UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #2

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Updates from court today.

Prosecution continues with the Child C - born weighing just 800g​

Child C, the prosecution claim, was murdered by Letby on 14 June.
He was, like many children in this case, born premature - prosecuting, Nick Johnson KC describes him as "significantly premature".
He weighed just 800g (less than 2lbs) when he was born, although he is described as "in good condition".
Although he initially showed signs of breathing distress, after a number of days his respiratory support was reduced and he began to manage to breath independently.
When the nurse checked Child C's stomach contents, they founded traces of bile - an early sign of necrotising enterocolitis (NEC), a serious gastrointestinal disease where a portion of the bowel becomes inflamed and may die.
As a result, the hospital temporarily stopped his feeds - but just hours later Child C was fine, and a decision was made to re-institue milk feeds.

The night shift of 13 June​

On the night shift of 13 June, beginning at 8pm, a different - less qualified - nurse was allocated responsibility for caring for Child C as he was seen to be stable.
Letby was assigned the care of another child, given the initials of JE, who was considered to be deteriorating. He was grunting, a "potential red flag for breathing problems". JE is not a child mentioned in the indictment.
The shift leader told Letby she had to keep a close eye on JE and "this was a message that [the shift leader] had to reinforce later in the shift when it became clear that Letby was ignoring her," Mr Johnson tells the court.
When Child C's assigned nurse left to go to the nursing station, she heard his alarm go off.
"When she went back into room one, there was Lucy Letby, standing next to Child C's cot," says Mr Johnson.
He says she had "no business" in that room.
At this point, Child C was desaturating - his oxygen levels were dropping - and his heart rate was going down.
He had "suffered a serious deterioration" and "there again at the bedside, or the incubator side, was Lucy Letby", the prosecution tells the court.
 
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I agree. I don't mind them being cautious about medical details, but having her name and face in the media contradicts a fair trial in my opinion. It's such an emotive case, that if she's found Not Guilty, she'll be in more danger from vigilantes outside prison than within.
They won't - you would only receive compensation for being held on remand for 2 years if you show that significant errors were made in the decisions to charge you or the court was misled when deciding on remand, or the law was applied incorrectly. Not sure there's any real avenue to get compensation for any of the rest of it. One imagines she would still be paying a mortgage on a house she was not allowed to live in while on police bail for 2 years. And may have been prevented from speaking to friends and former colleagues for the past 4 years.

Even if she's guilty I think this has taken far too long and makes a mockery of Article 5 of the ECHR, but apparently over 10% of people on remand have been held more than a year and over 10% of those held on remand are acquitted at trial - suggesting that at any given time, there are multiple innocent people who have been on remand for over a year. All of whom will come out to likely no job, bills but no pay for a year, significant debts, often no house (though they may have had one before) and they'll be lucky to get a "sorry for the inconvenience" from the state.

Even people whose convictions are overturned after spending years in prison can now only get compensation if they can prove to the courts satisfaction that they are actually innocent - rather than merely not guilty beyond reasonable doubt.
 

texted colleague she wanted to be in room with Child C - for her own wellbeing​

Staff tried to assist with Child C's breathing, using a "neopuff" device to help him breathe.
Although he quickly recovered within a short time, he had prolongued periods of low oxygen and his heart rate slowed.
Nick Johnson KC tells the court: "You might get the impression from this case that babies collapsing was a common event in the neonatal unit – after all this was the 3rd in a few days - but this was the first time Child C's assigned nurse had ever seen a collapse and resuscitation - that's how uncommon it was."
Her colleague says Letby told her: "He's going, he's going."
"She was right," Mr Johnson says.
He says Letby was unhappy with being assigned to a different room to Child C.
He tells the jury: "She texted an offduty colleague saying that she, Lucty Letby, wanted to be in room number one, saying it would be cathertic for her, it would help her wellbeing, to see a living baby in the space previously occupied by a dead baby - Child A - a baby who had died a few days earlier.
"But the shift leader had put her in room three. So she didn't like it

Child C's death was a 'refinement of the theme' Letby had started with Children A & B​

