Lucy Letby trial: Day 3. I am in the courtroom and will tweet lines of evidence during the day. Please refrain from comment to avoid legal prejudice. Coverage later on @BBCNews @BBCRadio4 and other channels, plus online. 
Counsel for the prosecution, Nicholas Johnson KC, shown here, is continuing to open the case against Lucy Letby who is charged with murdering 7 babies and attempting to murder another 10 at @TheCountessNHS in 2015-16. She denies all charges.
A reminder - we are not naming the children or their parents because of a court order. They are instead being referred to as babies A - Q.
Nick Johnson KC is continuing the process of telling the jury about each baby's case. He is now up to baby H - a girl, born prematurely.
Lucy Letby is charged with attempting to murder baby H on two occasions, during two consecutive night shifts on the hospital's neonatal unit.
Court told that baby H's case is complicated by the sub-optimal treatment that was given to her. There was an unacceptable delay in intubating her and administering surfactant (a protein which helps the lungs).
Jury told that baby H was being given treatment in the intensive care section of the neonatal unit, and that "Lucy Letby would have had the cover of legitimacy for accessing her intravenous lines just before she collapsed".
Pros: At 03:22am, baby H suffered a profound collapse which needed a full resuscitation. The attending consultant concluded that the cause was unclear but that there had been a shortage of oxygen.
Pros: "Lucy Letby wasn't baby H's designated nurse on the night of the 2nd attack. A doctor saw her giving oxygen and assumed she was the baby’s nurse. He took the medical history from her... (1/2)
... We suggest that is a pretty good indication of who it was that “discovered” that baby H was having problems" (2/2)
Pros: Baby H was transferred to another hospital (Arrowe Park). She stabilised in the ambulance taking her from one hospital to the other. Her mother speaks of her dramatic improvement as soon as she got there and the medical records bear this out.
Pros: "Mercifully, baby H has not suffered any permanent consequences from the events of her first 2 weeks of life. It is a notable fact that the removal of children from @TheCountessNHS (and the sphere of influence of Lucy Letby) they often suddenly, remarkably recovered".
Jury told about a week after the attacks on baby H, when she was on a day off, at about 1.15am, Lucy Letby searched on Facebook for information about the child's parents, and about the parents of two other babies who she's accused of attacking.
The prosecution is now moving onto the case of baby I, a little girl born prematurely at 27 weeks, who weighed 2lb 2oz. Although she was so little, she was born in good condition and did very well from the beginning.
Pros: "Baby I's case is an extreme example even by the standards of this case. There were four separate occasions on which we allege Lucy Letby tried to kill her. Baby I was resilient, but ultimately at the fourth attempt Lucy Letby succeeded in killing her".
Court hears that Lucy Letby first tried to murder baby I within a week of trying to kill two other babies.
Jury told that the first time Lucy Letby attacked baby I, she injected air into the baby through her nasogastric tube.
On the 2nd occasion, Lucy Letby wasn't baby I's designated nurse. She was standing in the doorway of the darkened room and commented that baby I looked pale. The designated nurse turned on the light and saw that baby I appeared at the point of death and was not breathing.
Pros: An X-ray showed gross gas swelling throughout the bowel + signs of chronic lung disease. So baby I had the same problem she had earlier when Lucy Letby fed her, and here was Lucy Letby again when it recurred out of the ether. Yet in the intervening 2 weeks she'd been fine.
Jury told that baby I had the same problem again on a third occasion, when Lucy Letby was her designated nurse, and baby I "was brought back from the brink of death at the very end of the night shift"
Baby I was transferred to another hospital which handles more extremely ill children. Prosecution: "She quickly stabilised. So as before in other cases – a child who had suffered life-threatening problems, had a speedy recovery once removed from Chester".
Pros: Baby I was well enough to be transferred back to Chester after two days and thereafter enjoyed a further 5 days of progress, a period that coincided with the absence from work of Lucy Letby.
On the fourth occasion, baby I's designated nurse left the nursery. She came back to respond to baby I’s alarm and Lucy Letby was standing by the incubator. Baby I was very distressed. The desig nurse wanted to intervene but Letby said “we will settle her”.
Baby I then 'collapsed'. Doctors tried to resuscitate her but were unsuccessful.
