UK - Lucy Letby - Post-Conviction Statutory Inquiry

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That might actually fit a pattern noticed before. Air embolism through the intravenous tube is nearly always fatal, deaths actually decreased after the first five fatalities and also most of which were IV air embolism. Deaths decreased but attacks continued. I think she may have realised it was clearly nearly always fatal and switched to other means like trying to impede with breathing. Fits the motivation of doing it for the scene and drama which also fits with her erratic behaviour. The following is graphic so beware, IV AE is quite rapidly fatal, impeding breathing takes much longer = more drama. Harsh to think.
 

Non-fatal collapses 'not recorded'

Judith Moritz
Reporting from the inquiry

Kennedy says that the trust accepts that non-fatal collapses "weren't recorded" in the hospital's internal online register of incidents and risks.
The deaths of children A, C, D, E, I. O and P were logged.



Regulator 'not aware of police referral

Judith Moritz
Reporting from the inquiry

Jones, speaking on behalf of the Nursing and Midwifery Council, says the regulator's ‘fitness to practice’ investigations are often put on hold while a criminal investigation is under way, though it does have the power to impose an interim order.

Jones says the NMC was first told there wasn't enough evidence against Letby to merit a referral by director of nursing, Alison Kelly.

The NMC wasn't aware there had been discussions about Letby being referred to the police, or the meetings about her being held by senior management, according to Jones.

It was also not sent the reports by the Royal College of Paediatrics and Child Health, Jones says.

She says the NMC received the press release about the start of the police investigation in 2017 at the same time as the media - after which the regulator phoned Kelly who said Letby was a witness, not a suspect.
 

'It was wrong to wait until Letby was charged'

Judith Moritz
Reporting from the inquiry

Jones says Letby's bail conditions after her arrest factored into the Nursing and Midwifery Council's decision not to apply for an interim order - which would have prevented her from practising as a nurse until she was charged.
The NMC says it has "seriously reflected" on this decision and accepts it wasn’t right to wait to apply until she was charged.
The fact of her arrest should have been enough, Jones says.
The NMC has now amended its internal guidance on interim orders.


Regulator 'struck by number of consultant concerns

Judith Moritz
Reporting from the inquiry

Jones says that the NMC had no power to investigate ward manager Eirian Powell, chief executive Tony Chambers and senior nurse Karen Rees because they had come off the nursing register.

She explains that the organisation's fitness to practice investigation into director of nursing, Alison Kelly, was put on hold at the request of Cheshire Police while the force's criminal investigation into Letby was underway.


She moves on to say the NMC has been "struck by the repeated and numerous occasions when the consultants raised concerns".

"They didn’t contact the NMC directly, though we make no criticism of them.

"We seek to understand what we can do to encourage those with such concerns to contact us directly."
 
FORTY PERCENT INCREASE in tube dislodgement at Liverpool whilst she was on shift ?
She was practicing there.
This is unbelievable.
Isn't it actually much worse than a forty percent increase? It increased from 1% to 40%. My maths is terrible so I'll leave someone else to work out what kind of an increase that is.

'Baker spoke about an audit of Letby's time at Liverpool Women's Hospital, where she did placements in 2012 and 2015, which he says showed the dislodgment of breathing tubes occurred on 40% of shifts she worked, while the usual rate was 1%'

 
Isn't it actually much worse than a forty percent increase? It increased from 1% to 40%. My maths is terrible so I'll leave someone else to work out what kind of an increase that is.

'Baker spoke about an audit of Letby's time at Liverpool Women's Hospital, where she did placements in 2012 and 2015, which he says showed the dislodgment of breathing tubes occurred on 40% of shifts she worked, while the usual rate was 1%'

Yeah, it means it was forty times more likely that a tube would be dislodged while Letby was on the ward. Whereas for another nurse, a dislodgement might be a one in one hundred shifts event, for Letby, it was close to half the shifts she worked.

