UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #14

[DinerMite]

I can't seem to understand this, can someone explain to a simpleton like me please:

"The doctor messages Letby on Monday, June 27 about the care for Child Q, and a Facebook conversation takes place.

A reference is made to clarify paperwork for a prescription for Child O during the resuscitation attempts.

On June 29, a Datix form is filed in which Child O 'suddenly and unexpectedly collapsed'.

Letby files a Datix form on June 30, in which it was recorded that equipment required for a procedure during resuscitation was not available on the unit.

It was clarified in July 2016 Child O did not lose peripheral access"

1. Who is "clarifying paperwork for prescriptions" and in doctor speak what does that mean - I know what a prescription is of course just not clarifying it after the fact?

2. How many datix reports were filed and by who?

3. What does it mean when it says "did not lose peripheral access" and why is it relevant?

Much appreciated

Link

 

[Tortoise]

Will this Ms Karen R be called as a witness?
I hope so.

I don't think she would be a witness in these proceedings. JMO

 

[ColourPurple]

I'd forgotten about the baby dying on the day of his/ her 100th day celebration and the one on the due date. I find these events very suspicious and if guilty shows incredible cruelty.

It was Baby G for both. She survived 3 alleged murder attempts but now has quadroplegic cerebal palsy and needs round the clock care.

LL remarked to her colleague on the 100 day birthday collapse "On today of all days"

 

[Dotta]

I don't think she would be a witness in these proceedings. JMO

And why not?
Won't Defence ask her why she "defended LL like Independence"??

 

[Tortoise]

And why not?
Won't Defence ask her why she "defended LL like Independence"??

I should think because there had been no evidence gathering at that point, for the allegations, and she wasn't involved in a hands on role in the care of these babies.

She can't offer any material information to advance the prosecution or the defence in whether deliberate harm occurred.

JMO

 

[ColourPurple]

I'd forgotten about the baby dying on the day of his/ her 100th day celebration and the one on the due date. I find these events very suspicious and if guilty shows incredible cruelty.

If guilty there are things that show real cruelty, in addition to the obvious cruelty of the alleged offences themselves. Things like texting her colleague to say how parents were worried sick about losing their other twin... and then allegedly trying to kill that other twin.

All imo

 

[Dotta]

I should think because there had been no evidence gathering at that point, for the allegations, and she wasn't involved in a hands on role in the care of these babies.

She can't offer any material information to advance the prosecution or the defence in whether deliberate harm occurred.

JMO

No evidence gathering after a year of "the strangest things" happening.
Phew!
I thought she was an executive nurse or something equally fancy.

This case is playing real havoc with my blood pressure.

 

[Sweeper2000]

Dr Brearey told the court that the death of the brothers was "distressing for those involved and deeply so with me".

He said: "All three triplets were born in such good condition, they were following a healthy path to growing and developing and hopefully going home."

Dr Brearey told jurors that Child O's collapse came "out of the blue" and observed that in the hours before his death there had been an "unusual" rash on his chest. He said this was something he had not "seen before or since". [...]

Dr Brearey said he called Karen Rees, the duty executive senior nurse, to report his concerns and explained that he "didn't want nurse Letby to come back to work the following day or until all this was investigated properly".

Dr Brearey said Ms Rees "said no" and told him "there was no evidence" for his claims.

Lucy Letby: Doctor asked for nurse to be taken off shift - court

very very interesting. The Datix report could have been used as a way of going over management’s head so to speak before it reached this point.

you see reading that article I would say this is the point of a official report. You have senior management and staff, the staff are saying “we havE these concerns as a group of clinicians and if you don’t do anything about it we will raise the issue further” This scenario is very different from a single doc saying something and then being dismissed. She was put on clerical a week after this strongly communicated discussion showing the management took it seriously at this point. I think the evidence here is almost overwhelmingly indicative of something worthy of being investigated. So many odd events at this point in time that maybe the seniors cottoned on after this accumulation of worries and the consultants communicating worry.

I think there were either three or four autopsies but not sure. The reason I asked is why some were considered “unexpected“ ie (child A) and others weren’t? It’s also my point that from the docs POV they might have taken the opportunity to actually get some evidence of wrongdoing via autopsy that way they could present it to the seniors without being rebuffed. that also wouldn’t involve any potential complaints from the suspected member of staff and you wouldn’t need senior staff to authorise it as it’s standard protocol. “You wanted proof, here it is”.

