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

[Tortoise]

Dan O'Donoghue BBC Tweets - https://twitter.com/MrDanDonoghue

Defence Case Wednesday 24th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD G

We're now moving to Child G (Nick Johnson says we will return to Child F at a later point). She was born in May 2015 and was the most premature of all the babies and had a number of "septic" or "suspected septic" episodes in the weeks after her birth.

The court heard that in mid-August 2015, she was transferred from Wirral's Arrowe Park Hospital and was "clinically stable" until 7 September, when she projectile vomited at about 02:00 BST.

Prosecutors say Ms Letby overfed Child G with milk through a nasogastric tube or injected air into the same tube and made two more attempts to kill her on 21 September. Jurors have heard the child now has quadriplegic cerebral palsy and requires round-the-clock care.

Mr Johnson says the 21 September was significant as this was the baby girl's full term due date. That coincided with some of the events - Ms Letby tells the court 'all it is is a coincidence'

We're back after lunch. Mr Johnson is focusing on Child G's projectile vomit at about 02:00 on 7 September. Ms Letby said before the break that the the vomit "potentially" could have been caused by a nursing colleague having mis-measured a feed.

"I can't say for definite that didn't happen. I'm not saying she did do that, but it is a possibility", Ms Letby said.

Mr Johnson is asking Ms Letby about her recollection of that night shift. She says Child G projectile vomited around 02:15, she says she never seen that on a neonatal unit before

Mr Johnson says 'I'm going to suggest to you that you deliberately misstated the time at which (Child G) had this event, this vomit, happened much closer to 2.30'. 'No I don’t agree', Ms Letby said

Mr Johnson says this is 'one of the occasions' Ms Letby is 'misrepresenting events in nursing notes' - she rejects this

Mr Johnson points to the notes of a doctor on shift who recorded being bleeped to attend at 2.35 as evidence the collapse happened at 2.30

Mr Johnson accuses Ms Letby of moving the time forward to 2.15 as it creates a 'more obvious link' to another nurse 'feeding the child', he says 'you wanted to create the impression that two events were linked' She denies this

Mr Johnson says 'in fact the reason (Child G) collapsed and the reason you aspirated so much air and milk from her is that you deliberately overfed her…you did it by putting milk into syringe and forcing air and milk into her' She says 'no, that's not true'

'You have inserted something into (Child G's) airway haven't you?', Mr Johnson says. 'No', Ms Letby replies. He accuses the nurse of causing 'bleeding' in Child G's throat, 'as you have with many other of these children' Ms Letby says 'no, not true'

We're now moving to the events of 21 September - the day Child G would have been full term

Mr Johnson asks Ms Letby 'did it annoy you you were in nursery four' on 21 September shift 'No, not at all no', she says. (nurseries were graded 1-4 based on need, 1 being for highest priority babies)

We're back after a short break - Mr Johnson is taking Ms Letby back over her defence statement, in regards to the events on 21 September

The court has previously heard that Child G was left on a treatment trolley after she had been cannulated and was not reconnected to a masimo monitor. Ms Letby recalls finding Child G in this state, she says she was a 'dusky blue' and was not breathing

Consultant Dr John Gibbs has previously accepted responsibility for leaving Child G unattended in that way.

Mr Johnson says 'knowing that doctors had left her behind the screen', Ms Letby took the 'opportunity to sabotage her' He adds 'you took advantage of a situation that presented itself'. 'no', she responds

Mr Johnson puts it to Ms Letby that 25minutes prior to Child G's collapse, she was in nursery four alone with her - Ms Letby rejects this saying she was 'in and out' of the nursery all day. She says nurses had to do 'many things...not purely based at babies cot side'

 

[Tortoise]

Judith Moritz BBC Tweets - https://twitter.com/JudithMoritz

Defence Case Wednesday 24th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD G

Nick Johnson KC turns to asking Lucy Letby about the next baby - baby G. A little girl who the nurse is alleged to have tried to murder on three occasions in September 2015. She denies the charges.

Lucy Letby says that baby G had "a lot of ongoing health issues as a result of her extreme prematurity". Nick Johnson KC asks her if she's exaggerating the baby's problems. The nurse says she isn't.

Lucy Letby agrees that before baby G first projectile vomited, all her observations and signs had been good.

Lucy Letby says "it's a possibility" that another nurse (who the media can't identify because of court order) "might have overfed baby G"

Court has resumed. Nick Johnson KC is continuing to question Lucy Letby about the first occasion (of three) when she's accused of attempting to murder baby G. This is when the baby projectile vomited so forcefully, the vomit was found outside the cot, on a chair.

Lucy Letby agrees that it's true that baby G vomited forcefully onto the floor and chair. She's asked why she didn't say this to the police when she was first interviewed about the allegation. She denies that she was lying to detectives.

NJKC - "This is an extraordinary event, the like of which you hadn’t seen before".
LL - "I have seen it but not on a neonate"
NJKC - "It would have stuck in your mind so why didn't you mention it to the police?"
LL - "It was an oversight"

Nick Johnson KC suggests that Lucy Letby deliberately falsified nursing notes to bring the time of the baby's vomit forward in the documentation. She denies this.

NJKC: "The reason you’ve done that is so there’s a more obvious link between your best friend (another nurse) feeding the baby and the vomit"
LL: "No"
NJKC: "Because you wanted to create the impression that the two events are linked"
LL: "No"

Nick Johnson KC: "The reason baby G collapsed and you aspirated so much air from her is that you deliberately overfed her"
Lucy Letby: "That’s not true"
NJKC: "And you did it by putting milk into the syringe and using it to force air and milk into her"
LL: "No that's not true"

Previously in the trial a doctor said she'd seen bloody fluid coming from baby G's trachea.
Nick Johnson KC: "You had inserted something into baby G’s airway hadn’t you?"
Lucy Letby: "No"
NJKC: "You caused the bleeding as you had with many other children"
LL: "No that’s not true"

NJKC: Do you remember what you were doing that night, when you were not in work?
LL: “I went back into work to sign some documentation”.. (1/2)

.. NJKC: “You went to visit baby G didn’t you?”
LL: “I didn’t visit her. I was there to sign documentation”
NJKC: “Were you looking for an opportunity to finish her off?”
LL: “No” (2/2)

Nick Johnson KC: "You had seen baby G many times on the unit. Do you agree with her father that she wasn’t the same, after the first incident (of vomiting)?
Lucy Letby: "I can’t comment on that. Nobody knows the child like the parents do".

Nick Johnson KC moves to ask Lucy Letby about the second of three occasions when she's accused of attempting to murder baby G, two weeks after the first occasion in Sept 2015.

Lucy Letby says she had some concerns about baby G having a low temperature on this second occasion. Nick Johnson KC shows the relevant temperature chart for the baby in which the temps are recorded as being within normal range... (1/2)

The barrister points to a column on the chart, in which he says two different temperatures seem to have been recorded. Asks "Did you go back after the event, and cook the chart to make it look like baby G was declining before she vomited?" Lucy Letby - "No"

Nick Johnson KC: "It’s not an innocent coincidence that baby G vomited and had to be aspirated an hour after you had fed her, is it?"
Lucy Letby: "It is a coincidence"

Court sees a message which Lucy Letby sent to another nurse describing baby G as looking "rubbish".
Nick Johnson KC: "Were you trying to create in the minds of your co-workers the impression that this was a child sickening for an infection?"
LL: "I wasn’t suggesting anything".

Nick Johnson KC: "When baby G collapsed on this occasion, all other medical professionals were out of the room weren’t they?"
Lucy Letby: "Yes"
NJKC: "Was that an innocent coincidence?"
LL: "Yes"

Lucy Letby has previously said she found baby G alone on a treatment trolley without sides, behind a screen, with her monitor off. Nick Johnson suggests doctors told nurse Letby they'd finished treating the baby and she should put her back in her cot. She disagrees.

Nick Johnson KC: "I'm suggesting that you took advantage of the situation that presented itself and you sabotaged baby G" Lucy Letby: "I disagree"

 

[Tortoise]

Chester Standard Updates - https://www.chesterstandard.co.uk/news/23543140.live-lucy-letby-trial-may-24---cross-examination-continues/

Defence Case Wednesday 24th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD H

3:58pm

Mr Johnson moves on to the case of Child H. Letby says she does recall Child H, due to the chest drains that were put in place.
Letby said chest drains had to be couriered from Arrowe Park Hospital, as it was "unacceptable" they didn't have sufficient supplies at the Countess of Chester Hospital. Mr Johnson asks if Letby filled in a Datix form for that. Letby says she does not recall.
Letby is asked about the text message she sent to Yvonne Griffiths on September 26, 2015, which said: "Thank you. That's really nice to hear as I gather you are aware of some of the not so positive comments that have been made recently regarding my role which I have found quite upsetting. Our job is a pleasure to do & just hope I do the best for the babies & their family."
The court hears this was with regard to Letby and colleague Shelley Tomlins being allocated shifts in room 1, over other nurses who needed the experience.
Letby says she cannot recall which nurses, specifically, had been making those comments, but they were band 6 nurses. Letby agrees this message followed events for Child H.
Mr Johnson refers to the staffing rota for September 25-26. Letby says it was not the night staff who were making the comments. Mr Johnson asks if it was the day staff, why did they allocate Child H to Letby? Letby replies the comments had come in recent days prior to this.

4:01pm

Letby, in her defence statement, questioned how familiar the doctors were with chest drains.
Letby, when questioned on this, says this would be non-consultants.
In her defence statement, Letby said she could not recall the specific details of Child H's collapses.

4:08pm

Letby is asked to refer to her defence statement, in which she said her memory for both nights when Child H's collapses "merged into one". Letby added she was also looking after a severely disabled baby.
Letby now accepts the disabled baby was born later in the shift.
Letby tells the court staffing levels were not a contributory factor in Child H's collapses.
Letby said she would "question whether the [chest] drains were securely put in" for Child H, as a potential contributory factor in Child H's collapses.

4:12pm

Letby accepts Child H was born in a good condition, and that she recovered quickly.
She tells the court she cannot comment on her interpretation of the security of the chest drains, from her observations.

 

[Tortoise]

Sky News Updates - https://news.sky.com/story/lucy-letby-murder-trial-latest-former-nurse-tells-court-why-she-repeatedly-searched-for-dead-babys-mother-on-facebook-12868375

Defence Case Wednesday 24th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD H

Mr Johnson then moves onto the case of Child H.

44m ago16:03

Letby denies colleagues were getting suspicious of her​

Lucy Letby found comments made about her "quite upsetting", according to a Facebook message shown to the court. But she says this message was in relation to Child H being placed in her care because other staff needed "the experience", not because people had grown suspicious.
The message, which was sent to a colleague, reads: "Thank you. That's really nice to hear as I gather you are aware of some of the not so positive comments that have been made recently regarding my role which I find quite upsetting. Our job is a pleasure to do & just hope I do the best for the babies & their family [sic]."
"Were people talking about you being associated to the collapse of lots of children?" Nick Johnson, the prosecution barrister, asks.
"No, not at all," says Letby.
"Were people starting to notice you were associated to lots of different collapses?" Mr Johnson asks.
"No," says Letby.

