A British nurse was sentenced to jail for the rest of her life on Monday for murdering seven newborn babies and attempting to kill six others while they were in her care.
Lucy Letby, 33, was convicted on August 18 of killing five baby boys and two baby girls, making her the UK's most prolific child serial killer in modern history.
However, the jury cleared Letby of two counts of attempted murder and were unable to reach decisions on six other counts of attempted murder.
She was arrested following a string of baby deaths at the neonatal unit of the National Health Service's (NHS) Countess of Chester Hospital in northwest England between June 2015 and June 2016.
The prosecution said Letby attacked her young and often prematurely born victims by either injecting them with air, over feeding them with milk or poisoning them with insulin.
The hospital's executives have come under fire for failing to act sooner on concerns about Letby, which were reportedly raised by senior doctors as early as 2015.
Among the doctors who first raised alarm about Letby were Dr Ravi Jayaram, a UK-born consultant paediatrician with Indian-origin, as well as Dr Stephen Brearey, head consultant of the ward where Letby worked. Five other doctors also alerted the hospital.
'I could have punched the air'
Dr Jayaram has been with the NHS for over 10 years.
Jayaram's interest in paediatric care put him in a position that allowed him to flag the string of suspicious deaths with the management of the Countess of Chester Hospital.
Jayaram was quoted by news reports as as saying some of those lives could have been saved if his concerns about Letby had been heeded and the police alerted sooner.
He told ITV News in a television interview after the verdict that four or five babies "could be going to school now who aren't", because of the inaction of the hospital management.
He said that the hospital's consultants first flagged the cases after three babies died in June 2015 - all of whom died while Letby was on duty.
After more babies collapsed and died, he said that senior medical consultants held several meetings to press hospital executives about the cases.
But it took the hospital executives until April 2017 to allow the consultants to meet with the police.
"The police, after listening to us for less than 10 minutes, realised that this is something that they had to be involved with. I could have punched the air," Jayaram said in an interview.
An investigation was launched immediately after leading to the arrest of Letby.
As controversy swirled over allegations of inaction by hospital officials, the British government has ordered an independent inquiry into the cases.
"The inquiry will look at the circumstances surrounding the deaths and incidents, including how concerns raised by clinicians were dealt with," the government said in a statement following the conviction on Friday.
'Cover-up'
Meanwhile, Dr Stephen Brearey, the lead consultant at the neo-natal ward of Countess of Chester Hospital, had gone one step ahead of Jayaram, accusing the medical facility's officials of a "cover-up" in a bid to hide the information from the police.
In an interview with BBC, Brearey said managers at the hospital were "engineering the narrative" to prevent police finding out about the suspicious deaths.
"I don’t know how you define a cover up but to us the evidence in front of us was quite clear, it felt like they’d tried to engineer a narrative, some way out of this which didn’t involve police. If you want to call that a cover up, then that’s a cover up."
Brearey also claimed that even after his request was first ignored, he repeatedly begged senior managers to take the convicted killer, Letby, off the ward.
Instead of listening to their concerns, the managers demanded he and the other consultants "apologise" to Letby, and threatened them with "consequences" if they did not put the incident behind them.
"The intention of the executives was to somehow close this case. I don’t have any doubt that Lucy Letby harmed these babies."
When the hospital officials acted it was too late.
Meanwhile, the families of the babies killed by Letby spoke of their search for answers and "extreme hurt, anger and distress" after the verdict.
"To lose a baby is a heartbreaking experience that no parent should have to go through," they said in a joint statement. "But to lose a baby or have a baby harmed in these circumstances is unimaginable."
The families cannot be named for legal reasons.
The parents of twin boys who Letby tried to murder revealed the turmoil that they had been through, going from the euphoria of the birth to the horror of seeing staff fight to keep their children alive.
Both the twins survived, but one suffered some brain damage and his parents worry it might impact him in the future.
The boys' father said he is now a "changed person" and suffers sleepless nights and depression.
With the government's order to conduct an independent investigation, the families are hoping get some answers, even if some are facing the reality that they are not getting their babies back.
