UK - Lucy Letby Trial - Media, Maps & Timeline *NO DISCUSSION*

[Tortoise]

Thursday November 24th 2022 - Live updates from the trial

Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


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Day 28 of Prosecution Evidence

(Twin) Child F


Unnamed Nurse CoCH - Day Shift 5 August 2015
& Video - Alaris Syringe Driver Demonstration - connected/w TPN Pump - for Lipids, Dextrose, Saline etc
& Video of Glucose/Dextrose administration

1:58pm

Members of the jury are now coming into court.
The next witness to give evidence is a nurse who cannot be named due to reporting restrictions. She has previously given evidence in the trial, and is now giving evidence in the case of Child F.

2:01pm

The nurse confirms she had some involvement in the care of Child F, but was not the designated nurse.
She confirms she administered an infusion of glucose to Child F on August 5 at 8.30am.
She says it would have been a bolus of glucose given as a "push" response to low blood sugar.

2:11pm

An Alaris syringe driver video is displayed to the court, showing how a syringe dose can be electronically administered via infusion, at various rates. These rates can be locked.
It is similar to the Alaris pump, and has alarms if the syringe is not loaded properly, if the infusion has been placed 'on hold' for a certain length of time, if the rate has been changed but has not been confirmed, if the infusion is complete, if there is a power failure or low on battery, if there is an error message.
The alarm colour would be amber on the machine, and can be paused for two minutes.
An event log would be available on the machine for 24 hours.
The nurse confirms it was a standard machine used at the Countess of Chester Hospital, and was standard practice.
The nurse said the event log wouldn't be looked at routinely by staff.

2:16pm

An 'occlusion' alarm would be a red alarm light, with an alarm sound.
The syringe would be primed beforehand with the fluid, attaching the syringe to a line, and would be 'flushed' so no air would be present.
The nurse says a different piece of equipment would be used for TPN bags, and this equipment would be used for the lipid [fats] element administered via syringe.
The nurse says this equipment would be used to administer smaller amounts of fluids, such as 10% dextrose, or a saline bolus, or antibiotics.

2:20pm

The video demonstrates an 'accelerated rate' of a drug could be administered via infusion via a 'purge' function on the machine, which would be used as a possible bolus administration.
The nurse says that 'purge' button would not be used at the Countess of Chester Hospital, and was not standard practice.

2:22pm

The video adds the 'purge' function would not add to the total millilitres of infusion administered on the machine's display - ie, any fluids administered during that 'purge' time would not be added to the total the machine had calculated so far.
The machine also does not have the ability to detect air, the video presented to the court concludes.

2:31pm

An IV administration chart for August 5 is shown to the court, with four 10% dextrose infusions focused on.
The nurse has co-signed for two of the four administrations, both boluses at 8.30am and 3.15pm. One more would have been through a bolus and another via an infusion at a certain rate, which would require mechanical assistance.
The nurse said she would have delivered the two boluses she signed for as a 'push' infusion (ie, push the fluid manually via syringe attached to a clean, 'flushed' infusion line), and the process would be 'straightforward'.

2:40pm

The nurse is shown a note from the 'grand round', which the court heard was carried out by the on-call consultant each Wednesday.
The note 'new long line' was made, and the nurse says that was because the existing long line had tissued.
The new long line was made at noon on August 5.

2:44pm

The nurse says her normal practice would have been for putting a new bag of fluids on the long line.

2:45pm

The Alaris pump video is shown once again to the court, for the nurse to provide potential further context on what is demonstrated in the video.

2:48pm

The Alaris pump would be used in connection with TPN bags.
The nurse says while there is an input port on the TPN bag, she would not input anything manually in conjunction with the machine.
The output port would be used for 'giving' the infusion to the patient.

2:54pm

The nurse confirms a 10% dextrose administration was given to Child F at 3.30pm via an infusion.
She tells the court the 10% dextrose infusion would have been administered, in addition to the existing dose from the new bag at noon, as the blood glucose level was still low for Child F.
The nurse says the 3.30pm dose would have been administered via a syringe.
Lipids would have been administered via a syringe driver.

3:01pm

The court is shown a 15% dextrose dose, plus sodium chloride, is administered for 7pm on August 5. The nurse has signed for that medication administration.
The nurse is also a co-signer for medication at 2am on Thursday, August 6.
The nurse explains the practice was someone from the day shift (in this case, herself) would co-sign for the drug during the day, then she would in practice text the person who was administering it to confirm it had been administered, and that the scheduled dose could be taken 'off the system' and wasn't at risk of being administered twice.

Cross-Examination

3:07pm

Ben Myers KC, for Letby's defence, asks about the administration of the drugs, and how they are administered.
The nurse says the 10% dextrose would come in 500ml bags, and can be divided up on the unit for infusions, or come available via the pharmacy in 50ml pre-made doses.
The nurse says she does not have an independent recollection of the event.
She confirms if the long line is tissued, it cannot be used again.
Mr Myers says if the long line is changed, then everything else is changed to avoid infection, including the TPN bag. The nurse confirms that would be the case.
Mr Myers: "You wouldn't put up an old [TPN] bag, would you?"
The nurse: "I wouldn't, no. And we wouldn't have put it up as we would have documented that."

3:08pm

Mr Myers says as a general rule, TPN bags would run for 48 hours unless there was a problem, and there would be a stock of maintenance bags in the fridge.
Mr Myers says one of those would have been used in the course of this. The nurse agrees.
The nurse says such bags are checked every night and if any were being used or out of date, then the stock would be replenished.

Prosecution Re-Direct

3:10pm

Simon Driver, for the prosecution, asks about the stock bags in the refrigerator.
He says every night, a check would be undertaken to see if any had been used.
He asks how the checker would know if they had been used.
The nurse says if there weren't the stock five TPN bags in the fridge, new ones would be ordered.
The refrigerator would have 'start-up' TPN bags and 'maintenance' TPN bags of nutrition.
The nurse says there may be fewer 'target stock' of the 'start-up' TPN bags.

3:11pm

Each of the bags would have a dated 'shelf life' the court hears.
The nurse says the bags would not be ordered in any particular fashion in the fridge.

3:15pm

A video of glucose/dextrose administration is played to the court.
The procedure is described as a 'two-person procedure'.

Juror Question

3:23pm

A question from a juror asks if the syringe driver could administer an infusion if the line has not been primed (ie if the line still has air in it).
The nurse confirms that would be the case. The equipment could have a filter connected, but it was the practice that the line would be primed before use.

Recap: Lucy Letby trial, Thursday, November 24

 

[Tortoise]

Friday November 25th 2022 - Live updates from the trial

Day 29 of Prosecution Evidence

(Twin) Child F


Anna Milan, Clinical Biochemist re. F's blood sample 5.56pm 5th August 2015

10:36am

The trial has now resumed.
The court is hearing from Anna Milan, a clinical biochemist, how insulin and insulin c-peptide tests were taken for analysis.

10:47am

Child F's blood sample, which was dated August 5, 2015, was taken at 5.56pm.
The court is shown a screenshot of Child F's blood sample results. Child F is referred to as 'twin 2' - Child E, the other twin boy, had died at the Countess of Chester Hospital on August 4.
Dr Milan says Child F's insulin c-peptide level reading of 'less than 169' means it was not accurately detectable by the system.
The insulin reading of '4,657' is recorded.
A call log information is made noting the logged telephone call made by the biochemist to the Countess of Chester Hospital, with a comment made - 'low C-Peptide to insulin'

10:55am

The note adds '?Exogenous' - ie query whether it was insulin administered.
The note added 'Suggest send sample to Guildford for exogenous insulin.'
The court hears Guildford has a specialist, separate laboratory for such analysis in insulin, although the advice given to send the sample is not usually taken up by hospitals.
Dr Milan said that advice would be there as an option for the Countess of Chester Hospital to take up.
Dr Milan said she was 'very confident' in the accuracy of the blood test analysis produced for Child F's sample.

Cross-Examination

Ben Myers, for Letby's defence, asks about the risk of the sample deteriorating if it is not frozen.
Dr Milan said the sample arrived frozen. If it wasn't frozen, it would be accepted in 12-24 hours.
She said the laboratory knew it arrived within 24 hours, and adds Chester has its own system in place to store the blood sample before transport.

10:57am

Mr Myers said the Child F blood sample would have been stored for seven days [in Liverpool], then disposed of. Dr Milan agrees.


Judge's Question

10:58am

On a query from the judge, Mr Justice James Goss, Dr Milan explains how the blood sample is frozen and kept frozen for transport.
She said the sample would not have been taken out of the freezer in Chester until it was ready to be transported.

LIVE: Lucy Letby trial, Friday, November 25

 

[Tortoise]

Friday November 25th 2022 - Live updates from the trial

Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


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Day 29 of Prosecution Evidence

(Twin) Child F


Professor Peter Hindmarsh, Expert Witness,
Professor of Paediatric Endocrinology and Diabetes

11:02am

The next witness to give evidence is Professor Peter Hindmarsh, an expert witness.
He explains to the court he is professor of paediatric endocrinology at University College London and consultant in paediatric endocrinology and diabetes at University College London Hospitals.
Nicholas Johnson KC, for the prosecution, asks whether Professor Hindmarsh was contacted by Cheshire Police in connection with the case of Child F. Professor Hindmarsh confirms he was.

11:04am

Professor Hindmarsh confirms he had been told there was a suspicion Child F had received insulin in an 'exogenous' way - ie the insulin was not produced within the body.

11:06am

He said he concluded the cause of the hypoglycaemia was exogenous, and the chemical findings were compatible with the administration of exogenous insulin.