35m ago16:12

Letby claims she was tending to baby who hadn't been born when alleged victim collapsed​

Letby has previously said she was looking after "another severely disabled baby" at the time Child H first collapsed.
But paperwork from the unit shows the severely disabled baby in question was born later in the shift.
When asked if medical incompetence contributed to the infant's collapse, Letby says she is not sure.
But she says she questions "if some of the drains were securely put in".
Nick Johnson, for the prosecution, asks: "Do you agree that Child H was born in good condition?"
"I can't comment on that," Letby replies.
Medical notes shown to the court indicate this was the case.

33m ago16:14

Court adjourned for the day​

Court has been adjourned for the day. It will resume tomorrow at 10.30am.

 

[Tortoise]

Dan O'Donoghue BBC Tweets - https://twitter.com/MrDanDonoghue

Defence Case Wednesday 24th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD H

We're now moving to Child H. She was born prematurely in September 2015 and had breathing difficulties.

The prosecution said her case was "complicated" by "sub-optimal treatment" as there was an "unacceptable delay" in helping her and needles were left in her chest which may have punctured her lungs.

The court heard Ms Letby allegedly caused the girl to collapse on 26 and 27 September 2015, but she survived and went to make a full recovery.

Mr Johnson is taking Ms Letby back over what she said in relation to Child H's first collapse in the early hours of 26 September 2015. He asks if staffing levels contributed to that event, she says no.

Asked if medical competence contributed, she says she's 'not sure of the exact details'. Asked if anyone's mistakes contributed, she said there is a 'question over whether some of her drains were securely put in'

We're stopping there for today. Back tomorrow - wrap here: Lucy Letby trial: Nurse says 'dirty' ward was factor in baby deaths



Judith Moritz BBC Tweets - https://twitter.com/JudithMoritz

Nick Johnson KC now asking Lucy Letby about the next baby, known as baby H. The nurse is accused of attempting to murder the little girl on two consecutive nights in Sept 2015.

Court sees a text sent by Lucy Letby to another nurse on the same day as the first alleged attack.
It reads "I gather you are aware of some of the not so positive comments that have been made recently regarding my role which i have found quite upsetting" (1/2)

(2/2) NJKC: "Were people talking about you being associated with the collapses of lots of children at different times?"
LL: "Not at all"
NJKC: "Was that the negative comments you were talking about?"
LL: "No"
NJKC: "Were people starting to notice (the association)?"
LL: "No"

Court is finishing for today. Back tomorrow morning at 1030 when the prosecution cross-examination of Lucy Letby will continue.

 

[Tortoise]

10% Evening Standard Accused Lucy Letby tells court doctors could have acted sooner to assist baby

“I just think collectively they could have acted sooner to respond to the blood issue.”

Mr Johnson said: “Their reaction would be dependent on when you told them there was a bleed?”

“Yes,” said Letby.

Mr Johnson said: “The prosecution case is that (Child E’s mother) is telling the truth and (Child E) was bleeding at 9pm.


“But you didn’t tell anyone about that until at least an hour later?”

Letby said: “No I disagree with that.

[...]

Mr Johnson went on: “I am suggesting to you that when (Child E’s mother) came down at 9pm you had inflicted an injury on (Child E) to cause bleeding?”

Letby said: “No, I don’t accept that. It didn’t happen.”

[...]

 

[Tortoise]

10% Daily Mail Lucy Letby tells trial 'raw sewage came out of the hospital sinks'

Later in today's cross-examination, Letby - originally from Hereford - denied feeling 'a cut above' some of the other nurses on the unit.

However, she agreed with Mr Johnson that she was 'always prepared to call out other people's mistakes' and 'not afraid to confront the medical staff if you thought they'd got it wrong'.

She told him: 'I was very confident in my clinical competencies.'

[...]

 

[Tortoise]

Chester Standard Updates - https://www.chesterstandard.co.uk/news/23545950.live-lucy-letby-trial-may-25---cross-examination-continues/

Defence Case Thursday 25th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD H continued

10:41am

Nicholas Johnson KC is continuing to cross-examine Lucy Letby on Child H.
Letby is asked if staffing issues contributed to Child H's collapse. She says "no", but believes the "management of the chest drains" was a contributory factor.
LL: "I believe it has been accepted throughout the trial that there were issues with the chest drains".
Letby said the location of the chest drains on Child H may have been a factor, and that Child H's pneumothoraces were not treated correctly, due to a lack of experience and "nobody seemed particularly confident" on managing the number of chest drains - she says that was down to "multiple" doctors. Asked who those wuold be, Letby said that would include Dr [Ravi] Jayaram, Dr [David] Harkness, Dr [John] Gibbs and "Dr [Alison] Ventress, even".

10:59am

Letby says she had dealt with chest drains in Liverpool, but not at the Countess of Chester Hospital. She says she did not have much experience, and had a nursing colleague to assist her in the care of Child H.
Letby is asked about the time between 8pm and 2am on September 25-26. She says she cannot recall, specifically, the assistance she had from a nursing colleague that night, but she was there 'on and off', and "gave me a lot of verbal advice that night" in the management of Child H's chest drains, and on baptism after the collapse of Child H.
Mr Johnson reads from Child H's father's statement. He refers to being at the unit until "about midnight", and was woken up from home "in the early hours".
Letby's nursing note is shown to the court. It includes: '...x2 chest drains in situ at start of shift - intermittently swinging. Serous fluid++ accumulating.
'2330 Bradycardia and desaturation requiring Neopuff in 100% to recover. 10ml air aspirated from chest drain by Reg Ventress...inserted a 3rd chest drain...'
Mr Johnson says Letby misrepresented the time of this event.
Letby tells the court she would have got that time from her notes written at the time.
An intensive care chart is shown to the court. It includes, for 2200 - '2210 desat...SHO present...serous fluid++ x2 drain'
Letby says she cannot recall which SHO was on duty that night. Mr Johnson says the SHO on duty was Jessica Scott, and she has not recorded a note saying she was present for this.
Another note 'Brady desat 2330 10ml aspirated from...drain...' Other details are '+clear [in the OP row]' and '+small blood stained [in the Suction ET row]'.
Mr Johnson says this is another child producing blood in Letby's care.
Letby says this blood has likely come from the ET Tube in the lungs. She denies moving it around to destabilise Child H.

11:04am

Letby accepts that a 52% desaturation is a potentially serious event.
She says: "I don't agree" to the suggestion she has "cooked the books" in the nursing notes.
She denies falsifying notes for Child H by giving the impression Child H was deteriorating prior to the collapse.
Letby is asked why the '52% desautation' is not in her nursing note.
"Not every single thing gets written down...that is an error on my part."
Letby says the SHO was present for that earlier desaturation.
Letby denies writing in the intensive care chart after Child H's collapse.
NJ: "You're making this up as you go along, aren't you?"
LL: "No."

11:08am

Mr Johnson says Child H's father's statement, which was agreed evidence, did not mention a collapse or an SHO being present.
Letby denies lying.
Dr Alison Ventress records a note for Child H, timed 11.50pm. It begins 'Several episodes of desaturation in past 2 hours...1st one after gas taken...became agitated...'
Mr Johnson says Letby told this information to Dr Ventress.
Letby says she did not know if she told her this information, she may have been present in the room.

11:12am

Dr Ventress adds: 'Further episodes no change in HR recovered with bagging...[oxygen requirement down] to 30% between episodes'.
Letby denies "trying it on" or "falsely creating the impression to Dr Ventress that [Child H] had been having problems for a couple of hours."
LL: "No, I don't agree that it was false."
Mr Johnson says the notes (on the observation chart and Letby's nursing notes) don't match.
Letby agrees it's an "innocent coincidence" (as said by Mr Johnson).

11:17am

An observation chart for Child H is shown for September 25-26. Letby is asked if the results show any concern up to midnight.
Letby: "This [the observations taken] reflects that specific moment in time" and says that chart shows no concerns, with all readings in the normal range.
Dr Ventress added in her 11.50pm note: '2nd chest drain advanced back in to 4cm as was almost out. Done prior to chest x-ray'. Mr Johnson says this was Dr Ravi Jayaram's x-ray.
Letby is asked why she had not noticed that. Letby says medical staff put drains in and managing them was not part of her nursing role.
She accepts she knew chest drains were more secure when stitched in rather than taped in. She says she was checking the chest drains. She denies removing the chest drain to cause a desaturation just after Child H's father left.

11:24am

Mr Johnson asks about Letby's error, as mentioned in her evidence, about the timing of the blood transfusion being completed. Letby said on May 15 the '0200 blood transfusion completed' should be 3am.
Letby says she has "miswritten" it from looking at the charts.
A blood infusion therapy chart is shown, in Letby's writing, which has in the time ended column what appears to be '0205' corrected to '0305'.
NJ: "The same mistake in two different places?"
Letby says she "couldn't say with clarity" adjusting the time after she had written her nursing notes.
NJ: "What happened after 0305?"
LL: "I don't recall."
NJ: "Really?...[Child H] had a cardiac arrest."
Letby is asked "how on earth" she made the 0205 error.
LL: "Because we're human people, we make mistakes."
Letby says the error is "mine" on the nursing notes, but the timings were otherwise accurate.
Letby says she cannot remember Child H's father being present.
The father recalled "mottling running out of her skin towards her fingers".
Letby says she agrees there was mottling on Child H's skin, but not that it was moving.

11:27am

A blood gas chart for September 26 is shown to the court for Child H.
Letby agrees the reading at 6.44am is a "good" blood gas reading.
Mr Johnson says Child H had had a "miraculous recovery".
Letby: "Yes."
NJ: "Were you pleased?"
LL: "Of course I was pleased."
NJ: "Or were you frustrated that you had failed in your attempt to kill her?
LL: "No."

11:30am

The second event is being discussed. For the night of September 26-27, Lucy Letby was the designated nurse for two babies in room 2. Nurse Christopher Booth was the designated nurse for Child G in room 2, and Nurse Shelley Tomlins was the designated nurse for Child H in room 1.
Elizabeth Marshall is the designated nurse for four babies in room 3, including Child I.
The court hears a seriously ill baby was brought into the unit during the night.

11:37am

The court hears Letby, in her evidence to defence on May 15, said she did not have much to do with Child H on the night shift.
Letby said she was reliant on medical notes as she did not recall "with any great detail" that night for Child H.
Dr Matthew Neame was the registrar that night, with Dr Jessica Scott the night SHO.
Letby accepts she had got "confused" in her defence statement between the events of this night and the previous night.
She rules out staffing levels as a contribution in Child H's deterioration.
She says she cannot comment on medical incompetencies as she was not Child H's designated nurse and was not present for much of the shift, and rules out a doctor or nurse making mistake(s).

11:43am

Letby is asked if she was involved in an event timed 9.15pm for Child H, who had a desaturation and bradycardia. Letby said she did not remember.
Dr Neame, in evidence, said "ETT removed by nursing staff" and that nurse was Letby, alone.
LL: "Well I don't have any recollection of that."
A text is shown from Letby to a colleague at 9.51pm: "'I've been helping Shelley so least still involved but haven't got the responsibility..."
Letby says she "does not agree" she would have removed an ET Tube by herself.
The neonatal schedule shown for 9-10pm shows no duties for Child H for which Letby has been named as the nurse for it.

