UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #26

[Tortoise]

A reminder of this message exchange on 30th June 2015.

LL texted a colleague that baby B had moved to a recovery room in the unit.
Colleague: "There's something odd about that night and the other three that went so suddenly."
LL: "What do you mean? Odd that we lost three and in different circumstances?'
Colleague: "I don't know, were they that different?" "Ignore me, I'm speculating."
LL: "C was tiny, obviously compromised in utero. D septic. It's A I can't get my head around."

1. LL has ignored completely her colleagues reference to baby B's collapse being odd.

2. "and in different circumstances" - this is how she gaslights; it's complete manipulation at play, IMO. It makes no sense to infer that it's odd if they were indeed different, so it draws attention to why she would have a need to persuade that they were different.

3. "It's A I can't get my head around" - again this is gaslighting; it's saying put C and D right out of your mind, I'm good authority on this and you don't need to think of them as odd anymore because only A is a puzzle. She's skipped B, so her colleague can forget that B also needed resuscitating.

4. She's the only person on the unit who didn't think four collapses/3 deaths in close succession was odd.

MOO

 

[Lincoln34]

It's an older clip but he looks like he means business!

And likes Pret A Manger …

 

[Moll]

10:32am

The trial is now resuming.
Nicholas Johnson KC is turning to the cases of Child O and Child P.

10:34am

He says the evidence of Dr Marnerides is uncontested, that Child O had a significant liver injury.
That injury and the "lacerations" in the surface of the liver are "the best evidence you could ever have" of someone "inflicting a violent injury on a small child", he tells the court.

Recap: Lucy Letby trial, June 20 - prosecution closing speech

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Moll]

10:37am

Lucy Letby's 'HELP' post-it note is shown to the court. Mr Johnson says it began with the note to all three triplets: 'Today is your birthday, but you aren't here + I am so sorry for that...I'm sorry that you couldn't have a chance at life...
'I can't do this any more. I want someone to help me but they can't. What's the point in asking. Hatemylife.'
Mr Johnson says this note would have been written in June 2017 or June 2018. The note was found in Letby's handbag.

10:37am

The note shown to the court.

Recap: Lucy Letby trial, June 20 - prosecution closing speech

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Moll]

Haven't managed to copy over the image of the note, can anyone?

 

[Tortoise]

LIVE: Lucy Letby trial, June 20 - prosecution closing speech

 

[Moll]

10:42am

Mr Johnson says Dr John Gibbs had given evidence to say if he had seen Letby 'in the act', he would have reported it to police at the time.
He said the deaths of Child O and Child P were a "tipping point" that something was "very wrong" on the neonatal unit.
He had been asked, in cross-examination, why he hadn't reported that to the police.
He said: "At that stage, I didn't know two children had been poisoned with insulin."
"At the time of the events I had never seen before which were unusual and unexpected - that's what raised the concern.
"Medicine is not an exact science...just occasionally a patient dies, and [a post-mortem examination does not give an answer].
"But this was happening again and again on our unit. And that cannot be just coincidence or bad luck. There must be a cause.
"That's when...one common cause was identified."
Mr Johnson tells the jury they have one advantage is they know two children were poisoned with insulin, and knew who hung up the bags.

10:45am

There had been "no concerns" for Child O or Child P on the shifts prior to the deterioration, Mr Johnson says.
Mr Johnson says Letby is "trying to persuade" the jury that a problem existed when there was none available.

Recap: Lucy Letby trial, June 20 - prosecution closing speech

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

Dan O'Donoghue

@MrDanDonoghue
·
13m

Prosecutor Nick Johnson KC will continue his closing speech at the Lucy Letby murder trial today. The nurse is accused of murdering seven babies and attempting to kill a further 10 between June 2015 and June 2016 at the Countess of Chester Hospital, she denies all charges

·
10m

Mr Johnson begins with the case of Child O. In evidence Dr Andreas Marnerides, an expert in neonatal pathology, told the court Child O's death was a result of an "inflicted traumatic injury to the liver"

·
10m

He said the severity of the injury was more consistent with that suffered in a road-traffic accident, adding: "I have also seen it in babies in the context of cases where they have suffered non-accidental types of injury."


