A premature baby boy in a neonatal unit was poisoned after a nurse accused of killing seven others "laced his food with insulin", a court heard on Tuesday.
Manchester Crown Court was told it was just one day after Lucy Letby allegedly murdered another baby boy by also poisoning him with insulin.
Nick Johnson KC said the boy, born seven weeks premature and weighing less than 3lbs, had breathing problems and was prescribed a small dose of insulin – and was being fed nutrients via a long line.
"Insulin is never added to bags of liquid nutrients," Mr Johnson said.
He alleged someone had added insulin to the baby's feeding bag, resulting in the boy's "dramatic drop in blood sugar" which, if uncorrected, "could have resulted in convulsions, coma, irreversible brain damage and death".
Mr Johnson told the jury that as soon as the bag was removed, the boy recovered, adding: "Somebody gave him synthetic insulin, someone poisoned him."
Letby, 32, a former neonatal nurse at Countess of Chester Hospital in Chester, is said to have signed a chart saying she had started the nutrient bag feed.
Mr Johnson said: "It cannot have been an accident. You know who was in the room and you know from the records who hung the bag.''
Letby told police she wasn't the baby's designated nurse and was not involved in his care. She admitted from the records she must have attached the nutrient bag "perhaps while someone was on a break".
Letby also told police she did not remember doing social media searches of any of the babies' parents.
Mr Johnson said: "We say there was only one credible candidate for the poisoning.''
Letby is on trial accused of murdering seven babies and trying to kill 10 others in an alleged year-long killing spree at the hospital. She denies all charges.
The jury was told of another alleged incident in which Letby tried to kill the same baby girl three times, twice on the same shift.
Born 14 weeks premature, the baby girl weighed just 1lb 2oz and was "tiny", said the prosecutor who alleged Letby made the first attempt to kill her on the 100-day anniversary of her life. The court heard nurses marked the occasion by putting up a banner and getting a cake.
Mr Johnson said the three attacks on the baby girl were "deliberate attempts to kill".
After an investigation, it was found that the only common denominator in an unusually high number of baby deaths was that Letby was on shift in each tragic case.
Letby, from Hereford, denies murdering five boys and two girls.
She has also pleaded not guilty to the attempted murder of another five boys and five girls between June 2015 and June 2016.
Family members of some of the alleged victims sat in the public gallery along with Letby’s parents, John, 76, and Susan, 62.
A court order bans the babies involved from being named.
The trial continues.
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