ALLEGED killer nurse Lucy Letby was 'caught trying to attack a new-born twin' by the child's mother, a court has heard.

Letby 32, denies seven counts of murder and 15 counts of attempted murder, in relation to the deaths of seven babies at the Countess of Chester Hospital and the attempted murder of 10 more.

Prosecuting at Manchester Crown Court on Tuesday, October 11, Nicholas Johnson KC said Child E was the twin brother of Child F - with Child F being allegedly poisoned with insulin.

Mr Johnson said it was at 9pm on August 3, 2015, when the mother decided to visit her twin sons, and "interrupted Lucy Letby who was in the process of attacking Child E", although the mum "did not realise it at the time".

Child E was 'acutely distressed' and bleeding from the mouth.

The mum said Letby attempted to reassure her the blood was due to the naso-gastric tube irritating the throat.

"Trust me, I'm a nurse," Mr Johnson told the court, as Letby "fobbed off" the mother and told her to return to the postnatal ward. 

The mother called her husband when she got to the labour ward, in a call lasting four minutes and 25 seconds, at 9.11pm.

The prosecution allege Letby later made deliberately false records after Child E had died, saying the mum had visited at about 7.30pm-8pm and 10pm that night, making no reference to 9pm.

The prosecution said 9pm was important as the mum had gone to visit to provide breastmilk for Child E.

A feeding chart presented to the court for that night showed the feed was 'omitted' for that time.

Letby made no mention of the child bleeding at 9pm.

The court heard Child E suffered a blood loss of 13 millilitres at 11pm - equivalent to 25 per cent of the child's blood volume - and was pronounced dead at 1.40pm following a sudden desaturation in which his abdomen "developed a striking discolouration with flitting white and purple patches."

The on-call consultant said Child E was a high-risk infant who had shown signs of NEC, a serious gastro-intestinal disorder.

The parents did not wish to have a post-mortem, the consultant did not deem one necessary, and the coroner's office agreed.

Mr Johnson said: "As subsequent reviews have established – that was a big mistake."

The prosecution added medical expert Dr Dewi Evans said Child E's death "was the result of a combination of an air embolus and bleeding which was indicative of trauma".

The air embolus was "intentionally introduced" into Child E's bloodstream via an IV line "to cause significant harm," the court heard.

In police interview, Letby said she could remember the mum leaving after 'the 10pm visit'.

The prosecution say Lucy Letby "took an unusual interest" in the family of Child E. She did social media searches on the parents two days after Child E’s death, and on August 23, September 14, October 5, November 5, December 7, and even on December 25.

The prosecution say there were further searches in January 2016.

Earlier, the court heard Letby murdered a five-day-old baby at the Countess of Chester Hospital by injecting air into his stomach through a nose tube.

Letby allegedly killed the baby boy, Child C, just six days after murdering for the first time, when she killed another baby boy, Child A, and days later attacked his twin sister, Child B, while working at the hospital's neo-natal unit.

Child C died because the air injected into his stomach made him unable to breathe and he suffered a cardiac arrest, Nicholas Johnson KC, told the jury on the second day of the prosecution opening at Manchester Crown Court.
The boy had been born prematurely at 30 weeks in June 2015, weighing only 800 grams, but despite going into intensive care was in good condition.

Five days later, during the night-shift, Letby was supposed to be looking after another, more poorly baby, in another room.

But she was the only person in the room when Child C suddenly and unexpectedly collapsed.

Prosecutor Mr Johnson continued: “Again, taking a step back, you can now see there was a pattern emerging.

“Lucy Letby was the only person working on the night shift when Child C died who had also been working on either of the shifts when Child A died and his twin sister Child B collapsed.

“What we are going to see, as we progress, is that Lucy Letby’s method of attacking the babies in the neo-natal unit was beginning to develop.

“She had injected air into the bloodstream of the first twins, Child A and B, and varied this approach by injecting air into Child C’s stomach via the naso-gastric tube.”

Mr Johnson said an independent pathologist – when reviewing the case – concluded Child C died because his breathing became compromised and he suffered a cardiac arrest.

The prosecutor told jurors: “If you are trying to murder a child in a neo-natal unit, it is a fairly effective way of doing it. It doesn’t really leave much trace.”

He said on the afternoon of June 14, 2015 – hours after Child C died – the defendant searched on Facebook for the youngster’s parents.

Mr Johnson suggested from the timings that this was “one of the first things she did when waking up” after she had earlier finished her shift at about 8am.

The court also heard Child D, a baby girl, was allegedly murdered in June 2015.

On the night-shift when Child D died, the baby girl collapsed three times. The first at about 1.30am, the second at 3am, and finally at 3.45am.

Mr Johnson: "On each occasion, those attending were struck by the sight of mottling, poor perfusion and brown/black discolouration to her skin, mainly over the trunk.

"We've heard that sort of thing before, haven't we?

"The prosecution say that this was another case of injecting a child via an IV air embolus."

The trial continues.