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

[DianaWW]

I also think, with autopsies, they can give a cause of death, but that doesn’t mean they can say how or why it occurred. For example the liver trauma. They know it was there, that’s indisputable. But the autopsy can’t determine how it happened. JMO.

 

[GoodDayToYouSir]

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.

So very sorry for your unimaginable loss x

 

[magikarpmagikarp]

So very sorry for your unimaginable loss x

That is very kind of you. I still feel she's always with me, and she's the reason for so much that I do.

 

[squish]

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

Agree, surely this will be interesting for the defense?

 

[notsure]

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.

You would also think that, if guilty, she would have been on her guard and watching out for people observing her. We've had no evidence of this being the case. IMO.

 

[katydid23]

I'm

I'm not sure of the date, but I don't think she looked after any patients after Baby Q?

I read that she worked 3 more shifts after Q, before she was taken off the floor, the following week.

 

[Sweeper2000]

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.

I believe evidence of incidences involving child abuse can be ascertained by looking at the children’s behaviour. If a child is normally happy, talkative etc and then becomes the opposite it is enough to go on. It’s different in this hospital scenario and say for instance if one of these autopsy reports came back with at least something do you think the seniors would have reacted differently?

you need at least something to go on or expect to get sued.

@Tortoise @magikarpmagikarp

i was thinking along those lines as well. It seems the experts opinions on the cod has actually taken precedence over the coroners. One looks at clinical history the other looks at physical causes of death. I’m wondering if there even would be a way for the coroner to conclude that AE was the cause of death? Anything th would be present after death that would give a solid sign of AE as a cause of death?

just guessing but its air, how would one determine its role in a death ?

Im not sure but shouldn’t the prosecution have covered it as it seems a weak point to me? whereas if they did say if it was an AE that killed these babies it would be difficult to determine in autopsy and that the stronger indicators are the clinical notes.

 

[Tortoise]

You would also think that, if guilty, she would have been on her guard and watching out for people observing her. We've had no evidence of this being the case. IMO.

a/ we don't know if anyone was observing what she was doing at all times and b/ no one saw her doing what she is alleged to have done so she could have been waiting for moments when others had their backs turned, were preoccupied, or absent.

One of the most obvious patterns in the evidence in this case is that people had just left the room, nurses and parents, when collapses occurred.

Would you expect there to be other evidence of her watching for people observing her?

 

[PoirotPink]

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.

Have just skimmed most of the messages in this thread, so apologies if I've misunderstood.

IMO, the main difference between schools and the NHS is accountability. In schools, safeguarding concerns are usually about the child's parents or caregivers. Teachers are "encouraged" to proactively report issues because not doing so would have worse repercussions for them personally.

Worst case scenario, in a school, the teacher reports a "safe" parent, the matter is investigated (by social workers or the police) and closed with no further action required. In this case, the teacher is deemed to have done their duty and would likely be told that they did the right thing to report their concerns. Conversely, if there were safeguarding concerns and the teacher did not report it, there would be questions over why and how they didn't notice.

In the NHS, IMO, there is likely to be a culture of denying accountability (especially amongst management), subconsciously so, even if no-one admits it. Workers with safeguarding concerns about their own colleagues, or the service they provide, would essentially be "whistleblowing". They may be seen as a troublemaker (by management) rather than someone who was trying to save patients or improve the service.

 

[katydid23]

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.

How do we know there weren't any conversations between senior staff and LL about any of these issues?

 

[katydid23]

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.

who was it who told the med director and do we know exactly what was said? I couldn’t envision it being senior staff and is close to the line of being official imo.

"You see I wouldn’t say reporting something is the same as telling someone something or in this context expressing concern."

If you want to report something, you go to your superiors to do so. That is the first step to making a formal report. If they tell you that you have nothing solid or verifiable in order to justify a report, then you cannot make one yet.

At that point there was nothing concrete.

 

[Sundial]

I believe evidence of incidences involving child abuse can be ascertained by looking at the children’s behaviour. If a child is normally happy, talkative etc and then becomes the opposite it is enough to go on. It’s different in this hospital scenario and say for instance if one of these autopsy reports came back with at least something do you think the seniors would have reacted differently?

you need at least something to go on or expect to get sued.

How do you look at children’s behaviour when they are toddlers, babies who are yet to speak?
In the instance of schools though (as per my example), not every child who is abused portrays the same “telltale” behaviour you might expect. Some children may become happier (attention, grooming), showered with gifts and affection. It is not that black and white.
But if you had a member of staff in a school who raised a concern (or a parent or anyone else for that matter), no matter how that child was behaving, there is a legal obligation to take action which is necessary under safeguarding responsibilities.

The only way this is different for a hospital is babies who can’t speak and yet even the doctors trying to protect them were dismissed. The problem here is premature babies who are likely to be poorly so an autopsy (as others have mentioned) may not provide a clear cut answer to your question. But even with babies who were poorly, those due to go home, their medical assessments by doctors and consultants which demonstrated how well they were doing; but dying is worrying.

