It must be hard to gauge the intent for attempted murder charges, because you also can’t rule out that the person was interrupted during administering or startled or overly cautious etc (obviously this is in the context of if baby B was administered air)
UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #4
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Supernovae
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I believe that the "almost always" fatal claim likely comes from the 1989 Lee and Tanswell paper:
This was also the paper that was mentioned by Dr Jayaram. I suspect the core problem on both the prosecution and defence side is that this is not a condition where there's an awful lot of empirical information out there, which would be why they're both having to reach back to this one very old case series, as it might be the only relevant paper out there.
The prosecution independent medical evidence still feels very much like they came to the conclusion that it had to be foul play because of the coincidences and the lack of a specific natural explanation and then worked backwards to a mechanism that would work with the lack of sinister toxicology. I'm sure I saw in one of the live blogs that Dr Evans also toyed with the possibility of smothering or deliberately removing the nasal prongs in an earlier version of his report. The former of course would be a non-starter as, if it happened, it would have had to have happened in a busy, open-plan NICU.
JosieJo
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Dr Bohin agrees with Ms Letby’s defence that it’s important in a case like this not to start with an assumption of deliberate harm and look for things that could support that [idea]. @BBCNWT
Mr Myers, defending, asks “Are you trying to explain away risks that could have contributed to collapse [of Child A] ? Are you doing that in any way ?” De Bohin replies “No.” @BBCNWT
Mr Myers asks if air can get into the bloodstream through medical “lines” into a patient [such as Child A had]. She says are examples in medical literature about adults but she’s seen no reports about it for neonates. 1/2
On Child B, Mr Myers suggests the fact that she made rapid & good recovery [after collapsing] is less suggestive of an air embolism. Dr Bohin replies “Not necessarily, no.” @BBCNWT
Mr Myers asks “Are you deliberately excluding something that reduces the likelihood of air embolism ?” Dr Bohin says “No.” @BBCNWT
Mr Myers, defending, asks “Are you trying to explain away risks that could have contributed to collapse [of Child A] ? Are you doing that in any way ?” De Bohin replies “No.” @BBCNWT
Mr Myers asks if air can get into the bloodstream through medical “lines” into a patient [such as Child A had]. She says are examples in medical literature about adults but she’s seen no reports about it for neonates. 1/2
On Child B, Mr Myers suggests the fact that she made rapid & good recovery [after collapsing] is less suggestive of an air embolism. Dr Bohin replies “Not necessarily, no.” @BBCNWT
Mr Myers asks “Are you deliberately excluding something that reduces the likelihood of air embolism ?” Dr Bohin says “No.” @BBCNWT
Sweeper2000
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Agreed but I would have assumed there would be ongoing effects after the embolism had been cleared by the body? Rather than seeming complete recovery.
Sweeper2000
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To be honest I don’t think there is more info out there on Baby B’s condition both at birth and during the stay than what’s going through the court today.
Recap: Lucy Letby trial, Wednesday, October 26
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…
Sweeper2000
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In munchausen by proxy the aim isn’t to kill but to garner attention and perhaps adoration through the deliberate creation of illness.in Münchausen syndrome you might pretend you are ill or make yourself ill while munchausen by proxy which I think in most cases would be parental you would make your child ill. You may have heard of people feeding their children too much salt, it’s a common one in parental munchausen. Check the link below. In a nurses case she/he will make patients ill so they can “rush in and be the hero”.
We don’t see any attention seeking behaviour nor are there any reports of any odd behaviour consistently from Lucy. Nothing at all as of yet that would bring her character into question.
Mother who killed son with salt for web attention jailed
A US woman is sentenced to 20 years for making her five-year-old son sick and eventually killing him in order to gain attention online.
www.bbc.co.uk
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Sweeper2000
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2:27pm
For Child B, Letby explained the discolouration was a different appearance to that of Child A.
Child B's appearance was observed before resuscitation attempts began.
She did not recall having had any concerns for Child B, or any alarm going off for her.
She confirmed she would have handled Child B to an extent for medication and to attach lines.
She said she did not recall how upset Child A and B's parents were at the time.
2:23pm
She agreed she had been taught to prime lines so air could not get in them.
She denied having done so via Child A's long line or UVC.
She said she didn't know exactly what an air embolism was.
