Tortoise
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Tuesday 18th June 2024 - no live updates
Chester Standard 10% - link Lucy Letby trial: Repeated intubation attempts 'would not have compromised baby'
Medical notes described Child K at birth as “initially dusky, floppy, no respiratory effort” but the duty registrar on the night, Dr James Smith, told jurors at Manchester Crown Court on Tuesday, June 18 that was “not unusual” for a baby of 25 weeks gestation. [...]
A “sudden deterioration” in Child K’s condition is said to have taken place at 3.50am when her blood oxygen levels dropped, the jury heard.
Dr Smith said he was not in nursery one at the time and returned to see on-call consultant paediatrician Dr Ravi Jayaram to the right of Child K’s incubator and assisting with her breathing. [...]
Tuesday's hearing concluded with Dr Ravi Jayaram giving evidence, which he will continue on Wednesday, June 19.
Manchester Evening News 10% - midday link Medics tried to revive baby allegedly attacked by Lucy Letby, jurors hear
On the fourth day of the trial at Manchester Crown Court, today (Tuesday) the doctor who delivered Child K, Dr Jonathan Ford, told jury the birth had been an 'uneventful breach birth'. [...]
Dr James Smith, a locum registrar in paediatrics at the Countess of Chester Hospital at the time, told the jurors Child K needed assistance to breath in the first minutes of life, when she was considered 'dusky and floppy'. [...]
He said he remembered coming into the room and seeing a consultant, Dr Ravi Jayaram, on the right hand side of the incubator disconnecting the infant from the ventilator and attempting to 'bag' the baby via an endotracheal tube. "He was trying to give breaths through the tube which was the correct thing to do but that was not successful. It's not working," said Dr Smith.
Dr Smith said he himself then took two attempts to successfully re-intubate the baby as he had already done it successfully previously. The infant was given a one-off dose of morphine to help the process, the jurors were told.
The witness told the court it was thought the breathing tube 'had moved and was displaced'. [...]
Dr Smith agreed intubation can cause trauma to a baby like Child K. He acknowledged that the medical notes had documented a 'large amount of blood secretions' but he told the jurors he had no memory of blood being suctioned or seeing any blood in the airways or any trauma. "I have no memory of that," he said. [...]
Manchester Evening News 10% - evening link https://www.manchestereveningnews.co.uk/news/uk-news/death-premature-baby-allegedly-attacked-29376494?
Consultant neonatologist Dr Srinrasaro Babarao agreed the outcome for the poorly newborn, referred to as Child K, may have been better had she been moved from the Countess of Chester Hospital. [...]
However, he concluded her care was 'sub-optimal' when taking into account the treatment she received before her arrival including a potential transfer of mother to Arrowe Park before the birth. He concluded the death was 'potentially avoidable' had the mother been moved before the delivery.
He cited 'multiple reasons' for his conclusion including that outcomes 'are different' at more advanced 'tertiary centres'. He said there were delays in transferring Child K to a tertiary centre and delays in providing fluids, antibiotics and nutrition as well as three 'accidental extubations'.
Pressed by the judge Mr Justice Goss, Dr Barbarao confirmed he used information provided to him by the transport team who moved Child K to Arrowe Park for his review and had not had the benefit of medical notes from the Countess of Chester Hospital. [...]
Dr Ravi Jayaram, a consultant paediatrician who was called into the Countess of Chester Hospital on the night of the birth, told the jurors it was 'entirely appropriate' that he was summoned to assist Dr Smith.
Asked whether he should have intervened earlier, Dr Jayaram pointed out there was 'good chest movement' suggesting oxygen was reaching Child K so it was 'appropriate' for Dr Smith to conduct the intubation. He added that if it had been a struggle to ventilate the baby or they needed to secure an airway sooner, he would have taken over following the second attempt to intubate the baby.
He confirmed his notes suggested that, following the birth, Child K was 'pink', not floppy, her pulses 'felt normal' and her tone was 'good'.
