A consultant has told a public inquiry he “should have had more courage” and voiced his concerns about Lucy Letby earlier.
Senior paediatrician Dr Ravi Jayaram caught the 34-year-old former nurse “virtually red-handed” after an incident in a nursery room at the Countess of Chester Hospital’s neonatal unit in February 2016, her trial last year heard.
Letby was later convicted of the attempted murder of Child K by dislodging her breathing tube – but Dr Jayaram did not tell anyone at the hospital, or the police, about the incident at the time.
Giving evidence on Wednesday at the Thirlwall Inquiry into the events surrounding Letby’s crimes, Dr Jayaram said he had been sitting outside the nursery reading medical notes when he realised Letby was alone with Child K and felt “significant discomfort” but also thought he was being “completely irrational and ridiculous”.
He decided to go in “just to make sure everything was fine”, he said.
“There has been a lot of speculation but I didn’t walk in and see anything. What I walked in and saw was a baby clearly deteriorating and when I went to assess Baby K, the ET [endotracheal tube] was dislodged.
“My priority was to resuscitate Baby K, which I did successfully. I will take this with me to my grave. At that point, I thought, ‘how has that happened?'”
Explaining why he said nothing about the incident at the time, Dr Jayaram said: “It is something of a mea culpa. Why didn’t I? I lie awake thinking about this.
“It’s the fear of not being believed. It’s the fear of ridicule. It’s the fear of accusations of bullying.
“I should have been braver and should have had more courage because it was not just an isolated thing. There was already a lot of other information.”
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Dr Jayaram said he first became aware that Letby could be causing “inadvertent or even deliberate harm” to infants when he returned from leave after the death of a baby girl, Child I, in October 2015.
He recalled conversations in corridors with fellow consultants about the repeated associated presence of Letby and sudden and unexplained deaths on the unit.
Despite an external review, Letby was only moved from the neonatal unit to clerical duties in July 2016 after the consultants expressed concerns to the hospital’s executive team.
Hospital bosses then opted to carry out several reviews into the increased mortality but did not call Cheshire Police to investigate until May 2017.
Letby, from Hereford, is serving 15 whole-life orders after she was convicted at Manchester Crown Court of murdering seven infants and attempting to murder seven others, with two attempts on one of her victims, between June 2015 and June 2016.
The inquiry, sitting at Liverpool Town Hall, is expected to sit until early 2025, with findings published by late autumn of that year.
