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

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Can they, though? Maybe in relation to specific things she's said on the stand which they claim don't match. Aren't the police interviews "agreed evidence, though? That would suggest that they can't now go on a fishing expedition trying to drag up anomalies on the stuff her defence hasn't asked her about, one would think?


If that were the case then surely all defence teams would just avoid asking the accused anything that they didn't want the prosecution questioning further.
 
Letby says she was in a different nursery when Child Q deteriorated
Lucy Letby says she felt "emotionally drained and just exhausted" on 25 June 2016 following the deaths of triplet boys Child O and P in the previous days.

She was Child Q's designated nurse on this shift - he was being looked after in nursery two of the Countess of Chester neonatal unit.

Letby tells the court that at the time of Child Q's deterioration at around 9.10am she was caring for another baby in intensive care nursery one, and had asked a different nurse to keep an eye on Child Q.

Defence barrister Ben Myers KC pulls up hospital records which show Letby and another nurse giving medication to another baby at 9.04am.

Letby recalls she first became aware something was happening with Child Q when she "heard something happening" outside nursery one.

"I walked through door and as I went out, I could see down corridor to nursery two and saw [two other nurses] with Child Q."

Letby says she was informed Child Q had vomited and could see he was still receiving "pressure" from a Neopuff but "had otherwise recovered".

She says she had no involvement in the steps taken to assist Child Q.

 
2:43pm

A feeding chart for June 23 is shown to the court for Child Q.
A '2ml milky' aspirate is recorded at 2030. At this point, the court hears, Child Q had received a total of 3.5ml of milk.
Letby said "you would hope" the aspirates would be decreasing throughout this time.
A 3ml aspirate is recorded at 3am on June 24. Letby says it "wouldn't be of great concern...but ideally we would want the aspirate [to be] the least possible".
At the time of the handover on the morning of June 25, Letby said she noticed from the observation chart he was "on the cold side" and she would want him reviewed by a doctor before the 9am feed.
Letby said she was concerned about the temperature, Child Q was "on the borderline" of being too cold on the chart, and the incubator temperature was increased from 30.2C to 32C throughout the day. The temperature remained low which Letby said "was a concern".
Letby said she should not feed Child Q until the doctors had reviewed him at 9am.
Letby said she was also caring for an intensive care baby in room 1. She said for cares to be given in room 1, she would have to ensure a nurse remained present in room 2. She informed two nurses when she said she needed to go to room 1.
One nurse was sat at the nursing station and the doctors were starting their ward round at about 9am. Letby said she went to room 1 just after 9am. She does not recall how the room 1 baby was doing.
A neonatal schedule for June 25 is shown to the court. Letby is recorded as making observations at 9am for Child Q. Letby assists a nurse in room 1 for medication at 9.04am.
Letby says she was in room 1 for "a few minutes" and could hear something going on outside the nursery.
"I went out through the door and I could see down the corridor"
Letby went to Child Q's cotside, where there were two nurses present. Letby heard from a colleague Child Q had vomited a 'mucusy vomit'. He had stopped and "recovered" by the time Letby arrived.
Letby's notes: '[0800]...observations as charted - temperature low, incubator increased x2. Tachycardiac. Active and alert...abdomen soft and non-distended.
'0910 [Child Q] attended to by S/N Lappalainen - he had vomited clear fluid nasally and from mouth, desauration and bradycardia, mottled++. Neopuff and suction applied. Reg attended. Air++ aspirated from NG Tube.'
Letby says all this was relayed to her, and not from her observation.
Nurse Minna Lappalainen wrote: 'Baby found to be very mucousy, clear mucus from nasopharynx oropharynx removed. Clear fluid+++ O2 via Neopuff...Dr...emergency to attend...NGT used to aspirate stomach by nurse Lucy Letby.'
Letby confirms the description of the type of fluid was the only one she heard. She did not administer the Neopuff breathing support.
Letby confirms she continued to care for Child Q after he was transferred to room 1.

