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

[Tortoise]

Is it that dr evans says there was air injected the night before when LL wasn’t on shift; therefore , based on that , LL couldn’t have caused the death . But by then saying that the air from the previous night wasn’t so bad, and saying that there was actually another “dollop “ in the morning when LL was on shift, dr evans brings it back round to LL being a murderer (allegedly )

LL was on shift the day before and fed him before handover to night-shift staff and his x-ray at 8pm revealed "striking gaseous distension throughout the stomach and whole bowel". She was also still in the unit writing up her notes for baby O at 8.51pm.

 

[Jazmania]

Thanks very much .

So what is dr evans referring to when he says the following:

“Mr Myers accuses Dr Evans of trying to fit his evidence to when Ms Letby was on shift. He says he 'cannot be accused of putting anyone in the frame' as his evidence also relates to the night shift before Ms Letby was working”

What evidence is he pointing to which doesn’t implicate LL?

I'm not sure really. I think the Chester Standard said something about a 'Brady' in the night, but they attributed that to being destabilised by the earlier gas when LL was on shift.

 

[Tortoise]

Thanks very much .

So what is dr evans referring to when he says the following:

“Mr Myers accuses Dr Evans of trying to fit his evidence to when Ms Letby was on shift. He says he 'cannot be accused of putting anyone in the frame' as his evidence also relates to the night shift before Ms Letby was working”

What evidence is he pointing to which doesn’t implicate LL?

"He said he was "more concerned" from his evidence at the time about the night care, when Child P was not taking feeds and had a bradycardiac event.

He adds he does not believe Child P would have collapsed without an additional administration of air in the morning.

Mr Myers says Dr Evans has "shunted" the sequence to the point where Lucy Letby was on duty for that day shift on June 24. Dr Evans denies this, saying if he was wanting to put Letby in the frame, he would have included events from the June 23 day shift, when Letby was also on duty."

and

"He says Child P could have been suffering the consequences of an administration of air from the previous night by the following morning, but that would have been insufficient to cause a collapse, not without a further administration of air."


By my readng, he's saying he excluded the air administered the night before from the sequence that precipitated his collapse at 9.30am and subsequent death. If he was going after LL he would have included the air present at 8pm.

 

[JosieJo]

Thanks very much .

So what is dr evans referring to when he says the following:

“Mr Myers accuses Dr Evans of trying to fit his evidence to when Ms Letby was on shift. He says he 'cannot be accused of putting anyone in the frame' as his evidence also relates to the night shift before Ms Letby was working”

What evidence is he pointing to which doesn’t implicate LL?

I think Dr Evans is saying is according to the roster LL shouldn't have been there ..but she stayed over a little

 

[Tortoise]

11:30am

Dr Bohin confirms she had looked through all the clinical notes for Child P, including one by Lucy Letby where she had written about the NG tube being on free drainage at 8am.
A note at 6.39am by Sophie Ellis, from the night shift, said Child P's abdomen was 'soft and non distended', with '25mls air aspirated' and 'NG Tube placed on free drainage'.
Letby later noted, at about 9.30am, Child P had an apnoea, brady, desat with mottled appearance, requiring facial oxygen and Neopuff for approx 1min. Abdomen becoming distended.'
A consultant doctor was called to the nursery where Child P was.

11:41am

Child P had a 'speedy recovery' that morning and Dr Bohin is asked if that was normal.
Dr Bohin: "No, it was not."
Child P then desaturated again at 11.30am and was given adrenaline and paralysed with a drug to aid ventilation. His circulation was restored but he continued to deteriorate throughout the day.

Recap: Lucy Letby trial, Thursday, March 23

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

 

[Tortoise]

11:51am

Dr Bohin is now telling the court about the adrenaline doses which were administered to Child P throughout June 24, their concentrations and totals.

Recap: Lucy Letby trial, Thursday, March 23

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

 

[Sundial]

Management didn’t appear to have any concrete evidence against LL when they took her off duty , only what the doctors were saying.

Normal management practice in my opinion would be once you have taken her off duty, to begin an investigation to see if there was in fact any merit to what the doctors were saying or not. The impression I’m getting is that hospital didn’t start any proper investigation for nearly 11 months after she was taken off the ward and instead hoped they could just get her back on the ward by wearing down the doctors by repeatedly trying to put her back on duty. When that failed, I suppose they had no choice but to fully commit to an investigation into the collapses ; or else put LL back on duty and risk the other medics rioting and refusing to work .