 

[Tortoise]

I think there were either three or four autopsies but not sure. The reason I asked is why some were considered “unexpected“ ie (child A) and others weren’t? It’s also my point that from the docs POV they might have taken the opportunity to actually get some evidence of wrongdoing via autopsy that way they could present it to the seniors without being rebuffed. that also wouldn’t involve any potential complaints from the suspected member of staff and you wouldn’t need senior staff to authorise it as it’s standard protocol. “You wanted proof, here it is”.

There were six post-mortems.

 

[LorriB]

This is what I don't understand. There was an external review about the standards of care, wasn't there? And when they found nothing that could explain the deaths, that's when they initiated a police investigation.

Why is the defence going down these lines when there's already been evidence to disprove that suboptimal care is responsible?

The report confirms the deaths are unexplained, but doesn't state the care provided wasn't a factor. It recommended an external independent review of each unexplained death.

So I don't think it's unexpected for the defense to explore suboptimal care. I can recall one example of it off the top of my head, so of course it happened.

 

[Sweeper2000]

There were six post-mortems.

and not a single autopsy report came back with conclusive evidence of wrongdoing?

 

[Sundial]

it’s not that I think. I don’t think they reported her for anything because they didn’t really have anything to report. They probably spoke to senior staff but did not. Raise it to an official level. Hence the senior staffs response of “no evidence“. you can’t really do anything when people come to you and say “we think this person did this” it’s just a suspicion aand without evidence or questionable behaviour the seniors would be without reason to act. Probably deemed just a rumour and thus not really something to act on. If dr j reported that they might have been able to actually do something sooner.

that goes without a informal conversation between senior staff and LL. to me without a doubt someone should have spoken with her, not necessarily accused her but enquired if she was confident in her job and is sure she is doing everything as trained. They couldn’t be accused of anything for having a chat at all.

But equally, when there are peoples lives at risk of harm, they had a duty of care and safeguarding responsibilities whether there was evidence or not. They were informed more than once over a 12 month period and yet did nothing. They took no action (as far as we have heard/are aware of).

I know we spoke of the “evidence” situation before and just because they don’t have evidence; didn’t mean they didn’t have a duty to act.

IMO they failed these families and could have prevented further tragedies. Had it not been for the doctors persisting- what then? This is appalling.

JMO

 

[Sundial]

You see I wouldn’t say reporting something is the same as telling someone something or in this context expressing concern. I’m talking about filing a report, something official not just saying things. All in all I think this is where the “no evidence“ bit comes in.

I respectfully have to disgaree.

Safeguarding is everyone’s responsibility and if dr j reported this (which he did), it is up to those further up the chain to action it- with evidence or not. Safeguarding is a legal obligation. He was not the only person who reported it. Again, it was not actioned.

If someone you worked with raised a concern about a member of staff, you would explore that further, you would not just leave things as they were to (potentially) continue.

Sometimes reports are not always filed by management (they should be yes, but not always!); but here’s a thing, whether someone is verbally or reportedly raising a concern (more than one person no less), there is a duty to act on that. They failed to act and failed to prevent this sad, awful case.

JMO

 

[Sweeper2000]

But equally, when there are peoples lives at risk of harm, they had a duty of care and safeguarding responsibilities whether there was evidence or not. They were informed more than once over a 12 month period and yet did nothing. They took no action (as far as we have heard/are aware of).

I know we spoke of the “evidence” situation before and just because they don’t have evidence; didn’t mean they didn’t have a duty to act.

IMO they failed these families and could have prevented further tragedies. Had it not been for the doctors persisting- what then? This is appalling.

JMO

As I said I’m shocked nobody spoke with her at all, not even once. it could have been approached as politically and as tentatively as possible and been well within the law but that didn’t happen. One might think a senior head would open that discussion as a midway between acknowledging staffs concerns and acting on it and bearing in mind that there is two sides to that situation. That wouldn’t be putting anyone at risk. From the seniors POV nobody is at risk just because some staff have concerns.

 

[Sundial]

If you were to put yourself in their shoes exactly what would you report to the senior staff?

at best you could say “we think she did this or that” then asked “why” what would your response be?

couldn’t be anything stronger in reply than “suspicions” at this point and that’s where you come a cropper.

I’m interested, how does that theory apply then say for example with children being abused, schools etc.
you have no concrete proof but something “seems” to happen every-time that person is around, or students are mentioning things. What then?
Under safeguarding rules, we don’t just leave these things. It’s everyone’s responsibility, it is investigated (whether verbally reported or written report).

