UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #13

[DianaWW]

Strange he can’t see an origin of the blood. One would think injury and resulting bleed would be noticeable if caused by an implement ie ng tube.

I don’t think that’s strange if it’s the back of the throat. Possible he couldn’t see any potential injury if it was too far down the back of the throat? But I have to say this one is a struggle to follow, not sure if it’s the poor reporting. JMO.

 

[Sweeper2000]

I don’t think that’s strange if it’s the back of the throat. Possible he couldn’t see any potential injury if it was too far down the back of the throat? But I have to say this one is a struggle to follow, not sure if it’s the poor reporting. JMO.

I would have thought that some kind of tool would be used to see down the throat? Get the doctor going say “arrrrrr” thing but obviously can’t do that with a baby. This Epiglottitis is it far down or near the top? wiki says it’s attached to the voice box. Can’t quite say exactly where this injury is but one would think the Epiglottitis is the most likely spot.

 

[JosieJo]

Strange he can’t see an origin of the blood. One would think injury and resulting bleed would be noticeable if caused by an implement ie ng tube.

If the throat was swollen you wouldn't see the damage if below the swelling imo

 

[Sweeper2000]

If the throat was swollen you wouldn't see the damage if below the swelling imo

jmo. would have thought the swelling would be around the injury with the site of injury at the most swollen point? Like a bump on the head usually has the impact point bang in the middle. Understand though that The Swelling or internal bleeding can extend below the impact site but not sure if that can happen above.

 

[marynnu]

I'm hoping we hear more from the Alder Hey doctor about what he thinks of the bleeding/swelling.

 

[Tortoise]

LL: 'What do you think caused his (Child N's) bleed?'
Doc: 'I think there will be a haemangioma or collection. If it was epiglottitis his crp should have been higher because he was starting to become unwell'. Doctor says he's 'optimistic he'll be okay'

My focus is on the question.

This doesn't appear to be a chicken or egg question. IMO, Doc would not have seen such swelling, if there was not pre-existing trauma when he tried to intubate. Unless the defence is going to argue that swelling wasn't there and occurred simultaneously with bleeding caused during 1st attempt at intubation.

 

[WaxLyrical]

I'm hoping we hear more from the Alder Hey doctor about what he thinks of the bleeding/swelling.

The Irish News: throat of baby ‘attacked by nurse', court told

Seemingly the alder hey doctor didn’t see any blood or swelling when he intubated.

 

[Tortoise]

The Irish News: throat of baby ‘attacked by nurse', court told

Seemingly the alder hey doctor didn’t see any blood or swelling when he intubated.

I think it had stopped bleeding by that time, which was 12 hours after the morning attempts to intubate and 3-4 hours after the afternoon collapse when blood was aspirated from his stomach.

He [Dr Gibbs] told the court he “couldn’t understand” why two consultants, two registrars and two anaesthetists had failed previously to intubate Child N throughout the day, but said the adrenaline may have helped reduce the swelling.

‘Unusual' presence of blood in throat of baby ‘attacked by nurse', court told

earlier tweets

Dr Mayberry was crash bleeped to attend the neonatal unit at around 15:00 due to a 'sudden desaturation following 3ml aspirate of blood from NG (tube)'

The doctor tells the court he tried to intubate Child N, but he 'was unable to get a very clear view because there was substantial swelling within the airway'. He said that this swelling was 'unlike anything I had encountered previously'

He said the infant's epiglottis (flap of tissue at the back of the throat) was 'quite swollen, it looked quite large and reddy pink in colour'. He adds 'I had not seen this in my practice before, only in textbooks'

He tells the court that his initial thought was that this could be epiglottitis - this often caused by an infection, but can also sometimes happen as a result of a throat injury

Dr Mayberry tells the court that he does not recall seeing any blood in Child N's throat. Asked if he could he could give a cause for the swelling, he says 'no it’s not something I've had much experience of'

https://twitter.com/MrDanDonoghue

 

[GoodDayToYouSir]

The Irish News: throat of baby ‘attacked by nurse', court told

Seemingly the alder hey doctor didn’t see any blood or swelling when he intubated.

