12:17pm
Dr Evans says this was "another" case, in Child I, receiving air administered.
He thought the nature of the collapse, the crying, the prolonged resuscitation, and the purple and white discolouration, were all symptoms of air embolus.
There was no account of natural disease.
Dr Bohin said the cause of death was air embolus - from the unexpected catastrophic collapse, Child I being unsettled and agitated, the 'extremely unusual' crying meaning Child I was in excruciating pain.
In cross-examination, Dr Bohin was asked if she had a coherent explanation for an air embolus.
Mr Johnson said Dr Bohin's answer, without hesitation, lasted for about 10 minutes.
She was asked about Child I's poor weight gain, and Dr Bohin said that did not make her more likely to have a cardiac arrest [as Child I had].
Prof Arthurs said it was 'unusual' to see the amount of dilation in Child I's stomach. He excluded CPAP belly as a cause. He said it was "reasonable to infer" air administered.
Dr Marnerides said at the time of Child I's death, she had no acute illnesses or abnormalities in the bowel, other than presence of air. The presence of gas had "no pathological cause". He said the collapses were air administered from the NG Tube.
Mr Johnson says Child I's case is a "stark one".
He says Letby made repeated efforts to kill Child I, and falsified notes both for Child I and another baby.
She 'gave herself away' in the event with Ashleigh Hudson.
"Lucy Letby's behaviour in the aftermath [of Child I's death] was bizarre and inappropriate.
She revelled in what she had done."
"Her voyeuristic tendancies caused her to look up [Child I's mother] on Facebook."
"
Having killed her [Child I], she wrote a condolence card. It was still on her phone when it was seized by the police."
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12:23pm
Mr Johnson details the case of Child J.
He says when Letby was giving evidence in this case, she said band 4 nurses [nursery nurses] cannot do intensive care or high dependency babies, or handling of stomas.
Letby said the unit was very busy as an explanation why a band 4 nurse was caring for Child J.
Mr Johnson says the implication of that exchange was to give that Child J received incompetent care, and staffing levels were compromised.
Letby had messaged a colleague on November 19, 2015: "It's shocking really that they are willing to take on the responsibility for things that they have no training or experience etc on. Don't think they appreciate the potential difficulties"
Mr Johnson says the jury will remember witnesses had been cross-examined about nursing guidelines.
He says the part that was never quoted was the bit about stomas.
The care, shown to the court, says special care day nurses can include care of a stoma.
Mr Johnson says that whole evidence "was designed to mislead you".
"It's the same type of beaviour that Lucy Letby engaged in with her colleagues."
12:26pm
Mr Johnson says Child J had no respiratory difficulties and was being bottle fed, and did not need respiratory support, and was in room 4.
Nurse Nicola Dennison said Child J was 'getting ready to go home' with a stoma by November 26, 2015. She wrote in notes that Child J was 'stable'.
Child J's mother left at the end of the day, intending to return at 8am the following day, but received an emergency call overnight.
Letby was in room 3, designated nurse for two babies that night shift. Nicola Dennison was the designated nurse for Child J and one other baby in room 4.
it’s just incomprehensible
Always has to be better and “more experienced” than everyone else. Hope it’s better than Big Sue on the wing when it comes to swinging jaws.