11:13am

The court hears about Child F's blood sugar being slightly below normal, just after birth, and he was given 10% dextrose, and that resolved the blood sugar level to a normal rate.
There was also a point around July 30-31 when Child F's blood sugar level rose to a higher than normal rate, and he was given a tiny amount of insulin to lower the rate. Subsequent blood sugar readings returned to normal.
The court is now shown Child F's observation chart for the night of August 4-5. Child F's heart rate rose from around 150bpm to 200-210bpm between 1.15am-4am.
Child F had received a TPN bag of nutrition at 12.25am on August 5.
Child F's blood sugar reading at 1.54am was 0.8. Professor Hindmarsh says it is a "significant" difference and "extremely low".
Mr Johnson: "Was it a cause for concern?"
Professor Hindmarsh: "Absolutely."

11:16am

A table, created by Professor Hindmarsh, records all of Child F's blood sugar readings from 11.32pm on August 4 to 9.17pm on August 5.
They are: 5.5 (August 4, 11.32pm)
0.8 (August 5, 1.54am)
2.3 (2.55am)
1.9 (4.02am)
2.9 (5am)
1.7 (8.09am)
1.3 (10am)
1.4 (11.46am)
2.4 (noon)
1.9 (2pm)
1.9 (4pm)
1.9 (6pm)
2.5 (7pm)
4.1 (9.17pm)
A reading of 'above 2.6' is considered 'normal'.
Professor Hindmarsh says the hypoglycaemia is "persistent" right through the day until the conclusion of the TPN bag at 6.55pm.


The 5am reading of 2.9, which the court hears is considered a 'normal' blood sugar reading, is gone into further detail.
Mr Johnson asks the court to show the intensive care chart for Child F for August 5.
For the 5am reading, the blood sugar reading signature has the initials 'LL'.

11:24am

The chart also shows Professor Hindmarsh's notes to provide context for the blood sugar readings throughout the day, when changes are made to the infusions for Child F.
Professor Hindmarsh says the hypoglycaemia continues "despite" five boluses of 10% dextrose and "ongoing" glucose delivery from the 10% dextrose infusion, and the glucose contained within the TPN bag.
He says that would, in total, give a glucose infusion which would be, at minimum, "twice the normal [daily] requirements of a baby".
He said it is likely more glucose was being delivered from the bolus injections.

11:26am

Professor Hindmarsh had noted three events during August 5, after 1.54am, when the TPN bag was administered.
At 10am, there were problems with the cannula infusion which meant the line had to be resited, and fluids were discontinued. The two further glucose readings after are '1.4' and '2.4', "implying" that the blood glucose level had started to rise "spontaneously" as there was "no contribution from the intravenous route".

11:28am

Mr Johnson said after Child F was taken off the 'double' dose of dextrose during that time, his blood sugar levels "actually rose".
Professor Hindmarsh: "That's how I see it, and I believe that is correct".

11:30am

The reading was "heading in the wrong direction" down to 1.9 by 2pm, the court hears.
The infusions stopped at 6.55pm.
Mr Johnson: "Is there a paradox between a child receiving glucose and their blood sugar falling?"
Prof Hindmarsh: "Correct."

11:34am

The 5.56pm blood sample for Child F is referred to, which has a blood sugar reading of 1.3.
Mr Johnson asks about the apparent disparity.
Prof Hindmarsh says the laboratory reading of blood plasma of '1.3' differs from the neopatient reading of '1.9' (taken at 6pm).
He explains a discrepancy of up to 0.8 between the two is considered acceptable.
He says whichever the more accurate reading is 1.3 or 1.9, it is still "very low".

11:37am

Child F's blood test result from the laboratory, as shown earlier to the court today, is presented to Professor Hindmarsh. The sample was taken at 5.56pm on August 5 and collected at the Liverpool laboratory at 4.15pm on August 6.
He says the insulin reading should be in proportion to the insulin C-Peptide reading, and should be several times higher in this context.

11:41am

Prof Hindmarsh explains to the court the dangers of prolonged low blood sugar in the body, which can lead to damage to the brain.
Breakdown of fats can be used as a temporary measure, as a substitute.
The problem, he says, is if the low blood sugar is caused by excess insulin.
The insulin will 'switch off' key body formation.
He says the brain would be in a "very, very susceptible state to receiving damage".
That depends on the depth and length of the hypoglycaemia episode.
An equivalent reading of 2.3 or so would lead to 'confusion' and difficulties reading/writing.
Professor Hindmarsh says lower readings than that could lead to seizures, death of brain cells, coma, and in some cases, death.

11:47am

Professor Hindmarsh added, in his report, the insulin used in the hospital, has been used in the past 20-25 years, and is synthetic insulin.
Stocks of pig/cow insulin would not be held as regular stock or in a pharmacy. They would have to be requested.
The two types of synthetic insulin are fast-acting - ones that work within 30 minutes, applied via an injection, the effectiveness lasting 4-6 hours. The other type is long-acting, which lasts up to 12-24 hours.
The second type of insulin, he explains, is not generally used for intravenous infusions, and he has never seen any evidence of that having been done.

11:50am

Professor Hindmarsh is shown a 10ml bottle of insulin, which normally comes with an orange, self-sealing cap.
To extract the liquid from the bottle, to administer 'therapeutically', a medical professional would have to use a syringe, the court hears.
Mr Johnson says by 'therapeutically', Professor Hindmarsh means 'legitimately'. Professor Hindmarsh agrees, and says the dose would have to be measured out carefully.

11:52am

The insulin bottle exhibit is shown to members of the jury and the defence.

12:00pm

Once a syringe is put into the bottle, the bottle self seals after the syringe is removed, the court hears.
Professor Hindmarsh says it is not possible to give insulin by mouth as it is a large molecule, so cannot be absorbed easily and the protein would be broken down by the acid in the stomach. It could not have been administered via the naso-gastric tube for the same reason.
The only ways would have been through a skin injection or intraveneously, he says.
For a skin injection, he says the duration of action [for the insulin] of 4-6 hours would not fit with the 17 hours of hypoglaycaemia. It would require multiple injections.
He says an intravenous route "would be the most likely explanation".
The way to do so would be a bolus of insulin - from testing in endrocrinology, the blood sugar level would fall within 90 minutes, then rise back to normal.
To maintain hypoglycaemia "over a protracted period of time" would require multiple insulin boluses "roughly every two hours".
The second route would be via infusion - "probably the most likely way of achieving the blood glucose effect that we have observed".
The infusion would be "continuous", using the bags available, and "fit nicely" with the time course of events.
It would "also be consistent" with the measurements that took place during and after the TPN bag was replaced.

12:03pm

Professor Hindmarsh says the exogenous insulin, if the fast-acting type, would have reduced from the '4,657' reading to 'almost none' after a couple of hours after the TPN bag was removed.
The rise of the blood glucose level in Child F to 4.1 by 9pm was "entirely consistent" with that.

12:16pm

Professor Hindmarsh says a rate of about 0.56ml/hr of insulin would have been required to lower Child F's blood sugar levels on the TPN bag.
This was calculated given the insulin level administered to lower Child F's blood sugar levels on July 31.
Mr Johnson: "Would that level have been visible to the naked eye?"
Prof Hindmarsh: "No."
Mr Johnson asks if the stock TPN bag was contaminated to the same degree as the bespoke bag.
Prof Hindmarsh says the glucose concentrations are not much different from 1.54am-10am, when the bag is changed, and after then.
"The contents [and contamination] are probably about the same."
Mr Johnson asks about Professor Hindmarsh's conclusion, that the fluid he was receiving could only have been contaminated with insulin.
"Yes I do."

LIVE: Lucy Letby trial, Friday, November 25

 

[Tortoise]

Friday November 25th 2022 - Live updates from the trial

Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


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Day 29 of Prosecution Evidence

(Twin) Child F


Professor Peter Hindmarsh, Expert Witness,
Professor of Paediatric Endocrinology and Diabetes

Cross-Examination

12:50pm

Ben Myers KC, for Letby's defence, is now asking Professor Hindmarsh questions.
He said the fast-acting insulin would not be visible.
Professor Hindmarsh confirms that type of insulin would have a "distinctive smell" about it.
Mr Myers says the concentration of insulin administered could, over time, could lead to complications for the patient.
Prof Hindmarsh: "That is correct."

12:57pm

Mr Myers said it would be about 25 minutes before the insulin administered would have its effect.
Prof Hindmarsh said it would take about 25 minutes for it to have its biggest effect.
Mr Myers says other than the heart rate and vomiting, Child F did not appear to suffer any other physical symptoms than the low blood sugar levels.
He asks, given the high level of insulin seen, would there be "more powerful, physical consequences?"
Prof Hindmarsh says vomiting is not an unusual feature.
In the magnitude of features, he says, the effects would be on brain function rather than any other peripheral manifestations.
He said physical features of hypoglycaemia would "not be easy to pick up in a newborn, or a premature" baby.
"Neurologically, that's different."
The features would also be "extremely variable".
The first symptom "could, and would often be, collapse and seizure".
Mr Myers says it is an alleged 17-hour period of exposure of high levels of insulin, and if the effects would have been more apparent.
Prof Hindmarsh says high levels of insulin have been recorded in babies with underlying conditions, and they present well up to the point of collapse.

1:03pm

The intensive care chart for Child F is presented to the court again.
The blood sugar reading of 2.9 is recorded for 5am.
"2.9 would present in the normal range wouldn't it?"
A normal range would be 3.5 or above, Professor Hindmarsh says.
A reading of 0.8 is at 1.54am, and 2.3 at 2.55am. Mr Myers says, while low, that is a "significant increase".
He shows an IV chart, in the intervening period at 2.05am, an administration of 10% dextrose for Child F.

