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

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Tortoise said:
I wouldn't expect anyone but the killer themselves to know what motivated serial killings. Who could come up with one and prove they were right?

If the babies were murdered and attacked (and poisoning non-accidental) then the shifts show it had to be LL or the other nurse, and the other nurse is not on trial.

JMO
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Absolutely! I think it's human nature to want/need to know why someone did a certain thing... I guess it could come out later, if guilty, IMO, etc.
 
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notsure said:
IMO, one of the defence's strengths is that nobody has come up with any credible motivation for the alleged offences. Also, Myers said today that LL had never been in any trouble before. I must admit, he presents quite a difficult dilemma.
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I bet someone in group conversations will bring up the possibility of her having the same motivation as many previous nurses/doctors/caregivers who allegedly murdered their patients. The criteria fits her perfectly and explains so much.

There is rarely a history of prior trouble or crimes committed. And their personalities are usually seen as kind and compassionate, even to a fault. She fits it like a glove, imo.
 
notsure said:
It seems a bit of a weird direction, tbh. I don't even know how somebody could ignore motivation.
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It's kind of a rabbit hole. A logical, rational sane person cannot comprehend these types of attacks. What motive could there possibly be that makes any sense to you or me?

The ONLY possible way I could kill someone is if someone was literally trying to kill me or my husband and kids, etc. Other than that, no way. I couldn't do it for insurance money or for a love affair or if hubby was cheating etc. I'd just get a divorce.

So if we try to understand and accept a motive for such a heinous crime, it does not work because it makes no sense at all.

The only thing that makes sense to me is if she had an intense compulsion---something so strong that she could not fight against it. There are people who have homicidal compulsions which take over their brains and bodies and they cannot resist the intense temptation and impulse.
 
katydid23 said:
The only thing that makes sense to me is if she had an intense compulsion---something so strong that she could not fight against it. There are people who have homicidal compulsions which take over their brains and bodies and they cannot resist the intense temptation and impulse.
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Sometimes such destructive compulsions are side effects of certain meds.
I once read about a woman who was treated while depressed.
After taking certain meds she started having terrible compulsions, e.g:
while driving a car she forced herself not to crash into cars opposite.
Imagine this!
Of course, she was immediately taken off these meds and compulsions vanished.
 
notsure said:
I haven't heard that saying before. I love it!
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Especially for you @notsure

:)

The proverb

The dogs bark, (a) the caravan goes on

is known in several languages, including in French

( Les chiens aboient(et) la caravane passe ).

We use it to make it clear that things are going their way, regardless of our disagreement with them, despite our protests.

This proverb comes from the Arabic language.

It depicts a situation in which the dogs barked with all their might at the passing caravan, but the camels that formed it did not care, as if disregarding the dogs' concern or "protests", and calmly went on.
 
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katydid23 said:
I am trying to figure out what you mean by a 'collapse' on the afternoon of June 12th, 2015.

That is the date that Meyers refers to as one of the incidents left off the spreadsheet:
"Mr Myers says there is a 'harm event' for Child C, as identified by experts, on June 12, 2015, which is not in the sequence of events, and is not on the list."

I read every testimony I could find about June 12th 2015 and Baby C, and found no reference to an actual collapse. Here is the nurse in charge of her on June 12th:

Dr Davis says she does not recall the previous night shift, but from her nursing notes on the night shift of June 12-13 she recalls the observations for Child C at 9.20pm on June 12, 2015.
The notes include "suspected sepsis" and "jaundice" on a list of ongoing problems. The latter is, the court hears, "very common" in premature babies.

Dr Davis added that, at that point, there had been 'no desaturations' or 'bradys' (bradycardia).
Child C was 'NBM' (nil by mouth) due to "billious aspirates".

www.chesterstandard.co.uk

Recap: Lucy Letby trial, Monday, October 3​


Yvonne Griffiths, CoCH Neonatal Unit Deputy Manager & Senior Nurse -
Re. Child C's medical notes for Day-Shift 12th June 2015

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."

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".