12:06pm

The trial is now resuming following a short break and a short legal discussion.
Mr Johnson is continuing to cross-examine Lucy Letby on the case of Child H.

12:07pm

Letby is asked about what she had been helping Shelley with, as per her text message - she says she had been helping with Child H.
She denies taking an "opportunity" to "sabotage" Child H.

12:10pm

Nurse Shelley Tomlins' note for 9.45pm is shown:
The court is shown nurse Tomlin's notes for that shift, which include: '...around 2030 [Child H] had profound desat and brady, air entry no longer heard and capnography negative therefore ETT removed and Drs crashbleeped. New ETT sited...on second attempt...Copious secretions obtained via ETT and orally, blood stained.'
'2145 - Desaturation to 40% despite good air entry and positive capnography. ETT suctioned quickly with thick blood-stained secretions noted. [Child H] recovered quickly after...'
Letby denies altering Child H's ET Tube to cause bleeding.

12:21pm

Mr Johnson asks if Letby was "bored" with the children she was looking after in room 2 prior to Child H's collapse.
LL: "No."
She denies she had "time on her hands".
At 12.45am on September 27, Letby is recorded as 'liking' a post on Facebook. At 12.46am, she liked a Facebook photo posted by a colleague.
Letby says she may have been on her break at this point.
Mr Johnson says Letby was involved in a fluid balance chart for one of her designated babies around that time. Letby: "Yes, at 1am."
Child H's father's statement is read to the court, in which he said "Quite late on [Saturday, September 26]" he went to rest, and was woken up shortly afterwards and to get to Child H's bedside.
Letby denies using the time the father was away as an "opportunity" to attack Child H.
LL: "No, I've never attacked any child."
Letby says she "couldn't say" if she was covering for Shelley Tomlins at 1am.
An observation chart is shown for Child H for September 26-27. Hourly observations are made between 8pm and 4am, except for 1am.
Crash call bleep data is made at 1.04am and 1.06am for Child H.
Mr Johnson says Dr Neame gave evidence to say when he arrived, Letby was present.
NJ: "Is that right?"
LL: "I can't say, from memory."
NJ: "You were there, weren't you?"
LL: "I can't say exactly where I was, from memory."
Letby denies making an "alibi" at 1am for the fluid balance chart for her designated baby.
LL: "That's me giving cares to the baby I was allocated."

12:23pm

Nurse Shelley Tomlins' record, written at 3.49am, for the 3.30am desaturation: '0330 - profound desaturation to 60s, again requiring neopuffing with no known cause for desat....copious amounts of secretions yielded orally, pink tinged. Small amount of ET secretions gained, again pink tinged. Heart rate mainly nomral during desat. Recovered slowly.'
Letby denies "interfering with [Child H's] ET Tube".

12:25pm

Letby says she is helping Shelley Tomlins after the desaturation.
NJ: "Why is it always you that ends up in nursery room 1?"
LL: "I don't agree it is always me."

 

[Tortoise]

Sky News Updates - https://news.sky.com/story/lucy-letby-murder-trial-latest-former-nurse-tells-court-why-she-repeatedly-searched-for-dead-babys-mother-on-facebook-12868375

Defence Case Thursday 25th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD H continued

2h ago10:41

Letby: Doctors at Countess of Chester 'lacked experience' when dealing with Child H​

Nick Johnson KC, for the prosecution, begins by asking Letby if she is suggesting staffing levels at the Countess of Chester Hospital contributed to the incidents with Child H.
"No," Letby replies.
Next, she is asked if medical competence or incompetence had any effect.
"Potentially with the location of the chest drains and how they were secured," Letby says.
There is a slight pause due to an issue with the court's transcribing software, so Mr Johnson asks the questions a second time so they can be submitted into the record.
Letby continues by saying the insertion of Child H's chest drains, and how they were secured, may have contributed to the infant's problems.
"Lack of experience and using multiple drains of different types that nobody seemed confident to use" may have played a part, she says.
"Multiple doctors" lacked the experience required, she says.

2h ago10:52

Letby texted colleague complaining about 'unsafe' unit​

The court is shown a Facebook message Letby sent to a colleague on 24 September 2015 in which she complained about the unit being unsafe.
The message reads: 'It's completely un safe [angry face emoticon]. Yeah I told [colleague] that & she is going to look into it. I still have to do next Wed day as can't cover it but getting paid as over time for last night. [sic]'
Letby admits she also lacked experience dealing with the chest drains Child H required. She says she had to get assistance from a colleague.
She is then asked about the help her colleague gave her.
"I can't remember every detail and I think it would be unrealistic if I could remember every detail," she tells the court.

2h ago10:59

Letby accused of 'misrepresenting' time on medical notes​

"Let's concentrate on what caused Child H to collapse," Nick Johnson, the prosecution barrister, now says.
Child H collapsed in the early hours of 26 September. Her father previously gave evidence in this trial.
His statement, first heard by the court in January 2023, is now being re-read to the court - it says:
"She was in an incubator and on c-pap to help her breathe...
"On the Friday I had been there late with Child H's grandmother, until about midnight. We had come back to the house and I was awoken by her in the early hours."
The prosecution says this witness statement shows that notes written by Letby at 4.28am "misrepresented the time" of Child H's problems.
Letby's notes say a senior doctor was present - something the prosecution says she has falsified.

2h ago11:18

'It's not lies': Letby defends omission in her nursing notes​

Letby is then asked if she interfered with Child H's tube, if she "moved it around a bit to destabilise her".
"No," Letby replies.
Letby's nursing notes suggest Child H began to deteriorate shortly before midnight and a senior doctor was present - but this doctor is unnamed in her notes (it just says SHO - senior house officer).
Letby tells the court a senior doctor was present as Child H began to deteriorate.
"I know that is what you say," Mr Johnson replies, before adding she has "cooked the records".
"I don't agree," Letby says.
"You are creating the impression Child H was deteriorating in the lead up to her more serious crash," Mr Johnson says.
"No," Letby replies.
Mr Johnson then continues: "You are making this up as you are going along, aren't you?"
"No," Letby says.
Mr Johnson claims Letby hasn't included the name of the senior doctor present because one wasn't there.
"It's common practice to write SHO or Reg," Letby says, adding that it is something that "all staff would do"
"In your case, it seems to happen when babies collapsed," Mr Johnson says.
"I can't answer that, we are only looking at collapsed babies, we aren't looking at my whole work over four years," Letby replies.
Mr Johnson says Child H's father's statement has "no mention of seeing his baby collapsing" and "no mention of a doctor being there".
He accuses her of lying.
"It's not lies," Letby says.


1h ago11:30

Letby 'sabotaged' Child H just after baby's father left neonatal unit​

The prosecution claims Letby has falsified the medical notes for Child H after the fact, making it appear as if she was deteriorating before she collapsed in the early hours.
"You were falsely creating the impression to the registrar, your friend, that Child H was a child who had been presenting problems over the proceeding hours," Nick Johnson, the prosecution barrister, says.
Child H's father left around midnight, so the prosecution claim he would have noticed if what was happening in Letby's nursing notes was the reality of the situation.
Letby refutes this.
Child H had chest drains inserted and Letby has previously said their insertion, and how they were secured, may have contributed to the infant's problems, and collapse later that shift.
"Why were you not checking the drains?" Mr Johnson asks.
"I was checking the drains," Letby says.
"Because you removed the drain," Mr Johnson says.
"No," says Letby.
"And that is the reason why Child H desaturated just before midnight just after her father left," Mr Johnson says.
"No," says Letby.
"Because you were sabotaging Child H that night, weren't you?" Mr Johnson says.
"No," says Letby.


1h ago11:32

Letby: 'People makes mistakes'​

Letby is now asked what happened at 3am on 26 September 2015.
"I don't recall," she says, before clarifying: "I don't recall the exact timings of everything that has happened."
"The child for which you were responsible had a cardiac arrest," Nick Johnson, the prosecution barrister, says.
"Okay," she replies, quietly.
She is asked again about another piece of medical paperwork where the time has been entered wrong.
"We are human and people make mistakes," she says.
"I agree the time is wrong," she continues, before adding that the timings were correct on her other notes.
Child H's collapse was "so serious" she needed CPR and there were fears she had sustained brain damage.
The infant made a "miraculous" recovery - Mr Johnson asks Letby if she was pleased by this.
"Of course I was pleased," she replies.
"Or were you frustrated by the fact your attempt to kill her had failed?" Mr Johnson asks.
"No," says Letby.

1h ago11:44

The second night shift where Child H collapsed​

The court is shown a series of messages Letby sent to colleagues the following day, during her second night shift with Child H - a baby girl she is accused of attempting to murder.
The prosecution claims Letby sabotaged Child H again on this night shift. She was not her designated nurse.
Letby has previously claimed she did not have much to do with Child H on this shift.
The first one read '[Child H] had good day' before going on to mention the infant's drain being taken out.
A second message reads: 'She's had a stable day. Took original drain out at 8, just blocked tube, loads of secretions!'
Letby denies staffing levels contributed to Child H's collapse. She is then asked if medical incompetence played a part.
"I can't comment because I wasn't the nurse looking after her that night," she says.
Mr Johnson, prosecution barrister, says this is "another shift where you wanted to be in nursery one".
(The prosecution has repeatedly claimed Letby wanted to be in the higher dependency rooms and felt slighted when she was required to look after babies in lower rooms).
"No," says Letby.

1h ago11:51

'At least I'm still involved': Letby's texts to colleague​

A doctor has previously said that during the night shift of 26 September, he saw Letby alone and caring for Child H. The infant would collapse a few hours later and require ambulance transport to another hospital.
Letby has previously claimed she had little to do with the infant during this night shift, as she was caring for other babies in a different room.
The court is then shown a text Letby sent during the shift.
The text reads: 'I've been helping [colleague] so least still involved but haven't got the responsibility.'
"Anything that went wrong wasn't going to come back on you, was it?" Nick Johnson says.
"No," says Letby.

1h ago12:15

Letby accused of taking opportunity to sabotage infant under colleague's care​

Nick Johnson KC, the prosecution barrister, is now returning to the text the court was shown just before the break.
In it, Letby talks about what she was doing on the night shift of 26 September 2015, before Child H collapsed for the second time.
Letby was not the designated nurse on this shift, and had previously said she had little involvement with her.
The text reads: "I've been helping [colleague] so least still involved but haven't got the responsibility."
She is asked what she meant by this.
"I had been helping [colleague] with [Child H] and I had been involved but hadn't got the responsibility," Letby says.
Mr Johnson asks if she used the opportunity to "sabotage" Child H because they were "not connected" via the neonatal unit's paperwork.
"No," says Letby.

58m ago12:28

Letby's Facebook activity shown to the court​

The prosecution claims Letby wanted to be in the higher dependency rooms and found it boring to look after children who required less specialised care.
On the night shift of 26 September 2015, she was looking after other children in a different room than Child H.
"Were you bored with the children that you were looking after in nursery two?" Mr Johnson asks.
"No," says Letby.
"Did you have time on your hands?"
"No," says Letby.
The court is then shown Letby's Facebook activity from that evening.
00:45: Lucy Letby likes [person's] post.
Letby says she cannot recall who this person is.
"Someone you don't even know very well?" Mr Johnson asks.
"Yes," says Letby.
"You were looking at their facebook account?"
"Yes," says Letby.
"On your phone?"
"Yes," says Letby.
A second image is shown to the court.
00:46: Lucy Letby likes [colleague's] photo.
"I may have been on my break at this point," says Letby.
But the neonatal review shows she was doing observations for another child at 1am, the prosecution says.


