"RAW sewage coming out of sinks" in a room caring for the most vulnerable babies was named by murder-accused nurse Lucy Letby as a contributory factor in their deteriorations.

Letby has continued to be cross-examined for a fourth day in her trial at Manchester Crown Court on Wednesday, May 24.

She denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more between June 2015 and June 2016.

Letby, 33, told the court that plumbing was a problem in the neonatal unit at the Countess of Chester Hospital, which had led to "raw sewage coming out of sinks" in nursery room 1, which the court has heard is the Intensive Treatment Unit for the most vulnerable babies the hospital is able to care for.

Letby added the "backing up" of sewage flow could have been a "contributory factor" to the deaths of neonatal babies if it meant the unit was "dirty" and staff were unable to wash their hands properly. 

She added it was not a "safe working environment".

The court also heard Letby say doctors could have acted sooner to try to stop the bleeding of a baby boy.

The prosecution says Letby, 33, inflicted an injury to Child E and also injected him with air while he was under her care at the Countess of Chester Hospital.

She is said to have targeted her fifth alleged victim, Child E, during a night shift in August 2015.

Letby is also accused of attempting to his murder his twin brother, Child F, by poisoning him with insulin.

Manchester Crown Court has previously heard from a prosecution medical expert that a rigid wire or tube may have been used to cause “extraordinary bleeding”.

Child E deteriorated from 11.40pm on August 3, the court heard, and later died early the next morning having lost a quarter of his blood volume.

The boy’s mother had told the court that she heard “horrendous crying” as she visited her son at 9pm and then saw blood around his mouth.

Letby says no bleeding took place prior to 10pm.

Prosecutor Nick Johnson QC asked: “Is it your case that medical incompetency contributed to his collapse or death?”

Letby replied: “Possibly, yes.”

Mr Johnson said: “Whose medical incompetencies?”

Letby said: “The medical team who were on that night.

“I just think collectively they could have acted sooner to respond to the blood issue.”
Mr Johnson said: “Their reaction would be dependent on when you told them there was a bleed?”

“Yes,” said Letby.

Mr Johnson said: “The prosecution case is that (Child E’s mother) is telling the truth and (Child E) was bleeding at 9pm.

“But you didn’t tell anyone about that until at least an hour later?”

Letby said: “No I disagree with that.

“I think once (Child E) was profusely bleeding after 10pm maybe a blood transfusion or something could have been given sooner.

“I don’t know if that would have made a difference.”

Letby said it would have been the decision of the duty consultant, registrar and senior house officer that night to have made the decision to prescribe and give a blood transfusion.

Mr Johnson went on: “I am suggesting to you that when (Child E’s mother) came down at 9pm you had inflicted an injury on (Child E) to cause bleeding?”

Letby said: “No, I don’t accept that. It didn’t happen.”

Mr Johnson said: “That’s why he was screaming, wasn’t it?”

“No,” said Letby.

Mr Johnson said: “Did you tell (Child E’s mother) that the source of the bleed was the insertion of a nasogastric tube?”

Letby said: “No.”

Mr Johnson said: “That is what you told (Child E’s mother) when she queried why he had blood around his mouth?”

Letby said: “No, I don’t recall that, I don’t believe I would have said something like that.”

The defendant denied the suggestion that she had “falsified records” including when failing to record a vomit of fresh blood on an observation chart.

Letby said: “It was an error on my part but it was in my nursing note.”

Mr Johnson said: “Or was it in the excitement of sabotaging (Child E) you overlooked it?"

“No,” said Letby.

Mr Johnson said: “You killed (Child E), didn’t you?”

“No,” said Letby.

Mr Johnson said: “And you injected him with air.”

“No,” said Letby.

Mr Johnson said: “Just as you had done with other babies before?”

Letby repeated: “No.”

Mr Johnson asked: “Why in the aftermath of were you so obsessed with (Child E’s mother)?”

Letby said: “I don’t believe I was obsessed with (Child E’s mother).

Mr Johnson said: “Why were you searching for her continually on Facebook?”

Letby replied: “Because I often thought about (Child E) and (Child F)."

The court has heard the defendant searched for Child E’s mother on nine occasions, including on the late evening of Christmas Day, 2015. Letby also searched for Child E's father on one occasion.

Mr Johnson said: “Didn’t you have better things to do on Christmas Day?”

Letby said: “I often thought of (Child E) and (Child F).”

Mr Johnson said: “Because you had killed one and had tried to kill the other.”

Letby said: “No I didn’t.

“I thought that myself and (Child E’s mother) had a good relationship.”

The trial of Letby, from Hereford, continues on Thursday, May 25.