UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #27

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3:29pm

Mr Myers refers to how Dr Evans came to be involved in the case. Dr Evans said he had been contacted by the National Crime Agency.
The court is shown an email from Dr Evans: 'Incidentally I've read about the high death rate for babies in Chester, and that the police are investigating. Do they have a paediatric/neonatal contact? I was involved in neonatal medicine for 30 years, including leading the intensive care set up in Swansea...'
Mr Myers says the email concluded 'interested to help. Sounds like my kind of case'. He says Dr Evans 'Did not like' the suggestion he was "touting" for work.
Mr Myers says his credibility was affected. He "touted for work on his kind of case" created a "misleading impression".
He says Dr Bohin was given a reference and Dr Marnerides has relied "heavily" on Dr Evans's opinions.
Mr Myers: "He is a full member of the prosecution team from the very start. He is not neutral. He is not independent in any way."

www.chesterstandard.co.uk

Recap: Lucy Letby trial, June 26 - defence 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 www.chesterstandard.co.uk
 
3:33pm

Mr Myers says he had, in evidence, asked Dr Evans if he had come up with air embolus first. He said he'd had.
Mr Myers refers to the chronology. He says doctors including Dr Jayaram were suggesting air embolus from July 2017.
Dr Brearey said there were two meetings with police, including one on May 15. At that meeting, Dr Jayaram raised concerns with police about air embolus. Mr Myers says this is before Dr Evans got in contact after that point.
Mr Myers says Dr Evans was "very keen to get involved" and "unless they [Dr Evans and the police] met in silence" in July 2017, then Mr Myers says Dr Evans would have been informed about a theory of air embolus after being relayed suspicions by the police.

www.chesterstandard.co.uk

Recap: Lucy Letby trial, June 26 - defence 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 www.chesterstandard.co.uk
 

Dan O'Donoghue
@MrDanDonoghue

Mr Myers turns to the expert evidence in this case, he says experts should be 'independent' and should not be trying to argue a case - he says if they do argue a case it 'should be game over' for their opinion


Mr Myers reminds the jury that in an unrelated case, a report by expert witness Dr Dewi Evans was described as “worthless” by a senior judge.

Court of Appeal judge Lord Justice Jackson said Dr Evans’ report was “worthless” and “makes no effort to provide a balanced opinion”. "He either knows what his professional colleagues have concluded and disregards it or he has not taken steps to inform himself of their views."

Mr Myers says the 'prosecution have not only ignored that, not addressed you about it, they have embraced him in support of these allegations, we say that is appalling'

Mr Myers says he 'underpins the whole of the medical evidence in this case....he most definitely undermines it'

Mr Myers is reminding the jury of how Dr Evans got involved in the case - earlier this year he accused the doctor of 'touting for work'

Jury again being shown an email sent by Dr Evans to the National Crime Agency (NCA) in May 2017, ahead of his involvement with Cheshire Police. In his message to “Nick” at the NCA, he wrote:
“Incidentally I’ve read about the high rate of babies in Chester and that the police are investigating. “Do they have a paediatric/neonatal contact? I was involved in neonatal medicine for 30 years including leading the intensive care set-up in Swansea.
"I’ve also prepared numerous neonatal cases where clinical negligence was alleged. “If the Chester police had no-one in mind I’d be interested to help. Sounds like my kind of case."


Bizarre few minutes in court, as Mr Myers is addressing the jury the microphone/speakers keep malfunctioning with strange feedback 'I suspect foul play' Mr Myers says with a grin

We're back - for now - Mr Myers again accuses Dr Evans of having touted for work, 'he is not independent, he is not neutral'
 
3:43pm

Mr Myers says Dr Evans was cross-examined "for months" about his 'lack of independence'.
He says Dr Bohin "has done the same thing but with rather more subtlety".
He refers to agreed facts, of December 5, 2022, of a judge's ruling in a court of appeal, in which there had been a report of Dr Dewi Evans. Included in his reasons for refusal, the judge said: "The report is worthless and shows no support whatsoever for an appeal.
“No attempt has been made to engage with the full range of medical information or the powerful contradictory indicators.
“Instead the report has the hallmarks of an exercise in ‘working out an explanation’ that exculpates the applicants.
“It ends with tendentious and partisan expressions of opinion that are outside Dr Evans’ professional competence and have no place in a reputable expert report.
“For all those reasons, no court would have accepted a report of this quality even if it had been produced at the time of the trial.”
Mr Myers says those comments are "appalling". He says the language from the judge "resonates very uncomfortably" with the evidence presented in this case.
"Those comments paint a disgraceful picture".
Mr Myers says those comments were put to Dr Evans. He said Dr Evans the Lord Justice of Appeal had got it wrong.
Mr Myers "the worrying thing" is "he wouldn't really accept the criticism at all".
Mr Myers says that decision "coincides with the months we have spent complaining about [him]".
Mr Myers says Dr Bohin hasn't 'peer reviewed' Dr Evans, but "supported him as far as she can", and "is every bit as much a part of the prosecution team [as he is]."

