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

[Tortoise]

3:30pm

Medical expert Dr Dewi Evans suggested Child A's collapse was "consistent with a deliberate injection of air or something else into [Child A]'s circulation a minute or two prior to deterioration," Mr Johnson told the court. Only Letby was present.
Another medical expert said the cause was "not some natural disease process, but a dose of air "deliberately administered".
An independent pathologist described the cause of death was 'unascertained', in that there was nothing in the autopsy that pointed to why Child A had died, but the cause was most likely 'exogenous air administration through the longline or UVC'.

3:31pm

Said explanations are also backed up, the prosecution say, by an independent radiologist.

LIVE: Trial of Lucy Letby accused of Countess of Chester Hospital baby murders

 

[Tortoise]

Now15:32

Child A 'most likely' died after being injected with air​

Multiple medical experts concluded the cause of Child A's collapse was "not some natural disease process".
One said his collapse was "consistent" with a "deliberate injection" a minute or two prior to his deterioration - at a time when only Lucy Letby was present.
Two doctors concluded his death was most likely caused by an injection of air into either his umbilical venous catheter (UVC) or his long line.
A radiologist concluded that "even allowing for post-mortem gases to develop, the gas pattern seen in the x-rays was unusual and in keeping with air being injected into Child A's bloodstream".

Lucy Letby trial - live: 'A poisoner was at work in the hospital' - Nurse accused of killing seven babies goes on trial
https://news.sky.com/story/lucy-let...n-trial-12716378?postid=4632301#liveblog-body

 

[cuecard]

So, not in good condition as far as newborn's go, then? This looks like very sloppy preparation, to be fair. OTOH it may be down the reporting not being 100% word perfect.

I don't think it is as black and white as that. Premature babies are at a higher risk of numerous issues due to being born too early. That's all well documented. Just because a premature newborn may be presenting as good condition at a specific time doesn't mean that can't rapidly change. It can and does.

 

[Marantz4250b]

A radiologist concluded that "even allowing for post-mortem gases to develop, the gas pattern seen in the x-rays was unusual and in keeping with air being injected into Child A's bloodstream".

Lucy Letby trial - live: 'A poisoner was at work in the hospital' - Nurse accused of killing seven babies goes on trial
Lucy Letby trial - live: 'A poisoner was at work in the hospital' - Nurse accused of killing seven babies goes on trial

One has to ask, then, as to why this wasn't investigated at the time. It's highly unnatural yet seems to have been ignored.

 

[JosieJo]

Now15:32

Child A 'most likely' died after being injected with air​

Multiple medical experts concluded the cause of Child A's collapse was "not some natural disease process".
One said his collapse was "consistent" with a "deliberate injection" a minute or two prior to his deterioration - at a time when only Lucy Letby was present.
Two doctors concluded his death was most likely caused by an injection of air into either his umbilical venous catheter (UVC) or his long line.
A radiologist concluded that "even allowing for post-mortem gases to develop, the gas pattern seen in the x-rays was unusual and in keeping with air being injected into Child A's bloodstream".

Lucy Letby trial - live: 'A poisoner was at work in the hospital' - Nurse accused of killing seven babies goes on trial
Lucy Letby trial - live: 'A poisoner was at work in the hospital' - Nurse accused of killing seven babies goes on trial

A radiologist concluded that "even allowing for post-mortem gases to develop, the gas pattern seen in the x-rays was unusual and in keeping with air being injected into Child A's bloodstream".

This is quite relevant in my opinion

 

[Tortoise]

3:36pm

When interviewed by police regarding the circumstances over Child A's death, Letby said she had given fluids to Child A at the time of the change of shifts.
She said within "maybe" five minutes, Child A developed 'almost a rash appearance, like a blotchy red marks on the skin'.
She said she had wondered whether the bag of fluid "was not what we thought it was".
In an interview in June 2019, Letby said she had asked for all fluids to be kept from the bag at the end to be checked, but the prosecution said there was was no record of her having made such a request.
It was suggested by police that Letby had administered an air emolus. She replied it would have been very hard to push air through the line.

3:38pm

In a November 2020 police interview, police put to her that Letby had tracked the family of Child A on Facebook. She said she had no memory of doing so but accepted it if there was evidence on her computer doing so.
The prosecution said there was evidence.

LIVE: Trial of Lucy Letby accused of Countess of Chester Hospital baby murders

 

[Tortoise]

3:40pm

Count 2: Child B attempted murder
Child B is the elder twin sister of Child A, born in June 2015. She required breathing support via a ventilator at birth.
Attempts to fit an umbilical vein catheter (UVC) twice failed, so a long line (IV) was inserted for fluids to be administered successfully.
Breathing support gradually lessened and Child B was stable.