In all of this sadness, however this has unfortunately panned out, the doctors should be commended by trying to speak out about their concerns and in a way “blocking” her return to work until management took action. I know its definitely not easy in debating with management with a genuine concern about a colleague; and most certainly where patient safety is concerned. Such a sad, very tragic shame they weren’t listened to even with the triplet cases and management were still pushing back trying to get her reinstated.
JMO

 

[katydid23]

Dan O'Donoghue


Dr Sandie Bohin is now in the witness box, she was approached to review Dr Evans' findings

Dr Bohin tells the court that Child P's first collapse on the morning of 24 June was 'very abnormal' as it was a 'a collapse with no prior indication'

We're now returning to the point Mr Myers raised yesterday about the adrenaline doses given to Child P on 24 June - he put it to a doctor that the amount of adrenaline was in excess of the ideal amount for a neonate, the medic agreed

Dr Bohin is talking the jury through a drugs chart for Child P. Prosecutor Nick Johnson says that a 'mistake is made' by the prescriber of adrenaline. Child P was administered with 'precisely double' the intended dose

[What the heck? Did we ever hear about the double dose mistake before?]

 

[Tortoise]

Also, dr evans really does has the most extraordinary phrasing of any medical expert I have heard. “A dollop of air “ sounds like something child would say .

perhaps it subconsciously reflects something that only a child would do, to a doll, not a nurse with a baby.

MOO

 

[Tortoise]

11:55am

Dr Bohin explains the rate of adrenaline administered to Child P, according to the medical notes, was not calculated correctly - it was double what it should have been.

Recap: Lucy Letby trial, Thursday, March 23

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

 

[Tortoise]

11:58am

Dr Bohin says the excess adrenaline would not have had any adverse effect, as it began to be administered after Child P had the collapse and was already suffering metabolic acidosis.
She says it is "impossible" to quantify any effect on lactic acidosis.
It did not adversely affect the blood pressure or heart rate, Dr Bohin adds.

Recap: Lucy Letby trial, Thursday, March 23

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

 

[Tortoise]

I wonder who was doing the calculations, would that be a doctor? or is that similar to the evidence we heard in an earlier case where a chart was missing and the designated nurse did the calculations.

JMO

 

[katydid23]

11:55am

Dr Bohin explains the rate of adrenaline administered to Child P, according to the medical notes, was not calculated correctly - it was double what it should have been.

Recap: Lucy Letby trial, Thursday, March 23

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

Meyers is going to have a field day with that mistake of double dosage!

 

[Tortoise]

12:01pm

Dr Bohin tells the court she was concerned about the gas in the initial abdominal x-ray, which had been taken as a 'precaution' with no concerns about the abdomen, but it was "full of gas" and "abdominal distention right through".
The x-ray was "abnormal".
Throughout the night, Child P became intolerant to feeds, and the abdominal distention was reduced, but then Child P's abdomen became "distended and loopy" in the morning. That was "difficult to explain".

Recap: Lucy Letby trial, Thursday, March 23

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

 

[katydid23]

I wonder who was doing the calculations, would that be a doctor? or is that similar to the evidence we heard in an earlier case where a chart was missing and the designated nurse did the calculations.

JMO

Donaghue said:

Child P. Prosecutor Nick Johnson says that a 'mistake is made' by the prescriber of adrenaline. Child P was administered with 'precisely double' the intended dose

[so does a prescriber refer to the attending doctor? Could it have been Dr Choc?]

 

[Tortoise]

12:03pm

Dr Bohin says Child P should have had a further x-ray sooner after he first collapsed, and more attention paid to the pneumothorax.

12:04pm

The ventilatory pressures were "quite high" for Child P, who had no underlying lung disease.
This was not a criticism of the staff, Dr Bohin says.

Recap: Lucy Letby trial, Thursday, March 23

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

 

[Tortoise]

12:06pm

For a cause to the collapse, Dr Bohin says she could find no reason why there was excess air from the previous night, and there was splinting of the diaphragm.
It was something "striking and out of the ordinary".
Child P had shown no signs of infection, and no evidence was found.
Dr Bohin says her conclusion was air had been administered via the NG Tube.
She cannot explain why Child P had further collapses on June 24.

Recap: Lucy Letby trial, Thursday, March 23

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

 

[Tortoise]

I'm going to be off for a couple of hours if anyone wants to post updates

Recap: Lucy Letby trial, Thursday, March 23

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

 

[katydid23]

Dan O'Donoghue


Dr Bohin said: 'I don’t think it had any adverse effect in that the infusion was started after (Child P) had at least two of his collapses' - she notes his heart rate or blood pressure didn't rise (which can happen as a result of adrenaline doses)

[ I think they might be on lunch break now?]

 

[Imogenia]

I wonder if there'll be a drive for CCTV in hospitals off the back of this.

Such a drive would encourage parents to participate vociferously. They would consider what they could do as well, (to ensure safety of babies in hospitals). I don’t see parents or grandparents sitting around passively at all once they know how management reacted to the experienced consultants’ concerns in this case.