1:05pm

Mr Myers says the infusion chart, shown to the court, has a 10% dextrose bolus at 4.20am.
Mr Myers adds between 4.02am and 5am, the blood glucose reading for Child F rises from 1.9 to 2.9.

1:12pm

Mr Myers refers to the level of contamination in the TPN bags.
He refers to the blood sample taken at 5.56pm on August 5, nearly 17 hours after the first TPN bag was put up for Child F.
He says that reading "only applies to the second [TPN] bag."
Professor Hindmarsh: "It did, yes."
Mr Myers: "That won't tell us what the insulin level was at 12.25am, would it?"
Prof Hindmarsh: "No, it won't. we haven't measured that."

Prosecution Re-Direct

Mr Johnson, for the prosecution, rises to clarify insulin levels.
He asks would it be reasonable to infer that if Child F has similar blood glucose levels throughout the day, he had had similar insulin levels inside him during that day.
Professor Hindmarsh says there is a caveat in that there had been efforts to raise Child F's blood sugar during the day through 10% dextrose boluses.
"Overall, the infusion [rate] has essentially stayed the same.
"I can't be absolutely sure...but it's safe to assume that the glucose infusion rate did not change, which would imply that the amount of insulin around would be similar throughout the 17-hour period - allowing for the breaks when the infusion was discontinued."
He adds that would be his conclusion.

Defence Re-Cross-Examination


1:14pm

Mr Myers has one more query, to which Professor Hindmarsh clarifies that a measurement of blood glucose is not a measurement of insulin or insulin C-Peptide, but there are 'clear relationships' between the two, and what they would be expected to be.

1:16pm

He adds the blood glucose level, via infusion, was consistent, and "it would be reasonable to assume" the insulin infusion would also be at the same rate was it was at 5.56pm as it would be as earlier in the day.

LIVE: Lucy Letby trial, Friday, November 25

 

[Tortoise]

Friday November 25th 2022 - Live updates from the trial

Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


-----

Day 29 of Prosecution Evidence

(Twin) Child F


Dr David Harkness, Registrar, CoCH, Night Shift 4th/5th August 2015


1:18pm

Dr David Harkness is being recalled to give evidence.
He has previously given evidence in the trial, and was employed at the Countess of Chester Hospital in summer 2015 as a paediatric registrar.
He is being asked about the night shift of August 4-5, and confirms he was accompanied by Dr Christopher Wood.
Notes showed he saw Child F on three occasions during that night shift.

1:23pm

He is asked about the 1.30am observations for Child F on August 5, of milky vomit and high heart rate.
He confirms the observations were made by himself.
He noted a 'soft continuous murmur' which is 'very common in babies'.
The plan was to rescreen, and use a second line for antibiotics.
There were "concerns" for Child F's heart rate, and that Child E, the twin baby boy, had passed away the previous night.

1:29pm

Dr Harkness's notes are shown to the court from 2.30am.
He noted Child F had 'large milky aspirate' and was 'quieter than usual'.
He said, from the heart rate observations being 'higher than normal', he was troubled by the possibility of infection, stress and pain, but those heart rates would go to 180bpm, not 200-210bpm, and come back down after a few seconds/minutes, not remain constantly high.
A septic screen and a number of blood tests were called for.
The blood sugar level of 0.8 [underlined on the note] was "very low".
Child F was "handling well" and pink and well perfused, indicating good circulation, Dr Harkness says, with heart sounds 'normal', but with a very quiet murmur.

1:32pm

The two problems were hypoglycaemia and tachycardia.
Dr Harkness's plan was for a dextrose bolus, a saline bolus, antibiotics, an ECG, and to consider medicine to slow the heart rate down - but that medicine had its risks and would only be used in the event of supraventricular tachycardia.

1:36pm

Dr Harkness's note at 3.30am for Child F showed a heart rate of 204.
A discussion with the on-call consultant Dr John Gibbs, in which it was decided it was unlikely Child F had supraventricular tachycardia as the heart rate would be closer to 300bpm.
Dr Gibbs suggested repeating the fluid bolus, continue to monitor Child F, and only to consider the heart-slowing medicine if the heart rate rose to near 300.
A blood gas reading suggested Child F was dehydrated at this time.
The plan was to continue to monitor Child F's sugar levels.

1:41pm

A 10% dextrose infusion is administered for Child F at 3.50am, plus a 10% dextrose bolus at 4.20am.
Dr Harkness said the administrations had "an effect", but the blood sugar levels "kept drifting up and down".


Cross-Examination

Mr Myers, for Letby's defence, says there will be no questions asked for Dr Harkness at this time.





LIVE: Lucy Letby trial, Friday, November 25

 

[Tortoise]

Friday November 25th 2022 - 10% Independent Baby’s heart rate soared after receiving insulin, murder trial told 10% Standard Baby’s heart rate soared after receiving insulin, murder trial told



[Prof Hindmarsh] "said Child F’s initial rise in heart rate was “consistent with the release of adrenaline, your first line of defence against a low blood glucose”. [...]

His calculations, he said, showed the synthetic insulin remained in a “steady state” in Child F’s system up until 6.55pm and disappeared more than 30 minutes later.

He also calculated from a subsequent blood sample, which showed an “extremely” high level of insulin, that the rate it was delivered was 17 times greater than a small “appropriately therapeutic” dose given to Child F in the days that followed his birth.

Prof Hindmarsh agreed with prosecutor Nick Johnson that the blood glucose measurements relating to the second stock bag suggested that it too had been contaminated “more or less to the same degree”.

[...]

The witness agreed with Ben Myers KC, defending, that the blood sample reading of high insulin came from the second stock bag so could not show what level was in the first bag attached in the early hours of August 5.

But Prof Hindmarsh said that similar blood glucose readings around the same period from a single person would likely mean they had a similar amount of insulin in their system earlier."

 

[Tortoise]

LL's texts and Facebook searches, in a timeline of the cases, with info known to date.
8 Jun 2015 to 30 Jun 2015


8 Jun 2015, Mon

9.21am -
LL received a text asking her to work night shift.
LL: "Yes that's fine...is it busy?"
Colleague: "We have 3 on CPAP...twins last night...wanted six staff on."
LL: "No problem."

9.25am –
outgoing message from LL to a friend/colleague:
LL: “I'm working tonight and tomorrow now as busy." "Will just have a quiet one today. Slept well. They have 3 30wkers on CPAP."
Colleague: "It will calm down again soon then."


LL reply to another colleague:
LL: "I've been moved forward as busy. Doing tonight and tom."

8pm – LL’s night shift

8.26pm - twin baby (boy) A collapsed

8.58pm - twin baby A pronounced dead - murder charge


9 Jun 2015, Tue

8am – LL finishes night shift

9.58am - Facebook mother of A&B

Before next night shift starts -
LL texted a colleague she didn't want to see [twin] A's parents.
Colleague: "That's understandable."
LL: "Don't mind being in 1 but don't want to have [twin] B."
Colleague offers to look after B, with LL also present in the room.
LL agrees and says: "I think it'd be good for you."

Later –
Colleague: 'Hi Lucy. Hope you are OK?'
LL: 'I think we all did everything we possibly could under very difficult and sad circumstances. Haven't had much sleep. Don't really want to see parents but it's got to be done. 'I said to [nurse] that I can't look after B because I just don't know how I'm going to feel seeing parents. Dad was on the floor crying saying ''please don't take our baby away'' when we took him to the mortuary. It's just heartbreaking. It's the hardest thing I've ever had to do. Hopefully have a more positive one tonight.'
Colleague responded saying she would prefer that LL cared for B so her parents 'don't have a totally new face'.

6.38pm -
A nurse messaged LL: 'You did amazing. I'm so proud of you. Hope that doesn't sound patronising…You did fab.'

Another colleague texted: 'I can't imagine how hard that must have been.'

8pm – LL’s night shift

LL to a colleague: "Hard coming back in tonight."

Later:
Colleague: 'We do have a good team. I just wish I could have given you the night off, but you're all needed.'
LL: 'It's the last time I do you a favour changing shifts! Haha!'


10 Jun 2015, Wed

12.30am - twin B (girl) collapsed - attempted murder charge. Designated nurse’s handover sheet for B found at LL’s home during police search.

8am – LL finishes night shift

Just after noon - 12.04pm
LL to a colleague: 'Will you let me know if any change with B.'
Colleague says the shift was "manic", and there had been "no change" with B.

Later –
LL texted a colleague to say she had been watching a TV documentary about life on a neonatal unit “An Hour To Save Your Life”.
Colleague: ….'get enough in work'.
LL: 'I just find it interesting, to see how our work is portrayed to the public.'

10.08pm –
LL again texted enquiring about B and was informed B was "looking really good".

11.09pm –
The same colleague told LL that the parents of twin A had taken a memory box for him.
LL: 'Oh good'. 'Hoped they would find comfort'.

11.31pm - Facebook mother of A&B


11 Jun 2015, Thu

Text messages show LL asking if there were spare shifts going, adding: "Think I need to throw myself back in on Saturday."
Colleague: "Hopefully it might settle down by then."
LL: "I think from a confidence point of view I need to take an ITU baby soon."
Colleague: "It does knock you a bit when things like that happen, but it's ok to have time out as well. Enjoy the sun"


12 Jun 2015, Fri

LL texted a colleague who had been off work after looking after A when he was born: "Hi [nurse] - you may have heard by now but wanted to let you know that we lost little A on Monday. Knew you looked after him."
Colleague: "I didn't know actually, thanks for letting me know. That's terrible!"
LL: "It was awful...he died very suddenly and unexpectedly just after handover. Not sure why. It's gone to the coroner. They are querying a clotting problem. Very sad.”
Colleague: "Oh god, he was doing really well when I left."
LL: 'Just collapsed very suddenly. Awful. He had really good day on Monday then I took over Monday night'. ‘Waiting for post-mortem results. Hopefully they can get to the bottom of it.’
Colleague: 'I'm sorry it happened when you were taking care of him. You're not having a good run at the moment.'
LL: 'I wasn't supposed to be in either - [boss] swapped my nights as unit busy - but these things happen unfortunately. I took pictures, hand and footprints etc. They are besides themselves worried that they will lose B too.’
Colleague: "Yeah it's the business we are in unfortunately. Hopefully B will be ok in the end."