Child C was pronounced dead just before 6am on the 14 June 2015.
At thge time, the consultant pathologist gave the cause of death as "widespread hypoxic/ischaemic damage to the heart/myocardium due to lung disease".
Child C's vocal cords were "swollen" - something the prosuection say is a reoccuring feature in this case.
Independent medical experts who reviewed the cases thought that infection was a "significant factor" in Child C's collapse, "but did not adequately explain it".
"The damage to his heart was the result of, rather than the cause of his collapse," says Nick Johnson, KC.
A second doctor said "althought Child C had pneumonia at the time of his death, she believed that was not the cause of death".
She said Child C's collapse was concerning and had no clear cause.
Her view was "the only feasible mechanism" for the excessive air in the gut at the time of the collapse was the deliberate introduction of air via the nasal gastric tube.
"This was a variation - or refinement - of a theme Lucy Letby had started with Children A and B," says Mr Johnson

'An effective way of murdering babies in a neonatal unit'​

The jury has been shown a diagram to explain how inflating a babies stomach with air or excess milk can "stop a baby breathing".
"If you are trying to murder a child in a neonatal unit it's a fairly effective way of doing it - it doesn't really leave much of a trace," says Nick Johnson KC.

Letby was interewed in 2018 and denied she had had anything to do with Child C "other than during the resuscitation".

Prosecuting, Mr Johnson says: "She said she had not been the person who had discovered the problem with Child C, although her texts put her in that room."

A year later, Letby agreed she had been the only person in the room when Child C collapsed.

Less than 24 hours after Child C had died, at 3.52pm, Letby searched on Facebook for his parents. Given she had come off duty at 8am, "the timing may suggest this was one of the first things she did having woken up".
 
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Child C, who was alive when the nightshift started at 8pm on 13 June, and deceased by 6am on 14 June, was described in the original charges as having been murdered between 12 and 15 June. (I can't link because his name was given in MSM at that time.)

I wonder why? Was there originally some suggestion that the wheels were set in motion for his death a day earlier?
 
[The Chester Standard coverage is slightly different, I'll post it in case it has additional info.]

11:08am

We are hearing evidence on Child C's death.
Dr Dewi Evans heard that infection was a "significant factor" in Child C's collapse, but could not adequately explain it.
He had concerns about Child C's sudden deterioration.
The cause of death was ‘widespread hypoxic/ischaemic damage to the heart/myocardium’ due to lung disease, with maternal vascular under perfusion as a contributary factor.

11:12am

As was the case with Child B, the prosecution say, Lucy Letby was not the designated nurse for Child C, a baby boy. Letby was assigned to look after a baby girl, and the leading nurse had to reinforce this assignment when, the prosecution say, Letby was 'ingnoring her'.

11:13am

A medical expert concluded Child C was killed by air "deliberately put into the nasal gastric tube".
The prosecution say this was a "variant or refinement of a theme Letby had started with the twins".

11:15am

The prosecution added an independent pathlogist said the skin colour changes in Child C were likely caused by prolonged unsuccessful resuscitation.
Child C had pneumonia, but the pathologist concluded Child C died as a result of having an excessive quantity of air injected into his stomach via the nasogastric tube (NGT).

11:19am

The court has heard Child C was being looked after by a nurse less qualified than Lucy Letby and had been given the responsibility as Child C was stable.
That nurse had left to go to the nurses station in the hospital. While there, she heard Child C's monitor sound an alarm.
Upon her return, Letby was already in the room, standing next to Child C's cot.
It was the third baby to have suffered a serious deterioration in the matter of a few days, the court heard.

11:20am

Letby was the only nurse who had been on duty for all three collapse incidents for Child A, B and C.

11:22am

In police interview, Letby denied she had anything to do with Child C, other than with the resuscitation.
She could not remember why she had ended up in nursery 1.
In a second interview, asked about texts which had been found on her phone placing her in that room, Letby said that she might have been sending them from the nurses’ station and then gone into room 1 “to do something else”.
She then agreed that she had been the only person in the room when Child C had collapsed.

11:24am

After finishing her shift, Letby searched on Facebook for Child C's parents.
The prosecution say this would've been one of the first things she would have done after that night shift ended.
Mr Johnson, for the prosecution, added Letby would have been the only adult in the room when Child C collapsed, as was the case with Child A, and was one of only two in the room when Child B collapsed.

11:25am

"What we are going to see as we progress is that Lucy Letby’s method of attacking the babies in the neonatal unit was beginning to develop," Mr Johnson tells the court.

