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

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I thought the crying was linked to potential violent acts rather than the air embolus themselves? He’s saying that the distress and crying is something the precaution is trying to link to the embolus right?
Baby N was said to be screaming due to an alleged inflicted painful stimulus or injection of air, Baby E after an alleged throat injury, and Baby I was said to have been crying loudly and relentlessly after an alleged injection of air. Baby D is also on the list of babies who screamed but I don't know the details of that.
 
I really don’t like the way the defence is running this. I guess they have to give LL the best defence possible to prevent an appeal or mistrial (or mega tantrum from the accused) but everything is making me nauseous. I’m switching off from it so I wonder what the jury are making of it all.
 
2:02pm

The trial is now resuming following its lunch break.

2:18pm

Mr Myers says, for the case of Child C, he looks at the post-mortem evidence of whether there was a gastrointestinal blockage.
He refers to the agreed evidence by the pathologist, Dr Kokai, who conducted the post-mortem examination, who recorded a 'distended colon' for Child C, which was not normal. He says Dr Marnerides refused to accept this evidence, who said the bowel was 'normal'.
The stomach contained 'a large amount of air'.
Mr Myers says Dr Evans was prepared to accept air being forced down the NG Tube on June 12 - when Letby was not on duty - but 'just came out' with air being forced down the tube, and an air embolus, in evidence for June 13, when he had not mentioned it in his pre-trial reports.
Mr Myers says that was "without any evidential basis at all".
He says Dr Bohin agreed that pneumonia was a contributory factor for Child C's death. He says the defence's position is that pneumonia made Child C more vulnerable, and Dr Bohin 'refused' to consider a combination of pneumonia and something else - such as an abdominal blockage - caused the collapse.
He says Child C was a "very poorly little boy" who "should have been transferred out of [Chester] with the problems he had", and had "sub-optimal care".


2:27pm

Mr Myers says Sophie Ellis "should not have been looking after" Child C, as she was "inexperienced" and put in charge of a "fragile little boy".
He says the collapse of Child C follows "the one and only feed" he received.
He says Sophie Ellis "didn't see Lucy Letby do anything wrong".
Mr Myers says the evidence of Melanie Taylor "contradicts" in court to what she said to police in 2018, "swapping Lucy Letby for Sophie Ellis". He says she was "utterly brazen about this" in cross-examination. He says the account changed so it put Lucy Letby in the room.
He says a female nurse colleague said in evidence was consistent with what she told police. She had been dealing with a different baby, in a different room, with Lucy Letby. She said between 10-11pm, she was called to assist Child C. She 'went to nursery 1, where Sophie Ellis and Melanie Taylor were Neopuffing [Child C]'.
Mr Myers says Letby is "nowhere near nursery room 1" at the time of the collapse.
 
2:39pm

Mr Myers moves to the case of Child D.
He says the "evidence is very clear" that Child D was "very unwell" at 12 minutes of age, but she wasn't given antibiotics for four hours, and Child D was born with pneumonia, and required ventilation, and was on it for 11 hours, and there were continuing signs of respiratory difficulties, requiring the use of CPAP.
He says after Child D's first collapse, it was discussed what to do, and there woul 'be a low threshold to intervene from a respiratory point of view'.
He says after the second collapse, Child D was taken off CPAP, and Child D later collapsed fatally, and post-mortem was found with acute lung damage.
He says Child D was "very ill from the outset".
He says it is "a very unfortunate decision" after the second collapse that Child D was taken off CPAP after a discussion of a 'low threshold to intervene'.

 
2:46pm

Mr Myers refers to the pathologist's report for Child D, recording damaged lungs, "continuing respiratory problems". Presence of infection is "not ruled out" following negative microbiology tests, as Child D had been on antibiotics.
Mr Myers said despite that, Dr Marnerides "preferred" air embolus as a conclusion. He said he had taken into account clinicians' views of how well Child D was doing. Mr Myers says Child D was not doing well on respiration.
He says Dr Bohin had 'revealed' 'distress' was a sign of air embolus, for the first time in the case.

