Baby allegedly attacked by nurse Lucy Letby 'had clear liquid forced down his throat'

A baby boy allegedly attacked by a nurse had a clear liquid forced down his throat which caused him to vomit, a court has heard.

The Crown alleges Lucy Letby, 33, harmed the youngster in the culmination of a three-day attack spree at the Countess of Chester Hospital after she murdered two triplet brothers.

It is alleged Letby murdered seven babies and attempted to murder 10 others on various dates between June 2015 and June 2016.

Giving evidence on Wednesday, expert medical witness Dr Dewi Evans said he believed water or saline, possibly together with air, was put down Child Q's stomach via a nasogastric tube (NGT).

The trial at Manchester Crown Court has heard the infant vomited clear liquid shortly after 9am on June 25 2016.

His heart rate fell and his blood oxygen levels also plunged before he recovered "relatively rapidly" after he received breathing support from neonatal staff.

Dr Evans told the court that Child Q was "not quite well" from the night before and was apparently unable to tolerate small feeds of milk.

But he said the feeding problem would not explain the "very significant" deterioration.

Dr Evans said: "I think we are dealing with two separate incidents."

Medics later suspected that Child Q may have a bowel disorder common to premature babies, the court heard.

The youngster was transferred to intensive care at Alder Hey Children's Hospital but surgeons there found no further issues and he was returned to the Countess two days later.

Prosecutor Nick Johnson KC asked Dr Evans: "If a significant quantity of clear fluid was vomited, what view did you come to?"

The retired consultant paediatrician said: "There was enough clear fluid injected down into his stomach to make him vomit.

"He was unable to breathe properly because his tummy was full of liquid."

Dr Evans said that "air++" was noted to have been emptied from Child Q's stomach after he received breathing support from a Neopuff face mask but he said "very little" of the latter was taking place.

He went on: "So it could well be as well as having clear fluid down his NGT he had some air injected into his stomach as well."

Dr Evans said he was "certain" that the suspected bowel problem, necrotising enterocolitis (NEC), was not a factor in the vomiting incident.

Ben Myers KC, defending, pointed out to Dr Evans that in three earlier reports he had concluded that the deterioration was due to "inappropriate care" with "a lot of air" given via his NGT.

Mr Myers said: "I am going to suggest that fluid is something you have added at a late stage."

Dr Evans replied: "I think in all these cases I have said in evidence, on a number of occasions, that I had to rely on notes that I have been presented with and the more accurate the information we get the more accurate the opinion is."

Mr Myers said: "What you are focusing on at that point exclusively is air. Now you have reached this point where you have added fluid now to keep the mechanism going, keep the allegation going, rather than reflect the facts?"

Dr Evans said: "No, no, no. You have got it wrong again.

"We are here now and we have heard the evidence from the people who were looking after him.

"So going on about what I wrote in 2017 and 2018 is rather missing the point."

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.