At 8.20pm on June 8, 2015, a twin boy who was being cared for in the neonatal intensive care unit at the Countess of Chester Hospital suddenly stopped breathing.
With his desperate parents looking on, doctors and nurses battled for more than half an hour to resuscitate the tiny infant.
“Please don’t let my baby die,” his tearful mother begged the medical team.
But despite their best efforts, the little boy could not be saved and the heartbreaking decision was taken to stop CPR. He was pronounced dead at 8.58pm.
Everyone on the ward appeared devastated, none more so than Lucy Letby, the 25-year-old staff nurse, who had been in charge of the infant’s care in his final hours.
Taking hand and footprints and a lock of hair from the child, who can only be identified as Baby A, Letby created a memory box for his broken parents.
“I thought it was a nice thing to do,” she would later explain.
Jurors convicted Letby of the murder of Baby A by a majority of 10-1.
While some sick and premature babies do inevitably die, the sudden and unexpected loss of Baby A was a mystery.
Despite being born nine weeks premature, weighing less than four pounds, to a mother who had an auto-immune condition, the little boy had been doing well in the first few hours of his life.
Doctors noted a mottled rash on his skin around the time he collapsed, but a post-mortem examination could find no obvious cause for Baby A’s sudden and unexpected deterioration.
Over the next 12 months, however, this agonising sequence of events would be played out time and time again on the ward, with 17 babies collapsing, nine of whom never recovered.
Medics struggled to understand what was going on. But they noted there was one common denominator in all of the cases – the presence of Letby, the nurse who had done so much to try to comfort the parents of Baby A.
Using a variety of methods including injecting air into their feeding tubes and stomachs, poisoning them with insulin, smothering or deliberately overfeeding them, Letby was eventually accused of murdering seven babies and attempting to murder 10 more.
While police and prosecutors worked out how she was attacking the defenceless infants, there was little clue as to why.
A popular and professional nurse from a loving family, the question of what had motivated this killing spree against the most vulnerable members of society may never be answered.
Baby B
But what is known is that once she started, she found it impossible to stop. Just 27 hours after Baby A died, his twin sister, Baby B, also collapsed on the unit.
While she had been more poorly than her brother at birth, she had been rallying and her collapse was again entirely unexpected.
Her parents, who were still coming to terms with the loss of their baby son, were forced to watch the desperate attempts to resuscitate their surviving child.
Fortunately, the doctors were able to stabilise Baby B and she recovered. But they were once again baffled as to why her deterioration had been so sudden.
As in the previous case, they had noted the presence of an odd rash on the baby’s skin and thought it unusual. But at that stage, nobody suspected Letby had tried to kill the siblings by injecting air into their bodies.
Jurors convicted Letby of the attempted murder of Baby B by a majority of 10-1.
Baby C
Four days later, on June 14, another premature baby suddenly collapsed and died on the ward.
Baby C had been delivered on June 10 at 30 weeks and weighed less than two pounds, with the nurse looking after him describing him as “the smallest baby I have ever seen”.
Despite the odds being against him, he initially did well. But when he was four days old his heart rate and oxygen levels crashed without warning.
The nurse who had been looking after him said the collapse happened when she moved away from the incubator around 11.15pm.
When she returned, she said Letby was standing by the cot.
Doctors tried to resuscitate Baby C, but around midnight it became clear he was not going to pull through and he was pronounced dead.
The post-mortem examination initially put the death down to natural causes, but medical experts later concluded Baby C had died as a result of having air pumped into his stomach, which pushed his diaphragm up and made it impossible for his lungs to inflate.
Jurors convicted Letby of the murder of Baby C by a majority of 10-1.
Baby D
A week went by before Letby struck again, this time attacking a baby girl.
Baby D was the only one of the victims who had not been born prematurely and was in the neonatal unit because she had developed an infection.
She was doing well and was not expected to deteriorate. But on the night of June 21, she collapsed three times and eventually could not be resuscitated.
Baby D’s father later said: “I was never given the impression that my daughter’s condition was life-threatening and it didn’t even cross my mind that she was in danger of dying. When she died, we were just not prepared for it.”
Experts subsequently concluded that Letby had made three attempts on the little girl’s life by injecting air into her bloodstream, eventually succeeding in killing her at the third attempt.
The neonatal unit had now seen three deaths and an unexpected collapse in a fortnight and Dr Stephen Brearey, who was in charge, was so concerned he carried out an informal review, discussing the matter with his colleague, Dr Ravi Jayaram, a consultant paediatrician.
They noted that Letby had been on duty on each occasion but, at that stage, the matter was not taken any further.
Jurors convicted Letby of the murder of Baby D by a majority of 10-1.
