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

[Sweeper2000]

2:20pm

An infusion chart is shown three records of the first 10% dextrose infusion. The first two are crossed out, with the third being the dose which was administered.
The judge asks to clarify that the only difference between the three records is the rate of infusion for the 10% dextrose bag. Dr Bhowmik confirms that is correct.
That concludes Dr Bhowmik's evidence.
2:17pm

Benjamin Myers KC, for Letby's defence, asks Dr Bhowmik to clarify the blood sugar readings for a healthy baby. 2.6 and above is healthy.
Mr Myers says Child L was recorded as having a 1.9 reading a couple of hours after birth.
He asks Dr Bhowmik questions about a 'hypoglycaemic pathway'. Dr Bhowmik says the correct course at the time would have been to start treating hypoglycaemia at the neonatal unit via IV fluids.
She tells the court she does not recall when the bag of IV fluids was put up, or who administered that bag.
2:07pm

Dr Sudeshna Bhowmik is continuing to give evidence.
She says most pre-term babies will have IV fluids, and this was altered for Child L because of the baby boy's weight and glucose levels.

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

 

[Sweeper2000]

2:49pm

The blood gas records show glucose levels for Child L on April 8 at 1.9 (10.58am) and 2.5 (12.14pm). The readings go above 2.5 in subsequent blood gas records for April 8, which only test for glucose levels.
She confirms she would have checked the infusion bag containing 10% dextrose with Lucy Letby, making sure it was in date, going to the right baby, and signing it. The infusion is noted as starting at noon on April 8.
Ms Davies says the pre-made dextrose concentrations available for infusion bags are 5% and 10%.
2:43pm

The court is now hearing evidence from Amy Davies, a neonatal practitioner who was employed in the neonatal unit at the Countess of Chester Hospital in April 2016. At the time, she was in Band 6.
She says she does not have any independent recollection of Child L.
From her notes, she was on the day shift on April 8, 2016, as shift leader. Lucy Letby was the designated nurse for Child L on the 8th, and Ms Davies confirms she assisted in the care.
She is asked if there was a specific pathway for babies with low blood sugar. Ms Davies confirms there was, and would involve giving milk before giving IV fluids with glucose, but each case differed.
In this case, a discussion would have taken place with the doctor, Ms Davies confirms. She said it was a decision which would not put the baby at risk, but was an alternative pathway.
Asked if she had any concerns about that pathway, Ms Davies replies: "No, no concerns."

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

 

[Sweeper2000]

3:03pm

Mr Myers, for Letby's defence, asks if Ms Davies was one of the nurses who transferred Child L and Child M to the neonatal unit.
Ms Davies confirms she would have been the designated nurse for Child M at that time.
Ms Davies is asked about the hypoglycaemic pathway. She says she is familiar with it, but keeps checking as policies regularly update. She confirms one was in place at the time.
Mr Myers says the policy was milk first, then IV fluids, in normal circumstances. He says circumstances mean a doctor might change that and go to IV fluids.
Ms Davies agrees.
Mr Myers says there are three types of nutrition bag available - start-up bags for the baby's first couple of bags, maintenance bags, and specifically prescribed TPN bags which would have a baby's name on it. Ms Davies agrees.
She tells the court the bag for Child L wouldn't have been referred to as a start-up bag, but would have been a standard 10% dextrose bag, as prescribed, to be infused.
That completes Ms Davies's evidence.
2:55pm

Ms Davies says the bags would be changed, regardless, every 48 hours.
Ms Davies is asked if she, at any point, administered Child L with insulin. She replies she did not, and is not aware of anyone doing so.
She says the circumstances for doing so would be two consecutive blood sugar readings of 12 or above, if a baby was hyperglycaemic.
2:49pm

The blood gas records show glucose levels for Child L on April 8 at 1.9 (10.58am) and 2.5 (12.14pm). The readings go above 2.5 in subsequent blood gas records for April 8, which only test for glucose levels.
She confirms she would have checked the infusion bag containing 10% dextrose with Lucy Letby, making sure it was in date, going to the right baby, and signing it. The infusion is noted as starting at noon on April 8.
Ms Davies says the pre-made dextrose concentrations available for infusion bags are 5% and 10%.