2:48pm

Mr Myers asks, in the context of the trial and every day at the hospital, whether this had been a significant event.
Letby: "This wasn't a significant event - this is something we deal with on a routine basis. Not that it's not important...he needed minimal intervention."
Mr Myers: "And in the course of the day, did [Child Q] have any further collapse?"
Letby: "No."
Lety's notes: '...respiratory rate declining...and intermittent pauses in breathing...blood gas stable but on downward trend and [Child Q] appearing 'tired'. Oxygen requirement developing. Discussed with consultant Gibbs and decision made to electively intubate...uneventful intubation...care handed over'
Letby says, other than Child Q requiring CPAP, there were no other outstanding issues for him.
A nursing note by Lucy Letby for Child Q is shown for June 29 and June 30. Letby confirms she was Child Q's designated nurse for those days. She does not recall, outside of the notes, being the designated nurse for Child Q those days.

 
2:09pm

The trial will resume shortly. Mr Myers will be asking Lucy Letby questions in the case of Child Q, the final of the 17 babies in the trial. Child Q, a baby boy, was born on June 22, 2016, weighing 2,076g.

2:21pm

Child Q was born at 31 weeks and 3 days gestation at the Countess of Chester Hospital.
Mr Myers tells the court there was one event for Child Q on the morning of June 25, vomiting, desaturation, bradycardia, with "air++" aspirated from the NG Tube.
A doctor gave a diagnosis of "probable NEC" the following day and Child Q was transferred to Alder Hey on June 27, returning to the Countess of Chester Hospital the following day.
A handover sheet for June 28, 2016 is shown to the court, in which Lucy Letby is deisngated nurse for three babies, not Child Q, that day, in room 3.
Letby said she was "drained and emotionally exhausted" by June 25, following the events for Child O and Child P.
A day shift for June 25 is shown. Rebecca Morgan is on duty as a student nurse. Letby tells the court she was no longer the mentor as she had said she could not give her that time to do so, and so Ms Morgan was overseen by other nurses.
Letby is the designated nurse for Child Q in room 2 and a baby in room 1.
Letby tells the court: "You'd have to split yourself between the nurseries" when given designated care for two babies in two different nursery rooms.
Nursing notes for June 24-25: '...[Child Q] self ventilating in air...feet pink and warm. New lipid syringe put up overnight...having trophic feeds of donor ebm, 0.5mls 2 hourly due to moderate aspirates. Abdomen full but soft.'
Letby says the 'trophic feeds' are to get a baby's digestive system going. The aspirates indicated Child Q was not ready to tolerate larger feeds yet.


Not "drained and exhausted" enough to have the day off as suggested though, it seems.
 
2:53pm

Messages are shown between Letby and a doctor: "Do I need to be worried about what Dr Gibbs was asking?"
Letby said she had become aware during the shift on who was present in the nursery when Child Q had his episode. She said she was worried she would be blamed for leaving him alone in the nursery.
Letby messaged: "I walked into equipment room, he was asking Mary who was present in room and how quickly someone had gone to him as I wasn't in the room.
"He asked who was there, I said I had popped out of room but Mary was in room and Minna at the desk."
The reply: "All he was doing was checking that there wasn't a delay and that a room had been left empty.
Was he HDU level because of uvc?
There is nothing to worry about."
Letby: "Ok. Was worried because I Wasn't with him at time, but Mary was in room and Minna outside, I had B in 1.
ITU because of uvc"
Letby tells the court Child Q had not been left unattended, but felt she may have been accused of leaving him unattended, and/or that she should not have left room 2.
Letby did not work on the unit after June 30, 2016.

 
Child Q's deterioration not a standout event on unit, Letby says
Child Q's deterioration was not a clinically "significant event", Lucy Letby tells the court, adding that it's something the Countess of Chester neonatal unit would deal with on a regular basis.

"He needed minimal intervention," she says.

She agreed that until the evening the incident didn't seem to lead to any further complications.

