Dr. Ravi Jayaram, a senior doctor at the Countess of Chester Hospital, testified in court that he witnessed no evidence of nurse Lucy Letby taking any action to help a deteriorating baby girl, known as Child K, before he entered the intensive care room. Child K was born extremely premature at 2.12 am on February 17th, 2016, weighing 1 lb 8 oz (692g). The prosecution alleges that Letby deliberately displaced the baby’s breathing tube, causing her oxygen saturation levels to drop.
Jayaram, who was sat at the nurses’ station near the intensive care room, stated that he had a “feeling” something was amiss, despite having no objective evidence to support his concern. This feeling, he admitted, was irrational. His internal dialogue told him to stop being paranoid and get back to work, but he couldn’t shake the sensation that something was wrong.
As he entered the room, he noticed that Letby was standing next to Child K’s incubator, doing nothing. He saw that the baby’s oxygen saturation levels were dropping rapidly, with readings in the low 80s and going downwards. Jayaram mentioned that alarms were supposed to sound if blood oxygen levels dipped below 90%, but he didn’t hear any. He didn’t notice whether the button to suspend the alarm had been pressed, but stated that the saturations continued to drop.
Upon closer examination, Jayaram noticed that Child K’s chest was not moving well, and she was not responding to the ventilator. He quickly disconnected the ventilator and attempted to breathe air into her using a bag and mask, but she didn’t respond. Jayaram stated that it was his reflex to go through this process, akin to doing an emergency stop in a car.
When questioned about whether there was any evidence of Letby having done anything before he arrived, Jayaram replied that he wouldn’t say there was. He didn’t hear any call for help from Letby, and was surprised that the alarm wasn’t sounding, given the baby’s critical condition.
Nurse Lucy Letby
Jayaram stated that he decided to remove the tube from Child K’s mouth and ventilate her again through a face mask, which resulted in her improving rapidly. His estimated time frame for the ventilation problems before entering the room was between 30 seconds and two minutes, although he acknowledged that there was no hard science to back this up.
In cross-examination, Jayaram explained that it’s possible for a child of Child K’s age and condition to move their own tube, but he had never seen it in a baby of this gestation. The tubes are secured in a fairly robust way, making it difficult for a baby to dislodge it.
The court heard that Child K’s oxygen levels dropped to less than 40% before she recovered, which is a life-threatening level if not addressed promptly. The prosecution does not allege that Letby caused Child K’s death, although the baby passed away three days later at Arrowe Park Hospital due to her extreme prematurity.
Letby, who is accused of attempted murder, denies the allegations. The trial continues, with a court order in place prohibiting the reporting of the identities of the involved children.