3:50pm

Mr Myers says Dr Bohin has "worked" to agree where she can.
"We do say she has been doing her best to shore up the allegations as far as she can."
He says of Dr Andreas Marnerides, a pathologist, "is not a clinician, is not a paediatrician or a neonatologist", which "puts some limits [on his expertise]". He says his expertise is on what happens following a death, not in life.
He says Dr Marnerides is "reliant" on the evidence of others, something which he agreed. He says he made a lot of reference to Dr Dewi Evans, and it is "too late in the day" to "insinuate" it is someone else.

www.chesterstandard.co.uk

Recap: Lucy Letby trial, June 26 - defence 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 www.chesterstandard.co.uk
 
Tortoise said:
11:25am

Mr Myers says evidence presented on October 25 by Dr Dewi Evans: "One tends not to spread news about the mistakes we make", in reference to doctors. He says that is a piece of evidence 'to keep in mind'.
He says that was "one of the many things" that came out of his "relatively lengthy" evidence.
He says: "In a way, haven't we seen that in this trial?" He says that in relation to doctors being resistant to criticism.
He adds no-one, including Letby, is immune to criticism. He says doctors would come with 'prepared speeches'.
He says "don't think the senior doctors came here without motives of their own".
He adds: "however you look at it, there was a terrible failing of care" at the unit.

11:26am

He says senior doctors have 'in various ways' suspected Letby was doing something 'for months and months'. He says those doctors 'said/did nothing to raise the alarm...when nothing prevented them from doing so.'
He says if they were right, that failure to do anything right was "staggering".
He says whichever way, it was a "terrible failing in care".

11:30am

Mr Myers: "You will understand the stakes [in this trial] are very high.
"We don't say 'doctors bad'. We say for those senior consultants who presided at that unit...Lucy Letby getting the blame matters."
He says the prosecution used the expression, the 'gang of four' consultants of Dr Jayaram, Dr Stephen Brearey, Dr John Gibbs and a female doctor [who cannot be named]. He says the doctors 'have an interest in what happens here' and each of them 'had gone out of their way to damage Lucy Letby' in their evidence. He cites an example on pneumothroaxes presented by Dr Gibbs which he says was "unneutral".
He says "one way or another" the unit "failed". He says this case is a "prime opportunity" to "hide" bad/poor outcomes.

11:32am

He says the unit was "noticeably busier" than it had been in previous years, and there was "no change in the staffing levels". He says doctors are "running to and from the neonatal unit" in emergencies. He cites an example in the final collapse of Child I.

11:35am

He cites Dr Sally Ogden's evidence that June 2015 was a "particularly busy" time at the unit, and that was a combination of factors, including the complexity of the babies' needs, the number of staff, and total unit admissions.
He says the increased busyness increases the likelihood of mistakes and the chances of missing developing problems in babies.

www.chesterstandard.co.uk

Recap: Lucy Letby trial, June 26 - defence 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 www.chesterstandard.co.uk
Click to expand...
Are doctors supposed to be based based on the neonatal unit ? Aren’t they covering several different places ? Like rooms where women are giving birth, operating theatres, and the units with babies on them ?
katydid23 said:
Here is the incident Meyers is referring to, with child C:

Thursday October 27th 2022 - Live updates from the trial

Day 10 of Prosecution Case

Child C

Yvonne Griffiths, CoCH Neonatal Unit Deputy Manager & Senior Nurse -

Re. Child C's medical notes for Day-Shift 12th June 2015

3:59pm

The court is now hearing evidence from Yvonne Griffiths, who was the Countess of Chester Hospital neonatal unit deputy manager in June 2015 and a senior nursing practitioner.
An 'admin error' had resulted in Ms Griffiths' notes for child C being written in the file for a different child, but the error was spotted and rectified quickly.
The note is written on June 14 on reflection notes from June 12, with care from 8am that day.
The notes record "assistance with ventilation by NCPAP", with oxygen levels varying from 37% to 25%.
Child C was "unsettled at times". Ms Griffiths said he "only loved to be held by parents in a kangaroo style".
The long line was administered, and at 6.30pm, 'bile noted on blanket'. Ms Griffiths said with any baby there is a worry with introducing feeds too early. On this occasion bile came out "spontaneously".
Ms Griffiths said the naso-gastric tube was aspirated as a matter of procedure and 2mls of black stained fluid appeared.
Child C was "too unsettled" for a lumbar puncture - plan to reassess later".
Ms Griffiths said they would not want to take the risk if the baby was too active, as a lumbar puncture would involve a needle.
Ms Griffiths added she came in the morning after Child C had died, to assist staff.

Cross-Examination



Mr Myers says Child C was "at the limit" [for weight] for being accepted into care at the Countess of Chester Hospital.
Ms Griffiths had said, in a police statement, the hospital did not often care for babies of that weight.
She tells the court there is a decision to be made whether the baby is suitable to be cared for at the Countess, or risking transfer to a tertiary centre, and that is made following consultation.



Ms Griffiths said, in the police statement, "it was very uncertain" what the outcome would be for Child C.
She confirms she was the designated nurse for Child C on June 12. She also confirms Letby was not in the unit that day.
Mr Myers talks through the nursing notes from the previous night shift, for June 11-12. At that point no bile aspirates had been recorded.

He refers to a note about Child C requiring an increase in oxygen when handling as Child C was desaturating.
Ms Griffiths says, in relation to the air in the stomach, the nurses "did everything" they could through the naso-gastric tube to aspirate air.


The note referring to bile found on the blanket and 2mls of black stained fluid being aspirated from June 12 at 6.30pm is referred to.
Mr Myers asks if dark bile is a matter for concern.

"Any bile is a matter of caution," Ms Griffiths replies, and feeds would be stopped as a precaution.
She added Child C did not desaturate when vomiting a small amount of fluid. She agrees it was important for close monitoring on Child C.

Mr Myers: "It is a potentially serious issue, isn't it?"
Ms Griffiths: "Yes - and I did get the doctor to review."

+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

OK, IMO, this^^^ is a red herring. There is no reason that 'incident' on June 12th with Baby C, would be listed on that spread sheet for unexplained deaths/collapses.

Baby C was very small and premature and only 2 days old on the 12th of June. She needed CPAP support for a short time and had a very small amount of fluid/bile aspirated ---BUT SHE DID NOT FULLY DESATURATE ----she needed observation and close monitoring but it was not a collapse.
Click to expand...
I think this is exactly the point that is relevant about baby C. The 12 June collapse is the one which Dr Evans said in seven out of his eight reports for this baby was caused by a deliberately injected air embolism. And then, in the eighth report, he changed his mind and said that 12 June was CPAP belly. So the incident was very relevant and indeed formed part of the prosecution’s reason for originally charging LL for baby C. If you look back at the charges when she was first arrested, the murder charge for baby C was for a period beginning, 12 June 2015.
 
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ColourPurple said:
I'm sure he was expecting it and Johnson did pre-warn the jury a little too.
Click to expand...
I think what Mr Johnson was alluding to, or may have said and it wasn't reported, was that he was approved as an expert by the court and continued to be approved throughout the whole trial.

"Mr Johnson says Dr Dewi Evans was justifiably criticised for not giving a cause of death for Child C in written evidence, then giving a cause in the witness box.
He says if anyone was caught by surprise, he returned to give evidence on 14 more occasions."

Recap: Lucy Letby trial, June 21 - prosecution closing speech
 
In my fence-sitting position I was open to the idea that the presented experts may be biased towards particular viewpoints; after all, it's only human to reach a decision and stay firm to that belief unless there is compelling evidence to prove otherwise, while others might look at the same situation and reach a different conclusion, if it's not too clear-cut.

But, if they're all so biased/unreliable, why was there no expert willing to voice the other possibilities for any of the cases? Since the defence apparently couldn't find any reliable expert to offer alternate possibilities, that only increases my confidence in the experts called in the prosecution case.
 
Kasmeer said:
In my fence-sitting position I was open to the idea that the presented experts may be biased towards particular viewpoints; after all, it's only human to reach a decision and stay firm to that belief unless there is compelling evidence to prove otherwise, while others might look at the same situation and reach a different conclusion, if it's not too clear-cut.