57m ago12:29

'I have never attacked any child,' says Letby​

The court is now being read a statement from Child H's father, previously given in evidence during this trial. He had left Child H's bedside on the evening of 26 September before she suddenly deteriorated.
'She was okay during the Saturday day and then quite late on I remember going to the parents' bedroom on the ward to get some sleep.'
Child H's father previously said there was a knock on the door a "short while later" and they were told Child H was deteriorating and to go to her bedside.
Nick Johnson KC, prosecuting, says there is a pattern of children being attacked after their parents left then.
Letby disputes this.
"I have never attacked any child," she says.
At 3.30am, the infant suddenly desaturated - Letby's colleague wrote in her medical notes there was "no known cause".

57m ago12:30

'Why is it always you?'​

"Why is it always you that ends up back in nursery one when something happens?" Nick Johnson, the prosecution barrister, asks Letby.
"I don't agree that it is always me," she says.
"You tried to kill Child H twice, didn't you?"
"No," says Letby.

 

[Tortoise]

Dan O'Donoghue BBC Tweets - https://twitter.com/MrDanDonoghue

Defence Case Thursday 25th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD H continued

Ms Letby is back in the witness box. Mr Johnson is continuing to ask her about her evidence in relation to Child H

Mr Johnson asks Ms Letby if she believes Child H's collapse, in late September 2015 was due to staffing issues at the hospital - she says no

Asked if it is an issue of medical competence, she says 'yes I think potentially with the management of her chest drains'. Asked to elaborate, she says management means 'the insertion of them and how they were secured'

Ms Letby says problems were a result of a 'lack of experience and using different types of drains that no one was feeling confident to use'...she says that was the responsibility of Dr Harkness, Dr Jayaram and Dr Gibbs

Ms Letby is being asked about what led to Child H's collapse on the night of 26/morning of 27. Mr Johnson quotes a statement from the girl's father, who said he was with his daughter till around midnight - he left with his mother in law and was called back in the early hours

Mr Johnson has pulled up Ms Letby's nursing note about this collapse, he says 'you misrepresented the time of this event, I'm going to suggest this another occasion where you have deliberately misrepresented the facts'

Mr Johnson is continuing to take Ms Letby over nursing notes from that shift. In one column, shortly before midnight she notes there was 'blood stained secretions' from Child H's mouth. Mr Johnson asks if this was a result of her interfering with the baby's ET tube, she says no

Mr Johnson points to Child H having a desaturation at around 22:10 on that shift, he says this would be a serious medical issue which would require assistance from a doctor - Ms Letby agrees, she says there was an SHO present.

Mr Johnson rejects this, saying she 'cooked' the books to make it look like there was one there. She says 'no'.

Mr Johnson accuses Ms Letby of 'making it up as you go along', she rejects this. He quotes evidence from Child H's father, who made no mention of an SHO/doctor being there with his daughter. He says 'this is your lies isn't it' - she says 'no'

Mr Johnson quotes notes from Dr Alison Ventress, who records that Child H had 'Several episodes of desaturation in past 2 hours' (this is at 23:50) Mr Johnson says Ms Letby gave this information to Dr Ventress

Mr Johnson accuses Ms Letby of 'falsely creating the impression to Dr Ventress that (Child H) was having problems for a couple of hours' - Ms Letby rejects this

Mr Johnson pulls up Ms Letby's observation charts for Child H in the hours prior to this, he says if there were problems they would be in these charts - the baby appears stable on these documents

Ms Letby says not necessarily, she says at the time those observations were taken 'everything was fine' with the baby girl

Mr Johnson puts it to Ms Letby that the reason Child H desaturated just after midnight was because she was 'sabotaging' her by removing a chest drain - she says 'no'

Mr Johnson has asked about Child H's cardiac arrest in the early hours. Her father, in agreed evidence, said while medics were performing CPR he saw 'mottling running out of her skin towards her fingers' - Ms Letby accepts there was mottling, but not that exact description

Mr Johnson says 'having been at the brink of fatal collapse three or four hours earlier, (Child H)had a miraculous recovery…were you pleased?' 'Of course I was pleased', Ms Letby says. Johnson asks if she was 'frustrated that your attempt to kill her had failed', 'no' she says

We're now moving to the night shift of 26 September 2015, another shift on which the Crown say Ms Letby attacked Child H

On this shift, Nurse Shelley Tomlins was the designated nurse for Child H in room 1. Ms Letby was caring for two other babies in nursery 2. Ms Letby has previously told the court that she 'didn't have much to do' with Child H on this shift

Mr Johnson says this was another shift on which Ms Letby 'wanted to be in nursery one', she says 'no'

Mr Johnson is going over the neonatal review (who was working on unit), Ms Letby spots a nurse on there that was not working night shift but day shift - Mr Johnson says 'yes', then says 'do you have an eye for detail', she says 'yes'

Mr Johnson asks Ms Letby if she was involved in an event on 26 September at around 21:15, Child H had a desaturation A doctor on shift, Dr Neame, has previously said in evidence that when he arrived Ms Letby was treating Child H. She says she does not remember

Mr Johnson pulls up a text message, Ms Letby sent to a colleague on that shift, saying she had 'been helping' Child H's designated nurse. Ms Letby agrees this would have been in reference to her helping with Child H

Mr Johnson puts it to Ms Letby, that as she wasn't Child H's designated nurse that night, did she see that as an 'opportunity to sabotage' her because she was 'not connected with her on the paperwork'. Ms Letby says 'no'

Mr Johnson says Child H had a desaturation shortly before 10pm as a result of Ms Lebty 'interfering' with her ET tube - she rejects this

Mr Johnson asks Ms Letby if she was 'bored' on her shift at 0045 that morning - she says no. He pulls up Facebook data which shows she was liking pictures of friends on there at that time, she says she may have been on her break at this time

Mr Johnson again accuses Ms Letby of sabotaging Child H - he says she waited until after her father had gone to get some sleep on the parents section of the ward. She says 'no, I've never attacked a child'

 

[Tortoise]

Judith Moritz BBC Tweets - https://twitter.com/JudithMoritz

Defence Case Thursday 25th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD H continued

Nick Johnson KC is asking Lucy Letby about the first occasion when baby L collapsed, overnight on 26th Sept 2015. He suggests that "this is another occasion" where she has "deliberately misrepresented the facts" in the nursing notes for the baby. She denies this.

CORRECTION: Nick Johnson is currently questioning Lucy Letby about baby H - not baby L. Baby H - a girl - collapsed twice on consecutive nights 26/27 Sept 2015. Lucy Letby denies attempting to murder her.

Nick Johnson KC: "Here we have another child in your care who’s producing blood stained secretions in their throat. Had you interfered with baby H's breathing tube? Had you moved it around a bit to destabilise it?"
Lucy Letby: "No"

Nick Johnson KC is looking at clinical notes relating to baby H. He tells Lucy Letby "Your nursing notes were typed and the handwritten notes on the charts don’t match up".
NJKC: Are you trying it on?
LL - No
NJKC: You’re making this up as you go along aren’t you?
LL - No

Nick Johnson KC asks why the nurse didn't check baby H's chest drain
Lucy Letby: I did check the drains
NJKC: You removed the (chest) drain and that is the reason why she desaturated just after her father had left... because you were sabotaging her that night weren’t you?
LL - No

Baby H was given CPR.
NJKC: Having been at the brink of fatal collapse about 3 or 4 hours earlier she had a miraculous recovery.
LL: Yes
NJKC: Were you pleased?
LL: Of course I was pleased.
NJKC: Were you frustrated by the fact your attempt to kill her had failed?
LL: No

The night after the first collapse, baby H collapsed for a second time. This time, Lucy Letby wasn't the 'designated (lead) nurse' for the baby. Nick Johnson KC asks "Was that your opportunity to sabotage baby H, because you were not connected with her in the paperwork ?"
LL "No"

Nick Johnson KC: "Yet again this was an incident which happened just after the baby's parents had left. (It) gave you the opportunity to sabotage baby H didn’t it?"
Lucy Letby: "No" (1/2)

(2/2) Nick Johnson KC: "Just as with (many other) babies. All cases where the children deteriorated just after the parents left. Is that something that you identified as an opportunity to attack children?"
Lucy Letby: "No I’ve never attacked any child"

Nick Johnson KC: "Why is it always you that ends up back in nursery 1 (intensive care) when something happens?"
Lucy Letby: "I don’t agree that it is always me"
NJKC: "You tried to kill baby H twice didn’t you?"
LL: "No"

 

[Tortoise]

Chester Standard Updates - https://www.chesterstandard.co.uk/news/23545950.live-lucy-letby-trial-may-25---cross-examination-continues/

Defence Case Thursday 25th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD I

12:26pm

Mr Johnson moves on to the case of Child I.
Letby agrees she remembers Child I "very well".
Mr Johnson says this is "another case where you falsified [her records]."

12:32pm

Letby is asked to look at her defence statement. She said Child I's stomach "bloated...regularly" and "all the nursing staff" were aware of it.
Letby said "nothing was ever done" about the concerns with Child I's bowel. Letby said she was one of those raising concerns, that she "was not getting the treatment she needed".
The defence statement adds Letby did recall one handover, to nurse Bernadette Butterworth, that Child I desaturated and became apnoeic, and she assisted in care thereafter.

12:41pm

Letby, when asked, rules out staffing levels as a problem that led to Child I's deterioration on September 30.
For September 30, Letby was looking after Child I and two other babies in room 3 on her long day shift.
Letby rules out medical incompetencies or mistakes made by medical staff that led to Child I's collapse on September 30.
Letby is asked to look at Child I's medical records from September 26-29, and observations early on Letby's shift on September 30.
Letby agrees Child I was stable at this time.
A temperature of 36.1C is recorded for Child I at 11am, and the 'hot cot' temperature was turned up.
Letby denies by this time she had "fallen out" with medical colleagues Ashleigh Hudson, Melanie Taylor and one other.

12:45pm

The ward round posted a "positive picture" for Child I on September 30. Letby agrees.
Child I was due her immunisations, as noted on the ward round. Mr Johnson says this positive picture was similar to Child G, when Child G was about to have her immunisations.
Mr Johnson asks what became an obstacle to that. Letby replies it was Child I vomiting and having to be transferred to room 1.

12:54pm

A feeding chart is shown for Child I for September 30. Mum fed and gave cares at 10am. The note is signed by Letby.
At 1pm a 35mls feed was given via the NG Tube which had a 5ml aspirate. Letby says the 5ml aspirate "is a very minimal amount". At 4pm a further 35ml feed is given via the NG Tube. On both occasions Child I was asleep.
At 4.30pm - 'large vomit + apnoea -> N1' [transfer to nursery 1].
Letby is asked about Child I's mother's routine. Letby: "Not specifically..." she adds the mother would visit the unit regulary.
Mr Johnson suggests Letby knew the family so well through the frequent visits that she got to know their routine when they would be in and out of the unit. Letby: "I don't agree."
Dr Lisa Beebe's note showed she was asked to review Child I due to a low temperature.
The note adds: '...mum reports [low] temperature has been happening over past few days'.
The note concludes: '...monitor closely, if further concerns for sepsis, screen but appears clinically well at present'.
Letby says she does not recall the conversation. She does not recall, as the prosecution suggests, telling the doctor one concern[low temperature] and the mother another [abdomen].
She denies "providing a cover", and says she did "monitor her [Child I] closely", as noted on the doctor's plan.

