Defence Case Continued 15th May 2023
Child I
Mr Myers moves on to the case of Child I, a baby girl born on August 7, 2015 at Liverpool Women's Hospital at a gestational age of 27 weeks.
She was transferred to the Countess of Chester Hospital on August 18. 'Active problems' noted by Dr Sally Ogden at the time of transfer included 'preterm, [respiratory distress syndrome], establishing feeds, jaundice, suspected sepsis'.
September 5-6, 2015, saw a number of events where Child I deteriorated and she was transferred to Liverpool. Mr Myers says Letby is not being blamed for those events.
Child I was transferred back to the Countess later that month, and on September 30, at 4pm, Child I had vomiting, brady, apnoea and desaturation, followed by a similar event later that day.
Another event happened on October 13 with Child I deteriorating. The following morning, Child I deteriorated and required resuscitation.
She was transferred to Arrowe Park on October 15 before returning to the Countess on October 17. Child I had a desaturation on October 22, and died the following morning.
Letby is asked if she had a recollection of Child I. Letby says she does.
She was a baby "with us for many months and got to know her [and the family] really well."
She had 'complex problems' which required frequent transfer to Liverpool. Child I's abdomen "was always more distended than normal" and there were occasions when that distention would increase, Letby tells the court.
Letby confirms to Mr Myers she looked after Child I on many occasions.
A radiograph from August 23, 2015, is shown to the court. Mr Myers says this had been part of what experts classed as a 'suspicious event', with a clincial note at the time recording 'non-specific gaseous distention of the abdomen which is suggestive of [NEC]' in Child I.
A record of Letby's work shifts shows Letby was not in work that day.
Mr Myers refers to the next events for Child I.
Nursing notes by Ashleigh Hudson on October 13 are shown to the court.
The notes include: '...'pale, pink in colour but well perfused.
0322- when in the nursery, neonatal nurse Lucy Letby noticed that [Child I] looked quite pale., when turning the light on for closer examination, we found [Child I] to be very pale in colour and not moving. Apnoea alarm in situ, had not sounded, breathing was shallow and rr appeared low....monitoring commenced....30% neopuff O2 commenced...chest compressions commenced at 0325, no heart rate heard...'
Lucy Letby's note, 'written for care given from 0345' - '[Child I] noted to be pale in cot by myself at 0320, S/N Hudson present. Apnoea alarm in situ and had not sounded...full resuscitation commenced as documented in medical notes'.
A nursing shift rota is shown for October 12-13, with Lucy Letby in room 1, designated nurse for one baby. Ashleigh Hudson was designated nurse for three babies in room 2, including Child G and Child I.
Letby says she cannot recall looking after Child I prior to 3.20am. She recalls going with Ashleigh Hudson the room 2 together, and noticing Child I looked pale.
"Ashleigh was doing something on the worktop...with her back to the cot. I was in the doorway, talking to Ashleigh."
Mr Myers: "What was the illumination level like?"
Letby: "I can see clearly enough that [Child I] was pale in the cot. [Child I] was in front of a window. At no point is any nursery in complete darkness.
"The only time we have that is in room 4, for babies preparing to go home.
"It's important we need to see them visually.
"We need to see the monitors and the babies themselves."
Letby adds the colour level of a baby "is one of the most important things we assess".
"I could see her face and her hands...she just looked very pale.
"I said to Ashleigh she looked very pale and we turned the lights up". Letby says she cannot recall if the light had been on a dimmer switch, but the lighting was turned up.
Child I was "very unwell" so care was given.
The apnoea alarm had not gone off as, Letby says, Child I was 'gasping' and occasionally taking in air.
Letby says she and Ashleigh Hudson called for help.
I JUST FOUND a reference to the trolley mistake in a Daily Mail article last December. Too late to edit my post...
https://www.dailymail.co.uk/news/ar...larm-save-infant-baby-deaths-trial-hears.html
Apparently she did make that accusation back then, but reporters didn't include it in their trial tweets?
Is she really the one who found the baby on the trolley, behind the screen with no monitor on? Any other witnesses to that?
According to Lucy, she was the one who found that emergency situation and moved the baby to the cot and called for help.