The crown claims that baby A suffered a gas embolism that led to his death

A “teaspoon-sized” amount of air would have been enough to kill a child allegedly murdered by nurse Lucy Letby, according to her trial.

Two expert pediatric consultants on the prosecution told Manchester Crown Court that, in their view, the air had entered the baby’s circulation “on purpose” through an intravenous line.

Baby A is said to be Letby’s first victim, 32, who allegedly caused her sudden collapse and death on the evening of June 8, 2015, more than 24 hours after her premature birth at 31 weeks.

The Crown states that the child suffered a gas embolism – in which a blockage occurs in the passage of blood – at the hands of the accused.

Manchester Crown Court, where Lucy Letby is on trial for murder (PA)

Several witnesses told the court that the twin had “unusual ski discoloration” of purple or pink flecks during the collapse that “came and went”.

Letby is on trial charged with the murder of seven children and the attempted murder of 10 others at the Countess of Chester Hospital’s neonatal unit.

Giving evidence on Tuesday, Dr Dewi Evans said, “Just before he collapsed (baby A) he was in stable condition. It was what could be expected. All the well-being indicators were very satisfactory.

“By then (Child A) he really survived the most dangerous journey of his life.”

However, he said the air had “somehow” entered his circulation.

He said he said he formed the opinion at the time without knowing about the rash or any hints of a gas embolism.

Dr. Evans said he ruled out other possibilities such as infection and suffocation due to Baby A’s stable vital signs prior to collapse.

He said the placement of various catheters and cannulas through the intravenous lines while treating Baby A was also not the cause.

Nick Johnson KC, the prosecution, asked, “How does an air embolism kill someone?”

Dr Evans said, “It interferes with the blood supply to the heart and lungs. It is the same mechanism as a clot. It blocks the blood supply and kills you.

Mr. Johnson said, “As for the means by which air could be injected into a child’s circulation, from what we know the way (Child A) was treated what are the possibilities?”

Dr Evans said, “Only one actually. Air would pass through an intravenous line. It could only have happened in two ways: accidentally or on purpose.

He added that “there was no way” it could have been accidental due to the “safety, alarm and monitoring systems” of the intravenous line equipment.

Expert colleague Dr Sandie Bohin said it was “extremely unlikely” that the air had been accidentally administered.

He said: “My experience is that the nursing staff who insert a line or take care of the line are absolutely meticulous in preventing air from entering those lines.

“The connecting lines and points are filled with saline so that even the smallest of air bubbles can’t get in.” It’s ingrained in the nursing staff. “

He said the amount of air that could be fatal in a baby like baby A, who weighed only 1.6 pounds at birth, was a “teaspoon of air.”

Baby A’s mother cried in the public gallery as Dr. Bohin said she had only one “plausible explanation” left for her son’s collapse and death, which was a gas embolism.

Dr. Evans said the pattern of the collapse of Child A’s twin sister, Child B, on the next night shift was “very similar” and he believed that the air was probably deliberately administered in his case.

The court heard that baby B had made a “remarkable recovery” and was discharged the following month.

Dr Evans said, “The doctors did a great job saving her.

“Either the volume of air was less or the air passed more slowly, or a combination of the two.”

Ben Myers KC, in defense, asked Dr. Evans: “Do you think you were influenced by the allegations rather than the facts of the case?”

“No,” said Dr. Evans who explained that he first learned of the defendant’s name when it was published in the media after her arrest.

The consultant confirmed that he was first contacted about the death by the National Crime Agency (NCA), but denied giving him the theory that deliberate harm had been inflicted on the children.

Dr Evans said: “All I was told was that there was a hospital in Chester where many children had died.

“This is a hospital where an average of three or four children die a year, but one way or another they’ve had far more deaths, which is a concern.

“Many of these were inexplicable, even more of a concern.

“Many of these have occurred in children who were previously stable, which adds to the concern and resuscitation was unsuccessful in some of the children who collapsed.

“We had a constellation of worries here.”

Letby, a native of Hereford, denies all alleged crimes said to have been committed between June 2015 and June 2016.

The trial continues on Wednesday.

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