1:08pm

Letby says she first monitored Child I's vital signs at 3pm. She said the concern raised with the doctor was Child I having a low temperature, and she had adjusted that by raising the hot cot temperature.
Mr Johnson suggests that "monitor closely" would mean more observations. Letby: "I disagree."
Letby is asked how long the 1pm 35ml feed with thickener, as listed on the chart, would take to administer. She agrees it would take "roughly" 15 minutes.
Letby's nursing note, written at 1.36pm is shown to the court: '...3x8 feeds ebm, 2bottles to 1NG Tube. abdomen appears full and slightly distended, soft to touch [Child I] straining++. Bowels have been opened. Mum feels it is more distended to yesterday and that [Child I] is quiet. Appears generally pale...Drs asked to review - to continue with current plan'
Letby says: "We monitor all our babies closely" in response to why Dr Beebe had said 'monitor closely' instead of 'do what you normally do'.
Mr Johnson: "This is yet another example of you writing nursing notes for something that didn't happen."
LL: "I don't agree."
Letby denies "cooking the notes" to show Child I was deteriorating prior to her collapse.

2:23pm

The trial is now resuming.
Prosecutor Nicholas Johnson KC is continuing to cross-examine Lucy Letby on the case of Child I.
An observation chart for Child I is shown for September 30. Hourly observations are made for 10am-1pm, and 3pm to the rest of the day.
Letby says there is "no reason" why the 2pm observation is not made.
Letby is asked which 'doctors' reviewed Child I at 3pm. Letby names one doctor and believes it was one doctor reviewed.
Mr Johnson says there is no medical note in relation to this.
Letby denies "making it up".
Mr Johnson asks Letby why the 'bottle-bottle-NGT' feed system is interrupted by 'bottle-NGT-NGT'.
Letby says the 4pm, 2nd NGT feed was as Child I was asleep.
Letby denies "lyingly" recording notes for when Child I had bowel movements during the day.
Mr Johnson says a doctor's notes do not note a prior examination. Letby denies making up the examination in her notes. She adds: "Just because it's [not there] doesn't mean it [didn't take place]."

2:26pm

Mr Johnson says Letby is "very keen" to raise doctor's mistakes with the likes of Dr Harkness and Dr Gibbs, but not in this case.
LL: "I don't believe this was noted at the time, my priority was [Child I], not medical notes."
NJ: "You force fed [Child I] didn't you?"
LL: "No, I didn't."
Letby says Child I did not wake for that feed, so an NGT feed was given as "standard practice".

2:31pm

Mr Johnson says "despite all the positive signs" for Child I, she vomited, just like Child G, and in both cases, Letby was there.
Letby says she does not recall if she was there when Child I vomited.
A medical report said Child I: "There is splinting of the diaphragm due to bowel distention..."
Letby denies "pumping" Child I full of milk or air.
Letby: "I fed [Child I] the normal dose of milk for her feed."
A blood gas chart for Child I is shown - the chart had not been noted up by Letby and it was found on a clipboard. It was signed by Bernadette Butterworth for Letby.
Letby says the chart was "not hidden - it was there for anyone to see."

2:34pm

Mr Johnson talks about the 7.30pm event for Child I.
Letby's notes add: 'At 1930 [Child I] became apnoeic, - abdomen distended++ and firm. Bradycardia and desaturation followed, SHO in attendance and registrar crash called....'Air++ aspirated from NG Tube...[Child I] is now very pale and quiet'.
Letby denies forcing air into Child I.

2:37pm

Observations for Child I in the remainder of September 30 are shown to the court.
Bernadette Butterworth's nursing note: 'During handover [Child I] abdo had become more distended and hard she had become apnoeic and bradycardiac and sats had dropped. IPPV given and despite a good seal with Neopuff there was still no chest movement, aspirated NGT air +++ and 2mls of milk obtained, eventually got chest movement and sats and heart rate normalised...'

2:50pm

Mr Johnson talks about the second event for Child I, which was on the night of October 12-13, when Letby said she was standing in the doorway when she could see Child I looked pale, and the lights were turned up.
Letby says the lighting was on in that room so Child I could be seen prior to the lights being turned up.
Letby is asked to look at her defence statement. She recalls Ashleigh Hudson was "quite inexperienced" to be looking after Child I.
Letby said Child I required "very close monitoring", and adds that, "looking back", Ashleigh had stopped monitoring her when she should have been.
Asked to explain where that instruction to monitor Child I came from, Letby says it was policy that Child I should have been monitored as she had come off antibiotics some time in the previous 48 hours.
Letby adds: "I'm not saying Ashleigh made a mistake."
The judge seeks clarification on 'monitoring'. Letby says it includes monitoring observations if a baby is on a monitor, but otherwise involves keeping an eye, regularly, on the baby.

2:57pm

Mr Johnson says there had been at least 48 hours since Child I had gone off antibiotics before the event occurred.
Letby is asked in what way Ashleigh Hudson was inexperienced.
LL: "I don't think Ashleigh had a lot of experience in recognising changes in babies, potentially."
Letby says the more experience you have, the more you can detect changes, such as changes in colour, in a baby.
Letby tells the court she does not recall a reason why she went into room 2 with Ashleigh Hudson.
In her defence statement, Letby said as they entered the room, they turned the light up on the light dimmer switch, and she saw Child I looking pale, and they went to assist. Child I was "gasping" and the alarm had not gone off.

3:07pm

Letby rules out staffing levels, medical incompetencies or staffing mistakes as a cause of Child I's desaturation on October 12-13.
A nursing shift rota is shown for October 12-13, with Lucy Letby in room 1, designated nurse for one baby. Ashleigh Hudson was designated nurse for three babies in room 2, including Child G and Child I.
Letby repeats there was no issue with staffing ratios to babies cared for, for that night.
Letby agrees with the evidence Ashleigh Hudson said that Child I was doing well - "prospering", and that the level of care had been scaled back.
Before the collapse, Child I was in air and on bottle feeds.
Letby says she has "no memory" if Ashleigh Hudson, as said in evidence, left room 2 to help colleague Laura Eagles in room 1.
Letby says she had a baby in room 1, and cannot recall who was to look after nursery 2.
In evidence, she said she was not the nurse called to room 2.
She tells she would have remembered having to hand over care of her baby and look after three babies in room 2.

3:17pm

Letby said "very quickly", she had noticed and saw Child I was pale.
Letby is asked why she was at room 2. She replies there was "nothing sinister" about that, that she had been in a chat with a colleague.
NJ: "The lights were off, weren't they?"
LL: "I can't say."
Letby is asked to look at her police interview.
In it, she says she had taken over Child I's care as Ashleigh Hudson had been "quite junior". For the observation of Child I, she replied the lights were off at night, and then they put the lights on, adding she could see Child I and: "I noticed that she was pale in the cot."
Letby, asked why she had told the jury the lights were "never off", says the lights are "never off completely", they are turned up.
A second police interview has Letby: "We put the light on - the lights aren't on in the nursery at night."
Asked why she did not refer to a dimmer switch in her police interview, Letby says: "I don't know."
NJ: "Are to trying to massage the evidence by [now] saying the lights were on low?"
LL: "No."

3:21pm

NJ: "What effect does going from a bright corridor [looking into] a [dark/dimly lit] room have on your eyesight?"
LL: "I don't know.
NJ: "You really don't know?"
LL: "No."
NJ: "Everybody knows, don't they?"
Letby says: "You wouldn't be able to see as well."
Mr Johnson says Letby was able to see "straight away" as she had caused Child I's deterioration.
LL: "No."

3:41pm

The photo of the cot, as shown previously, is displayed.

NJ: "Do you agree it is accurate?"

LL: "No...there would be more light visible. The cot would potentially be nearer to the light.

LL: "I think it was nearer to the workbench than that."

Mr Johnson asks how big Child I's hands would be - Letby says they would be small.

Mr Johnson says Child I would be almost entirely obscured.

LL: "Just her hands and her face."

NJ: "Which would be covered by that tentlike structure."

LL: "Not entirely no."

Mr Johnson asks how Letby could spot something Ashleigh Hudson could not, as mentioned from her police interview.

LL: "I had more experience so I knew what I was looking for - at."

NJ: "What do you mean looking 'for'?"

LL: "I don't mean it like that - I'm finding it hard to concentrate."

3:44pm

The judge, Mr Justice James Goss, says it "has been a long day" and the trial is adjourned for today.

3:46pm

The next court day scheduled will be for Tuesday, May 30.

 

[Tortoise]

Sky News Updates - Lucy Letby trial latest: Letby's Facebook messages shown in court - as lawyer says she 'cooked the records'

Defence Case Thursday 25th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD I

12:30

​

Mr Johnson now moves onto the case of Child I.

3h ago12:47

Letby 'raised concerns' about Child I's treatment​

Letby says she raised concerns about Child I to "senior nursing staff", telling them the infant "was not getting the treatment she perhaps needed".
She is accused of attempting to kill the infant four times before succeeding.
Nick Johnson, for the prosecution, is now reading out a statement Letby previously made to the court, in which she said 'I didn't look after Child I a great deal.'
Letby also previously told the court many of the incidents took place while she was off shift.
She now tells the court she doesn't agree that staffing levels, medical incompetence, or mistakes by staff played a role in Child I's death.

2h ago13:04

Infant was 'doing well' before she collapsed​

The prosecution claims Letby only liked being in the highest dependency nursery (nursery one).
"I liked being in all of the nurseries," Letby says when asked about this.
Nick Johnson, the prosecution barrister, then asks if she didn't like her new colleague on the unit.
"I don't agree with that," Letby says.
He says Letby had also fallen out with another colleague, who "wouldn't talk to you in the aftermath of [children A & B]."
(RECAP: Children A and B are twins - Child A died within 90 minutes of Letby coming onto shift. The prosecution says he 'most likely' died after being injected with air. His elder sister was attacked 28 hours later but survived.)
She again disputes this.
Paperwork from 30 September 2015 shows Child I was making good progress - and similar to Child G had been due to receive her immunisations. (This is something only done once an infant is reasonably healthy.)
"This is a baby who was doing well, who was demanding milk and taking it from a bottle at 00.30," says Mr Johnson.
"Yes," says Letby.

2h ago13:06

Letby knew routine of victim's family 'very well'​

The prosecution claims Lucy Letby knew the routine of Child I's family "very well".
She is accused of attempting to kill the infant four times before succeeding.
"The family were very attentive and present at the unit a lot," Letby says.
Nick Johnson, barrister for the prosecution, says Child I's mother would visit her new daughter after dropping her older children off at school.
"She visited regularly, yes," Letby says.

