On the sweltering summer morning when Lucy Letby began giving her evidence at Manchester crown court, the scene outside courtroom seven looked more like the queue for Centre Court at Wimbledon than for a criminal trial over the alleged attempted murder of a newborn baby girl.
Two dozen spectators crowded the doors for a seat in the cramped courtroom where Letby would speak publicly for the first time since she was convicted last year of murdering seven babies and attempting to kill six others.
Unlike the usual band of true crime fans who often attend such cases, the crowd at Letby’s trial were almost unanimous in their view: they considered the woman convicted of being the worst baby killer in modern British history to be innocent.
Many wore yellow butterfly badges similar to one the defendant had worn on her blue nurse’s scrubs. One person was escorted out of the court for disrupting proceedings. Another had his gilet searched for hidden recording devices. One woman said she had travelled a long distance “just to see inside the courtroom”.
Through the middle of this scrum walked two broken, haunted parents. Their daughter, who can be identified only as Baby K, was born 15 weeks premature at the Countess of Chester hospital in north-west England at 2.12am on 17 February 2016. She weighed just 692g and was no bigger than an adult hand.
The parents sat at the back of the public gallery as jurors heard how their daughter had hovered between life and death before they made the agonising decision to stop treatment. Three days of “poking and prodding” had left her tiny frame swollen and bruised.
Wrapped in a blanket, wearing the smallest knitted hat nurses could find, Baby K took her final breaths in the arms of her father shortly after 5am on 20 February 2016. She was three days old.
It was not the prosecution case that Letby, 34, had caused Baby K’s death. She was initially charged with causing the infant’s death, but prosecutors later dropped that charge after deciding there was insufficient evidence.
Instead, she was charged with attempting to murder the infant barely 90 minutes after she was born. Prosecutors said she tampered with the girl’s breathing tube twice in the following hours to give the impression that this minuscule baby, sedated with morphine, was somehow moving the tube herself. Baby K had not yet even been named.
The defendant was said to have been caught “virtually red-handed” when a senior doctor, Dr Ravi Jayaram, walked in on her alone beside Baby K’s incubator doing nothing as the child’s blood oxygen levels fell to life-threatening levels. An alarm that should have been sounding was silent.
Jayaram, a consultant paediatrician, said he walked in on the nurse because he was “very uncomfortable” leaving her alone with babies after he and other senior colleagues had linked her to a number of “unusual incidents”. But this was the first time he had witnessed anything untoward.
Letby was found guilty last year of murdering five babies and attempting to murder three others by the time Baby K arrived on the neonatal unit. She would go on to murder another two infants – triplet brothers – and to try to kill three more before she was removed from frontline nursing in July 2016.
While Letby’s first trial spun on complex areas of medical science, this case rested largely on one question. Who did the jury believe: Jayaram or Letby?
The category A prisoner looked drawn and weary behind the glass-enclosed dock of the courtroom, where she was brought each morning from HMP New Hall in Wakefield, West Yorkshire.
Flanked by three female prison officers, she made darting sideways glances at the public gallery where two of her friends were sitting in the front row. Her parents, John and Susan, had attended every day of her first trial, but stayed away this time.
If Letby felt somewhat defeated, she had every reason. Her barrister, Benjamin Myers KC, had argued that she could not possibly get a fair trial given the notoriety of the case. The judge disagreed.
It was clear that Letby had been shielded in prison from the full blaze of publicity that followed her convictions when, on day five, she became tearful as an ITV News interview with Jayaram was played in court. In the seconds-long clip, the doctor said walking in on Letby with Baby K was “etched in my nightmares for ever”. At this, she welled up, her only flicker of emotion throughout.
In the witness box, Letby restricted her answers to as few words as possible. Most of the prosecutor’s questions were met with “I don’t recall” or “I have no memory of the event”.
Her defence was straightforward: she did not remember any events of that morning. She had no memory of Jayaram walking in on her while Baby K deteriorated, nor of two later incidents when she was placed with the baby by medical records and staff accounts.
Letby’s only memory of Baby K, she said, was that she was so small – born at 25 weeks’ gestation – and it was “unusual” for the Countess to take such babies. The infant was on the neonatal unit for only half a day and Letby was never her designated nurse.