LIVE: Trial of Lucy Letby accused of Countess of Chester Hospital baby murders

 

[Tortoise]

2m ago15:39

Letby searched for victims' families on Facebook after alleged attacks​

It was to be more than three years after Child A's death before Lucy Letby was arrested and interviewed.
In her first interview, Letby told police she had wondered at the time "whether the bag of fluid was not what we thought it was".
Prosecuting, Nick Johnson KC describes this as an "interesting turn of phrase" given that experts "have concluded that the poisoner put the insulin in the fluid bags" given to Child F and Child L.
Letby claimed she had asked for fluids to be kept from the bags "to be checked".
"There is no record of her having made such a request," says Mr Johnson.
Police later questioned Letby about why she had tracked the families of her alleged victims on Facebook.
"Lucy Letby's interest in the families of the children who we say she attacked is another feature of the case which we will see as the evidence emerges," he says.
"We suggest it is an unusual interest and we will see that on occasions she searched in quick succession for several of the families of children's names who appear on this indictment."

Lucy Letby trial - live: 'Baby A' died 90 minutes after 'poisoner' nurse came on shift, jury hears

 

[Tortoise]

3:44pm

A designated night-shift nurse was responsible for Child B. Shortly before midnight, the blood/oxygen levels had fallen to 75% and the Cpap nasal prongs were dislodged from Child B's nostrils. The nurse repositioned the prongs and the levels recovered.
Just after midnight, Letby started a bag of liquid feed with Child B, with the nurse, through an IV line.
At 12.16am Letby - while not Child B's designated nurse - took her blood gases.
About 28 hours after her twin brother had died, at about 12.30am, Child B's alarm sounded and Letby had called the nurse to the child's incubator. Child B was not breathing.

LIVE: Trial of Lucy Letby accused of Countess of Chester Hospital baby murders

 

[Sarahlou]

A radiologist concluded that "even allowing for post-mortem gases to develop, the gas pattern seen in the x-rays was unusual and in keeping with air being injected into Child A's bloodstream".

This is quite relevant in my opinion

I agree.
This evidence is pretty grim to read. Feel so bad for the babies and parents.

 

[Tortoise]

3:47pm

A crash call was put out at 12.33am, and resuscitation began. The nurse noted purple blotches and white patches all over Child B's body, and the heart rate had dropped.
In a witness statement three years later, Letby's colleague, the designated nurse for Child B, said she and Letby had been preparing antibiotics at the time of the collapse.
After efforts to resuscitate Child B, Child B "recovered very quickly".
A doctor subsequently found "loops of gas filled bowel".
The prosecution say this was a finding replicated many times in the upcoming cases.
Child B improved until being discharged the following month.

3:47pm

Dr Dewi Evans concluded Child B was "subjected to form of sabotage" that night, the court hears.

LIVE: Trial of Lucy Letby accused of Countess of Chester Hospital baby murders

 

[JosieJo]

I agree.
This evidence is pretty grim to read. Feel so bad for the babies and parents.

It must be awful for them

 

[Pinkizzy]

Don't ICUs have cameras to watch the babies?

 

[Tortoise]

Now15:49

Child B the victim of 'sabotage'​

About 28 hours after Child A had been killed, shortly before midnight, Child B's oxygen levels began to fall. Another nurse adjusted Child B's head and nasal prongs and her levels began to recover.
At 00.05am, Letby began a bag of liquid feed on Child B and - even though she was not Child B's designated nurse - took her blood gases.
At around half past midnight Child B's alarm sounded as she was not breathing.
Her oxygen saturation levels had fallen to 50%.
"She was blue, she wasn't breathing and she was limp," says Nick Johnson KC. Child B also had purple blotches and white patches all over her body.
Child B "recovered quickly" once resuscitated, her heart rate increased, her breathing resumed, "she became very lively" and required minimal respiratory support thereafter. She survived the incident - without suffering any further consequences.
Subsequent tests found "loops of gas-filled bowel".
A doctor concluded she was "subjected to some for of sabotage before or after midnight on the night of the 9 / 10 June 2015".
A second doctor observed the sudden discolouration, profound collapse and "relatively quick recovery is rare and only explained by a dose of air administered into the bloodstream".

Lucy Letby trial - live: 'Baby A' died 90 minutes after 'poisoner' nurse came on shift, jury hears

 

[Tortoise]

3:49pm

Another medical expert said an airway obstruction would cause a "sudden desaturation and reduction in heart-rate", but would not account for the "florid change in skin colour and perfusion noted at the time".
The medical expert said a "relatively quick recovery" would "only be explained by a dose of air...deliberately administered in the bloodstream".

3:51pm

A blood expert added "no blood disorder would account for the sudden deterioration suffered by [Child B]."