Baby E
There were no more attacks in June or July, but on Aug 4, Letby killed one of two identical twin boys, who had been born prematurely.
The mother should have given birth at Liverpool Women’s Hospital, but it was full, so she was admitted to the Countess.
Both boys were in the intensive care section of the ward and on the evening of August 3, their mother discovered Baby E screaming with blood coming from his throat.
Letby was sitting at her workstation close by, apparently ignoring the screaming. She attempted to reassure the mother that everything was fine.
But later that evening, Baby E vomited a large volume of blood, equating to a quarter of all that was in his body. The doctor in charge said he had never seen such significant blood loss in a small baby.
Around 11.40pm, Baby E’s oxygen levels suddenly plummeted and medics found themselves battling to save his life.
Tragically, there was nothing they could do and at 1.40am he was pronounced dead. In what has now been acknowledged as a major mistake, no post-mortem examination was ordered.
Experts later concluded Baby E had been killed as a result of having a breathing tube or some other form of equipment forced down his throat, as well as having air pumped into his stomach.
As the parents struggled to come to terms with the sudden loss of one of their baby twins, Letby finished her shift and went home.
The next day when she returned to work, she tried to kill his brother.
Jurors convicted Letby of the murder of Baby E by a majority of 10-1.
Baby F needed to be resuscitated at birth and had low blood sugar levels, so was put on a nutrient drip to help stabilise him.
This should have resulted in his blood sugar levels rising but inexplicably, they continued to go down. It was only when his feed bag was changed that he started to stabilise.
In an effort to understand what was going on, a sample of Baby F’s blood was analysed. It showed high levels of synthetic insulin, the hormone that reduces blood sugar.
Experts later concluded that somebody on the ward must have deliberately tampered with the feed bags, contaminating them with insulin.
Fortunately, Baby F survived, but it would not be the only time Letby would try to use insulin.
Jurors unanimously convicted Letby of the attempted murder of Baby F.
Doctors were able to resuscitate her but it was later concluded that Letby had tried to kill her by deliberately overfeeding her with milk and injecting air into her stomach.
She was transferred back to Arrowe Park for more specialist care but recovered well enough to return to The Countess, only for Letby to try to finish what she had started.
On September 21, Baby G collapsed twice and stopped breathing. On the second occasion, the monitor that should have alerted the staff to any problems had been switched off.
While doctors were able to resuscitate her and she was eventually discharged, a scan later revealed she had suffered irreversible brain damage.
She is unlikely ever to walk, is visually impaired and needs round-the-clock care.
Jurors found Letby not guilty of one count of attempted murder of Baby G but found her guilty of another two.
The next two attacks were alleged to have taken place just a week later on consecutive nights against Baby H, who had been born six weeks early.
Jurors found her not guilty of one of the attacks and were unable to reach a verdict on the remaining charge.
Baby I
Three days after attempting to kill Baby H, Letby attacked a premature baby girl three times, succeeding in murdering her on the fourth attempt.
The first attack took place on September 30, when Letby was working a day shift. Without warning, Baby I’s stomach swelled up and she began to struggle to breathe.
Doctors managed to stabilise her, but X-rays later showed a huge amount of gas in her stomach and bowels crushing her lungs.
Baby I recovered well and doctors were even talking about discharging her but, in the early hours of Oct 12, Letby made another attempt on her life.
Medics stabilised her again, but just a few hours later there was a third collapse.
“Our daughter seemed to deteriorate whenever we left her alone and predominantly at night,” said her mother.
She was transferred to Arrowe Park, where she quickly recovered and was able to return to the Countess. But on October 22 when Letby was back on a night shift, she attacked Baby I again, finally succeeding in murdering her.
Letby sent a sympathy card to the parents and would later tell one of her colleagues: “It’s always me when it happens. My babies.”
On the day of Baby I’s death, an email was sent to staff expressing concerns about an increase in mortality rates on the unit.
Concerns were also shared with Alison Kelly, who was the director of nursing in October 2015, but she dismissed the idea that a member of staff might be involved as “unlikely”.
Jurors convicted Letby of the murder of Baby I by a majority of 10-1.
Baby J
Just over a month later, Letby was alleged to have resumed her attacks.
Baby J, who had been born at 32 weeks, required bowel surgery after birth, but was doing well. Her parents had been preparing to take her home when she suffered two seizures in quick succession.
Fortunately, Baby J recovered quickly, but it was later alleged that the attack was “consistent with some form of obstruction of her airways, such as smothering”.
The jury was ultimately unable to reach a verdict on this charge and could not determine whether Letby was responsible for the attack.