11:27am

Child D - murder allegation from June 2015
Child D was a baby girl, born as 'full-term' (ie not premature).
The court hears there is valid criticism for the hospital as the mother should have been given antibiotics to stave off infection, after her waters broke early, but she was not.
Although born healthy, Child D "lost colour" and "became floppy" in her father's arms. She was put under observation as she was showing signs of respiratory distress, by grunting, and her temperature dropped.

11:29am

Child D was admitted to room 1 in the neonatal unit, placed into an incubator, and given oxygen therapy and antibiotics.
She developed a very high temperature and a rise in her heart rate.
She was inturbated, and ventilated. She improved "significantly, but was still affected by her infection".

 
11:32am

Child D had catheters inserted and the levels of infection dropped.
"All good signs," Mr Johnson tells the court.
A designated nurse other than Letby was assigned care for Child D in room 1 on the night-shift, along with a different child in room 2.
Letby was the designated nurse for the two other babies in room 1.

 
11:34am

On that night-shift, Child D collapsed three times. The first at about 1.30am, the second at 3am, and finally at 3.45am.
Mr Johnson: "On each occasion, those attending were struck by the sight of mottling, poor perfusion and brown/black discolouration to her skin, mainly over the trunk.
"We've heard that sort of thing before, haven't we?
"The prosecution say that this was another case of injecting a child via an IV air embolus."

 
11:36am

At 1.15am, the designated nurse checked Child D, recording observations.
At 1.25am, the designated nurse and Letby noted the starting of an infusion.
An aspirate - drawing liquid through the nasogastric tube - is noted at 1.30am.
At 1.29am a doctor noted "an unusual...spreading, non-blanching rash" on Child D.

 
11:41am

There is a note in Lucy Letby's records she was engaged in the care of a different baby at the time, but the prosecution say nursing notes suggest Letby and the designated nurse called the doctor to the room.
The prosecution allege either the notes recorded were simply inaccurate, or Letby was setting herself up with an alibi in someone else's medical records.
Child D was successfully resuscitated.
At 2.40am, medication was administered by Letby and the designated nurse, who then left to another room.
But Child D then collapsed at 3am. Letby was in the room, the designated nurse was not, and no-one else had a reason to be in the room.

 
11:43am

Child D was resuscitated again but, according to the prosecution, Letby "did not leave things there".
At 3.20am, there is a record of Letby starting an infusion and Letby appears to have remained in the room, as a record shows her caring for another baby in the room at 3.30am.
At 3.45am, Child D suffered her third and final collapse. CPR began and Child D was pronounced dead at 4.25am.
The coroner gave the cause of death as "pneumonia with acute lung injury."

 
11:45am

Medical expert Dr Dewi Evans, the prosecution says, observed that a child "exhibiting a window of near recovery on two occasions followed by another collapse was not consistent with the fatal evolution of antenatal pneumonia."
He added the "abdominal discolouration was indicative of air embolus".

 
11:48am

Another medical expert said the clinical status of Child D the previous night was not that of a deteriorating baby who would be dead a few hours later.
She added the injection of '3-5ml per kilogram' of air would be sufficient to kill.
Child D had been observed in distress prior to her death, and the medical expert added this would also be consistent with cases of air embolus (air injected into the system).

 
11:50am

The court is told none of the medical staff on duty that night had also been present for the collapses of Child A, B or C - other than Letby.
For nursing staff, two of the nurses had been on duty for one each of the other collapses.

 
11:53am

Letby, in police interview, said she "cannot remember" how she got involved.
She seemed to accept that she had administered medication with a syringe at 1.25am – 5 minutes before the first collapse.
In a June 2019 police interview, she said she could not remember calling back the doctor when Child D collapsed, but it was possible she had.
It was put to Letby, in November 2020, that she had searched for the parents of Child D on Facebook.
She said that she could not recall but accepted she had done so. She said she could not explain why she had done it.

11:53am

The prosecution said: "We suggest that if you searched for that family of a baby who you had seen die you would know and remember why you had done it."

 
11:54am

Letby was asked about a text message in which she had referred to "an element of fate" being involved.
She said that it was 'fate that babies get unwell sometimes' but that she would have to know the context.
The prosecution say for Child D, her bad luck, or fate, was the fact Letby was working in the neonatal unit.

 
Yeah that's got to be a lie. You don't forget repeatedly searching for the victims families on Facebook. It reminds me of someone I know who will compulsively lie even when clearly caught out.

I hope she won't say "I can't remember" for everything she's asked.

It won't look good.

Especially later on in the trial when she'll be asked some very difficult questions......
 
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