UK - Lucy Letby Trial - Media, Maps & Timeline *NO DISCUSSION*

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Prosecution evidence, March 15th 2023, Day 72 -


Triplet O

Unnamed Doctor

[...] a doctor, who cannot be named for legal reasons, [...] told the court that he noticed Child O's "skin looked unusual" and "mottled" on the afternoon of 23 June.

Dr Dewi Evans, Prosecution Expert Witness

[...] Medical expert Dr Dewi Evans told the court Child O's death was a result of an intravenous air injection and trauma to his liver, which caused an internal bleed.

[...]

Dr Evans ruled out CPR being a cause for the liver bleed, saying that the chest compressions needed by Child O on 23 June were "carried out by experienced doctors" and "doesn't get near the liver".

[...]

Dr Evans said the rash observed was a signal the boy had been injected with air and noted the similarities between this baby's collapse and the collapse of the second child in this case, Child B, in June 2015.

[...]

"Nothing about a small discoloured rash on the chest wall matches any description in the literature of air embolus, does it?", the lawyer said.
Dr Evans said it was not just the rash that brought him to the conclusion of air embolus, but also the repeated collapses and the fact resuscitation was unsuccessful.

[...]

Lucy Letby Police Interviews - Re. Facebook search on anniversary of Baby O's death


[...] when asked why by police she "could not explain why she would be doing it".

Lucy Letby: Baby triplet died after trauma to liver, jury told

Nurse Lucy Letby is accused of killing the baby triplet after returning from a holiday in Ibiza.

www.bbc.co.uk

 

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Child O

Dr Dewi Evans, Prosecution Expert witness

Dr Evans said that inflicted trauma to the liver took place at some point and an amount of air was put down the infant’s nasogastric tube which caused vomiting and swelling to his stomach.

Mr Myers said: “I suggest that vigorous chest compressions can cause or are capable of causing internal injuries to the liver.”

Dr Evans replied: “I have never seen it.”

Dr Sandie Bohin, Prosecution Expert Witness

Fellow expert witness, neonatologist Dr Sandie Bohin, said she too had never seen liver damage from CPR.

She told the court she concluded that injections of air “with no innocent cause” were responsible for Child O’s “unexpected” deterioration.

Dr Bohin said the small discoloured mark observed on Child O’s right chest wall was more probably due to an injection of air rather than liver trauma

Baby allegedly murdered by nurse Lucy Letby was injected with air, court told

Expert witness Dr Dewi Evans said that he believed the child was the victim of an ‘air embolus’ – in which gas bubbles block blood supply.

www.independent.co.uk

 

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"Dr Evans [...] invited police to ask an expert pathologist to view the available evidence 'and to ask whether, in the pathologist's view, it was likely to be the result of trauma'. [...]

Dr Sandie Bohin, [...] added: 'Certainly the medical and nursing personnel are sure they've not seen them before or since, but have said that they were graphic'.

When interviewed about the alleged murder Letby told detectives that mottled skin was seen regularly in neonates, though not 'to this extent'.

She said she remembered the infant's abdomen repeatedly swelling up. His death was 'unexpected: and it had left her feeling 'shocked and upset'.

Letby agreed she had been caring for Baby O alone at the time a registrar – the one she was frequently messaging on Facebook at the time – had gone to speak to his parents.

When asked who had harmed the baby, she replied: 'It wasn't me'.

She recalled messaging a nursing colleague to suggest a cause of death as sepsis or NEC, a serious inflammation of the gut. She thought that at the time because 'it was a discussion they had all had' on the unit."

Baby killed with injection of air by nurse Letby, medical expert says

Dewi Evans, a leading paediatrician called in by the prosecution, said he could see no evidence that the collapse of Baby O could have been accidental.

www.dailymail.co.uk

 

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Prosecution evidence, March 16th 2023, Day 73 -


Triplets O and P

PA news reports only

snipped for copyright

Professor Owen Arthurs, Great Ormond Street Hospital, Prosecution Expert Witness

[...]

Dr Arthurs came to the same conclusions regarding an X-ray of Child O, captured hours before his death.

He said: “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.”

Dr Arthurs agreed with Ben Myers KC, defending, that another possible explanation for Child P’s dilation was an “unidentifiable cause”.

[...]

Lucy Letby Text Messages - Child P

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.”

