'Unusual' amount of gas found in baby hours after brother allegedly killed by nurse Lucy Letby
A baby who was in the care of Cheshire Nurse Lucy Letby had an "unusual" amount of gas detected in his system just hours after his brother died, a court heard.
Letby, 33, is alleged to have given fatal doses of air to two baby brothers who died at the Countess of Chester Hospital, one day after the other, in June 2016.
One of the triplet boys, Child O was pronounced dead at 5.47pm on 23 June - just 48 hours after all three were born in good condition.
After Child O's death, his brother Child P was reviewed at the hospitals neo-natal unit by a consultant who ordered an abdominal X-ray.
Manchester Crown Court heard how an X-ray, which took place at 8.09pm, noted "gas filled loops throughout the abdomen".
Letby was the designated nurse for Child O and P on the day shift of 23 June and continued to care for Child P the subsequent day.
Child P collapsed on numerous occasions on 24 June from 9.35am onwards.
He required resuscitation after his heart rate and blood oxygen levels dropped.
However medics, including Letby, were unable to revive the little boy from his final collapse around 3.15pm. He was pronounced dead at 4pm.
A transport ambulance team had arrived at the Countess of Chester at 3pm in preparation for transferring Child P to a specialist hospital.
When he died, his parents "begged" the team doctor to take their surviving triplet instead, which he agreed to.
Giving evidence on Thursday 16 March, Dr Owen Arthurs, professor of radiology at London's Great Ormond Street Hospital, said the 23 June X-ray of Child P was "very similar in appearance" to one taken of Child O.
He said to the court: "This is gas throughout the gut. This degree of gas is quite unusual in a baby like this."
He said potential causes were infection or necrotising enterocolitis (NEC), a common bowel disorder in premature-born babies.
He also said an alternative explanation was the administration of air via a nasogastric tube.
Dr Arthurs came to the same conclusions regarding an X-ray of Child O, captured hours before his death.
"This shows a lots of gas in his stomach, small and large bowel. This is more than what would be expected in a normal baby", he said.
Dr Arthurs agreed with Ben Myers KC, defending, that another possible explanation for Child P's dilation was an "unidentifiable cause".
The court heard how on 24 June, Letby was also assigned the day shift care of the surviving triplet.
Ahead of the shift a doctor, who cannot be identified for legal reasons, messaged Letby: "Are you OK? It's rubbish not to sleep well in the middle of 3 long days. Hope your day goes OK."
Letby replied: "Hmm maybe. I'll be watching them both (Child P and the surviving triplet) like a hawk.
"I'm OK. Just don't want to be here really. Hoping I may get the new admissions."
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.