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

[merrypason]

"Because of the inability of doctors to find genuine medical reasons for the deaths and collapses the police were called in'. Officers from Cheshire Constabulary commissioned a detailed review by experienced doctors with no connection to the Countess of Chester Hospital."

Looks like the police were called in before any detailed hospital investigation.

Lucy Letby 'tracked families of her alleged baby victims on Facebook'

Lucy Letby, 32, is alleged to have gone on a year-long killing spree while working at the Countess of Chester Hospital - including one who died less than 90 minutes after being handed into her care

www.dailymail.co.uk

 

[bastien]

Interesting to note the mood here so far seems to be leaning more into a presumption of innocence than these threads usually do - partly, I’m sure, because of how little info we have so far, and partly perhaps because of our own natural biases towards such an unlikely killer. It’s a sentiment I share: I really *don’t want* her to be guilty. I don’t want that reality to exist.

All v good points being made, so I don’t say that to undermine anything or anyone. Just an interesting snapshot to take now, before we hear any more.

Personally, I think there's a few reasons for this. Firstly, we know little of the evidence so there isn't much basis to work on before the trials. In a lot of other cases, you can snoop around or there's witness accounts, gossip and so on. Much of what's being said so far is the first time it's been disclosed publicly and it's only the first day of the trial so it's easy to poke holes or questions in it or suggest plausible explanations (though no doubt these will all have crossed the prosecution's mind and will be covered later though).
Secondly, I think people recognise the severity of what the defendant is accused of - if guilty, it's one of the worst crimes in recent memory - and so naturally have an element of skepticism or a desire for watertight evidence.

That said, it may be true that the defendant's 'nice', 'innocent' appearance may subconsciously influence us more than we'd like to admit.

 

[Eloise]

Interesting to note the mood here so far seems to be leaning more into a presumption of innocence than these threads usually do - partly, I’m sure, because of how little info we have so far, and partly perhaps because of our own natural biases towards such an unlikely killer. It’s a sentiment I share: I really *don’t want* her to be guilty. I don’t want that reality to exist.

All v good points being made, so I don’t say that to undermine anything or anyone. Just an interesting snapshot to take now, before we hear any more.

For me it's just that an extraordinary claim requires extraordinary evidence and so far we've seen or heard of very little evidence.
I'm really just waiting for the trial before I form any actual opinion. And I don't think I presume her innocence, per se. More just that I need to hear/see more than what we have so far. The impressions of her put out by the media seem like a normal young woman who worked hard at her degree and job and has a normal social life for a woman her age, but I know that doesn't necessarily mean anything. I just haven't seen anything about either her or what she's supposed to have done (what exactly is she supposed to have done?) that really tips me off the fence either way.

(Like even what was being discussed earlier, that the media reported she lives alone with 2 cats. I mean, so what? It's the norm for a young woman her age with a career to be single and have a couple of 'fur babies'. It's not 1845, she's not been 'left on the shelf', and its reprehensible if the media really are trying to push that angle, it's old-fashioned misogyny).

 

[branmuffin]

Three useful articles (5 mins reads) from MSM to refresh memories on the background to this case and the RCPCH report findings.

The first from The Guardian in 2017 reporting on the concerns of increased mortality at the CCH, together with the relevant statistics.

Police investigating baby deaths at Countess of Chester hospital

Cheshire police will look at deaths of 15 babies and six non-fatal incidents between 2015 and 2016 after trust contacted them

www.theguardian.com

The second from Cheshire Live giving some background on the mortality concerns and the timeline of the police investigation from May 2017 until November 2020, when LL was charged and the subjudice rules came into play.

Timeline of the Chester hospital baby deaths investigation

Key developments from the ongoing probe into infant deaths at the Countess of Chester Hospital's neonatal unit

www.cheshire-live.co.uk

The third is an article from ITN outlining the findings of the RCPCH report into the elevated mortality on the neonatal unit.

Report found inadequate staffing numbers at Hospital | ITV News

The neonatal unit at the Countess of Chester hospital was found to have inadequate staffing numbers, according to a report. | ITV News Granada

www.itv.com

The last sentence in the ITV article says it all. It appears to me that the prosecution is basing their case solely on the fact that LL was present at the time of death.

