UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #19

[Sweeper2000]

Why do you say it magically disappeared? There's been no medical evidence or witness evidence to this effect. All we've heard is: (Lucy Letby: ‘Unusual’ presence of blood in throat of baby).

"Alder Hey anaesthetist Dr Francis Potter told jurors that he did not see blood or swelling in Child N’s throat when he successfully inserted the breathing tube." BBM

As for Dr Gibbs - "He 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."

The swelling subsided because of the adrenaline that was provided, and the blood too. Dr Potter wasn't asked and didn't respond about seeing traumatic injury or bruising, he's only commented on not seeing swelling or blood. Which makes sense as that is what he would be focused on when trying to intubate. An injury to the upper airway as Dr Evans has said wouldn't necessarily be picked up by anyone not looking for it - bruising takes time to develop even in adults, and even if spotted later on, the assumption at Alder Hey would have been it's due to failed intubation at CoCH. They wouldn't have realised the blood appeared before intubation.

Also Dr Potter was an anaesthesist - so doubt he would have been looking for trauma or injury to the upper airway, just called to help intubate.

The way I was reading it was that the respiratory problems necessitated immediate treatment ie intubation if that wasn’t possible a tracheotomy was planned. That to me sounds like the docs would continue with baby n up until successful intubation or if necessary tracheotomy. Not wait four hours for the ah team to arrive. If the swelling or whatever the problem was seen right up until that cardiac issue and then literally disappeared when the ah team arrived what was the actual problem? As I say swelling doesn’t just disappear without a trace, as far as I know the strongest anti inflammatory drugs aren’t capable of that so for the ah specialist to not see a single trace of injury or swelling so soon after it was reported by the coch team might mean whatever was causing the problem had rectified itself or wasn’t present in the first place. I can assure you dr potter will have full knowledge of what a throat looks like and is as good as any to see swelling, injury or blood. That’s quite literally his job.

four hours after this problem ie swelling was last seen and then the adrenaline might explain why it wasn’t noticed but the injury should still be there. I’m not really questioning the blord as it would only be present with an open injury, the swelling or injury itself would still be there especially with a baby whose wounds do not close easily as is haemophiliac.

 

[Sweeper2000]

It doesn't say there was any further episodes of swelling after leaving the unit at all. It just says there were "episodes of “apnoea” in which he would temporarily stop breathing."

The swelling causes the apnoea by restricting air flow, in an anaphylactic reaction swelling is normal. Imo

my point remains that swelling doesn’t disappear completely and the ah doc saw no swelling, blood or injury otherwise it would be reported and in line with the alleged injury.

 

[Jazmania]

The way I was reading it was that the respiratory problems necessitated immediate treatment ie intubation if that wasn’t possible a tracheotomy was planned. That to me sounds like the docs would continue with baby n up until successful intubation or if necessary tracheotomy. Not wait four hours for the ah team to arrive. If the swelling or whatever the problem was seen right up until that cardiac issue and then literally disappeared when the ah team arrived what was the actual problem? As I say swelling doesn’t just disappear without a trace, as far as I know the strongest anti inflammatory drugs aren’t capable of that so for the ah specialist to not see a single trace of injury or swelling so soon after it was reported by the coch team might mean whatever was causing the problem had rectified itself or wasn’t present in the first place. I can assure you dr potter will have full knowledge of what a throat looks like and is as good as any to see swelling, injury or blood. That’s quite literally his job.

four hours after this problem ie swelling was last seen and then the adrenaline might explain why it wasn’t noticed but the injury should still be there. I’m not really questioning the blord as it would only be present with an open injury, the swelling or injury itself would still be there especially with a baby whose wounds do not close easily as is haemophiliac.

The link that Tortoise just posted says the COCH last attempted to intubate 4 hours previously. It was the Alder Hey team that had the strategy to attempt to intubate before doing a tracheostomy.

