The nurse Lucy Letby tried to kill a premature baby by giving him fluids contaminated with insulin, her murder trial has heard.
The boy’s blood sugar levels fell dangerously low and his heart rate rose sharply after Letby intentionally added insulin to his intravenous feed during a night shift, Manchester Crown Court was told.
Letby, 32, is accused of attempting to kill the boy, known as Child F, less than 24 hours after she allegedly murdered his twin brother, Child E, by injecting air into his bloodstream.
The children’s real names cannot be revealed for legal reasons.
The nurse, who is originally from Hereford, denies murdering seven babies and the attempted murders of 10 others between June 2015 and June 2016.
Peter Hindmarsh, professor of paediatric endocrinology at University College London, told the court on Friday that poisoning was the only reasonable explanation for Child F’s sudden deterioration at the Countess of Chester Hospital’s neonatal unit in the early hours of 5 August 2015.
After the infusion of nutrients, which began after midnight, the boy’s heart rate surged to 200 beats per minute and his blood sugar fell to an “extremely low” reading.
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Intravenous refers to a way of giving a substance through a needle or tube inserted into a vein.
Prof Hindmarsh said that a commonly used synthetic human insulin known as Actrapid – a colourless solution – was administered via the infusion.
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He said the brain is reliant on a “constant supply” of glucose to function and the dangers of low blood sugar included seizures, coma and sometimes death.
The boy’s glucose levels stayed low throughout the day shift of 5 August, even after the intravenous line and the connected bag containing the nutrients were replaced.
‘Low blood sugar for 17 hours’
Child F’s blood glucose only rose to safe levels after a decision to stop the nutrients from a second bag at 6.55pm and give him extra sugar independently, the court was told.
Prof Hindmarsh said it was apparent that the boy’s low blood sugar was “persistent” for those 17 hours.
During that time, Child F received twice the amount of glucose normally given to correct hypoglycaemia in a baby, he said.
Child F made full recovery
The witness agreed with Letby’s lawyer, Ben Myers KC, that the blood sample reading of high insulin came from the second stock bag so could not show what level was in the first bag attached in the early hours of 5 August.
But Prof Hindmarsh said similar blood glucose readings around the same period from one person were likely to mean they had a similar amount of insulin earlier in their system.
Child F went on to make a full recovery and was later discharged, the court heard.
John Swinney has won the SNP leadership contest and is set to be named as Scotland’s new first minister, replacing Humza Yousaf.
Mr Swinney could become Scotland’s seventh first minister as early as Tuesday.
The SNP leadership nominations closed at 12pm on Monday, with the party confirming Mr Swinney was the sole nominee.
He is expected to give a speech later in the day.
Posting on X, he said: “I am deeply honoured to have been elected as leader of the SNP. I will give all that I have to serve my party and my country.”
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Former finance secretary Kate Forbes had been tipped to join him, but later announced she would not stand and instead threw her support behind Mr Swinney.
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Mr Swinney has said he would want Ms Forbes to “play a significant part” in his government if elected as first minister.
Potential challenger Graeme McCormick also withdrew his bid at the 11th hour.
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The veteran SNP activist claimed he had secured the 100 nominations from 20 branches needed to enter the contest but backed out of the campaign on Sunday evening after a “lengthy and fruitful conversation” with Mr Swinney.
The SNP has appeared keen to avoid an explosive leadership contest similar to the one that followed Ms Sturgeon’s resignation.
Scottish Tory leader Douglas Ross congratulated Mr Swinney on becoming SNP leader for a second time, but urged him to abandon his “relentless push for independence”.
Mr Ross added: “It’s difficult to see how he can be the fresh start Scotland needs when he’s the ultimate continuity candidate.”
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Patrick Harvie, Scottish Greens co-leader, said Scotland “needs a period of stable government”.
He added: “Mr Swinney knows that if he is to have our support then it must be on the basis of progressive policies that help us to tackle the climate crisis and build a fairer and more equal future.”
Mr Harvie said his party remains “utterly committed” to the policies delivered as a result of the Bute House Agreement and will “oppose any move away from them or steps to dilute them”.
He added: “We are committed to delivering on our vision of a fairer, greener and more equal Scotland, and are open to talks with John Swinney and his team about how we can work together to make that happen.”