13 Jun 2015, Sat

8pm – LL’s night shift

9.48pm –
JJ-K: "You ok? x"
LL: "I just keep thinking about Monday. Feel like I need to be in 1 to overcome it, but [nurse] said no x"
JJ-K: "I agree with her, don't think it will help. You need a break from full-on ICU, you have to let it go or it will eat you up."
LL: "Not the vented baby necessarily, I just feel I need to be in 1, to get the image out of my head. To be in 3 is eating me up. All I can see is him in 1. It probably sounds odd but it's how I feel x"
JJ-K: “It sounds very odd and I’d be complete opposite.
LL: “Well that’s how I feel. I don’t expect people to understand but I know how I feel and how I have dealt with it before. I voiced that so can’t do any more, but people should respect that.”
JJ-K: “I think they do respect it but also trying to help you. Why don’t you go in 1 for a bit?”
LL: "Yeah, I have done a couple of meds in 1. I’ll be fine. Forget I said anything, I will be fine, it's part of the job but just don't feel like there is much team spirit tonight x"
JJ-K: "I am not going to forget but think you're way too hard on yourself."
11pm - The WhatsApp conversation concludes at around 11pm.

11pm - baby C (boy) 1st collapse after designated nurse left the room

11.15pm - baby C 2nd collapse - while designated nurse on computer - could not be revived


14 Jun 2015, Sun

5.58am - baby C pronounced dead - murder charge

8am – LL finishes night shift

Morning, after work –
LL to JJ-K: "Sorry if I was off, just wasn’t a great start to the shift but sadly it got worse."
JJ-K: "You weren't off, you just were not happy and there is nothing I could say that was going to make it any better."
LL: "I was struggling to accept what happened to A, now we’ve lost C as well and it's all a bit much."
JJ-K: "It will be but it does happen to these babies unfortunately. Maybe you’ll feel better when you know what happened to A. So sad. It's a very sad part of our job and I think because we don’t see it much it’s harder." JJ-K recalls a baby who had previously died in the neonatal unit, but had “overwhelming sepsis" so "nothing would have saved that baby".
LL: "C is the little 800g baby. He went off very suddenly. I know it happens but it's so sad and cruel isn’t it. X” “I just keep seeing them both. No one should have to see and do the things we do. It’s heartbreaking.”
JJ-K: "Hoping you are going to ok, this is not like you. Sending the biggest hugs."
LL: "It's heartbreaking but it's not about me, we learn to deal with it."
JJ-K: It’s horrible and heartbreaking, I don’t think those babies ever leave you. Chin up chuck we will get through it together."
LL: "It's not about me or anyone else, it's about those poor parents who have to walk away without their baby. It’s so unbelievably sad."
Messages are relayed detailing how nursing staff on the night shift were upset by what happened.
JJ-K: "This is where we have to pull together and look after each other."
LL: "Think we support each other brilliantly...just such a shock especially after Monday."
JJ-K advises LL to "switch off for a bit".

Before 10.12am –
LL messaged her own mum: "We lost a little one overnight. Very unexpected and sad xx" LL added: "He only weighed 800g. Sophie the new girl was looking after him, she was devastated."

Before 10.12am –
LL messaged another colleague asking when she is next at work, before adding: "We lost little C overnight, everyone's devastated."
Colleague: "Damn. Infection? Crap week. How is B?"
LL gives an update and says, for C: "Doing well on Optiflow. Then collapsed. All happened very quickly. Sophie had him and is devastated."
Colleague: "Damn. As quick as A?
Colleague or LL?: Yeah, s*** week."
LL: "Parents sat with C in the family room...persuaded them to have hand and footprints but they just wanted to go home."
Colleague: "That is so sad, don't know what to say."
LL: "There are no words, it's been awful."
Colleague: "It's a really tough week, especially for you."
10.12am - The text conversation ends.

3.32pm - Facebook parents baby C

Afternoon –
A text conversation LL has with a third colleague, Sophie Ellis, (C’s designated nurse):
LL: "I don't really want to go in tonight."
SE: "I don't particularly but we will get each other through it."
LL: "We are a good team and we will get through. You did so, so well."
SE: "We all did - so lucky to work with such an amazing and supportive team."


21 Jun 2015, Sun - Father’s Day

8pm – LL’s night shift


22 Jun 2015, Mon

1.30am - baby D (girl) 1st collapse while designated nurse on 1hr break

3am – baby D 2nd collapse

3.45am – baby D 3rd and final collapse

4.25am – baby D pronounced dead - murder charge

8am – LL finishes night shift

8.36am –
LL: "We had such a rubbish night. Our job is just far too sad sometimes."
Colleague: "No, what happened?"
LL: "We lost baby D."
Colleague: "What!!!! But she was improving. What happened? I can't believe you were on again. You are having such a tough time."
LL: "messed about a couple of times and came out in this weird rash looking like overwhelming sepsis, then collapsed and had full resus. So upsetting for everyone. Parents absolutely devastated, dad screaming. Andrew Brunton and Liz Newby said it will probably be investigated. Dad is beside himself.”
Colleague: "Dad was very anxious all day." adding, in relation to the investigation, "What the delay in treatment?"
LL: "Just overall looking into the case. And reviewing what antibiotics she was on if sepsis."
The colleague refers to what D looked like in their care. “D was behaving septic. Damn, poor family. You okay?”
LL: It’s just been another shock for us all. I feel a bit numb this time. But it's part of the job and it's hard for everyone."
Colleague: "Yes but you have had it all recently. Oh hun. You need a break.”
LL: "Hmm well it's happened and that is it, got to carry on. Sorry to moan to you. Not what you want to hear first thing.
Colleague: It’s fine, I want to know. I was there when she came in. More importantly I’m always here for you and it’s not moaning. We have the shittiest job in the world sometimes, and the best.
LL: Absolutely, on a day to day basis it’s an incredible job with so many positives but then sometimes I think how is it such sick babies get through and others die so suddenly and unexpectedly. Guess it’s how it’s meant to be.
Colleague: We’re a good team that give excellent care. We just don’t have magic wands.
LL: I know that. I think there is an element of fate involved, there’s a reason for everything.
Colleague: “You go to bed, you’re an excellent nurse Lucy. Don’t forget it. It's important to remember that a death is not a failure."
LL: I know and I don’t feel it’s a failure as such, more than it’s just very sad to know what families go through.
LL refers to her planned time off. The conversation then discusses staffing arrangements, and the difficulties of the job, before noting an instance of a happier occasion on the unit.


23 Jun 2015, Tue

8pm – LL’s night shift

Evening –
Colleague: "How you doing?"
LL: "I'm ok - trying not to think about it. Work busy but at least we have 6 tonight."
Colleague asks about D and whether anything had been said about not "bringing her through sooner on Saturday".
LL: "I don't think so", before adding there was a theory D may have had meningitis.
Colleague: "I'm worried I missed something."
LL: "I don't think any of us did and she was on the right antibiotics."
Colleague: "Yeah, just would treatment sooner have made a difference."
LL asks her colleague if D had a lumbar puncture.
The colleague replies she was not sure it ever got done, given that D had been ill and had been on CPAP. She adds her gas reading was "appalling" when she first came through to the unit.
LL: "I think we did what we could." LL then refers to the condition of the mother of baby D.


25 Jun 2015, Thu

9.50pm – Facebook mother of A&B
9.51pm – Facebook parents of baby D


26 Jun 2015, Fri

LL messaged colleague Minna Lappalainen: "Work has been awful."
ML: "Oh dear. Staffing probe?"
LL: "We have had three unexpected deaths, transfer out, few sick ones, unit full”. "What I’ve seen has really hit me tonight."
ML: "Have you worked today?"
LL: "No, been off since Wednesday morning and now it has all hit me."
ML asks if LL tries "talking to a proper counsellor".
LL replies that she does not think she can.
ML: "Why not?"
LL: "I can't talk about it now...I can't stop crying...I just need to get it out of my system."
ML advises LL to think carefully what to do, before adding: "Maybe you need to take time off."
LL: "Work is always my priority. I won’t let it affect it. I just haven’t let myself cry over it until now. Once I’ve let it out my head will be clear."


30 Jun 2015, Tue

LL texted a colleague that baby B had moved to a recovery room in the unit.
Colleague: "There's something odd about that night and the other three that went so suddenly."
LL: "What do you mean? Odd that we lost three and in different circumstances?'
Colleague: "I don't know, were they that different?" "Ignore me, I'm speculating."
LL: "C was tiny, obviously compromised in utero. D septic. It's A I can't get my head around."

Later –
LL to a colleague: said she was 'nodding off' in a cinema. She added: "I had a mini meltdown last night about what's happened at work..."I just need some time off with mum and dad."

 

[Tortoise]

LL's texts and Facebook searches, in a timeline of the cases, with info known to date.
Part 2 - Jul 2015 to 2018



Jul 2015

baby B went home


27 Jul 2015, Mon

LL was sent a text, on her time off, asking if she would be back in time for a debrief regarding baby A. She says she will be looking to get back in time for that.


