Prosecution evidence, March 2nd 2023, Day 65 - live updates Chester Standard -LIVE: Lucy Letby trial, Thursday, March 2
Child N
Electronic evidence 2nd June 2016 to 4th June 2016
11:01am
Cheshire Police intelligence analyst Claire Hocknell is now talking the court through the first of two sequences of events for Child N.
The first is a Facebook message from a Countess of Chester Hospital doctor at 11.56am on June 2, asking Lucy Letby for an 'opinion on something'.
Lucy Letby replies: "Hope I can help!"
Child N is born via C-section at 1.42pm, weighing 1.67kg, at 34 weeks plus 4 days gestation. His 'APGAR' scores, recording how well Child N was doing immediately after birth, are 9/10 at 1 minute and 9/10 at 5 minutes.
Nurse Caroline Oakley records Child N was admitted to the neonatal unit at 2pm, and Child N had 'prematurity and clotting disorder'.
A blood sample was taken at 2.30pm.
A clinical note by Dr Anthony Ukoh reports: '34+4 baby boy cried immediately, required no active resus'.
'Not for IM Vit K for now until haemophilia status known'.
'Observations: ...intermittently grunting++'
11:03am
A desaturation down to 67% oxygen saturation, lasting one minute, is recorded by nurse Caroline Oakley at 3.10pm.
The nurse adds, in a nursing note: '[Child N] Allowed to rest. Sounds very mucousy. Grunting intermittently...dropped saturations to 67% when upset; temp being recorded and required 60% O2 to recover...awaiting blood results before being given Vit K.'
11:06am
The note adds: 'Decision made to screen and [nil by mouth], IV fluids/Vit K IV as prescribed as still grunting'
11:12am
An x-ray result before 6pm recorded that Child N likely had an infection.
Nurse Caroline Oakley recorded at 6.47pm that Child N's temperature, which had been low, was recovering.
A family communication is recorded: 'Dad has visited baby on unit and updated by [Belinda] Simcock. She has also visited mum... and updated...'
A haemophilia diagnosis is confirmed for Child N.
11:14am
Lucy Letby is recorded as starting her night shift on June 2 at 7.30pm, in time for the 7.30pm-8pm staff handover.
Letby is a designated nurse, with shift leader being Melanie Taylor and other designated nurses being Christoper Booth and Sophie Ellis.
Booth has two babies in room 1, including Child N, Ellis had one in room 2 and two in room 3, and Letby had two in room 4. Two babies were in transitional care, and another baby was 'rooming in with her parents' - that baby's designated nurse was Letby.
11:17am
A few minutes after entering the neonatal unit, Letby Whatsapps a colleague and says she had a 'paper handover' as colleague Caroline had gone home.
Nurse Christopher Booth records 'care taken over approx 2000...oxygen saturations predominantly in mid 90s-100%'. He also records the usual handover checks.
11:20am
Letby messages 'We have got a baby with haemophilia'
Reply: 'How many weeks?'
LL: '34'
R: 'oh'
LL: 'Everyone bit panicked by seems of things but baby appears fine'
R: 'male?
LL: 'yeah'
LL: 'Oh and had weird FB message from [doctor] earlier...'
Letby adds she does not know much about haemophilia. Her colleague replies to be careful with cannula and blood samples.
11:26am
The conversation continues about discussion of other babies, and Letby messages her colleague: 'Had strange message from [doctor] earlier...'
Reply: 'Did u? Saying what?' 'Go commando?
Laughing emojis are replied by Letby.
Letby: 'Asking when I was working...'
R: 'Think he likes you too...'
LL: '...Just wants my opinion on something'
R: 'Hmm'
LL: 'Do you think he's being odd?
R: 'Thought as flirty as u'
LL: 'Shut up!'
R: 'What?!'
LL: 'I don't flirt with him!'