She said her relationship with the child's parents was "strictly professional" and could not explain or remember why she had searched the mum's name on Facebook several times in the following weeks.
She explained, for a later search, she may have been searching for their names for an update on Child B.
2:20pm
Letby said she could not recall Child A's resuscitation, but recalled Dr Jayaram had entered the room.
She said the death of Child A "had been difficult" for her, and said there was a support network among the nursing team.
She said she could not recall who attached the fluids line, but believed it was her nursing colelague Melanie Taylor who had connected the fluids.
She said photos were taken of Child A in accordance with the parents' wishes on their phone, along with a lock of hair and hand/footprints.
2:17pm
She said Child A had a rash-like appearance, which Letby put as being the result of an infection, or being cold.
"He was more pale than the areas of the mottling."
She was asked if anyone had seen the mottling. Letby replies: "Yes."
She said they were advised to stop administration of the fluids.
Child A was then not breathing, and Dr Harkness was called over.
2:15pm
She said Child A went pale after a colleague had connected the fluids. She said Child A had "gone pale" 'about five minutes' after the fluids were administered.
2:15pm
She was asked why the fluids were a priority, and Letby explains Child A had gone 'a few hours' with a lack of fluids.
She said that "wasn't ideal".
2:14pm
For the case of Child A - the first interview took place in July 2018.
Letby was allowed to look through the case notes, and was asked if she remembered the specific shift. She replied: "Yes."
Letby gave details of the handover and the long line administration.
She said she checked the fluids and a nurse colleague "had the bag out".
She said they noticed Child A was "pale and mottled", and a crash call was put out.
She said full resuscitation attempts followed.
She said Child A had been "a little bit jittery in appearance" and believed that was due to low blood sugar levels.
She said a colleague was there with the fluids at the handover.
2:11pm
The jury is now coming back in.
Nicholas Johnson KC, for the prosecution, explains to the jurors he will now read a summary of the police interview Lucy Letby had in respect of Child A and Child B.
The wording of the summary has been agreed between the prosecution and defence.
2:02pm
We have had an adjournment for lunch. Court is resuming in the next few minutes.
For Child B, Letby explained the discolouration was a different appearance to that of Child A.
Child B's appearance was observed before resuscitation attempts began.
She did not recall having had any concerns for Child B, or any alarm going off for her.
She confirmed she would have handled Child B to an extent for medication and to attach lines.
She said she did not recall how upset Child A and B's parents were at the time.
2:23pm
She agreed she had been taught to prime lines so air could not get in them.
She denied having done so via Child A's long line or UVC.
She said she didn't know exactly what an air embolism was.
She said her relationship with the child's parents was "strictly professional" and could not explain or remember why she had searched the mum's name on Facebook several times in the following weeks.
She explained, for a later search, she may have been searching for their names for an update on Child B.
2:20pm
Letby said she could not recall Child A's resuscitation, but recalled Dr Jayaram had entered the room.
She said the death of Child A "had been difficult" for her, and said there was a support network among the nursing team.
She said she could not recall who attached the fluids line, but believed it was her nursing colelague Melanie Taylor who had connected the fluids.
She said photos were taken of Child A in accordance with the parents' wishes on their phone, along with a lock of hair and hand/footprints.
2:17pm
She said Child A had a rash-like appearance, which Letby put as being the result of an infection, or being cold.
"He was more pale than the areas of the mottling."
She was asked if anyone had seen the mottling. Letby replies: "Yes."
She said they were advised to stop administration of the fluids.
Child A was then not breathing, and Dr Harkness was called over.
2:15pm
She said Child A went pale after a colleague had connected the fluids. She said Child A had "gone pale" 'about five minutes' after the fluids were administered.
2:15pm
She was asked why the fluids were a priority, and Letby explains Child A had gone 'a few hours' with a lack of fluids.
She said that "wasn't ideal".
2:14pm
For the case of Child A - the first interview took place in July 2018.
Letby was allowed to look through the case notes, and was asked if she remembered the specific shift. She replied: "Yes."
Letby gave details of the handover and the long line administration.
She said she checked the fluids and a nurse colleague "had the bag out".
She said they noticed Child A was "pale and mottled", and a crash call was put out.
She said full resuscitation attempts followed.
She said Child A had been "a little bit jittery in appearance" and believed that was due to low blood sugar levels.
