Yesterday, pediatric consultant Dr Ravi Jayaram said he “couldn’t explain” the sequence of events that led to one tot’s death.
He said Child A’s decline was very sudden and did not “fit with any disease process that I have seen, learned or read about”. He added: “It didn’t make sense to me.”
He told Manchester Crown Court he and senior colleagues “began to raise concerns” to managers at the Countess of Chester Hospital, Cheshire, about Letby regularly being present when some babies became ill.
Letby, 32, denies murdering seven infants and attempting to murder another 10 at the hospital’s neonatal unit from 2015 to 2016.
Dr Jayaram, who has been on ITV’s This Morning and BBC’s The One Show, said: “At that time we were being told that we shouldn’t be saying such things and not to make a fuss. I didn’t really have any hard evidence but I wish I’d been more courageous at the time.”
Prosecutor Nick Johnson KC told the court earlier that in 2016 Dr Jayaram walked in as Letby allegedly tried to kill Child K, a newborn girl.
He said Dr Jayaram decided to check on Child K after he noticed a “coincidence between the unexplained deaths, serious collapses and the presence of Lucy Letby”.
Mr Johnson added: “We allege she was trying to kill Child K when Dr Jayaram walked in.” In yesterday’s evidence a nurse revealed she thought, “Not again” when a baby – Child B – suddenly collapsed.
The girl’s twin brother – known as Child A – had deteriorated rapidly the previous evening before he died, the court was told.
It is alleged Letby injected air into his bloodstream, shortly after coming on shift in 2015 – just 24 hours after his premature birth. Prosecutors say she used the same method to attack his sister, Child B, on the following night.
The nurse, who cannot be named for legal reasons, said when Child B’s monitor alarm sounded, Letby, the first to go to the cot, called her for help.
Asked about Child B’s appearance, the nurse said: “She looked very ill. She looked very like her brother did the night before.
“Pale, white, with this purple blotchy discolouration. It was all over her body. I just remember thinking, “Not again” – to see his sister with the same appearance.”
A breathing tube was inserted and Child B “started to stabilize quite quickly”, the nurse said.
She added:[Child A’s] Deterioration was very sudden and to an unusual degree. Babies can be very poor quickly, but there is usually some indication that is happening. We had no undue concerns.
“To go from that is very unusual and then [Child B] had been good throughout the evening for me. Then she became ill very quickly. She deteriorated very quickly, and then this discolouration.”
Child B was discharged a month later, the court heard.
Under cross-examination by defense lawyer Ben Myers KC, the nurse said she and Letby had become “good friends” through work and she had acted as Letby’s “mentor”.
Mr Myers asked if Letby, of Hereford, was “highly professional” and “dedicated” to her work. The nurse said: “Yes.”
The trial continues.