A HEREFORD nurse has been accused of being "a poisoner at work" within the neo-natal unit of the hospital where she worked as the prosecution opened at her murder trial.

Lucy Letby, wearing a blue jacket over a black shirt, appeared before Manchester Crown Court on Monday (October 10) as the prosecution opened their case.

The 32-year-old nurse, who is of Arran Avenue, Hereford, grew up in Hereford before studying nursing at the University of Chester.

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She is accused of murdering seven babies and 15 charges of attempted murder, involving 10 babies, while working at the Countess of Chester Hospital between June 2015 and June 2016.

Opening the prosecution case, Nick Johnson KC said the Countess of Chester Hospital was a “busy general hospital” which included a neo-natal unit that cared for premature and sick babies.

But, he said, "a poisoner was at work" within the neo-natal unit at the hospital.

Why were suspicions raised?

Mr Johnson said that, prior to January 2015, the statistics for the mortality of babies at the hospital were comparable to other like units, but over the next 18 months or so, there was a significant rise in the number of deaths and "catastrophic collapses".

The prosecution said babies were deteriorating unexpectedly, with some collapsing dramatically and then, equally dramatically, recovering.

“Their collapse and recovery defied the normal experience of treating doctors," Mr Johnson said.

The rise was noticed by consultants and they searched for a cause, Mr Johnson said.

What action did the hospital take?

Mr Johnson said police were called in and conducted a “pain-staking review”.

He said: “That review suggests that in the period between mid-2015 and the middle of 2016 somebody in the neo-natal unit poisoned two children with insulin."

Why did suspicion fall on Lucy Letby?

The prosecution alleges that many of the collapses happened on the night shift, but when Letby was moved to the day shifts, the collapses and deaths also moved to the day shifts.

Jurors were shown a chart showing nurses who were present on duty when the alleged criminal incidents were said to have taken place.

Pointing out, as examples, the first three alleged offences in time he said the chart showed the only person that was present on all three occasions was the defendant.

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What is alleged to have caused the collapses?

A reporting restriction is in place prohibiting the identification of the 17 alleged victims. They will be referred to as child A to Q.

Mr Johnson said child A, the first alleged murder, was attacked at just a day old, on June 8 2015.

He was born early by C-section, but was in good condition. However, just 26 minutes after Letby came on shift, she called doctors to his incubator.

The doctors noted an odd discolouration on the child's skin, which Mr Johnson said became a "hallmark" of some of the cases in which Letby allegedly injected air into the bloodstream of the victim. Child A was pronounced dead 32 minutes later.

Letby is accused of attempting to kill child B, the twin of child A, on June 9, 2015.

Child B required some resuscitation at birth on June 7 but recovered quickly and stabilised but shortly before midnight, it was noted her blood oxygen levels had fallen and that nasal prongs providing additional oxygen had been dislodged.

Her alarm monitor sounded at 12.30am and she was found to be blue, not breathing, and limp. She was resuscitated by doctors.

Mr Johnson said an expert paediatrician, who reviewed the case, had concluded child B was subjected to “some form of sabotage” and she may have been injected with a dose of air.

Mr Johnson said the two children poisoned with insulin, identified as child F and child L, were two baby boys, both born twins; the first born in summer 2015 and the other born in spring 2016.

Both survived due to the skill of medical staff who appreciated low blood sugar can have natural causes.

He said their twin brothers, child E and child M, were both also allegedly attacked by Letby, by having air injected into the bloodstream. One did not survive.

Mr Johnson said the attacks were varied, with babies on other occasions given too much milk.

The prosecution will resume today (October 11).

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