10m

Mr Johnson said the evidence shows Child O suffered a 'a forceful, violent injury'


8m

Mr Johnson shows the jury this note, found in Ms Letby's home when it was searched by police. He reads the lines beginning 'today is your birthday' which is in reference to the baby


4m

Mr Johnson is now quoting the evidence of Dr John Gibbs who previously told Manchester Crown Court that the deaths of Child O and brother Child P, who were part of a set of identical triplets, on successive days in late June 2016 became a "tipping point" for his team


4m

At this time, Dr Gibbs told the jury he had "become increasingly concerned at the accumulating number of unusual, unexpected and inexplicable collapses that had been happening on the neonatal unit and that Staff Nurse Letby had been involved in all of them".

·
55s

Mr Johnson says Ms Letby has tried to suggest there were problems with Child O in her evidence, where there were none. He says 'she’s doing to you (the jury) what she’s done on the ward, trying to persuade you a problem existed where none existed'

 

[Moll]

10:52am

Dr Huw Mayberry "remembered" Child O and he was "very well" with a "mildly distended abdomen" but all observations within normal limits.
Mr Johnson says Letby's 'issue' for Child O did not exist. He says Letby pointed out that Dr Mayberry did not make a note.
Mr Johnson says there were two occasions when Letby made up notes for doctors. One was a telephone call in the case of Child E, and another was the 'imaginary examination' of Child I by a doctor.
Mr Johnson says Sophie Ellis's notes record that 'Reg Mayberry' was involved in being informed and 'reviewed' on June 23, 2016 for Child O. That was the difference, Mr Johnson explains, as Letby's notes do not attribute any doctor.

10:54am

Mr Johnson says student nurse Rebecca Morgan was on her first day on the ward, fed Child O, and got a trace aspirate. Shift leader Melanie Taylor said there were no concerns for Child O at the start of the shift. "She did not expect [Child O] to collapse."

10:58am

An examination of child O's abdomen revealed "no concerns" and this situation was "uncomplicated", and ruled out the possibility of liver haematomas at that stage. Had there been one, Child O would have had symptoms of deteriorating.
Mr Johnson said it was accepted by Letby that Child O's liver injury happened during her day shift, and accepted the evidence of Dr Andreas Marnerides.

11:00am

Mr Johnson says Letby was missing a doctor colleague and had been in a text converation with him: "Bit rubbish that you couldn't stay on nnu". He said at 10.36am he should be finished on clinic duty in an hour. He then went to observe Child Q on his arrival. He then saw Child O.
Letby recorded 'no problems' at 12.30pm. Mr Johnson says it is "obvious" Child O was "deliberately overfed" by Letby at this stage. There was "an issue" at 1.15pm.

11:05am

Mr Johnson says Child O had been 'supposedly' fed 13ml of milk. By this stage he had vomited and his abdomen was distended.
Letby was 'fulfiling two objectives', Mr Johnson says, by 'sabotaging' Child O and 'attracting the attention' of the doctor at the same time.
Letby had recorded Child O was 'tachycardiac', which Mr Johnson says was 'an exaggeration'.
Samantha O'Brien had said, in agreed evidence, Child O had a distended abdomen but looked otherwise normal.
Letby messaged: "Blew up abdomen think it's sepsis" to a nursing colleague at 9.15pm and, for Child P the following day: "Just blew tummy up and had apnoeas, downward spiral. Similar to [Child O]."
Mr Johnson says the 1.15pm vomiting by Child O was 'unusual', as observed by a doctor, but Mr Johnson says this is not so much in the context of Child E, Child F, Child G and Child L.

11:09am

Mr Johnson says Letby made a false reading for Child O at 1.20pm on the blood gas chart. "Even by the standards of misrecording information, this is right up there."
He says the note Child O was put on to CPAP from Optiflow was "a lie", and it had been spotted by Dr Sandie Bohin.
Mr Johnson says someone looking at the paperwork, retrospectively, might conclude this note could form an innocent explanation as to why Child O had died.
Letby had said in evidence 'he wasn't on the full CPAP machine, he may have been receiving CPAP via Neopuff, I don't know.'
A doctor had noted Child O's abdomen was distended. Mr Johnson says this was because Letby had pumped Child O full of air.

