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

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Prosecution evidence, February 10th 2023, Day 52 -

10% Daily Mail - 'Inconsolable' baby 'proved nurse injected air into them,' trial told

Child I

Dr Sandie Bohin - Prosecution Expert Witness

'This was inconsolable crying. I think she must have been in severe pain to be this upset. It was over and above what is normal'.

Dr Bohin, who was called in by Cheshire Police to peer review the findings of another expert witness, Dr Dewi Evans, said she could think of no innocent explanation for mottling on the infant's trunk and her subsequent death. [...]

Ben Myers KC, defending, suggested that if the court had wanted her independent views it would have been better for her not to have seen the numerous reports produced by Dr Evans.

Dr Bohin replied: 'If I'm understanding you correctly, you're saying I've just rubber-stamped Dr Evans' findings, and that is less than discourteous.

'I was asked whether I agreed with his findings after reviewing the notes myself, or whether I found a different cause. I have disagreed with some of his findings and added my own evidence.

'I'm not backing up what he said. I'm reviewing the case and coming to my own conclusions. If that's in alignment with Dr Evans' view, that's in alignment with his view'. [...]

'In this case I think as well as air being distributed around the body, it's likely that air went in down the coronary arteries'.

[...]

Child J

Mother's Evidence

Neonatal nurse Lucy Letby tried to smother a premature baby girl on a day the infant was on the verge of being allowed home, a jury heard today.

Baby J appeared perfectly healthy when she was born by Caesarean section on October 31, 2015.

[...]

'We were totally and utterly shocked because prior to this she was extremely well. She was coming home. We were preparing for her to come home. Other than (an issue of) weight gain she was fine'.

The infant recovered so quickly that by the afternoon of the next day she was back up to full feeds. She was given no indication of what had caused her baby's collapse, aside from a doctor telling her there was no infection.

 

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Prosecution evidence, February 10th 2023, Day 52 - Chester Standard live updates - Recap: Lucy Letby trial, Friday, February 10

Child J

Mother's Evidence

12:44pm

The court will next hear evidence in relation to Child J.

1:46pm

The trial is now resuming after a lunch break, and will hear evidence from the prosecution in the case of Child J.
In the prosecution opening, the Crown say Letby attempted to murder Child J, a baby girl, on the night shift of November 26-27.

1:53pm

The mother of Child J is called to give evidence.
She says she had a difficult pregnancy, and following a difficult operation in London, one of her planned twins was lost.
She said she gave birth to Child J, a baby girl, at 32 weeks and two days gestation on October 31, 2015.
Child J "appeared to be extremely well" and was shown to her after birth, and there appeared to be "no concern" before the baby girl was taken to the neonatal unit.
The mother said she visited Child J later at the unit, she was in an incubator. The baby girl was seen in the 10-minute time there to produce a bit of brown bile.
Child J was then taken to Alder Hey by ambulance. The mother said she was told there were concerns about Child J's bowel at the time.

1:58pm

The mother said it was discussed afterwards that Child J had 'NEC' [necrotising enterocolitis: a serious gastro-intestinal disorder where a portion of the bowel becomes inflamed] and had emergency surgery at Alder Hey.
The bowel was 'cut', 1cm was removed - "a little amount", and the decision was made to give Child J two stomas.
Child J returned to the Countess of Chester Hospital on November 10, and the mother recalls being there frequently., establishing a routine. Child J was "absolutely" progressing well, going from being treated in room 1 (most intensive treatment), to room 2, to room 3, to room 4, over the course of four weeks in November.

1:59pm

Child J's mother recalls there were issues with the baby girl's weight gain, which 'concerned her' and she relayed those concerns "frequently".
She said those concerns were treated "not very seriously - they weren't overly concerned".
There were "quite a lot of challenges" with the stoma management.

2:03pm

Child J's mother says, between November 10-27, there were no major concerns with the stoma management, but the bags were not lasting as long as expected, and breastfeeding was impractical, but attempts at breastfeeding were made as Child J was doing well.
She tells the court the approach of staff at the Countess was different to Alder Hey. While Alder Hey was 'inclusive', the communication did not feel the same at the Countess.

2:07pm

Events leading up to the morning of November 27 are discussed, when Child J collapsed.
Child J's mother said the family were "really excited" to get Child J home, as she was off the heart monitor, and the mother was at the hospital ready to provide daytime cares, having also been involved in the night-time process.
The court hears it was 'a dry run' for life at home.
Overnight on November 25-26, Child J's mother was at the hospital, attending for cares, including stoma bag management.
On November 26, Child J's mother went and stayed home, intending to return as usual at 8am on November 27. She said 8am would be after the handover, and staff preferred parents not to be on the ward at the time of the handover.

2:08pm

The mother recalled receiving a telephone call on the morning of November 27 telling her Child J had collapsed, and to attend hospital as soon as possible. She said that would have been about 7.10am.
The mother attended the hospital as quickly as she could with her husband. Child J was in room 2 in a 'hot cot', connected back up to a monitor and looked "very floppy...pale, yellowy in colour and not very responsive".

2:10pm

Child J's mother said she was "totally and utterly shocked because prior to this, she was extremely well, she was coming home...we were preparing for her to come home.
"Other than the weight gain, everything was fine."
Child J's father spoke to Dr John Gibbs and the mother recalled joining in the conversation, being "very stressed about what I was seeing and experiencing".

2:11pm

After the collapse, Child J's mother said nurses led the care, and the parents stayed overnight.
It was established there was not an infection - it was "unknown at that stage", the mother tells the court, and Child J recovered "quite quickly".
By the afternoon of November 28, Child J was "back up to full feeds", the mother tells the court.

2:14pm

In the following weeks after that, Child J had another collapse around December 16, 2015.
"That was when we really started to see issues with the stomas and the bags", the mother tells the court, with the bags not lasting anywhere near as long as before, and would stop working as they should.
After the second collapse, there were "concerns" when Child J was pressed in the abdomen, she would wince and feel pain, so Child J was transferred to Alder Hey to have the operation reversed and the stomas were closed, the bowel reattached.
On January 5, 2016, Child J returned home.


Cross-Examination

2:24pm

Mr Myers, for Letby's defence, asks the mother about Child J's birth, and that 'things seemed to be all right'. The mother agrees.
The mother said she saw the brown bile from Child J's mouth and informed staff at the Countess. She agrees staff were "concerned".
Mr Myers says if there was a point when they were asked if Child J should be Christened. The mother agrees.
The court hears Child J had an 11-day stay at Alder Hey, during which she had a bowel operation. The details of the procedure and how to use the stoma bags are relayed in court, and the mother says she and her husband had it explained to them.
The mother said she would not say the stoma bags procedure was explained as well to them by Countess staff.
Mr Myers asks if the mother was told 'this could be a bit of a rollercoaster - that babies could go up and down' for Child J. The mother replies she is not sure when that was said to her, and could have been after Child J collapsed.
The mother says Alder Hey checked with the Countess of Chester Hospital to do the recycling of the stomas, and the Countess hospital had said yes, but did not seem to be as prepared.
The mother, having looked at a statement she gave to police, says that on reflection, the Countess staff were not as prepared for such procedures, and the 'time-consuming process' meant she offered to help with the stoma and the bags.
She adds that without the expertise of her husband, she would not have been able to position the stoma bags correctly, and without the prior experience, it would be considered a 'challenging' procedure.
The mother tells the court she felt if she raised concerns on the stoma care, they were not taken as seriously by Countess staff as the staff at Alder Hey.

