UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #24

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Okay but the biggest problem with baby K I think was that when RJ came into the room, she was looking at RJ head on doing nothing.
You make some good points though about other evidence in relation to this case not being strong. It really comes down to whether the jury believe Dr RJ against LL.
Other things to consider in relation to baby K are whether her pattern of deterioration mirrors what would be expected in a 25 weeker. I'd argue that 25 weekers are notoriously unstable in the first few days so the profound desat not all that surprising in itself, her reaction though, if true sounds suspicious.
My understanding is that for older babies in NICU , the approach is to give them a chance to self correct from a desat. If LL wasn’t used to dealing with a 25 weeker (she mentioned they didn’t get them at COCH), she may have been (incorrectly) applying the standard practice for older babies to this little 25 weeker.
 
Child
Can we really say that though? I’d be interested to know if she ever applied for jobs at a tertiary unit, or expressed an interest in higher level care of neonatal than the countess provided.

I also think in terms of this baby that she would be more memorable than most. I also find it really hard to accept she doesn’t have any recollection of her standing and watching the baby desat, when the desat happened, we know she was “babysitting”. You’d think she’d remember attending to the desat.
 
Or there’s been a pre trial ruling that the cause of death can’t be brought up.
That would not be deemed fair for Letby and would be grounds for appeal, if the baby died of a condition that could have caused the collapses she is charged with, so the prosecution would have no interest in applying for a ruling of that nature.


JMO
 
Yeah I think it was noted in evidence that she had career aspirations to become an ANNP ( not that that's a crime!)
Regards the desat, it was more her reaction to it rather than the desat itself I think.
If RJ's account was to be believed, she was literally ' caught with her hands in the cookie jar'
She should not have been staring staight at him as he entered the room, her back should have been to him, if that makes sense, because she was dealing with the baby.
 
Genuine question:

For those saying some babies cases don't seem to be as strong, do you mean because you don't feel it is proven that the babies died in suspicious circumstances? Or you don't believe they have proved LL is responsible?

Cos me personally if I was on the jury... if I'm finding her guilty of some murders, then I'm finding her guilty of all the murders. And tbh if she's guilty of most of the murders, then I'd have no problem finding her guilty of all of them, even ones with less 'evidence'. The fact that she's the common denominator would be enough evidence for me, in those cases where the evidence is less strong.

I don't think we can judge this case by what rules would apply if each case was considered individually. Because they literally can't be. So it would be wrong to do so. IMO. Not a legal expert! Just imagining myself on that jury!
 
On the other hand we have a style of attack entirely inconsistent with anything else that’s alleged. No air, no poisoning, no internal trauma.
It is no surprise that someone who had already, allegedly, attacked 10 babies with 4 other various methods of attack, would then add a new method for the 11th victim.

We have seen evidence already that IF guilty, the defendant likes to use opportunities based upon the patient's illnesses to craft her methods of assault. Babies with prior blood sugar issues receive insulin, while babies with CPAP receive dollops of air by injection.
So a tiny baby with a breathing tube that is giving 100% oxygen support would be very vulnerable to tampering.

I wouldn't rule her out as a suspect just because she used a new method, considering she had already used a large amount of different methods already.

No paper towel keepsake, or any other notes.
That we know of.
No sympathy card. No memory box.
The baby did not die at the Countess. So she could not have been involved in this process.
No initials in her diary. No post it note ramblings.
Not that we know of. There could be many notes that were never located.
No Facebook searching until a matter of weeks before her arrest, suggestive in my view of her being tipped off on which babies are being investigated, rather than her stalking the parents’ grief.
Maybe, but it then raises doubts of her claim she remembers nothing about this baby, if she had been told that she was being investigating, and she began researching her online.
Then she learned she charged with attacking her, and she didn't refresh her memory?
We’ve got her acting seemingly normal when “caught” by Dr J, and not like the rabbit in headlights you’d expect if someone was caught red handed trying to murder a baby.
How was she acting normal? She was standing motionless, doing nothing to help a baby who was desaturating.
Look how she appears in court, while under tremendous pressure. She is unflappable.