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

 

[Sweeper2000]

3:49pm

Dr Ukoh confirms a hypo screen test result, taken at noon on April 9, which is handwritten, is in his writing.
He says it is not a complete hypo screen results sheet, and said that would have been done in response, and at the time of, a low blood sugar reading.
Some of the results would have required sending away for analysis.
He says the test results would have been received by the lab at 6.26pm.
3:26pm

Dr Ukoh's notes for Child L from April 9, 2016, at 10.20am, are shown to the court.
He noted the baby was breathing well, and Child L was on an extra 10% dextrose dose as the blood sugars were running at a "relatively low level for his age", but was "not unusual" for premature babies.
There were no 'red flags' from the observations.
The plan was 'as per hypoglycaemic protocol', to increase the infusion of 10% dextrose administration, "to make up for the low blood sugars", and to repeat blood sugar checks.
3:18pm

Dr Anthony Ukoh is called to give evidence.
He says his recollection was that Child L and Child M were born premature, not extremely so, and for Child L, he did not have any 'red flags' as a baby who would become unwell.

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

 

[Sweeper2000]

4:02pm

The judge asks for the hypoglycaemic blood test, if there was just one blood sample taken from Child L for the various tests carried out.
Dr Ukoh agrees that was the case, and that some of the results would not come back straight away.
3:58pm

Mr Myers, for Letby's defence, asks to clarify Dr Ukoh's explanations for the way some of the results are presented.

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

 

[Sweeper2000]

A roundup of today’s evidence

Lucy Letby: Nurse 'celebrated Grand National bet hours after trying to murder twins'

NURSE Lucy Letby celebrated a winning bet on the Grand National shortly after she attempted to murder twin boys, a court heard.

www.chesterstandard.co.uk

 

[ClazzyGalxo]

2:20pm

An infusion chart is shown three records of the first 10% dextrose infusion. The first two are crossed out, with the third being the dose which was administered.
The judge asks to clarify that the only difference between the three records is the rate of infusion for the 10% dextrose bag. Dr Bhowmik confirms that is correct.
That concludes Dr Bhowmik's evidence.
2:17pm

Benjamin Myers KC, for Letby's defence, asks Dr Bhowmik to clarify the blood sugar readings for a healthy baby. 2.6 and above is healthy.
Mr Myers says Child L was recorded as having a 1.9 reading a couple of hours after birth.
He asks Dr Bhowmik questions about a 'hypoglycaemic pathway'. Dr Bhowmik says the correct course at the time would have been to start treating hypoglycaemia at the neonatal unit via IV fluids.
She tells the court she does not recall when the bag of IV fluids was put up, or who administered that bag.
2:07pm

Dr Sudeshna Bhowmik is continuing to give evidence.
She says most pre-term babies will have IV fluids, and this was altered for Child L because of the baby boy's weight and glucose levels.

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

Thanks for the summary. I tried to keep up on a daily basis following on very specific YouTuber but it became so incredibly complex and has seemingly been going on what seems like FOREVER at this, I had to stop following daily updates. Do you follow this case daily and consistently post updates?

 

[Dotta]

A roundup of today’s evidence

Lucy Letby: Nurse 'celebrated Grand National bet hours after trying to murder twins'

NURSE Lucy Letby celebrated a winning bet on the Grand National shortly after she attempted to murder twin boys, a court heard.

www.chesterstandard.co.uk

THIS

"NURSE Lucy Letby celebrated a winning bet on the Grand National shortly after she attempted to murder twin boys, a court heard."

sounds to me like apogee of some mania

JMO

 

[Tortoise]

draft timeline child L from today's evidence



8 Apr 2016, Fri - LL’s day shift

Twins L & M born at 33 wks & 2 days. Child L weighed 3lb 3oz

10.30am – Child L admitted to the nnu. Obs taken by LL. On 2 hrly feeds NG/bottle. Shift-leader nurse Amy Davies confirms she would have been the designated nurse for Child M at that time.

10.58am – child L blood sugar – 1.9. [2.6 and above is healthy per testimony]

11.15am – Dr Sudeshna Bhowmik sited an IV line for child L.

Noon – L given 10% dextrose infusion. Shift-leader nurse Amy Davies confirms she would have checked the infusion bag containing 10% dextrose with Lucy Letby, making sure it was in date, going to the right baby, and signing it. The infusion is noted as starting at noon on April 8. Ms Davies says the pre-made dextrose concentrations available for infusion bags are 5% and 10%. Ms Davies says the bags would be changed, regardless, every 48 hours. Ms Davies is asked if she, at any point, administered Child L with insulin. She replies she did not, and is not aware of anyone doing so. She tells the court the bag for Child L wouldn't have been referred to as a start-up bag, but would have been a standard 10% dextrose bag, as prescribed, to be infused.

12.14pm – 2.5

4.00pm – 5.8

6.00pm – 3.3

6.15pm – LL messaged a colleague saying she was unpacking and may do an extra shift at the weekend. She also messaged her mother saying she was thinking of working an extra shift on Saturday.