In the immediate aftermath of baby I's death her parents were taken to a private room. Lucy Letby and another nurse asked if the baby's mum wanted to bathe her daughter... (1/2)
...As the mother bathed her recently departed child, Lucy Letby came into the room and in the words of the mother, she “was smiling and kept going on about how she was present at the baby's first bath and how much the baby had loved it”.
After her arrest Lucy Letby was asked about a sympathy card she had sent to baby I's parents. She said that to send a card was not normal – indeed this was the only time she had done it; but that it was not often the nurses got to know a family as well as they had known baby I's.
She accepted that she had kept an image of the sympathy card on her phone. She denied giving baby I air via the nasogastric tube.
Court told that before murdering baby I, Lucy Letby had texted a colleague, asking to be assigned to that baby's care on the following shift.
Pros: What happened to baby I followed the pattern of what had happened to others before and what was yet to happen to others. All of a sudden out of nowhere came vomiting, breathing problems and critical desaturations.
Pros: Baby I had been pumped with air when the designated nurse was away from her. The designated nurse returned in response to the alarm and found Lucy Letby standing over her. It was persistent, calculated and cold-blooded.
Court told that baby J was a premature baby girl who Lucy Letby is accused of trying to murder, unsuccessfully. She also suffered 'collapses' but recovered.
Pros: "We suggest that it is highly significant that children within the orbit of Lucy Letby persistently and consistently suffered unexplained collapses. Sometimes the evidence of her hand at work is more obvious than others... (1/2)
... and it is remarkable that on many occasions, when children who had suffered unexpected spectacular and life-threatening collapses were removed from her orbit, they had exceptional recoveries" (2/2)
Pros: "(Baby J's) case is one where we suggest that its parallels with other cases tells you what happened, and who was responsible"
Baby K was a premature baby girl, who Lucy Letby is accused of attempting to murder. The baby died later at another hospital.
Baby K was born at 25 weeks gestation and should have been born at a hospital which deals with more seriously ill children, but there wasn't time to get her mum there, so she was delivered at @TheCountessNHS
Baby K was in an incubator and on ventilation via a breathing tube. Lucy Letby booked her into the neonatal unit.
The paediatric consultant who delivered baby K was standing at the nurses' station compiling his notes when he became aware that baby K's designated nurse wasn't there, and the only nurse with the child was Lucy Letby.
Pros'n say that the consultant felt uncomfortable with this because he had started to notice the coincidence between the unexplained deaths / serious collapses and the presence of Lucy Letby. He decided to check on where Lucy Letby was and where baby K was.
Pros'n: As he walked into the room he saw Lucy Letby standing over baby K's incubator. She did not have her hands inside the incubator, but he could see from the monitor that the oxygen saturation level was falling dangerously...
... But the alarm was not sounding as it should have been. Prosecution say that Lucy Letby had not called for help and was making no effort to help baby K.
Pros'n: The doctor went straight to treat baby K and found her chest was not moving, he asked Lucy Letby if anything had happened to which she replied, “she’s just started deteriorating now”.
Prosecution say "Upon examination the doctor found that baby K's breathing tube had been dislodged. Whilst it is possible for a baby to cause this if sufficiently active, baby K was not only very premature, but she was sedated and inactive".
Jury told that the doctor "was troubled as Nurse Letby had been the only person in the room... Given the oxygen values he witnessed the alarm should have sounded..."
Court hears that despite his concerns at the time, the consultant paediatrician did not make a contemporaneous note of his suspicions or the alarm failing to activate.
Pros'n say that Lucy Letby logged onto baby K's nursing record despite the fact that she was not her designated nurse.
Pros'n: Shortly afterwards at the shift handover, Nurse Letby was again at baby K's cot calling for help. She was assisting the baby with her breathing and it was found that this time, the breathing tube had slipped too far into her throat.
That morning baby K was transferred to a different hospital. She died there three days later.
Pros'n: "Whether or not there are medical reasons for suspicion, we say that (i) it is notable that once baby K moved hospital there were no similar incidents; (ii) that the 2nd incident happened 5 minutes after Letby had made a note in baby K's nursing records about the tube..
... and (iii) that Letby was the person who “discovered” the final tube issue. We allege she was trying to kill baby K when the doctor walked in".
Pros:"This case has echoes of some of the other cases: first the allocated nurse had just gone on a break;and second, Lucy Letby said to the doctor that she had seen what was going on and was about to do something but had not as she was waiting to see if the child self-corrected"
Court is now hearing about the case of twin baby brothers, babies L & M. Lucy Letby is charged with attempting to murder both boys.
