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

[ConcernedThirdParty]

I got to page 42 of the previous thread.

Don't think she was "move from nights to days" because there was anything wrong, as I've said a few times, nurses tend to do both and I don't think that matched the timeline - she was still doing night shifts near the last ones chronologically. It was just a misleading wording of, when she was on night vs when she was on days, which she would be moved between all the time by the person drawing up the rotas.

Pretty sure I saw the timeline made it apparent that she was aware of the police investigation and something of the nature of it before her arrest - although ostensibly it was started in May. It also seems pretty clear that the police were brought in because the hospital already suspected her, why they took her off clinical duties after the previous June. So I'm pretty sure that note was written after she knew in broad brushstrokes that there was a police investigation into whether she killed babies.

Given that timeline, and this would be one of my first concerns too, the comment about never marrying or having children is most likely simply the realisation that she may in prison for the rest of her life, or even if not convicted, it will be too late by the time it's all over and people stop seeing her as a baby killer if that ever happens.

I honestly think all but the best of saints would think of themselves and not the babies that died (some of which they may recall from a year or two previously) on learning that they faced prison for the rest of their lives, branded a baby murderer. And even those true saints among us wouldn't have their halos dimmed for writing one note that doesn't mention the babies and their families even while thinking of them all the time. So I don't know if she's guilty, or if she was thinking of the babies then or at other times, but I don't think their absence from that post-it tells us anything about anything. I'm surprised there are so many people here who have never encountered someone writing or saying pretty irrational things when faced with much pettier issues, feels like a failure of imagination.

Something struck me about the TV doctor - a lot of us get stuff wrong and later play down how adamant we were, and forget and even come to believe that we were pretty open minded, or even that we actually thought the opposite of what we did. There are certainly many people, including TV doctors, who had significant turnarounds about COVID and would deny it apart from the old tweets and clips. I feel like a TV doctor is going to be the most likely person to say "I had my suspicions even then" (but I didn't say or do anything about it so it's completely unverifiable) - not saying that is the case, but it's not unusual and he could really believe it despite having only suspected her later. Memory is a very tricky thing.

For this case, the only evidence I can imagine being fairly conclusive one way or the other is statistical. Everything else feels tainted. A lot of, how were they murdered rather than were they murdered evidence. A lot of memory of events long after, a half dozen awkward/unprofessional moments told to us in a matter of hours with the worst spin, but in reality spread over a year of otherwise good work? A lot of appeals to very questionable pop-psych, and tropes from crime fiction rather than fact (from some in this thread and basically everyone on twitter/facebook as opposed to the prosecution).

They've told us about all these coincidences, but they need to give us more than: "there's usually 2 or 3 deaths, she was involved in the care of 7 - but not in 7 others", she just happened to have her killing spree almost hidden by a spike in natural deaths over the same time period? I imagine in twins, it's common if one dies, the other is not in much better health? I imagine if a baby suffers a "collapse", further collapses and death are far more likely? Surely there were far more "collapses" than those mentioned, not attributable to LL? Is it more or less common for deterioration to occur shortly after feeds, changing of meds, any intervention? Is there even an odd pattern to, as soon as she comes on shift, or shortly after her shift, or in the middle of her shift?

There's a lot of questions, I wouldn't be confident either way without some answers. Hope we'll get into it, but worried the investigation didn't look that far into the multiple staff, deaths and collapses that were outside their scope and the defence wouldn't have the resources and possibly the legal basis to go there.

 

[Eloise]

I got to page 42 of the previous thread.

Don't think she was "move from nights to days" because there was anything wrong, as I've said a few times, nurses tend to do both and I don't think that matched the timeline - she was still doing night shifts near the last ones chronologically. It was just a misleading wording of, when she was on night vs when she was on days, which she would be moved between all the time by the person drawing up the rotas.

Pretty sure I saw the timeline made it apparent that she was aware of the police investigation and something of the nature of it before her arrest - although ostensibly it was started in May. It also seems pretty clear that the police were brought in because the hospital already suspected her, why they took her off clinical duties after the previous June. So I'm pretty sure that note was written after she knew in broad brushstrokes that there was a police investigation into whether she killed babies.

