A DOCTOR had “no clear explanation” why a baby girl allegedly attacked by nurse Lucy Letby suffered a second significant collapse within 24 hours, a court heard.

It is alleged Letby, 32, attempted to murder the youngster, Child H, on two occasions while on nightshift duty at the Countess of Chester Hospital’s neo-natal unit.

The prosecution say she first struck in the early hours of September 26 2015, and then again the following morning after Child H’s designated nurse had temporarily left the intensive care room.

On Monday, registrar Dr Matthew Neame told Manchester Crown Court about his involvement with the second incident and how he was twice summoned by nurses on the shift.

The first emergency crash bleep was received after a “profound” drop in Child H’s blood oxygen levels and heart rate as medics discovered her breathing tube was blocked with secretions, the court heard.

Several hours later at 00.55am on September 27, Child H suffered more profound desaturations while on a ventilator – but this time her breathing tube contained no secretions.

Child H’s heart rate plunged to 40 beats per minute a 1.07am and full resuscitation, including chest compressions and doses of adrenaline, was needed for six minutes before she recovered.

Asked how the second crash call was different, Dr Neame said: “The distinction is the lack of clear explanation for the event at this time and the fact that it has happened again in a relatively short space of time.

“Both those things would have made me more concerned about (Child H’s) condition.”

Dr Neame said he thought Letby was the nurse who he first spoke to upon his arrival to the second crash call.

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Soon after Child H was transferred to Wirral’s Arrowe Park Hospital where she “came on in leaps and bounds”, said her parents, before she was discharged the following month.

In his discharge letter to Arrowe Park, Dr Neame wrote: “Thank you for accepting this baby who has had two significant episodes of bradycardia (low heart rate) requiring resuscitation, adrenaline and CPR in the last 24 hours with no clear precipitating factors.

“Her care has been complicated by the development of respiratory distress syndrome and pneumothoraces (collapsed lung) but the acute episodes with desaturation and bradycardia do not seem to be directly related to the respiratory problems.”

Nurse Shelley Tomlins, Child H’s designated nurse on the nightshift beginning September 26, said she would not have been in the baby’s presence throughout. She said she would have been covered by a colleague while on a break or if she had popped out of the room.

She told the court: “Given that she was unwell, I don’t think we would have left her in her room alone but I can’t be sure.”

Ms Tomlins said she she could offer no explanation why Child H’s blood oxygen levels dropped at 00.55am on September 27.

She told Ben Myers KC, defending, that her recollection of Child H was that she was a “very poorly baby”.

Fellow nurse Christopher Booth, who was on duty on both nightshifts, told Mr Myers that Letby had completed an overtime shift that week.

He said: “That was not unusual for her. She was very conscientious.”

Mr Myers went on: “Was she someone willing to work extra or have shifts changed at short notice?”

“Yes,” replied Mr Booth.

Mr Myers said: “Did you find her to be a hard worker?”

Mr Booth said: “Without doubt, yes.”

Asked if Letby became upset as events involving babies continued, Mr Booth said: “Oh definitely. It was a harrowing time. We were all upset. Without doubt, Lucy as well.”

Letby, originally from Hereford, denies the murders of seven babies and the attempted murders of 10 others between June 2015 and June 2016.

The trial continues on Tuesday.

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