ITV https://www.itv.com/news/granada/20...f-gas-found-in-baby-allegedly-killed-by-nurse
Chester Standard Lucy Letby trial: ‘Unusual’ amount of gas detected in baby

 

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Giving evidence, Dr Owen Arthurs, professor of radiology at London's Great Ormond Street Hospital, said the X-ray of Child P was "very similar in appearance" to one taken of Child O.
He told 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.
An alternative explanation was the administration of air via a nasogastric tube, he said.

Lucy Letby: Unusual amount of gas in baby, trial hears

Nurse Lucy Letby is accused of administering fatal doses of air to two baby brothers.

www.bbc.co.uk

 

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Mel Barham

@MelBarhamITV
·
7h

Expert Dr Arthurs says in case of Baby O, an X-ray before his death shows more than expected gas in his bowel. “Gut abnormality cd cause this, alternative is gas administered through nasal gastric tube”

Mel Barham

@MelBarhamITV
·
4h

Jury shown a Facebook message from Lucy Letby to a dr colleague where she says “I might see if she (a student nurse) can work with someone else as don’t feel I’m in frame of mind to support her properly and paperwork to finish off”

 

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Prosecution evidence, March 20th 2023, Day 74 -


Triplet Baby P

Lucy Letby: Nurse's messages after baby deaths read to jury

Nurse Lucy Letby is accused of administering fatal doses of air to two baby brothers.

www.bbc.co.uk

Lucy Letby 'fainted after she and fellow medics could not revive baby'

NURSE Lucy Letby fainted at work after she and fellow medics could not revive a baby boy, her murder trial has heard.

www.chesterstandard.co.uk

[...]

He later asked: “What are u doing? I can’t concentrate on anything.”

Letby said: “Wanting to (cry emoji).”

The doctor said: “Did in car. Must have looked a right mess when I got in.”

Letby replied: “I keep thinking of them (Child O and Child P) both in the cot together. So peaceful yet beyond words how awful it is.

“So sad. The family thanked me when I took (Child P) in dressed. And I know age doesn’t make it any easier/harder but such a lot to go through at a young age.”

The doctor said: “I don’t know how it would be possible to get over losing a child, let alone 2.”

Letby responded with a crying emoji and wrote: “Think my head may explode…”

 

[Tortoise]

Dan O'Donoghue
@MrDanDonoghue
·
6h

An hour after Child P's death, Ms Letby text a colleague to say 'Life is too sad', 'lost another and third going to women’s' Her colleague responded: 'Omfg!! what the hell is going on! Don’t know what to say…will have a big hug for you when I get there'

Dan O'Donoghue
@MrDanDonoghue
·
6h

In a message to a doctor, who cannot be named for legal reasons, later that night Ms Letby said the two boys - who were part of a set of triplets - looked 'beautiful' together, but added that it was 'beyond words how awful it is'

Dan O'Donoghue
@MrDanDonoghue
·
3h

The doctor tells the court that on the afternoon of 24 June he fitted a chest drain for Child P as he was suffering a suspected pneumothorax

Dan O'Donoghue

@MrDanDonoghue
·
3h

The court has just heard how Child P went into cardiac arrest at 15:14, the doctor recalls how chest compressions were commenced along with breathing support and four doses of adrenaline administered

Dan O'Donoghue

@MrDanDonoghue
·
3h

After 45mins the decision was taken, in conjunction with his family, to stop resuscitation. Prosecutor Simon Driver asks the doctor: 'Can you understand the course his life took over those few days (since his birth)' 'No', the medic responds

 

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The Trial of Lucy Letby, Episode 23: The Triplets, Part One: Baby O, “Everything seemed to be going well for the triplets. It was never explained to us how this sudden downturn happened.”

www.mailplus.co.uk

March 20, 2023

The Trial of Lucy Letby, Episode 23: The Triplets, Part One: Baby O, “Everything seemed to be going well for the triplets. It was never explained to us how this sudden downturn happened.”​

In this episode Caroline and Liz examine what the prosecution say happened to Baby O, the first of two identical triplets allegedly murdered by Lucy Letby at the end of June 2016.

 

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Prosecution evidence, March 21st 2023, Day 75 - PA News report only

"Nurse Lucy Letby found caring for less sick infants in hospital was “boring”, her murder trial was told.

She is also said to have argued with a senior colleague when asked to work in an ‘outside nursery’ where babies were treated in preparation for going home. [...]

“She said it was boring and she didn’t want to feed babies. She wanted to be in the intensive care”. [...]

