Neonatal nurse Lucy Letby ‘poisoned baby boy by contaminating two intravenous bags with insulin’ 

Neonatal nurse Lucy Letby ‘poisoned baby boy by contaminating two intravenous bags with insulin invisible to the human eye’

  • Lucy Letby, 32, from Hereford is accused of – but denies – murdering seven babies and attempting to murder a further 10 
  • Court heard she poisoned baby by contaminating two bags of intravenous feed 
  • Colleagues tried to discover why Baby F began to collapse of low blood sugars

Neonatal nurse Lucy Letby poisoned a baby boy by contaminating two bags of intravenous feed with insulin that could not be detected by the human eye, a court heard today.

For 17 hours her colleagues at the Countess of Chester Hospital tried desperately to discover why Baby F had begun to collapse as a result of low blood sugar levels and a raised heart rate.

During some of that time Letby, 32, was off-duty and enjoying an evening of salsa dancing with another nursing colleague.

She was periodically swapping WhatsApp messages with a nurse on the night shift, enquiring about Baby F’s health and asking to be given updates.

Neonatal nurse Lucy Letby allegedly poisoned a baby boy by contaminating two bags of intravenous feed with insulin

Neonatal nurse Lucy Letby allegedly poisoned a baby boy by contaminating two bags of intravenous feed with insulin

Letby, originally from Hereford, is on trial accused of murdering seven babies and attempting to murder a further 10 – she denies all the charges.

Today Professor Peter Hindmarsh, an expert paediatric endocrinologist, said he believed Baby F had been poisoned by insulin put into two TPN bags being used to feed him intravenously.

The first of these was a ‘bespoke’ bag specifically drawn up for his individual needs, the second one of the stock bags kept in a locked fridge on the unit but available to any of the nurses on duty.

The alleged contamination continued for 17 hours, with the only brief interruption coming when the first bag was routinely discarded because a longline into the baby had ’tissued’.

The professor of paediatric endocrinology at University College London and consultant in paediatric endocrinology and diabetes at University College London Hospitals, told Manchester Court he had been brought into the investigation by Cheshire Police.

His understanding was that there was a suspicion Baby F had received a large amount of insulin produced synthetically rather than naturally within the body.

Doctors trying to treat the infant at the time were confused by the difficulty they had in raising his blood sugar level, and felt that his symptoms did not match they normally encountered on the unit.

Letby, originally from Hereford, is on trial accused of murdering seven babies and attempting to murder a further 10 - she denies all the charges

Letby, originally from Hereford, is on trial accused of murdering seven babies and attempting to murder a further 10 – she denies all the charges

Texts between Lucy Letby and colleague

The jury was also shown earlier messages between Lucy Letby and a fellow nurse following the death of baby F’s brother, Baby E, at 1.40am on August 4, 2015.

Jennifer Jones-Key, a nursing colleague, contacted her at 7.55pm that evening to ask: ‘Hey, how’s you? X’

Letby: ‘Not so good. We lost E overnight.’

Ms Jones-Key: ‘That’s sad. We’re on a terrible run at the moment. Were you in (Nursery) 1? x’

Letby: ‘Yes, I had him and F’.

Ms Jones-Key: ‘That’s not good. You need a break from it being on your shift’.

Letby: ‘It’s the luck of the drawer (sic), isn’t it unfortunately. Only 3 trained (nurses) so I Iended up having both whereas just had F the other shifts’.

Ms Jones-Key: ‘You seem to be having some very bad luck though.’

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They carried out a blood test and sent it off to a laboratory. When it came back a week later it revealed an abnormally high level of insulin in Baby F’s blood – 4,657 Ua/mL. It had not been prescribed and he should never have received it.

Professor Hindmarsh said he believed the insulin had been administered through a continuous infusion using the bags of fluid available.

He told the court: ‘It would fit nicely with the time course of events when the fluids were discontinued at 10am on August 5. It would also be consistent with the measurements that took place after the TPN stopped at 1855’.

The presence of insulin in the feed bags would not have been visible to the human eye. Nor would there be any noticeable change in the shape or size of the bag.

The sequence of events suggested that both the bespoke bag and the stock bag had been contaminated, and to the same degree, it is alleged. 

Asked about the effects an overdose of insulin would have, he replied: ‘It causes mental confusion. If you’re involved in any cognitive process, such as reading or writing, there will be a deterioration.