2:26pm

The mother says there were concerns raised 'frequently' about the lack of weight gain for Child J, and they were raised with Countess staff.
Those concerns were "not met with any changes - not taken very seriously", the mother tells the court.
After the first collapse, Child J's mother says they were much more alert on medication as 'things were missed'.

2:30pm

The mother says there was "a general concern" for Child J for an increased risk of infection.
Mr Myers asks if there was a case when Child J was not tidied up.
The mother replies 'yes', as there was one case where she arrived to find Child J's bottom had waste visible, and was wrapped around with a towel. She raised the issue with a consultant, after asking staff "what would you do in my situation?".
The mother said she felt "pushback" on raising those concerns.

 

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Prosecution evidence, February 10th 2023, Day 52 - Chester Standard live updates - Recap: Lucy Letby trial, Friday, February 10

Child J


Electronic Evidence & Text Messages

2:34pm

Intelligence analyst Kate Tyndall has returned to talk the court through events for Child J, who was born at 3pm on October 31, 2015, weighing 3lb 12oz.
Child J was admitted to the neonatal unit 10 minutes later.
A picture was taken of the baby girl.
She remained at the Countess until 4am on November 1, being transferred to Alder Hey, before coming back to the Countess on November 10, being admitted to the neonatal unit by Lucy Letby.

2:35pm

The same day, Letby messages a colleague saying "It's chaos here" and she had had a row with another colleague.

2:42pm

A selection of messages, recovered from Letby's phone, are shown to the court for the period from November 10-26.
Letby sends a lengthy message to her colleague explaining why the unit was 'chaos' and why she had a disagreement with a colleague, adding staff were "peeing her off".
Her colleague replies: "Nothing like a bit of team spirit eh! x"
Letby apologises for her rant, saying: "Just really gets me down sometimes and some...want the easy life"

2:51pm

Letby asks a colleague on November 16 about how often a procedure for the Broviac line for Child J needed to be carried out. She receives a reply that it is carried out weekly.
Letby says she had three missed calls on November 25, having been to Las Iguanas and was at salsa, saying no-one at the unit knew how to administer immunoglobin, and they rang her. Her colleague sympathises, saying they should not be ringing staff not on duty, but should be contacting Liverpool Women's Hospital first.

2:54pm

The events of November 26 are now being talked through the court.
At 10.30am, a doctor's note says Child J was 'pink, well perfused, no respiratory distress' 'Abdomen- soft. Mum says mild distention soft abdomen. Stoma looks healthy'.
The note adds 'if [increased] distention to inform' as the plan, along with the feed for expressed breast milk and donor.

2:56pm

Letby messages a colleague saying 'staffing really needs looking at', before messaging colleague Jennifer Jones-Key to say 'sounds like you had a mad day'.
Letby adds the situation is 'just not manageable'.

3:00pm

Letby adds: "It's a nightmare isn't it...especially with no management x"
Jennifer Jones-Key said the staff [on duty] were going to ring Letby or Yvonne Griffiths the previous night [regarding how to administer immunoglobin], but thought that would have been done so sooner.

3:12pm

Letby adds the staff there should not have been in that position.
She adds, for her November 26-27 night shift: "Ah well. Hopefully be a bit calmer for me tonight lol x"

3:15pm

A colleague messages Letby at 5.16pm: "U well rested for work? x"
Letby replies: "Yep I've had a chilled day and slept well..."
She adds: "Ready to face anything" with a strongarm emoji, before discussing about being contacted the previous night, and querying why she had been contacted when staff on duty had other lines of enquiry, such as Liverpool Women's Hospital or the transfusion department.

3:20pm

Letby, as she sets off to work, messages her colleague: "Off to the mad house x" with a neutral face emoji.
Once inside, she messages the colleague to say she is in room 3 of the neonatal unit for the night shift.
A shift rota for that night is presented to the court.
There are two babies in room 1, two babies in room 2, two babies in room 3 (both designated nurse Letby), and two babies in room 4, one of them being Child J.
In addition, there are two babies in transitional care, and two babies whose location could not be confirmed from the records.

3:26pm

Nurse Ashleigh Hudson records, for Child J at the November 26 night-shift handover: 'Observations satisfactory as charted...Broviac remains in situ...[Child J] appears to be in no pain or discomfort.'
Letby received and sent messages between 7.36pm and 10.53pm, but not related to Child J.
At 1.57am on November 27, swipe data shows Letby recorded as entering the neonatal unit, at 3.47am and at 4.29am.

3:31pm

At 4.40am, an apnoea/brady/fit chart records Child J having an episode of apnoea, heart rate down to 100, lasting for three minutes.
At 5.03am, a desaturation to '30s' is recorded, heart rate to 100, lasting two minutes. In each event, a Neopuff device is administered.
Nurse Nicola Dennison records Child J looking unwell at 4.40am. In an untimed note [written retrospectively at 7.37am], Child J is moved from nursery room 4 to room 2.

3:34pm

Letby says, in a message to a colleague, she had not had a good shift, as Child J had '2 profound desats' and there were 'only 5 staff' on duty.
The colleague replies: 'We closed again then? x'
Mr Johnson explains to the court 'closed' by this definition means the unit would be closed to new arrivals, not closed entirely.
Letby confirms the unit is closed until they can get someone in.

3:36pm

There is an event timed as 6.56am which marks Child J's desaturation.
A retrospective note created by Mary Griffith, referencing Lucy Letby, is made at 7.11am.
The note says '[Child J's] monitor went off at 6.56 myself and L Letby attended. Found baby with pale hands and baby very ridged...'

3:41pm

A note is made at 7.15am recording that the parents of Child J are informed of the collapse and to come to the hospital as soon as possible.
Child J had a further collapse at about 7.24pm. Dr John Gibbs records the event in his notes.
Resuscitation efforts are made and a range of medication is administered, while observations are recorded and an x-ray made.

3:42pm

Letby is recorded as using her swipe card at the neonatal unit acess door at 8.55am.

3:47pm

Lucy Letby messages Jennifer Jones-Key just before 10.30am: "Wow it turned manic - left at 9.15 but others still there."
The reply: "Warned you..don't know what it is", adding that things seem to go "pear-shaped".

3:55pm

Jennifer Jones-Key messages Letby saying, of the staffing situation, 'more staff will just go off sick'.
A colleague of Letby messages her on the afternoon of November 27 to say: 'Oh and Tony Chambers n some woman turned up earlier! x'
Letby replies: 'Gosh it's mad. At least things are moving in right direction. Is it bit calmer now? Still only 5 tonight? Hope Tony got stuck in and helped!!'

4:00pm

Letby is on a night shift on November 27-28. She recorded Child J's vital signs and her fluids.
Nurse Mary Griffith messages Letby to say she had left the hospital at 9.45am, getting back home at 10.30am, adding she hopes Letby has a better shift tonight.
Letby replies: "You must be tired. Thanks for staying....still busy as only 5 on. [Child J] quiet hasn't done anything else abnormal and xray etc ok..."

4:03pm

Notes from a doctor on November 28, 2.30am, for Child J record '...no respiratory distress...'
The plan was 'continue to slowly increase feeds...to achieve full feeds by 1800 today'.