Why was she just standing there, and not calling for help at least? Originally she said she was waiting for the child to recover on her own. But since then we have learned that was against protocol for a tiny preemie:

Elizabeth Morgan, Agreed Evidence
For a baby of this gestational age, it would be standard practice for a nurse to take corrective action, carry out checks and call for help if a desaturation was noted.
It would 'not be normal practice' to wait and see if the baby self-corrects, for a baby of this gestational age.


We’ve got inconsistencies in recollections between Dr J and the designated nurse. We’ve got a breathing tube that was so insecure it was able to dislodged multiple times.
If it had dislodged on it's own, why wasn't nurse Letby doing anything about it when she claims she knew the baby was desaturating?

Minutes before LL entered Baby K's room, the breathing tubes were in a good place:

The prosecution is now asking about the time period when Ms Williams left the nursery room to inform the family on what had been happening.
She said she would not have done so if Child K was not satisfactorily stable.
She tells the court, other than being born very premature, there was nothing of concern.
She does not remember asking anyone in particular to look after Child K in her absence.

Elizabeth Morgan, Agreed Evidence
The court now hears an agreed statement from Elizabeth Morgan, who says in her experience, it is very unlikely a nurse would leave the nursery of a baby if the baby's ET tube was not settled in a position and the baby was settled.

Baby K is just not the open and shut case for me as it seems to be for everyone else. JMO.


It may not be an open and shut case, but there are a lot of very suspicious things that point to Nurse Letby, in my opinion.

The Baby was settled, with the breathing tube in place, as the designated nurse left the unit. Five minutes later, LL is standing by cot side, just as Baby K is desaturating because of a dislodged tube. And she is breaking protocol by not calling for help and beginning to help her.

I don't think it matters if there was a handover sheet or a post-it-note found afterwards. Or if Dr J and the designated nurse both remember if they had a conversation about it or not, afterwards. None of that changes the fact that the very same pattern, seen in the previous incidents is seen here.

Once the designated nurse and/or the parents of a settled baby leaves the room, Nurse LL steps into the room, allegedly, and minutes later the baby has a sudden, unexplained collapse. This happened about 22 times in that q12 month span.
 
Yes, exactly. If guilty, there must have been a very good reason why she had got away with serial murder for a whole year (or maybe more), right under the noses of dozens of educated professionals, and dozens of loving parents. This is that reason. She is an incredible actress and liar.


(ETA - this is not sub judice, I saw it with my own eyes and ears on Friday, whether or not she committed the crimes she stands accused of).
Would be very interesting if true. I’m going to ask a very specific question. When she was speaking did it ever seem like she used her vocalisms in a purposeful way? That is knowingly and with a end goal in mind in terms of shaping the thoughts of others?

Does anyone know if these TPN bags are made up at the hospital? The reason I say that is because when I attended on Monday it was almost as if Lucy was saying “I have no idea how the insulin would have ended up in the bag, maybe it came from outside the hospital when it was produced”

Now let me make it clear she didn’t use those words but In my opinion it was clear what she was trying to say. She wasn’t able to articulate clearly what she meant during that exchange and Mr Johnson moved on to another question.
Yes the tpn bags are made bespoke at the hospital chemist dispensary.

can you remember specifically what it was that she said that made you think 5that? The words specifically though. Might involove the words “source”, “origin“ or manufacturer.

if what you say is true that’s a sign of someone being honest. That’s actually a social Skill and a true positive. Imo Displaying an awareness of peoples general oppositional nature and An understanding how to use words in a compositional way that doesn’t lie but empathically shapes the visual and emotional elements of thought making. It’s management of thought rather than manipulation. It’s absolutely fitting with what you said about her use of vocalisms imo assuming she is aware of it. It’s an extremely fine line between a manipulation and a social skill also imo a telling trait of intelligence and level of deviousness or absence thereof.
 
My understanding is that for older babies in NICU , the approach is to give them a chance to self correct from a desat. If LL wasn’t used to dealing with a 25 weeker (she mentioned they didn’t get them at COCH), she may have been (incorrectly) applying the standard practice for older babies to this little 25 weeker.

If so, why wouldn't the defense say that? It would be pretty surprising that a confident, skilled nurse who usually worked with the poorly babies would not know that a 25-weeker would need instant support.

Elizabeth Morgan, Agreed Evidence
For a baby of this gestational age, it would be standard practice for a nurse to take corrective action, carry out checks and call for help if a desaturation was noted.
It would 'not be normal practice' to wait and see if the baby self-corrects, for a baby of this gestational age.
 
