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LIVE: Lucy Letby trial, Friday, May 5 - defence continues
Defence Case
CHILD D
2:04pm
Mr Myers is now referring to the case of Child D, a baby girl born on June 20, 2015, weighing 3.13kg.
The mother's waters had broken several hours earlier.
Notes show Child D '12 mins age - in dad's arms - lost colour, floppy. 5 rescue breaths + 2mins IPPV. Reviewed by SHO - on arrival, good resp. effort'.
Child D 'started grunting in theatre' and the midwife was 'not happy' with Child D's colour.
Child D later stabilised and had been transferred to the neonatal unit.
2:06pm
Child D suffered three collapses on the morning of June 22, the court is told, the last of those at 3.45am. Child D later died at 4.25am.
Mr Myers refers to police interviews with Letby, in which she said she did not recall Child D.
2:21pm
The nursing rota for the night shift of June 21 is shown to the court, in which Letby was on duty in room 1, designated nurse for two babies.
Nuse Caroline Oakley was the designated nurse for Child D in room 1 that night.
Mr Myers refers to Child D's mother's statement in which she said a conversation was had with Letby at 7pm, and also saw Letby at the point Child D collapsed - "hovering around not doing much", holding a clipboard.
Letby says she does not recall the 7pm converation. She said she would not have been on duty in the clinical nurseries at that time, and would have arrived after 7pm for work, then going on to the nursery.
Swipe data for Letby is shown at the entrance to the maternity neonatal entrance doors at 7.26pm. Letby says that would be to prepare for her shift.
A text message is sent from Letby's phone at 7.15pm where she says: "Im just about to leave for a night shift so no problem. Hope all ok x". Letby says she would have been in Ash House at the time she sent the message.
Nursing notes by Kate Bissell for Child D are inputted into the system, the last of those at 7.45pm.
Observations for Child D are shown to the court, which do not have Letby's initials on them.
Letby denies she was in the nursery unit at 7pm.
Nursing notes by Caroline Oakley are now shown for Child D, written retrospectively at June 22. '0130 called to nursery by [nurse] and Letby. [Child D] had desaturated to 70s.
The notes add Child D also desaturated (to 70s) at 3am and 3.45am. For the latter 'stimulation given to no effect; bagging via Neopuff at 3.52am. SHO on unit and called to help. Dr crash called and resus commenced...'
2:22pm
Lucy Letby says she has no recollection of the first event or the build-up to it.
2:25pm
A timeline of nursing duties is shown for June 22 from midnight is shown to the court. Letby is shown as one of two nurses for an infusion at 1.25am with Caroline Oakley. Letby says she has no recollection of this event.
She says that night she would have been caring for babies on room 1 and helping other nurses, along with other miscellaneous duties.
2:30pm
A timeline shows Lucy Letby and Caroline Oakley are "checking medication for" Child D at 2.18-2.39am, and had started an infusion at 2.40am.
The order of the signatures did not have any indication on who administered the infusion, Letby tells the court.
At 2.44am, Letby and Caroline Oakley give medication to Child D.
2:33pm
Letby says she does not recall any details for the 3am entry made on a fluid chart for Child D.
An infusion for Child D is made by Letby and Caroline Oakley at 3.20am.
Mr Myers says there is nothing recorded on the timeline for Letby's involvement in respect of Child D between 3.20am-3.45am.
Letby says she has no memory of the events leading up to Child D's collapse at 3.45am.
2:35pm
Letby says she cannot recall what happened to Child D.
CHILD E
2:45pm
Mr Myers moves on to the cases of twin boys Child E and Child F.
The twins were born on July 29, 2015. Child E was born weighing 1.327kg, gestational age 29 weeks +5 days.
On the evening of August 3, Child E bled from his mouth, Mr Myers tells the court. Child E died in the early hours of August 4.
Mr Myers reads out nursing notes by Letby which include: 'prior to 21:00 feed, 16ml mucky slightly bile-stained aspirate obtained and discarded, abdo soft, not distended. SHO informed, to omit feed'.
Child E declined through the night after vomiting blood. Resus happened at 1.15am and Child E bled from the mouth.
In family communication: 'Mummy was present at start of shift attending to cares...aware that we had obtained blood from his NG tube and were starting some different medications to treat this.'
2:50pm
Mr Myers asks Letby about the nursing note, about the 16ml aspirate. The note has her signature initials.
Letby says the aspirate was obtained before the 9pm feed.
The note adds: 'At 2200 large vomit of fresh blood. 14ml fresh blood aspiate obtained from NG Tube'. Mr Myers says a 15ml aspirate is obtained on the chart, by Belinda Simcock.
Letby says the '14' is a typo on her behalf and should be 15.
2:56pm
A night shift staff diagram is shown to the court for the night of August 3-4. Letby was the designated nurse for Child E and Child F in nursery 1.
As Child E's needs increased that night, Belinda Simcock took care of Child F, Letby tells the court.
Mr Myers shows a feeding chart for August 3 for Child E.
No feed is recorded for 9pm. Letby says she had a large mucky aspirate obtained prior to then, so it was "standard practice" not to give the feed.