‘But it can also lead on to seizures, the death of brain cells, coma, and on occasion death’.

The jurors were shown a chart Professor Hindmarsh had produced from medical notes and his own calculations.

He said it would have taken about 25 minutes for the insulin in the feed bag to have its biggest effect.

However, because the hormone moves so quickly from the body’s circulation the effects would have ended ‘fairly rapidly’.

So by 19.20 on August 5 there would have been almost no exogenous insulin in the baby’s circulation.

Professor Hindmarsh said that to maintain a level of 4,657 you would need an insulin infusion rate of approximately 1.8 units per hour.

Professor Hindmarsh said he believed the insulin had been administered through a continuous infusion using the bags of fluid available (stock image)

Professor Hindmarsh said he believed the insulin had been administered through a continuous infusion using the bags of fluid available (stock image)

Baby F’s blood sugar readings recorded by professor

Professor Hindmarsh’s chart records all of Baby F’s blood sugar readings between 11.32pm on August 4 and 9.17pm on August 5. A reading of ‘above 2.6’ is considered ‘normal’.

The readings were:

5.5 (August 4, 11.32pm)

0.8 (August 5, 1.54am)

2.3 (2.55am)

1.9 (4.02am)

2.9 (5am)

1.7 (8.09am)

1.3 (10am)

1.4 (11.46am)

2.4 (noon)

1.9 (2pm)

1.9 (4pm)

1.9 (6pm)

2.5 (7pm)

4.1 (9.17pm).

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Ben Myers, KC, defending, suggested that aside from the baby vomiting and having a raised heart rate he did not appear to suffer any other physical symptoms. 

Given the high level of insulin, would there not have been ‘more powerful’ physical consequences?

The professor replied: ‘The main effects would be on brain function rather than any peripheral manifestations’.

He added: ‘The physical features of hypoglycaemia would not be easy to pick up in a newborn or premature baby. The first symptoms could and would often be collapse and seizure’.

He believed the glucose infusion has essentially stayed the same ‘throughout the course of this event’.

‘I think it is safe to assume that the glucose rate didn’t change, which would imply that the amount of insulin around would be similar throughout the 17-hour period, allowing for breaks when fluids were discontinued’.

He agreed that the synthetic insulin would have had a distinctive smell.

Letby was still at her salsa session on August 5, 2015, when her on-duty colleague updated her about the infant’s health.

The nurse tells her the infant is ‘a bit more stable’, but that staff are concerned and ‘doing various tests’ to try to identify the cause of his hypoglycaemia.

‘Oh dear,’ writes Letby. ‘Thanks for letting me know’.

She then suggests a possible cause for the baby’s distress. ‘Wonder if he has an endocrine problem,’ she says. ‘Hope they get to the bottom of it’.

A short time later Letby is on her way home and tells her friend she feels better for having gone out. She asks about the parents of E and F, and is told they’re ‘ok’ but tired and have just gone to bed.

Letby responds: ‘Glad they feel able to leave him’.

Her friend replies: ‘Yes, they know we’ll get them So good they trust us’.

The jury was also shown earlier messages between Letby and a fellow nurse following the death of baby F’s brother, Baby E, at 1.40am on August 4, 2015.

Jennifer Jones-Key, a nursing colleague, contacted her at 7.55pm that evening to ask: ‘Hey, how’s you? X’

Letby tells her: ‘Not so good. We lost E overnight’.

Ms Jones-Key: ‘That’s sad. We’re on a terrible run at the moment. Were you in (Nursery) 1? x’

Letby: ‘Yes, I had him and F’.

Her colleague replies: ‘That’s not good. You need a break from it being on your shift’.

The alleged killer responded: ‘It’s the luck of the drawer (sic), isn’t it unfortunately. Only 3 trained (nurses) so I Iended up having both whereas just had F the other shifts’.

Ms Jones-Key responded saying: ‘You seem to be having some very bad luck though.’

The prosecution alleges that Letby carried out two separate attacks on Baby E – once to cause a major internal bleed with an ‘introducer’ and again with a fatal injection of air.

In her conversation with Ms Jones-Key at the time she wrote back: ‘Not a lot you can do really. He had a massive haemorrhage. Could have happened to any baby’.

The trial continues.  

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