4:06pm

Letby records further observations for Child J at 5.06am on November 28, with 'shallow breathing observed at times' and, in a family communication note, Child J had been 'out for cuddles' with parents, who 'seemed happier' that Child J was recovering and feeds were gradually being increased.

4:08pm

Child J continued to be cared for at the Countess of Chester Hospital's neonatal unit until 3.30am on December 18, 2015, when she was transferred to Royal Manchester Children's Hospital.

6:47pm

A round-up story from today in court:
Lucy Letby trial: Mother 'utterly shocked' at baby girl's collapse

 

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Prosecution evidence, February 10th 2023, Day 52 -

10% Daily Mail - 'Inconsolable' baby 'proved nurse injected air into them,' trial told

Child J

A series of WhatsApp messages sent on the day of Baby J's birth reveal Letby's claim that the unit was in 'chaos'.

She had had a row with a colleague and felt that some of her colleagues 'want the easy life'.

On November 26 – the night of Baby J's collapse – she tells a colleague that 'staffing really needs looking at' and that the situation 'is just not manageable'.

[...]

'Sometimes the evidence of her hand at work is more obvious than others and it is remarkable that on many occasions, when children who had suffered unexpected spectacular and life-threatening collapses were removed from her orbit, they had exceptional recoveries'.

 

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Prosecution evidence, February 13th 2023, Day 53 -

BBC 10% - Lucy Letby: Baby making progress before collapse, trial hears

Chester Standard - Lucy Letby: Baby girl had two unexplained seizures within 30 minutes

ITV - https://www.itv.com/news/granada/20...-lucy-letby-suffered-two-unexplained-seizures

Child J

Dr John Gibbs, Consultant Paediatrician

Dr John Gibbs, a consultant paediatrician, said Child J had been making "steady, acceptable and encouraging progress".
He added that within two-and-a-half weeks, Child J had moved on to bottles feeds and was "fine" and without any respiratory complications.

But in the early hours of 27 November 2015, Child J suffered seizures and four desaturations with her heart rate also dropping on the third and fourth occasion, the court heard.
"Both occurring together is of more concern than one occurring by itself," Dr Gibbs told the court.

Dr Stephen Brearey, Consultant Paediatrician

Dr Stephen Brearey, who reviewed medical tests carried out that day, said "nothing explained" why the infant had collapsed.
"She [Child J] normalised very quickly over the course of the day and all the investigations we had undertaken couldn't identify why she had the desaturations or explain why she had a seizure.
"I do know hypoxia causes seizures so that would be possibly the most likely cause.
"There remains the question why was [Child J] hypoxic when two or three weeks beforehand she had been breathing normally in air and there was no suggestion of infection.
"In fact, we stopped antibiotics 36 hours after starting them because there was no evidence of infection in the blood tests and she remained well for weeks afterwards."

He reviewed further tests two days later on 29 November 2015 where he described her as in a "good condition".
"I didn't have any concerns at that stage," he said.
"Looking back on it now we didn't have an explanation for the events on 27 November.

 

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The Trial of Lucy Letby, Episode 15: Baby J, “We were totally and utterly shocked because she was extremely well and coming home.”

www.mailplus.co.uk

In this episode Liz and Caroline explain the evidence the jury have heard in relation to a premature baby girl, Baby J, who Lucy Letby is accused of attempting to murder by smothering in November 2015.

 

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Prosecution evidence, February 10th 2023, Day 52 - Tweets - https://twitter.com/JudithMoritz

Child J

Lucy Letby trial: I'm in court. The jury has begun hearing evidence about baby J, a premature baby girl who the nurse is accused of attempting to murder in November 2015

A reminder - a court order prevents us from identifying any of the babies or their families in this trial. Baby J is no 10 out of 17 who Lucy Letby is alleged to have attacked (7 x murder, 10 x attempted murder). She denies all charges.

The jury has been hearing evidence from the mother of baby J. She told the court that her daughter was born 8 weeks early and had a perforated bowel which was operated on.

Baby J's mum tells the court that despite her bowel problems the little girl was doing well, other than concerns re weight gain. Then one night, she was phoned by the hospital and told to get there quickly as her daughter was suddenly gravely ill.

She said "We were totally and utterly just shocked, because prior to this she was extremely well, she was coming home, we were preparing for her to come home, everything other than her weight gain was fine”.

The court heard that baby J was treated by nurse and recovered quickly after her sudden collapse. The jury has previously been told that a prosecution expert witness believes she may have been smothered.

Baby J's mum says that at the time of the collapse it was established there was no infection and the cause was unknown.

Baby J’s mother told the jury that her daughter had also been cared for at @AlderHey in Liverpool, and that the staff there had communicated well with the family, but the staff at the @TheCountessNHS didn’t take their concerns seriously.

She recounted one occasion when she’d arrived to find her daughter wrapped in a towel covered in faeces, and also said that she and her husband had had to prompt staff about baby J’s medication.

The jury is being shown text messages between Lucy Letby and other colleagues which were exchanged around the time of baby J's collapse. They discuss staffing levels on the neonatal unit where they worked.

The Lucy Letby trial has finished for this week and will recommence on Monday morning.

 

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Prosecution evidence, February 14th 2023, Day 54 - Tweets - https://twitter.com/ElaineWITV

Child J

A nurse, Mary Griffith, who worked at the Countess of Chester hospital for more than 40 years before retiring in 2016 - agreed with the defence, that Lucy Letby was "knowledgeable", "caring" & "thorough" in her job. We'll hear from more staff & expert witnesses today.

Designated Nursery Nurse Nicola Dennison

Nicola Dennison, a nursery nurse at Chester's neonatal unit - worked there since 1985. She cared for baby J- & said she was "a lively, alert and engaging baby, she had stomas, after a bow[e]l operation - but she was a well baby & getting ready to go home."

Nicola Dennison says baby J was moved to nursery 2 for more monitoring when she became unwell during the night & nursing staff took over her care, when she suffered two unexplained collapses. Lucy Letby was part of her care that night, 26/27 November 2015

Dr Dewi Evans, Prosecution Expert Witness

Dr Dewi Evans, a medical witness for the prosecution says there was no natural cause for baby J's sudden seizures. He told the court the baby's brain had been deprived on oxygen.

 

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Prosecution evidence, February 14th 2023, Day 54

Child J

Dr Dewi Evans and Dr Sandie Bohin, Prosecution Expert Witnesses

10% Chester Standard Lucy Letby: Baby girl's seizures 'did not happen naturally'
10% BBC Lucy Letby: Baby's seizures did not happen naturally, trial hears


Giving evidence earlier, expert medical witness Dr Dewi Evans told prosecutor Nick Johnson KC: [...]
I noted the markers for inflammation were normal which tended to rule out infection.
"The second pair coincided with what the doctors describe as a seizure or a fit. This is indicative of something going wrong with the brain.
"My opinion was that [Child J's] brain was deprived of oxygen for a sufficient level of time to cause hypoxia, i.e loss of oxygen to the brain causing fits.
"As far as I know this was the only occasion when she had seizures and the cause of this was the hypoxia, the lack of oxygen to the brain."
Mr Johnson asked the retired consultant paediatrician: "So far as the hypoxic incidents that had caused these seizures were concerned, could you identify any natural process that might have caused that?"
Dr Evans replied: "No, I could not. There was no reason why she suddenly became hypoxic." [...]