Letby was unable to say why she had searched for the baby’s family on Facebook more than two years later. “I’m not sure. I don’t have any recollection at the time, or now, why I did that,” she told jurors.
“Were you looking for grief?” asked the prosecutor, Nick Johnson KC. “I don’t understand the question,” Letby replied. “The parents, on their Facebook. Were you hoping to find evidence of grief?” he asked. “No,” Letby said.
The jury of six women and six men were told of Letby’s convictions. They were also told that the original jury had been unable to decide whether Letby had tried to kill Baby K, who would now be eight years old and in primary school had she lived.
Jurors were not told, however, that the former nurse had been cleared of two counts of attempted murder. The judge, James Goss KC, ruled that the two acquittals had “no relevance or probative value” in this trial because the evidence in relation to each of the babies was “fact-specific”.
Goss said Letby’s convictions could be used in evidence as they showed “a propensity” to kill. But the acquittals fell into a different category. There would be “no unfairness” to Letby as a result, he said in a ruling that can only now be reported.
Throughout the three-week trial there was an elephant in the courtroom. A 13,000-word New Yorker article, published weeks earlier, had raised questions about the safety of Letby’s convictions and fuelled the campaigns of those who believe she is innocent.
Cheshire constabulary is understood to have reported the publication to the attorney general’s office as a breach of the strict contempt laws that had bound the UK press since last September, when prosecutors decided to seek a retrial.
Although the New Yorker’s US publisher, Advance Publications, had officially blocked the article from view in the UK, it was widely available online. Some branches of WH Smith newsagents, which stocks the same printed copy of the magazine as US stores, even sold copies containing the article.
While arguments about the case raged on social media, Letby’s attempt to overturn her convictions was dealt a significant blow by the court of appeal as it refused her legal challenge after a three-day hearing in April.
Myers, for Letby, had argued that her convictions were unsafe because Goss, the trial judge, had been mistaken in law when he refused four separate applications made by the defence.
It can now be reported that Letby’s legal team said the evidence of the prosecution’s key expert, Dr Dewi Evans, should have been struck out for being “dogmatic and biased”.
Myers also argued that the medical evidence behind Letby’s convictions for fatally injecting air into babies’ bloodstreams, producing what is known as an air embolus, was “very weak” and could not be relied upon.
Dr Shoo Lee, an academic who researched the phenomenon of air embolus in babies in 1989, gave evidence to the court of appeal on behalf of the defence, telling judges that the “only sign” of it was of pink blood vessels “superimposed” on a pink or blue body.
When questioned by Johnson, the prosecutor, Lee accepted that he had not assessed any of Letby’s victims’ medical records or seen any of the eyewitness testimony provided by other medical staff, who noted strange rashes on a number of the murdered babies.
Letby’s third argument was that the judge was wrong to direct the jury that they did not have to be sure of the precise act, or acts, that led to a baby’s collapse or death.
Finally, Myers said the judge failed to properly investigate a complaint made about a juror in the final days of the trial, when they were allegedly overheard saying they had “made up their minds from the start” about Letby’s guilt.
It was later suggested that the complaint may have been made maliciously as the complainant was traced back to a cafe owner who had been in dispute with the juror’s partner over the sale of an iPhone.
The appeal court judges refused Letby’s application to appeal on all grounds, in effect ending her legal challenge in the absence of significant new evidence.
In a 59-page ruling published on Tuesday, the appeal court judges said Goss’s handling of the trial had been “thoughtful, fair, comprehensive and correct”. They ruled that none of the four legal challenges advanced by Letby were “arguable” and that the criteria for the admission of fresh evidence – in the form of two research papers by Lee – had not been met.
In a police building near Chester racecourse, meanwhile, dozens of detectives are sifting through the records of 4,000 babies connected to Letby during her short nursing career. Other investigators are exploring possible corporate manslaughter charges against the hospital.
A public inquiry will begin at Liverpool town hall in September into the hospital’s handling of concerns raised by senior doctors and whether Letby could have been stopped sooner. For the families of the babies who died in her care, the wait for answers goes on.