2h ago13:09

'You are lying, aren't you?'​

More of Child I's medical records have been shown to the court.
The prosecution claims Letby "cooked the books" to give the impression Child I was deteriorating before she did.
On 30 September, Letby wrote that Child I's mother expressed concerns about the infant's swollen stomach and noted the infant was "quiet".
But the mother disputes this and has previously told the court it was Letby who expressed the original concerns.
"You are lying about this, aren't you?" Nick Johnson asks.
"No," says Letby.
"This is another example of you not producing in the nursing notes what really happened," Mr Johnson says.
"No," says Letby.

1h ago14:33

Letby accused of making up 'fictional medical examination'​

Prosecution barrister Nick Johnson says he will continue by looking at Letby's "invention of a medical examination at 13.00".
This is in the case of Child I - it is claimed Letby tried to kill the infant four times before succeeding.
A NICU observation chart is being shown to the court. Letby stopped recording on this at 13.00. Previously, the court had heard neonatal staff were instructed to "monitor closely".
In her notes, Letby put "drs [doctors] were crash called" to the infant. Letby has again not specified which doctors these were.
Letby tells the court they "can't read" into the use of doctors (plural). She thinks only one doctor was called.
She is asked why she hasn't specified which doctor was called to Child I.
"I can't say," she replies.
"I am going to suggest an explanation - you didn't want it to be attributed in case anyone asks questions of the doctor," Mr Johnson says.
"I disagree," says Letby.
Mr Johnson calls it a "fictional medical examination".

1h ago14:35

'It's not my error' - Letby​

Notes from another medical examination an hour and 40 minutes later contain no trace of the one Letby claims happened.
Letby claims Child I had a serious medical incident that required a senior doctor to visit at 1pm.
The same senior doctor inspected Child I just before 3pm - his contemporaneous notes, which are being shown to the court, contain no mention of the 1pm crash call.
Prosecution barrister Nick Johnson questions why the doctor would not have included such a serious call in his notes, only an hour later.
"Just because it is not written there, that is not necessarily my error," Letby tells the court.
"You force-fed Child I, didn't you?" Mr Johnson says.
"No, I did not," Letby replies.

1h ago14:38

Child I's stomach was so swollen her diaphragm had splintered​

Child I's stomach was so swollen her diaphragm had splintered, according to medical notes shown to the court.
"You had pumped her with air or milk, hadn't you?" Nick Johnson, the prosecution barrister, asks.
"No," says Letby.
"Were you excited by what you did?" Mr Johnson asks,
"No, I fed [Child I] a normal tube feed," Letby replies.
Mr Johnson says Letby forced a lot of air into Child I, which is why "a lot of air came out when she collapsed".
"I do not agree," Letby says.
After Letby left for the night, Mr Johnson says "Child I improved". Her heart rate came down, and the temperature in the incubator came down.

1h ago14:50

Letby was 'standing in the doorway' when she spotted Child I looked pale​

Prosecuting, Nick Johnson is now moving on to the second incident involving Child I. (It is claimed Letby tried to kill this child four times before she succeeded.)
This incident took place on the night shift of the 12th into the 13th October 2015.
Letby agrees she was "standing in the doorway when she noted Child I's colour, face and hands". She says the baby looked "pale".
She tells the court "a baby like [Child I] needs close monitoring" but her colleague had stopped monitoring her.
Letby says that "retrospectively, looking at the notes, she should have been on a monitor and this would have alerted" staff to her changes in condition sooner.
The judge then asks Letby to clarify if she means monitoring as in getting the general picture of Child I's condition, or if she is referring to an electric monitor.
Letby clarifies she means looking at the whole picture of Child I's condition.

46m ago15:13

Baby was 'white and gasping for air'​

Letby tells the court the colleague who was meant to be monitoring Child I lacked experience.
"I don't think [colleague] had a lot of experience in recognising changes in babies," Letby tells the court.
Letby's defence statement is now being read to the court.
In it, she says: 'I could see she was white and gasping for air.'
Letby agrees this was correct.
Nick Johnson, prosecuting, is asking - as he has with all the babies - if staffing levels or incompetence contributed to the death of Child I.
Letby says: "No."

37m ago15:23

'When a child collapses, you are there'​

The prosecution is continuing to try to pick holes in Lucy Letby's version of events.
The nurse had been supposed to be looking after children in a different room than Child I.
Letby has previously said she was stood in the doorway of nursery two with a colleague when she noticed Child I looked pale. She claimed the lights were turned off and they turned the lights on upon entering.
"A colleague said when she returned with milk for one of the children in her care, she was preparing it and you were standing in the doorway [of nursery two]," Mr Johnson says. "It was at that point you said, 'Don't you think Child I looks pale'."
"Yes," Letby replies.
He then asks Letby if she wasn't the person that had swapped into nursery two what was she doing in the doorway?
"I don't think there is anything sinister in that," Letby replies, adding that staff often walked around the unit and chatted to each other at night.
Mr Johnson replies: "Yet again when a child collapses you are the person there."
"I don't agree," says Letby.

34m ago15:25

Prosecution questions Letby's eyesight​

The prosecution is now questioning Letby over her claims she was able to spot that Child I was pale from the doorway of the nursery.
Letby says the lights in the corridor of the neonatal unit would have been on.
Nick Johnson, prosecuting: "If you go from a light corridor into a dark nursery does that make your eyesight very good?"
Letby: "I don't understand."
Mr Johnson: "Oh I think you do."
Mr Johnson: "What effect doesn't coming from a bright corridor into a dark nursery have?"
Letby: "I don't know."
Mr Johnson: "You really don't know? You are a nurse. Everybody knows."
Mr Johnson then says the reason Letby saw Child I straight away is because she "had caused what you purported to notice".
Letby: "No."

24m ago15:36

Court resumes​

The jury has filed back in.
Letby is visibly more tearful and holds tissues in her hands which she occasionally uses to wipe her eyes.

15m ago15:45

Letby refuses to answer a question - as judge ends early​

The court is being shown an image of nursery two in a state of almost total darkness.
Nick Johnson, the prosecution barrister, asks if this is an accurate representation of what it was like on 12/13 October, when Letby is alleged to have attacked Child I.
"No," says Letby.
The cot has a tent-like structure over it - Letby says this is to "minimise bright light" to the baby.
"There is almost nothing to see," Mr Johnson says.
"Just her hands and face," Letby replies.
"Which could have been covered by that tent-like structure," Mr Johnson says,
"Not entirely no," says Letby.
She refutes what a colleague previously said - the colleague said people "can't see anything" from that doorway.
'Maybe I spotted something that [colleague] wasn't able to spot. The rooms are never that dark that you can't see the baby at all,' Letby previously said in a police interview.
She now says she had more experience "so knew what I was looking for".
"What do you mean by that," Mr Johnson asks.
There is silence as Letby refuses to answer the question.
Letby then says she is finding it "quite hard to concentrate on all of the dates".
The judge then concludes proceedings early, "having observed the witness" he says it has been a "long day" for Letby.

15m ago15:46

Court is adjourned early​

It will resume again at 10.30am on Tuesday morning.

 

[Tortoise]

Dan O'Donoghue BBC Tweets - https://twitter.com/MrDanDonoghue

Defence Case Thursday 25th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD I

We're now moving to Child I - a baby girl who was born prematurely at Liverpool Women's Hospital and transferred to the Countess of Chester on 18 August 2015. On 30 September, she needed emergency attention after she vomited and her heart-rate dropped.

She collapsed again on 13 and 14 October, before a fatal deterioration on 23 October. A medical expert for the prosecution told the court she had been "been subjected to an infusion of air", which prosecutors said Ms Letby had administered

Mr Johnson, as he has done with every child, asks Ms Letby if staffing levels contributed to Child I's first collapse - she says no, asks if medical competence played a role, she says no

Mr Johnson asks if on 30 September there was anything of concern with Child I. Ms Letby says 'maybe some concern about temperature…I don’t recall any specific concerns no'

We're back after a break for lunch. Mr Johnson is asking Ms Letby about an event at 1500 on 30 September 2015

Ms Letby's notes state that at 1500 Child I was 'reviewed by drs', that she 'appeared mottled in colour'. Mr Johnson says this was a 'fictional medical examination'. He says there was no medical note from a doctor on this and that she had 'made it up'

Ms Letby says she does not agree. She does acknowledge that there is no record of this examination in medical history though

Mr Johnson asks her why, if 'drs' had examined the baby and this was not recorded, did she not raise this in a DATIX report. She said her priority was caring for Child I, not looking at what had been written on forms

Mr Johnson says 'you had pumped her with air or milk hadn’t you', Ms Letby said no. He says 'were you excited by what you did', she says 'no, I fed (Child I) a normal tube feed'

We're now moving to the second incident involving Child I on 12 October 2015

Ms Letby tells the court that Ashleigh Hudson was her designated nurse, she says she was "quite inexperienced" to be looking after Child I. She said: 'I don’t think Ashleigh had a lot of experience identifying changes in babies potentially'

Ms Letby says that nurse Hudson 'wasn't doing monitoring when she should have been', she says children who have come off antibiotics need close obs for 48hrs after. Mr Johnson shows that 48hrs had already passed by this time

Mr Johnson is now focusing on an event on 13 Court has previously heard that nurse Hudson was Child I’s carer on the night-shift but she said she asked Letby or the nursing shift leader to keep an eye on the youngster as she was required to help a colleague

Nurse Hudson previously said that procedure took about 15 minutes and she then walked to a store room to collect Child I’s milk. On her return to nursery room 2 she started preparing the milk for a feed on a counter which faced the lit corridor, she said.

She previously told the court that she remembers "Lucy standing in the doorway. She was leaning up against the frame. She pointed out from where she was that she thought (Child I) looked pale.” Ms Letby says there is 'nothing sinister' about her standing in the doorway

She says nurses often move around the unit, talking to each other, doing observations etc.

Mr Johnson asks how quickly she noticed the baby was pale, Ms Letby says she 'can't put a definitive time, but quickly'. Mr Johnson asks how she got to the doorway of n2. Ms Letby says she can't recall, but gives various routes from nursing station or other nurseries

Mr Johnson suggests all those routes involve going via the corridor, she agrees. Mr Johnson asks her if the corridor is lit, she agrees - he asks her 'what effect coming from a bright corridor into a dim room has on your eye sight'

Ms Letby says she does not know. But when pressed, says 'yes you wouldn’t be able to see as well'. Mr Johnson asks her how then she could see Child I was pale 'quickly'. He puts it to her that she saw because she had 'caused what you purported to notice'

She rejects this. We're now on a break.

Ms Letby has just said she is 'finding it quite hard to concentrate on all of the dates at the minute' The judge responds 'having observed the witness and given that it's been a long day in the witness box, we will stop proceedings there this afternoon'

Back next Tuesday. Wrap here Lucy Letby trial: Nurse attacked babies after parents left, jury told

 

[Tortoise]

Judith Moritz BBC Tweets - https://twitter.com/JudithMoritz

Defence Case Thursday 25th May 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD I

Nick Johnson KC begins to ask Lucy Letby about the next baby, known as baby I, a girl who died in October 2015.

The prosecution has previously said that baby I's case "is an extreme example even by the standards of this case. There were 4 separate occasions on which we allege Lucy Letby tried to kill her. She was resilient, but ultimately at the 4th attempt Lucy Letby succeeded"

Nick Johnson KC says that before baby I collapsed for the first time, she had been showing "very positive signs". He says "this was a baby that was doing well, demanding milk and taking it from a bottle". Lucy Letby agrees.