However fellow expert witness, consultant paediatrician Dr Sandie Bohin, said she had excluded infection. [...]

Dr Bohin told Mr Myers she had not been able to identify an “obvious cause” for her collapses.

 

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Prosecution evidence, February 14th 2023, Day 54

Child J

Dr Sandie Bohin, Prosecution Expert Witness

10% ITV - https://www.itv.com/news/granada/20...uffered-by-baby-girl-did-not-happen-naturally


Tests carried out on Child J showed no signs of infection and did not identify the cause of her seizures. [...]


Dr Bohin said the desaturations were "completely unexpected" and the baby needed facemask ventilation for a long period of time before she recovered.

She continued: “I thought that seemed extremely unusual – the speed of the collapse, the longevity of the resuscitations and the fact that she seemed to recover quite quickly.

“That is not the way that infection normally plays out.”

Dr Bohin noted that Child J was clinically well and back to her normal self before she even received antibiotics.

 

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Prosecution evidence, February 15th 2023, Day 55 - Live Updates LIVE: Lucy Letby trial, Wednesday, February 15

Twins - Child L and Child M

Electronic Evidence

10:39am

Prosecutor Nicholas Johnson KC tells the jury the case is now proceeding to the cases of twins, Child L and Child M. This is slightly out of the order in the sequence of the trial, chronologically, so far. The case of Child K will be heard slightly later in the trial.
Intelligence analyst is talking the court through the sequence of events for Child L and Child M, twin boys born on April 8.
Child L was admitted to the neonatal unit at 10.30am, and had observations taken by Lucy Letby, with a blood sugar reading of 1.9 recorded at 10.58am.
He was treated with a 10% dextrose (sugar) infusion.

10:41am

Lucy Letby's note, written in retrospect at 5.42pm, noted the blood sugar reading of 1.9, with the registrar commencing dextrose and expressed breast milk.
At 12.14pm, the blood sugar reading had risen to 2.5.

10:45am

Lucy Letby records communication with Child L and Child M's parents: "Parents were shown babies in theatre and had a quick cuddle....Photographs given and visiting hours discussed. Daddy visited the unit and had cuddles."

10:47am

For Child L, a blood sugar reading of 5.8 is recorded at 4pm.

10:52am

Letby records for Child L at birth "Initially had some recession with a raised respiratory rate, quickly normalised and remained self ventilating in air. Blood gases good...
"2 Hourly feeds, NG/bottle. Minimal aspirates obtained..."
Recording communication with the parents: "Parents updated by myself on CLS and photograph taken....fully updated on care by myself and reg Bhowmik. Aware of need for septic screen..."
A 6pm blood gas reading records blood sugar of 3.3

10:57am

Letby messages a colleague at 6.15pm - "Unpacking! Stuff everywhere lol! May do an extra shift this weekend x"
The court previously heard Letby had recently moved into a home near the hospital.
Letby messages her mother: "Think Im going to do tomorrow [Saturday, April 9] as an extra but go in a bit later."
Child L's blood sugar reading at 9pm is 2.3.
Letby's colleague Sophie Ellis messages her: "How's the house pal? *advertiser censored*"
Letby: "Hey, it feels a bit weird having a whole house but it's good thanks, although stuff everywhere as moved in properly on Tue and been at work Wed, Thurs and today...", followed by a monkey emoji with its hands over its eyes.
Sophie Ellis: "...it'll feel more homely once you've sorted everything out." She also asks about how busy the unit is.
Letby: "...Unit is busy, no-one particularly unwell just volume and few people off sick. I prefer 4 days to 4 nights..."
Letby adds: 'We've got nice mix of babies at the mo really. Shift goes quick anyway!'

11:02am

Child L's blood sugar reading is 2.2 at 10pm, then 3.6 at midnight.
Further medications are administered throughout the night.
Agency nurse Tracey Jones records notes for Child L from the night shift, noting the cannula was knocked out by the baby boy during the night so was reinserted. There had been no contact with the parents during the night.

11:04am

For the day shift on April 9, 2016, Lucy Letby is a designated nurse for two babies in nursery 1. Mary Griffith is the designated nurse for Child L and Child M, who are the other two babies in room 1.
Four babies are in room 2, three in room 3 and four in room 4. There are seven designated nurses for the neonatal unit babies in total.

11:06am

Child L records a blood sugar reading of 1.9 at 10am, pre-feed.
Nurse Mary Griffith records notes, written retrospectively, saying the IV dextrose [infusion] was increased for Child L.

11:08am

Letby messages colleague Alisa Simpson at 10.34am, wishing her good luck at picking the horses at the Grand National that day, and that her feet don't get too sore.
Child L's blood sugar reading is 1.6 at 11am.

11:17am

A handwritten entry for hypo screen results at noon, not attributed to a name, record results for Child L.
Child L's blood sugar reading is 1.6 at noon, pre-feed.
Letby co-signs a 10% dextrose infusion for Child L, around noon.
Notes for Child M record that designated nurse Mary Griffith took a break around 12.30pm.
Letby is engaged in messaging people between 11.12am and 12.33pm.
Letby messages Alisa Simpson shortly afterwards: "Oh good hope you have a fab time. Im in work doing an extra! x"
Letby also messages her mother, asking if her father was betting on the Grand National, and if so, to put a bet on grey horses for her. Her mother replies that has already been done.

11:25am

The court hears Letby continues to be involved in messaging, including a group message to colleagues and friends: "Sorry guys mad 4 busy days in work..." then invites the three people to crash at hers, apologising she hasn't fully unpacked yet.
She adds: "Got magnum prosecco and vodka woop. No disco ball but sure we can manage. x"
Child L's blood sugar reading is recorded as 2.0 at 2pm, and 1.5 at 3pm.
Letby is a co-signer for the administration of medication at 3.35pm.
Mary Griffith records a blood sample was taken from Child L at this time, which was taken to the Royal Liverpool Teaching Hospital for analysis.
The prosecution say the blood sample had a very high insulin level recorded, and a low level of C-peptide.
Child L was also given a bolus of dextrose, prescribed at 3.35pm and administered at 3.40pm.

11:30am

A note from the hospital's pathology department records the blood specimen sample for Child L.
The blood was "taken for lab but due to emergency not poded at once", nurse Mary Griffith records.
That one emergency identified in the neonatal unit, the prosecution tells the court, was for the twin brother, Child M's "dramatic collapse".

11:34am

Child L's blood sugar reading at 4pm is 1.5.
Child M's collapse is recorded at this time. A crash call is put out.
Friends message Lucy Letby around this time, saying they can have "an unpacking party".
For Child L, the dextrose administration is increased to 12.5%, from 10%.
Child L's blood sugar reading at 5pm is 1.7, which was "still very low", the prosecution say.

11:38am

Letby's mother messages Letby at 5.28pm telling her: "You've won rule the world :-D xx"
Child L's blood sugar reading at 6pm is 1.9.
Letby responds to a colleague at 6.01pm: "Haha why not!! Work has been s***e but...I have just won £135 on Grand National!!"
She also sent a group message: "Unpacking party sounds good to me with the flavoured vodka...Just won the Grand National!"