She said a colleague was there with the fluids at the handover.
2:11pm
The jury is now coming back in.
Nicholas Johnson KC, for the prosecution, explains to the jurors he will now read a summary of the police interview Lucy Letby had in respect of Child A and Child B.
The wording of the summary has been agreed between the prosecution and defence.
2:02pm
We have had an adjournment for lunch. Court is resuming in the next few minutes.
Sweeper2000
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10:43am
The prosecution refer to an event where the nasal prongs were dislodged, prior to the collapse.
Dr Bohin said the prongs can be "misplaced", and the babies are "probably quite uncomfortable", and if left for a prolonged period of time, there would be a desaturation, with prior warning.
She added: "It was noted, the prongs were replaced, and everything went back to normal".
Dr Bohin replies to the question if the misplaced prongs had anything to do with the subsequent collapse: "No, none at all".
10:41am
Dr Bohin said the circumstances of Child B's collapse were not normal, but "very concerning".
She said: "Despite being on CPAP, she was otherwise normal."
If such babies deteriorate, there is normally "prior warning", but there was "nothing to suggest she was going to collapse in this way".
10:38am
Dr Bohin says Child B was "compromised" at birth, and required respiratory support, which was "not that unusual" for someone of her prematurity.
"She stabilised very quickly," Dr Bohin added, and was "in air" with "normal" blood gases, and "stable enough" to have skin to skin contact with her mother and for feeds to be started.
10:36am
Child B collapsed at 12.33am on June 10, 2015, at the neonatal unit. She later recovered and, four weeks later, was discharged from the Countess of
Sweeper2000
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Really not liking the court case today. Lots of details about these poor kids families. Can’t imagine the grief especially in this circumstance.
magikarpmagikarp
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Agreed. Also this article - it's not a direct quote so some information is missing, but this is a bizarre thing to say:
(Lucy Letby trial: Countess of Chester Hospital nurse 'injected new-born twins with air', court told)
Air is a fluid. It's a gaseous fluid, but a fluid nonetheless. It's not any harder to push air than it is to push 10% dextrose or 1/2 NS or NS; air isn't more viscous than either of those standard fluids. That's the reason why we're fanatical about checking things for air. Long lines are a little more difficult to push things through, but they are primed (outside of the patient!) and flushed (in the patient) when they are inserted, so it's obviously done. An umbilical line is not difficult to push fluid through at all. It's a really strange thing to say.
notsure
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I imagine the families will all be supporting each other through their shared ordeal. Terrible for them.
MsBetsy
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What is significant to me is that baby B had the same unusual purple blotches and collapsed the day after Baby A had the same symptoms and died. The nurse testified that for Baby B, LL was standing by the cot and was the one who called for help.To be honest I don’t think there is more info out there on Baby B’s condition both at birth and during the stay than what’s going through the court today.
Recap: Lucy Letby trial, Wednesday, October 26
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…www.leaderlive.co.uk
Also, Letby seemed to be the only person involved in their treatment who didn't think the incidents were similar. She specifically stated in her text they occurred under "different circumstances."
I would think she would have known it was unusual, especially since she had watched the show about air embolism around that time.
MsBetsy
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Yes, I thought she told another nurse that she was so upset, she did not want to face the parents. She described the father crying on the floor, begging them not to take their child away? She also searched the mother's FB around this time, didn't she? And again at Christmas time?
JosieJo
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Yes it's difficult to believe...also as a nurse I find it really difficult to believe she did not know what an air embolus was ..she was a trained nurse and had done additional neonatal training...even if you didn't know in depth signs or symptoms you would know what one was
Sweeper2000
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This is after child A which is when the parents were upset. She is referring to the following shift when I think she had asked not to work in room 1 and preferred not to have to interact with the parents of Baby B.
Sweeper2000
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Do you think she might not know the word embolus ? Or possibly that an injection of air is referred to as an air embolus? Or that perhaps any blockage caused by an object in a vein or artery is referred to as an embolus?
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JosieJo
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No I honestly don't...embolus is a commonly used phrase ...you can get fat embolus..pulmonary embolus etc ...air embolus is drilled into nurses as a complication when priming fluids
JosieJo
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I do not think its clear 100% when it refers to to be honest . I'm not sure why the police would ask about seeing the parents upset "at a specific time"
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