11:12am

Nurse Melanie Taylor had said to Letby 'I don't think he looks as well as he did before', and queried if Child O should be moved to nursery room 1. Letby had said no, to leave Child O in room 2 with his brother.
NJ: "Lucy Letby was so insistent, Melanie Taylor felt put out - she felt undermined."

11:16am

Mr Johnson explains Facebook messages were exchanged between Letby and a doctor. Child O collapsed a few minutes after the last message Letby sent.
The collapse was a sign for Child O of a cardiac arrest if there had been no intervention by medical staff, the doctor had said in evidence.
Professor Arthurs said the gas in Child O's bowel, as shown in an x-ray from that afternoon, was more than there should be. The causes were NEC - which Mr Johnson says had been ruled out - or someone injecting air down the NasoGastric Tube.
Mr Johnson says this is "even after a vomit", which would decompress the stomach.

Recap: Lucy Letby trial, June 20 - prosecution closing speech

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

Dan O'Donoghue

@MrDanDonoghue
·
10m

Mr Johnson tells the jury that 'it’s obvious' on the afternoon of 23 June 2016 that 'Lucy Letby deliberately overfed' Child O. He says that on that morning, Ms Letby was missing a doctor - who cannot be named for legal reasons

·
10m

He says that Ms Letby's act of 'sabotaging' Child O was her way of 'attracting the attention of (the doctor who cannot be named)'

 

[Tortoise]

I wonder if he's pointing out all the twins/triplets as a point of 'coincidence' in this case, after E and F, and L and M yesterday, now dealing with O and P.

 

[Moll]

11:19am

Mr Johnson says the liver injury for Child O had "been inflicted by about this stage", and this was "long before" CPR.
A '"small rash" had been seen on Child O's chest, a "purpuric rash - which is very, very rare in a neonatal infant", similar to a sign of meningitis. Dr Stephen Brearey, who had noted it, thought at the time it could have been a sign of sepsis.

11:25am

Two doctors entered the NNU at 3.53pm and saw Child O 'being bagged by the nurse', and Child O was "very unwell".
A female doctor was "shocked by what she saw" as it had been "completely unexpected".
The doctors said there had been "good air entry" but Child O's saturation levels "were not improving", Mr Johnson says. Child O was reintubated and cannulated.
Dr Brearey was called to help. Child O had been resuscitated. Spontaneous circulation had been re-established - "a miraculous recovery", Mr Johnson tells the court. "But [Child O's] perfusion was not as good as before."
Dr Brearey said the rash was "perplexing" and something he had never seen before, Mr Johnson explains. An experienced doctor said the series of collapses were also like nothing she had seen before.
Mr Johnson tells the jury: "You know the reason for it, don't you?"
Mr Johnson says Child O's mother gave a descrption of the rash. The father said of Child O: "You could see his veins, all bright blue, changing colour...
"You could see something oozing through his veins."

11:32am

During Child O's resuscitation in his final collapse, a doctor had said efforts were made to decompress Child O's abdomen.
In cross-examination it had been suggested this was the cause of the liver injury.
Dr Brearey and Dr Marnerides had rejected this, Mr Johnson tells the court.
An x-ray was taken of Child O, and Professor Owen Arthurs had explained the bowel gas which was "unusual" and showed an NG Tube in situ and no presence of NEC. Child O and Child P didn't have bowel obstructions, and Prof Arthurs said you are left with injection of air by the NG Tube.
Dr Brearey said all triplets had been born in good condition and were "following a healthy path", and these events were "exceptionally unusual", and the type of rash was 'something he had never seen before or since'.
NJ: "All natural causes were excluded...even with the benefit of all the years that intervened."
Another doctor said it was "incredibly unexpected".

