UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #25

[Legal]

Looking at the article I've just posted, above your post, it looks though as if she didn't respond to his first question as he expected. I think he was expecting her to say 'I was out but I wasn't having a good time'. When she said she was having a good time he then had to do more work. I think he was having to think on his feet how can I steer this towards having a good time but not feeling good generally, but he never managed it IMO because she wasn't picking up his cues. MOO

Yes, I agree with this. It seemed to me in the redirect that BM was asking leading questions that most of us would probably pick up on but she didn't. Like the example I posted above, where he asked why she would remember some babies more than others and she didn't think to mention how long they'd been in the unit. So he then asked her "are they all on the unit for the same length of time?".

I'm not sure Eirann would want to come back to the stand having said LL was an exceptional nurse and good at reporting others' mistakes, now we have seen how she falsified documents, texted constantly and made mistakes.

 

[katydid23]

Eirian was already re-called on the prosecution's last day of evidence, with the defence questioning her first.

Recap: Lucy Letby trial, Thursday, April 27

Eirian Powell, NNU Manager

Defence Questions

12:32pm

The trial is now resuming after a short break.
Eirian Powell, who was the neonatal unit ward manager at the Countess of Chester Hospital between 2011-2017, is being recalled to give evidence.
Mr Myers has a few questions to ask Ms Powell.

12:34pm

Ms Powell first met Lucy Letby when the latter was a University of Chester student on a four-week placement.
She agrees Letby was "very keen to improve her practice" and saw her to the point when she was working on the neonatal unit.
Mr Myers: "She was an exceptionally good nurse?"
Ms Powell: "Yes, she was."

12:38pm

Ms Powell confirms Letby was "committed" in progressing with her training, including training in intensive treatment units.
She said Letby was 'hard-working and flexible' - "extraordinarily so", and worked a lot with premature babies in the neonatal unit.
"She was very particular with attention to detail".

12:39pm

Mr Myers asks about the 2016 reallocation to day shifts, following a number of deaths on the neonatal unit.
Ms Powell said the move to the day shift was to give Letby "more support" in staffing numbers, and was not "a punishment".
Mr Myers said the unit remained busy during those days.

12:44pm

Mr Myers asks about the redeployment of Lucy Letby away from the neonatal unit in July 15, 2016, which was announced in an email signed by Ms Powell, as part of a period of clinical supervision.
The email said 'This is not meant to be a blame or a competency issue', and was in preparation for an external review.
Ms Powell confirms Lucy Letby was "upset" at being removed from the unit.

12:49pm

Ms Powell recalls the review meeting was "very upsetting" for Lucy Letby and herself. She does not recall if Lucy Letby was told not to talk to several other members of staff.
"She was distraught at that point". Ms Powell said Letby was upset at what was said in the meeting, about what was suggested Letby may have done.
Ms Powell said everyone's competency was being reviewed at that time, but "not to the extent" of Letby's.
She adds she was "keen" to get Letby back on the unit.

Prosecution Questions

12:51pm

Nicholas Johnson KC, for the prosecution, rises to ask a couple of questions.
He asks if Letby made mistakes.
Ms Powell said Letby made mistakes, as everyone did, but was "good at reporting mistakes", and would report mistakes that other nurse practitioners or medical staff had made, regardless of seniority.

12:54pm

Mr Johnson asks what was said in the review meeting.
Ms Powell said that Letby would have to come off the unit, but could not recall what else was said.
Mr Johnson asks what was being suggested in that meeting.
"That she was the common [element] in all of the deaths".

Mr Johnson asks what was being suggested in that meeting.
"That she was the common [element] in all of the deaths".

So Johnson got Eirian Powell to say that LL was seen as " the common element in all of the deaths."

 

[Cardgame]

Yes, I agree with this. It seemed to me in the redirect that BM was asking leading questions that most of us would probably pick up on but she didn't. Like the example I posted above, where he asked why she would remember some babies more than others and she didn't think to mention how long they'd been in the unit. So he then asked her "are they all on the unit for the same length of time?".

I'm not sure Eirann would want to come back to the stand having said LL was an exceptional nurse and good at reporting others' mistakes, now we have seen how she falsified documents, texted constantly and made mistakes.

And how she may have been 'reporting' others mistakes in order to try and put them in the frame for potential collapses.

 

[Dotta]

I really, I mean really don't think it was BM's idea for her to take the stand.

But he could not influence her decision - it was her gamble.
And only hers.

