A premature triplet allegedly killed by nurse Lucy Letby suffered a liver injury similar to a traffic collision, according to her trial.
Letby is alleged to have attacked the newborn, known as Child O, on June 23, 2016, after returning from a holiday in Ibiza.
The 33-year-old nurse is accused of murdering seven babies and attempting to murder 10 others at the Countess of Chester Hospital between 2015 and 2016.
Letby, originally from Hereford, denies all charges.
Manchester Crown Court heard how Child O was born in good condition until he suddenly collapsed two days later in Letby’s care before progressively going downhill as doctors were unable to save him.
Nurse Lucy Letby (pictured) is alleged to have attacked the newborn, known as Child O, on June 23, 2016, after returning from a holiday in Ibiza.
Manchester Crown Court (pictured) listened as Child O was born in good condition until he suddenly collapsed two days later in Letby’s care
On the next day’s shift, Letby is alleged to have murdered Child P, one of Child O’s triplet brothers.
The trial has heard how Dr Dewi Evans, an expert pediatrician, said he believed Child P had initially been destabilized by the introduction of air sometime before an X-ray was taken at 8:09pm on June 23 .
But it was the introduction of an additional “drop of air” the next morning that splinted his diaphragm and caused the first in a series of collapses that ended in his death.
Shortly after the death of two of their babies, the parents pleaded with doctors to transfer their surviving triplet to Liverpool Hospital for Women because they feared he too would die if he remained in Chester.
Dr. Andreas Marnerides, a pediatric pathologist, said he did not believe the “impact” injury caused to boy O could have been the result of efforts to resuscitate him.
The baby died in part due to an “impact-type” internal liver injury, discovered after his death.
Jurors were shown photographs of post-mortem examinations showing two separate sites of bruising, as well as areas of a blood clot.
Prosecutor Nick Johnson KC asked the consultant: ‘How does that injury occur in a child of the age of (Child O)?’
Dr Marnerides, who practices at St Thomas’ Hospital in London, said: “The distribution, pattern and appearance of the bruises indicate an impact type injury.” I’m pretty sure it’s an impact injury.
He explained that the photograph showed “extensive hemorrhage in the liver,” which he had only previously seen in a traffic collision and in non-accidental assaults by parents or caregivers.
Dr. Andreas Marnerides (pictured), a pediatric pathologist, said he did not believe the “impact” injury caused to boy O could have been the result of efforts to resuscitate him.
Johnson said: “Looking at this sequence of photographs, can you rule out the possibility that these injuries were caused by CPR?”
Dr Marnerides said: ‘I cannot convince myself that in a neonatal unit setting this would be a reasonable proposition to explain this. I don’t think CPR can cause such extensive damage to the liver.
Mr Johnson said: “To the extent that you’ve talked about an impact type scenario to cause that internal injury, would you necessarily expect to see any external signs on the skin itself?”
The consultant replied: ‘You can have the most devastating injury internally and nothing can be seen externally. That is very common.
Mr. Johnson continued: “What, in your opinion, was the cause of death of (Child O)?”
Dr Marnerides said: “In my opinion, the cause of death was traumatic liver injury, deep gastric and intestinal distension following acute excessive injection/infusion of air through a nasogastric tube, and air embolism due to administration into a venous line.’
The consultant was approached by Cheshire Police in late 2017 to review the deaths of several babies at the hospital, the court heard.
He gave his opinion on their causes of death after having reviewed the pathological evidence as well as the information received from clinical and radiological reviews.
The 33-year-old nurse (pictured) is accused of murdering seven babies and attempting to murder 10 others at the Countess of Chester Hospital between 2015 and 2016.
Dr. Marnerides said that Child A, a twin boy, apparently died as a result of air being injected into his bloodstream.
Child C, a boy, underwent an excessive infusion/injection of air into his nasogastric tube, he said.
The ‘probable explanation’ for the death of Child D, a girl, was an air embolism in her circulation.
Another girl, Child I, received an excessive injection of air into her stomach, she said.
He told the court that he could not offer any opinion on the death of child E, a twin boy, because a post-mortem examination was not carried out.
The trial continues on Thursday.