Recap: Lucy Letby trial, Thursday, October 27


SO WE HAVE BOTH MEDICAL CAREGIVERS IN CHARGE OF BABY C, TESTIFYING THERE WAS NO COLLAPSE OR BRADYS OR SEVERE DESATURATIONS on June 12th---not until early morning, JUNE 13TH


Maybe it was just CPAP belly because there was no collapse or resuscitation needed.

Evidently they changed their minds because the event did not meet the criteria?
Click to expand...
So Doctor Evans originally wrote in his reports that based on an x-ray/scan done on baby c on 12 June, the baby was given an air embolism on 12 June which he said, caused the collapse on 13 June.
 
katydid23 said:
I wonder why BM didnt give those figures, since he made a big point of how many more they had taken in than usual.
Click to expand...
I wonder if a lot of this is a combination of sparse reporting early on and something Tortoise suggested a week or so ago : that a load of data / evidence had been entered into evidence early on (eg swipe data), which allows the barristers to refer to it as and when
 
GoodDayToYouSir said:
So Doctor Evans originally wrote in his reports that based on an x-ray/scan done on baby c on 12 June, the baby was given an air embolism on 12 June which he said, caused the collapse on 13 June.
Click to expand...
This is totally wrong in all respects.

I will quote the evidence reported, and include the evidence of the other experts so that you can see that they all say the same thing as regards June 12th, but they do not say that baby C's collapse and death on the 13th was attributed to air seen on the 12th. Dr Evans not giving a cause for the collapse and death on 13th in his reports is the very opposite of bias against Letby. Continuing to say there was a possibility of deliberate harm on 12th, along with all the other experts, is the very opposite of engineering a case against Letby because she wasn't on shift. Dr Evans was criticised for not having given an opinion that the death was unnatural until he went in the witness box and said his final opinion was based on that of the reports of the radiologist and the pathologist.


Dr Evans Cross-examination -

"He confirms his initial conclusion from 2017 was 'one may never identify the cause of his collapse'.

Mr Myers says up until the evidence of today, he had not provided in his reports an allegation of harm.

Dr Evans says this case "will always be a challenging case" for any clinician as it is difficult to separate the pathological problems from an event where Child C "was placed in harm's way by some kind of deliberate act."

Mr Myers says the 2019 report said Dr Evans raised a possibility of deliberate injection of air from June 12 via the naso-gastric tube.
Dr Evans, reflecting on that report, said: "Can't rule it out".

Dr Evans said what was being discussed, on June 12, there was a "distinct possibility" Child C had excess air in the stomach from CPAP belly.
He was "still stable" from a respiratory point of view.
He tells the court: "However the air went in, it would have been insufficient to splinter the diaphragm on the 12th, as he would've collapsed and died on the 12th."
The air which had gone in was 'insufficient' to cause a collapse. There was 'nothing to suggest' the excess air was enough on June 12.
He says the two events on June 12 and 13 "are quite different" in the way they happened.
Mr Myers said that it was Dr Evans's view, a couple of months ago, there was deliberate harm on June 12.
"That was a possibility, yes it was."

He adds that in coming to his conclusion for this case he is not relying solely on his opinions, but taking in other clinical evidence and reports.
"That is what doctors do, we do it all the time." in what Dr Evans says is a "complicated case".

Mr Myers says the x-ray from June 12 had helped form Dr Evans's initial view that there had been an air injection into the stomach.
"That was an opinion I have expressed, yes."
Mr Myers asks Dr Evans what evidence there is to support that air had been injected into the stomach on June 13.
Dr Evans: "The baby collapsed and died."

Dr Evans says none of the normal processes described why a baby collapsed.
He adds, for further medical information, he would prefer to defer the matter to the radiologist and pathologist.
He said he objects to being accused by Mr Myers of making things up, and says he is putting forward the information in this case as a result of his own opinion and that of other people's reports.

Recap: Lucy Letby trial, Tuesday, November 1


Dr Bohin's evidence

Asked to explain a build-up of gas in Child C’s abdomen detected on a X-ray on June 12 – the day before his fatal collapse – Dr Bohin said air could have accumulated via respiratory support he was receiving. The alternative explanation is a deliberate introduction of air down a fitted nasogastric tube, she said.