Given that timeline, and this would be one of my first concerns too, the comment about never marrying or having children is most likely simply the realisation that she may in prison for the rest of her life, or even if not convicted, it will be too late by the time it's all over and people stop seeing her as a baby killer if that ever happens.

I honestly think all but the best of saints would think of themselves and not the babies that died (some of which they may recall from a year or two previously) on learning that they faced prison for the rest of their lives, branded a baby murderer. And even those true saints among us wouldn't have their halos dimmed for writing one note that doesn't mention the babies and their families even while thinking of them all the time. So I don't know if she's guilty, or if she was thinking of the babies then or at other times, but I don't think their absence from that post-it tells us anything about anything. I'm surprised there are so many people here who have never encountered someone writing or saying pretty irrational things when faced with much pettier issues, feels like a failure of imagination.

Something struck me about the TV doctor - a lot of us get stuff wrong and later play down how adamant we were, and forget and even come to believe that we were pretty open minded, or even that we actually thought the opposite of what we did. There are certainly many people, including TV doctors, who had significant turnarounds about COVID and would deny it apart from the old tweets and clips. I feel like a TV doctor is going to be the most likely person to say "I had my suspicions even then" (but I didn't say or do anything about it so it's completely unverifiable) - not saying that is the case, but it's not unusual and he could really believe it despite having only suspected her later. Memory is a very tricky thing.

For this case, the only evidence I can imagine being fairly conclusive one way or the other is statistical. Everything else feels tainted. A lot of, how were they murdered rather than were they murdered evidence. A lot of memory of events long after, a half dozen awkward/unprofessional moments told to us in a matter of hours with the worst spin, but in reality spread over a year of otherwise good work? A lot of appeals to very questionable pop-psych, and tropes from crime fiction rather than fact (from some in this thread and basically everyone on twitter/facebook as opposed to the prosecution).

They've told us about all these coincidences, but they need to give us more than: "there's usually 2 or 3 deaths, she was involved in the care of 7 - but not in 7 others", she just happened to have her killing spree almost hidden by a spike in natural deaths over the same time period? I imagine in twins, it's common if one dies, the other is not in much better health? I imagine if a baby suffers a "collapse", further collapses and death are far more likely? Surely there were far more "collapses" than those mentioned, not attributable to LL? Is it more or less common for deterioration to occur shortly after feeds, changing of meds, any intervention? Is there even an odd pattern to, as soon as she comes on shift, or shortly after her shift, or in the middle of her shift?

There's a lot of questions, I wouldn't be confident either way without some answers. Hope we'll get into it, but worried the investigation didn't look that far into the multiple staff, deaths and collapses that were outside their scope and the defence wouldn't have the resources and possibly the legal basis to go there.

Nick Johnson KC, prosecuting, told the jury that three months after the death of Baby K, in April 2016, Letby had been moved to day shifts “because the consultants were concerned about the correlation between her presence and unexpected deaths and life-threatening episodes on the night shifts”.

From Doctor interrupted nurse Lucy Letby’s attempt to kill newborn baby, court told

 

[MsBetsy]

I got to page 42 of the previous thread.

Don't think she was "move from nights to days" because there was anything wrong, as I've said a few times, nurses tend to do both and I don't think that matched the timeline - she was still doing night shifts near the last ones chronologically. It was just a misleading wording of, when she was on night vs when she was on days, which she would be moved between all the time by the person drawing up the rotas.

Pretty sure I saw the timeline made it apparent that she was aware of the police investigation and something of the nature of it before her arrest - although ostensibly it was started in May. It also seems pretty clear that the police were brought in because the hospital already suspected her, why they took her off clinical duties after the previous June. So I'm pretty sure that note was written after she knew in broad brushstrokes that there was a police investigation into whether she killed babies.

Given that timeline, and this would be one of my first concerns too, the comment about never marrying or having children is most likely simply the realisation that she may in prison for the rest of her life, or even if not convicted, it will be too late by the time it's all over and people stop seeing her as a baby killer if that ever happens.

I honestly think all but the best of saints would think of themselves and not the babies that died (some of which they may recall from a year or two previously) on learning that they faced prison for the rest of their lives, branded a baby murderer. And even those true saints among us wouldn't have their halos dimmed for writing one note that doesn't mention the babies and their families even while thinking of them all the time. So I don't know if she's guilty, or if she was thinking of the babies then or at other times, but I don't think their absence from that post-it tells us anything about anything. I'm surprised there are so many people here who have never encountered someone writing or saying pretty irrational things when faced with much pettier issues, feels like a failure of imagination.