I’ve heard of various police cases where someone has verbally raised something and the police have gotten involved. This whole thing is absolute madness imo.

 

[GoodDayToYouSir]

Dr Brearey told the court that the death of the brothers was "distressing for those involved and deeply so with me".

He said: "All three triplets were born in such good condition, they were following a healthy path to growing and developing and hopefully going home."

Dr Brearey told jurors that Child O's collapse came "out of the blue" and observed that in the hours before his death there had been an "unusual" rash on his chest. He said this was something he had not "seen before or since". [...]

Dr Brearey said he called Karen Rees, the duty executive senior nurse, to report his concerns and explained that he "didn't want nurse Letby to come back to work the following day or until all this was investigated properly".

Dr Brearey said Ms Rees "said no" and told him "there was no evidence" for his claims.

Lucy Letby: Doctor asked for nurse to be taken off shift - court

Just for the avoidance of doubt, the duty executive senior nurse would have been someone who had many years of hands on nursing experience, wouldn’t she? Same with the medical director? These are people who, for example, management, people who have excelled in non-medical areas who are parachuted into hospitals?

I could perhaps understand that a non-medical person may not Realise the significance of a doctor reporting concerns such as these, but I am surprised that a fellow medic, with many years of on the job experience, was apparently so dismissive of concerns raised.

I really would like to hear from these two executives to hear their versions of exactly what they say was reported to them or raised as a concern, because I just don’t understand from a risk management perspective, how they didn’t come up with some way of taking LL off clinical duties earlier on (even if it was for some some manufactured reason , and they didn’t outright tell her that concerns have been raised about her presence at the deaths of babies).

 

[Tortoise]

and not a single autopsy report came back with conclusive evidence of wrongdoing?

far be it from me to give medical opinions, but I think what was recorded in the post-mortems is compatible with natural and unnatural causes, if you exclude the route to death ie. the clinical/medical observations before death.

for instance baby C - ‘widespread hypoxic/ischaemic damage to the heart/myocardium’ due to lung disease' - but the experts say he died with pneumonia not because of it. I believe hypoxic is to do with lack of oxygen which could be sinister, or not.

baby D - pneumonia - again the experts say she died with it not because of it. however she had recovered between collapses.

baby I - Hypoxic ischaemic damage of brain and chronic lung due to prematurity - same as baby C, lack of oxygen.

baby O - intra-abdominal bleeding - the cause of this bleeding could have been asphyxia, trauma or vigorous resuscitation.

baby P - prematurity - unable to identify underlying cause.

JMO

 

[Parker Knoll]

So this Karen Rees reported today as saying no to Dr B appears to have won the “Haygarth Medal for Nurse of the Year” at CoCh in 2017.
Baffling.

 

[magikarpmagikarp]

Sweeper, what would be conclusive evidence of wrongdoing in the autopsy? I agree with Tortoise here.

Autopsies don't always tell you what they think you will. Many years ago, I had a child who had a very serious hypoxic birth injury. Technically her cause of death was renal failure. That's what they put on her death certificate. We were recommended an autopsy because the doctor thought her response to resuscitation was unexpected, and they thought there might have been something else wrong with her. Her autopsy showed widespread hypoxic ischemic damage, and diffuse bleeding, and no other malformations. But the cause of her death that mattered to me was that her umbilical cord was pinched for 20 minutes - and that information was only gotten (much later after the autopsy) through history taking and report of what was seen and felt by both me and the paramedics who attended me, not by autopsy.

The autopsies of the victims in this case are not incongruent with criminal wrong-doing, and, at least from a medical point of view, they are not the only evidence that can or should be used to understand what happened. Perhaps it is different from a legal point of view. I defer to anyone with a better understanding, for I surely do not know.

JME and JMO.

 

[Sundial]

As I said I’m shocked nobody spoke with her at all, not even once. it could have been approached as politically and as tentatively as possible and been well within the law but that didn’t happen. One might think a senior head would open that discussion as a midway between acknowledging staffs concerns and acting on it and bearing in mind that there is two sides to that situation. That wouldn’t be putting anyone at risk. From the seniors POV nobody is at risk just because some staff have concerns.

We don’t know that yet either (if someone spoke to her). Saying that, there was a doctor asking questions when she walked into the treatment room where she then messaged “do I need to be worried”.

Previous comments too which seems reflective in her messages of the “not so nice comments” as she put it, and heard in evidence where people were expressing thoughts about her role etc.

MOO