MOO
 
Yeah, it means it was forty times more likely that a tube would be dislodged while Letby was on the ward. Whereas for another nurse, a dislodgement might be a one in one hundred shifts event, for Letby, it was close to half the shifts she worked.

MOO
That's what I thought, and an online calculator confirms it's a 3,900% increase! (Statisticians please check.) Anyway, remarkable in anyone's book, surely.
 
Revelations today that solidify everything. Zero chance at all of a appeal working now I think and good. Interesting because it confirms allot of worse fears postulated early on in the first trial.
 
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That's shocking about the breathing tubes. So many babies lives could have been saved if they'd caught her earlier (obviously).
I really hate how so many people question if she is actually guilty. I try to avoid reading about it on social media/newspapers now as it infuriates me.
 
Isn't it actually much worse than a forty percent increase? It increased from 1% to 40%. My maths is terrible so I'll leave someone else to work out what kind of an increase that is.

'Baker spoke about an audit of Letby's time at Liverpool Women's Hospital, where she did placements in 2012 and 2015, which he says showed the dislodgment of breathing tubes occurred on 40% of shifts she worked, while the usual rate was 1%'

There’s quite a bit of information missing from that statement of just the two figures- they only did the audit whilst LL was on a placement there, so they have pulled the 1% from their guesstimates, rather than making a direct comparison using data collected from other trainee nurses- they have compared her figures to the whole unit and all other qualified staff. At that point LL was a student on a training placement- they make no comparison to the percentages with other student nurses at the same point in their training. If you have a look online there is massive issues with the dislodgement of breathing tubes and them being incorrectly inserted in neonatal wards- to the point that in 2021(many years after LL was training) a working party of 23 experts across Europe was created, their figures on it potentially occurring during student placements was up to 80% error rate.

 
There’s quite a bit of information missing from that statement of just the two figures- they only did the audit whilst LL was on a placement there, so they have pulled the 1% from their guesstimates, rather than making a direct comparison using data collected from other trainee nurses- they have compared her figures to the whole unit and all other qualified staff. At that point LL was a student on a training placement- they make no comparison to the percentages with other student nurses at the same point in their training. If you have a look online there is massive issues with the dislodgement of breathing tubes and them being incorrectly inserted in neonatal wards- to the point that in 2021(many years after LL was training) a working party of 23 experts across Europe was created, their figures on it potentially occurring during student placements was up to 80% error rate.

Is that equation made by using every stage of tube placement though? They may be including all stages of using them but dislodgement would presumably just be once it's in situ?
 
There’s quite a bit of information missing from that statement of just the two figures- they only did the audit whilst LL was on a placement there, so they have pulled the 1% from their guesstimates, rather than making a direct comparison using data collected from other trainee nurses- they have compared her figures to the whole unit and all other qualified staff. At that point LL was a student on a training placement- they make no comparison to the percentages with other student nurses at the same point in their training. If you have a look online there is massive issues with the dislodgement of breathing tubes and them being incorrectly inserted in neonatal wards- to the point that in 2021(many years after LL was training) a working party of 23 experts across Europe was created, their figures on it potentially occurring during student placements was up to 80% error rate.

Just goes to show how hard it is for the average person to evaluate the evidence. Thanks for the clarification!
 
There’s quite a bit of information missing from that statement of just the two figures- they only did the audit whilst LL was on a placement there, so they have pulled the 1% from their guesstimates, rather than making a direct comparison using data collected from other trainee nurses- they have compared her figures to the whole unit and all other qualified staff. At that point LL was a student on a training placement- they make no comparison to the percentages with other student nurses at the same point in their training. If you have a look online there is massive issues with the dislodgement of breathing tubes and them being incorrectly inserted in neonatal wards- to the point that in 2021(many years after LL was training) a working party of 23 experts across Europe was created, their figures on it potentially occurring during student placements was up to 80% error rate.

But Letby wasn't placing the tubes herself. So it isn't like these were explicable, student accidents while learning. These were dislodgement events that were inexplicable that happened at a greater than 40x average incidence on the shifts when she was present. That's a completely different thing.

MOO
 

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