Something struck me about the TV doctor - a lot of us get stuff wrong and later play down how adamant we were, and forget and even come to believe that we were pretty open minded, or even that we actually thought the opposite of what we did. There are certainly many people, including TV doctors, who had significant turnarounds about COVID and would deny it apart from the old tweets and clips. I feel like a TV doctor is going to be the most likely person to say "I had my suspicions even then" (but I didn't say or do anything about it so it's completely unverifiable) - not saying that is the case, but it's not unusual and he could really believe it despite having only suspected her later. Memory is a very tricky thing.

For this case, the only evidence I can imagine being fairly conclusive one way or the other is statistical. Everything else feels tainted. A lot of, how were they murdered rather than were they murdered evidence. A lot of memory of events long after, a half dozen awkward/unprofessional moments told to us in a matter of hours with the worst spin, but in reality spread over a year of otherwise good work? A lot of appeals to very questionable pop-psych, and tropes from crime fiction rather than fact (from some in this thread and basically everyone on twitter/facebook as opposed to the prosecution).

They've told us about all these coincidences, but they need to give us more than: "there's usually 2 or 3 deaths, she was involved in the care of 7 - but not in 7 others", she just happened to have her killing spree almost hidden by a spike in natural deaths over the same time period? I imagine in twins, it's common if one dies, the other is not in much better health? I imagine if a baby suffers a "collapse", further collapses and death are far more likely? Surely there were far more "collapses" than those mentioned, not attributable to LL? Is it more or less common for deterioration to occur shortly after feeds, changing of meds, any intervention? Is there even an odd pattern to, as soon as she comes on shift, or shortly after her shift, or in the middle of her shift?

There's a lot of questions, I wouldn't be confident either way without some answers. Hope we'll get into it, but worried the investigation didn't look that far into the multiple staff, deaths and collapses that were outside their scope and the defence wouldn't have the resources and possibly the legal basis to go there.

I think she was moved from the night shift after the doctor and possibly others noticed a pattern.

Letby was allegedly 'present for all 24 incidents;' the unexpected collapses and deaths, between 2015- 2016.

According to Johnson, 'when she was moved to the day shift, the rate of collapses shifted to day.'

Surprisingly, she did not seem to recall many of the victims or what they went through.

When she was interviewed she claimed she wasn't present for one incident, but the cellphone data placed her in the room. For child F, she told police she had no recollection of the incident, or any involvement in administering the IV bag, but confirmed her signature on the TPN form. This was the interview in which she asked police 'if they had access to the bag she connected.'

She also didn't remember child L, who was reportedly doing well before Letby started caring for her, the prosecutor said. Out of nowhere the baby started projectile vomiting, had difficulty breathing and 'critical desaturation levels.' The prosecutor stated LL had no recollection of this, apparently, although this is the family she got a sympathy card for and took a picture of.

For baby G, someone allegedly switched off the monitor when the baby collapsed, which was discovered by LL. She denied switching it off. She also didn't remember doing a FB search of the parents. I'm not sure if she admitted to any of the searches, but I find it hard to believe she'd forget after they had suffered such a tragic loss.

For child B and C, she was not the designated nurse, but instead for a baby boy. The designated nurse tried to 'reinforce her assignment," but allegedly LL 'was ignoring her.'
Hopefully we will hear in more detail how she ended up caring for them.
I believe it was Baby B that she kept the handover sheet for?

I haven't heard anything about which deaths were outside their scope or how it would relate to the case.

Finally, as soon as the victims were taken to the other hospital, they all made a speedy or remarkable recovery.

In what way is the evidence 'tainted?' I got the impression investigators have been meticulous. And yes, it will likely be
presented in much further detail during the trial.

I hope the families will see justice served in the end. They have been waiting a very long time.

 

[kittythehare]

There is a fairly common CBT/self coaching practice mostly known as a ‘thought download’ that encourages you to get out all the racing thoughts in your head and put them down on paper. Your worst thoughts, your defensive thoughts, your wildest fears and emotions, etc.
The idea being that it’s healthier to get them out, and you’re more able to look at them critically and not necessarily be under their spell as much once you get them ‘out of your head’.