“It was more that we were worried for Lucy’s mental heath because it can be upsetting, emotional and sometimes exhausting as well at the end of a shift, if you’re constantly put in that stressed situation all the time."

snipped for copyright

Nurse Lucy Letby found caring for less poorly infants ‘boring’, trial hears

Nurse Lucy Letby found caring for less sick infants in hospital was “boring”, her murder trial was told.

www.belfasttelegraph.co.uk

Nurse Lucy Letby found caring for less poorly infants ‘boring’, trial hears

Letby is accused of murdering seven babies and attempting to murder 10 others at the Countess of Chester Hospital’s neo-natal unit.

www.shropshirestar.com

 

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"The consultant's harrowing account emerged when she was asked if any conversations that day had stuck in her mind.

She recalled going through to Nursery 1 to Nursery 2 shortly after receiving an optimistic gas reading that suggested Baby P might recover.

'A few nurses were there, including Staff Nurse Lucy Letby. I remember when you face one wall there's a clock in front. It was just going past 12. I was desperately wanting this baby to get better and feeling totally out of my depth.

'I just said, almost thinking out loud: "Ok, the transport team are going to be here". Staff Nurse Letby said "He's not leaving here alive, is he?"

'I found it absolutely shocking at the time. I turned round and said "Don't say that – he's had a good gas". In my mind he was very much alive. I said that and left the room.'

[...]


'Staff Nurse Letby was against the door and she was very animated, saying to the parents "Do you want me to make a memory box, like I did for (Baby) O?"

'I remember thinking "This is not a new baby, this is a dead baby. Why are you so excited about this?"

'That's how she was. Saying "Do you want me to make a memory box" like it was a bounty pack. I found that very inappropriate. It was the way it was said, not what was said.'

[...]

She said although she did not go to the police, she raised it with colleagues, including the clinical lead and the neo-natal unit manager, at their regular Monday meeting three days later. The court heard Letby was removed from the ward soon afterwards."

Lucy Letby: Doctor nearly begged for triplet to go to another hospital

The neonatal nurse (pictured), 33, is accused of administering fatal doses of air to both infants in successive days while working at the Countess of Chester Hospital in June 2016.

www.dailymail.co.uk

 

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Ben Myers KC, defending, asked her: “Is that because you thought the Countess of Chester’s neonatal unit was unable to cope or are you suggesting that Lucy Letby poses such a danger to small babies?”

The doctor replied: “It definitely was not because the Countess of Chester was not able to cope with a baby like (the surviving triplet). They were completely normal triplets who were expected to run a healthy course.

“I was extremely worried. I couldn’t understand what had gone on in the last two days. In my mind what had gone on was not normal. [...]

Mr Myers asked: “Because of the danger posed by nurse Letby?”

“Yes,” she said.

The barrister went on: “Did you call the police?”

“No,” said the consultant.

[...]

She explained that at the time she thought the “correct thing” to do was to raise the matter with her colleagues a few days later, and with the neonatal ward manager.

Mr Myers accused her of “dramatising for the benefit of the jury and these proceedings”.

The doctor replied: “No, that’s honestly how I felt at the time. I have no intention of dramatising events. It’s tragic enough as it is.”

[...]

The doctor said: “Other junior doctors, some consultant colleagues. But again not in a way that would make you think anything untoward in the way of harm being done was going on.”

Doctor ‘shocked’ as Lucy Letby asked if baby was ‘leaving here alive’

A DOCTOR was “shocked” when Lucy Letby asked whether a baby was “leaving here alive”, the nurse’s murder trial heard.

www.herefordtimes.com

 

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Prosecution evidence, March 22nd 2023, Day 76 - Tweets

https://twitter.com/MrDanDonoghue

Child P

Nurse Lucy Letby's murder trial continues at Manchester Crown Court this morning. We'll be hearing evidence in relation to the death of Child P, who the Crown say Ms Letby murdered in June 2016 by injecting a dose of air. She denies all charges

Jurors yesterday heard from a consultant who told the court that Ms Letby had asked her whether Child P was “leaving here alive” while they were waiting for a planned transfer of the infant to another hospital

Recalling the conversation the consultant told the court: “I just said, the transport team are going to be here soon, almost thinking out loud. Lucy Letby then said ‘he is not leaving here alive, is he?’, which I found absolutely shocking at the time.”