Indeed, and further apnoea at alder hay which was never explained

 

[LorriB]

LL: 'What do you think caused his (Child N's) bleed?'
Doc: 'I think there will be a haemangioma or collection. If it was epiglottitis his crp should have been higher because he was starting to become unwell'. Doctor says he's 'optimistic he'll be okay'

My focus is on the question.

This doesn't appear to be a chicken or egg question. IMO, Doc would not have seen such swelling, if there was not pre-existing trauma when he tried to intubate. Unless the defence is going to argue that swelling wasn't there and occurred simultaneously with bleeding caused during 1st attempt at intubation.

It seems something was wrong with the baby the night prior to the incident - he was unsettled, had the mottling, was pale and slightly distended stomach and looked 'like *advertiser censored*' according to his designated nurse.

Was the swelling another symptom to add to the other unexplained ones? I'm interested in hearing what they think was actually wrong with him and if the swollen throat is part of that.

 

[WaxLyrical]

I think it had stopped bleeding by that time, which was 12 hours after the morning attempts to intubate and 3-4 hours after the afternoon collapse when blood was aspirated from his stomach.

He [Dr Gibbs] told the court he “couldn’t understand” why two consultants, two registrars and two anaesthetists had failed previously to intubate Child N throughout the day, but said the adrenaline may have helped reduce the swelling.

‘Unusual' presence of blood in throat of baby ‘attacked by nurse', court told

earlier tweets

Dr Mayberry was crash bleeped to attend the neonatal unit at around 15:00 due to a 'sudden desaturation following 3ml aspirate of blood from NG (tube)'

The doctor tells the court he tried to intubate Child N, but he 'was unable to get a very clear view because there was substantial swelling within the airway'. He said that this swelling was 'unlike anything I had encountered previously'

He said the infant's epiglottis (flap of tissue at the back of the throat) was 'quite swollen, it looked quite large and reddy pink in colour'. He adds 'I had not seen this in my practice before, only in textbooks'

He tells the court that his initial thought was that this could be epiglottitis - this often caused by an infection, but can also sometimes happen as a result of a throat injury

Dr Mayberry tells the court that he does not recall seeing any blood in Child N's throat. Asked if he could he could give a cause for the swelling, he says 'no it’s not something I've had much experience of'

https://twitter.com/MrDanDonoghue

4 hours is a fairly short amount of time for swelling to go from severe to absent. I take on board the suggestion that adrenaline might be behind that, but I would have still thought the original injury resulting in an attempted murder charge would have been visible. JMO.

 

[GoodDayToYouSir]

The Irish News: throat of baby ‘attacked by nurse', court told

Seemingly the alder hey doctor didn’t see any blood or swelling when he intubated.

Seven (?) failed intubation attempts by COCH staff, and then a medic from alder hey, which is a hospital which is more specialised at treating sicker babies, does it in one? It doesn’t paint a great picture of COCH in my view.

 

[Tortoise]

Seven (?) failed intubation attempts by COCH staff, and then a medic from alder hey, which is a hospital which is more specialised at treating sicker babies, does it in one? It doesn’t paint a great picture of COCH in my view.

The Alder Hey anaesthetist did not see the swelling that was present earlier, so it's not the same set of circumstances.

JMO

 

[marynnu]

The Irish News: throat of baby ‘attacked by nurse', court told

Seemingly the alder hey doctor didn’t see any blood or swelling when he intubated.

True, I just wondered if he had any theories re. the earlier problem and why it seemed to resolve.

 

[Tortoise]

4 hours is a fairly short amount of time for swelling to go from severe to absent. I take on board the suggestion that adrenaline might be behind that, but I would have still thought the original injury resulting in an attempted murder charge would have been visible. JMO.