Genuine question:

For those saying some babies cases don't seem to be as strong, do you mean because you don't feel it is proven that the babies died in suspicious circumstances? Or you don't believe they have proved LL is responsible?

Cos me personally if I was on the jury... if I'm finding her guilty of some murders, then I'm finding her guilty of all the murders. And tbh if she's guilty of most of the murders, then I'd have no problem finding her guilty of all of them, even ones with less 'evidence'. The fact that she's the common denominator would be enough evidence for me, in those cases where the evidence is less strong.

I don't think we can judge this case by what rules would apply if each case was considered individually. Because they literally can't be. So it would be wrong to do so. IMO. Not a legal expert! Just imagining myself on that jury!
For me, some of the charges aren’t proved on the medical evidence , so you don’t therefore get onto the question of whether it was a particular person who was the perpetrator or not .
 
Would be very interesting if true. I’m going to ask a very specific question. When she was speaking did it ever seem like she used her vocalisms in a purposeful way? That is knowingly and with a end goal in mind in terms of shaping the thoughts of others?


Yes the tpn bags are made bespoke at the hospital chemist dispensary.

can you remember specifically what it was that she said that made you think 5that? The words specifically though. Might involove the words “source”, “origin“ or manufacturer.

if what you say is true that’s a sign of someone being honest. That’s actually a social Skill and a true positive. Imo Displaying an awareness of peoples general oppositional nature and An understanding how to use words in a compositional way that doesn’t lie but empathically shapes the visual and emotional elements of thought making. It’s management of thought rather than manipulation. It’s absolutely fitting with what you said about her use of vocalisms imo assuming she is aware of it. It’s an extremely fine line between a manipulation and a social skill also imo a telling trait of intelligence and level of deviousness or absence thereof.
Hi Sweeper, there were no words used which were that obvious and descriptive and definitely no bold words like “manufacturer” which stuck out in particular but have you ever been in a conversation with someone where you are almost finishing their sentence in your own head or almost willing/expecting them to use a specific word, it was very much like that.

This was when Mr Johnson was asking Letby “Well how could that insulin have found itself in that bag!?”

In that moment it felt like I was watching someone who was equally searching for answers or ways in which this could have happened but not in a deflective manner.

It certainly was by no means fluid but from memory Letby said something to the affect of “Well I wouldn’t know how it got there, I didn’t put it in the bag….pauses….I don’t know…I don’t know….if the evidence is saying it was administered via the TPN then I don’t know…maybe it came from the outside”

Her reply was in no way frantic, it was to be honest quite confused and perplexed, almost searching for answers in her own mind.

The one phrase I definitely remember is her suggesting it could have come from outside (which is what I thought she was trying to get at the entire time but I was expecting a word to come out of her mouth like manufacturer or maybe it was delivered like that)

It didn’t feel like Letby believed this was a very likely scenario but it was almost like “Well if it’s in the bag and I haven’t put it there then how is it there” was it there the entire time ?

This didn’t feel like she was clutching at straws, it just appeared to be someone who genuinely felt confused by how this has happened.

It is so hard to articulate what I mean when I say this but it wasn’t a bold, confident deflection or a bold claim it could have come from elsewhere and it didn’t appear like a response out of desperation either. Before she could actually articulate what she meant Mr Johnson was already asking her another question.

I could be totally wrong but these are just my interpretations having seen her giving evidence that day.
 
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For me, some of the charges aren’t proved on the medical evidence , so you don’t therefore get onto the question of whether it was a particular person who was the perpetrator or not .
If you look at each case individually, you may be able to consider there is another possible, although improbable, non-malicious possibility.

But if you look at all 22 incidents, then what?
Am I to believe that 22 different times, babies who were settled and healthy, suddenly collapsed, often with unexplained internal bleeding, and/or a very unusual mottled purplish rash, and each and every time, Nurse Letby was on duty, allegedly and in most cases, was cot-side minutes before?

When I look at the entire pattern of incidents, I cannot accept that there would be a huge spike in unexplained collapses which all happened, allegedly, right under LL's nose.

Especially when the collapses did not ever happen when she was away on her two vacations , but resumed the very day she returned. And the collapses switched from night time to day time just as she switched shifts from night to day shifts. Allegedly.