But, if they're all so biased/unreliable, why was there no expert willing to voice the other possibilities for any of the cases? Since the defence apparently couldn't find any reliable expert to offer alternate possibilities, that only increases my confidence in the experts called in the prosecution case.
Click to expand...
Exactly. He's trying to discredit all of the medical experts, whilst having none of his own.

He's pointing out Dr Evans isn't a neonatologist, ignoring the fact that Dr Bohin is, and then he doesn't have a neonatologist to dispute their findings anyway.
 
ColourPurple said:
Exactly. He's trying to discredit all of the medical experts, whilst having none of his own.

He's pointing out Dr Evans isn't a neonatologist, ignoring the fact that Dr Bohin is, and then he doesn't have a neonatologist to dispute their findings anyway.
Click to expand...
I hope the Prosecutor brings this point up in his closing after Johnson is done trashing the experts.
 
Tortoise said:
2:55pm

Mr Myers says experts should be assessed as other witnesses. He says they don't decide the case, and their assistance is needed to explain how the babies collapsed.
He says the jurors should take their evidence into account, but "you don't have to accept them".
He says there are 'certain features which are important', that the witnesses in their field "must be an expert" and the "expert is an expert on their topic", and that was something, he said, was recognised by Prof Sally Kinsey, an expert in haematology, who "acknowledged frankly" she was "not an expert" on air embolus.

www.chesterstandard.co.uk

Recap: Lucy Letby trial, June 26 - defence 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 www.chesterstandard.co.uk
Click to expand...
With this in mind, one could question how much of an expert the plumber was as the only person called to provide evidence for the defence. I’m really having trouble in following some of his closing points tbh, it feels quite disjointed.

All JMO
 
12:10pm

Mr Myers says "various factual allegations" came across Lucy Letby which amounted to 'wholescale document fraud', referred from 'page 34,536 of the evidence', he says, including children not on the indictment - such as 'the Stoke baby'.
He asks why witnesses were not cross-examined about such incidents, on 'falsely identifying names' on paperwork, over the months.
He says the "prosecution have been looking for things...so they can shore up".

Recap: Lucy Letby trial, June 26 - defence closing speech

This was Letby's cross-exam about it -

57m ago14:05

Letby accused of changing the time of medical records the night child died​

Child I deteriorated just before midnight, at 11.57pm. Letby is now being asked what she was doing in the lead-up to that collapse.
The baby Letby was assigned to care for was transferred to Royal Stoke University Hospital during the night shift of 22-23 October. (He is not a baby she is accused of harming).
The court is shown a text Letby sent to a colleague at the start of the shift: 'Oh that's fantastic. Unit nice. Transport on way to take my baby back to stoke. Only 8 babies. Off duty not out.'
This transfer, Letby says, would not have been a five-minute job and would have required a handover with the transport team and speaking to the family.
"I am going to suggest you were dealing with [the other baby] at 11pm," Mr Johnson says.
"Do you remember falsifying a recording relating to [the other baby]?"
Letby refutes this.
The court is then shown records relating to the baby in Letby's care. A close-up image of a medical note shows this baby being given a dextrose infusion at 00.00 (midnight), prior to the transfer.
But, the prosecution says, the four has been changed from a three, and the actual time this took place was 23.00 (11pm). They are accusing Letby of changing the notes to give herself an alibi in the lead-up to Child I's collapse.
"No I would not have changed a record, that was obviously written in error," Letby says. She says the note would have been signed off by her colleague.
The prosecution says she could have changed the time after it was signed.

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


Firstly Myers cross-examines the witnesses, not Johnson!

Secondly, there was nothing to ask the colleague. Letby said her colleague signed off on it, the prosecution says there was nothing to stop her altering the time after her colleague signed.



More from Myers -


"He cites a piece of evidence from the case of Child H, a note by Alison Ventress about a chest drain. He says she gave evidence, and she was cross-examined about it, about chest drains moving. He says that was no part of any allegation, and "it came out of nowhere" in cross-examination, "it suddenly became part of an allegation"."


How would Dr Ventress know if Letby moved baby H's chest drain? She wouldn't be able to answer that, she was called to see the baby after the drain moved.

All of this is just hollow when you examine what he's saying.

Of course it was put to Letby when she took the stand, because it is the prosecution's case of how she sabotaged the babies and falsified records, and it would always have been the prosecution's theory in closing speech. They didn't suddenly do all this homework and analysis of the nursing records overnight to produce more stuff on her when she took the stand.

"He says the prosecution have been looking for things so they can shore up"

:D It's laughable. They spent three years on their case before they charged her.

IMO
 
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