30 Jul 2015, Thu

Staff debrief into death of baby A


2 Aug 2015, Sun

8pm – LL’s night shift

10.34pm –
JJ-K: "Hope work ok".
LL: "yeah it's fine, bit too Q word really."
JJ-K: "Don't complain as Wed and Thurs horrible lol! It will pick up again."


3 Aug 2015, Mon

8am – LL finishes night shift


8pm – LL’s night shift

9pm - twin baby (boy) E’s mother visited and saw him bleeding from mouth

11.40pm – twin baby E collapsed


4 Aug 2015, Tue

1.40am – twin baby E pronounced dead - murder charge

8am – LL finishes night shift

8.58am –
Colleague: "You ok? Just heard about E. Did you have him? Sending hugs xx"
LL: "News travels fast - who told you? Yeah I had them both, was horrible."
Colleague: someone at the handover 'told me just now'. 'Had he been getting poorly or was it sudden?' ‘Poor you. You’re having a *advertiser censored* time of it.”
LL: He had a 'massive gastrointestinal haemorrhage'.
Colleague: ‘Damn. He’d always struggled feeding. I just feel for his parents and you. You’ve had really tough times recently.’
LL: E was 'IUGR [Intrauterine growth restriction] and REDF [Reversal of umbilical artery end-diastolic flow]' Guess he was very high risk. Was just awful, he was bleeding from everywhere during resus. Got him back but gas incompatible. Parents completely distraught. I feel numb.

8pm – LL’s night shift

7.55pm –
JJ-K: "Hey how's you?"
8.01pm -
LL: "Not so good, we lost E overnight."
8.02pm -
JJ-K: "That’s sad. ‘We’re on a terrible run at the moment. Were you in 1? x"
8.02pm
LL: "Yes. I had him and F x"
JJ-K: "That’s not good, you need a break from it being on your shift. x"
LL: "It's the luck of the drawer (sic) isn’t it, unfortunately. Only three trained, so I ended up having both, whereas just F the other shifts."
JJ-K: "You seem to be having some very bad luck though."
LL: "Not a lot I can do really. He had massive haemorrhage could have happened to any baby. x"
JJ-K: "No, you did everything you could, I know it can happen to any baby, very scary", I have seen one, my baby did it in nursery 3 once, horrible.”
LL: "Wasn’t nice. This was abdominal. I’ve only seen pulmonary before.”
JJ-K: Hope your be ok. Chin up”
LL: I’m ok. Went to [colleague] for a chat earlier on and with nice people tonight.
JJ-K: Hope your night goes ok.”


5 Aug 2015, Wed

12.25am– alleged contamination of baby (boy) F’s TPN bag with insulin

8am – LL finishes night shift

Before 10am –
LL has been messaging the night shift designated nurse for F;
LL: "Did you hear what F's sugar was at 8[am]?"
Nurse: "No?"
LL: "1.8"
Nurse: "[S***]!!!!", adding she felt "awful" for her care of F that night.
LL: "Something isn't right if he is dropping like that with the amount of fluid he’s had and being 1.65kg" adding that F's heel has to be taken into consideration [as blood gas tests are taken via heel pricks, and cannot be done too regularly].
Nurse: "Exactly, he had so much handling. No something not right. Heart rate and sugars."
LL: "Dr Gibbs came so hopefully they will get him sorted. "He is a worry [though]."
Nurse: "Hpe so. He is a worry."
LL: "Hope you sleep well...let me know how F is tonight please."
Nurse: "I will hun".

day shift – twin baby F low blood sugar persisted despite 5 dextrose injections – readings mean he must have been given synthetic insulin - attempted murder charge

4pm - LL’s phone receives an invitation from an estate agency firm confirming a viewing for a property in Chester, near the hospital. This home would be the address where LL stayed until her 2018 arrest.

6pm –
LL texts a colleague Minna Lappalainen:
LL: "Hi! Are you going to salsa tonite?"
ML: "Should do really as I haven't been for ages. Meet at TF 2020?”
LL: 'ok' emoji. LL adds: "Need to try and find some sort of post nites energy"
ML: “Don’t have to stay late.”
LL: "Hasta luego".

Evening –
Night shift designated nurse messaged LL: "He is a bit more stable, heart rate 160-170. Changed long line but sugars still 1.9 all afternoon. Seems like long line tissued was not cause of sugar problem, doing various tests to try to find answers”
LL: "Oh dear, thanks for letting me know."
Nurse: "He’s defo better tho. Looks well, handling fine."
LL: "Good."

11.58pm –
LL’s text to same nurse: "Wonder if he has an endocrine problem then. Hope they can get to bottom of it. "On way home from salsa with Minna. Feel better now I’ve been out."
Nurse: "Good, glad you feel better. Maybe re endocrine. Maybe just prematurity."
LL: "How are parents?"
Nurse: "OK. Tired. They've just gone to bed."
LL: "Glad they feel able to leave him."
Nurse: "Yes. they know we'll get them so good they trust us."
LL: Yes.
?: "Hope you have a good night."


6 Aug 2015, Thu

LL had a house-viewing appointment.

7.58pm - Facebook mother of E&F


7 Aug 2015, Fri

LL gave twin F’s mother a photograph of him ‘holding' twin E's teddy.


9 Aug 2015, Sun

10.17pm –
LL texted a nurse: I said goodbye to [E&F]’s parents as F might go tomorrow. They both cried and hugged me saying they will never be able to thank me for the love and care I gave to E and for the precious memories I’ve given them. It’s heartbreaking’
Nurse: 'It’s heart-breaking, but you’ve done your job to the highest standard with compassion and professionalism. 'When we can’t save a baby we can try to make sure that the loss of their child is the one regret the parents have. It sounds like that’s exactly what you have done. You should feel very proud of yourself esp as you’ve done so well in such tough heartbreaking circumstances. Xx’
LL: 'I just feel sad that they’re thanking me when they have lost him and for something that any of us would have done. But it’s really nice to know that I got it right for them. That’s all I want.'
Nurse: ‘It has been tough. You’ve handled it all really well. They know everything possible was done and that no-one gave up on E till it was in his best interest. As a parent you want the best for your child and sometimes that isn’t what you’d choose. Doesn’t mean that your [sic] not grateful to those that helped your child and you tho.’
LL: ‘Thank you xx’


23 Aug 2015 – Facebook mother of E&F

2 Sep 2015 – Facebook mother of A&B


6 Sep 2015, Sun

8pm – LL’s night shift


7 Sep 2015, Mon

2.15am - baby (girl) G vomited violently out of cot onto nearby chair & floor and stopped breathing while designated nurse was on her 1hr break. After vomiting the amount of milk aspirated from baby G’s stomach was equal to her feed. X-ray showed air in abdomen & intestines.

6.05am – 100mls of air was aspirated from baby G’s nasogastric tube - attempted murder charge


9 Sep 2015 – Facebook parents of A&B

14 Sep 2015 – Facebook mother of E&F


21 Sep 2015, Mon

8am – LL’s day shift

10.20am – baby G projectile vomited twice and stopped breathing

mid pm – baby G collapsed and her monitor was seen to be off. Baby G is severely disabled as a result of the two episodes - 2 x attempted murder charges

21 Sep 2015 – Facebook parents of baby G
21 Sep 2015 – minutes later Facebook mother of E&F
21 Sep 2015 – minutes later Facebook mother of another baby listed in the charges


25 Sep 2015, Fri

8pm – LL’s night shift


26 Sep 2015, Sat

3.22am – baby (girl) H collapsed and required CPR after LL administered fluids - attempted murder charge

8am – LL finishes night shift


8pm – LL’s night shift


27 Sep 2015, Sun

12.55am - baby H collapsed – LL’s signatures on medicine administrations

3.30am – baby H collapsed again - LL was treating & gave the history to the attending doctor despite not being her designated nurse - attempted murder charge


30 Sep 2015, Wed

8am – LL’s day shift

4.30pm - baby (girl) I vomited and was struggling to breathe after LL fed her

5.39pm – x-ray of baby I showed massive amount of gas in stomach & bowels and lungs squashed - alleged attempted murder (not charged but chgd w/murder)


Oct 2015 – (either 3rd, 10th, 17th, 24th or 31st) Facebook father of baby D
5 Oct 2015 – early hours – Facebook mother of baby I
5 Oct 2015 – early hours – Facebook father of E&F
5 Oct 2015 – early hours – Facebook mother of H


12 Oct 2015, Mon

8pm – LL’s night shift


13 Oct 2015, Tue

3.20am – LL remarked from the nursery doorway that baby I was looking pale but the room was darkened – nurse found her pale and not breathing but the alarm had not sounded. CPR was performed. X-ray showed gaseous distention of abdomen & bowel - alleged attempted murder (not charged but chgd w/murder)

8am – LL finishes night shift


8pm – LL’s night shift


14 Oct 2015, Wed

5am – baby I had increasing abdominal distention

6.05am – baby I’s x-ray showed widespread gaseous distention

Time? – baby I collapsed and required CPR - alleged attempted murder (not charged but chgd w/murder)


22 Oct 2015, Thu


8pm – LL’s night shift

just before midnight - baby I collapsed and required CPR – LL was attending - alleged attempted murder (not charged but chgd w/murder)


23 Oct 2015, Fri

1.06am - baby I’s monitor alarm sounded and she screamed – LL was beside the incubator – baby I died - murder charge

After Baby I’s death LL sent a sympathy card to baby I’s parents and kept a photo of it on her phone


5 Nov 2015 – Facebook – mother of E&F


12 Nov 2015, Thu

8.32pm -
A colleague texted LL: [E&F]’s parents brought a gorgeous huge hamper in today. Felt awful as couldn’t remember who they were till opened the card. Was very nice of them though n F looks 'fab x'.
LL: 'Oh gosh, did they, awe wish I could have seen them. That’ll stay with me forever. Lovely family x'.