The aspirate was shown to Belinda Simcock "as it was an abnormal finding" and the SHO was informed. Letby says she did not know who informed them.
Letby tells the court the advice was to omit the feed.
3:00pm
At 10pm, the registrar attended, Dr David Harkness, when fresh blood was obtained from Child E.
Mr Myers asks if Letby can provide an exact time Dr Harkness arrived. Letby says she cannot. She says she is not sure if Dr Harkness was there on the unit just for Child E or whether he was there for anything in addition.
Letby says she can recall Child E and Child F's mother being on the unit that night, until about 10pm.
3:05pm
A nursing note shows 'mummy was present at start of shift attending to cares. Visited again approx 2200'.
The mother had said Child E was, when she visited, "screaming" with "fresh blood around his mouth".
Letby is asked if Child E had been screaming. She replies: "No."
"He was unsettled at some points, but not screaming."
A diagram the mother had drawn of where she said fresh blood was on Child E is shown to the court, around the mouth. Letby is asked if she can recall this when the mother visited.
She replies: "Not that I can recall, no."
Letby says she cannot recall why the mother came down specifically, but she came down with breastmilk.
Letby denies telling the mother to leave. She says that is not something that would be done.
Letby says there was "no" blood around Child E's mouth at 9pm. She says the blood was noticed on Child E at 10pm.
3:12pm
The court is shown the timeline for the night shift on August 3-4. Letby is shown administering medication for Child F at 9.13pm, with nurse Caroline Oakley also present, in room 1 - the same as Child E.
Letby is asked if Caroline Oakley observed blood on Child E's face at that point, or if it was noted. Letby replies: "No."
3:27pm
The trial is now resuming.
Mr Myers is now asked to look at her police interview in the section of Child E.
3:30pm
Police ask about 9pm, which the mother said was when she arrived at the neonatal unit, seeing Child E crying and having blood come out of his mouth.
Letby said this was not the case. She said a 'large vomit of fresh blood' is at 10pm.
She said she was not accepting the mother's statement that blood was in Child E's mouth at 9pm.
3:34pm
Letby said she could not recall what Child E was like when the mother visited, but did not accept blood was present on Child E's mouth.
Letby says she first saw blood at 10pm.
3:36pm
Letby replies: "Not that I can recall, no" and there was "no blood at that point" in response to if she had cleaned up blood from Child E's mouth at 9pm.
She says there was a large mucky aspirate obtained prior to 9pm, but it did not have blood in it.
3:41pm
Letby said she did not ignore a bleed, and nor did any of her colleagues, as there was no bleed at 9pm. She denies failing to record a bleed.
She says when there was a bleed, she escalated it to the registrar.
Letby recalls, from 10pm onwards, the 15ml fresh blood aspirate was "very concerning".
A red line around Child E's abdomen was also displaying, around the umbilical cord area. Letby says that could have been a sign of a bleed in the abdomen.
3:46pm
The note '0036 acute deterioration' is made by Letby.
She tells the court Child E was intubated, was 'actively bleeding', and continued to decline.
Becoming tearful, Letby says Child E was "bleeding from his mouth and his nose".
She says Child E's parents were present for resuscitation.
She denies Child E's deterioration was something she had wanted to happen.
Following Child E's death, Letby says teddy bears were given to Child E and Child F, and on the parents' wishes, a photo was taken of the twins.
Letby says she continued to look after Child F after the night shift.
For Child E, she said she found his death "very traumatic", having not seen that kind of sight before.
CHILD F
3:48pm
Mr Myers moves on to the case of Child F, after asking if Lucy Letby is ok to continue.
Child F was born weighing 1.434kg.
3:52pm
Mr Myers says the issue of Child F will focus on his blood sugar and insulin levels.
On August 5, from 1.55am-7pm, there were "issues" with Child F's blood glucose levels being too level.
At 5.56pm, a blood sample was taken which, when the results were returned, came back with extremely high insulin (4,657) and very low insulin c-peptide (169) levels.
3:59pm
Letby is asked to talk through blood glucose level readings taken for Child F throughout the day.
The readings are low until 9.17pm on August 5.
4:02pm
Letby was not the designated nurse for Child F on August 4-5, and was the designated nurse for a baby in room 2. Child F was also in room 2, with another nurse the designated baby.
An intensive care chart on August 1 is shown to the court, for Child F. Performing "various cares" for Child F is Lucy Letby, the court hears, as hourly observation readings are signed by her on the chart throughout the night, until 7am on August 2.
4:04pm
Letby was also providing cares for August 2-3, and part of the way through August 3-4 until Child E deteriorated, the court hears.
4:06pm
Letby is asked what she wanted to do on that August 4 night shift.
Letby: "I wanted to care for him."
Mr Myers: "Did you want to 'finish off' anything you had started anywhere else, as is alleged?"
Letby: "No."
4:08pm
Letby says her priority was to get Child F well and get him home.
4:14pm
That concludes today's evidence.
The case will resume with Lucy Letby giving further evidence in respect of Child F.
Members of the jury are reminded not to discuss the case with anyone and not to conduct any research into the case.
4:20pm
The trial will resume next Thursday, May
10. [11th]
