UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #4

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Sweeper2000 said:
It would be interesting to see how easily an individual would be able to administer an air embolism without detection. Room 1 would be easy as it’s the only room that seems to be out of sight. I might have thought that other staff would notice if someone was doing something out of the ordinary and would have been mentioned by someone already. The only thing they notifed was Lucy being present not Lucy doing things she shouldn’t have been.
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From what I remember the one nurse was typing on a computer and the Dr was scrubbed inserting a line on another baby which would take all his concentration.
 
JosieJo said:
From what I remember the one nurse was typing on a computer and the Dr was scrubbed inserting a line on another baby which would take all his concentration.
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Do we know how many nurses should have been on the ward? I doubt it’s two and a doctor. Would go against the prosecution if these incidents also occurred during periods of being short staffed.
 
Sweeper2000 said:
Do we know how many nurses should have been on the ward? I doubt it’s two and a doctor. Would go against the prosecution if these incidents also occurred during periods of being short staffed.
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It has been presented in court but I'm not sure ...but those were the ones in the vicinity I believe
 
12.02 pm

Dr Bohin agrees there were breathing problems for Child B at birth.

Mr Myers: "Do you agree that Child B could deteriorate without deliberate harm?"

Dr Bohin: "It is a possibility."

Mr Myers: "Air embolus is usually fatal, isn't it?"

Dr Bohin agrees there is a risk.

Dr Bohin says a small quantity of air could create an air embolus. She said it is the volume and speed which are the factors.

Mr Myers says it is "almost always" fatal.

Dr Bohin replies that can be the case with adults [to which there have been medical reports published].
 
Again that last post throws the air embolism thought into question especially regarding how a baby of poorer health could survive it but his healthier twin couldn’t, especially as an air embolism is “nearly always fatal”. Baby B had problems whereas baby A didn’t yet baby B recovered without issue.
 
Sweeper2000 said:
Again that last post throws the air embolism thought into question especially regarding how a baby of poorer health could survive it but his healthier twin couldn’t, especially as an air embolism is “nearly always fatal”. Baby B had problems whereas baby A didn’t yet baby B recovered without issue.
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The important factor is the amount of air and speed ...baby b is an attempted murder charge...it may well be that death was not the ultimate aim .."just" harm
 
Sweeper2000 said:
Again that last post throws the air embolism thought into question especially regarding how a baby of poorer health could survive it but his healthier twin couldn’t, especially as an air embolism is “nearly always fatal”. Baby B had problems whereas baby A didn’t yet baby B recovered without issue
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The “almost always” point looks like it’s been made by the defence KC too.
 
12:13pm
We are having a short adjournment in court. The trial will resume in a few minutes.

12:08pm
A clinical note refers to the "purple blotching...pink and active" for Child B, and is shown to the court.

Mr Myers asks if 'pink and active' refers to the baby.

Dr Bohin: "Yes."
 
I would have assumed something as dangerous as an air embolism would have left baby B needing much more care than was apparently needed. An already compromised and premature child being administered a lethal dose of air would have had catastrophic results, we don’t see that do we?
 
12:52pm
Intelligence analyst Claire Hocknell is now being brought back into court to point out a few corrections made in the bundle of evidence for Child A and Child B. The corrections are largely typos and names for text messages being the wrong way around. All such evidence was corrected during the course over the past few days and has been automatically updated on the jurors' electronic bundles.

12:47pm
Dr Bohin says the colour change 'on its own' is not diagnostic of an air embolus, but needs to be taken into context with the sudden and unexpected collapse.

12:45pm
A note, dated July 14, relays a progress report for Child B.

Mr Johnson asks if there is any evidence of breathing problems in that note.

Dr Bohin says there isn't.

12:41pm
Dr Bohin is asked if there is any link between Child B not getting fluids and the collapse which happened 28-30 hours later.

Dr Bohin: "No."

12:39pm
Dr Bohin clarifies she has never heard of a case, in clinical experience or in educational courses, or in published literature, of a neonatal having an air embolus as a result of negative air pressure, as described in the medical paper concerning air embolisms in adults.

12:32pm
Dr Bohin presents a UVC to the court, and explains how it is administered and left so there is no air left in the tube.

She explains a long line looks similar, but has a wire inside it.

12:30pm
The blood gas record is shown to the court.

One of the parameters from a blood capilliary reading, a 'PO2' recording, is typically "disregarded" as it is not reliable, Dr Bohin says.

12:23pm
The prosecution, led by Nicholas Johnson KC, is clarifying a few matters from Dr Bohin's evidence.

Dr Bohin said she needs to be "completely independent" and base her conclusion on the evidence presented to her.

12:13pm
We are having a short adjournment in court. The trial will resume in a few minutes.
 