Nick Johnson KC reminds the court that Lucy Letby sent a sympathy card to baby I's parents after the baby's death. He suggests that the nurse knew baby I's parents so well, she'd know their routine and when they tended to come and go from the unit. Lucy Letby disagrees.

Nick Johnson KC again looks at differences within the medical documents.
NJKC: "You were cooking the notes again weren’t you Lucy Letby?"
LL: "No, I disagree"
NJKC: "To create the impressions baby I was deteriorating just before the time at which the collapse happened?"
LL :"No"

NJKC: You force fed baby I, didn’t you?
LL: No I did not
NJKC: She vomited 30 mins after you recorded giving her a feed and up to that point she’d shown no signs of anything being significantly wrong with her had she?
LL: Other than a low temperature no

Nick Johnson KC: You had pumped baby I with air or milk hadn’t you?
Lucy Letby: No
NJKC: Were you excited by what you did?
LL: No. I fed baby I a normal tube feed

Nick Johnson KC: You forced air into the nasogastric tube of baby I didn’t you?
Lucy Letby: No I did not
NJKC: And that is the reason why a lot of air came out after she collapsed for the second time on this shift.
LL: No, I do not agree.

Nick Johnson KC, on baby I's second collapse: "A short time beforehand, she had a full bottle, she was breathing for herself in air, and was demanding feeds. They were all good signs". Lucy Letby agrees.

Lucy Letby says that on the occasion of baby I's 2nd collapse, she was at the door of the room when she noticed "very quickly" that the baby was very pale.

NJ: What effect does coming from a very bright corridor into a dark nursery have on your eyesight?
LL: I don’t know
NJ: You really don’t know?
LL: No
NJ: You're a nurse. Everybody knows don’t they?
LL: It'd depend on brightness of the light but you wouldn’t be able to see as well

Lucy Letby has become tearful. She says "I’m finding it quite hard to concentrate on all of these dates at the minute". The judge, Mr Justice Goss says "Having observed the witness in the witness box it’s been a long day for her". He stops the proceedings for today.

Court isn't due to sit tomorrow, and will be off for the bank holiday, so is next due to sit on Tuesday May 30th.

 

[Tortoise]

10% Evening Standard Lucy Letby ‘attacked nine babies just after their parents left their cotsides’
10% ITV - https://www.itv.com/news/granada/20...-just-after-their-parents-left-their-cotsides
BBM

A neonatal nurse attacked nine of her alleged victims just hours after their parents left their cotsides, a court has been told.

[...]

Mr Johnson suggested to the defendant: “(Child H’s father) leaving gave you the opportunity to sabotage (Child H), didn’t it?”

Letby said: “No.”

Mr Johnson said: “Just as in the cases of (Child B), (Child C), (Child E), (Child I), (Child M), (Child N), (Child O) and (Child P) – all children who deteriorated shortly after their parents left.

Five of the children – Child C, Child E, Child I, Child O and Child P – all died on the unit, Manchester Crown Court heard.

[...]

The prosecutor accused Letby of attacking another baby girl, Child I, when her mother left the nursery.

He said she tried to kill the infant on September 30 by force-feeding her milk and air while Child I’s mother had left the unit to pick up her other children from school.

 

[Tortoise]

10% Daily Mail - Lucy Letby five 'murdered babies after their parents went to get rest'

"She immediately corrected herself, replacing 'for' with the word 'at'.

Mr Johnson responded with a sigh. 'Ah. 'I knew what I was looking for'. What did you mean by that?'

Looking distressed, Letby replied: 'I didn't mean it like that. I'm finding it hard to concentrate'. She added: 'I'm not sure of the dates at the moment'.

The defendant remained silent in her chair, her eyes sometimes darting from side to side, at other times closing for a few seconds, as the trial judge, Mr Justice Goss, intervened to call an early halt to the day's proceedings."

 

[Tortoise]

Episode 36, False trails

www.mailplus.co.uk

Episode 36, False trails​

In this episode Caroline and Liz explain what Lucy Letby said when questioned by the prosecution about four of the alleged victims in the case - Baby E, Baby G, Baby H and Baby I.

 

[Tortoise]

Defence Case Friday 2nd June 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD I continued

Chester Standard Updates - https://www.chesterstandard.co.uk/news/23563043.live-lucy-letby-trial-june-2---cross-examination-continues/

1:01pm

Members of the jury are now coming into court.
The trial will now resume, and is expected to hear evidence until around 4pm.

1:04pm

Nicholas Johnson KC, for the prosecution, continues to cross-examine Letby in the case of Child I. He moves on to the third incident, on October 14, 2015.
Mr Johnson says Letby does not refer to this incident in her statement. Letby, in her evidence, said she did not recall this night.

1:05pm

Letby rules out staffing levels, medical incompetence or staffing mistakes as a contributory factor in the collapse of Child I for this incident.

1:16pm

The staffing rota for October 13-14, 2015 is shown to the court, with Letby in room 1 as the designated nurse for Child I. Joanne Williams is the designated nurse for two other babies in room 1 that night.
Letby is asked to look at her nursing notes for that night. Mr Johnson says Child I was tolerating handling and 'tone appears improved', according to Letby's notes.
The notes add: 'At 0500 abdomen noted to be more distended and firmer in appearance with area of discolouration spreading on right-hand side, veins more prominent. Oxygen requirement began to increase, colour became pale...gradually requiring 100% oxygen...blood gases poor as charted. Clear air entry, slightly reduced on left, chest movement reduced...continued to decline. Reintubated at approx 0700 - initially responded well. Abdomen firm and distended. Overall colour pale. Xrays carried out...resuscitation commenced as documented...night and day staff members present'
Letby says she cannot recall the discolouration now. She does not recall it moved, but it was spreading by getting larger.
NJ: "Where did you get the time of 5 o'clock from?"
LL: "I don't know. I don't know if it's from paper charts or memory."
Mr Johnson says if Letby had seen this, she would have escalated it to a doctor.
LL: "I can't comment on what time the doctor did come."
Mr Johnson says almost 24 hours earlier, Child I was found "almost dead", and then this incident happened. He asks what Letby would have done.
LL: "I would have escalated it to someone, senior like a doctor."
Mr Johnson shows the doctor's note, which mentions: "Abdomen distended and mottled".
LL: "I can't say specifically what time I asked him to come, the note says he came at 5.55am".
Mr Johnson says this would have been an emergency for Child I.
LL: "I don't believe it was an emergency, I believe it showed a decline."
NJ: "You sabotaged [Child I] at about 6 o'clock, didn't you?"
LL: "No."

1:24pm

A prescription chart shows Dr Matthew Neame prescribed morphine sulphate for Child I, and the infusion was commenced at 5.50am.
A fluid chart shows '0530 abdo distended++' in Letby's writing.
Letby says by 6am, the oxygen requirement had gone up to 100% for Child I, from 60% at 5am.
Letby had written 'squeaky' for the oxygen level at 5am. Letby tells the court this meant the air entry for Child I was not clear.
Letby says squeaky air entry is not an emergency.
Mr Johnson says there is also expanding discolouration and a distended abdomen.
Letby denies copying the word 'squeaky' for the 5am oxygen column from Dr Neame's 5.55am note. Letby: "I disagree."
Letby says she recalls Dr Neame saying the mottling was unusual; she cannot recall the mottling specifically.

1:26pm

A report showed Child I's gaseous distention of the bowel had increased on October 14 since the previous x-ray at October 13. Child I had been on a ventilator and nil by mouth.
Letby denies injecting air into Child I.
NJ: "You had inflated [Child I] with air, hadn't you?"
LL: "No."

1:28pm

At 7am, Child I had a significant desaturation.
Letby's note: 'Reintubated at approx 0700 - initially responded well. Abdomen firm and distended. Overall colour pale. Xrays carried out.'
NJ: "That is because you were sabotaging her, isn't it?"
LL: "No."

1:29pm

Letby says she does not remember the 7am desaturation "with any clear detail".

1:34pm

Mr Johnson moves to the final event for Child I, when she died on October 23.
Prior to that, Child I had been moved to Arrowe Park Hospital before returning to the Countess of Chester Hospital's neonatal unit.
Mr Johnson shows Letby observation charts for Child I from the previous day. Letby accepts Child I's observations were stable, save for one slightly raised respiration rate reading.
She agrees Child I was self-ventilating in air at this point. She accepts Child I's abdomen was, the previous day, soft and non-distended.

1:35pm

NJ: "Would you agree that despite three life-threatening events in the previous three weeks, [Child I] appeared to be in a stable condition?"
LL: "Yes."

1:40pm

For the night of October 22-23, Lucy Letby is a designated nurse for a baby in nursery room 2 and one in room 3. Ashleigh Hudson is the designated nurse for Child I in room 1 and one other baby.
Mr Johnson tells the court the baby in room 2 went to a hospital in Stoke during that night shift.
Letby says there were staffing issues, which were "not ideal", which were a contributory factor in the treatment of Child I following the collapse, in that a doctor had to be called away during the event.
Letby: "Considering what [Child I] had been through, she was a poorly baby, the doctors were not with her at all times...once she deteriorated."
Letby adds she believed Ashleigh Hudson was capable of looking after Child I, for Child I's nursing needs at this stage.

1:45pm

The neonatal schedule for that night is shown to the court.
Letby sent a message on October 22 at 8.47pm to a colleague: '...Unit nice. Transport on way to take my baby back to Stoke. Only 8 babies. Off duty not out. X'
Mr Johnson says this refers to the baby he mentioned earlier who was transferred out during that night.
The court hears that transfer process, noted as completing at 1am, is not a 'five-minute' process, and takes time and involves family communication.

1:58pm

Child I collapsed at 11.57pm.
Letby denies falsifying a note for the Stoke-transfer baby prior to that at 11pm.
The court is shown a nursing note by Ashleigh Hudson, which the court heard was timed at 10.57pm. 'Longline removed due to constant occlusions; neonatal nurse Lucy Letby unable to flush, so Paeds Reg Rachel Chang informed.'
Dr Chang had written, for the Stoke-transfer baby at 10pm, the baby was safe for transfer.
Letby's note for this baby was written at 10.50pm, and completed at 10.52pm. It included a documentation of a longline infusion with a 10% dextrose fluid. Letby has co-signed the document.
Mr Johnson says the 'original 2300' reading has been changed to '2400' by Letby.
Letby said the '2300' reading was an error and it was changed to '2400' as the correct time. She adds: "The charts are there for everybody to look at."

2:05pm

Letby denies falsifying a fluid balance chart for the Stoke-transfer baby.
Mr Johnson asks if Letby recalls what Ashleigh Hudson said for the 11.57pm desaturation. He says Ms Hudson gave evidence to say Child I was crying, making a noise she had not heard before, different to a cry for hunger.
Letby: "I did not hear that cry at that point. When I entered that nursery, she was quiet...and apnoeic."
Letby says for this event, it was a case where one of the three nurses on duty that night would have had to come and assist in room 1.