26 Nov 2015, Thu

Before her nightshift started
LL texted a work colleague complaining that the babies she was to look after, including J, only needed help feeding.

8pm – LL’s night shift


27 Nov 2015, Fri

6.56am - baby (girl) J had a seizure. Her oxygen level dropped so low it was unrecordable

7.20am – LL gave baby J a glucose infusion – baby J collapsed again and CPR was performed - attempted murder charge (consistent with obstruction of airways - smothering)


Nov 2015 – Facebook – parents of baby J

7 Dec 2015 – Facebook - mother of E&F

25 Dec 2015 – 11.26pm - Facebook – mother of E&F

Jan 2016 – Facebook mother of E&F

10 Jan 2016 – Facebook – mother of E&F (last time)


16 Feb 2016, Tue

8pm – LL’s night shift


17 Feb 2016, Wed

am – baby (girl) K sedated premature baby stopped breathing – Dr found LL standing over the incubator not helping, the breathing tube secured with tape to K’s headgear was dislodged, and the monitor alarm not sounding.

later am – LL called for help - baby K’s breathing tube had moved too far into her throat - attempted murder charge


After 17 Feb 2016 – LL moved to day shifts


9 Apr 2016, Sat

8am – LL’s day shift –

twin baby (boy) L – insulin - attempted murder charge
twin baby (boy) M – alleged injection of air - attempted murder charge

Handwritten log of drugs administered to baby M during his collapse was found at LL’s house and she had noted his collapse in her diary.


2 Jun 2016, Thu

8pm – LL’s night shift


3 Jun 2016, Fri

1.05am – baby (boy) N collapsed and was crying and screaming. He was resuscitated – 1st attempted murder charge


15 Jun 2016, Wed

8am – LL’s day shift

8am – baby N collapsed when 2nd nurse’s back turned. He had blood in his mouth – 2nd attempted murder charge.

3pm - baby N collapsed again – more blood in throat – 3rd attempted murder charge


16-22 Jun 2016 – LL in Ibiza


23 Jun 2016, Thu

8am – LL’s day shift –

triplet baby (boy) O – liver injury – alleged impact trauma – and air injected into bloodstream and NGT - murder charge


24 Jun 2016, Fri

8am – LL’s day shift –

triplet baby (boy) P – air allegedly injected into stomach - murder charge


25 Jun 2016, Sat

8am – LL’s day shift –

baby (boy) Q – air and fluid allegedly injected into stomach via NGT - attempted murder charge

Handover sheet for morning of 25 Jun 2016 for baby Q was found at LL’s home



2016 – LL transferred to an admin role


23 Jun 2017 – anniversary of baby O’s death – Facebook – Surname of baby O (and P)

Apr 2018 – Facebook – parents of baby K

Other unreported dates – Facebook – parents of baby G


3 Jul 2018 – LL’s first arrest.

No Facebook searches for babies L, M, N, (O & P at the time, although she did do one a year later) or Q. All of these babies came to the unit after LL was moved to day-shifts.

 

[LiverpoolUK2222]

LL's texts and Facebook searches, in a timeline of the cases, with info known to date.
Part 2 - Jul 2015 to 2018



Jul 2015

baby B went home


27 Jul 2015, Mon

LL was sent a text, on her time off, asking if she would be back in time for a debrief regarding baby A. She says she will be looking to get back in time for that.


30 Jul 2015, Thu

Staff debrief into death of baby A


2 Aug 2015, Sun

8pm – LL’s night shift

10.34pm –
JJ-K: "Hope work ok".
LL: "yeah it's fine, bit too Q word really."
JJ-K: "Don't complain as Wed and Thurs horrible lol! It will pick up again."


3 Aug 2015, Mon

8am – LL finishes night shift


8pm – LL’s night shift

9pm - twin baby (boy) E’s mother visited and saw him bleeding from mouth

11.40pm – twin baby E collapsed


4 Aug 2015, Tue

1.40am – twin baby E pronounced dead - murder charge

8am – LL finishes night shift

8.58am –
Colleague: "You ok? Just heard about E. Did you have him? Sending hugs xx"
LL: "News travels fast - who told you? Yeah I had them both, was horrible."
Colleague: someone at the handover 'told me just now'. 'Had he been getting poorly or was it sudden?' ‘Poor you. You’re having a *advertiser censored* time of it.”
LL: He had a 'massive gastrointestinal haemorrhage'.
Colleague: ‘Damn. He’d always struggled feeding. I just feel for his parents and you. You’ve had really tough times recently.’
LL: E was 'IUGR [Intrauterine growth restriction] and REDF [Reversal of umbilical artery end-diastolic flow]' Guess he was very high risk. Was just awful, he was bleeding from everywhere during resus. Got him back but gas incompatible. Parents completely distraught. I feel numb.

8pm – LL’s night shift

7.55pm –
JJ-K: "Hey how's you?"
8.01pm -
LL: "Not so good, we lost E overnight."
8.02pm -
JJ-K: "That’s sad. ‘We’re on a terrible run at the moment. Were you in 1? x"
8.02pm
LL: "Yes. I had him and F x"
JJ-K: "That’s not good, you need a break from it being on your shift. x"
LL: "It's the luck of the drawer (sic) isn’t it, unfortunately. Only three trained, so I ended up having both, whereas just F the other shifts."
JJ-K: "You seem to be having some very bad luck though."
LL: "Not a lot I can do really. He had massive haemorrhage could have happened to any baby. x"
JJ-K: "No, you did everything you could, I know it can happen to any baby, very scary", I have seen one, my baby did it in nursery 3 once, horrible.”
LL: "Wasn’t nice. This was abdominal. I’ve only seen pulmonary before.”
JJ-K: Hope your be ok. Chin up”
LL: I’m ok. Went to [colleague] for a chat earlier on and with nice people tonight.
JJ-K: Hope your night goes ok.”


5 Aug 2015, Wed

12.25am– alleged contamination of baby (boy) F’s TPN bag with insulin

8am – LL finishes night shift

Before 10am –
LL has been messaging the night shift designated nurse for F;
LL: "Did you hear what F's sugar was at 8[am]?"
Nurse: "No?"
LL: "1.8"
Nurse: "[S***]!!!!", adding she felt "awful" for her care of F that night.
LL: "Something isn't right if he is dropping like that with the amount of fluid he’s had and being 1.65kg" adding that F's heel has to be taken into consideration [as blood gas tests are taken via heel pricks, and cannot be done too regularly].
Nurse: "Exactly, he had so much handling. No something not right. Heart rate and sugars."
LL: "Dr Gibbs came so hopefully they will get him sorted. "He is a worry [though]."
Nurse: "Hpe so. He is a worry."
LL: "Hope you sleep well...let me know how F is tonight please."
Nurse: "I will hun".

day shift – twin baby F low blood sugar persisted despite 5 dextrose injections – readings mean he must have been given synthetic insulin - attempted murder charge

4pm - LL’s phone receives an invitation from an estate agency firm confirming a viewing for a property in Chester, near the hospital. This home would be the address where LL stayed until her 2018 arrest.

6pm –
LL texts a colleague Minna Lappalainen:
LL: "Hi! Are you going to salsa tonite?"
ML: "Should do really as I haven't been for ages. Meet at TF 2020?”
LL: 'ok' emoji. LL adds: "Need to try and find some sort of post nites energy"
ML: “Don’t have to stay late.”
LL: "Hasta luego".

Evening –
Night shift designated nurse messaged LL: "He is a bit more stable, heart rate 160-170. Changed long line but sugars still 1.9 all afternoon. Seems like long line tissued was not cause of sugar problem, doing various tests to try to find answers”
LL: "Oh dear, thanks for letting me know."
Nurse: "He’s defo better tho. Looks well, handling fine."
LL: "Good."

11.58pm –
LL’s text to same nurse: "Wonder if he has an endocrine problem then. Hope they can get to bottom of it. "On way home from salsa with Minna. Feel better now I’ve been out."
Nurse: "Good, glad you feel better. Maybe re endocrine. Maybe just prematurity."
LL: "How are parents?"
Nurse: "OK. Tired. They've just gone to bed."
LL: "Glad they feel able to leave him."
Nurse: "Yes. they know we'll get them so good they trust us."
LL: Yes.
?: "Hope you have a good night."


6 Aug 2015, Thu

LL had a house-viewing appointment.

7.58pm - Facebook mother of E&F


7 Aug 2015, Fri

LL gave twin F’s mother a photograph of him ‘holding' twin E's teddy.


9 Aug 2015, Sun

10.17pm –
LL texted a nurse: I said goodbye to [E&F]’s parents as F might go tomorrow. They both cried and hugged me saying they will never be able to thank me for the love and care I gave to E and for the precious memories I’ve given them. It’s heartbreaking’
Nurse: 'It’s heart-breaking, but you’ve done your job to the highest standard with compassion and professionalism. 'When we can’t save a baby we can try to make sure that the loss of their child is the one regret the parents have. It sounds like that’s exactly what you have done. You should feel very proud of yourself esp as you’ve done so well in such tough heartbreaking circumstances. Xx’
LL: 'I just feel sad that they’re thanking me when they have lost him and for something that any of us would have done. But it’s really nice to know that I got it right for them. That’s all I want.'
Nurse: ‘It has been tough. You’ve handled it all really well. They know everything possible was done and that no-one gave up on E till it was in his best interest. As a parent you want the best for your child and sometimes that isn’t what you’d choose. Doesn’t mean that your [sic] not grateful to those that helped your child and you tho.’
LL: ‘Thank you xx’


23 Aug 2015 – Facebook mother of E&F

2 Sep 2015 – Facebook mother of A&B


6 Sep 2015, Sun

8pm – LL’s night shift


7 Sep 2015, Mon

2.15am - baby (girl) G vomited violently out of cot onto nearby chair & floor and stopped breathing while designated nurse was on her 1hr break. After vomiting the amount of milk aspirated from baby G’s stomach was equal to her feed. X-ray showed air in abdomen & intestines.