8.00pm – Agency nurse Tracey Jones records notes for child L for the night shift. During night shift L knocked out his cannula and it was reinserted

9.00pm – 2.3

Post-Shift? -
Sophie Ellis to LL: "How's the house pal? Xx"
LL: "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.
SE: "it'll feel more homely once you've sorted everything out." She also asks about how busy the unit is.
LL: "Unit is busy, no-one particularly unwell just volume and few people off sick. I prefer 4 days to 4 nights. We've got nice mix of babies at the mo really. Shift goes quick anyway!'

10.00pm – 2.2

Midnight – 3.6


9 Apr 2016, Sat - LL’s day shift.

LL designated nurse for 2 babies in room 1. Mary Griffith designated nurse for L & M in room 1.

7.30am – LL came on duty

10.00am – pre-feed – 1.9. He was given increased dextrose.

10.20am - Dr Ukoh noted child L was breathing well, and was on an extra 10% dextrose dose as the blood sugars were running at a "relatively low level for his age", but was "not unusual" for premature babies. There were no 'red flags' from the observations. The plan was 'as per hypoglycaemic protocol', to increase the infusion of 10% dextrose administration, "to make up for the low blood sugars", and to repeat blood sugar checks.

10.34am – LL to Ailsa Simpson : wishing her good luck at picking the horses at the Grand National that day, and that her feet don't get too sore.

11.00am – 1.6

11.12am to 12.33pm - LL is engaged in messaging people between 11.12am and 12.33pm.

Noon – pre-feed - 1.6. He was given 10% dextrose. LL co-signed.

Noon – Dr Ukoh confirms a hypo screen test result, taken at noon on April 9, which is handwritten, is in his writing. He says it is not a complete hypo screen results sheet, and said that would have been done in response, and at the time of, a low blood sugar reading. Some of the results would have required sending away for analysis. He says the test results would have been received by the lab at 6.26pm.

12.30pm – designated nurse Mary Griffith went on break

Shortly after 12.30pm – LL to Ailsa Simpson: "Oh good hope you have a fab time. Im in work doing an extra! x"
LL to 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.

Just before 2pm - LL continues to be involved in messaging, including a group message to 3 colleagues and friends: "Sorry guys, mad busy 4 days in work. U can come to mine if you want to. Just need to unpack first. Haven’t got a spare bed yet tho so can’t stay unfortunately. Looking forward to a catch up. Got magnum prosecco and vodka woop. No disco ball but sure we can manage. x"

2.00pm – 2.0

3.00pm – 1.5

3.35pm – LL co-signed meds for L. Mary Griffith takes blood to send to the lab. Bolus dextrose prescribed.

3.40pm – given a bolus of dextrose

4.00pm – child M collapsed and crash call put out.

4.00pm – 1.5 – dextrose increased from 10% to 12.5%

Abt 4.00pm - Friends message LL around this time, saying they can have "an unpacking party".

5.00pm – 1.7

5.28pm - LL's mother messages LL telling her: "You've won rule the world :-D xx"

6.00pm – 1.9

6.01pm – LL responds to a colleague at 6.01pm: "Haha why not!! Work has been s***e but...I’ve just won £135 on Grand National!!"
LL sent a group message to the 3 colleagues invited earlier: "Unpacking party sounds good to me with my flavoured vodka ha ha. Just won the Grand National!"

6.26pm – Dr Ukoh says the test would have been received by the lab at 6.26pm.

8.00pm – 2.0

9.00pm – 2.4

9.22pm – LL makes notes re Child M (still at work)

10.00pm – 2.3

10.11pm - Belinda Simcock messages LL: "Thanks for listening, I'm ok x"
LL: "Don't need to thank me, glad you felt able to tell me..."

Midnight – 2.1

10 Apr 2016, Sun - LL not working

2.00am – 2.1. A long line is inserted, with an x-ray taken, and medication administered.

4.00am – 2.3

6.00am – 2.2 – glucose further increased

7.00am – 2.2.

Time? - LL receives a message from Yvonne Farmer asking if she wanted to do more overtime shifts on Sunday night, Monday day or Monday night, appreciating she may be tired, with LL responding: "Sorry but need some days off now."
She adds she could be on call for nights, and would be free for Thursday day/night shifts.

9.00am – 2.2

2.00pm - normalised – 3.0

Afternoon - LL refers to her previous shifts as "not nice" in a message to Jennifer Jones-Key.
JJ-K : says LL 'hasn't got many nights' coming up on the rota, adding she likely won't see LL as she works mainly nights herself. "We never see each other if we do work together as always mad shifts".