JMO

 

[marynnu]

100% - in all my life I have only ever heard 'worse for wear' applied to a person used in the context of being drunk / hungover. How awful to use it in this context. I guess he could be secretly alluding to 'poisoned'?

I've used it in relation to illness & being extremely tired. To me it indicates how you are after an event, when you're recovering but still not OK. It did leap out to me as,an odd expression to use for a neonate. JMO

 

[Tortoise]

Of course BM could simply say, we don’t believe the prosecution have proved their case and rest without presenting any more witnesses.

I know in the US a defendant does not have to offer an alternative theory and a jury can’t draw a negative inference if they don’t hear an alternative from the defence as the burden of proof is on the prosecution.

Is it the same rule for the UK? I know we don’t have the 5th amendment right against self incrimination here so I think the jury can draw a negative inference from a defendant not testifying, however LL has testified. In the UK can they simply rest without offering an alternative explanation and the jury just have to decide if the prosecution have proven their case without assuming that because the defence didn’t present experts etc that they don’t have any to refute the prosecution?

MOO

The defence has put forward its alternative explanations during the cross-examination of the prosecution's experts.

It's up to the jury if they accept the prosecution experts' opinions, after cross-examination, which is what Myers said in his opening address.

I'm certain defence doesn't have any medical experts. I don't believe the judge would have said they may have further evidence, if defence had an expert scheduled. Those alternative expert opinions (if they existed) would have to have been put to the prosecution's experts to deal with in advance of trial and during the prosecution's case. Otherwise it becomes an untenable situation (IMO) of the prosecution having to call its experts back after the defence case to rebut the defence experts' evidence. LL herself would also have known about it and had reasons for the collapses to put forward both in her defence statement and during cross-examination. As it is, Myers has focused only on attacking the prosecution experts' conclusions, expertise and impartiality.

MOO

 

[katydid23]

Chester Standard:
She says she believes the bolus, which has 'time started: 1440', was in response to Child O's collapse.
A doctor's note recorded for the '~1440' collapse: '10ml/kg 0.9% sodium chloride bolus already given.'
Letby agrees the two desaturations for Child O that day were "profound" ones.
Letby's note: 'Approx 1440 [Child O] had a profound desaturation to 30s followed by bradycardia. Mottled++ and abdomen red and distended. Transferred to nursery 1 and Neopuff ventilation commenced. Perfusion poor'

Letby, when questioned, says babies would "frequently desaturate", to this level, and this happened prior to June 2015, and "often".

Here is another mistruth in her testimony---
Letby, when questioned, says babies would "frequently desaturate", to this level,[30%] and this happened prior to June 2015, and "often".

That^^^ is absolutely incorrect. And she said it just to try and make it not a big deal, not an unusual occurrence, that a healthy settled baby would have a sudden fatal collapse, under her watch

---
12:14pm

Letby says the redness to the abdomen on Child O was abnormal, and the description of mottling was normal.

And here is another half truth^^^^---where she claims the mottling is normal---in opposition to what the consulting doctors are testifying to

Mr Johnson says during the intubation, Dr Stephen Brearey, in evidence on March 15, said Child O had a rash on his chest, on the right side, about 1-2cm in size.

He said it was an "unusual" rash that was initially pupuric, and it later disappeared.

Letby says: "I don't believe that's what I saw. I saw mottling. If that's what Dr Brearey saw, then if that's what you could take as being true, then yes."

At the start of the defense case it seemed they were going to claim that Dr Brearey was framing Nurse Lucy by describing the unusual rashes and pretending she injected air.

But now her response to his claims about the unusual rash is a rather weak one="...if that's what you could take as being true, then yes."

 

[Tortoise]

Here is another mistruth in her testimony---
Letby, when questioned, says babies would "frequently desaturate", to this level,[30%] and this happened prior to June 2015, and "often".

That^^^ is absolutely incorrect. And she said it just to try and make it not a big deal, not an unusual occurrence, that a healthy settled baby would have a sudden fatal collapse, under her watch

And here is another half truth^^^^---where she claims the mottling is normal---in opposition to what the consulting doctors are testifying to

At the start of the defense case it seemed they were going to claim that Dr Brearey was framing Nurse Lucy by describing the unusual rashes and pretending she injected air.

But now her response to his claims about the unusual rash is a rather weak one="...if that's what you could take as being true, then yes."

under re-examination -

Letby says, in her statement, Dr Jayaram and Dr Brearey had been "set against her for some time" and did not accept "in good faith" their evidence.