Recap: Lucy Letby trial, June 20 - prosecution closing speech

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[MachinaCollecta]

Seeing it all laid out like this is extremely moving, I have to say.

 

[Parker Knoll]

It seems like that to me.

 

[Tortoise]

Dan O'Donoghue

@MrDanDonoghue
·
3m

Child O continued to decline throughout the afternoon and was pronounced dead at 5.47pm on 23 June 2016. Mr Johnson is quoting evidence from medical experts on the baby boy's cause of death - one of which is administering air via an NG tube.

·
3m

The boy was also found with a liver injury, the severity of which was akin to him having been in a road traffic collision

 

[Moll]

11:34am

Mr Johnson says Letby took Child O to his death. He says Letby was "sowing the seeds" for Child P the following day.
The message sent by Letby to a nursing colleague at 9.33pm on June 23, 2016: "Worry as identical".

Recap: Lucy Letby trial, June 20 - prosecution closing speech

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Moll]

11:39am

A conversation between the doctor and Letby is shown to the court. The doctor said he hoped he was able to help.
Letby replied: "Yes you did++"
NJ: "Two plusses was the best he was going to get."
A Datix form is shown to the court, recorded by Letby, which Mr Johnson says was inaccurate in the 'peripheral access lost' note. Dr Brearey said "it's not correct".
Mr Johnson says "it's a lie".
He says Letby is trying to invent evidence that peripheral access was lost. If it was, Mr Johnson say, then air could not be injected into the infant. He says if that note was accepted, it would support her case that this was not air embolus.
Mr Johnson asks the jury to find why Letby was lying - "to cover up what she had done...we are sure this was air embolus."

Recap: Lucy Letby trial, June 20 - prosecution closing speech

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Moll]

11:41am

Dr Dewi Evans was "taken to task" for changing his opinion while writing his numerous reports in cross-examination, Mr Johnson says, having come up with a number of theories.
Mr Johnson says more information came to light during the course of writing his reports between 2017-2019. One was Dr Brearey's note about the purpuric rash 'disappearing'. It was established there had been no mention in medical notes of the rash disappearing, and he was only informed about it by Dr Brearey's witness statement in 2019.
Mr Johnson says is the impression by the defence to say Dr Evans "doesn't know what he's talking about?"
He says it would be "astonishing" if Dr Evans hadn't changed his mind when handed new information.

11:54am

Mr Johnson says Dr Evans said in court: "Inevitably, one amends one's opinion as a result."
Dr Evans was asked about chest compressions for Child O. He had said he had known no case that chest compressions had resulted in a liver haematoma as seen in the case of Child O.
A doctor had said chest compressions were carried out correctly for Child O.
Dr Bohin had "spotted that lying entry in the gas chart". She had taken all the evidence into account, including that of Child O's father, of the description of the veins, like 'prickly heat', Mr Johnson tells the court.
Mr Johnson said it had been suggested Prof Arthurs had ruled out air embolus as a cause. NJ: "Nothing could be further from the truth."
He says Prof Arthurs said the air in the great vessels could be from a number of causes, including air injected, or CPR or trauma. Mr Johnson asks the jury why CPR was required for Child O - he says it was because of air embolus. Prof Arthurs was 'deliberately not doing' what the jury can do, and was treating the cases independently.
Prof Arthurs added radiographic evidence of air embolus is "very rare".

Recap: Lucy Letby trial, June 20 - prosecution closing speech

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

Dan O'Donoghue

@MrDanDonoghue
·
1m

Mr Johnson quotes the defence line of questioning on the liver injury, in those exchanges it was suggested CPR could have caused this - the prosecutor said, on the back of the expert evidence, this is not a 'reasonable' suggestion

 

[Tortoise]

11:39am

A conversation between the doctor and Letby is shown to the court. The doctor said he hoped he was able to help.
Letby replied: "Yes you did++"
NJ: "Two plusses was the best he was going to get."

Recap: Lucy Letby trial, June 20 - prosecution closing speech

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

Is this a reference to her not showing the same level of interest in him as he was showing in her?

Because she said they were just friends?