6.05am – 100mls of air was aspirated from baby G’s nasogastric tube - attempted murder charge


9 Sep 2015 – Facebook parents of A&B

14 Sep 2015 – Facebook mother of E&F


21 Sep 2015, Mon

8am – LL’s day shift

10.20am – baby G projectile vomited twice and stopped breathing

mid pm – baby G collapsed and her monitor was seen to be off. Baby G is severely disabled as a result of the two episodes - 2 x attempted murder charges

21 Sep 2015 – Facebook parents of baby G
21 Sep 2015 – minutes later Facebook mother of E&F
21 Sep 2015 – minutes later Facebook mother of another baby listed in the charges


25 Sep 2015, Fri

8pm – LL’s night shift


26 Sep 2015, Sat

3.22am – baby (girl) H collapsed and required CPR after LL administered fluids - attempted murder charge

8am – LL finishes night shift


8pm – LL’s night shift


27 Sep 2015, Sun

12.55am - baby H collapsed – LL’s signatures on medicine administrations

3.30am – baby H collapsed again - LL was treating & gave the history to the attending doctor despite not being her designated nurse - attempted murder charge


30 Sep 2015, Wed

8am – LL’s day shift

4.30pm - baby (girl) I vomited and was struggling to breathe after LL fed her

5.39pm – x-ray of baby I showed massive amount of gas in stomach & bowels and lungs squashed - alleged attempted murder (not charged but chgd w/murder)


Oct 2015 – (either 3rd, 10th, 17th, 24th or 31st) Facebook father of baby D
5 Oct 2015 – early hours – Facebook mother of baby I
5 Oct 2015 – early hours – Facebook father of E&F
5 Oct 2015 – early hours – Facebook mother of H


12 Oct 2015, Mon

8pm – LL’s night shift


13 Oct 2015, Tue

3.20am – LL remarked from the nursery doorway that baby I was looking pale but the room was darkened – nurse found her pale and not breathing but the alarm had not sounded. CPR was performed. X-ray showed gaseous distention of abdomen & bowel - alleged attempted murder (not charged but chgd w/murder)

8am – LL finishes night shift


8pm – LL’s night shift


14 Oct 2015, Wed

5am – baby I had increasing abdominal distention

6.05am – baby I’s x-ray showed widespread gaseous distention

Time? – baby I collapsed and required CPR - alleged attempted murder (not charged but chgd w/murder)


22 Oct 2015, Thu


8pm – LL’s night shift

just before midnight - baby I collapsed and required CPR – LL was attending - alleged attempted murder (not charged but chgd w/murder)


23 Oct 2015, Fri

1.06am - baby I’s monitor alarm sounded and she screamed – LL was beside the incubator – baby I died - murder charge

After Baby I’s death LL sent a sympathy card to baby I’s parents and kept a photo of it on her phone


5 Nov 2015 – Facebook – mother of E&F


12 Nov 2015, Thu

8.32pm -
A colleague texted LL: [E&F]’s parents brought a gorgeous huge hamper in today. Felt awful as couldn’t remember who they were till opened the card. Was very nice of them though n F looks 'fab x'.
LL: 'Oh gosh, did they, awe wish I could have seen them. That’ll stay with me forever. Lovely family x'.


26 Nov 2015, Thu

Before her nightshift started
LL texted a work colleague complaining that the babies she was to look after, including J, only needed help feeding.

8pm – LL’s night shift


27 Nov 2015, Fri

6.56am - baby (girl) J had a seizure. Her oxygen level dropped so low it was unrecordable

7.20am – LL gave baby J a glucose infusion – baby J collapsed again and CPR was performed - attempted murder charge (consistent with obstruction of airways - smothering)


Nov 2015 – Facebook – parents of baby J

7 Dec 2015 – Facebook - mother of E&F

25 Dec 2015 – 11.26pm - Facebook – mother of E&F

Jan 2016 – Facebook mother of E&F

10 Jan 2016 – Facebook – mother of E&F (last time)


16 Feb 2016, Tue

8pm – LL’s night shift


17 Feb 2016, Wed

am – baby (girl) K sedated premature baby stopped breathing – Dr found LL standing over the incubator not helping, the breathing tube secured with tape to K’s headgear was dislodged, and the monitor alarm not sounding.

later am – LL called for help - baby K’s breathing tube had moved too far into her throat - attempted murder charge


After 17 Feb 2016 – LL moved to day shifts


9 Apr 2016, Sat

8am – LL’s day shift –

twin baby (boy) L – insulin - attempted murder charge
twin baby (boy) M – alleged injection of air - attempted murder charge

Handwritten log of drugs administered to baby M during his collapse was found at LL’s house and she had noted his collapse in her diary.


2 Jun 2016, Thu

8pm – LL’s night shift


3 Jun 2016, Fri

1.05am – baby (boy) N collapsed and was crying and screaming. He was resuscitated – 1st attempted murder charge


15 Jun 2016, Wed

8am – LL’s day shift

8am – baby N collapsed when 2nd nurse’s back turned. He had blood in his mouth – 2nd attempted murder charge.

3pm - baby N collapsed again – more blood in throat – 3rd attempted murder charge


16-22 Jun 2016 – LL in Ibiza


23 Jun 2016, Thu

8am – LL’s day shift –

triplet baby (boy) O – liver injury – alleged impact trauma – and air injected into bloodstream and NGT - murder charge


24 Jun 2016, Fri

8am – LL’s day shift –

triplet baby (boy) P – air allegedly injected into stomach - murder charge


25 Jun 2016, Sat

8am – LL’s day shift –

baby (boy) Q – air and fluid allegedly injected into stomach via NGT - attempted murder charge

Handover sheet for morning of 25 Jun 2016 for baby Q was found at LL’s home



2016 – LL transferred to an admin role


23 Jun 2017 – anniversary of baby O’s death – Facebook – Surname of baby O (and P)

Apr 2018 – Facebook – parents of baby K

Other unreported dates – Facebook – parents of baby G


3 Jul 2018 – LL’s first arrest.

No Facebook searches for babies L, M, N, (O & P at the time, although she did do one a year later) or Q. All of these babies came to the unit after LL was moved to day-shifts.

Thank you, this is written out so perfectly. When I read it all together it gives me goosebumps, knowing it’s possible these babies were murdered/attempted murders. So far my thoughts have been possibly guilty.

 

[Tortoise]

BBC link dated 18 Oct 2022, for additional details of text message exchange of 12 June 2015, not found in Chester Standard's live reporting -


Two days later, Ms Letby texted a nurse who had looked after Child A when he was born.
She wrote that it was "awful", adding: "He died very suddenly and unexpectedly just after handover.
"Waiting for post-mortem results. Hopefully they can get to the bottom of it."
Her colleague messaged that Ms Letby was "not having a great run at the moment", to which she replied: "I was not supposed to be in either.
"I took pictures, hand and footprints etc.
"They are besides themselves worried that they will lose [Child B] too."
Lucy Letby: Nurse told colleagues of baby death heartbreak, court told

 

[Tortoise]

DM link dated 19 Oct 2022, providing additional details of text message exchange of 12 June 2015, not found in Chester Standard's live reporting, also many other texts -

Lucy Letby 'told colleagues she had

"It was awful. He died very suddenly and unexpectedly just after handover. Not sure why. It's gone to the coroner. They are querying a clotting problem. Very sad.'

Referring to the end of her own shift earlier the same day, the colleague responded: 'Oh God, he was doing really well when I left.'

Letby then told her: 'Just collapsed very suddenly. Awful. He had really good day on Monday then I took over Monday night'.

The colleague expressed sympathy that Letby was on duty at the time, adding: 'I'm sorry it happened when you were taking care of him. You're not having a good run at the moment.'

Letby replied: 'I wasn't supposed to be in either. But these things happen unfortunately.'

The nurse also said the parents of Baby A and Baby B had been 'beside themselves' over worries they would also lose their infant daughter."

 

[Tortoise]

Monday November 28th 2022 - No live Chester Standard updates from the trial

Tweets https://twitter.com/MrDanDonoghue

Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


-----

Day 30 of Prosecution Evidence

(Twin) Child F


Consultant paediatrician Dr Satyanarayana Saladi , CoCH

I'm back at Manchester Crown Court for the murder trial of nurse Lucy Letby. Jurors will continue to hear evidence in relation to Child F this morning, who survived after allegedly being poisoned with insulin by Ms Letby, who denies all charges against her

Consultant paediatrician Dr Satyanarayana Saladi is in the witness box. He is taking the court through his notes from August 2015 when Child F was at the Countess of Chester

Dr Saladi is taking jurors through clinical notes from early August 2015 which show Child F's blood sugar levels were low. Other measures such as white blood cell levels were in the 'normal range' and the baby was 'handling well'

The medic says that there was no abnormal breathing or heartrate and no abnormal bowel sounds. He assessed the baby's condition as 'satisfactory' on the morning of August 5

 

[Tortoise]

Monday November 28th 2022 - No live Chester Standard updates from the trial

Tweets https://twitter.com/MrDanDonoghue

Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


-----

Day 30 of Prosecution Evidence

(Twin) Child F

Dr Alison Ventress, registrar, CoCH

Dr Alison Ventress, who was a registrar at the Countess of Chester in 2015, is now in the witness box. She's taking the court through medicine charts recorded in the days following Child F's birth

She explains that a dose of insulin would always be prescribed by a doctor and it would always be administered as a separate infusion, never added to another fluid

 

[Tortoise]

Monday November 28th 2022 - No live Chester Standard updates from the trial

Tweets https://twitter.com/MrDanDonoghue

Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


-----

Day 30 of Prosecution Evidence

(Twin) Child F

Unnamed Nurse, CoCH,
Day Shift 3rd August 2015, and "hours before" 1am on 5th August 2015

A nurse, who cannot be named for legal reasons, is now giving evidence. She is going over her notes from the morning of 3 August 2015, which show that Child F was in some respiratory distress, but was coping well.