R: 'Ok'
LL: 'Certainly don't fancy him haha just nice guy'
R: 'Ok'
11:27am
The conversation continues back on work, asking why there was a staff shortage on the unit. One of the staff members is speculated to be off with stress.
11:28am
The conversation on Whatsapp, now continuing after 10pm, discusses another baby's condition.
11:33am
Further observations are recorded regularly for Child N up to 1am.
Child N then suffered a desaturation at 1.05am.
Nurse Christopher Booth: 'One episode whilst I was on my break, whereby infant was crying++ and not settling.
He became dusky in colour, desaturating to 40s. Responded to facial oxygen within 1-2 minutes, crying [subsided] after 30 minutes'. The note adds Child N's colour returned to pink perfusion.
11:34am
Nurse Booth added, up to 2.04am: 'No further episodes observed. Oxygen saturations have been consistently mid 90s-100%...in view of earlier episode, infant remains nil by mouth...'.
11:36am
Nurse Ashleigh Hudson takes over care of Child N for the day shift on June 3.
'Tachypnoeic on handover, unsettled'
11:39am
Letby messages the same colleague: 'been busy...' adding what had happened to a number of babies during the night shift, and what staff on duty had been doing.
She adds: 'Glad to be off, survived my nights tho' followed by a smiley face emoji.
11:42am
Dr Sudeshna Bhowmik records a list of 'problems' for Child N, including prematurity, jaundice and respiratory distress.
A plan was to discuss with Alder Hey Children's Hospital haemotology, and that discussion was carried out.
11:47am
A dose of vitamin K is prescribed for Child N during the day shift.
Nurse Ashleigh Hudson records a 'slightly mucky aspirate' for Child N towards the end of the day shift, at about 6pm.
The note of a summary of care between 8am-6pm records Child N was 'settled for the rest of the day', with 'minimal aspirates obtained. Aspirates clear with tiny old blood specks'.
'Paeds have liased with AHCH'
11:49am
Nurse Christopher Booth, at the time of the night shift handover for June 3-4, records at 8pm Child N was settled.
A family communication note by nurse Hudson: 'Both parents updated on current condition and plan of care. Mum very anxious, worried about baby being in the incubator. Explained need for it, to keep baby warm and make observation easier...'
11:52am
The sequence of events goes up to June 4 at 3am, where Christopher Booth records 'No significant desaturations, bradycardias or apnoeic episodes observed overnight...'
12:18pm
Kate Tyndall, intelligence analyst for Cheshire Police, is now talking the court through the neonatal review schedule for the events in the case of Child N.
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Tweets
Mel Barham
@MelBarhamITV
·
1h
Hearing now from Cheshire Police intelligence analyst Claire Hocknell. Lucy Letby is recorded as starting night shift at 7:30pm. She was designated nurse for 2 other babies, she wasn’t designated nurse for baby N
Mel Barham
@MelBarhamITV
·
1h
Jury has been shown whats app messages between Letby and another member of staff, where they talk about baby N having haemophilia. Letby says “I’ll have to google it later, don’t know much about it”
Dan O'Donoghue
@MrDanDonoghue
·
1h
Cheshire Police intelligence analyst Claire Hocknell is now talking the court through sequencing evidence for Child N
Dan O'Donoghue
@MrDanDonoghue
·
58m
Court is now being shown messages sent between Ms Letby and a colleague who can't be named for legal reasons on June 2. Messages are discussing a doctor, who also cannot be named
Dan O'Donoghue
@MrDanDonoghue
·
57m
Ms Letby says: 'Had strange message from [doctor] earlier...' Her colleague says 'Did u? Saying what? Go commando?' (with laughing emojis) 'Think he likes you too
Dan O'Donoghue
@MrDanDonoghue
·
57m
Ms Letby went on to say: 'I don't flirt with him! Certainly don't fancy him haha just nice guy'
Dan O'Donoghue
@MrDanDonoghue
·
45m
We're continuing to go over door swipe data and observation charts for Child N on June 2/3 2016