I think when we look at each case individually we can always find questions about the medical evidence because there is always going to be an alternative scenario. But when we look at the big picture, there is no rational explanation for the obvious pattern of suspicious events. JMO
 
It is no surprise that someone who had already, allegedly, attacked 10 babies with 4 other various methods of attack, would then add a new method for the 11th victim.

We have seen evidence already that IF guilty, the defendant likes to use opportunities based upon the patient's illnesses to craft her methods of assault. Babies with prior blood sugar issues receive insulin, while babies with CPAP receive dollops of air by injection.
So a tiny baby with a breathing tube that is giving 100% oxygen support would be very vulnerable to tampering.

I wouldn't rule her out as a suspect just because she used a new method, considering she had already used a large amount of different methods already.


That we know of.

The baby did not die at the Countess. So she could not have been involved in this process.

Not that we know of. There could be many notes that were never located.

Maybe, but it then raises doubts of her claim she remembers nothing about this baby, if she had been told that she was being investigating, and she began researching her online.
Then she learned she charged with attacking her, and she didn't refresh her memory?

How was she acting normal? She was standing motionless, doing nothing to help a baby who was desaturating.
Look how she appears in court, while under tremendous pressure. She is unflappable.

Why was she just standing there, and not calling for help at least? Originally she said she was waiting for the child to recover on her own. But since then we have learned that was against protocol for a tiny preemie:

Elizabeth Morgan, Agreed Evidence
For a baby of this gestational age, it would be standard practice for a nurse to take corrective action, carry out checks and call for help if a desaturation was noted.
It would 'not be normal practice' to wait and see if the baby self-corrects, for a baby of this gestational age.



If it had dislodged on it's own, why wasn't nurse Letby doing anything about it when she claims she knew the baby was desaturating?

Minutes before LL entered Baby K's room, the breathing tubes were in a good place:

The prosecution is now asking about the time period when Ms Williams left the nursery room to inform the family on what had been happening.
She said she would not have done so if Child K was not satisfactorily stable.
She tells the court, other than being born very premature, there was nothing of concern.
She does not remember asking anyone in particular to look after Child K in her absence.

Elizabeth Morgan, Agreed Evidence
The court now hears an agreed statement from Elizabeth Morgan, who says in her experience, it is very unlikely a nurse would leave the nursery of a baby if the baby's ET tube was not settled in a position and the baby was settled.




It may not be an open and shut case, but there are a lot of very suspicious things that point to Nurse Letby, in my opinion.

The Baby was settled, with the breathing tube in place, as the designated nurse left the unit. Five minutes later, LL is standing by cot side, just as Baby K is desaturating because of a dislodged tube. And she is breaking protocol by not calling for help and beginning to help her.

I don't think it matters if there was a handover sheet or a post-it-note found afterwards. Or if Dr J and the designated nurse both remember if they had a conversation about it or not, afterwards. None of that changes the fact that the very same pattern, seen in the previous incidents is seen here.

Once the designated nurse and/or the parents of a settled baby leaves the room, Nurse LL steps into the room, allegedly, and minutes later the baby has a sudden, unexplained collapse. This happened about 22 times in that q12 month span.
100% agree.

A nurse!!! doing NOTHING but watching while the tiniest Baby is struggling just boggles my mind.

WTH?? o_O

Just imagine,
struggling for YOUR life,
and there is this montionless figure observing you.

Shivers!

JMO
 
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Does anyone know if these TPN bags are made up at the hospital? The reason I say that is because when I attended on Monday it was almost as if Lucy was saying “I have no idea how the insulin would have ended up in the bag, maybe it came from outside the hospital when it was produced”

Now let me make it clear she didn’t use those words but In my opinion it was clear what she was trying to say. She wasn’t able to articulate clearly what she meant during that exchange and Mr Johnson moved on to another question.
Hi. Wouldn't the insulin bind to the bags if left for any amount of time? This element really confused me. Would like to know more specifics about how long it would take and whether it would alter the appearance of the bag after a period of time
 
Regarding the insulin cases.
It's pretty much proven that insulin was put in the bags in both cases. LL agrees ..the second case its been shown with a degree of certainly that the insulin had to be added some time after the bag was hung ..at cotside.
There were only 2 nurses with access to insulin and the cotside at both cases

If there were just one insulin case I might think hang on this one sticks out like a sore thumb is this connected? But not with 2 cases.