Afternoon – L still receiving 15% dextrose through the afternoon. Nursing note Laura Eagles says "Blood sugars maintained...remains on 15% dextrose via long line...very unsettled at times."

5.00pm – 2.8

8.00pm – nurse Samantha O’Brien designated nurse for L for night shift.

9.00pm – 2.7. 15% dextrose continued through the night

11.00pm – 2.9

11 Apr 2016, Mon - LL not working

2.00am – 2.7

Samantha O'Brien, in her nursing note, records: "...1% glucose infusing via long line in left leg,. 3 hourly blood sugars, all have been above 2.6 so far this shift. Plan to continue [current medication administration] "Baby unsettled at times, settles with comfort measures."

5.00am – 2.9

8.45am LL messages colleague "The unit is in dire way with staff," highlighting which trained staff were on duty and who else was on in the last shift, and who was off at that time.
colleague replies: "that's terrible"
LL replies the overall situation was "not good", "mad and poor skill mix".

11.00am – 2.8

Registrar Dr Huw Mayberry, in a clinical note, records the feeds/fluids for Child L, which were increased due to low blood sugar and falling sodium levels.

3.00pm – 3.5

5.00pm – 3.5

Nurse Belinda Simcock said registrar Mayberry was aware of the 3.5 readings, and if they continued to remain above three, then feeds would be increased.

7.00pm – 4.7



14 Apr 2016, Thu

Child L’s blood test results came back

 

[Sweeper2000]

Thanks for the summary. I tried to keep up on a daily basis following on very specific YouTuber but it became so incredibly complex and has seemingly been going on what seems like FOREVER at this, I had to stop following daily updates. Do you follow this case daily and consistently post updates?

No problem . Tbh I will keep it updated if the other more regular updaters aren’t able to. Tortoise and lady edgeworth are the most frequent posters on this case.

I agree this is Very very complex and intricate. I try to narrow it down to one case at a time and struggle to do even that lol. If it seems like this has been going on a long time we still have more to come with a predicted finish around may time.

I do follow it daily as it’s my first glimpse into a court case and I find it fascinating to learn how the prosecution and defence have approached their role in the court room. learning about the law is interesting as well. The glimpses we see into the past concerning the defendant are interesting as well and everyone else involved but much of this is very very sad and tragic. So much information as well, it’s been stated on here before but it must be difficult for the jurors to keep up with even with some computers for easy storage of info.

 

[Sweeper2000]

THIS

"NURSE Lucy Letby celebrated a winning bet on the Grand National shortly after she attempted to murder twin boys, a court heard."

sounds to me like apogee of some mania

JMO

on a thrill high if guilty.

 

[notsure]

on a thrill high if guilty.

Everything can be interpreted as one thing if innocent and another if guilty. Strange, isn't it?

 

[Imnothere]

So when the results came back it showed that the baby was given insulin (probably between 4pm and 6pm) which explains why their readings were below 2.6 for so long? The contaminated bag would have been changed at midday on the 10th.

Are the readings not checked between midnight and 10am on the 9th?

 

[Dotta]

Who are the Babies?
All 17 of them

Who are the children alleged to have been murdered by Lucy Letby? | ITV News

Nurse Lucy Letby is accused of murdering seven babies and attempting to kill 10 more. Here is a breakdown of the babies and the allegations. | ITV News Granada

www.itv.com

 

[Sweeper2000]

Everything can be interpreted as one thing if innocent and another if guilty. Strange, isn't it?

Totally. I’ve yet to see anything indicative of manipulation as of yet and remain in the belief that if she did do it the suspicion resulting from knowing one might presume would come with it just is not showing. It’s really weird IMO. I would have expected to see some hyper vigilance or being particularly guarded, which is just not showing. I might think the move to day shifts would make a guilty person ask questions but nope she said she preferred it.

 

[Sweeper2000]

So when the results came back it showed that the baby was given insulin (probably between 4pm and 6pm) which explains why their readings were below 2.6 for so long? The contaminated bag would have been changed at midday on the 10th.

Are the readings not checked between midnight and 10am on the 9th?

we know she had the opportunity to retrieve insulin in the first case but this time round she doesn’t seem to have had it. We know the insulin is in the fridge and one set of keys to open the fridge but I’m not sure how it can be conceived she was able to. That’s today’s evidence though maybe after all the logged events we will hear the prosecution’s suggestions tomorrow.

