UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #3

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4m ago15:33

Letby 'sabotaged' triplet boy while supervising student nurse​

When Child O's body was examined after his death, "an injury to his liver was found", the prosecution opening continues.
Letby was working the day shift on 23 June and came on duty at 7.30am.
She was the designated nurse for Children O and P - two of three triplets.
"This gave her an open opportunity to sabotage the babies," prosecutor Nick Johnson KC says, although Letby was also supervising a student nurse at the time.
Their triplet brother - who is not mentioned in the indictment - was in a separate room, as he was deemed "the most needy" of the triplets.
As of 9.30am there was no cause for concern and there are three records of feeds made by Letby.
Prior to Child O's collapse, a colleague said to Letby: "He doesn’t look as well now as he did earlier.
"Do you think we should move him back to room one to be safe?"
Letby did not concur, the court is told.

Now15:38

Triplet Child O died 'within a few minutes' of Letby entering neonatal unit​

Letby recorded that she had taken Child O's observations at 2.30pm on 23 June, the prosecution says.
But data from her phone shows she was sending Facebook messages and the door recorded her as entering the unit at 2.39pm.
Nick Johnson tells the jury: "Whether the timing of that observation is correct or accurate may be a matter we will consider in the evidence."
Within a few minutes of her entry onto the ward, Child O suffered his first collapse.
Letby was alone in his room at the time, the prosecution says.
A breathing tube was inserted and he was successfully resuscitated. He was then kept on a ventilator.
At 3.49pm his oxygen levels fell again. Letby's notes suggest it was she who called for help.
Child O suffered a further collapse at 4.15pm and resuscitation attempts were unsuccessful.
He died a short while after.

Lucy Letby trial - latest: Nurse 'killed two out of three triplets' - and 'smiled after killing another premature baby girl at fourth attempt'
 
3:37pm

After the shift, Letby sent a series of messages to the doctor on Facebook, and to her colleague. She suggested Child O "had a big tummy overnight but just ballooned after lunch and went from there."
A post-mortem examination found free un-clotted blood in the peritoneal (abdominal)space from a liver injury. There was damage in multiple locations on and in the liver. The blood was found in the peritoneal cavity. He certified death on the basis of natural causes and intra-abdominal bleeding.
He observed that the cause of this bleeding could have been asphyxia, trauma or vigorous resuscitation.
The prosecution say no-one would have thought a nurse would have assaulted a child in the neonatal unit.

3:38pm

Dr Dewi Evans concluded Child O's death was the result of a combination of intravenous air embolus and trauma. The liver injury was not in his view consistent with vigorous CPR. His view was that the liver damage would have occurred before the collapse and contributed to it and was probably the reason for his symptoms through the morning. As for the air in the bowel loops, Dr Evans concluded that that was consistent with excessive air going down via the NGT.
Dr Bohin concluded concluded that together with the chest wall discolouration seen by the doctor that was indicative of air having been injected into Child O's circulation. She agreed that the abdominal distension was due to excess gas via the NGT.

 
3:39pm

Dr Andreas Marnerides, the reviewing pathologist, thought that the liver injuries were most likely the result of impact type trauma and not the result of CPR.
He thought that the excess air via the NGT was likely to have led to stimulation of the vagal nerve which has an effect on heart rate and would have compromised Child O's breathing.
He could not say whether it was either of these factors in isolation or in combination which caused Child O's death.
He certified the cause of death to be “Inflicted traumatic injury to the liver and profound gastric and intestinal distension following acute excessive injection or infusion of air via a naso-gastric tube” and air embolus.

 
3:41pm

In police interview, Letby said she had responded to child O's alarm at 1.15pm and found he had vomited.
She responded first at 2.40pm and discovered mottling all over with purple blotches and red rash. She said that his abdomen just kept swelling and suggested thatsometimes babies can gulp air when they are receiving assistance from Optiflow, as Child O was.
A year later, on the anniversary of Child O's death, Letby carried out a search on Facebook on the surname of the child.

 
3:43pm

The court is now adjourning for today.
Tomorrow (Thursday), the prosecution is expected to conclude its opening.
The defence is also expected to give its opening statement.