11:44am

The pathology records the lab specimen of a blood sample for Child L. Among the blood test results sought for the sample are insulin and C-peptide.
The insulin level is recorded as 1,099, and the C-peptide is recorded as 264. These readings are entered into the system on April 14, having obtained the results from Liverpool.
The C-peptide "should be 5-10 times the level of insulin", but the ratio is recorded as 0.2.

11:46am

Child L is recorded to have hypoglacaemia [low blood sugar].
Doctors record the hypoglacaemia continued despite the regular infusions of dextrose throughout the day.

11:50am

Child L has a blood sugar reading of 2.0 at 8pm.
Child L's blood sugar at 9pm is 2.4.
Letby records notes for Child M at 9.22pm.

12:13pm

Child L's blood sugar reading at 10pm is 2.3.
A colleague of Letby, Belinda Simcock, messages her at 10.11pm: "Thanks for listening, I'm ok x"
Letby: "Don't need to thank me, glad you felt able to tell me..."
Child L's blood sugar reading at midnight is 2.1, and remains "low" at 2.1 at 2am.
A long line is inserted, with an x-ray taken, and medication administered.
The blood sugar reading at 4am is 2.3, and 2.2 at 6am.
The glucose is further increased, but the blood sugar reading "remains stubbornly low" at 2.2 at 7am.
It remains at 2.2 at 9am.
Letby receives a message from Yvonne Farmer asking if she wanted to do more overtime shifts on Sunday night, Monday day or Monday night, appreciating she may be tired, with Letby responding: "Sorry but need some days off now."
She adds she could be on call for nights, and would be free for Thursday day/night shifts.
Child L's blood sugar reading at 2pm on Sunday had "normalised" at 3.0.

12:16pm

Letby refers to her previous shifts as "not nice" in a message to Jennifer Jones-Key.
Jennifer Jones-Key says Letby 'hasn't got many nights' coming up on the rota, adding she likely won't see Letby as she works mainly nights herself.
"We never see each other if we do work together as always mad shifts".

12:26pm

Child L was still receiving 15% dextrose through the afternoon of Sunday.
A nursing note made by Laura Eagles that afternoon records: "Blood sugars maintained...remains on 15% dextrose via long line...very unsettled at times."
The family had been kept updated of the situation, according to a family communication note.
Child L's blood sugar levels were "normal" at 2.8 at 5pm.
Samantha O'Brien becomes the designated nurse that night for Child L, and the 15% dextrose administration continues through the night.
The blood sugar levels are 2.7 at 9pm, 2.9 at 11pm, 2.7 at 2am.
Samantha O'Brien, in her nursing note, records: "...1% glucose infusing via long line in left leg,. 3 hourly blood sugars, all have been above 2.6 so far this shift. Plan to continue [current medication administration]...
"Baby unsettled at times, settles with comfort measures."
The blood sugar level is 2.9 at 5am on Monday, April 11.
Letby messages a colleague at 8.45am, saying: "The unit is in dire way with staff," highlighting which trained staff were on duty and who else was on in the last shift, and who was off at that time.
A colleague replies, in her message: "that's terrible"
Letby replies the overall situation was "not good", "mad and poor skill mix".

12:31pm

Child L's blood sugar readings are 2.8 at 11am.
Dr Huw Mayberry, in a clinical note, records the feeds/fluids for Child L, which were increased due to low blood sugar and falling sodium levels.
Child L's blood sugar at 3pm is 3.5, remaining at 3.5 at 5pm.
Nurse Belinda Simcock said registar Mayberry was aware of the 3.5 readings, and if they continued to remain above three, then feeds would be increased.
The blood sugar increases to 4.7 at 7pm.

12:32pm

Child L continued to be cared for at the hospital's neonatal unit until May 3, and was then discharged.

 

[Tortoise]

Prosecution evidence, February 15th 2023, Day 55 - Live Updates LIVE: Lucy Letby trial, Wednesday, February 15

Twins - Child L and Child M

Parents' Statements

12:36pm

The court is now hearing a statement from the mother of Child L and Child M, who had had a "routine pregnancy" until a stage when she was "not well".
She recalls being "surprised and shocked" at being told she had to be admitted to hospital.
She stayed there for 15-17 days and was asked if she was going to deliver naturally or via a C-section. Staff had looked through her file and were "worried", so the decision was made for the birth to take place, via c-section, on April 8.
The babies, weighing 3lb each, looked "very nice".
The family were taken to the neonatal unit to see them in room 1 the following day and the family were "happy", and at that time it was not known what they were going to be called - deciding on the names a week later.

12:39pm

Later, the mother was asked by a nurse named Yvonne to come down as soon as possible. She came down and saw Child M had collapsed and chest compressions were under way.
She was praying to see her, asking God to see them. Child L was ok on the other side of the room, and Lucy Letby was present.
She said her mind was "totally blank" and she just prayed.
After what felt like "hours", Child M had stabilised.
Each day, the mother would come down daily to see the twins, who had stabilised.
Three weeks later, the mother was discharged, and she continued to visit daily until the twin boys were discharged. They hadn't put much weight on and were small, but otherwise healthy.
Child M had "no after effects for what happened to him".

12:44pm

A statement from the father is now being read out. He said he was "shocked" at the news his wife needed to go to hospital due to concerns over the pregnancy, and she stayed there for "over two weeks" before the C-section birth took place.
The doctor said the babies looked "very healthy" before being taken to the neonatal unit by Lucy Letby and another nurse.
He saw the twins a couple of hours later and they were "both still fine".
The following day, the family visited - "we were both proud parents, and very happy".
Within 10 minutes of being on the ward, the father "rushed" back to the neonatal unit, where he saw a doctor doing chest compressions on Child M.
He said: "It was a very distressing image, and one that still is in my mind."
The staff said they didn't know what had happened to Child M, and Child M had had a heart attack.
Child M later stabilised after about half an hour, and there were no further issues with the twins in subsequent care.
Child M had a brain scan, with 'no damage' recorded.
The twins were "only on the unit because they didn't weigh enough", and it was "a relief to get the boys home".

Midwife's Statement

12:47pm

A statement from the midwife is now being read out to the court.
She said there was concern one of the twins was not growing as he should have in the womb, so an elective surgery took place so there were no further complications with the lack of growth.
Both babies "were in good condition" and there was time for "a quick cuddle" with the parents before the twins were taken to the neonatal unit "without any problems".

12:49pm

Both twins began crying after birth, one of them requiring a little extra help to do so.
The 'Apgar score', which records the conditions of the babies shortly after birth, recorded 10/10 scores for both twins at 10 minutes after birth.
Child M has a low oxygen saturation rate, but he had that rectified with breathing support.

 

[Tortoise]

Tweets

Andy Gill

@MerseyHack
https://twitter.com/MerseyHack
Today the trial is hearing evidence about the next alleged victim in the case, to be known as Baby L. It’s alleged Ms #Letby tried to kill him in April 2016. (NB Evidence relating to alleged victim Baby K will be heard at a later date.)
@BBCNWT

Baby L and his twin brother Baby M were born at @TheCountessNHS in April 2016 at 33 weeks and 2 days gestation. Shortly after Baby L’s birth he had low blood sugar levels.

Jury hears that Lucy Letby spoke to L’s parents on the day he was born about using donor breast milk. A note by Ms Letby says she had introduced herself to L’s parents before delivery.

