UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #11

[Tortoise]

I find this suggestion by dr bohin odd.

“Mr Myers says Dr Bohin had said there was no evidence it was in situ as Child I was bottle feeding, so the tube couldn't be in.

"Well, someone could've put one in," Dr Bohin replies.”

Recap: Lucy Letby trial, Friday, February 10

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

im wondering what grounds she has to suggest something like that. Seems to be suggested to fit a diagnosis made before the facts are looked at.

Well I don't think Mr Myers argument stands to reason because in the first alleged incident child I was being bottle fed by her mother when she was awake and by NGT when she was asleep.


Also we didn't get to hear about this evidence because of the lack of reporting earlier last week, but in the opening speech for the incident in question the prosecution said this :


" '[Child I] noted to be pale in cot by myself at 03:20hrs … apnoea alarm in situ and had not sounded. On examination [Child I] centrally white, minimal shallow breaths followed by gasping observed.'

The registrar was called to the unit at 3.23am. On arrival, he saw nurses giving Child I full CPR. The notes suggest he had to reposition the ETT.

A consultant doctor administered adrenaline, intubated and ventilated Child I.

An X-ray showed gross gaseous distention throughout the bowel and signs of chronic lung disease of prematurity (CLD).

Child I, the prosecution say, had the same problem that she had when Letby had fed her on September 30.

The medical team felt that the abdominal distention had affected her ability to expand the chest and in turn caused desaturation.

Both nursing and medical staff commented on a bruised like discolouration to the right of the sternum. They assumed this was the result of chest compressions.

The category of nursing care was raised a level.
"Ironically," the prosecution say, Letby was made the designated nurse, as she was more qualified.

Medical notes showed the ETT had been "displaced" and, at 4.25am, the NGT was "curled in the oesophagus", which the prosecution say would have prevented release of the pressure created by excess air in the stomach."

Recap: Prosecution opens trial of Lucy Letby accused of Countess of Chester Hospital baby murders

 

[Tortoise]

9:35am

Here is a recap of what has happened in the trial so far over the past 16 weeks of evidence: Countess nurse Lucy Letby: What has happened in trial so far

Recap: Lucy Letby trial, Wednesday, February 15

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[GoodDayToYouSir]

I'm unsure what you mean. Opinions are formed on facts, and we haven't heard what their opinions were, to be able to say they changed them.

I don't think I've heard the defence say this in more than one case, which was child C. Do you have more examples?

- Indeed, all the drama with baby c and the event which dr evans initially said was an air injection but then it turned out LL wasn’t on duty when that happened, and dr evans then decided
That event wasn’t an air injection .

- I was also thinking of baby E , where Myers said that dr Evans was "looking for possible items just to support the allegation, then simply looking at all the available facts".

Medical tool may have injured baby, expert says - BBC News

A baby's internal bleeding had no innocent explanation, a doctor tells the trial of Lucy Letby.

www.bbc.co.uk

- And baby I last week where Myers was referring to an event which dr Bohin described as “suspicious “ in an earlier report when LL wasn’t on duty. The reporting on that event was terrible. No further information was given on whether Myers asked Bohin why it was suspicious but now isn’t, or what’s changed.

- And also for baby I:

“Mr Myers suggests Dr Bohin is adapting the air embolism cause to these collapses.

Dr Bohin: "That is not the case."

She tells the court she has looked for pathological causes to explain the collapses, and had not been able to find any.

Mr Myers says Dr Bohin is 'reaching' for air embolism as a 'catch-all' cause. Dr Bohin disagrees.”

Recap: Lucy Letby trial, Friday, February 10

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[Sweeper2000]

Is there a suggestion that the ngt being curled Was a deliberate act?

im also wondering how if a ngt is curled in the throat it could then be used to deliver air into the stomach?

I think a ngt is supposed to be checked upon insertion to ensure it is in the right place. Either via x ray or aspiration of the stomach contents. With the x ray being done around the 3.30 mark I would have thought that would show it being curled. does that mean the ngt wasn’t checked Upon insertion?

i don’t know but couldnt that explain the gaseous distension?

 

[katydid23]

Andy Gill

@MerseyHack


Hello. I am at #Manchester Crown Court to report on the continuing trial of nurse Lucy #Letby. She denies murdering 7 babies and attempting to murder 10 others at the
@TheCountessNHS
in 2015 and 2016. Updates here and
@BBCNWT



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


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

 

[katydid23]

I really hope Chester Standard is there today, if they're moving on to Child K.

With two and a half months between Child J at the end of November and Child K in February, I'm interested to see if they will focus at all on what led Dr Jayaram to check up on LL with Child K.

Also I think Child K might be a relatively quick case to present, with her only being at the Countess for a matter of hours, so if Chester Standard misses that, evidence could be finished in a day and they could move on to Child L tomorrow.

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

 

[Tortoise]

- Indeed, all the drama with baby c and the event which dr evans initially said was an air injection but then it turned out LL wasn’t on duty when that happened, and dr evans then decided
That event wasn’t an air injection .