Ms Letby's defence lawyer, Ben Myers KC accused her of “dramatising for the benefit of the jury and these proceedings”

When proceedings resume, at around 10.30am, we'll be hearing from more senior consultants - who worked with Ms Letby and a number of medical experts, who'll be giving their view on the cause of death of Child P

Consultant Dr John Gibbs

Consultant Dr John Gibbs is first in the witness box. He is recalling the events immediately after Child O's (Child P's brother) death on June 23 2016

Dr Gibbs tells the court that when he saw Child O, in the moments before his death, he remembered 'feeling uncomfortable and thought oh no, not another one' …

He said he had become 'increasingly concerned at the accumulating number of unusual, unexpected and inexplicable collapses that had been happening on the neonatal unit and that staff nurse Letby had been involved in all of them'

Dr Gibbs tells the court that after Child O's death, his brother Child P was started on antibiotics and sent for an abdominal X-ray as a precaution

Dr Gibbs said that Child P was a 'well baby' on 23 June. He said he was 'extremely concerned' to learn of Child P's death the following day, he said he 'would not have expected that at all'

Dr Gibbs tells the court that the death of the brothers was a 'tipping point for realising something very abnormal and wrong was happening on our neonatal unit'

Cross-Examination

Ben Myers KC puts it to the medic that if he had a genuine concern, he himself would have taken action - Dr Gibbs says he was aware his colleague Dr Stephen Brearey had raised concerns with nursing management and senior managers at the hospital

Mr Myers repeatedly put it to Dr Gibbs that if he had concerns he would have taken action. Dr Gibbs repeated that he knew it had been raised by colleagues with management. He said the senior consultants had openly discussed 'the one common factor' in the baby deaths

He said it was noted that Ms Lebty had been present on the unit or caring for the babies when they had collapsed in unusual circumstances. Mr Myers asks why it hadn't been reported to the police, Dr Gibbs said it was 'difficult' as they didn't have 'the full picture'

Eventually, Dr Gibbs said that consultants insisted that Ms Letby be removed from the unit. He tells the court that management pushed for her to return a month later - they said only if CCTV is installed in each unit

He said the 'TV cameras never came and neither did nurse Letby'

Dr Gibbs said 'over the next 11months we had to resolutely resist attempts by management to have staff nurse Letby back on the unit'

 

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Prosecution evidence, March 22nd 2023, Day 76 - Tweets

https://twitter.com/MrDanDonoghue

Child P

Dr Stephen Brearey

Dr Stephen Brearey is now giving evidence about the death of Child P.

Dr Brearey said he carried out a review of the case, that highlighted 'some minor deficiencies in care but none of which would have effected the outcome of (Child P)'

The medic said the events of 24 June were 'horrific' and that they would have 'traumatised' even the most experienced members of staff

He said he would expect 99% of babies born at 33week gestation on fourth day of life to survive

Dr Brearey starts to make a broader point about the times at which the deaths had occurred in 2015 and 2016. Mr Myers raises objections, judge says broader conclusions can be made elsewhere in other means

 

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Prosecution evidence, March 22nd 2023, Day 76 - Tweets

https://twitter.com/MrDanDonoghue

Child P

Dr Oliver Rackham, from Arrowe Park Hospital (transport team)

We're now back after a short break for lunch. Dr Oliver Rackham is now in the witness box. He was part of the transport team from Arrowe Park Hospital (he was overseeing the transport of Child P to the hospital before his death)

Dr Rackham was on the neonatal transport team responsible (called Connect) in June 2016. He remembers being given a briefing on 24 June about Child P (he had suffered a number of desats that morning)

The medic tells the court that soon after he arrived at the Countess of Chester, at around 3pm, to transport Child P he collapsed and needed resuscitation. During the course of that resus he received seven doses of adrenaline - all to no effect

Dr Rackham said the medics 'had no explanation for why' Child P collapsed. Asked, with his experience, if he could give any reason for Child P's collapse, he said 'there was no obvious cause, it didn't fit with any obvious reason'

The medic said following Child P's death, there was a debrief on the unit. He said it was a chance for staff who work on resuscitation to 'make sure' that there was nothing missed. He said: 'We felt we had carried out resus well and in accordance with all appropriate guidelines'

Cross-Examination

Ben Myers KC has just invited Dr Rackham to give his view on adrenaline charts for Child P from that day. They show he received 16 bolus injections of adrenaline over the course of the day and was also given a slow infusion of the drug