"It found the post-mortem examinations for babies who died on the unit had not included systematic tests for toxicology, blood electrolytes or blood sugar."



I've highlighted parts of the abstract regarding insulin overdoses in postmortem investigations.

"Toxicological analysis for these compounds is challenging due to the large molecular weight, the limited stability of insulin in whole blood, and complexities associated with sample preparation and instrumental testing. As a consequence, determination of insulin in postmortem specimens is not routinely offered by most forensic toxicology laboratories. Forensic death investigation is further complicated by interpretative difficulties such as the frequent absence of anatomical findings, concentration interpretation in known insulin users, and addressing the impact of chemical instability and postmortem redistribution."

Here's the rest of the article.

The Determination of Insulin Overdose in Postmortem Investigations

The analysis of biological specimens for the presence of exogenous insulin is of special interest in select postmortem investigations. Insulin analogues are primarily used to mediate the regulation of blood glucose concentrations; however, their use has ...

www.ncbi.nlm.nih.gov

I also find the following information very interesting regarding intravenous air bubbles.

The Reality of Intravenous Air Bubbles: A need to correct Misinformation and Myth

Over many decades, nurses and other health care practitioners have been under the impression that air in an intravenous line is not harmful or dangerous to the patient, as long as this air volume is less than 50 cc. These same practitioners are also under the impression that volumes of air greater t

www.linkedin.com

 

[HongKongPhooey]

The Facebook search info is superficially reminiscent of that awful case of the hospital mortuary rapist from last year, who would look up his victims before attacks.

But it will be vital to know whether she also searched for other families she was involved with who had good outcomes for their babies. It’s entirely possible she would just look up families she had an emotional attachment to, at times. To my knowledge, there’s no rules or laws against that.

I’m interested to hear what they offer as a motive. Why target these particular babies, sometimes repeatedly, while letting - helping, even - countless others live?

I think it would have looked better for her if she said she had felt sad for the families and took an interest in their well-being after the babies died. Rather than saying she couldn’t remember doing it.

 

[Whitehall 1212]

Lucy Letby 'tracked families of her alleged baby victims on Facebook'

Lucy Letby, 32, is alleged to have gone on a year-long killing spree while working at the Countess of Chester Hospital - including one who died less than 90 minutes after being handed into her care

www.dailymail.co.uk

She allegedly tracked the babies' families on Facebook.

Oh my. If that's on her laptop or phone data history, then that's not good.

It's unlikely to prove murder either. Viewing the families on Facebook is a circumstantial element which the prosecution will likely use to support their presentation of motive, psychological state etc.

FWIW it is not necessary to show the motive to prove the offence.

 

[merrypason]

The last sentence in the ITV article says it all. It appears to me that the prosecution is basing their case solely on the fact that LL was present at the time of death.

"It found the post-mortem examinations for babies who died on the unit had not included systematic tests for toxicology, blood electrolytes or blood sugar."



I've highlighted parts of the abstract regarding insulin overdoses in postmortem investigations.

"Toxicological analysis for these compounds is challenging due to the large molecular weight, the limited stability of insulin in whole blood, and complexities associated with sample preparation and instrumental testing. As a consequence, determination of insulin in postmortem specimens is not routinely offered by most forensic toxicology laboratories. Forensic death investigation is further complicated by interpretative difficulties such as the frequent absence of anatomical findings, concentration interpretation in known insulin users, and addressing the impact of chemical instability and postmortem redistribution."

Here's the rest of the article.

The Determination of Insulin Overdose in Postmortem Investigations

The analysis of biological specimens for the presence of exogenous insulin is of special interest in select postmortem investigations. Insulin analogues are primarily used to mediate the regulation of blood glucose concentrations; however, their use has ...

www.ncbi.nlm.nih.gov

I also find the following information very interesting regarding intravenous air bubbles.

The Reality of Intravenous Air Bubbles: A need to correct Misinformation and Myth

Over many decades, nurses and other health care practitioners have been under the impression that air in an intravenous line is not harmful or dangerous to the patient, as long as this air volume is less than 50 cc. These same practitioners are also under the impression that volumes of air greater t

www.linkedin.com

Oh not sure that's a correct interpretation. There was an RCPH review conducted in 2016 - "In July 2016, when the unit changed admission arrangements and stopped providing intensive care, the trust asked the Royal College of Paediatrics and Child Health (RCPCH) to conduct a review into the increased mortality rate."