 
2:53pm

Messages are shown between Letby and a doctor: "Do I need to be worried about what Dr Gibbs was asking?"
Letby said she had become aware during the shift on who was present in the nursery when Child Q had his episode. She said she was worried she would be blamed for leaving him alone in the nursery.
Letby messaged: "I walked into equipment room, he was asking Mary who was present in room and how quickly someone had gone to him as I wasn't in the room.
"He asked who was there, I said I had popped out of room but Mary was in room and Minna at the desk."
The reply: "All he was doing was checking that there wasn't a delay and that a room had been left empty.
Was he HDU level because of uvc?
There is nothing to worry about."
Letby: "Ok. Was worried because I Wasn't with him at time, but Mary was in room and Minna outside, I had B in 1.
ITU because of uvc"
Letby tells the court Child Q had not been left unattended, but felt she may have been accused of leaving him unattended, and/or that she should not have left room 2.
Letby did not work on the unit after June 30, 2016.

I can’t help but wonder, if guilty, whether because of dr j walking in and finding her with baby k (as has been heard from his witness testimony), whether she’s then creating situations to seemingly make it look like she wasn’t in the room.
JMO
 

Letby says concern over colleague's enquiries was due to leaving baby​

The court has previously heard how a doctor on the unit had made enquiries about who was present at the time of Child Q's collapse on 25 June 2016.
In a text to another registrar doctor sent that evening, Lucy Letby said: "Do I need to be worried about what [the doctor] was asking?"
"What would there be to be worried about?" her defence barrister Ben Myers KC asks about the text.
"I was worried I shouldn't have left him in the nursery," Letby says.

 
3:06pm

Letby says for the annual leave on July 4-6, [my note think that should be 4-16] 2016, she was on a family holiday.
She recalls, the day before she was due to go back to work, she received the news she was going to a meeting with Eirian Powell. She would not be going back to the unit 'for the time being', the court hears.
Further messages between Letby and the doctor are shown to the court: "Did you manage some sleep?
Back on nnu....They want to send [Child Q] back as a medical NEC.
Not sure if the unit is open for transfers. Few managers / medical director around this morning."
Letby: "Yes got some sleep , did you?
Good news about both. Hope they don't rush [Child Q] back…"
Letby tells the court other babies had been brought back to the Countess too soon, including Child I and Child G.
The doctor: "Got about 3 hours, coffee is good!
It was odd - he's only been there for 14 hours, I think this is a sign of how AH it's going to be.
They are so short of beds that they can only accommodate emergency patients. It's not good holistic care, and it's rubbish for his parents."
Letby says 'they' refers to Alder Hey, and Child Q was 'no longer an emergency baby', so was sent back.
Letby's messages between herself and a nursing colleague are shown, for June 27: Letby: 'I reckon there's going to big meetings etc about what's gone on with unit being closed, lack of staff etc'.
Letby tells the court the unit being 'closed' was closed to new arrivals.
Letby had messaged: 'were way over capacity, and its skill mix too.' - Letby tells the court it was "an ongoing issue".
Late that day, Letby messaged her: "E just phoned telling me to do days this week and not Go in tonight as trying to protect me "
Response: "What's that mean?"
LL: "I don't know. Asked if there was a problem and she said No just trying to protect me as had a difficult run just before holidays, less people on nights etc and we can have a chat etc tomorrow.
"But Im worried Im in trouble or something"
Letby said "it seemed an unusual thing to do".
Response: "Don't worry, how can you be in trouble you haven't done anything wrong
"Just very unfortunate"
LL: "I know but worrying in case they think i missed something or whatever. Why leave it til now to ring."
Letby says she thought she might have overlooked something. She tells the court getting things right in her work "was my life, my job".
Letby is asked why a Datix report is on her phone - Letby said this was something she needed to do for Child O and Child P. Letby says she cannot recall if she did these tasks.

