A DOCTOR said a “chill went down my spine” when he found a possible explanation for numerous collapses of babies, the murder trial of Lucy Letby heard.

Dr Ravi Jayaram said a number of “unusual and “inexplicable events” at the Countess of Chester Hospital’s neo-natal unit led to a meeting of consultants at the end of June 2016.

Nurse Letby, 33, is accused of murdering seven babies and attempting to murder 10 others on various dates between June 8, 2015 and June 25, 2016.

On Wednesday, consultant Dr Jayaram told Manchester Crown Court how he saw “bright pink” patches that “flittered around” the abdomen of one infant he treated in April 2016.

Jurors were told how he responded to an emergency call from nurses to attend Child M, a twin baby boy, who had stopped breathing as his heart rate and oxygen levels plummeted.

He said it was a prolonged resuscitation that lasted “close to 30 minutes” and at one point he thought of stopping the efforts to revive him.

However, Child M “suddenly recovered” as his heart rate rose and he started breathing again, he said.

Dr Jayaram said: “I was very pleased but I couldn’t really explain what had caused it and why he had suddenly got better.”

He later stated to police he witnessed Child M’s “unusual” skin discolouration when he arrived during the resuscitation.

Dr Jayaram told the court: “They were patches of very bright pink on his torso that flittered around. They would appear and disappear.

“Once circulation was restored and his heart rate came up above 100 (beats per minute) they vanished.”

He said the discolouration was “very similar” to what he had seen in his treatment of Child A, the first alleged murder victim.

Other colleagues had spoken of seeing skin discolouration in other babies who had also collapsed on the unit, he said.

A meeting of a consultants was held on June 29, 2016, the court heard.

Dr Jayaram said: “After a number of further unusual, unexplained and inexplicable events on the neo-natal unit the whole consultant body sat down and said ‘we really need to work out what is going on here’.

He said that “one thing that came up in our discussion” was air embolism – when gas bubbles enter a vein or artery and can block blood supply.

Dr Jayaram said it prompted him that evening to conduct a literature search in which he found a research paper which described the effects of air embolism.

He said: “I remember sitting on my sofa at home with the iPad and reading that description, and the physical chill that went down my spine because it fitted with what we were seeing.”

Dr Jayaram emailed colleagues a link to the research paper the next day.

Letby, originally from Hereford, is said to have attacked several of her victims by injecting air into their bloodstream.

Jurors have heard Dr Jayaram did not refer to skin discolouration in his clinical notes concerning Child M.

Dr Jayaram disagreed with Ben Myers KC, defending, that that was because he had not seen such an appearance.

He said: “There were far more important things. The important thing was dealing with his cardiac arrest.”

Mr Myers said: “I am going to suggest it would be incompetent to leave that out of the clinical note if you saw it.”

The consultant replied: “I disagree. In many ways I wish I had written it down.

“At that time I had no knowledge or suspicion that the discolouration could have been related to something else that could have caused cardio-respiratory arrest, which is probably why I didn’t specifically put it in the notes.”

Mr Myers said given his previous similar observations about Child A then there was “all the more reason” to note changes in skin colour.

Dr Jayaram replied: “At the time it was not the priority. I wish I had and we would not be sitting here years later having this rather academic discussion.”

In a sharp retort, and pointing to the defendant in the dock, Mr Myers said: “It’s not academic. She is on trial here for multiple murders and attempted murders.”

He agreed with Mr Myers he had also failed to mention skin discolouration in his clinical notes on Child A, or in his subsequent statement to a coroner.

The court went on to hear that Dr Stephen Brearey, head of the neo-natal unit, reviewed the circumstances surrounding the case of Child D shortly after her death in June 2015.

Dr Jayaram said it was not a formal review and he discussed the findings with Dr Brearey who had looked at case papers and files.

Mr Myers said: “He identified Lucy Letby as a person of interest.”

Dr Jayaram replied: “I think he noticed that Lucy Letby was the nurse looking after these babies and that was it.”

Mr Myers went on: “He raised with you the fact that Lucy Letby was present on these occasions?”

“Yes,” said Dr Jayaram.

Mr Myers said: “With that in mind, she became the focus of interest as events unfolded. She had been flagged up as somehow linked in some way.”

Dr Jayaram said: “There was an association with her being present. Nothing more.”

Mr Myers said: “You and Stephen Brearey were already talking about Lucy Letby in June 2015, weren’t you?”

The consultant replied: “In terms of association but as clinicians we have to think about all possibilities … we don’t generally consider unnatural causes or deliberate things.

“Nothing like that was being contemplated at that stage.

“It was simply an association.”

Mr Myers said: “Miss Letby had been a person identified as a potential link by June 2015.”

Mr Jayaram said: “Yes and other colleagues had noticed the association as well.”

Mr Myers said: “So all eyes on Ms Letby then?”

The consultant replied: “Well clearly yes because there is an association.”

Jurors heard the defendant continued to work in the unit for the following 11 months.

She denies all the allegations.

The trial continues on Thursday.