An injury to the upper airway could potentially be below or further down the airway than seen by the doctors. Or Dr Evans said such an injury may not always be observable

 

[Dotta]

The way I was reading it was that the respiratory problems necessitated immediate treatment ie intubation if that wasn’t possible a tracheotomy was planned. That to me sounds like the docs would continue with baby n up until successful intubation or if necessary tracheotomy. Not wait four hours for the ah team to arrive. If the swelling or whatever the problem was seen right up until that cardiac issue and then literally disappeared when the ah team arrived what was the actual problem? As I say swelling doesn’t just disappear without a trace, as far as I know the strongest anti inflammatory drugs aren’t capable of that so for the ah specialist to not see a single trace of injury or swelling so soon after it was reported by the coch team might mean whatever was causing the problem had rectified itself or wasn’t present in the first place. I can assure you dr potter will have full knowledge of what a throat looks like and is as good as any to see swelling, injury or blood. That’s quite literally his job.

four hours after this problem ie swelling was last seen and then the adrenaline might explain why it wasn’t noticed but the injury should still be there. I’m not really questioning the blord as it would only be present with an open injury, the swelling or injury itself would still be there especially with a baby whose wounds do not close easily as is haemophiliac.

Good thing we have a doctor here

 

[ColourPurple]

The swelling causes the apnoea by restricting air flow, in an anaphylactic reaction swelling is normal. Imo

my point remains that swelling doesn’t disappear completely and the ah doc saw no swelling, blood or injury otherwise it would be reported and in line with the alleged injury.

They've only mentioned there were "episodes of “apnoea” in which he would temporarily stop breathing."". There is no mention of anaphylactic reactions or of swelling. You're adding those details yourself.

AFAIK none of the doctors reported seeing an actual injury, just the blood and swelling. That doesn't mean there was no injury or source of the blood or that they'd imagined everything.

With Baby G the blood was said to have been coming up into the throat from beneath the vocal chords, so if it was the same as that, and any injury was beyond the vocal chords, the injury may not have been visible even when the swelling (and bleeding) subsided.

 

[Sweeper2000]

The link that Tortoise just posted says the COCH last attempted to intubate 4 hours previously. It was the Alder Hey team that had the strategy to attempt to intubate before doing a tracheostomy.

An injury to the upper airway could potentially be below or further down the airway than seen by the doctors. Or Dr Evans said such an injury may not always be observable

It’s reported


“Child N collapsed just before 3pm and a consultant was called at 2.59pm. While awaiting a consultant, a junior doctor looked into the airway of Child N and saw a “large swelling at the end of his epiglottis” he could only just see the bottom of the vocal cords. He had never seen anything like this before in a newborn baby.”

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

I think that’s the relevant part. should be able to have full vision of that but the sight of swelling and presumably injury is blocking seeing further down. I have heard nothing about the potential for there to be zero swelling let alone injury at that point in time.

 

[Sweeper2000]

They've only mentioned there were "episodes of “apnoea” in which he would temporarily stop breathing."". There is no mention of anaphylactic reactions or of swelling. You're adding those details yourself.

AFAIK none of the doctors reported seeing an actual injury, just the blood and swelling. That doesn't mean there was no injury or source of the blood or that they'd imagined everything.

With Baby G the blood was said to have been coming up into the throat from beneath the vocal chords, so if it was the same as that, and any injury was beyond the vocal chords, the injury may not have been visible even when the swelling (and bleeding) subsided.

Wasn’t a statement was a suggestion about a possible allergen being responsible for the problem Including those further episodes of unexplained apnoea which obviously have nothing to do with the up until yesterday enigmatic defendant. Not unreasonable considering the lack of evidence of an injury.

would still be interested to hear if this problem could have been caused by some form of drug or other possible allergen for instance meropenem.

 

[marynnu]

It’s reported


“Child N collapsed just before 3pm and a consultant was called at 2.59pm. While awaiting a consultant, a junior doctor looked into the airway of Child N and saw a “large swelling at the end of his epiglottis” he could only just see the bottom of the vocal cords. He had never seen anything like this before in a newborn baby.”

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

I think that’s the relevant part. should be able to have full vision of that but the sight of swelling and presumably injury is blocking seeing further down. I have heard nothing about the potential for there to be zero swelling let alone injury at that point in time.

I don't understand. When has anyone reported seeing an injury?

 

[Sweeper2000]

I don't understand. When has anyone reported seeing an injury?

Alleged injury.

eta it’s kind of the fact that no one saw it that makes me think it likely didn’t exist which makes me think, swelling and apnoea might suggest the anaphylactic reaction or just bodily reaction to some other unknown aggravating factor like meropenem.

 

[Parker Knoll]

Sweep - you do realise that the best medical teams available have been through this ENDLESSLY with a fine stethoscope?

 

[marynnu]

Alleged injury.

eta it’s kind of the fact that no one saw it that makes me think it likely didn’t exist which makes me think, swelling and apnoea might suggest the anaphylactic reaction or just bodily reaction to some other unknown aggravating factor like meropenem.