During this day Lucy #Letby was exchanging messages with colleagues about her having moved into a new house in #Chester. When asked how it feels Ms Letby replied “Feels a bit weird having a whole house but it’s good thanks.” She also volunteered to work an extra shift.

At the start of this trial the court was told that Lucy Letby allegedly tried to murder Baby L by poisoning him with insulin. She denies this, as she denies all the charges she faces.

On the day Ms Letby allegedly tried to murder Baby L she sent a message to her mother asking if her father could place a bet for her on any grey horses running in that day’s Grand National.

She also on that day exchanged messages with colleagues about them visiting her in her new house. In one she wrote “Got a magnum of Prosecco and vodka. Woop.”

At 1535 on the Saturday after Baby L was born, a blood sample was taken which, the Crown say, subsequently showed a very high reading for insulin in him.

Court hears that close to the time when a blood sample was taken from Baby L, his twin Baby M collapsed dramatically in the neonatal unit. Nurse Letby also faces a charge that she attempted to murder Baby M, which she denies.

Insulin results from the blood sample taken from Baby L were not available until 5 days after the sample was taken. The insulin level recorded was at the upper limit of the capacity of the laboratory machine to measure insulin.

Court has been read a statement by the mother of Lucy Letby’s alleged victim Baby M, the twin of Baby L. M collapsed dramatically the day after he was born. When his parents got to the neonatal unit they saw doctors performing chest compressions on him. 1/2

In her statement M’s mum says “I’d never done anything wrong to other people. I was calling on my God to save him. My mind was blank other than praying to my God.” She says her husband was crying.

M’s mum says nurses told her M had been well the day before and they didn’t know why he had collapsed. “We never got an explanation why it happened.” Both Baby L and Baby M were discharged from hospital in May 2016.

The prosecution claim Lucy Letby attempted to murder Baby M by injecting him with air. Miss Letby denies this, as she denies all the charges she faces.

Elaine Willcox

@ElaineWITV


The jury has been shown text messages between Lucy Letby, her parents & friends, after she won a bet on the Grand National. These were on the day the prosecution allege she attempted to murder newly born twin boys, by poisoning with insulin & admin air causing sudden collapse

Jury also shown some of Lucy Letby's text messages describing Chester's neonatal unit as "in a dire way with staff" & some of the staff weren't trained for some procedures. She texted a colleague, saying the overall situation was "not good", "mad and poor skill mix".

Jury being read a statement from the mother of twin boys, L and M, which Lucy Letby is accused of attempting to murder. She said the Lucy Letby was there at the C section, the boys weighed 3lbs and doctors said they were healthy. The following day she was rushed to the unit.

Jury told the mother saw baby M had collapsed and a doctor was doing chest compressions. She said she was praying for her twins. Child L was ok on the other side of the room, Lucy Letby was present. After "hours", Child M had stabilised.

The twin baby's father said "it was very distressing to see a doctor doing chest compressions on Child M. He said: "It was a very distressing image, and one that is still in my mind." A nurse said his baby "had been absolutely fine and then his heart had stopped".

The twin's father said, "staff didn't know what had happened to Child M". The baby later stabilised after about half an hour. He said, "the twins were only on the unit because they didn't weigh enough", and it was "a relief to get the boys home".

 

[Tortoise]

Prosecution evidence, February 15th 2023, Day 55 - Live Updates LIVE: Lucy Letby trial, Wednesday, February 15

Twins - Child L and Child M

Registrar Dr Sudeshna Bhowmik

12:57pm

Dr Sudeshna Bhowmik, who was working as a paediatric trainee at the time in April 2016 at the Countess of Chester Hospital, has been called to give evidence.
She says, outside of the clinical notes, she has no memory of the twins, Child L and Child M.
She confirms, from the notes, she was present at the birth of the twins, citing an IV line for Child L on April 8 at 11.15am, which was "quite a routine procedure to be done on the neonatal unit".
The baby was "generally well", although the breathing rate was "a little elevated".
The court hears that was not a concern as that would usually be the case for babies born via C-section.
The weight of 1.465kg [3lb 3oz] was "quite low", and the blood sugar of 1.9 was "a little bit low", which can be found in premature babies who are quite small.
With glucose feeds, that would "stabilise".

1:00pm

The plan was to commence dextrose via IV fluids and feeds via expressed breast milk, to see if the latter would be tolerated 'in small amounts'.
She added at that time, there was no need to administer antibiotics. Dr Bhowmik tells the court with Child M showing signs of jaundice, however, that plan may need to have been revisited.
The plan was also to repeat the blood sugars in half an hour.

2:07pm

Dr Sudeshna Bhowmik is continuing to give evidence.
She says most pre-term babies will have IV fluids, and this was altered for Child L because of the baby boy's weight and glucose levels.

Cross-Examination

2:17pm

Benjamin Myers KC, for Letby's defence, asks Dr Bhowmik to clarify the blood sugar readings for a healthy baby. 2.6 and above is healthy.
Mr Myers says Child L was recorded as having a 1.9 reading a couple of hours after birth.
He asks Dr Bhowmik questions about a 'hypoglycaemic pathway'. Dr Bhowmik says the correct course at the time would have been to start treating hypoglycaemia at the neonatal unit via IV fluids.
She tells the court she does not recall when the bag of IV fluids was put up, or who administered that bag.

2:20pm

An infusion chart is shown three records of the first 10% dextrose infusion. The first two are crossed out, with the third being the dose which was administered.

Judge's Question

The judge asks to clarify that the only difference between the three records is the rate of infusion for the 10% dextrose bag. Dr Bhowmik confirms that is correct.
That concludes Dr Bhowmik's evidence.

 

[Tortoise]

Prosecution evidence, February 15th 2023, Day 55 - Live Updates LIVE: Lucy Letby trial, Wednesday, February 15

Twin - Child L

Neonatal Nurse Amy Davies Shift Leader 8th April 2016

2:43pm

The court is now hearing evidence from Amy Davies, a neonatal practitioner who was employed in the neonatal unit at the Countess of Chester Hospital in April 2016. At the time, she was in Band 6.
She says she does not have any independent recollection of Child L.
From her notes, she was on the day shift on April 8, 2016, as shift leader. Lucy Letby was the designated nurse for Child L on the 8th, and Ms Davies confirms she assisted in the care.
She is asked if there was a specific pathway for babies with low blood sugar. Ms Davies confirms there was, and would involve giving milk before giving IV fluids with glucose, but each case differed.
In this case, a discussion would have taken place with the doctor, Ms Davies confirms. She said it was a decision which would not put the baby at risk, but was an alternative pathway.
Asked if she had any concerns about that pathway, Ms Davies replies: "No, no concerns."

2:49pm

The blood gas records show glucose levels for Child L on April 8 at 1.9 (10.58am) and 2.5 (12.14pm). The readings go above 2.5 in subsequent blood gas records for April 8, which only test for glucose levels.
She confirms she would have checked the infusion bag containing 10% dextrose with Lucy Letby, making sure it was in date, going to the right baby, and signing it. The infusion is noted as starting at noon on April 8.
Ms Davies says the pre-made dextrose concentrations available for infusion bags are 5% and 10%.

