Senior paediatrician Dr Ravi Jayaram had to resuscitate a baby girl after walking into a nursery room at the Countess of Chester Hospital where her breathing tube had been dislodged.
Former neonatal nurse Letby was later convicted of the attempted murder of Child K in February 2016.
The prosecution at Letby's trial said she was caught "virtually red-handed" by him, although he did not alert the hospital.
Giving evidence at the Thirlwall Inquiry, which is looking into the events surrounding the crimes, Dr Jayaram said he had been sitting outside the nursery reading medical notes when he realised Letby was alone with Child K.
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