Prosecutor Nick Johnson KC asked: “When you looked for a reason for (Child C’s) collapse on June 13, can you find an explanation?”

Dr Bohin replied: “No. Babies like this should not collapse. You get prior warning that something is amiss.


Lucy Letby trial: Murder-accused nurse told police she found baby’s lingering death ‘quite hard’


Professor Arthurs' evidence -

A further x-ray image is shown for Child C at June 12 at 12.36pm, which is centred at the child's abdomen.
He says the most striking feature about this image is the dilatation of the stomach, which is 'full of gas'.

He says this is more gas in the stomach 'than you would expect for a child of this age'.
There was a 'small tube' in the stomach taking out air.

Professor Arthurs says, for his conclusion for Child C, that the 'marked gas dilatation' in the stomach noted at June 12 had several potential causes, including CPAP belly, sepsis, NEC or exogenous administration of air by someone.

Professor Arthurs, asked by the prosecution about a bowel obstruction, says if the bowel was blocked at a particular point, it would give a 'marker' of where the obstruction was.
He says the image shows no such marker, and as bowel obstructions are a 'common clinical occurrence', it would be diagnosed and babies would go to theatre for an operation.
He says there is no evidence of a bowel obstruction on the imaging, on the clinical notes, or in an autopsy.
Referring to the possibility of a twisted bowel, which he says 'can happen in small babies' and result in a blockage. He says that is often a surgical emergency, and would be documented as such, and found post-mortem if there is such a finding.

Recap: Lucy Letby trial, Friday, November 11



Prosecution closing speech -

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.
Mr Johnson says Dr Evans's evidence can be disregarded if there had been any confusion for this case, as Dr Marnerides had given more detailed evidence on this.
Dr Bohin excluded the possibility of a bowel obstruction.
Dr Marnerides said there was "nothing unusual" about Child C's bowel. He concluded Child C died "with pneumonia not from pneumonia" and the gas in the bowel could not be explained by infection or an abnormality in the bowel.
He said "air must have been injected into the nasogastric tube", splinting the diaphragm, which would have compromised Child C's breathing and killed him.
He added: "I have never in the past 10 years, come across even a suggestion that 'CPAP belly' would lead to the deterioration of a baby, let alone this gastric distention that would lead to [a baby's death]."
Mr Johnson says Child C came off CPAP 12 hours before his collapse, and "did so well" after kangaroo care he was put on to Optiflow, a 'much less invasive method of breathing support, and his NG Tube had been aspirated shortly before his collapse, and no air was found.
Dr Marnerides described "massive" gastric distention, using the word "ballooning".

Recap: Lucy Letby trial, June 21 - prosecution closing speech
 
My head is spinning from yesterday and if the next few days carry on like this I will be so dizzy I won’t remember my own name. Myers KC took us on a weird journey akin to an awful fairground ride that seemed never ending, I was totally exhausted, which would have hardly scratched the surface of how the families of the babies felt.
 
10:35am
The trial is now resuming.

Benjamin Myers KC is referring to the case of Child A.

He says there was sub-optimal care in that case.

He says on a neonatal unit, babies "are there for a reason" and many of the babies have "signficant problems" and are "at risk of deterioration".

10:37am
He says Melanie Taylor was designated nurse for Child A and Child B. They were both intensive care babies.

He says the prosecution have relied on nursing guidelines for some of the children, but not on the "fundamental issue" of staffing numbers. He says there "should not have been just one nurse" looking after Child A and Child B. He says if there was one nurse for each, they would be "more confident" the issue of lines and nursing care was resolved. He adds Dr David Harkness was stretched between a number of babies for the shift on June 8, 2015.

10:46am
The respiration rate chart for Child A is shown, with what Mr Myers says is "escalating up to the point of collapse", and is in a yellow bracket (ie elevated above normal). He says [medical expert] Dr Sandie Bohin would not accept that, saying it was stable.