 

[esther43]

Totally. I’ve yet to see anything indicative of manipulation as of yet and remain in the belief that if she did do it the suspicion resulting from knowing one might presume would come with it just is not showing. It’s really weird IMO. I would have expected to see some hyper vigilance or being particularly guarded, which is just not showing. I might think the move to day shifts would make a guilty person ask questions but nope she said she preferred it.

Its true to say that when looking at it through the eyes of a person capable of experiencing remorse you would expect to see a bit more of an 'edge' but than what we've seen so far.
But delving further into the research it seems those who are capable of serial killing are usually also very skilled at impression management.
According to the article below those involved in inflicting crimes in a heath care setting may experience 'killing' differently. This, they put down to a few things. Firstly it's the desensitisation to death and experience of being among it, secondly it's the ability to adapt quickly in a death type situation. So to use thinking skills 'in the moment'
Article also refers to 'doubling' which allows perpetrators to develop two 'selves'
All very weird and bizarre but here's the article incase you are interested.

Brave Clarice—healthcare serial killers, patterns, motives, and solutions - Forensic Science, Medicine and Pathology

Healthcare serial killing involves the intentional killing of multiple patients by a healthcare professional. It is a formidable challenge to identify in the medical context, and a daunting legal task to prove beyond reasonable doubt. What can be done or remains to be done to intercept these...

link.springer.com

 

[GoodDayToYouSir]

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

Another explanation which someone else pointed out was that baby k was born on 17 February and died 2 days later. So maybe they have moved her attempted murder evidence back because otherwise, it would mean that her parents would have to attend court to give evidence and/or sit through her case on the anniversary of her birth, when they may well wish to spend it in some other way remembering her.

 

[Sweeper2000]

Thought it would be a good idea to add the info from the prosecution’s opening.


“Child L's blood glucose level was noted to be low and he was treated with a dextrose infusion. His condition improved and he was stable by the day-time shift of April 9.
Letby came on duty that day at 7.30am.
By this time, the prosecution say, Letby was supposed only to be working day shifts because the consultants were concerned about the correlation between her presence and unexpected deaths and life-threatening episodes on the night-shifts.
2:16pm

Child L was born in April 2016. It is the prosecution case Letby poisoned Child L, while also attacking Child M - the twin.

In the hours that followed, Child L's glucose levels fell abnormally low. He was given additional doses of glucose, but they proved ineffective.

The answers to these levels were found after a lab sample sent to the Royal Liverpool Teaching Hospital laboratory came back with results some time later.

The results of the test were "grossly abnormal", but nothing was done about it as Child L had, by the time the results came back, returned to normal.


Prosecutor Nicholas Johnson KC: "We say Lucy Letby added insulin to that bag of dextrose. She did it deliberately to kill [Child L].
"She had failed to kill [Child F] so gave an increased dose."

2:22pm

The reading was "at the very top of the scale" the equipment could measure, the court hears.
There was no correspondingly high level of C-peptide: it was within the normal range. The only explanation for this anomaly is that what was being measured was synthetic insulin, which had not been prescribed to Child L but was stored and readily available in the neonatal unit.

Letby had been present for the birth of Child L. She cared for him on his first day and the prosecution say would have been aware of his mild hypoglycaemia.
Child L's blood sugar level remained "dangerously low" through the day.
At 4.30pm, a new infusion bag was required and this was being applied when Child L, the twin brother, was being taken ill.
2:25pm

The court is shown an 'infusion therapy prescription sheet', a written record of the dextrose bag fed to Child L.
The bag was running from noon on April 8, when it had been set up an hour earlier by Letby and another nurse.

2:29pm

The prosecution says medical expert evidence is this was a case of insulin poisoning, administered intravenously via Child L's liquid feed.
In police interview, Letby said she was aware of Child L's low blood sugar levels and knew the insulin was kept in a locked fridge, with a variety of other drugs. Keys were passed around nursing staff and there was no record of who held the keys at any time.
She agreed the insulin could not have been administered accidentally, but denied being responsible.
Her explanation was it must have been in one of the bags already being received.
The prosecution say that is not a credible possibility.

Recap: Prosecution continues opening of Lucy Letby trial

The prosecution continues its opening in the trial of Lucy Letby, accused of multiple baby murders at the Countess of Chester Hospital.

www.chesterstandard.co.uk

 

[esther43]

we know she had the opportunity to retrieve insulin in the first case but this time round she doesn’t seem to have had it. We know the insulin is in the fridge and one set of keys to open the fridge but I’m not sure how it can be conceived she was able to. That’s today’s evidence though maybe after all the logged events we will hear the prosecution’s suggestions tomorrow.

I don't think insulin is in the fridge. I think the bags are though. I could be wrong but I always thought insulin came out of the drugs cabinet.