Recap: Lucy Letby trial, June 9 - cross-examination continues

 

[Marantz4250b]

Letby blames raw sewage on nursery floor for baby deaths​

Nick Johnson, for the prosecution, begins - following a four day break in proceedings - by asking Letby "whether or not there is anything you have said that you wish to review in the light of the time you have had to think about it?"
She replies: "No."
He then moves on to the case of Child E. He asks Letby if she believes his death was the result of incompetence in the neonatal unit.
She says: "Collectively the doctors could have acted sooner to react to his bleeding issue."
"When are you suggesting that something that wasn't done should have been?" Mr Johnson asks.
Letby says: "Once Child E was profusely bleeding after 10pm, maybe a blood transfusion could have been given sooner, maybe that would have made a difference."
She says she attributes this mistake to the "medical team collectively".
Letby then says it is an "important factor to note there were often plumbing issues within the unit".
Letby is asked what this has to do with the death of Child E - or any of the children involved.
She says there was "raw sewage coming out of the sinks and running onto the floor in the intensive care unit".
She says this could have had an effect as well as staff being unable to properly wash their hands.

Lucy Letby trial: Facebook searches of nurse accused of murdering babies read out in court


Gotta love the way she says 'properly' there. Like they would have still washed their hands in it, but not properly.

I can't believe Mr Myers didn't delve into this further with her! Or maybe it's one he wanted to forget about. I doubt he's got the maintenance guy on his witness list.

MOO

I have to say that the whole "raw sewage coming up through the sinks and running into the floor" thing is completely and utterly ludicrous in the extreme. I just can't see how that would happen.

 

[katydid23]

under re-examination -

Letby says, in her statement, Dr Jayaram and Dr Brearey had been "set against her for some time" and did not accept "in good faith" their evidence.

Recap: Lucy Letby trial, June 9 - cross-examination continues

Again, seems like a very weak response if one's defense is going to be a 'Gang of Four' framing you for murder.

 

[IDK]

For me, one of the most compelling revelations over the last few days was the Datix report LL completed about a missing stopper on an IV line. Apparently this was done shortly before she was removed from the NNU?

If this is the only time she brought up concern about the possibility of air embolism in a Datix report, it does make you wonder. On the other hand, if she had made similar reports the year previously, it wouldn’t be as powerful. IMO. And only if guilty.

 

[marynnu]

For me, one of the most compelling revelations over the last few days was the Datix report LL completed about a missing stopper on an IV line. Apparently this was done shortly before she was removed from the NNU?

If this is the only time she brought up concern about the possibility of air embolism in a Datix report, it does make you wonder. On the other hand, if she had made similar reports the year previously, it wouldn’t be as powerful. IMO. And only if guilty.

JMO, but it struck me as a bit OTT to file a report about this. Obviously it's less than ideal, but in the greater scheme of things quite minor. You see little things like this all the time, as people are only human, so you just sort it out & forget it. IMO.

 

[marynnu]

DBM duplicate

 

[marynnu]

dbm

 

[ColourPurple]

For me, one of the most compelling revelations over the last few days was the Datix report LL completed about a missing stopper on an IV line. Apparently this was done shortly before she was removed from the NNU?

If this is the only time she brought up concern about the possibility of air embolism in a Datix report, it does make you wonder. On the other hand, if she had made similar reports the year previously, it wouldn’t be as powerful. IMO. And only if guilty.

Yes what are the chances, that on 30th June, after concerns being raised about her actions with Baby Q and being told not to come in on her night shift on 27th and her subsequent meltdown...she, of all people, then discovers a baby with a missing port bung, that she said, could, of all things, cause an "accidental" air embolism... which then turns out to be exactly what she's accused of causing deliberately in other babies?

Even more interesting though to me, is why hasn't she used this as her defence in the air embolism cases? Would I be right in assuming that an uncovered port alone would not be enough to cause an air embolism, without somebody injecting air into that port?



All JMO

 

[Cardgame]

Eirian was already re-called on the prosecution's last day of evidence, with the defence questioning her first.

Recap: Lucy Letby trial, Thursday, April 27

12:39pm

Mr Myers asks about the 2016 reallocation to day shifts, following a number of deaths on the neonatal unit.
Ms Powell said the move to the day shift was to give Letby "more support" in staffing numbers, and was not "a punishment".
[...]

12:49pm

Ms Powell recalls the review meeting was "very upsetting" for Lucy Letby and herself. She does not recall if Lucy Letby was told not to talk to several other members of staff.
"She was distraught at that point". Ms Powell said Letby was upset at what was said in the meeting, about what was suggested Letby may have done.
Ms Powell said everyone's competency was being reviewed at that time, but "not to the extent" of Letby's.
She adds she was "keen" to get Letby back on the unit.