 
2:58pm

Mr Myers refers to nurse Caroline Oakley's notes of skin discolouration for Child D at the time. He says there is nothing there to identify a discolouration that matches air embolus.
He says in cross-examination, she began to give colours such as 'red-brown', and "ended up saying 'I remember an unusual rash'".
He says Kathryn Percival-Ward [Calderbank] had said in 2018 police interview that [Child D] changed colour, was mottled, and had seen it before, but...it looked unusual'. He says her memory had developed by the trial, calling it a 'mosaic' and giving a more detailed description with 'oval markings meeting up with each other'. He says "five years later we have a lurid description".
He says he is repeating himself by witnesses giving more detailed descriptions five years later.
Mr Myers suggests staff had met up in the meantime to 'share recollections', and this 'almost certainly' happened.
He says for Dr Bohin, there had been lengthy cross-examination on air embolus, and it went 'increasingly circular' and 'self-feeding'.
He says Dr Bohin had said Child D had two non-fatal collapses by referring to research in dogs, pigs and rabbits, and the results were "variable". Mr Myers says those "vague assertions" does not give confidence as to what happened with Child D.
He asks why the descriptions of discolourations vary each time, and why Child D was not seen to be in distress before the final collapse [having been in distress prior to an earlier collapse].

 
https://twitter.com/MrDanDonoghue
@MrDanDonoghue
·
8m

Mr Myers again focuses on the supposed patches/unusual rashes witnessed on the skin. He says one nurse gave a 'striking' description of unusual blotches on Child C [my note - think he means child D] in the witness box, but made not mention of this in her notes at the time or in her first police interview

@MrDanDonoghue
·
7m


He says this keeps on happening, 'witnesses who haven’t said things at the time have then given striking evidence to you years later…it's almost as if they have been speaking with people between the time of giving their first account and evidence to you'


@MrDanDonoghue
·
3m


Mr Myers again hammers home the point about differing descriptions of rashes, he says 'how does any of this stack up, we say it doesn’t…we have experts knitting together bits of available detail to meet the allegation'
 
Last edited:
3:04pm

Mr Myers says doctors had agreed blood gas test results for Child D had declined - and Caroline Oakley agreed they "were not as good as they had earlier" on June 22, 2015, at 1.14am.
He refers to the 3.45am note by Caroline Oakley: '[Child D] desaturated and then became apnoeic. Called SN Letby to help.'
He says "yet again" Letby was being held responsible for an event where she did not have responsibility for that baby at that point. He says there is nothing linked to doing any harm.
BM: "Again - what is meant to have happened?"
He says the jury have to be sure of what.

 
Dan O'Donoghue

@MrDanDonoghue
·
4m


In the case of Child D, Mr Myers says 'this is such a blunt point to be made, in this case it seems so insensitive, but I have to make it....we're looking at the intention to kill, from somebody who the prosecution allege plainly knows what they’re doing...

Dan O'Donoghue

@MrDanDonoghue
·
3m


'Because by this point it has already happened with air embolis, if that’s right it’s not going to take three go's is it? just think about that, one shot, sudden rapid and fatal, unless we’re going to alter the theory to support the allegation'
 
3:04pm

Mr Myers says doctors had agreed blood gas test results for Child D had declined - and Caroline Oakley agreed they "were not as good as they had earlier" on June 22, 2015, at 1.14am.
He refers to the 3.45am note by Caroline Oakley: '[Child D] desaturated and then became apnoeic. Called SN Letby to help.'
He says "yet again" Letby was being held responsible for an event where she did not have responsibility for that baby at that point. He says there is nothing linked to doing any harm.
BM: "Again - what is meant to have happened?"
He says the jury have to be sure of what.



Bolded by me - from the judges instructions this is not correct. The jury don’t have to decide how the babies were harmed, just that they were harmed by LL.

Is he allowed to tell the jury this when it is strictly not true?

MOO
 
3:07pm

He says there is "such a blunt point to be made": "We are looking at intentions to kill, from somebody whom the prosecution allege knows what they are doing [as it has already happened by this point, in their view].
"It's not going to take three goes is it? It would be one shot, sudden, and fatal."
Mr Myers the suggestion Child D did not die of pneumonia, as opposed to with pneumonia, is "unrealistic".
He says the case against Letby is "incoherent".