This was the review where no toxicology reports were done, as it wasn't a criminal investigation. And what the last line of the ITV article refers to.

The police were asked to investigate in 2017 and had only just begun when the article was printed. "The Countess of Chester Hospital Hospital Foundation Trust has asked police to investigate a higher than usual number of baby deaths on the neonatal unit between June 2015 and June 2016."

So we don't know if toxicology reports at post mortem were done as part of the police investigation or other forensic evidence was indeed found.

 

[infinit]

Oh not sure that's a correct interpretation. There was an RCPH review conducted in 2016 - "In July 2016, when the unit changed admission arrangements and stopped providing intensive care, the trust asked the Royal College of Paediatrics and Child Health (RCPCH) to conduct a review into the increased mortality rate."

It's interesting that as soon as anyone put some serious attention into investigating the deaths, they stopped. The findings of the review didn't come out until February 2017 with recommended improvements. So if that was the cause I wouldn't have expected the deaths to stop until they were implemented. I know there is a lot of evidence to come, but if I apply Occam's Razor...

 

[Whitehall 1212]

Hi I looked at the defence profile posted here, he seems to be very top barrister. Do you get this type of defence for free or would she have had to hire him privately?

Free representation in criminal court. LL's solicitor will have arranged the lead defence barrister. Each side will also have a number of more junior barristers in support.....a blitz attack and a strong defence on the try line, if you like

 

[Marysmith]

As a nurse in that unit I would think, as I’m a nurse myself, she was one on one or two on one with those babies and in her own kind of secluded pod… so it’s not like you are being watched closely.

 

[HollyHunter9]

It was mentioned that some of these babies had umbilical catheters. Although a very common procedure it does come with some quite serious risks and complications...

"The complications of umbilical vein catheterization may include: blood-borne catheter-related general infection, air embolism, a substantial blood loss during catheterization or due to detachment of the cannula, thromboembolic complications, heart tamponade, disorders of the heart rhythm, pericardial or pleural ..."

Complications of umbilical vein catherisation. Case Report

Umbilical vein catheterization is a relatively easy procedure performed routinely on the neonate intensive care units. It provides a fast central vein access, but some complications have been described in the literature.We presented a case report of a ...

www.ncbi.nlm.nih.gov

"UVC insertion is a blind procedure, performed, in most centres, by junior residents. The length of insertion is usually decided based on the birth weight or the shoulder umbilical length. Often, this estimate is incorrect, resulting in mal-positioning of the catheter."

Case Report: Advantages of being diligent: lessons learnt from umbilical venous catheterisation in neonates

Umbilical venous catheters (UVCs) are commonly used in neonatal units. Abdominal radiograph, taken soon after the insertion, is used to confirm the correct placement of the catheter. However, as demonstrated by our case series, complacency when an initial ...

www.ncbi.nlm.nih.gov

So the radiologist may very well have seen evidence of air embolism on x rays but that doesnt mean they were injected there on purpose it could have resulted from poor placement of the umbilical catheter which apparently can happen due to a number of factors outlined in the attached links above.

 

[annpats]

It's unlikely to prove murder either. Viewing the families on Facebook is a circumstantial element which the prosecution will likely use to support their presentation of motive, psychological state etc.

FWIW it is not necessary to show the motive to prove the offence.

Yes, I understand that, but what I'm saying is that it gives her a creepier feel and a more sinister edge that she was looking her victims families up on Facebook.

That's a data protection issue right there.
Plus if she didn't kill these babies, why look up their families on Facebook?
Why look up and stalk patients families online? That's not right for a start.

MOO.

 

[Whitehall 1212]

I think it would have looked better for her if she said she had felt sad for the families and took an interest in their well-being after the babies died. Rather than saying she couldn’t remember doing it.

Maybe she was being honest about not recalling checking that particular family on Facebook, when asked over two years later. Maybe she was like a rabbit in the headlights, not knowing which way to turn.

I can only imagine her anxiety, particularly if she is innocent, at being arrested multiple times for murder and attempted murder as all the wheels of police detention start to turn, with custody process and rounds of interviews.

 

[infinit]

Yes, I understand that, but what I'm saying is that it gives her a creepier feel and a more sinister edge that she was looking her victims families up on Facebook.