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Mr Swinney is now clear to take over as SNP leader, but will need to seek parliamentary approval to succeed Mr Yousaf as first minister.
The timing is decided by the parliamentary bureau, and could take place as early as Tuesday.
The parliament will have 28 days to nominate a replacement for Mr Yousaf once his resignation has been accepted by the King.
As the SNP is comfortably the largest party in Holyrood, the onus is on them to find a new leader who can work with other parties in a minority government.
The SNP’s tally of 63 MSPs leaves them just short of a majority in the 129-member parliament, meaning politicians from other parties would need to be persuaded to either vote for Mr Swinney, or at least abstain in the ballot, for the party to be successful.
The leaders from other political parties can also put themselves forward and MSPs can nominate a candidate, although it must be seconded by another member.
If that happens, any candidate that secures more than half of all votes will win the nomination.
If no one reaches that threshold, the candidate with the fewest votes will be eliminated – with the process repeated until the candidates are whittled down to two.
At that point, a candidate will only require a simple majority to win.
Whoever wins the vote is then formally appointed by the King.
An official swearing-in ceremony at the Court of Session in Edinburgh would then take place.
However, if no new first minister can be selected within the 28 days, the Scottish parliament would be forced to hold an extraordinary general election.
West Ham have agreed a deal in principle with Julen Lopetegui to take over from David Moyes as manager at the end of the season, Sky Sports News understands.
Lopetegui, 57, has been out of work since leaving Wolves three days before the start of the season but has stayed in England in hopes of landing another job in the Premier League.
The Spaniard, who has also managed Porto, Spain, Real Madrid and Sevilla during an illustrious coaching career, looks set to take charge at the London Stadium at the end of the season after Moyes’ expected departure.
West Ham are ninth in the league after Sunday’s 5-0 defeat at Chelsea.
Moyes, 61, who is out of contract in the summer, has faced increased questions about his future as his team has won only one of its previous nine league games.
He said he felt “really sorry” for West Ham fans after watching his side fall to a heavy loss at Stamford Bridge.
He said: “The fans have been great but I feel bad for them.
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“I don’t normally have teams who get beaten like this but we are lacking some ingredients – mental toughness and leadership to get better results, or at least not get hammered.
“The fans played their part and I can only say I’m really sorry for how it played out.”
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The Scot, whose second spell as Hammers boss began in 2019, led the club to its best Premier League points total of 65 in 2021, finishing in sixth place.
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The following year they finished seventh and reached the semi-finals of the Europa League.
They went one better last year, winning the Europa Conference League final, the club’s first European trophy since 1965.
In November, Lopetegui told Sky Sports News he had unfinished business in the Premier League.
He said: “It’s why I’ve said no to different countries and different situations because I would like to stay here in England. I feel like our team here is just starting and we want to achieve our dreams.
“The way the country lives football here is special – it’s the best league in the world, the most competitive league in the world, the best environment for the players, coaches and fans too.”
Rishi Sunak has admitted the Tories may not win the general election after grim defeats in the local polls.
The prime minister suggested the UK was on course for a hung parliament and claimed voters would not want to see Labour leader Sir Keir Starmer “propped up in Downing Street” by the SNP or smaller parties.
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0:33
PM on ‘disappointing’ election results
Sunak urged to take party towards right
Former home secretary Suella Braverman urged him to mould the party towards the right in order to win back voters.
But she told the BBC a change of leadership was not a “feasible prospect,” adding: “There is no superman or superwoman out there who can do it.”
Ms Braverman urged the prime minister to adopt several measures to win back voters, including further tax cuts and a cap on legal migration.
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2:32
Rishi Sunak ‘up for the fight’ in general election
Tories ‘up for the fight,’ minister insists
But Transport Secretary Mark Harper insisted Mr Sunak and the Tories are “up for the fight” of a general election despite their terrible results in the local contests.
Talking to Sky News’ Sunday Morning With Trevor Phillips, the minister said: “I think the key thing that people need to do now is get behind the prime minister, focus on the things the government is focused on delivering – the British people’s priorities around the economy, dealing with migration – and get out there and take that fight to the country ahead of the general election.”
Labour won 1,158 seats in the 107 councils in England that held elections on 2 May, an increase of more than 232.
The Liberal Democrats won 552 seats, up nearly 100, while the Tories came in third place on 515 seats, down nearly 400.