Jury told that it is the prosecution case that Letby attacked baby L first (with insulin) and then, whilst that attack was underway also attacked baby M.
Pros say "By this time Letby was supposed only to be working day shifts because the consultants were concerned about the correlation between her presence and unexpected deaths / life-threatening episodes on the night-shifts"
Jury told that Lucy Letby added insulin to baby L's nutrient feed. Prosecution say "It was a deliberate act of sabotage done with the intention of killing (him). She had failed to kill baby F (in the same way) and she increased the dose"
Pros: Baby L's twin brother baby M "was born in good condition and there were no concerns. He did not need any assistance with breathing and there was no evidence of infection. He was classified as a “special care” as opposed to “high dependency” baby within the NNU".
Pros: Baby M suffered an unexpected life-threatening event at around 4pm on 9th April 2016 i.e. at the same time that his twin’s blood sugar was dangerously low as the result of the insulin poisoning
Pros: Without warning baby M's heart rate and breathing dropped dramatically and he required full resuscitation by medical staff. He came close to death.
Jury told that the consultant attended and noticed unusual patches of discolouration on baby M's skin, which he thought was similar to the appearance of skin on some of the other babies Lucy Letby is now accused of attacking
Pros: The doctor could not find any cause for the sudden 'collapse' of baby M, but the discolouration he saw caused him to suspect an injection of air.
Pros: Lucy Letby noted that baby M was tensing his limbs, curling his fingers and toes and rotating his hands and feet inwards. Such actions are indicative of the brain having been starved of oxygen – you will remember similar observations in the case of baby J.
Jury told that when Lucy Letby’s home was searched following her arrest two years after this incident, the handwritten log of drugs administered during baby M's collapse was found. She had also made a note of his collapse in her diary.
In police interview Lucy Letby "denied that the medical notes found at her house were a souvenir and denied deliberately trying to harm baby M".
Moving onto baby N. A boy, born prematurely at 34 weeks. It's alleged that Lucy Letby tried to kill him on three occasions.
Baby N had a mild blood disorder. Pros'n: We allege that Lucy Letby thought that this gave her cover to attack him. If she caused him to bleed she thought it would be put down to his (blood disorder) – and she was right".
Court told that baby N was bleeding in his throat - something the jury has been told about in the cases of 3 of the other babies.
Jury hears that one of the doctors there saw a “large swelling" at the end of baby N's throat. He could only just see the bottom of the vocal cords. He had never seen anything like this before in a newborn baby.
Pros'n: the doctor was unable to see down baby N's throat as the view was obscured by fresh blood. "Something - somebody, we say - had caused him to bleed again."
Baby N was transferred to @AlderHey where he recovered quickly. Prosecution point out this follows the pattern of what happened to other babies who moved hospitals.
Prosecution medical experts have suggested that Baby N's bleeding is likely to have been caused by trauma because the bleeding happened before anyone tried to put a tube down his throat.
Court hearing about babies O & P. They were baby boys. Two out of a set of triplets. Lucy Letby is charged with murdering them both. Their surviving triplet brother is not a part of this case.
Prosecution say that Lucy Letby was the designated nurse for babies O & P and "this gave her an open opportunity to sabotage the babies though she did have the responsibility of supervising a student nurse"
Pros: "Within a few minutes of Lucy Letby coming back onto the neonatal unit, as shown by the door entry swipe system, baby O suffered his first collapse".
Court told that a breathing tube was inserted by the medical staff and baby O was successfully resuscitated. But he 'collapsed' again later, and this time doctors were not able to resuscitate him.
Jury told that the consultant present was particularly concerned about baby O's death as he was clinically stable before these events, his collapse was so sudden and he did not respond as he should have done to resuscitation.
Nick Johnson KC, leading the prosecution, says "Of course, no one would have thought that a nurse would have assaulted a child in the neonatal unit of an NHS hospital".
The jury is told that a year later, on the anniversary of baby O's death, Lucy Letby carried out a Facebook search for his family's surname.
Court is about to end for the day. The jury has been told that the prosecution should finish opening their case tomorrow, and then Lucy Letby's defence counsel will make an opening statement on her behalf.
Thanks for following these tweets today. I'm now heading outside court to edit reports about today's proceedings for this evening's @BBCNews @BBCRadio4 #bbcnewssix #bbcnewsten. I'll be back at court tomorrow as the case continues.
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