 
I can’t help but wonder, if guilty, whether because of dr j walking in and finding her with baby k (as has been heard from his witness testimony), whether she’s then creating situations to seemingly make it look like she wasn’t in the room.
JMO

I'm getting the same thoughts. That if guilty the method may have been adapted to include .. attacking the baby whilst doing obs etc, quickly leaving to go to another room or ward before the collapse happens, then being recorded either carrying out a procedure in the other room or using the swipe card to (re)enter the NNU once the collapse is in effect

All JMO , if guilty.
 
Can they, though? Maybe in relation to specific things she's said on the stand which they claim don't match. Aren't the police interviews "agreed evidence, though? That would suggest that they can't now go on a fishing expedition trying to drag up anomalies on the stuff her defence hasn't asked her about, one would think?
No idea. I would think it would be unfair if the prosecution couldn't ask her any questions they liked as long as it related to evidence heard in the trial. But perhaps you're right. Hopefully there's a legal expert here lurking...
 
Dan O'Donoghue

@MrDanDonoghue
·
3m

In one message exchange with a nursing colleague, the pair are discussing that there had been an issue with Child O's UVC line. It states in the messages that there was a port left open on the line

Dan O'Donoghue

@MrDanDonoghue
·
2m

Ms Letby said in those messages 'I thought it's a massive infection risk and risk of air embolism, don't know how long it had been like that'

Dan O'Donoghue

@MrDanDonoghue
·
48s

Mr Myers asks if knowing about air embolism was unusual - she says no and that it is 'part of training' and that nurses 'would be expected' to be aware of the dangers of air embolism
 
3:19pm

The email from Yvonne Griffiths on July 15 is shown to the court referring to Letby's redeployment to an office-based role in the hospital.
Letby said she "wasn't happy" about the move, and it had been imposed on her.
She said she was aware that, by this time, the Countess neonatal unit had been redesignated to a level 1 unit.
Letby's message on August 8 to a nursing colleague: "Tony phoned. He's going to speak to Karen and insist on the review being no later than 1st week of Sept but said he definitely wouldn't advise pushing to get back to unit until it's taken place. Asked about social things and he said it's up to me but would advise not speaking with anyone in case any of them are involved with the review process. Thinks I should keep head down.and ride it out and can take further once over.
"Feel a bit like Im being shoved in a corner and.forgotten about by.the trust. It's my life and career.
"He's not been.given any information about the evidence he asked for.which is good. He's not sure what the external people.are going to look at in relation to me but we are in the process now.so have to ride it out"
Reply: "Ok well just have to take his advice then suppose
""
LL: "Still can't believe this has happened.
"It's making me feel like I should hide away by saying not speak to anyone and going on for months etc - I haven't done anything wrong."
Letby said she was expected to lie about things going on, that she was 'happy' to be redeployed elsewhere.
After the email was sent about secondments, Letby said: "Omg She's sent email about secondments!"
Reply: " [three laugh cry emojis]
"Email is on fire!"
LL: "Bloody hell fuming
"Im in email and makes it sound like my choice"
The court hears Letby had filed a grievance procedure against the hospital.
Letby tells the court that by this point: "I didn't know what to do - it was having a massive imapct on all aspects of my life.
"It was emotionally very difficult, I was lonely...I didn't know what was going on."


[emojis in texts not carried over]
 
Letby says job was her 'life'
Lucy Letby recalls how she was told at the last minute not to go in for her night shift on 27 June 2016.

In a message to a registrar doctor, she said she was "worried" about the request.

In different messages to another nurse, Letby said: "I'm worried I'm in trouble or something", and was concerned "in case they think I missed something".

Asked why the request not to work worried her, Letby says it was "unusual" for a shift to be cancelled so soon to starting but that she wasn't made aware there was any problem.

"How much did you want to get things right?" asks Ben Myers KC, defence lawyer.

"That's the aim... you do your best," Letby says.

"How much did getting things right matter to you?"

"It was everything - it was my life, my job."

 
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