UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #21

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Dan O'Donoghue

@MrDanDonoghue
·
1m

We're turning to Child L's twin Child M. Who collapsed pretty much at the same time Child L's blood sugar levels fell

Dan O'Donoghue

@MrDanDonoghue
·
52s

Mr Myers asks Ms Letby, who was assisting with treatment of both twins, if she recalled any blotches or patches on Child M's skin - she says 'no'
 
So am I right in thinking that they are saying that the initial dextrose bag on the 8th couldn't have been contaminated with insulin, as glucose levels remained normal afterwards? Then the 10am low glucose reading was before the new dextrose bag was started?

I can't remember, which bag did the prosecution argue was contaminated?
We don't have good reporting from this portion of the trial.
 
Dan O'Donoghue
@MrDanDonoghue
·
1m

Jurors have previously heard how an emergency crash call went out to medics to attend Child M at 16:02 on 9 April 2016 after he stopped breathing.

Dan O'Donoghue
@MrDanDonoghue
·
1m

Over 25 minutes senior doctors and nurses gave CPR and administered dose after dose of adrenaline in a battle to stabilise the infant. The baby boy improved at around 16:31 and was placed on a ventilator.

Dan O'Donoghue
@MrDanDonoghue
·
20s

Mr Myers has pulled up documents found in Ms Letby's home on screen. They are prescription charts from Child M's resus, he asks her why she has them at home

Dan O'Donoghue

@MrDanDonoghue
·
12s

She says they were in her uniform pocket and came home with her, she said it was an 'error' on her part
 
That explains why I'm struggling to remember what the evidence was. At least we will learn more from the prosecution cross examination presumably
All I remember is that Prof Hindmarsh said at least potentially three bags of dextrose were contaminated.

edited to add testimony -

"He told the court that in his opinion, to produce the blood glucose levels detected, around at least three or potentially four bags could have been contaminated."

https://twitter.com/MrDanDonoghue

"He told the court that insulin could “potentially” have been added to at least three dextrose bags if the giving sets were also changed."

Baby had dangerously low blood sugar levels over three days, Letby trial told
 
Last edited:
2:56pm

Letby, asked again by Mr Myers, denies doing anything to affect Child L's insulin levels. She agrees Child L's blood sugar levels remained low, and cannot explain why that was the case.
Letby says another nurse and Dr Ravi Jayaram came to assist Child M. She says she cannot recall any observation or discussion of discolouration on Child M's skin.
Letby says she left later than 8pm that night as she had a lot of documentation to file at the end of her shift.
A nursing note for Child M by Letby is recorded as being written between 9.14pm-9.22pm on April 9. Letby said this was after attending to the clinical needs of Child M.
Letby said she would write contemporaneous notes on the back of handover sheets or on paper towels to keep track during the day.
The court is shown a few notes written on paper towels which were recovered from 'the Morrisons bag' at Letby's home by police. There are also medical notes on sheets of paper. They feature notes in the resuscitation of Child M.
Letby says the notes were kept in the pocket of her uniform, and came home in her uniform.
She says she did not have any other use for them.
Also among the notes is a blood gas printout for Child M.
Asked to explain that note, Letby says she had put it in her pocket and taken it home.
Asked by Mr Myers why she hadn't binned it: "That is an error on my part."
She denies having any use for the notes.

 
3:02pm

Letby confirms she continued to care "quite frequently" for Child L and Child M following their events, until they were both discharged from hospital on May 3.
Nursing and family communication notes by Letby in respect of Child L and Child M are shown to the court on April 16, 17, 24, 25, including when Letby had been their designated nurse.
"I did my best for them," Letby tells the court.

 
Dan O'Donoghue
@MrDanDonoghue
·
4m

Mr Myers pulls up a text message she sent to a colleague at the time in which she conveyed that the babies on the unit were progressing well. He asks if that's what she wanted, 'yes absolutely' she said. He asks if she wanted to hurt them, 'no' she says

Dan O'Donoghue
@MrDanDonoghue
·
3m

We're now moving onto Child N. He was born with a blood disorder, which made him prone to bleeding, in early June 2016, but his condition was described as "excellent" by medics.

Dan O'Donoghue
@MrDanDonoghue
·
3m

The prosecution said the disorder gave Ms Letby "cover" to attack him and his three deteriorations in June 2016 were consistent with some kind of "inflicted injury" or him having received an injection of air.

Dan O'Donoghue

@MrDanDonoghue
·
4m

Ms Letby is accused of trying to kill the boy on three occasions. Manchester Crown Court has heard that the first attempt came in the early hours of 3 June. Child N experienced a "sudden deterioration" and was heard “screaming" and crying for 30minutes.
 

Defendant says she was preparing infusion bag when Child M collapsed​


At the time of Child M's collapse at around 4pm on 9 April 2016, Lucy Letby says she was preparing a bag of dextrose for Child L with another nurse.

Asked the first thing she recalls about Child M's deterioration, Letby says she remembers his monitor alarm was sounding.

The defendant says she went over to find Child M "struggling" and not breathing.

Other parents in the room at this point were asked to leave, she says.

Another nurse and a doctor became involved in resuscitation attempts for Child M, Letby tells the court.

Other members of staff started the process of making Child L's dextrose bag from the beginning after it had to be abandoned to care for Child M, she said.