I do this practice most days, both for myself and for clients, especially in times of emotional distress. I’ve done it in my phone notes, on the back of envelopes and receipts - whatever I have to hand. (It’s very helpful! 10/10 would recommend as long as you’re not on trial for murder)

I think most of us, especially women, can relate to having some “maybe it’s all my fault, i must be a terrible person” type thoughts when accused of doing something wrong - even when we know we’re not to blame. It’s part of the normal functioning of a human brain.

I hear these exact types of thoughts from my lovely, non-murderous female clients every day! An example of a genuinely concerning thought would be something like “they should all be thanking me for doing this” or similar distorted thinking - none of which I see on the note.

It’s a bit terrifying to think that the normal panic of the human mind could be used to ‘prove’ guilt or murder, and shown to the national press!

JMO of course - no idea what LL’s intentions were with the post it.

Would clients not be encouraged to destroy these notes immediately?

 

[catgreen]

Ah interesting! Thanks for finding and sharing that.

I always find it interesting to read between the lines of what the legal teams do and don’t say in assertions like this.

If they were so certain at the time that insulin had been erroneously or maliciously administered then there would have been a significant investigation with detailed reports and blame apportioned accordingly.
But if that happened, they’d be saying so, right? They’d be saying, “a contemporaneous investigation already established her guilt” or similar. And they’re not.

It’s not my area of expertise but to my knowledge, you can measure blood insulin but there’s no way to test what is synthetic vs natural insulin, and lots of natural things can cause blood insulin levels to spike. My prediction is that these insulin cases will be equally ambiguous and difficult to prove either way. It’s what is going to make this case so difficult.

JMO and interpretation though. Hopefully things will become clearer in due course!

see note above yours by JTS101 about c-peptides, there are other ways to understand insulin levels more fully

 

[Marantz4250b]

Would clients not be encouraged to destroy these notes immediately?

Why?

 

[AnnesCuthberts]

Would clients not be encouraged to destroy these notes immediately?

Pre-facing this by saying my comment should no way be interpreted as a comment on LL’s guilt or innocence but instead is a general response to this question.

I’m not a mental health professional but have been a service user (of private therapy and also NHS through the psychology and the community psychiatric nurses services), I’ve multiple notes spanning years saved on my phone or in my diary or even just random documents saved on old computers, I’ve never been encouraged to destroy them as they can be good to self-reflect on down the line or recognise distorted thought patterns. In my experience/opinion, writing thoughts down does tend to be on the list of things recommended whenever I’m having a mental health crisis (along with the golden oldies of “have you tried meditation?” “try having a warm bath”).

Obviously my circumstances are not LL etc etc and the generalisation may not be relevant at all in this case. I’ll be interested to see the evidence and arguments made from both sides in the trial regarding the LL note along with any further documents there may be.

 

[kittythehare]

Pre-facing this by saying my comment should no way be interpreted as a comment on LL’s guilt or innocence but instead is a general response to this question.

I’m not a mental health professional but have been a service user (of private therapy and also NHS through the psychology and the community psychiatric nurses services), I’ve multiple notes spanning years saved on my phone or in my diary or even just random documents saved on old computers, I’ve never been encouraged to destroy them as they can be good to self-reflect on down the line or recognise distorted thought patterns. In my experience/opinion, writing thoughts down does tend to be on the list of things recommended whenever I’m having a mental health crisis (along with the golden oldies of “have you tried meditation?” “try having a warm bath”).

Obviously my circumstances are not LL etc etc and the generalisation may not be relevant at all in this case. I’ll be interested to see the evidence and arguments made from both sides in the trial regarding the LL note along with any further documents there may be.

my question was a general one too.
I would have always been encouraged to destroy such notes, the objective having been catharsis- get it out of you.
Even to this day, if I write any contentious document, like a complaint I invariably forget it then.

 

[catgreen]

Very good point annpats, some equipment, like a syringe pump, for example may be used for more than one patient as they are expensive and have no direct contact with the patient, thus it is imperative that they are checked (and the checks documented) that they are working and accurate. Machines like this can lose their accuracy, or develop faults over time. There is a possibility that due to pressure of work in a busy department, checks and recalibrations can be overlooked.