2:11pm

Letby says she does not recall Ashleigh Hudson going to call for Child I's parents.
Letby says there is an error on the IV chart, and the time has changed.
Mr Johnson: "Three different mistakes on two different babies?"
Letby says she does not know who wrote in the different times.
NJ: "How do those sorts of mistakes happen?
Letby says when the unit gets busy, "we" can make errors on the paperwork.
NJ: "We? Or you?"
LL: "I don't believe it would have been me - we would both have been there for it."
NJ: "Or is it you altering medical records to put some time between you and serious events for [Child I]?"
LL: "No."
Letby adds: "I did not deliberately falsify any paperwork."

2:17pm

At 1.06am, Child I was crying again, the court hears.
Letby recalls Child I was crying, but cannot recall being there by the cotside first. She accepts she was in the nursery.
Mr Johnson asks if Ashleigh Hudson was called over by Letby.
LL: "She might have been in the nursery when I called her, I couldn't say."
Letby adds she could have "come in" [as her defence statement says] from the other part of the nursery.
Letby says she had her hands in the incubator, "trying to settle [Child I]."
LL: "My assessment of [Child I] at that time was she was hungry and rooting."
NJ: "You had pumped her full of air?
LL: "No."
NJ: "You were doing your best to kill her?"
LL: "No."

2:18pm

Letby: "I have never injected air into any baby."

2:25pm

NJ: "Do you remember interrupting [Child I]'s mother?"
LL: "No."
Mr Johnson says Child I's mother, in agreed evidence, recalled Letby was "smiling" and had talked about how Child I had been going on about 'enjoying' her bath. Child I had been bathed as part of the bereavement process following her passing.
NJ: "Why did you say that?"
LL: "It's trying to, in that awful situation - it wasn't meant with any malice. We still talk to them and treat them as if they were alive. It wasn't joking or...malice, it was trying to reflect on a happier memory."
NJ: "How can you say such things?"
LL: "She had her first bath when she was alive and that was what she had enjoyed, not the one when she had passed away."
NJ: "How do you know it was her first bath?"
LL: "Because I was there, we took photographs, it was a big occasion."
Mr Johnson asks how many baths Child I had in Arrowe Park - Letby says she cannot say.
NJ: "You were getting a thrill out of the grief and despair in that room, weren't you?
LL: "Absolutely not."

 

[Tortoise]

Defence Case Friday 2nd June 2023 - LUCY LETBY'S CROSS-EXAMINATION

CHILD I continued

Sky News Updates - https://news.sky.com/story/lucy-letby-murder-trial-latest-former-nurse-tells-court-why-she-repeatedly-searched-for-dead-babys-mother-on-facebook-12868375

1h ago13:21

Letby says she 'doesn't remember' shift where infant collapsed​

Letby is sitting in the dock flanked by two members of court security. She is wearing a navy blue blazer and the witness stand sits facing the jury.
Prosecution barrister Nick Johnson is moving on to the third incident involving Child I.
This took place on the night shift of 13-14 October 2015.
Letby previously told the court, when giving evidence for the defence, that she did not remember this shift.
The court is shown a map that outlines who was working the shift and where they were. Letby was Child I's assigned nurse.
At the start of the shift, the infant is described as "stable, pink and has good chest movement" despite being on a ventilator.
By 1am - a few hours later - Letby recorded in her nursing notes that the baby was "improving".
At 5am, Letby recorded that Child I's "abdomen was noted to be more distended" with an "area of discolouration" that was "spreading" and "veins more prominent".
Resuscitation on the infant was commenced at this time.
Mr Johnson asks Letby about this incident.
"I can't comment because I don't remember it now," she tells the court.
"Don't or won't?" Mr Johnson asks.
"Don't," says Letby.

1h ago13:23

'You sabotaged the infant, didn't you?'​

Nick Johnson, prosecution, says the child had "been almost dead 24 hours earlier" and began displaying signs of a distended abdomen.
"Is that a positive or negative sign?" asks Mr Johnson.
"Negative," says Letby.
He then asks: "What would you have done if what you wrote was true?"
"Escalated it to a senior nurse or doctor," she says.
He claims if what Letby had written in her nursing notes was true, this would have been an emergency.
Letby refutes this.
Mr Johnson says Letby's nursing notes "creates the impression of a more gradual decline than what in fact really happened".
"No, I don't agree," says Letby,
"You sabotaged Child I at about 6am, didn't you?"
"No," says Letby.

1h ago13:30

Letby accused of inflating child with air​

By 6am, the child had desaturated.
In her nursing notes, Letby described Child I's breathing as "squeaky" - she says this "means you haven't got clear entry and aren't getting full lung expansion".
Mr Johnson questions why, when at 5am there was a child whose abdomen has expanded and become harder, with spreading discolouration, who is on a ventilator and who has got "squeaky" air entry, she did not call a doctor.
Letby says "squeaky" air entry is not an emergency.
"I can't say now what time I called the doctors or who I escalated it to," Letby says.
"'Asked to see patient' is not very urgent," Mr Johnson says, referring to her notes.
Letby says there is no other way to call a doctor, other than an emergency call which she didn't think was warranted.
By the end of Letby's shift, "everything had been decompressed", Mr Johnson says.
"You had inflated Child I with air, hadn't you Lucy Letby," he asks.
"No," says Letby.

1h ago13:42

Child I 'alert' and being cuddled by parents a day before she died​

"Child I collapsed again at 7am, didn't she?" Nick Johnson, prosecuting, says.
"Yes," says Letby,
"This is one of those cases where air was going in and out of her but she was not oxygenating. Do you remember that?"
"Yes," says Letby.
The night shift handover commences at 7.30am, so at this point Child I was handed into the care of another nurse.
Letby continues to say she does not remember this shift.
Between the 15 - 17 October, Child I was taken to Arrowe Park Hospital. She returned to the Countess of Chester Hospital on 17 October and continued to make good progress.
Child I died while Letby was working a night shift on the 22 - 23 October,
During the night shift 24 hours before (the 21 - 22 October) Letby's colleagues describe the infant was "easy to settle", and her observations were stable, with the "slight exception of a single raised respiration reading at 10pm".
Her abdomen was "soft and non-distended".
During the day of the 22 October, Child I was "alert" and "had been out for cuddles" with her parents.
Despite three life-threatening situations in the previous three weeks, Child I "appears to be in good condition" before Letby began her shift on the evening of the 22 October.
Letby agrees this appears to be the case.

1h ago13:45

'I have nothing to be jealous of', says Letby when asked about her colleague​

Nick Johnson, the prosecution barrister, now turns to the night shift where Child I died.
Lucy Letby was not her assigned nurse.
Mr Johnson asks the same questions he has asked in all cases - if Letby thinks staffing issues, incompetence or individual mistakes contributed to Child I's death.
"I think potentially there were staffing issues that may have affected her [the nurse on duty] but I don't know how," she says.
"The staffing was not ideal."
Mr Johnson asks if this is because she thought the colleague assigned to Child I was "not up to the job".
Letby says no, and says she means because "the doctor had to be called away to another delivery" in the labour suite.
"You didn't like being in nursery three though," Mr Johnson asks.
"No, I disagree," says Letby.
He then asks if she was jealous of her colleague for being in a higher dependency nursery.
"No, I have nothing to be jealous of," says Letby.

57m ago14:05

Letby accused of changing the time of medical records the night child died​

Child I deteriorated just before midnight, at 11.57pm. Letby is now being asked what she was doing in the lead-up to that collapse.
The baby Letby was assigned to care for was transferred to Royal Stoke University Hospital during the night shift of 22-23 October. (He is not a baby she is accused of harming).
The court is shown a text Letby sent to a colleague at the start of the shift: 'Oh that's fantastic. Unit nice. Transport on way to take my baby back to stoke. Only 8 babies. Off duty not out.'
This transfer, Letby says, would not have been a five-minute job and would have required a handover with the transport team and speaking to the family.
"I am going to suggest you were dealing with [the other baby] at 11pm," Mr Johnson says.
"Do you remember falsifying a recording relating to [the other baby]?"
Letby refutes this.
The court is then shown records relating to the baby in Letby's care. A close-up image of a medical note shows this baby being given a dextrose infusion at 00.00 (midnight), prior to the transfer.
But, the prosecution says, the four has been changed from a three, and the actual time this took place was 23.00 (11pm). They are accusing Letby of changing the notes to give herself an alibi in the lead-up to Child I's collapse.
"No I would not have changed a record, that was obviously written in error," Letby says. She says the note would have been signed off by her colleague.
The prosecution says she could have changed the time after it was signed.

47m ago14:15

'I don't remember this baby without the notes' - Court shown 'falsified' paperwork​

Nick Johnson, the prosecution barrister, asks Letby if she remembers saying she had "no recollection" of Child I, other than what appeared in the notes.
"I don't remember this baby without the notes," Letby agrees.
Letby's colleague said before Child I collapsed she had "been very unsettled" and made a sound she had never heard before.
Her colleague described this as a "loud, relentless,s almost constant with no fluctuation, cry" that was "very different to a hunger cry".
"This is another case of you gravitating to nursery one when you were in other less acute nurseries," Mr Johnson asks.
Letby refutes this was deliberate and says one of the three members of staff "would have had to assist".
She was involved in giving Child I medication - something she says she cannot remember but is backed up by the nursing notes.
The court is then shown more nursing notes, where the times have clearly been changed - with digits overwritten.
Mr Johnson says there were "three different mistakes in the paperwork in 25 minutes".
"Yes, potentially yes," Letby says.
"Two different children," Mr Johnson says.
"Yes," says Letby.
Mr Johnson then asks "how do those sorts of mistakes happen?"
"When there is a lot going on in the unit we may have written down the wrong time," Letby says.
"We, or you?" Mr Johnson asks.
Letby says it wouldn't have been just her responsible.
Mr Johnson says Letby changed the paperwork to "put some time between yourself and serious events" involving the infant.

37m ago14:25

Letby had her 'hands in infant's incubator'​

At 1.06am, Child I began crying again.
"I do remember being in the nursery and she was crying," Letby says. She then called for her colleague, according to her previous defence statement.
Mr Johnson says this indicates Letby was first in the room, and alone with the infant.
But Letby says this could have meant she called her colleague over from the other side of the room.
Mr Johnson disputes this, saying Letby's defence statement clearly states the colleague "came into" the room.
"You were in there at a time when Child I was crying relentlessly, and nobody else was there," says Mr Johnson.
"Potentially yes," she says.
Her colleague previously told the court when she entered the room, Letby "had her hands in the incubator".
"I do recall trying to settle Child I," Letby says.
Letby is accused of injecting the infant's circulation with air. Despite the best efforts of the doctors, Child I died later on during that shift.

36m ago14:27

Letby 'smiling' in the wake of Child I's death​

Letby is accused of "interrupting" Child I's parents as they bathed their dead daughter.
The mother previously said: 'Lucy came back in. She was smiling and kept going on about how she was present at Child I's first bath and how much she loved it.'
The ex-nurse said it "wasn't meant with any malice" but wanted to refer to a positive memory. She says it is normal practice to treat the infant as though she was still alive.
"Do you understand the difference between life and death?"
"Yes," Letby says.
She is accused of getting a "thrill" out of the grief and despair in the room.
"Absolutely not, no," Letby says.
Three weeks later, Letby sent a sympathy card to Child I's - taking a picture of it on her phone before she posted it.

36m ago14:27

Court adjourned​

The court is now taking a 20-minute break.
It will resume at 2.45pm.