Chester Standard 10% - link Lucy Letby trial: Repeated intubation attempts 'would not have compromised baby'
Medical notes described Child K at birth as “initially dusky, floppy, no respiratory effort” but the duty registrar on the night, Dr James Smith, told jurors at Manchester Crown Court on Tuesday, June 18 that was “not unusual” for a baby of 25 weeks gestation. [...]
A “sudden deterioration” in Child K’s condition is said to have taken place at 3.50am when her blood oxygen levels dropped, the jury heard.
Dr Smith said he was not in nursery one at the time and returned to see on-call consultant paediatrician Dr Ravi Jayaram to the right of Child K’s incubator and assisting with her breathing. [...]
Tuesday's hearing concluded with Dr Ravi Jayaram giving evidence, which he will continue on Wednesday, June 19.
Manchester Evening News 10% - midday link Medics tried to revive baby allegedly attacked by Lucy Letby, jurors hear
On the fourth day of the trial at Manchester Crown Court, today (Tuesday) the doctor who delivered Child K, Dr Jonathan Ford, told jury the birth had been an 'uneventful breach birth'. [...]
Dr James Smith, a locum registrar in paediatrics at the Countess of Chester Hospital at the time, told the jurors Child K needed assistance to breath in the first minutes of life, when she was considered 'dusky and floppy'. [...]
He said he remembered coming into the room and seeing a consultant, Dr Ravi Jayaram, on the right hand side of the incubator disconnecting the infant from the ventilator and attempting to 'bag' the baby via an endotracheal tube. "He was trying to give breaths through the tube which was the correct thing to do but that was not successful. It's not working," said Dr Smith.
Dr Smith said he himself then took two attempts to successfully re-intubate the baby as he had already done it successfully previously. The infant was given a one-off dose of morphine to help the process, the jurors were told.
The witness told the court it was thought the breathing tube 'had moved and was displaced'. [...]
Dr Smith agreed intubation can cause trauma to a baby like Child K. He acknowledged that the medical notes had documented a 'large amount of blood secretions' but he told the jurors he had no memory of blood being suctioned or seeing any blood in the airways or any trauma. "I have no memory of that," he said. [...]
Manchester Evening News 10% - evening link https://www.manchestereveningnews.co.uk/news/uk-news/death-premature-baby-allegedly-attacked-29376494?
Consultant neonatologist Dr Srinrasaro Babarao agreed the outcome for the poorly newborn, referred to as Child K, may have been better had she been moved from the Countess of Chester Hospital. [...]
However, he concluded her care was 'sub-optimal' when taking into account the treatment she received before her arrival including a potential transfer of mother to Arrowe Park before the birth. He concluded the death was 'potentially avoidable' had the mother been moved before the delivery.
He cited 'multiple reasons' for his conclusion including that outcomes 'are different' at more advanced 'tertiary centres'. He said there were delays in transferring Child K to a tertiary centre and delays in providing fluids, antibiotics and nutrition as well as three 'accidental extubations'.
Pressed by the judge Mr Justice Goss, Dr Barbarao confirmed he used information provided to him by the transport team who moved Child K to Arrowe Park for his review and had not had the benefit of medical notes from the Countess of Chester Hospital. [...]
Dr Ravi Jayaram, a consultant paediatrician who was called into the Countess of Chester Hospital on the night of the birth, told the jurors it was 'entirely appropriate' that he was summoned to assist Dr Smith.
Asked whether he should have intervened earlier, Dr Jayaram pointed out there was 'good chest movement' suggesting oxygen was reaching Child K so it was 'appropriate' for Dr Smith to conduct the intubation. He added that if it had been a struggle to ventilate the baby or they needed to secure an airway sooner, he would have taken over following the second attempt to intubate the baby.
He confirmed his notes suggested that, following the birth, Child K was 'pink', not floppy, her pulses 'felt normal' and her tone was 'good'.