From the numbers on the slow infusion chart, Mr Myers says this is 'significantly' higher than the dose that would be ideal - the doctor, with some caution, agrees

Mr Myers asks him to spell out what an excessive amount of adrenaline could do to a neonate - he says that it can cause increased heart rate, blood pressure and have an adverse effect on lactic acidosis

Judge's Question

The judge seeks some clarification from the witness. He says that if Child P had been given excessive adrenaline, you would expect to see the effect within 10/15mins

 

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Prosecution evidence, March 22nd 2023, Day 76 - Tweets

https://twitter.com/MrDanDonoghue

Child P

Dr Dewi Evans, Prosecution Medical Expert Witness

Medical expert Dr Dewi Evans is now in the witness box, he was asked to review the baby deaths by Cheshire Police in 2017

Dr Evans said he was 'at a loss to explain how this baby had collapsed'.

He noted 'a lot of gas' in Child P's bowel from the evening before his death, he said it 'begs the question whether excess gas in the abdomen 8pm on night before, was the result of air being injected down his NG tube'

Dr Evans will be cross examined tomorrow. Wrap up of today’s evidence

Doctors resisted nurse's frontline return - trial - BBC News

Senior doctors requested the removal of nurse Lucy Letby from their neonatal unit, her trial hears.

www.bbc.co.uk

 

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"Ben Myers KC, defending, put it to Dr Gibbs that if he had sufficient concern, he himself would have raised the issue with management or the police.

Dr Gibbs said, as consultants, they "work together" and he knew a colleague had already reported the matter.

But he went on to say that he and his colleagues did not have "the full picture" and that they knew only that babies had been dying and Ms Letby's presence was a "common factor"."

10%

Doctors resisted nurse's frontline return - trial - BBC News

Senior doctors requested the removal of nurse Lucy Letby from their neonatal unit, her trial hears.

www.bbc.co.uk

 

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"He [Dr Gibbs] told the court: “We said that should only happen if CCTV was put in each room in the unit.

“The CCTV didn’t come and neither did staff nurse Letby.”

Dr Gibbs, now retired, went on: “In the 11 months before the police got involved, after we raised concerns about the deaths of (Child O and Child P), senior management were extremely reluctant to involve the police to discuss what had happened because we had to keep insisting the police be involved.” [...]

Ben Myers KC, defending, said: “The reality is, as we stand here now, you are heavily influenced by a bias against nurse Letby that applies to all of you.”

Dr Gibbs replied: “I was most heavily influenced by what was happening to babies on the unit… there was only one common factor.” [...]

Jurors were told Letby submitted a formal grievance to management after she was removed from the unit."

10%

Senior doctors wanted CCTV if Lucy Letby returned to neonatal unit

SENIOR doctors demanded the installation of CCTV cameras at a hospital unit if Lucy Letby was allowed to return to nursing duties, her murder trial…

www.chesterstandard.co.uk

 

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[...]

"He told Ben Myers KC, defending, the collapses were unique events 'that I'd never seen before in my career'.

Dr Gibbs continued: 'Medicine could never be an exact science and there were occasions when doctors were unable to find an explanation for a patient's demise.

'But this was happening again and again on our unit and that can't just be coincidence or bad luck. There had to be a cause.

[...]

'Over the next 11 months we had to resolutely resist repeated attempts by management to have Staff Nurse Letby come back to the unit.'

[...]

Dr Brearey told the jury: 'What struck me was the horrific nature of the whole day…I could see the trauma on the faces of the staff involved. The events of that day struck me as being very exceptional.'

He said a baby of 33 weeks' gestation would normally have higher than a 99 per cent chance of survival at birth. 'This was a 33-week gestation baby on Day 4 of life and he'd been very well'.

Dr Brearey had 'clearly' been aware of the association with Letby, and he recalled how Baby P's collapse had occurred near the start of a day shift. This had also been the case in the death of Baby O.

Questioned by Philip Astbury, prosecuting, he went on to point out that the collapses of Baby N and of a set of twins in the case, Baby L and Baby M also happened during day shifts.

At this point Mr Myers rose to say he had 'identified the fact that this going on to what Dr Brearey wants to say rather than simply answering the question'."