Over the Christmas holidays, Letby temporarily stopped trying to kill the children in her care, and there was a brief period of calm at the hospital.
Baby L had low blood sugar so was put on a glucose drip. But as in the case of Baby F seven months earlier, Letby used a feed bag that had been contaminated with insulin.
As medics tried to stabilise Baby L, Letby texted her mother: “Is dad betting on the Grand National? If so can he see which are greys and put a bet on for me please x.”
An hour later, she messaged friends about having an “unpacking party” to celebrate moving into her new house.
“Looking forward to a catch-up. Got magnum prosecco and vodka, woop. No disco ball but sure we can manage,” she wrote.
Baby L recovered, but just before 4pm his twin brother collapsed and needed to undergo life-saving CPR led by Dr Jayaram, who again noted a distinctive rash on the infant’s skin.
At 5.25pm, Letby’s mother texted her to tell her that her horse, Rule The World, had won the Grand National.
Half an hour later, Letby messaged a friend: “Work has been sh-te but ... I’ve just won £135 on the Grand National!”
While Baby M survived the attack, he suffered permanent brain damage.
Jurors convicted Letby of the attempted murder of Baby L by a majority of 10-1. They also convicted Letby of the attempted murder of Baby M by a majority of 10-1.
Baby N
In early June, Baby N was born. Because he had haemophilia, was admitted to the neonatal unit.
Around six hours after he was born, Letby came on shift and expressed an interest in his blood condition, texting a friend to say the infant only had a 50 per cent chance of survival.
Around 1am, nurse Chris Booth, who was looking after Baby N, went for a short break. Seven minutes later, while he was away, the child began screaming.
Prosecutors would later allege that Letby was attacking babies because she enjoyed being in the drama of an emergency alongside Dr A.
Baby N made a full recovery and as his parents prepared to leave the Countess with him, Letby hugged the child’s mother and said: “I hope he’s okay.”
The following day, Letby went to Ibiza for a week’s holiday. When she arrived home on June 22, she texted a colleague about her impending return to the neonatal unit.
“Probably be back in with a bang lol,” she said.
The following day, she attacked again.
Jurors convicted Letby of the attempted murder of Baby N by a majority of 10-1. They could not reach a verdict on two other counts of attempted murder.
Baby O and Baby P were two of a set of naturally conceived identical triplets and were in a relatively healthy condition before Letby returned to work at 7.30am on June 23.
After a quiet morning, during which Letby texted a colleague about her holiday and the fact she had a student nurse “glued to her”, Baby O suffered a “remarkable deterioration”.
The medical team managed to temporarily revive him briefly before he later suffered another, fatal collapse.
A post-mortem examination found unclotted blood in Baby O from a liver injury, which led a coroner to conclude his death was due to natural causes.
An independent pathologist, who later reviewed the case, said the boy had suffered an “impact injury” akin to a road traffic collision.
That night, Letby spent four hours talking to Dr A about the death of the baby boy.
Dr Brearey was now so concerned about what was happening on the unit that he decided to raise the matter with hospital managers the next day.
But before he was able to do that, Baby P suddenly deteriorated and died.
The triplet’s parents had now lost two children in less than 24 hours and begged ambulance staff to move the surviving infant to another hospital.
The deaths of the two boys was the “tipping point” for the hospital and four days later the decision was made to remove Letby from front-line nursing duties.
Jurors unanimously convicted Letby of the murder of Baby O. Jurors convicted Letby of the murder of Baby P by a majority of 10-1.
Before she was finally removed and placed in a non-clinical role, another baby died in the unit.
Jurors, however, were unable to reach a verdict on the charge of attempted murder relating to Baby Q.
Even after she was removed from front-line duties, hospital managers repeatedly attempted to have Letby reinstated and the deaths were not referred to the police for another 11 months.
While under suspicion, Letby continued to socialise with her friends, posting pictures of fun nights out with friends and colleagues as if she did not have a care in the world.
She even lodged a formal grievance against the hospital for her removal from the neonatal ward.
But on July 3 2018, just over two years after she was removed from the neonatal unit, Letby was arrested on suspicion of murder.
Taken from her home in Chester in handcuffs, Letby spent hours being questioned by detectives but maintained a cold, detached air, denying everything.
However, rambling notes recovered from her home helped persuade police she was guilty.
One line read: “I am evil I did this,” while another read: “I don’t deserve to live. I killed them on purpose because I am not good enough. I am evil. I did this.”
Letby was rearrested in June 2019 and bailed for a second time while detectives tried to build the evidence against her.
But in November 2020, more than five years after the death of Baby A, Letby was charged with eight murders and 10 attempted murders. One of the murder charges was later dropped from the indictment.