being unattended on a procedure trolley, alone behind screens, and with a monitor switched off.
Letby said she raised those concerns with a nursing colleague, and was keen to file a 'Datix report'. The nursing colleague was less keen, Letby says, to raise the issue, as the procedure had been carried out by Dr Gibbs.
Letby said she "took assurances" the issues would have been dealt with as discussed.
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…
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