10%

Hospital bosses spent 11 months reinstating Lucy Letby, trial hears

Letby, 33, is accused of murdering seven babies and attempting to murder 10 others at the Countess of Chester Hospital's neo-natal unit over the course of a year from June 2015 to June 2016.

www.dailymail.co.uk

 

[Tortoise]

Prosecution evidence, March 23rd 2023, Day 77 - Chester Standard Live Updates LIVE: Lucy Letby trial, Thursday, March 23

Child P

Dr Dewi Evans, Prosecution Medical Expert Witness


Cross-Examination


10:34am

The trial has now resumed.
Benjamin Myers KC is cross-examining medical expert Dr Dewi Evans, who has written reports on all babies involved in the trial.
The cross-examination today is focusing on Child P, one of two triplets who died at the Countess of Chester Hospital.

10:40am

In his reports, Dr Evans suggested the cause of death for Child P was complications from his pneumothorax. He was, however, suspicious of the large volume of air in the stomach and intestines evident on an x-ray.
In his subsequent reports Dr Evans concluded that excess air in the stomach could have “splinted” the baby's diaphragm compromising his breathing.
Mr Myers is first asking about the efforts to save Child P's brother Child O, about damage to the liver. Mr Myers asks if this could come as a result of chest compressions. Dr Evans says if the compressions are done properly, this would not be the case.

10:42am

A video is shown to the court showing the correct procedure on providing chest compressions to an infant.
Mr Myers again asks if it is possible for damage to be caused to the liver by several minutes of 'vigorous' chest compressions. Dr Evans says he has never seen it in his experience.

10:47am

The questions now move on to Child P.
Mr Myers confirms what Dr Evans had written for his three reports concerning Child P, involving complications to the pnuemothorax.
Dr Evans said his view was that he could not explain, at the time of the first report, any other cause for why resuscitation was not successful.

10:48am

Dr Evans confirms he could come up with no 'natural cause' for Child P's death.

10:54am

Mr Myers asks about the 'splinting' of the diaphragm Dr Evans had written about in his report for Child P.
He says in a following report, 'it is necessary to scrutinise the night care from June 23/24'.
Dr Evans said it was the 'option at the time'. He says there was excess air in the x-ray from the night before which destabilised the baby, and meant he was unable to take feeds properly.
He says in light of evidence given by local staff over the past few days, additional air was given to Child P during the morning of June 24 which splintered the diaphragm and caused the collapse.
He says there were two events - excess given prior to the x-ray, which destabiised the baby, and further air into the stomach on the morning of June 24.
He says that is a "more accurate way of explaining the events".

10:58am

Dr Evans says the most recent of his reports is from 2019, and he has since had a far better understanding of the clinical sequence of events as a result of the trial in 2023.
He said he was "more concerned" from his evidence at the time about the night care, when Child P was not taking feeds and had a bradycardiac event.
He adds he does not believe Child P would have collapsed without an additional administration of air in the morning.
Mr Myers says Dr Evans has "shunted" the sequence to the point where Lucy Letby was on duty for that day shift on June 24. Dr Evans denies this, saying if he was wanting to put Letby in the frame, he would have included events from the June 23 day shift, when Letby was also on duty.

11:00am

Dr Evans says an "extra dollop" of air would have been administered just before 9.40am on June 24.
He says Child P could have been suffering the consequences of an administration of air from the previous night by the following morning, but that would have been insufficient to cause a collapse, not without a further administration of air.

11:01am

Mr Myers says Dr Evans is "coming up with ideas and theories" rather than relying on the medical evidence available. Dr Evans says that is "incorrect".
Mr Myers says Dr Evans has "invented an extra dollop of air".
Dr Evans says he is satisfied, from a clinical perspective, about the additional administration of air on the morning of June 24.
He says it is not a "guess" but a "clinical assessment".

11:08am

A blood gas result for Child P is shown to the court from June 23, showing 'normal gas readings'.
Dr Evans says an administration of air would not necessarily lead to a baby "crashing". It would lead to them not tolerating milk.
Observations for Child P are shown for the night of June 23.
Dr Evans says there is more to a baby than a pair of lungs, there is also the stomach and intestines. The 'first administration of air' did not affect the breathing, he tells the court, but led to Child P being unable to feed. The 'second administration of air' the following morning caused splinting of the diaphragm, he says.

11:16am

Mr Myers repeats that Dr Evans has 'invented a theory' of a dollop of air to get it 'over the line'.
Dr Evans denies this.

11:19am

That concludes Dr Evans's evidence for Child P.