2:55pm

Ms Davies says the bags would be changed, regardless, every 48 hours.
Ms Davies is asked if she, at any point, administered Child L with insulin. She replies she did not, and is not aware of anyone doing so.
She says the circumstances for doing so would be two consecutive blood sugar readings of 12 or above, if a baby was hyperglycaemic.

Cross-Examination

3:03pm

Mr Myers, for Letby's defence, asks if Ms Davies was one of the nurses who transferred Child L and Child M to the neonatal unit.
Ms Davies confirms she would have been the designated nurse for Child M at that time.
Ms Davies is asked about the hypoglycaemic pathway. She says she is familiar with it, but keeps checking as policies regularly update. She confirms one was in place at the time.
Mr Myers says the policy was milk first, then IV fluids, in normal circumstances. He says circumstances mean a doctor might change that and go to IV fluids.
Ms Davies agrees.
Mr Myers says there are three types of nutrition bag available - start-up bags for the baby's first couple of bags, maintenance bags, and specifically prescribed TPN bags which would have a baby's name on it. Ms Davies agrees.
She tells the court the bag for Child L wouldn't have been referred to as a start-up bag, but would have been a standard 10% dextrose bag, as prescribed, to be infused.
That completes Ms Davies's evidence.

 

[Tortoise]

Prosecution evidence, February 15th 2023, Day 55 - Live Updates LIVE: Lucy Letby trial, Wednesday, February 15

Twin - Child L

Dr Anthony Ukoh, 9th April 2016

3:18pm

Dr Anthony Ukoh is called to give evidence.
He says his recollection was that Child L and Child M were born premature, not extremely so, and for Child L, he did not have any 'red flags' as a baby who would become unwell.

3:26pm

Dr Ukoh's notes for Child L from April 9, 2016, at 10.20am, are shown to the court.
He noted the baby was breathing well, and Child L was on an extra 10% dextrose dose as the blood sugars were running at a "relatively low level for his age", but was "not unusual" for premature babies.
There were no 'red flags' from the observations.
The plan was 'as per hypoglycaemic protocol', to increase the infusion of 10% dextrose administration, "to make up for the low blood sugars", and to repeat blood sugar checks.

3:49pm

Dr Ukoh confirms a hypo screen test result, taken at noon on April 9, which is handwritten, is in his writing.
He says it is not a complete hypo screen results sheet, and said that would have been done in response, and at the time of, a low blood sugar reading.
Some of the results would have required sending away for analysis.
He says the test results would have been received by the lab at 6.26pm.

Cross-Examination

3:58pm

Mr Myers, for Letby's defence, asks to clarify Dr Ukoh's explanations for the way some of the results are presented.

Judge's Question

4:02pm

The judge asks for the hypoglycaemic blood test, if there was just one blood sample taken from Child L for the various tests carried out.
Dr Ukoh agrees that was the case, and that some of the results would not come back straight away.

 

[Tortoise]

Prosecution evidence, February 15th 2023, Day 55

Twins - Child L and Child M

10% Shropshire Star Nurse ‘celebrated Grand National bet after trying to murder twins’, court told

10% Guardian - Lucy Letby: nurse won Grand National bet on day of attempted baby murders, court told

"Two hours after the unexpected collapse of Child M, Letby messaged a friend: “Work has been *advertiser censored* but … I’ve just won £135 on the grand national!! (horse emoji).”

On a group WhatsApp post to friends just before 2pm on the same shift, she wrote: “Sorry guys, mad busy four days in work. U can come to mine if you want to. Just need to unpack first.

“Haven’t got a spare bed yet tho so cant stay unfortunately. Looking forward to a catch up.
“Got magnum prosecco and vodka woop. No disco ball but sure we can manage”.

Following her Grand National winning bet, she tells the same group chat: “Unpacking party sounds good to me with my flavoured vodka ha ha. Just won the Grand National!! (horse emoji)."

 

[Tortoise]

Prosecution evidence, February 15th 2023, Day 55

Twins - Child L and Child M

10% Chester Standard Lucy Letby: Nurse 'celebrated Grand National bet hours after trying to murder twins'

"Letby volunteered to work on April 9 as an extra shift because she wanted the overtime pay, the court heard.

She told a friend the neo-natal unit was “full so struggling for staff”.

A total of 16 children were spread across the unit’s four nurseries on April 9, with the twins and three other infants in intensive care room 1.

Three nurses, a nursery nurse and the nursing shift leader were on duty.

On April 11 Letby messaged the same friend, who cannot be named for legal reasons, that the “unit is in dire way with staff”.

She added: “Me and Mary (another nurse) in 1 with 5 babies, one collapsed with full resus, 1 on exchange and 1 hypo. It was mad and poor skill mix x”"

 

[Tortoise]

draft timeline child L from today's evidence



8 Apr 2016, Fri - LL’s day shift

Twins L & M born at 33 wks & 2 days. Child L weighed 3lb 3oz

10.30am – Child L admitted to the nnu. Obs taken by LL. On 2 hrly feeds NG/bottle. Shift-leader nurse Amy Davies confirms she would have been the designated nurse for Child M at that time.

10.58am – child L blood sugar – 1.9. [2.6 and above is healthy per testimony]

11.15am – Dr Sudeshna Bhowmik sited an IV line for child L.

Noon – L given 10% dextrose infusion. Shift-leader nurse Amy Davies confirms she would have checked the infusion bag containing 10% dextrose with Lucy Letby, making sure it was in date, going to the right baby, and signing it. The infusion is noted as starting at noon on April 8. Ms Davies says the pre-made dextrose concentrations available for infusion bags are 5% and 10%. Ms Davies says the bags would be changed, regardless, every 48 hours. Ms Davies is asked if she, at any point, administered Child L with insulin. She replies she did not, and is not aware of anyone doing so. She tells the court the bag for Child L wouldn't have been referred to as a start-up bag, but would have been a standard 10% dextrose bag, as prescribed, to be infused.

12.14pm – 2.5

4.00pm – 5.8

6.00pm – 3.3

6.15pm – LL messaged a colleague saying she was unpacking and may do an extra shift at the weekend. She also messaged her mother saying she was thinking of working an extra shift on Saturday.

8.00pm – Agency nurse Tracey Jones records notes for child L for the night shift. During night shift L knocked out his cannula and it was reinserted

9.00pm – 2.3

Post-Shift? -
Sophie Ellis to LL: "How's the house pal? Xx"
LL: "Hey, it feels a bit weird having a whole house but it's good thanks, although stuff everywhere as moved in properly on Tue and been at work Wed, Thurs and today...", followed by a monkey emoji with its hands over its eyes.
SE: "it'll feel more homely once you've sorted everything out." She also asks about how busy the unit is.
LL: "Unit is busy, no-one particularly unwell just volume and few people off sick. I prefer 4 days to 4 nights. We've got nice mix of babies at the mo really. Shift goes quick anyway!'

10.00pm – 2.2

Midnight – 3.6


9 Apr 2016, Sat - LL’s day shift.

LL designated nurse for 2 babies in room 1. Mary Griffith designated nurse for L & M in room 1.

7.30am – LL came on duty

10.00am – pre-feed – 1.9. He was given increased dextrose.

10.20am - Dr Ukoh noted child L was breathing well, and was on an extra 10% dextrose dose as the blood sugars were running at a "relatively low level for his age", but was "not unusual" for premature babies. There were no 'red flags' from the observations. The plan was 'as per hypoglycaemic protocol', to increase the infusion of 10% dextrose administration, "to make up for the low blood sugars", and to repeat blood sugar checks.