That's a big assumption. I have no idea what happened, but you could argue equally that if something was forced through/past the epiglottis to cause an injury and bleeding further down the airway it might well cause some swelling.
Why do you mention meropenem as an aggravating factor?

 

[ColourPurple]

Wasn’t a statement was a suggestion about a possible allergen being responsible for the problem Including those further episodes of unexplained apnoea which obviously have nothing to do with the up until yesterday enigmatic defendant. Not unreasonable considering the lack of evidence of an injury.

would still be interested to hear if this problem could have been caused by some form of drug or other possible allergen for instance meropenem.

You said it to suggest a cause for what you said were further incidents of swelling, but there were no further incidents of swelling. There were only incidents of apnoea. You're inventing things to fit your theory.

 

[Sweeper2000]

Sweep - you do realise that the best medical teams available have been through this ENDLESSLY with a fine stethoscope?

I appreciate that really I do. I don’t think dr evans is one of the best. Jmo

That's a big assumption. I have no idea what happened, but you could argue equally that if something was forced through/past the epiglottis to cause an injury and bleeding further down the airway it might well cause some swelling.
Why do you mention meropenem as an aggravating factor?

poss Aggravating factor, only thing is this child was never given anti bios so not sure if it’s applicable but is known to cause symptoms similar to anaphylactic shock. Just I don’t think the swellings disappearing act is in line with the alleged injury.

jmo

 

[ColourPurple]

Alleged injury.

eta it’s kind of the fact that no one saw it that makes me think it likely didn’t exist which makes me think, swelling and apnoea might suggest the anaphylactic reaction or just bodily reaction to some other unknown aggravating factor like meropenem.

Just because you can't see the source of something doesn't mean that the most likely explanation is that it didnt exist.

 

[Jazmania]

It’s reported


“Child N collapsed just before 3pm and a consultant was called at 2.59pm. While awaiting a consultant, a junior doctor looked into the airway of Child N and saw a “large swelling at the end of his epiglottis” he could only just see the bottom of the vocal cords. He had never seen anything like this before in a newborn baby.”

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

I think that’s the relevant part. should be able to have full vision of that but the sight of swelling and presumably injury is blocking seeing further down. I have heard nothing about the potential for there to be zero swelling let alone injury at that point in time.

I'm sorry I'm not sure I understand your point. The doctor couldn't see because of swelling. That's the whole argument of the prosecution. How did that swelling get there? The witnesses said they saw swelling and in some cases blood. That's different to seeing an injury. Swelling and blood are indicative of an injury. The injury could be further down the windpipe where it would be unseen. Swelling will also appear quickly, while other aspects of injury like bruising will take hours to develop.

However I'm not a medical expert. I'm relying on the testimony of people who are. If the defence have experts who will testify to what you're saying, then I'll take your theory more seriously.

 

[Sweeper2000]

You said it to suggest a cause for what you said were further incidents of swelling, but there were no further incidents of swelling. There were only incidents of apnoea. You're inventing things to fit your theory.

Tbh think I was confusing the evidence with the symptoms of anaphylactic shock. My mistake. It is possible for any swelling to have been missed In those further unexplained instances of apnoea which are obviously not related to the defendant. Hence my suggestion why the bodily reaction could potentially be caused by some other aggravating but unknown factor, That may be the true reason for the alleged events in regards to child n.

 

[Sweeper2000]

Just because you can't see the source of something doesn't mean that the most likely explanation is that it didnt exist.

But does it once there is something that indicates what is alleged didn’t happen like what seems to be the swelling disappearing without a trace?

 

[Dotta]

I don’t think dr evans is one of the best.

Objection!

The Expert Dr Evans was not treating this patient!

The doctors at CoCh Hospital were, and wrote down their observations.

PS
It is very rude to write somebody's surname starting with small letter.

JMO

 

[Sweeper2000]

Would like to ask anyone here in personal or professional experience, what’s the quickest you have ever seen swelling related to trauma subside to no swelling at all?

my experience always more than 24 hours. At a guess reduces by two thirds quite quickly.

 

[Sweeper2000]

Objection!

The Expert Dr Evans was not treating this patient!

The doctors at CoCh Hospital were, and wrote down their observations.

PS
It is very rude to write somebody's surname starting with small letter.

JMO

He was the origin of the alleged injury in diagnosis and other alleged events.

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