“I should have been braver"
A doctor whose evidence helped convict Lucy Letby has denied that he made up allegations against the ex-nurse.
Dr Ravi Jayaram, a consultant paediatrician at the Countess of Chester Hospital, was said to have “virtually” caught Letby red-handed, when he found a breathing tube dislodged from a premature baby in February 2016.
At a retrial in July 2024, she was found guilty of the attempted murder of the infant, known as Baby K.
This followed Letby’s conviction of the murder of seven newborns and the attempted murder of six others in August 2023.
Giving evidence at the Thirwall Inquiry, Dr Jarayam admitted he had not told anyone of the incident at the time but insisted that he had not invented the allegations.
He said: “It’s been suggested to me that I just made that up, which is, you know, I refute, it’s nonsense.
“There’s no reason I would.
“It’s been said to me in many different fora, why didn’t you just pick up the phone to the police, or why didn’t you raise it with somebody else, or why didn’t you do anything at all?
“I lie awake thinking about this, there’s a fear because it is such a seemingly outlandish, and unlikely, thing – that someone is causing deliberate harm.
“It’s the fear of not being believed, it’s the fear of ridicule, it’s the fear or accusations of bullying.
“I should have been braver, I should have more courage.”
Dr Jayaram said he had not seen Lucy Letby harming the baby and if it happened in isolation, he would have “probably thought nothing more of it”.
Baby K was born at the Countess of Chester in the early hours of Feb 17, 2016, at 25 weeks. Such an early delivery would usually have been carried out at a tertiary centre such as the Liverpool Women’s Hospital, but there was no time to transfer her mother.
Dr Jayaram was on duty when the baby collapsed about 90 minutes later.
He said Letby had been left “babysitting” the infant after the designated nurse had gone to the delivery suite to update the parents.
He told the hearing: “There has been a narrative that I walked in and caught Letby doing something and that’s incorrect.
“I was sitting outside the room writing the notes. I just felt uncomfortable knowing that Letby was in the room, I was convincing myself I was being completely irrational and ridiculous.
“And so I got up and went in just to make sure everything was fine. I didn’t walk in and see anything happening.
“What I walked in [on] was to find a baby clearly deteriorating. And then when I went to assess Baby K the endotracheal tube was dislodged.”
Usually, a nurse would have flagged a premature baby’s deterioration but Letby did not.
Dr Jayaram added: “Had I walked in with Baby K and witnessed something then that would have been very easy. You know that’s [a] no-brainer.
“And I think we felt or we believed because it was such an outlandish and unlikely possibility that we did need more to raise it.
“I will never know if I’d articulated that concern at that point, would [it] have made a difference.”
Dr Jayaram said he was also concerned that a chest drain valve had been turned off in the case of Baby H, a premature girl born in September 2015.
He said: “Having been called in that night, it struck me ‘it’s Letby again’ and my thinking at the time is, you know, she’s very unlucky, she seems to be associated with all of these.
“In terms of the chest drain valve… it seemed to be in a closed position.
“I can’t say whether that was deliberately closed or not. It wasn’t something that I had even considered at the time.
“I was wondering whether it could just have been accidentally knocked. Now again, in retrospect, it’s less likely.”
“The honest answer is I don’t know.”
In Baby H’s case, the prosecution accepted the baby had received sub-optimal care at the Countess of Chester Hospital.
Butterfly needles were left in her chest for prolonged periods, which may have punctured her lung tissue. There was also criticism of the way chest drains were administered and managed.
In relation to Baby H, Lucy Letby was found not guilty on the first attempted murder charge. The jury could not reach a verdict on the second count.
Peter Skelton KC, representing the parents of some of the children, also questioned why Dr Jayaram had not raised his suspicions about Letby at an inquest into Baby A.
Dr Jayaram said he had suggested to the coroner there was a “potential issue of staffing”, which was an “oblique reference” to Letby.
He said: “I was trying to throw as many breadcrumbs as possible for the coroner to pick up without explicitly saying what my suspicion was.
“I appreciate that this was the wrong judgement. I just didn’t have the courage to say it and I think part of this,
“I guess, was being influenced by the pushback that we were getting that ‘there’s nothing to see here’.”
Mr Skelton said: “You should have told the coroner that a member of staff might have been responsible for the child’s death.”
Dr Jayaram said: “Yeah I should have done that.”
The hearing continues.
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