Mr Myers says the defence wonder how much attention was paid to Child A, with Melanie Taylor looking after two babies.

Mr Myers says Child A received no fluids for four hours, and Dr Bohin agrees it was "sub-optimal".

He says the long line was "in the wrong place" for Child A. He said the records show it was not correctly sited. He refers to an x-ray review on June 8: 'Long line...to be pulled back'. Dr David Harkness put in 9.20pm he was unable to move the long line as he had been called to another patient.

Mr Myers says Dr Harkness had a review with colleagues the following day and they agreed it was in a 'perfect place'.

Mr Myers cross-examined Dr Bohin on the long line position, which she reported was 'not in the best position'. He says Dr Bohin didn't mention it in her evidence.

Mr Myers says the line 'was too close to the heart', and fluids were put down it, and Child A had a fatal collapse within 20 minutes of that. He says Dr Harkness removed the line as soon as the collapse happened.

10:50am
He says Letby helped a nurse with sterilisation. He asks when was she supposed to have done what she was alleged to have done, and next to Dr Harkness and Melanie Taylor.

He says there is "nothing to support" that Letby got a syringe and injected some air.

He says "no-one could access" the lines without opening the incubator first.

www.chesterstandard.co.uk

Recap: Lucy Letby trial, June 27 - 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
 
10:55am
Letby said it was Melanie Taylor who set up and connected the line and put up the fluids. Melanie Taylor "couldn't remember which way it was". Mr Myers says that is something the prosecution would have "absolutely slated" her is she was the one accused.

Mr Myers says another nursing colleague gave "lots of evidence", but "could not remember", in evidence, who connected the line. He says in cross-examination, from her January 2018 police interview, the colleague said: "it appears I was able to say then it was Mel who did it".

Mr Myers says on the evidence, there is "no basis" of Letby being guilty of any offence for Child A. He says this account is "firmly based on the experts" who agreed on air embolus.

www.chesterstandard.co.uk

Recap: Lucy Letby trial, June 27 - 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'Donghue via Twitter:

Lucy Letby's defence lawyer Ben Myers KC is about to get back on his feet at Manchester Crown Court where he's delivering his closing speech to the jury. The nurse has been on trial for the last nine months for the murder of seven babies and attempted murder of a further 10
10:30 AM · Jun 27, 2023

Mr Myers is going back over each case in turn. He begins with count one on the indictment, the alleged murder of Child A in June 2015 - he outlines that the medical experts have said the cause of death was an injection of air
10:33 AM · Jun 27, 2023

He says with this child 'we have sub optimal care, inadequate staffing, a collapse and death in front of everyone and when Ms Letby had been there for minutes, 20 or so minutes. There's no suggestion in evidence she did anything physically to (Child A) at all'
10:35 AM · Jun 27, 2023

He notes that Child A did not have a dedicated nurse caring for him - in breach of guidelines and that a doctor caring for him on the unit was 'stretched' across multiple children
10:37 AM · Jun 27, 2023

Mr Myers notes that some time after 17:00 on 8 June 2015, Dr David Harkness inserted a long line into Child A. This was intended to deliver fluids.

He pulls up the medical notes from the time which state the line should be 'pulled back' -Mr Myers says it was 'not properly sited'
10:45 AM · Jun 27, 2023

Mr Myers says the 'line was too close to the heart, it was left there when it should been moved, fluids were put down it and (Child A) went into fatal collapse 20minutes after that' - Mr Myers notes the line was removed by Dr Harkness after the collapse
10:47 AM · Jun 27, 2023

Mr Myers also notes that at that time a nurse was on the unit, next to Child A's cot, making notes on a computer. He asks the jury to consider how Ms Letby could have attacked the boy, he says 'did she get a syringe and inject air in front of everybody?'
10:48 AM · Jun 27, 2023

Mr Myers says 'we have allegations of harm bowled out there without support in fact'
10:49 AM · Jun 27, 2023

He accuses the Crown of 'lumping everything together and saying it must be (Ms Letby) because she’s there'