12:54pm

Mr Johnson asks what was said in the review meeting.
Ms Powell said that Letby would have to come off the unit, but could not recall what else was said.
Mr Johnson asks what was being suggested in that meeting.
"That she was the common [element] in all of the deaths".

[Snipped and bolded by me]


This is so interesting to remember IMO.

Because it's such a big problem for the idea of the consultant 'conspiracy'. IMO.

Even people who were on LL's 'side' had noticed that she was a common element. Their assumption was that it was a competency issue and she needed extra support.

In her own defence in court, LL maintains that she is an excellent nurse. Her lawyers are not suggesting she was inadvertently responsible for the deaths through incompetence.

Which means this pattern aspect of the case is horribly hard to explain away IMO.

IMO if guilty, she was so convinced that she that she had gotten away with it for so long without detection because of how clever she had been.

But in fact, it was because they were giving her the benefit of the doubt for as long as was humanly possibly.

This is the opposite of a conspiracy. No one was out to get her. They tried to help her.

 

[Observe_dont_Absorb]

I would be very interested to know if it was true that she was eventually told she was allowed to have contact with people on the unit.

Given that behind the scenes the situation was surely escalating, is it likely that the rule was relaxed?

Dunno. MOO.

Maybe the rule wasn't relaxed so much as it never properly existed in the first place and so they held back from reiterating it on legal advice when things got more serious?

I'm not sure there's any legislation that covers instructing staff members to not speak to people in their free time outside of work, apart from legislation that probably says you can't. JMO

 

[Cardgame]

Do you mean she fabricated it to add to the sense that she was being victimised?

Def seems possible.

 

[IrisAtwood65]

I agree completely, I have wondered if the defence have offered to get her mental state assessed but LL has refused? The notes are alarming and I think anyone investigating would have had the thought of maybe some psychosis or paranoia going on. I would have wanted to know if there were any other similar notes found from before the redeployment of ramblings such as this?

Maybe she refused to go down that route, maybe she thought if they brought her psychological state into it then it would only add fuel to the prosecutions assertion that she did this?

The song lyrics and name doodling I can look past. It’s the whole ‘I killed them on purpose because I’m not good enough to care for them’ that I just cannot think of a reasonable explanation for. I could understand if she had written over and over ‘I did not do this’ ‘I did not harm any babies’ ‘I have never harmed a child’. But by the looks of it she hasn’t.

Like you say it’s like finding a serial killers trophies, the ramblings of a mad woman, the keepsake box with roses on the top with a single handover note from 2010 inside. All MOO and only if guilty.

There is a podcast called Mother’s Guilt about the Kathleen Folbigg case in Australia which has an episode dedicated to her diaries and explains the trauma response in relation to the entries. Folbigg was convicted (although pardoned 20 years into her sentence) of killing her four children and diary entries similar to the comment made by LL were used as evidence. A psychologist specialising in trauma explained how women may internalise their guilt for the death of an infant and express it as suggesting that they are responsible in some way. Highly recommend the podcast too.

 

[JosieJo]

IMO BM has a big battle on his hands. Any experts he presents won’t be able to exclude air embolism completely as a possible cause of collapse IMO. From what we heard during the prosecution case, there is no one test to either confirm or exclude air embolism. That the babies showed many symptoms of air embolism along with the expert evidence, x rays showing gas in the bowel etc leads me to believe that they could well have been given a bolus of air before their collapse. Even though there’s not a way to prove definitively air embolism, there is not a way to exclude it either from what we’ve heard. So any expert when cross examined will most likely have to concede that it is a possibility.

Same as how one expert for the prosecution answered BM about something else being the cause with ‘it’s possible but not probable’. IMO when looking at all the evidence as a whole, how the babies showed similar symptoms, the distended abdomens, loops in bowel, discomfort, unusual rash unlike any that some doctors had ever seen in their career, it’s very much a likely cause IMO.

It was also powerful testimony also from Dr J I think it was how he got chills after researching air embolism in neonates and realising the symptoms were almost identical to those shown by babies in this case. I’m sure any defence expert could give other explanations for collapse, but they IMO need to give one that lines up with the symptoms, the presence of gas, something that has quite a high occurrence rate considering how many times this happened and could cause babies to suddenly and inexplicably collapse shortly after LL had the opportunity to be in contact with them and for every single event to happen while LL was on shift…

MOO

I agree I'd imagine he is just going through the motions now