 
Dan O'Donoghue
@MrDanDonoghue
·
4m


In the case of Child D, Mr Myers says 'this is such a blunt point to be made, in this case it seems so insensitive, but I have to make it....we're looking at the intention to kill, from somebody who the prosecution allege plainly knows what they’re doing...

Dan O'Donoghue
@MrDanDonoghue
·
3m


'Because by this point it has already happened with air embolis, if that’s right it’s not going to take three go's is it? just think about that, one shot, sudden rapid and fatal, unless we’re going to alter the theory to support the allegation'

Ummm… multiple attempts IMO points to very clear intention to kill. Administering air to just one baby, realising it is fatal and then making the decision to administer air to many more babies, points to an intention to kill. If you do something once and it kills someone, if you don’t want to kill anymore people you are careful not to do it again!

Of course if someone is getting a kick out of causing pain and enjoyment out of witnessing a deterioration they may make a conscious decision to experiment with doses and methods to monitor the results. JMO

What on earth is he on about?

MOO
 
Ummm… multiple attempts IMO points to very clear intention to kill. Administering air to just one baby, realising it is fatal and then making the decision to administer air to many more babies, points to an intention to kill. If you do something once and it kills someone, if you don’t want to kill anymore people you are careful not to do it again!

Of course if someone is getting a kick out of causing pain and enjoyment out of witnessing a deterioration they may make a conscious decision to experiment with doses and methods to monitor the results. JMO

What on earth is he on about?

MOO
Each circumstance is going to be different too, in terms of available time if one is trying to hide what one is doing from others, how fast and how much, IMO
 
3:20pm

The trial is resuming after a short break.
Mr Myers is turning to the case of Child E.

3:23pm

He says there is a lot of pressure with all these events, and it is traumatic for the parents of Child E. He says it is important to look at the evidence as objectively as the jurors can.
He says the defence will look at the evidence of Child E's mother as 'sensitively' as they can.

 
3:30pm

He says it is important to note there was no post-mortem examination - "in this, of all cases", and that absence has 'allowed the prosecution to make all sorts of suggestions'.
He says doctors failed to deal with a bleed for Child E which was identified or suspected at 10.10pm on August 3. Mr Myers says it was "obvious" a transfusion would be required. He says a further note by Dr David Harkness at 11pm recorded a further gastrointestinal blood loss. He says "even here, no action for a transfusion". He says it was "delayed a further 45 minutes".
A female doctor said it was a "serious situation" at 10pm and a "very serious situation" by 11pm, and she agreed she wished she had got there sooner, as it was a medical emergency.
He says this is "obviously sub-optimal care".

3:35pm

Mr Myers it may not have been anyone's fault that Child E was at the Countess, but Liverpool Women's was 'full'.
He says it is "not extraordinary" that Child E became unwell, and one of the nurses suggested that stress could have caused acidosis and, as a consequence, bleeding.
Mr Myers says Dr Bohin would not consider bleeding as a cause of death. He says he knows it is distressing to talk about, and Child E did bleed to death. He says "everybody here could see [Child E] needed a blood transfusion".

 
3:39pm

Mr Myers refers to the allegation Letby attacked Child E at 9pm.
He says Child E's mother's account was she walked in and Letby was not near the incubator at the time. He says the prosecution's statement was a "highly charged" statement.
He says "that is the evidence", that Letby was "not causing harm".
He says he is sympathetic with Child E's mother. He says the prosecution have "done their best" to turn this "into a binary choice" - that 'either Lucy Letby is lying or [Child E's mother] is lying'. He says the prosecution have done that deliberately.
He says the question is what degree of accuracy has each said.
BM: "Perhaps can we take the heat out of that?"

 
Bolded by me - from the judges instructions this is not correct. The jury don’t have to decide how the babies were harmed, just that they were harmed by LL.

Is he allowed to tell the jury this when it is strictly not true?

MOO
All I can say is thank goodness they have the judge's instructions in writing.
 
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