The doctors raising concerns more than once by more than one person, is worrying. They had a spike in deaths (whether suspicious or not) and the senior nursing exec did not explore that. Even after the doctors are raising these concerns and the spike in deaths increases; there was still no action by her. It was the doctor who asked for her to be removed from shifts.

Just appalling IMO

 

[Sundial]

Have just skimmed most of the messages in this thread, so apologies if I've misunderstood.

IMO, the main difference between schools and the NHS is accountability. In schools, safeguarding concerns are usually about the child's parents or caregivers. Teachers are "encouraged" to proactively report issues because not doing so would have worse repercussions for them personally.

Worst case scenario, in a school, the teacher reports a "safe" parent, the matter is investigated (by social workers or the police) and closed with no further action required. In this case, the teacher is deemed to have done their duty and would likely be told that they did the right thing to report their concerns. Conversely, if there were safeguarding concerns and the teacher did not report it, there would be questions over why and how they didn't notice.

In the NHS, IMO, there is likely to be a culture of denying accountability (especially amongst management), subconsciously so, even if no-one admits it. Workers with safeguarding concerns about their own colleagues, or the service they provide, would essentially be "whistleblowing". They may be seen as a troublemaker (by management) rather than someone who was trying to save patients or improve the service.

It applies to the NHS and schools.
The working together to safeguard children is everyone’s responsibility..whistleblowing as you describe, yes, effectively. Sadly the alternative is unnecessary deaths/harm.

But the responsibility still remained with the senior exec to action it. MOO

EDA; The CQC is potentially more relevant to the health safeguarding legislation but a similar rule in duty of care has been massively overlooked in my opinion.

Ofsted safeguarding policy

www.gov.uk

 

[Dotta]

It applies to the NHS and schools.
The working together to safeguard children is everyone’s responsibility..whistleblowing as you describe, yes, effectively. Sadly the alternative is unnecessary deaths/harm.

But the responsibility still remained with the senior exec to action it. MOO

Ofsted safeguarding policy

www.gov.uk

I guess all the "actors" in this tragedy are sitting on needles and pins observing
the trial.

JMO

 

[katydid23]

You would also think that, if guilty, she would have been on her guard and watching out for people observing her. We've had no evidence of this being the case. IMO.

There is some evidence of her being on guard. For example, there is a pattern of the babies allegedly being attacked, right after her co-worker goes on break, or right after the parents leave the hospital room.

 

[marynnu]

I see today's hearing has been covered on the BBC news, not something you see very often. I guess it's made an impression.

 

[Dotta]

"I put it to her was she happy to take responsibility for this decision in view of the fact that myself and my consultant colleagues all wouldn’t be happy with nurse Letby going to work the following day.

“She responded she was happy to take that responsibility.

“We had further conversations with executives the following week and action was taken.”

https://www.itv.com/news/granada/2023-03-14/lucy-letby-tried-to-murder-baby-after-bid-to-remove-her-from-duties-refused

 

[Anxala]

You would also think that, if guilty, she would have been on her guard and watching out for people observing her. We've had no evidence of this being the case. IMO.

This is what I find so bizarre. If guilty, it suggests a level of 'nerve' on her part that borders on, well, the ridiculous. Almost to a farcical degree in that if this were a dark tv drama, we'd be collectively eye-rolling and saying, nope, not real life, no one could do what she's doing and expect to avoid detection. She was - colleagues on a break, in another room, attending to another baby notwithstanding - operating in plain sight imo and yet doesn't seem, based on what we've heard of her general behaviour, to have had the slightest idea that she could be under suspicion!

It's bizarre.

 

[marynnu]

This is what I find so bizarre. If guilty, it suggests a level of 'nerve' on her part that borders on, well, the ridiculous. Almost to a farcical degree in that if were this a dark tv drama, we'd be collectively eye-rolling and saying, nope, not real life, no one could do what she's doing and expect to avoid detection. She was - colleagues on a break, in another room, attending to another baby notwithstanding - operating in plain sight imo and yet doesn't seem, based on what we've heard of her general behaviour, to have the slightest idea that she's under suspicion!

It's bizarre.

Similar to Beverley Allitt perhaps? I know we have to be cautious about drawing parallels, but her behaviour strikes me as quite reckless. IMO.

 

[JosieJo]

Just wanted to add some context regarding the executive nurse mentioned in court today.
The consultant said he phoned "the on call executive" so presumably was on a week day after 6pm or a weekend day.
This nurse wasn't the hospital nurse director (chief nurse) she was senior nurse for the urgent care division...she would also not have been a executive nurse for maternity/ neonatal.
She just happened to be on call.
I can understand why she would not agree to suspend someone not from her division based on an "on call" phone conversation...but imo ..and jmo I would have expected an on call director to immediately phone the chief exec and / or the chief nurse / and / or the HR director to take further advice based on such a serious call.