So what is the implication - that the swelling seen by six doctors wasn't there at all?

 

[WaxLyrical]

So what is the implication - that the swelling seen by six doctors wasn't there at all?

No, I believe there was swelling at attempt one, the way Dr Choc describes it. What I’m not so sure of is whether it was the result of deliberate trauma done in a split second by a serial killer when another nurse’s back was turned. If something had been forcefully jammed down the baby’s throat at lightning speed, I feel like it would have left some trace.

When I read about this case, I see a baby whose presentations are often referred to as unusual, whose swelling got out of control and then resolved quite suddenly, who had a clotting disorder and no factor 8 while he was bleeding.

It just seems more likely to me that the original swelling was caused by something else, perhaps NG tube irritation, or the resolution of his desaturation at 7:15am, and it then progressed into what seems like a nightmare for everyone concerned. I would like to know more about haemophilia and how it might be able to explain the strange goings-on in the throat.

Everyone testifying seems to say “can’t think of any natural reason”, but we’re also talking about a hospital that didn’t have factor 8 and needed to call in specialists to intubate, so I do not feel like they’re the ultimate authority on what’s possible and what’s not.

JMO.

 

[Legal]

So I'm a bit behind today but I just wanted to make a point about the offer from the doctor to lend LL his car. Apologies if everyone already knows this but I'm thinking of members who may not be from the UK, because it's a little different here. I've lived abroad and I know in many countries, it's the car itself which is insured, so people would lend each other their cars to use quite freely. However, in England, it's generally the driver who is insured to drive that particular car so it's a completely different ball game. When I've driven my mum's car in the past she has called the insurance company and added me to the insurance policy as a named driver. So in my experience, it's not common for people to lend each other their cars here unless it's someone you know very well, and the borrower would usually be added to the insurance. JMO.

 

[Tortoise]

No, I believe there was swelling at attempt one, the way Dr Choc describes it. What I’m not so sure of is whether it was the result of deliberate trauma done in a split second by a serial killer when another nurse’s back was turned. If something had been forcefully jammed down the baby’s throat at lightning speed, I feel like it would have left some trace.

When I read about this case, I see a baby whose presentations are often referred to as unusual, whose swelling got out of control and then resolved quite suddenly, who had a clotting disorder and no factor 8 while he was bleeding.

It just seems more likely to me that the original swelling was caused by something else, perhaps NG tube irritation, or the resolution of his desaturation at 7:15am, and it then progressed into what seems like a nightmare for everyone concerned. I would like to know more about haemophilia and how it might be able to explain the strange goings-on in the throat.

Everyone testifying seems to say “can’t think of any natural reason”, but we’re also talking about a hospital that didn’t have factor 8 and needed to call in specialists to intubate, so I do not feel like they’re the ultimate authority on what’s possible and what’s not.

JMO.

Dr Choc

Agreed that we need authority on this. I'm looking forward to hearing from Professor Kinsey and the other experts.

Come on Chester Standard, you've got to be there.

I'll even send them chocolate.

 

[GoodDayToYouSir]

The Alder Hey anaesthetist did not see the swelling that was present earlier, so it's not the same set of circumstances.

JMO

I wonder if the alder hey specialist didn’t observe any remarkable swelling on the basis that swelling is common with haemophilia, and given that the alder hey docs saw this condition all the time (in comparison to COCH staff) , it was a normal presentation in his opinion for a baby with haemophilia ?

Just spitballing ideas, as I agree with the other poster that it seems unlikely that adrenaline would make swelling disappear completely.

 

[GoodDayToYouSir]

Dr Choc

Agreed that we need authority on this. I'm looking forward to hearing from Professor Kinsey and the other experts.

Come on Chester Standard, you've got to be there.

I'll even send them chocolate.

I’m certain all my ailments would be resolved if I had a visit from Dr Choc …