After that bag was eventually hung for Child L, his blood sugar remained low.

"Did you do anything to interfere with that bag?" Ben Myers KC, defence lawyer, asks.

"No," Letby replies.

Letby says 'error' that blood gas printout found at her home wasn't discarded​


The court is shown a photograph of handwritten notes on pieces of paper discovered in a police search of Lucy Letby's home after her arrest in 2018 - some which relate to Child M.

Letby says the notes would be in her uniform pocket and would end up going home with her.

She says she had no other use for them.

Another picture shows a blood gas printout for Child M, which Letby also says would have stayed in her pocket.

"The question that arises, Ms Letby, is why it doesn't just go in the bin after that?" says Ben Myers KC.

"That's an error on my part," she says.

Letby says she had no use for any of the hospital records - some of which relate to babies involved in this case - found at her home during the police search.

I didn't want twins to be hurt, Letby says​

Lucy Letby says she continued to care for Child L and M "quite frequently" over the weeks that followed the incidents on 9 April 2016.
Asked what kind of care she provided, she says: "I did my best for them".
"Did you want them to be hurt?" Ben Myers KC, defending, asks.
Letby says she didn't.
The twins were discharged on 3 May 2016.

 
3:19pm

Mr Myers now turns to the case of Child N, a baby boy born on June 2, 2016, gestational age 34 weeks plus 4 days, weighing 1,670g.
Mr Myers asks Letby how important it was for her to treat these babies.
"Very important - I took the job extremely seriously...we want to make sure the babies go home."
Mr Myers says Child N was born with haemophilia.
Mr Myers says the first event was on June 3, at 1am when Child N was said to be "screaming or crying", desaturating, and was treated with breathing support.
The second event was on the morning of June 15, when Child N had a "profound desaturation", and following from that, there were attempts to intubate him, and blood was found in the oropharynx.
The third event was a "profound desaturation" at about 3pm on the same day and 3ml of blood aspirated from the NG Tube, followed by multiple attempts to intubate Child N. At 7.40pm, as a team arrived from Arrowe Park, there was a further desaturation for Child N.

 
All I remember is that Prof Hindmarsh said at least potentially three bags of dextrose were contaminated.

edited to add testimony -

"He told the court that in his opinion, to produce the blood glucose levels detected, around at least three or potentially four bags could have been contaminated."

https://twitter.com/MrDanDonoghue

"He told the court that insulin could “potentially” have been added to at least three dextrose bags if the giving sets were also changed."

Baby had dangerously low blood sugar levels over three days, Letby trial told
Interesting. Would the insulin have to be added when making up the bags, or could it be added later at cot side?
 

Letby: Staff were 'panicked' about caring for baby with haemophilia​

Lucy Letby says staff on the Countess of Chester neonatal unit were "panicked" at having Child N on the ward with his condition.
She tells the court she herself had not encountered a baby with haemophilia before and she "doesn't think anyone" was familiar with how to deal with it.
Ben Myers KC, her barrister, pulls up a text Letby sent to a colleague about Child N on 2 June 2016, where she says: "Everyone bit panicked by seems of things although baby appears fine."
Asked about this, Letby says "all nursing staff, medical staff... were panicked by the condition Child N had and how they were going to manage that".

 
3:32pm

Mr Myers asks Letby about Child N. Letby says she had not encountered a baby with haemophilia and staff on the unit were "quite panicked" about the prospect of caring for a baby with haemophilia, as they had little/no experience either.
A message Letby sent to a colleague on June 2: "Everyone bit panicked by seems of things although baby appears fine"
The response: "Male?"
LL: "Yeah"
The response: "Factor 8?"
LL: "Not sure I only know what's on handover sheet as Dr etc all in with him doing head scan etc"
Letby said at the time, she did not know what 'factor 8' referred to.
The response: "Lad with haemophilia when worked community with Leighton on placement"
LL: "Ah ok I'll have to Google it later lol don't know much about it"
Response: "Have to b careful with cannula/heel pricks etc
"Give Factor 8 or Factor 9 I think it is dependent on which clotting factor deficiency is
"Have as infusion for rest of life"
LL: "Wow"
Response: "Nearly always make [then corrected to 'male']"
"We were going out supervising parents starting to give the boy his prevention injections themselves
"Wonder if knew antenatally
"Must have done suppose to know now
"Sure boy we went to had it thru port-a-[cath]"
LL: "Complex condition, yeah 50;50 chance antenatally"
Letby says her nursing colleague had more experience, and it was a 50:50 chance that the mother would pass on the condition to the baby. She said it was something she had heard of, but did not know the details of that.

 
Dan O'Donoghue
@MrDanDonoghue
·
2m

Mr Myers asks if reports of the child screaming were a result of Ms Letby 'performing some sort of attack', she responds 'no it’s not'. She denies causing the baby any harm

Dan O'Donoghue
@MrDanDonoghue
·
47s

Mr Myers asks Ms Letby if she had any involvement with the treatment of Child N at that time in the morning, she says 'no'

Dan O'Donoghue

@MrDanDonoghue
·
25s

Mr Myers asks Ms Letby: 'Did you know that there had been an incident with (Child N)?', she says 'no'. Door swipe data from the time shows Ms Letby enters the unit at 01:15hrs that morning - 10mins after Child N's collapse
 
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