3:53pm

In police interview, Letby was asked about the circumstances regarding the connection of a liquid feed bag at 12.05am. She said she had looked at paperwork for the lipid syringe (an addition to the liquid feed bag to children not being given milk), and said the prescription was "not her writing" but "she had signed for it" and "ideally it should have been co-signed by somebody".
The rules are that two nurses have to sign for things administered to a baby.

LIVE: Trial of Lucy Letby accused of Countess of Chester Hospital baby murders

 

[Marantz4250b]

Now15:49

Child B the victim of 'sabotage'​

About 28 hours after Child A had been killed, shortly before midnight, Child B's oxygen levels began to fall. Another nurse adjusted Child B's head and nasal prongs and her levels began to recover.
At 00.05am, Letby began a bag of liquid feed on Child B and - even though she was not Child B's designated nurse - took her blood gases.
At around half past midnight Child B's alarm sounded as she was not breathing.
Her oxygen saturation levels had fallen to 50%.
"She was blue, she wasn't breathing and she was limp," says Nick Johnson KC. Child B also had purple blotches and white patches all over her body.
Child B "recovered quickly" once resuscitated, her heart rate increased, her breathing resumed, "she became very lively" and required minimal respiratory support thereafter. She survived the incident - without suffering any further consequences.
Subsequent tests found "loops of gas-filled bowel".
A doctor concluded she was "subjected to some for of sabotage before or after midnight on the night of the 9 / 10 June 2015".
A second doctor observed the sudden discolouration, profound collapse and "relatively quick recovery is rare and only explained by a dose of air administered into the bloodstream".

Lucy Letby trial - live: 'Baby A' died 90 minutes after 'poisoner' nurse came on shift, jury hears

If doctors were saying this at the time then surely you'd have the police in that very night? Or is this something they've said years after the event?

 

[Tortoise]

3:55pm

Letby told police she had conducted observations on Child B, but the other nurse was the allocated nurse.
Letby also said it was the other nurse who had alerted her to the problem with Child B.
In a June 2019 police interview, Letby said it was her signature on the blood gas record at 12.15am, just before Child B collapsed.
The prosecution say this is an example of Lucy Letby signing the charts for a baby who was not her designated patient at a time just before the child collapsed.

LIVE: Trial of Lucy Letby accused of Countess of Chester Hospital baby murders

 

[Tortoise]

Now16:00

The 'obvious conclusion'​

Nick Johnson KC reiterates that Letby was always on shift at the time of these, sometimes fatal, incidents, telling the jury: "You might be tempted to draw what, we suggest, is the obvious conclusion."
A handover sheet relating to Child B was also later found during a search of Letby's home address.
At the time of Child B's death, Letby was the "designated nurse" for two babies in other rooms of the neonatal unit, indicating she should have had no involvement in Child B's care.
Yet it was her signature found on the blood gas record shortly before Child B began to deteriorate.
"Taking a step back, it's easy to get sucked in by the detail in this case but important always to keep a sense of perspective," he says.
But, Mr Johnson says both Child A and B were born "prematurely but in pretty good condition".
"No one expected them to face grave problems yet both suffered unusual symptoms within a short time of each other which, in an interview, Lucy Letby said were similar," he says.

https://news.sky.com/story/lucy-let...n-trial-12716378?postid=4632463#liveblog-body

 

[Tortoise]

3:59pm

In November 2020, Letby was asked by police about a handover sheet relating to Child B found at her home address in a search.
The sheet showed she had been the designated nurse for two babies in a different room that night.
Mr Johnson said: "Here you can see that we have twins who were born prematurely but in pretty good condition.
"No one expected them to face grave problems, yet both suffered unusual symptoms within a short time of each other which in interview Lucy Letby said were similar.
"The prosecution’s expert paediatricians say that the collapses and skin mottling were the result of air being injected into their bloodstream.
"The first injection caused the death of [Child A], the second the dangerous collapse of his sister.
"We say that there is no plausible alternative to an air injection [air embolus]. The fact that it happened in 2 cases just over 24 hours apart shows that these were no accidents.
"Lucy Letby was the only person present [with Child A] at the time he collapsed...and was in the room when the same happened to [Child B].
"We also say that you are entitled to look at the evidence of what happened to [Child A and B] in the context of one, what Lucy Letby did to other children and two, most starkly, her having poisoned [two other children] with insulin."

4:00pm

The case is now being adjourned for Monday.
The prosecution will continue outlining the case tomorrow.

LIVE: Trial of Lucy Letby accused of Countess of Chester Hospital baby murders

 

[Marantz4250b]

Would there be any sensible reasons as to why a patient record sheet would be found at her home?