That's a data protection issue right there.
Plus if she didn't kill these babies, why look up their families on Facebook?
Why look up and stalk patients families online? That's not right for a start.

MOO.

I think it matters quite a bit if this is something she was exclusively doing for these little ones or if she does this to other families who lost babies or just generally to patients. I'm not saying it's right any way, but I don't think we have the context yet.

 

[Ruby12345]

I can imagine they searched quite well!

It's not a case fo just 'finding someone' who was in the unit at the same time, because that's circumstantial evidence, and you need more than that for it to hold up in court.
There is obviously forensic evidence that links her, and only her.

That's certainly not been suggested in the opening statement.

 

[meanmaryjean]

It was mentioned that some of these babies had umbilical catheters. Although a very common procedure it does come with some quite serious risks and complications...

"The complications of umbilical vein catheterization may include: blood-borne catheter-related general infection, air embolism, a substantial blood loss during catheterization or due to detachment of the cannula, thromboembolic complications, heart tamponade, disorders of the heart rhythm, pericardial or pleural ..."

Complications of umbilical vein catherisation. Case Report

Umbilical vein catheterization is a relatively easy procedure performed routinely on the neonate intensive care units. It provides a fast central vein access, but some complications have been described in the literature.We presented a case report of a ...

www.ncbi.nlm.nih.gov

"UVC insertion is a blind procedure, performed, in most centres, by junior residents. The length of insertion is usually decided based on the birth weight or the shoulder umbilical length. Often, this estimate is incorrect, resulting in mal-positioning of the catheter."

Case Report: Advantages of being diligent: lessons learnt from umbilical venous catheterisation in neonates

Umbilical venous catheters (UVCs) are commonly used in neonatal units. Abdominal radiograph, taken soon after the insertion, is used to confirm the correct placement of the catheter. However, as demonstrated by our case series, complacency when an initial ...

www.ncbi.nlm.nih.gov

So the radiologist may very well have seen evidence of air embolism on x rays but that doesnt mean they were injected there on purpose it could have resulted from poor placement of the umbilical catheter which apparently can happen due to a number of factors outlined in the attached links above.

I literally grabbed a doc's hand and stopped her mid-procedure because she had not bled the air out of the catheter and stopcock first. Nothing nefarious - just the middle of the night and a crisis situation.

 

[Marantz4250b]

I think it would have looked better for her if she said she had felt sad for the families and took an interest in their well-being after the babies died. Rather than saying she couldn’t remember doing it.

I don't think it would have mattered. The prosecution would still have painted it as being weird and unprofessional.

Besides, perhaps she couldn't remember doing it when asked?

 

[Cherwell]

Yes, I understand that, but what I'm saying is that it gives her a creepier feel and a more sinister edge that she was looking her victims families up on Facebook.

That's a data protection issue right there.
Plus if she didn't kill these babies, why look up their families on Facebook?
Why look up and stalk patients families online? That's not right for a start.

If people have publicly viewable FB pages, I can't see how data protection comes into it.
As for looking up patients' families - not necessarily "stalking" them - it could just be curiosity. Have you never looked up anyone on social media with whom you have only a passing connection, or none at all? I certainly have, but with no "creepy" or "sinister" intent.

 

[Whitehall 1212]

That's a data protection issue right there.
Plus if she didn't kill these babies, why look up their families on Facebook?
Why look up and stalk patients families online? That's not right for a start.

1. It's not a data protection issue. It's information in the public domain.

2. As an example, if a baby in her care had died and she'd done nothing wrong, she may be grieving in a way which many may not understand as it wasn't a family member, friends child etc. Nevertheless she may have felt it inappropriate to contact the family but she wanted some connection and FB could have been it.

We'll have to wait and see the extent, nature and timing of the FB activity to gain a clearer perspective. However, viewing does not automatically imply guilt.

3. I refer you to my answer at 2

As the evidence is fully examined and cross-examined over the months we should form a much clearer picture of its strengths and weaknesses and then be in a much better position to make an informed judgement.

 

[Jules2021]

What do they mean by facebook "stalking", just viewing someones fb profile? Isn't that what everyone does? isn't that the point of fb? Ok she was a nurse so it's a bit different, but still...