He says the whole idea of harm/air embolis is 'based firmly on the opinion of experts'. He says Dr Evans and Dr Bohin 'are the ones pushing this' theory
10:56 AM · Jun 27, 2023

Mr Myers notes the 'key piece of research' the experts relied upon was this medical paper written back in 1989, in which 53 cases were looked at (of air embolism). In one case there was a description of a rash, which has formed basis for this whole case
ncbi.nlm.nih.gov
Pulmonary vascular air embolism in the newborn.
11:00 AM · Jun 27, 2023
 
10:59am
Mr Myers refers to the 'overarching theory of air embolus'. He says "at the heart of it" are Dr Dewi Evans and Dr Sandie Bohin, 'neither of whom are experts on air embolus'. He says they relied on a research paper written over 30 years ago.

He says he asked them the clinical signs of identifying an air embolus. They both said a sudden and unexpected collapse. They said a skin discolouration, and the presence of air in the great vessels. Dr Evans added 'resuscitation is unsuccessful'.

Mr Myers not one of those criterium have been applied consistently across the trial, and they have been 'chopped and changed' to suit the evidence, with 'extraordinary contortions' to fit. "My word, it changed", he adds.

11:05am
Mr Myers says the research paper from 1989 identified 5 out of 53 infants with skin discolouration, and one had a rash, of 'bright pink vessels against a generally cyanosed cutaneous background'.

He says it is a very specific description, of one case study. He says as the basis of convicting someone of murders and/or attempted murders it is "tenous in the extreme", but Dr Evans and Dr Bohin have made reference to it.

That "meagre" research has "carried into pure guesswork", he adds.

Professor Sally Kinsey, a professor of haematology, had also given evidence. She had said in cross-examination, she was not an expert in air embolus. She agreed she hadn't seen it herself, and that air embolus did not feature in her expertise. She said she had given evidence because "she had been asked to". Mr Myers said she had relied upon Dr Evans and Dr Bohin, which he adds was a "big mistake".

www.chesterstandard.co.uk

Recap: Lucy Letby trial, June 27 - 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
 

Mr Myers says the experts have not applied the parameters of air embolism 'consistently across the cases under consideration in this trial', he says 'they have chopped and changed them as much as required to fit available evidence'
11:01 AM · Jun 27, 2023

Mr Myers describes the paper as a 'meagre piece of research' that is 'tenuous in the extreme' and not a basis upon which to convict someone for murder
11:02 AM · Jun 27, 2023

Mr Myers notes how once the theory of air embolism is introduced by Dr Evans and supported by Dr Bohin it has become a 'self perpetuating cycle' and 'feeds upon itself'
11:06 AM · Jun 27, 2023

Mr Myers says 'this material feeds itself back into this case over and over again....see if you can find any description in the clinical notes (of air embolism), you won't'
11:08 AM · Jun 27, 2023

Mr Myers notes how the descriptions of rashes 'come months or years after' and says there has been 'contamination' by recollections being 'pooled or shared' on the unit
11:11 AM · Jun 27, 2023

'Time after time (Ms Letby) is nowhere near events….that is not good luck, she hasn't planned that, it just doesn’t fit…it has led to some extraordinary contortions from the experts in explaining how this could be done', he said
11:12 AM · Jun 27, 2023
 
11:15am
Mr Myers says there are many causes of discolouration to a baby, and there isn't a precise description as there is no photograph of any. He says the descriptions vary between the witnesses. He adds sometimes the descriptions have come months or years afterwards, after people have listened to other people's descriptions, and the dangers of recollection being 'contaminated or influenced are obvious'.

Mr Myers says 'unexpected collapses' can happen to neonatal babies. He says Child D had pneumonia and was at risk of collapse.

He says for 'resuscitations unsuccessful', the proportion of babies who recovered in this case "doesn't make sense".

He says the air is 78% nitrogen and "doesn't just go". He says it is "static, it is a blockage", and would be found post-mortem. He says the jury won't find air in the heart, post-mortem, in any of the cases.

www.chesterstandard.co.uk

Recap: Lucy Letby trial, June 27 - 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
 
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