 
3:41pm

In police interview, Letby said she had responded to child O's alarm at 1.15pm and found he had vomited.
She responded first at 2.40pm and discovered mottling all over with purple blotches and red rash. She said that his abdomen just kept swelling and suggested thatsometimes babies can gulp air when they are receiving assistance from Optiflow, as Child O was.
A year later, on the anniversary of Child O's death, Letby carried out a search on Facebook on the surname of the child.

Anniversaries significant to her for some reason?
 
Now15:48

Child O, a triplet, died with liver trauma 'likely the result of an assault'​

We are still hearing the prosecution opening - all the alleged victims are being identified as Child A-Q and the jury is currently being told about Child O, one of two triplets to have died.
The consultant said he was "particularly concerned" about Child O's death because he had been "clinically stable" beforehand.
The prosecution tells the court that Child O's collapse was "so sudden" and he did not respond to resuscitation as he should have.
Trauma was found on Child O's liver. One doctor said this could have been due to vigorous CPR.
However, prosecutor Nick Johnson KC says: "Of course, it wouldn't have occurred to him that a nurse would have assaulted a child on the neonatal unit."
One medical expert, who received the case, concluded that Child O's death was a result of an injection of air and trauma - it was not his view that the liver damage was consistent with CPR, the jury is told.
Mr Johnson says experts concluded the damage was "likely the result of some impact trauma".
"In brutal terms, an assault," the prosecutor says.
He certified the death to be: "Inflicted traumatic injury to the liver and profound gastric and intestinal distension following acute excessive injection/infusion of air via a naso-gastric tube, and air embolus."
One year later, on the anniversary of Child O's death, Letby carried out a Facebook search for the family's surname, it is claimed.

Now15:48

Court concludes for the day​

The prosecution opening is scheduled to conclude tomorrow, with the defence putting forward their opening argument on behalf of Letby.

Lucy Letby trial - latest: Nurse 'killed two out of three triplets' - and 'smiled after killing another premature baby girl at fourth attempt'
 
Just caught up...the details of the events are becoming increasingly unnatural imo based on what we know so far obviously.

<modsnip: sub judice>

The texts repeatedly sent do all have the possibility there of someone covering their back.

Most disturbing today for me is having a photo of the sympathy card she sent to the grieving parents also remembering anniversary of a death specifically
 
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It is going to be interesting to see what the defence go with tomorrow and going forward. It looks rather bleak for LL right now imo but that is the prosecutions job essentially to make you feel like that. I think the next six months will be a pretty uncomfortable and bumpy ride to read/hear about.
 
He certified the cause of death to be “Inflicted traumatic injury to the liver and profound gastric and intestinal distension following acute excessive injection or infusion of air via a naso-gastric tube”
This sounds like like something that could only be caused by malice or incompetence, at which point you'd think the whole ward management team is going nuts and very quickly the closest people to the child (doctors, nurses and parents) would all be under suspicion. Does anyone know if there would be any reason why it might just be considered "one of those things" or at least not unusual in this situation?
 
It is going to be interesting to see what the defence go with tomorrow and going forward. It looks rather bleak for LL right now imo but that is the prosecutions job essentially to make you feel like that. I think the next six months will be a pretty uncomfortable and bumpy ride to read/hear about.
<modsnip: sub judice> I know it's only the opening statement of the prosecution so bound to highlight the worst and not yet challenged, but ... They have literally rebuilt her life over at least twelve months (and probably three years or so), timelined every message, webpage, diary entry, and record form she completed, then cross referenced that with what the other parties involved were doing at the same times. You can see how it has taken so long to build this case it's truly mammoth.
 
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Deeply unimpressed by the prosecution’s case so far. It’s all incredibly circumstantial - so much is relying on the opinion and conjecture of their chosen ‘experts’ after the fact.

Ask 20 doctors to review a case, pick the one who says it looks like murder. It’s much too flimsy IMO. I expect the defence will be able to offer plenty of contradictory expert testimony to put against it.

Re: FB searches - Facebook suggests your previous searches to you when typing in a name, so her choosing to check in on multiple families in a single sitting isn’t necessarily suspect. It’s a deliberate feature designed to make you spend more time in the app doing exactly that!

Most of all, there’s just no pattern. No common way of killing or cause of death, no pattern in ages or health. No motive. No consistent pattern to the supposed “souvenirs” (a photo of a sympathy card, a handover sheet, not much else?).

Flimsy flimsy flimsy. JMO
 
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