A doctor has denied he was ‘out of his reach’ and had made a ‘serious error’ in his care of a baby who was allegedly murdered by Hereford nurse Lucy Letby.
Dr David Harkness has dismissed claims he was “far too slow” to order an emergency blood transfusion for the boy while he was being treated at the Countess of Chester Hospital in 2015.
The prosecution at Manchester Crown Court said Child E was the fourth baby murdered in the neonatal unit by Letby in six weeks.
The Crown says Letby. 32, injected a lethal amount of air into Child E’s bloodstream, but the defense suggested to Dr Harkness that the baby had in fact died of “acute loss of blood”.
Dr Harkness said he had diagnosed gastrointestinal bleeding but questioned the cause after noting that a “sudden large volume of fresh blood” had come out of Child E’s feeding tube in the evening of August 3.
Under cross-examination, Ben Myers KC, defending Letby, said: “I’m going to suggest even at this point…the thought of a transfusion is something you should have had in mind.”
Dr Harkness said: ‘If there is any suggestion that his observations were unusual then yes I would have gone straight for an emergency transfusion. At that time, I wouldn’t have done anything different.
Manchester Crown Court heard that 50 minutes after his first note, the then pediatric trainee recorded at 11pm a further loss of ‘blood stained fluid’.
Mr Myers told jurors that at this point Child E had effectively lost up to a quarter of his blood supply and his oxygen levels had rapidly dropped.
He said to the witness, “At this point, it’s an emergency, isn’t it?” »
Dr Harkness replied: “He is still sufficiently stable based on his blood pressure and heart rate, and he was doing well. So things change but it’s stable enough that it’s not a crash situation.
Accusing him of not considering an urgent transfusion, Mr Myers said: “I suggest that was a serious mistake.”
Dr Harkness said: “I disagree.”
Jurors were told that Dr Harkness and a trainee doctor on internship at the hospital were the only doctors working in the neonatal unit and children’s ward during the night shift.
An on-call consultant at a nearby hospital was also available, the court heard.
Dr Harkness denied he should have insisted the consultant visit the unit after the second major blood loss.
Mr Myers said: ‘You were overwhelmed by then, weren’t you?
Dr Harkness, now a pediatric consultant, said: “I disagree…I think it’s wrong and disrespectful to my abilities.”
He said saline replacement fluid was administered and a plan was in place to find out what was going on.
Child E suddenly deteriorated from 11:40 p.m., the court heard, and the consultant – who cannot be identified for legal reasons – was called.
Shortly after arriving, the infant collapsed with no detectable heart rate, as chest compressions began and a blood transfusion took place at 12:50 a.m.
Further blood loss was lost during resuscitation before the child was pronounced dead at 1.40am, the court heard.
Mr. Myers told the witness: “He died of acute blood loss, didn’t he, from what we can see here?”
Dr Harkness replied: “There is no autopsy to confirm or deny that.”
The consultant apologized in court to the parents of child E on Wednesday for not ‘pushing’ an autopsy, after initially concluding he died of a gastrointestinal disorder.
Dr Harkness told Mr Myers that it was “not for me” to insist on a post-mortem examination.
Mr Myers explained to the witness that his reaction since the initial diagnosis of gastric bleeding was “far too slow”.
Dr Harkness replied: “No.”
Mr Myers continued: “Would you admit it, if it was?”
“Yes,” said Dr. Harkness.
The witness had described ‘unusual’ discoloration of the skin on the patient’s abdomen during the previous sudden deterioration.
Dr Harkness said: “There were these weird purple spots on the outside of her belly, so spots, not a single solid purple area.”
He said he only saw something similar during his treatment of Child A, whom Letby is also charged with murdering in June 2015.
Dr Harkness agreed with Mr Myers that hospital staff were discussing what they had seen around that time regarding a number of babies.
Mr Myers said: “I’m going to suggest that you put things together, mix things up and come up with things you haven’t seen.”
“No,” said Dr. Harkness.
Letby, from Hereford, is also accused of attempting to murder Child E’s twin brother, Child F, by poisoning him with insulin.
She denies the murders of seven babies and the attempted murders of 10 others between June 2015 and June 2016.
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. trial for murder Lucy Letby doctor denies be off reach