A nurse accused of murdering premature babies 'cooked' medical notes to try and shift blame and cover her tracks, a court heard today.
Lucy Letby, 33, allegedly faked the time a baby girl collapsed to link it to a milk feed given by a colleague.
She also deliberately altered the tot's temperature on her observation chart to make it look like she was becoming poorly before she stopped breathing, it is claimed.
Letby, of Hereford, denies the murder of seven babies and attempted murder of ten others in the neonatal unit of the Countess of Chester Hospital, in Chester, between June 2015 and June 2016.
Nick Johnson KC, prosecuting, questioned Letby for a fourth day at Manchester Crown Court about two allegations of attempted murder against the very premature infant, known as Baby G.
Lucy Letby, 33, who is accused of murdering premature babies, alledgedly 'cooked' medical notes to try and shift blame and cover her tracks. She's seen being cross examined in a court sketch last week
The child had been born weighing just over a 1lb at just 23 weeks gestation, in May 2015.
Letby is charged with attacking her three times on two significant milestones in her life - her 100th day and her due date a fortnight later.
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The court heard the child survived but suffered serious brain damage and will need round the clock care for life.
The first attack allegedly took place in the early hours of September 7, 2015 while the nurse who was looking after Baby G - Letby's best friend who cannot be named for legal reasons - was on a break.
The nurse fed Baby G 45ml of milk around 2am before, the prosecution say, Letby forced more milk and air down her nasal feeding tube, causing her to collapse sometime later.
According to a note made by Letby, she and another nurse, Ailsa Simpson, went to help Baby G after hearing a loud retching noise and finding her vomiting violently from her mouth and nose at around 2.15am.
But Mr Johnson said other notes made by Dr Alison Ventress, who was crash called to help, indicate the collapse actually took place 'closer to 2.30am'.
'You have deliberately put the time of the event forward to 2.15am,' Mr Johnson said.
'No, I disagree,' Letby replied.
'The reason you've done this is so there is a more obvious link to your best friend feeding the child and the event, because you wanted to create the impression that the two events were linked, whereas in fact the reason Baby G collapsed is that you deliberately overfed her.'
Letby said: 'That's not true.'
'You did it by putting milk into a syringe and by using a plunger to force air and milk into her,' the barrister said.
'No that's not true,' she repeated.
Letby denies the murders of seven babies and the attempted murders of ten others in the neonatal unit between June 2015 and June 2016
Instead Letby claimed air later drawn out of the baby's tummy was there because she had received oxygen via a mask to help her recover.
Letby said it was 'possible' that her friend had mistakenly overfed Baby G, but later conceded it was 'not a realistic possibility'.
Later that evening, after she had finished her shift, Letby returned to the hospital. She claimed she went back to 'sign some documentation.' But Mr Johnson said: 'You went to visit Baby G, didn't you? Were you looking for an opportunity to finish her off?
'No,' Letby replied.
A fortnight later, on September 21 - the date Baby G should have been born if she hadn't come early - Letby allegedly attacked her twice again.
She is accused of injecting her with air and overfeeding her at 9.15am and sabotaging her care at around 3.30pm, on the same shift.
Mr Johnson suggested that, after Baby G vomited and collapsed at around 10.20am, Letby went back and altered her observation chart to make it appear like her temperature was falling in the hours before.
'Did you go back after the event and cook the chart to make it look like Baby G was declining before she vomited?' he asked Letby.
She replied: 'No...I've not mis-documented anything.'
Today Letby also claimed 'raw sewage' was often spilling out of sinks onto the floor in the neo-natal unit's intensive care room and they frequently had 'plumbing issues.'
Sheclaimed that plumbing issues meant the intensive care unit for babies at the Countess of Chester Hospital 'was not a safe working environment'.
She said effluent would sometimes come out of the sinks and spill on to the floor in one of the nurseries, she told Manchester Crown Court.
She is said to have targeted another alleged victim, Child E, during a night shift in August 2015.
Letby is also accused of attempting to murder his twin brother, Child F, by poisoning him with insulin.
She has pleaded not guilty to all the charges against her.
The nurse told prosecutorNick Johnson KC that the plumbing issue was 'an important thing to know' when understanding the conditions in which her unit operated.
She has previously told the jury at Manchester Crown Court that there were issues with understaffing and on occasion the 'wrong' mix of skills among the nurses.
Later in today's cross-examination, Letby - originally from Hereford - denied feeling 'a cut above' some of the other nurses on the unit.
However, she agreed with Mr Johnson that she was 'always prepared to call out other people's mistakes' and 'not afraid to confront the medical staff if you thought they'd got it wrong'.
She told him: 'I was very confident in my clinical competencies.'
Letby denied having lied about the time the mother of Baby E and his twin, Baby F, came down to the unit with expressed milk on August 3, 2015.
She claims it was 10pm, while the mother said in evidence that it was 9pm – a timing that coincided with a scheduled feed for one of the boys.
The neonatal nurse said it was 'an error' on her part that she had failed to record in a medical chart that Baby E had vomited fresh blood at 10pm.
She denied an allegation that on other occasions she had persuaded other nurses to write entries into charts 'to cover up what you were doing'.
Letby agreed that the twins' mother had seen blood around Baby E's mouth, but disagreed with her evidence about the timing.
Mr Johnson put it to her: 'You're not telling the truth about that, are you?'
'Yes,' said Letby.
Mr Johnson said: 'I suggest that when she came down at 10pm you'd inflicted an injury, and that he was screaming.'
Letby replied: 'No, I don't accept that.'
The barrister pressed her, saying: 'You killed [Baby] E, didn't you? You injected him with air.'
Letby denied the allegation.
Mr Johnson added: 'Just as you had done with other babies?'
The defendant replied: 'No.'
Letby agreed that in the months after Baby E's death she had carried out a number of Facebook searches on his mother – including one at 11.26pm on Christmas Day.
But she denied being obsessed with her. She had simply wanted to 'see how [Baby] F was doing' since he had become well enough to go home.
The searches had not been carried out, she told Mr Johnson, so she could 'see what reaction you'd get from this grieving family'.
The trial continues.
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