I think it has to be remember if guilty she did use a variety of methods (very clever)
Air in bloodstream
Air in stomach
Milk in stomach
Trauma
Interfering with breathing tubes
Insulin

If she only ever used one method..say Air embolism and just one insulin case popped up out of many cases again I might think it's unrelated...but not with 2 insulin cases amongst a variety of methods

In a situation such as this if insulin was used regularly or in close proximity it is a method that would likely spike suspicion very quickly so it would be understandable not to use it too often.
 
If there were just one insulin case I might think hang on this one sticks out like a sore thumb is this connected? But not with 2 cases.

I agree. I also find it interesting that the insulin cases were not added until later. So it's not as though, they found the insulin and then came to the conclusion it was LL. They literally knew there was a problem with LL and then what do you know, it also turns out she was present for these and also only one of two possible nurses that were at both insulin events.
 
I think the method of air embolism is why she (allegedly) got away with this for so long. The symptoms aren’t something well known, the incidence of AE in neonates is rare. It’s not something that medical staff are immediately looking for as a cause of collapse IMO. Had insulin been used each time I imagine by the 5th or so collapse suspicion would be rife. Add in the overfeeding, inflicted trauma, tube dislodging, and each collapse may not have looked all that similar on the surface, if guilty then I think she went about this in a calculated manner using a different method in between AE to avoid suspicion and possibly to experiment to see the results of each method IMO.

Have been doing a bit of research on AE in neonates and the similarities in symptoms to these cases are striking IMO, there’s very limited info available because of how rare it is to occur even with an innocent cause. Unsure if I can link an essay on the subject as a source but I can see why Dr RJ felt a chill down his spine when he researched the symptoms of AE in neonates.

All MOO
 
Regarding the insulin cases.
It's pretty much proven that insulin was put in the bags in both cases. LL agrees ..the second case its been shown with a degree of certainly that the insulin had to be added some time after the bag was hung ..at cotside.
There were only 2 nurses with access to insulin and the cotside at both cases

If there were just one insulin case I might think hang on this one sticks out like a sore thumb is this connected? But not with 2 cases.

I think it has to be remember if guilty she did use a variety of methods (very clever)
Air in bloodstream
Air in stomach
Milk in stomach
Trauma
Interfering with breathing tubes
Insulin

If she only ever used one method..say Air embolism and just one insulin case popped up out of many cases again I might think it's unrelated...but not with 2 insulin cases amongst a variety of methods

In a situation such as this if insulin was used regularly or in close proximity it is a method that would likely spike suspicion very quickly so it would be understandable not to use it too often.
The chances of insulin poisoning happening to two twins on the same unit in 12 months, whose twin collapsed with alleged air embolism in the same room within the same timescale, must be off the scale. JMO
 
If so, why wouldn't the defense say that? It would be pretty surprising that a confident, skilled nurse who usually worked with the poorly babies would not know that a 25-weeker would need instant support.

Elizabeth Morgan, Agreed Evidence
For a baby of this gestational age, it would be standard practice for a nurse to take corrective action, carry out checks and call for help if a desaturation was noted.
It would 'not be normal practice' to wait and see if the baby self-corrects, for a baby of this gestational age.
Yes it's agreed evidence. If defence didn't agree with her they'd have had to call her in to challenge her evidence on the stand.
 
Here is how we ended last session:
[RE: Baby K]

Letby says she does not recall the latter two desaturations for Child K, and does not accept Dr Jayaram's evidence in the first desaturation.

Mr Johnson says he will deal with these in a different order than chronologically; he will cross-examine on the second desaturation first.

Letby says she does not know what happened to Child K, so does not cite staffing levels as a contributory factor in Child K's desaturations.

She says she feels "potentially" the ET Tubes were not secured for Child K.

The second desaturation occurred at 6.10-6.15am on February 17, 2016.

The court hears a note on Child K's birth and assessment was typed up by Letby on a computer from 6.04am-6.10am. The note would have been taken from paper charts taken by the cotside.

NJ: "You were at [Child K's] cotside a minute or two before she desaturated, didn't you?"

Letby says she would have got the notes from the cotside "at some point" prior to her typing them up.

The trial has concluded for today.
 
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