Lucy Letby may have killed three more babies and tried to murder another 15, a paediatrician at her trial claimed yesterday.
Dewi Evans, who gave expert evidence against the neo-natal nurse, raised fresh concerns about the deaths of children not part of the prosecution’s case.
He also has suspicions over the cases of five children who survived, including one potentially poisoned with insulin.
And he told the Mail’s Trial of Lucy Letby podcast that he had identified a further ten surviving children who could have been harmed by Letby.
All were likely to have had their breathing tubes tampered with by the killer nurse whose ‘modus operandi changed over time”, he said.
Letby, 33, was convicted last month of murdering seven babies and attempting to murder six more at the Countess of Chester Hospital’s neo-natal unit.
She injected children with air, overfed them milk and assaulted them.
She was jailed for life.
Last week her legal team applied for permission to appeal against the convictions.
Dr Evans said: “Initially, I looked at 32 cases and there are seven of those [which were not part of the trial] that need more scrutiny.
“These babies had illnesses that were life-threatening and three of them died – but we need to look at them to see if they were placed in harm’s way as well. they were poorly so it may be impossible to show beyond reasonable doubt whether they were the victim of inflicted harm.
“But there are seven cases that concern me which we need to look at more thoroughly. I will be liaising with Cheshire Police to bring those cases to their attention.”
Dr Evans said that, following Letby’s arrest in July 2018, he was asked to review the notes of another 48 babies – not included in the trial – and found concerns with as many as 18.
“They go back to 2012, although most date back to June 2014 – 12 months prior to the first fatality,” he said.
“I found several cases that are highly suspicious where an endotracheal tube – placed in a baby’s throat when they need breathing support – had been displaced, had come out.
“These tubes can come out accidentally, but for so many to come out is very, very unusual, especially in what I consider to be a good unit.
“I suspect these tubes were displaced intentionally. Of the 18, there could be up to ten babies who were placed in harm’s way. As far as I know they survived without suffering any long-term harm.”
Dr Evans, who was the prosecution’s main expert and gave evidence on 17 separate occasions over the ten-month trial, added:
“One thing we can be reasonably sure of is that Lucy Letby did not turn up to work one day and decide to inject a baby with air into their bloodstream.
“I think the modus operandi evolved over time and i think that prior to air embolus tube displacement was probably something that she did.”
During Letby’s trial, at Manchester Crown Court, the jury were told she completed a training course on air embolus and how to inject drugs just weeks before she murdered her first victim, Baby A, on June 8, 2015.
He died when air was injected into his bloodstream.
All of the babies reviewed by Dr Evans were born at the Countess, although he said he had heard ‘anecdotally’ concerns about babies with displaced breathing tubes at Liverpool Women’s Hospital – cases that the police were looking into.
Letby did training placements there in 2012 and 2015. Dr Evans said he was also suspicious that at least one other baby, whose notes detailed that he had a high insulin level, may have been poisoned by Letby around November 2015.
This was ‘in the middle’ of the other two insulin cases: Baby F, who was poisoned in August 2015, and Baby L, who had insulin deliberately administered into his drip in April 2016.
Dr Evans described the failure of doctors on the unit to appreciate the significance of blood test results from Baby F as an ‘awful tragedy’.
“If they had acted on that it would have stopped all the other deaths and collapses,” he said.
Three more babies died and another four were harmed by Letby over the following ten months, before she was eventually removed from the ward in June 2016.
Cheshire police are reviewing the medical notes of 4,000 babies admitted to the neonatal units of the Countess of Chester Hospital and Liverpool Women’s Hospital during the ‘footprint’ of Letby’s fiveyear nursing career.
Their investigation, codenamed Operation Hummingbird, is ongoing and they have not ruled out Letby being charged with more crimes.
Following the trial, sources told the Guardian that detectives had identified around 30 other babies, in addition to the 17 who featured in the trial, who may have been harmed by Letby.
They all survived.
Dr Evans urged detectives to look closely at the medical notes of the babies named on 257 nursing handover sheets discovered at Letby’s home following her arrest.
Her trial heard the sheets should have been destroyed in confidential waste at the hospital at the end of each shift.