A BABY girl was killed by an injection of air into her bloodstream, the murder trial of a nurse has heard.

It is alleged Lucy Letby, 33, murdered the premature-born infant at the fourth attempt by administering the fatal dose during a night shift at the Countess of Chester Hospital’s neonatal unit.

The death of Child I, who cannot be identified for legal reasons, in the early hours of October 23, 2015 followed sudden collapses on September 30, October 13 and 14.

On Thursday, February 9, retired consultant paediatrician Dr Dewi Evans gave expert evidence at Manchester Crown Court, in the trial's first day of evidence since the previous Friday.

He stated that, in his opinion, Child I had on the first three occasions been injected with air into her stomach via a feeding tube.

But an “extremely disturbing phenomenon” of Child I’s noted “relentless, loud” crying prior to her final collapse led him to believe a different method was used.

The first collapse, he told the court, was “out of the blue”.

Dr Evans said: “She was entirely stable right up to the point of collapse.

“My opinion was that (Child I) had been subjected to an infusion of air. In other words, air had been injected into her stomach.

“That interferes with your ability to move your diaphragm up and down, and that interferes with your breathing.”

He said there was “striking evidence” from an abdominal X-ray which showed “lots of air”.

Dr Evans said he came to the same conclusion that Child I had suffered “splintering of the diaphragm” in the early hours of October 13.

On the following night shift he said her condition deteriorated again “as a result of some kind of event that had interfered with her breathing”.

In one report he prepared he wrote this collapse was “also suspicious and suggestive of inappropriate care, most likely due to the perpetrator injecting a large amount of air via the naso-gastric tube”.

He told the court an X-ray showed an “astonishingly large amount of air” in her stomach.

Dr Evans said Child I was again stable prior to a sudden deterioration shortly before midnight on October 22.

The court has heard Child I quickly recovered after medical staff gave her breathing support but less than an hour later she deteriorated again.

Nurse Ashleigh Hudson told jurors about Child I’s “relentless” and “very loud” crying from her incubator at just before midnight.

Dr Evans said: “Ashleigh Hudson’s evidence was very moving because nurses and doctors know what a normal cry sounds like.

“Babies will cry if they are hungry, or if you take a blood test because it hurts.

“This was very abnormal. A different kind of a cry. I interpreted it as the cry of a baby in pain and in severe distress.

“That is an extremely disturbing phenomenon. There was no obvious explanation why she was crying relentlessly and it was very loud.”

Asked by prosecutor Nick Johnson KC as to what his conclusion was for the cause of the fatal collapse, Dr Evans replied: “I think she was the victim of air being injected into her blood circulation. This probably explains her crying and distress, and the failure of the medical team second time round to save her life.”

Dr Evans agreed with Ben Myers KC, defending, that Child I had recurrent episodes of a swollen stomach and oxygen desaturations during her time at the unit.

But he disagreed with his suggestion that Child I was “in general a very poorly baby regardless of the events we are looking at”.

Dr Evans said he thought both collapses on the night shift of October 22/23 were due to injections of air which caused a blockage to the passage of blood.

He said he could not say how much, or how quickly, air was administered as there was “not a great deal of research” available on air embolisms in babies.

Dr Evans denied Mr Myers’s assertion that it was “utter guess work” on his part.

The expert said: “It is consistent with what has happened in previous cases here.”

Letby, originally from Hereford, denies murdering seven babies and attempting to murder 10 others at the Countess of Chester’s neonatal unit between June 2015 and June 2016.

  • The trial continues on Friday, February 10. The Standard will be reporting live coverage from the day.