Lucy Letby Thirlwall Inquiry: I failed to protect babies, doctor tells inquiry
10:51AM
Evidence hearing begins
It’s week four of the Thirlwall Inquiry. Today, the inquiry is hearing evidence from Dr John Gibbs, a consultant paediatrician who worked at the Countess of Chester during the years Lucy Letby was a nurse on the neonatal unit.
Over the last two weeks, the inquiry has conducted private sessions with witnesses the heard expert evidence.
11:14AM
Doctor initially had ‘no concerns’ over child’s sudden death
Dr John Gibbs said that he originally had ‘no concerns’ over the death of Child C who deteriorated quickly and died in June 2015.
Letby was convicted of killing the baby just four days after its birth by injecting air into its stomach.
Dr Gibbs said he was called to the neonatal unit at the Countess of Chester in the evening, at which point Child C had already collapsed and staff were attempting resuscitation.
He said: “When a baby suddenly collapses you would hope to get some response even if it was not sustained.
“I attended 10 minutes into the resuscitation and there was no response onwards. I didn’t know why Child C had collapsed and died.”
Asked by Nicholas de la Poer KC, counsel for the inquiry, whether he had any concerns that there was anything ‘wildly out of the ordinary’, he replied: “Not at all.”
Dr Gibbs also said he did not feel that Child C had the same rash as the other babies, which had been later deemed as a sign of air ambolism.
11:20AM
I worried baby deaths were from ‘superbug’ or contamination, says doctor
Dr John Gibbs, a paediatric consultant at the Countess of Chester, said that he was concerned that there was an infection or medical problem behind the deaths of babies on the unit.
He told the hearing. “There was something that was affecting these babies.
“I worried at this stage that we had some kind of medical problem on the unit, you do get superbugs or some nasty infection, or as has happened on some units, contamination of the feeding fluid for babies.”
11:33AM
Doctor felt sympathy for Letby after noticing correlation
Dr John Gibbs, a consultant at the neonatal unit, said he originally felt sympathy for Lucy Letby after it was noticed she had been present at the resuscitation of four babies who had died.
He said that he himself had experienced a ‘bad run’ where there had been a high number of incidents and deaths.
“I felt sympathy for Letby at that time, because I felt she had been unlucky to be involved in a number of incidents,” he told the hearing.
“It can happen to any of us, and it’s happened to me during my career, that you have a bad run when you’re on call or on duty, and in a short space of time a number of unfortunate incidents and other deaths may happen, but that stops happening, it’s just an unfortunate coincidence.
“I’m not sure how closely we considered other members of staff. Obviously Letby wasn’t the only nurse involved in all of those.”
11:58AM
It is not always possible to explain a death, says doctor
Dr John Gibbs said that he was initially satisfied that Child C’s death had been “partly explained”. After receiving a cause of death from a post mortem, he said he felt a sense of “relief”.
He added: “It would not compensate for the tragedy of losing a child, but is likely to help a bit with an explanation for the child’s death.
“Some causes of death will have an influence or possible consequences for future children or pregnancies and so on.”
He said that in his experience of neonatal units “it was not always possible to explain a death”.
He added: “When that situation keeps arising, something very strange is happening.”
12:07PM
‘Serious collective failure’ from paediatric team
Dr John Gibbs said that with “hindsight” it was a “serious collective failure” on the part of the paediatric team not to recognise the significance of blood test results relating to Child F in 2015.
The results showed that insulin had been given to him, but Dr Gibbs told the inquiry he only became aware of them two years later.
12:21PM
Doctor presumed Letby’s innocence
Discussing the death of Child I, who Lucy Letby killed with an injection of air into her stomach and bloodstream, Dr John Gibbs said he did not realise at the time that she was responsible for other attacks.
He said this influenced his thinking as to why the baby had collapsed. “I thought this was a baby who was quite precarious, who decompensated quickly,” he said.
Dr Gibbs denied telling the mother of Child I that her baby needed to have a post-mortem in order to clear the hospital of wrongdoing.
He said he “was sure the mother” thought he said that “so he was not going to argue with her”, but said he would never tell the family of a patient that they were being forced into having a post-mortem.
12:30PM
Letby’s involvement realised by early 2016
Dr John Gibbs has been asked about a thematic review that took place in February 2016 into the higher-than-expected mortality rate at the unit in 2015.
He said: “By 2016 [there was] definitely the realisation that Letby was involved with most of them.
“There were some deaths and collapses that I knew she wasn’t around at the time, but that association was causing concern.”
He added that it would have been “inappropriate” to tell CQC inspectors who visited the hospital that same month about their concerns.
“It is a bit inappropriate to just tell the CQC inspectors when they happen to be visiting if you haven’t tried to sort that out within your own trust management structure,” he said, adding: “It’s almost like telling Ofsted you’ve got a problem with the teacher, and you’ve never told anyone in the school.”
12:40PM
I should have gone to the police after senior nurses closed ranks, says doctor
On 7 April, 2016, Lucy Letby was moved to day shifts after concerns were raised about a connection between her working at night when babies collapsed unexpectedly.
Dr John Gibbs said “one aspect that made it more difficult” to “confirm his suspicions” was a “very firm pushback” from senior nurses.
He said: ”There was a very strong argument being put forward from the senior nurse on the unit, that this suspicion was totally wrong and that it was maligning nurse Letby and that she was a very competent, safe nurse.”
Dr Gibbs admitted that he should have gone to the police following the thematic review.
He said: “I regret that we or I didn’t go to the police at this time after the thematic review. Why didn’t I go straight to the police, why didn’t we paediatricians go straight to the police?
“I know the parents of the later babies will not thank us for this”.
He said that while there were suspicions that something might have been done to the babies “it was best managed” through senior levels in the trust.
1:00PM
Doctor did not suspect Letby despite further deaths
Dr John Gibbs said that even after further collapses occurred in April, including those of Child L and his twin brother, Child M, he “still wasn’t clear that harm was happening to the babies”.
He said: “Despite that thematic review most of the babies had an explanation for their deaths from the post mortem.”
Dr Gibbs said that while all of the babies hadn’t had post-mortem’s the majority had done.
He continued: “Because we had explanations for all the deaths I wasn’t sure that harm had happened to these babies.”
He said that while some of the babies did “have risk factors”, there were “unusual features like strange rashes”.
“They were deaths that had explanations but they weren’t entirely satisfactory, especially when you look back at them.”
Following the collapse of Child O, on 23 June 2016, however, Dr Gibbs said his first thought was not “it’s Letby again” but just that “we have had another collapse”.
He said: “Looking back on it it sounds foolish to say I just wasn’t sure what’s happening on the unit.”
1:12PM
Inquiry breaks for lunch
The inquiry will resume at 2.05pm