10.34am – LL to Ailsa Simpson : wishing her good luck at picking the horses at the Grand National that day, and that her feet don't get too sore.

11.00am – 1.6

11.12am to 12.33pm - LL is engaged in messaging people between 11.12am and 12.33pm.

Noon – pre-feed - 1.6. He was given 10% dextrose. LL co-signed.

Noon – Dr Ukoh confirms a hypo screen test result, taken at noon on April 9, which is handwritten, is in his writing. He says it is not a complete hypo screen results sheet, and said that would have been done in response, and at the time of, a low blood sugar reading. Some of the results would have required sending away for analysis. He says the test results would have been received by the lab at 6.26pm.

12.30pm – designated nurse Mary Griffith went on break

Shortly after 12.30pm – LL to Ailsa Simpson: "Oh good hope you have a fab time. Im in work doing an extra! x"

1.00pm - LL to her mother: “Is dad betting on the Grand National? If so can he see which are greys and put a bet on for me please x” Her father, John, gave her the names of three horses including the eventual winner Rule The World, the court was told. Mr Letby placed a £2 each-way bet for his daughter on Rule The World because it shared its name with the popular Take That song, the court heard. Her mother replies that has already been done.

Just before 2pm - LL continues to be involved in messaging, including a group message to 3 colleagues and friends: "Sorry guys, mad busy 4 days in work. U can come to mine if you want to. Just need to unpack first. Haven’t got a spare bed yet tho so can’t stay unfortunately. Looking forward to a catch up. Got magnum prosecco and vodka woop. No disco ball but sure we can manage. x"

2.00pm – 2.0

3.00pm – 1.5

3.35pm – LL co-signed meds for L. Mary Griffith takes blood to send to the lab. Bolus dextrose prescribed.

3.40pm – given a bolus of dextrose

4.00pm – child M collapsed and crash call put out.

4.00pm – 1.5 – dextrose increased from 10% to 12.5%

Abt 4.00pm - Friends message LL around this time, saying they can have "an unpacking party".

5.00pm – 1.7

5.28pm - LL's mother messages LL telling her: "You've won rule the world :-D xx"

6.00pm – 1.9

6.01pm – LL responds to a colleague at 6.01pm: "Haha why not!! Work has been s***e but...I’ve just won £135 on Grand National!!"
LL sent a group message to the 3 colleagues invited earlier: "Unpacking party sounds good to me with my flavoured vodka ha ha. Just won the Grand National!"

6.26pm – Dr Ukoh says the test would have been received by the lab at 6.26pm.

8.00pm – 2.0

9.00pm – 2.4

9.22pm – LL makes notes re Child M (still at work)

10.00pm – 2.3

10.11pm - Belinda Simcock messages LL: "Thanks for listening, I'm ok x"
LL: "Don't need to thank me, glad you felt able to tell me..."

Midnight – 2.1

10 Apr 2016, Sun - LL not working

2.00am – 2.1. A long line is inserted, with an x-ray taken, and medication administered.

4.00am – 2.3

6.00am – 2.2 – glucose further increased

7.00am – 2.2.

Time? - LL receives a message from Yvonne Farmer asking if she wanted to do more overtime shifts on Sunday night, Monday day or Monday night, appreciating she may be tired, with LL responding: "Sorry but need some days off now."
She adds she could be on call for nights, and would be free for Thursday day/night shifts.

9.00am – 2.2

2.00pm - normalised – 3.0

Afternoon - LL refers to her previous shifts as "not nice" in a message to Jennifer Jones-Key.
JJ-K : says LL 'hasn't got many nights' coming up on the rota, adding she likely won't see LL as she works mainly nights herself. "We never see each other if we do work together as always mad shifts".

Afternoon – L still receiving 15% dextrose through the afternoon. Nursing note Laura Eagles says "Blood sugars maintained...remains on 15% dextrose via long line...very unsettled at times."

5.00pm – 2.8

8.00pm – nurse Samantha O’Brien designated nurse for L for night shift.

9.00pm – 2.7. 15% dextrose continued through the night

11.00pm – 2.9

11 Apr 2016, Mon - LL not working

2.00am – 2.7

Samantha O'Brien, in her nursing note, records: "...1% glucose infusing via long line in left leg,. 3 hourly blood sugars, all have been above 2.6 so far this shift. Plan to continue [current medication administration] "Baby unsettled at times, settles with comfort measures."

5.00am – 2.9

8.45am LL messages colleague "The unit is in dire way with staff," highlighting which trained staff were on duty and who else was on in the last shift, and who was off at that time.She added: “Me and Mary in 1 with 5 babies, one collapsed with full resus, 1 on exchange and 1 hypo.
colleague replies: "that's terrible"
LL replies the overall situation was "not good", "mad and poor skill mix".

11.00am – 2.8

Registrar Dr Huw Mayberry, in a clinical note, records the feeds/fluids for Child L, which were increased due to low blood sugar and falling sodium levels.

3.00pm – 3.5

5.00pm – 3.5

Nurse Belinda Simcock said registrar Mayberry was aware of the 3.5 readings, and if they continued to remain above three, then feeds would be increased.

7.00pm – 4.7



14 Apr 2016, Thu

Child L’s blood test results came back

 

[Tortoise]

Prosecution evidence, February 16th 2023, Day 56

10%
Chester Standard Lucy Letby breaks down as doctor gives evidence at trial
Independent Nurse accused of murdering babies breaks down as doctor gives evidence at trial
Evening Standard Nurse accused of murdering babies breaks down as doctor gives evidence at trial
BBC Lucy Letby: Murder-accused nurse breaks down at trial
Gazette Nurse accused of murdering babies breaks down as doctor gives evidence at trial
Daily Mail https://www.dailymail.co.uk/wires/pa/article-11759719/Nurse-accused-murdering-babies-breaks-doctor-gives-evidence-trial.html

Twin - Child L

Unnamed registrar, night shift 10th April 2015


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Lucy Letby, 33, abruptly left her seat in the middle of the glass-panelled dock at Manchester Crown Court on Thursday, February 16 as the medic, who cannot be identified for legal reasons, confirmed his name.

She was visibly upset as she walked towards the exit door before she had a brief, hushed conversation with a woman dock officer.

Still appearing unsettled, she spoke with her solicitor through the glass panel before her barrister, Ben Myers KC, indicated to trial judge Mr Justice James Goss that proceedings could continue, as the trial completed its 16th week before a jury.

The doctor, a registrar at the Countess of Chester Hospital in 2016, continued his evidence screened from the public gallery and the defendant.

Letby listened on as she wiped away tears with a tissue and took a few sips of water.

The doctor told the court about his care of Child L, a twin boy born prematurely, who the Crown say the defendant attempted to murder by poisoning him with insulin.

He treated Child L in the early hours of April 10 2015 – the day after Letby is said to have attacked the baby.

The youngster’s blood sugar levels were decreasing during the night shift and were “lower than what I would have wanted”, he said.

Asked by prosecutor Philip Astbury why it was necessary to stop the levels falling, the doctor said: “Because low blood glucose levels in a baby can cause seizures.

“It’s damaging to a baby. If it falls to a much lower level, then it can cause liver damage and brain injury.”

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