By the end of her shift that day he was 'satisfactory' showing 'no signs of any issues'

The nurse's notes show that in the hours before Child F's heart rate surged to over 200bmp and his blood sugars dropped, he was stable and handling well

Her notes also show that Child F was, at the request of his parents, due to be moved from the Countess of Chester to another hospital, but the transport team was unavailable due to another unrelated emergency

 

[Tortoise]

Monday November 28th 2022 - No live Chester Standard updates from the trial

Tweets https://twitter.com/MrDanDonoghue

Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


-----

Day 30 of Prosecution Evidence

(Twin) Child F

Another Unnamed Nurse, CoCH, Night Shift 4th/5th August 2015

Another nurse, who also cannot be named for legal reasons, is now in the witness box. Again she is taking the court through Child F's breathing/heart rate charts from her night shift - all showing the infant was 'stable'

The nurse said she had 'no concerns' about Child F on the evening of August 4

We're back after a short break. A former nursing colleague of Ms Letby, who cannot be named for legal reasons, is continuing to give evidence. She's talking the jury through Child F's medical charts in the days after his birth

The nurse is talking the court through the process of fitting a new babiven bag (used to supply fluids/medicines). She says the bags are checked by two nurses and says nothing new would be added to the bag once it was made up

Her note from the early hours of August 5 show that Child F 'became quieter' and was 'slightly jaundiced'....doctors administered fluids and medicines and he became 'more lively' as a result. She said that during this period his blood sugar levels were 'dangerously low'

The nurse observed that Child F had been 'nice and stable' but in the hours between midnight and 1am his heart/breathing rates 'suddenly' rose to a 'concerning level'

 

[Tortoise]

Monday November 28th 2022 - No live Chester Standard updates from the trial

Tweets https://twitter.com/MrDanDonoghue

Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


-----

Day 30 of Prosecution Evidence

(Twin) Child F

IV Bag manufacture video

The jury are now being shown a 22minute instructional video on how intravenous bags are manufactured and prepared (this is to aid with understanding of evidence due to be given tomorrow, which the prosecution say is fairly technical)

 

[Tortoise]

Monday November 28th 2022 - ITV - 10% Colleague of Lucy Letby denies adding anything to baby’s feed bag | ITV News

"The colleague, who cannot be named for legal reasons, said she had no recollection of the specific event and could not be sure whether it was Letby or her who put up the bag.

Philip Astbury, prosecuting, asked the nurse if she had put anything in the nutrient bag.

She replied: "Absolutely not."

She also answered "no" when asked if she gave child F any insulin at any stage during that shift, in any way."

 

[Tortoise]

Tuesday November 29th 2022 - Chester Standard updates from the trial


Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


-----

Day 31 of Prosecution Evidence

(Twin) Child A

Professor Sally Kinsey, Prosecution Expert Witness,
Retired Consultant Paediatric Haematologist (Blood Expert)

11:29am

The trial has now resumed.
Professor Sally Kinsey, a blood expert, is going to give evidence in relation to a number of the cases so far in the trial.

11:32am

Professor Kinsey confirms she was approached by Cheshire Police to look at several cases in the course of this trial. One is yet to come, while the other three are the cases of Child A and Child B (both twins) and Child F.
She also confirms she has looked at the records of Child F's twin brother, Child E, for the purpose of her investigation.
She has written reports for each case and set out the relevant backgrounds for each child, the court hears.

11:45am

Her first report is dated March 4, 2020, relating to Child A.
The court hears the conditions that Child A and Child B's mother had before her birth, and the decision to deliver the twins by C-section in June 2015.
The events of Child A's treatment at the Countess of Chester Hospital neonatal unit, subsequent collapse and death, are relayed in court.

11:57am

Child A's blood count was considered 'normal' for his age.
She said she had considered whether Child A's mother's auto-immune disease could have been a significant factor in the death of Child A.
Said auto-immune disease was a rare condition (affecting about 50 in 100,000 people) which affected the mother, which can cause increased blood clotting.
It is "well recognised" that pregnancy can cause issues, which can cause nutritional problems for babies in the womb, and a C-section can be required "to save the life of the mother and the child".
The court hears it can cause premature birth and blood clotting for the mother.
Nicholas Johnson KC, for the prosecution, asks: "Did the...syndrome pass on to [Child A or Child B]?"
Professor Kinsey: "No, that is not the case."

11:58am

Mr Johnson says there was concern the condition had passed from mother to son, but says Professor Kinsey is sure it did not.
"It didn't," Professor Kinsey replies.

12:02pm

Prof Kinsey says, for the conclusion of air embolus for Child A, the doctors' descriptions of skin discolourations on the baby had "cemented" her concerns.
She adds it is very "rare" and has not seen it in her experience, but she says she has read it from literature, and the skin discolurations are a "stark" feature.
Prof Kinsey says she is sure the cause of Child A's death does not have a haematological origin.

LIVE: Lucy Letby trial, Tuesday, November 29

 

[Tortoise]

Tuesday November 29th 2022 - Chester Standard updates from the trial


Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


-----

Day 31 of Prosecution Evidence

(Twin) Child B

Professor Sally Kinsey, Prosecution Expert Witness,
Retired Consultant Paediatric Haematologist (Blood Expert)

12:16pm

The case of Child B, a baby girl, is now being discussed.
The events of Child B's treatment at the neonatal unit and her collapse are relayed to the court. The jury is being shown clinical records which have previously been shown as part of the sequence of events and from doctor/nurse witnesses.
Prof Kinsey confirms she had noted what was written for Child B's skin discolouration on June 10 - the 'purple blotching'.
For all the blood results Prof Kinsey had seen, she said they were 'normal' for her age and the time the tests were taken.
There was, like Child A, no passing on of the mother's auto-immune disease to Child B, she adds.
The question of air embolus is raised. She said she had made similar observations to Child A.
The professor says there was no haematological evidence that could have caused Child B's collapse, and wanted to draw attention to the skin discolouration in the area around the chin, which she said was most likely a 'rash' caused when medical staff were trying to administer air.




LIVE: Lucy Letby trial, Tuesday, November 29

 

[Tortoise]

Tuesday November 29th 2022 - Chester Standard updates from the trial


Colour Code

Blue text - Lucy Letby's (Defendant's) texts and Facebook searches
Green text - Countess of Chester Hospital medical staff
Black text - Police/Intelligence Analysts evidence
Orange text - Medical expert witnesses
Purple text - Agreed Facts and Parents evidence


-----

Day 31 of Prosecution Evidence

(Twin) Child E

Professor Sally Kinsey, Prosecution Expert Witness,
Retired Consultant Paediatric Haematologist (Blood Expert)

12:24pm

The case now turns to Child E and Child F, and the sequence of events is relayed to the court.
Prof Kinsey says to determine whether Child E had a hereditary blood condition, the records of surviving twin brother Child F were examined.
The sequence of events is now relayed for Child E.

12:36pm

Prof Kinsey noted she had observed from the nursing notes, a naso-gastric tube had been present for Child E, and the aspirates were 'unremarkable'. The abdomen was 'soft, not distended' and Child E's bowels opened.
At August 3, 10.44am, Child E was 'pink and well perfused'.
The professor confirms she had recorded Lucy Letby's nursing note for August 4, 2015, an observation chart for Child E on August 4, and blood gas record for Child E recording a decline for the baby boy.

12:40pm

Prof Kinsey said the "striking thing" was there had been a big change [a drop] in the haemoglobin levels for Child E from 10.21pm at August 3 to 1.05am on August 4.
It was significant in that Child E had lost blood in the aspirates, and would only have had a calculated total blood volume of 142ml in his system at that time.

12:41pm

Prof Kinsey said, for her conclusion for Child E, the haemoglobin count had been normal, as had the platelet count, prior to the deterioration.
"This was spontaneous bleeding, with no clear explanation."

12:46pm

The case now turns to Child F.
Mr Johnson says the significance of Child F is on a comparative basis to identical twin brother Child E.
Prof Kinsey confirms she has had access to Child F's medical records, which was for the context of Child E on a haematological level.
She said she looked at the history of Child F, and 'one or two things happened' which helped her in her investigation.
She said there were three blood investigations for Child F, over the space of two and a half years, which showed 'normal results'.
Child F had had a physical accident when a small child, and there were no haematological-related problems when he was checked, the court hears.
Child F was said to be 'slightly iron deficient' when tested at the age of two years old, but that was 'normal for infants'.
The blood results were "completely normal" for Child F.
The bleeding for Child E in August 2015, based on that medical history, was "not spontaneous", Professor Kinsey tells the court.

12:50pm

Skin discolourations were noted for Child E, the court is told.
Mr Johnson asks about the issue of air embolus as a cause for Child E's death.
Prof Kinsey has produced diagrams to display how an air embolus in the body can present itself externally.
These diagrams are shown to the court.

12:52pm

Haemoglobin is found in red blood cells.
Deoxygenated haemoglobin is blue in colour, while oxygenated haemoglobin is bright red.
A diagram is shown on how part of the air/blood circulation system works in a body.

1:07pm

Further diagrams explaining the circulation system are presented to the court.

LIVE: Lucy Letby trial, Tuesday, November 29