Charlot123 said:
I think they need to feed all data about all kids treated in the unit from 2012 till 2018, all info they have, as well as the names of all unit staff working in the unit during these years, and look at the probability of the kids being killed by LL.
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I imagine this will come out in either the prosecutions argument or the defences, whichever side it 'favours'
 
Sweeper2000 said:
It’s not my belief that the “kill switch” in cases of serial killers is something that happens spontaneously more that it is preceded by escalating patterns of harm on other beings Eventually leading to murder. It’s a fix the same way an addict will get “a fix”. In psychopaths there is always a low emotionality and in cases of serial killers this Low emotion creates a want of feeling and they get what they want (emotion) through the feelings bought about by the murders. It’s why they take souvenirs so they can relive the moment and kind of feel those things again.

Münchausen syndrome by proxy which doesn’t fit the bill here is the creation of false illness to draw sympathy and or attention to the caregiver.
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Please can you clarify the MBP comment as to me it very much fits, and with your description of the condition ie "creation of false illness" = babies collapsing and "attention to the caregiver" = LL as the nurse on scene...
 
JosieJo said:
The important factor is the amount of air and speed ...baby b is an attempted murder charge...it may well be that death was not the ultimate aim .."just" harm
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I agree the key here is speed and amount of air. It's not either/or. Either it always kills OR it's not an air embolism. I think the medical experts have done a good job explaining how they came to their diagnosis. If a little less air entered circulation or a little more slowly, it will cause symptoms but not necessarily be fatal. (This is supported by literature.) If enough air has entered, it is fatal and the baby is unable to be resuscitated.

It is air in the arterial circulation that is usually fatal. As the air gets to the venous bed of the lungs, it gets filtered out. That's why in adults, small amounts of air in venous circulation are not fatal. Babies also have a communication between venous and arterial circulation (ductus arteriosis) that typically closes in the first few days of life. Being one day older may have made a difference for twin B, if the DA was closed or closing. There would be no way to verify that without having gotten an echocardiogram before the collapse (because collapse events can reopen the DA due to hypoxia) but there was absolutely no clinical reason to have gotten an ECG at that time.

Other thoughts, baby B... can someone point me to exactly what sort of trouble baby B was in at birth? Such as needed 30 second of chest compressions, or intubated for surfactant and a day on the ventilator? Both of those do not portend a baby who is going to be ill for a prolonged period of time or who is necessarily more frail or unstable.

Also, as far as not needing follow up care - after the air has been filtered out by the lungs (all blood eventually gets to the lungs), and if she was fortunate enough not to have had a stroke, it is plausible that she would have recovered quickly. In fact this may lend even more credence to the idea that it was an air embolism, because other causes for collapse (sepsis, etc) would have left her on a ventilator, possibly with vasoactive drips, etc, after the initial resuscitation.`
 
Sweeper2000 said:
I would have assumed something as dangerous as an air embolism would have left baby B needing much more care than was apparently needed. An already compromised and premature child being administered a lethal dose of air would have had catastrophic results, we don’t see that do we?
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Baby B required resuscitation. I’d argue that was a catastrophic result.
 
magikarpmagikarp said:
I agree the key here is speed and amount of air. It's not either/or. Either it always kills OR it's not an air embolism. I think the medical experts have done a good job explaining how they came to their diagnosis. If a little less air entered circulation or a little more slowly, it will cause symptoms but not necessarily be fatal. (This is supported by literature.) If enough air has entered, it is fatal and the baby is unable to be resuscitated.

It is air in the arterial circulation that is usually fatal. As the air gets to the venous bed of the lungs, it gets filtered out. That's why in adults, small amounts of air in venous circulation are not fatal. Babies also have a communication between venous and arterial circulation (ductus arteriosis) that typically closes in the first few days of life. Being one day older may have made a difference for twin B, if the DA was closed or closing. There would be no way to verify that without having gotten an echocardiogram before the collapse (because collapse events can reopen the DA due to hypoxia) but there was absolutely no clinical reason to have gotten an ECG at that time.

Other thoughts, baby B... can someone point me to exactly what sort of trouble baby B was in at birth? Such as needed 30 second of chest compressions, or intubated for surfactant and a day on the ventilator? Both of those do not portend a baby who is going to be ill for a prolonged period of time or who is necessarily more frail or unstable.

Also, as far as not needing follow up care - after the air has been filtered out by the lungs (all blood eventually gets to the lungs), and if she was fortunate enough not to have had a stroke, it is plausible that she would have recovered quickly. In fact this may lend even more credence to the idea that it was an air embolism, because other causes for collapse (sepsis, etc) would have left her on a ventilator, possibly with vasoactive drips, etc, after the initial resuscitation.`
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Great Post thanks
 
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