I can do the Standard updates for a bit, but I will have to go out at some point, not sure when yet.
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10:34am
The judge has arrived in court. Proseuctor Nicholas Johnson KC will resume the prosecution case outline shortly.
Firstly, discussions on the use of iPads that the jury will use are taking place.
The iPads will not have internet access, and have bespoke passwords for each juror, and will only store the evidence in the case for them to access.
10:38am
Child P - murder allegation
The prosecution allege Child P was murdered the following day from brother Child O.
10:39am
Letby was the designated nurse for Child P.
Letby fed Child P donor expressed breast milk at 8am, 10am, noon, 2pm and 6pm.
The final feed, if accurately recorded, was about 13 minutes after Child O had died.
10:45am
A feeding chart is presented to the court.
All the feeds from 8am-4pm are signed by a student nurse and co-signed by Letby.
The 6pm feed is signed only by Letby.
The court hears on the day shift feeds there is nothing more than a 'trace' aspirate (checking if there is anything in the stomach before the baby is fed), apart from a small amount of vomit at noon. The 8pm feed - the first after Letby's shift, produced a 14ml milk acidic (pH3) aspirate.
10:47am
The court hears because Child O had died in unusual circumstances, Child P was reviewed by Dr Gibbs at 6pm. The abdomen was “full … mildly distended”. There was no tenderness and he had active bowel sounds – good signs.
He was screened for infection.
An x-ray taken at 8pm showed striking gaseous distension throughout the stomach and whole bowel.
Lucy Letby made her nursing notes at 8.24pm - therefore she was still in the neonatal at this time, Mr Johnson tells the court.
10:47am
The allegation is Letby "deliberately caused the problems" as she was ending her day shift, so she would not be detected, Mr Johnson tells the court.
10:49am
On that night shift, milk feeds were stopped for Child P on the grounds that a further large part-digested aspirate was drawn up the NGT at feeding time.
At 6.39am, a nurse recorded the abdomen was "soft and non distended."
25ml of air had been aspirated by one of the nurses, and the NGT had been placed on "free drainage".
Mr Johnson said the "problem" Child P had when Letby handed over to the night shift had been resolved. The problem appeared to be air.
10:51am
When the next day shift happened, Letby was Child P's designated nurse again.
He was with his other brother - the third of the triplets - in room 2.
The court hears as events unfolded, while Letby was the designated nurse for the other triplet, care was transferred to another nurse.
Text messages Letby sent to a doctor at just after 8.30am suggest she had sent, or was sending, her student with a baby who needed an MRI scan.
10:54am
A registrar noted Child P, at 9.35am, had “desat + bradys” and had a moderately distended / bloated abdomen and slightly mottled skin.
Letby's nursing notes from that night (9.18pm-10pm) recorded: "Written in retrospect...NG tube on free drainage - trace amount in tube. Abdomen full – loops visible, soft to touch … Reg...arrived to carry out ward round – [Child P] had apnoea, brady, desat with mottled appearance requiring facial oxygen and neopuff for approx. 1 min. Abdomen becoming distended. Decision made to carry out bloods and gas (approx. 09:30)”
10:55am
The prosecution says it follows the problem with which Child P had been handed over by Letby to the night shift, but then apparently reappeared within 90 minutes of Letby taking over again.
15 minutes later, Child P had an acute deterioration. A crash call went out. Child P was intubated and improved, and efforts were made to transfer him to Arrowe Park Hospital
THE prosecution in the trial of Lucy Letby, accused of murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to…
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