- I was also thinking of baby E , where Myers said that dr Evans was "looking for possible items just to support the allegation, then simply looking at all the available facts".

Medical tool may have injured baby, expert says - BBC News

A baby's internal bleeding had no innocent explanation, a doctor tells the trial of Lucy Letby.

www.bbc.co.uk

- And baby I last week where Myers was referring to an event which dr Bohin described as “suspicious “ in an earlier report when LL wasn’t on duty. The reporting on that event was terrible. No further information was given on whether Myers asked Bohin why it was suspicious but now isn’t, or what’s changed.

- And also for baby I:

“Mr Myers suggests Dr Bohin is adapting the air embolism cause to these collapses.

Dr Bohin: "That is not the case."

She tells the court she has looked for pathological causes to explain the collapses, and had not been able to find any.

Mr Myers says Dr Bohin is 'reaching' for air embolism as a 'catch-all' cause. Dr Bohin disagrees.”

Recap: Lucy Letby trial, Friday, February 10

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

I don't think these are examples of the defence saying they changed their opinions, apart from child C. JMO

With Child E they always said it was air embolus, based on the clinical information. Once Dr Evans received the mother's statement about her baby screaming and bleeding, which wasn't in LL's notes, he was able to give an opinion on what caused the bleeding but he didn't change his opinion on the cause of death.

With Child I I don't think there's been any report Dr Bohin changed her opinion.

JMO

 

[GoodDayToYouSir]

Andy Gill
@MerseyHack


Hello. I am at #Manchester Crown Court to report on the continuing trial of nurse Lucy #Letby. She denies murdering 7 babies and attempting to murder 10 others at the
@TheCountessNHS
in 2015 and 2016. Updates here and
@BBCNWT



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


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

Wait, what? Why have we skipped baby k?

 

[Tortoise]

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

How strange! Perhaps witness availability, if it's only going to be a short case?

 

[GoodDayToYouSir]

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

Baby L is the second insulin poisoning, isn’t it? It will be interesting to see how this compares to baby F and, in particular, whether we get into the whole one or two tpn bags debate again

 

[katydid23]

I find this suggestion by dr bohin odd.

“Mr Myers says Dr Bohin had said there was no evidence it was in situ as Child I was bottle feeding, so the tube couldn't be in.

"Well, someone could've put one in," Dr Bohin replies.”

Recap: Lucy Letby trial, Friday, February 10

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

im wondering what grounds she has to suggest something like that. Seems to be suggested to fit a diagnosis made before the facts are looked at.

Mr Myers says Dr Bohin had recorded there was no evidence the naso-gastric tube was in situ at the time of October 13.

Dr Bohin says staff were "notoriously poor" on noting whether naso-gastric tubes were in situ, inserted, replaced or removed.

Mr Myers says Dr Bohin had said there was no evidence it was in situ as Child I was bottle feeding, so the tube couldn't be in.

"Well, someone could've put one in," Dr Bohin replies.


And then the prosecution clarified her statement by asking her:

The prosecution ask about the October 13-14 collapse, and how quickly a naso-gastric tube can be inserted and removed, and Dr Bohin confirms that can be done in "seconds".

Mr Johnson says there is no evidence "from the records" showing an NGT was in place, but "on the balance of probabilities", that was the cause - Child I receiving excess air via the NGT - which Dr Bohin favoured. Dr Bohin agrees.

 

[GoodDayToYouSir]

How strange! Perhaps witness availability, if it's only going to be a short case?

I would hate to be the poor person at CPS who is trying to organise the trial and coordinate the diaries of all these witnesses. It would be a tall enough order to do it in the first place, but then when you’ve got unexpected delays in the court process, including whole days where no evidence is heard because of illness or other matters, it must be a logistical nightmare .

 

[katydid23]

How strange! Perhaps witness availability, if it's only going to be a short case?

Maybe the family or relevant co-workers need to testify and had to reschedule?

 

[Tortoise]

10:29am

The trial is due to resume imminently.

10:39am

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

10:41am

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

10:45am

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

10:47am

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

10:52am

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

10:57am

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

Recap: Lucy Letby trial, Wednesday, February 15

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

11:02am

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

11:04am

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

11:06am

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

Recap: Lucy Letby trial, Wednesday, February 15

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[katydid23]

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

https://twitter.com/MerseyHack
@MerseyHack
·

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

Andy Gill

@MerseyHack


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

 

[Tortoise]

11:08am

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

Recap: Lucy Letby trial, Wednesday, February 15

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

11:17am

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

Recap: Lucy Letby trial, Wednesday, February 15

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

Baby L is the second insulin poisoning, isn’t it? It will be interesting to see how this compares to baby F and, in particular, whether we get into the whole one or two tpn bags debate again

This is the case where they say she put insulin in the glucose. Child L was on milk feeds, not TPN.

 

[Tortoise]

11:25am

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

11:30am

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

Recap: Lucy Letby trial, Wednesday, February 15

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk