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

[JosieJo]

Yeh some but couldn’t give dates or cases. Dr bohin “fleetingly rare” for child e I think, “in the absence of any other pathological pathway” “gas can gather post mortem” there are others, they haven’t said “this is the only possible explanation”.

They have all given their final opinion on cause of death or collapse..the words "explaining" there diagnosis may at times seem a little ambiguous but their final conclusion isn't.
Unless the defence produce equal medical expert witnesses who can show what they have said is wrong.. surely the jury will take their diagnosis as correct

 

[Tortoise]

Yeh some but couldn’t give dates or cases. Dr bohin “fleetingly rare” for child e I think, “in the absence of any other pathological pathway” “gas can gather post mortem” there are others, they haven’t said “this is the only possible explanation”.

yes they have said it.

Just one example, for baby B, because I've linked all of these many times before in response to your posts, the last time fairly recently too.

"He says the cause of her collapse - like her brother Child A - was an air embolism, 'there was nothing else to explain this collapse, which was so sudden and unexpected', he said"

https://twitter.com/MrDanDonoghue

"Dr Bohin said other factors, such as infection or cardiac arrhythmia, could be discounted, and the only conclusion left was "air embolus"."

Recap: Lucy Letby trial, Wednesday, October 26

And when Dr Bohin said "fleetingly rare" she was talking about the cause of the bleeding in baby E. She was not talking about her diagnosis of air embolus.

 

[esther43]

Organized people might still have attention-deficit. The amount of paperwork in the hospitals is insurmountable. It should have been computerized by 2015, but computerization takes money. So the sheets are not a clue. IMHO. It is LL in the hospital, the rest might be suspicious or not depending on the people. The true problem is, there is nothing of LL on camera.

Not sure it has been suggested the notes were ferried back and forth to the hospital, if that is what you are hinting at.

Taken to a different house, yes. But just because they were all discovered, lumped together in what has been labelled a "work bag" means nothing in terms of where the notes may have journeyed.

JMO

I think LL said that both bags were used to keep her uniform and shoes in etc. that she carried to and from work. Not that I take that as hard evidence...

 

[Tortoise]

Yeh some but couldn’t give dates or cases. Dr bohin “fleetingly rare” for child e I think, “in the absence of any other pathological pathway” “gas can gather post mortem” there are others, they haven’t said “this is the only possible explanation”.

could you link to those articles with your quotes please (apart from "fleetingly rare")

 

[Tortoise]

I don’t REM remember what was said about the tip of the catheter, any pointers?

The Trial of Lucy Letby, Episode 26: Unnatural Causes? - The Mail

www.mailplus.co.uk

 

[Sweeper2000]

have They after pointing to any single piece of evidence said that this hard evidence or physical evidence can only be present after a air embolism Or etc? Or is the only thing they can be without a doubt about is the diagnosis based on med notes?

for instance I know dr marnerides said “these globules probably traveled their while this baby alive” but did he say “the air near the Cathether tip can only be there because of AE?

pardon for not remembering the provided quotes.

 

[Tortoise]

pardon for not remembering the provided quotes.

What does this mean please?

 

[JamesMcGillEsquire]

What does this mean please?

Pardon is just a polite way of saying pardon me/excuse me/sorry but..

Very common in English.

 

[Tortoise]

Pardon is just a polite way of saying pardon me/excuse me/sorry but..

Very common in English.

Thank you. I do know what the word means. I'm asking what his sentence means. Is he sorry for not providing links previously, and will rectify that, or is he sorry he isn't going to provide links because he doesn't have them. I want to see if they are actual quotes from the medical experts, or if they are the poster's own words that he's put quotes around and passed off as the experts' words, as has happened many times.

 

[soppppheiie]

I find the over feeding theory really frustrating.
Yes if she fed 20 mls you could vomit 20 mls but that’s suggesting the stomach is completely empty.
I can aspirate NG tubes and get no aspirate for a few hours and then suddenly the next time 100s of mls. Just like patients can vomit significantly more than what they have had in NG feed over the last hour.
The main reason being usually the ng tube is in such a position in the tummy it isn’t allowing aspiration, usually it’s stuck to the side of the stomach wall and there’s no real way of knowing this is the case. This has happened so many times in my career.
It’s the reason X-rays are needed so frequently as it’s difficult to aspirate from them sometimes. Usually just moving position can help.
It’s well known that the stomach and digestive system can slow to a stop and although the NG feed is going into the stomach it is not being taken further along the digestive tract and effectively just sitting there.
Then over time each 20mls feed is accumulating until vomiting a large amount.

 

[Jazmania]

have They after pointing to any single piece of evidence said that this hard evidence or physical evidence can only be present after a air embolism Or etc? Or is the only thing they can be without a doubt about is the diagnosis based on med notes?

for instance I know dr marnerides said “these globules probably traveled their while this baby alive” but did he say “the air near the Cathether tip can only be there because of AE?

pardon for not remembering the provided quotes.

I don't think that there is one single piece of evidence that is diagnostic, of itself, of air embolism. This is the case with most diseases however. Doctors use a range of symptoms to diagnose conditions.

The evidence that points to air embolism includes:

The sudden nature of collapse, which is not explained by any disease state. And the fact that babies would then suddenly inexplicably get better.

The fact that resuscitation methods that should work did not.

Presence of gas on x rays with no medical reason why that should be there

The fleeting rash not observed before by doctors with decades of experience. But then this becomes a regular occurrence on the ward. This is symptomatic of AE.

 

[Sweeper2000]

yes they have said it.

Just one example, for baby B, because I've linked all of these many times before in response to your posts, the last time fairly recently too.

"He says the cause of her collapse - like her brother Child A - was an air embolism, 'there was nothing else to explain this collapse, which was so sudden and unexpected', he said"

https://twitter.com/MrDanDonoghue

"Dr Bohin said other factors, such as infection or cardiac arrhythmia, could be discounted, and the only conclusion left was "air embolus"."

Recap: Lucy Letby trial, Wednesday, October 26

And when Dr Bohin said "fleetingly rare" she was talking about the cause of the bleeding in baby E. She was not talking about her diagnosis of air embolus.

pardon my temporary misplacement of this information you had indeed quoted in reply.

I do have the quotes it’s just going to take ages to find them. im almost sure that they have never referred to any single piece of hard evidence and said “only ae would leave this behind”, that’s what I’m getting at not the diagnosis. Although at this point in time I don’t know if dr marn has said that about the catheter air or otherwise.

 

[Sweeper2000]

I don't think that there is one single piece of evidence that is diagnostic, of itself, of air embolism. This is the case with most diseases however. Doctors use a range of symptoms to diagnose conditions.

The evidence that points to air embolism includes:

The sudden nature of collapse, which is not explained by any disease state. And the fact that babies would then suddenly inexplicably get better.

The fact that resuscitation methods that should work did not.

Presence of gas on x rays with no medical reason why that should be there

The fleeting rash not observed before by doctors with decades of experience. But then this becomes a regular occurrence on the ward. This is symptomatic of AE.

There is and it’s gas Bubbles in certain places in post mortem.

“Venous air embolism is a rare cause of death. Entry of gas into the circulation is caused by trauma, mostly surgical or therapeutic, and sometimes resulting from criminal intervention. The detection of air embolisms requires special precautions during autopsy. An aspirometer has to be used for the detection, measurement and storage of gas originating from the heart ventricles. The aspirometer has to be filled completely with distilled water containing two drops of Tween 80 to reduce the surface tension of the water and to prevent adherence of small air bubbles to the wall of the aspirometer. Subsequently the gas has to be analysed by gas chromatography. When the results correspond with the main criteria defined by Pierucci and Gherson [2] the diagnosis "air embolism" is justified. The technique for the detection of air embolism is simple but requires a careful procedure which is described in detail.”

Proof of fatal air embolism - PubMed

Venous air embolism is a rare cause of death. Entry of gas into the circulation is caused by trauma, mostly surgical or therapeutic, and sometimes resulting from criminal intervention. The detection of air embolisms requires special precautions during autopsy. An aspirometer has to be used for...

pubmed.ncbi.nlm.nih.gov

 

[Parker Knoll]

pardon my temporary misplacement of this information you had indeed quoted in reply.

I do have the quotes it’s just going to take ages to find them. im almost sure that they have never referred to any single piece of hard evidence and said “only ae would leave this behind”, that’s what I’m getting at not the diagnosis. Although at this point in time I don’t know if dr marn has said that about the catheter air or otherwise.

It would be helpful if you could link them.
It’s very important to keep things as factual as possible.

 

[Tortoise]

I find the over feeding theory really frustrating.
Yes if she fed 20 mls you could vomit 20 mls but that’s suggesting the stomach is completely empty.
I can aspirate NG tubes and get no aspirate for a few hours and then suddenly the next time 100s of mls. Just like patients can vomit significantly more than what they have had in NG feed over the last hour.
The main reason being usually the ng tube is in such a position in the tummy it isn’t allowing aspiration, usually it’s stuck to the side of the stomach wall and there’s no real way of knowing this is the case. This has happened so many times in my career.
It’s the reason X-rays are needed so frequently as it’s difficult to aspirate from them sometimes. Usually just moving position can help.
It’s well known that the stomach and digestive system can slow to a stop and although the NG feed is going into the stomach it is not being taken further along the digestive tract and effectively just sitting there.
Then over time each 20mls feed is accumulating until vomiting a large amount.

The medical experts said they knew there was no milk in her stomach before she was fed, 15 minutes before she vomited, because of the pH reading taken before her feed.

"On this occasion, a pH reading of four would indicate the presence of stomach acid, indicating the NGT was in the correct place, Dr Evans says."

"Mr Myers says 'we now know' the stomach was not aspirated prior to 2am.
Dr Evans says that was not the case, as the nurse had aspirated to get a pH reading.
Mr Myers says the nurse had not aspirated the milk, as she would not have done so in a baby as young as Child G as a matter of procedure.
Dr Evans: "No, this is too simple." He says milk is a neutral pH, so if the reading is '4', then that sample was indicative of acid in the stomach."

"Dr Bohin says "no", as the stomach was empty, with a pH reading of 4. If there was milk in the stomach, it would have 'neutralised' the stomach and the pH reading would have been higher."

Recap: Lucy Letby trial, Monday, December 12

 

[Sweeper2000]

It would be helpful if you could link them.
It’s very important to keep things as factual as possible.

It’s going to take me an hour. I thought someone else would better remember. I believe most of that which I’m referring to would come from the answers during cross questioning by mr Myers.

 

[Tortoise]

It’s going to take me an hour. I thought someone else would better remember. I believe most of that which I’m referring to would come from the answers during cross questioning by mr Myers.

If you've quoted words that aren't actual quotes/links that you have available, you need to request a moderator to delete your post, or edit it yourself if it's within the editing window. Quotes need MSM links at WS.

 

[JamesMcGillEsquire]

Thank you. I do know what the word means. I'm asking what his sentence means. Is he sorry for not providing links previously, and will rectify that, or is he sorry he isn't going to provide links because he doesn't have them. I want to see if they are actual quotes from the medical experts, or if they are the poster's own words that he's put quotes around and passed off as the experts' words, as has happened many times.

Can you provide links to some examples of when this has happened, many times?

<modsnip: not necessary>

 

[Sweeper2000]

these are examples of what I am referring to.

Mr Myers then asked him whether vigorous CPR could be "categorically excluded" as a possibility for Child O's injuries.
Dr Marnerides compared it to the hypothetical discovery of a dead man in the desert with a pot next to him, saying it could be "possible" that a helicopter flew over and dropped the pot on his head, but that it was not "probable".

He said the "likely explanation" for the death of Child D, a girl, was an air embolism into her circulation, while another girl, Child I, received an excessive injection of air into her stomach.

Lucy Letby: Bruises on baby not caused by CPR, trial told

Nurse Lucy Letby is accused of killing the boy before also allegedly murdering his triplet brother.

www.bbc.co.uk

Dr Arthurs said he could not say from the image alone that an air embolism – a gas bubble which enters a blood vessel – was the cause of Child A’s death.

Expert in Lucy Letby trial says line of gas in baby post-mortem X-ray ‘unusual’

Letby is on trial accused of the murders of seven babies and the attempted murders of ten others at the Countess of Chester Hospital’s neo-natal unit.

www.manchestereveningnews.co.uk

took me long enough.


He agreed with Mr Myers that 'one possibility' that would explain the line of gas shown in the image would have been air administration. Other possible causes could have been attempts made at resuscitation or post-mortem changes.

Nurse felt final heartbeat of baby 'murdered' by Letby, court hears

A nurse sat crying in the witness box today after telling the trial of neonatal nurse Lucy Letby how she felt the final heartbeat of a baby she was trying to resuscitate.

www.dailymail.co.uk

it is in line with what dr bohin said when saying “no singular thing that is diagnostic of AE“.

 

[WaxLyrical]

The medical experts said they knew there was no milk in her stomach before she was fed, 15 minutes before she vomited, because of the pH reading taken before her feed.

"On this occasion, a pH reading of four would indicate the presence of stomach acid, indicating the NGT was in the correct place, Dr Evans says."

"Mr Myers says 'we now know' the stomach was not aspirated prior to 2am.
Dr Evans says that was not the case, as the nurse had aspirated to get a pH reading.
Mr Myers says the nurse had not aspirated the milk, as she would not have done so in a baby as young as Child G as a matter of procedure.
Dr Evans: "No, this is too simple." He says milk is a neutral pH, so if the reading is '4', then that sample was indicative of acid in the stomach."

"Dr Bohin says "no", as the stomach was empty, with a pH reading of 4. If there was milk in the stomach, it would have 'neutralised' the stomach and the pH reading would have been higher."

Recap: Lucy Letby trial, Monday, December 12

But wasn’t there another baby who also had an acidic ph who did have milk in their tummy, and when Myers referred back to baby G, SB didn’t have an answer as she didn’t have G’s notes in front of her? I thought that maybe called into question whether there was milk in G’s tummy for sure.

Edit: Child P, aspirated 20ml of milk with a ph of 3.

Link: Recap: Lucy Letby trial, Thursday, March 23