When I worked in ICU, CCU, High Dependency all our equipment was regularly recalibrated and signed off, it is a legal requirement, and it was inspected annually by electronic engineers and records kept, all required by the Health and Safety Executive

 

[catgreen]

I think you have to take into consideration that hospitals are manic places. New patients, shift changes, nurse changes, births, deaths, different conditions, medications etc. I could see why a situation like this could go under the radar for a period of time before anyone started to think something was off/wrong.

I agree, it is often when the death rate etc is considered statistically over a period of time

 

[catgreen]

Hi, first time poster here. I’m an NHS employee, working within the NHS for 13 years, so hopefully I can try and answer some of the questions you raised.

Insulin is usually stored on NHS hospital wards in a locked fridge (either code or key accessed). It should be accessible to all nurses on the ward. However, it cannot be administered by anyone (either nurse administration or patient self-administration) without a doctors prescription. The prescription is checked by the nurse prior to administration and signed for post administration on either a paper or electronic medical prescription record. Administering without an existing prescription would be a huge breach of medication dispensing/administration rules. I’ve never seen a nurse even consider doing this, it’s taken extremely seriously!

So the system described at the CoCh hospital is completely normal, and the same as every ward and hospital I’ve ever worked in. Insulin is usually relatively easily accessible on a ward (as opposed to a fully controlled drug such as morphine, which has far stricter storage and administration procedures) because so many patients need to use it at various times - on an adult ward, for example, some adults may have to take up to 6-7 injections a day, at specific times. I can’t comment on how many neonates would require insulin as treatment relative to adults, although I suspect it’s likely much less.

Insulin doses are usually quite small amounts in relative terms of the amount of insulin in a vial or pen. Standard insulin strength is U100 - 1unit=1ml. A mealtime dose of insulin for an adult is often 4-6 units (4-6ml), which is quite hard to detect when taken from a 100ml vial.

I guess what I’m trying to explain is: the dose needed for a neonate is likely to be very small, even an excessive, dangerous dose, and likely barely noticeable if taken from a 100ml insulin vial. So very hard to pick up on these amounts if being used off-prescription, even if stocks were audited daily.

I hope this is helpful!

absolutely accurate, and this is the problem with people saying 'what were they doing there have no strict measuring of the remaining insulin and how come anyone can have the key to the fridge without a record', unless you have worked as a staff nurse on a busy ward it is difficult to appreciate that accessibility of medication is so critically important (except in case of controlled drugs) to the smooth running of everything - clearly 99% of the time these practices work well

 

[Supernovae]

This is the other main expert:

Dr Sandra Bohin | Forensics and Expert Witnesses Magazine

www.forensicandexpertwitness.co.uk

 

[cuecard]

I agree, it is often when the death rate etc is considered statistically over a period of time

100% correct. A good friend of mine actually works in a mother and baby unit at a hospital and she says it can be chaos at times just due to the nature of all the factors involved.

 

[Supernovae]

Dr Ravi Jayaram:

Dr Ravi Jayaram - Knight Ayton

Dr Ravi Jayaram is a Consultant Paediatrician at the Countess of Chester Hospital. He co-presented Channel 4's series Born Naughty? and featured on th...

knightayton.co.uk

 

[Legal]

I've just been reading through this thread when the incongruity (if that's the right word) struck me of the fact that the nurse who was the face of a fundraising campaign for the hospital is now accused of killing babies in her care. This may very well be a coincidence but if she is found guilty, I wonder if this could have played a role, psychologically speaking. Just my own uninformed opinion and thoughts.

 

[Tortoise]

I'd like to know if the two experts worked independently when they formulated their opinions.

I'd also like to know if more than two experts were consulted and if there were opinions not used. I have a feeling they'd have to present that though.

 

[Whitehall 1212]

I'd like to know if the two experts worked independently when they formulated their opinions.

I'd also like to know if more than two experts were consulted and if there were opinions not used. I have a feeling they'd have to present that though.

I would hope that neither expert knew the other had been instructed and that their opinion is entirely independent. Maybe Mr Myers KC will advance that point.

The rules on 'disclosure' require the police to disclose to the defence any unused material acquired during the course of the investigation which may undermine the prosecution case or support the defence case.

This would include expert medical opinion which disagreed or provided doubt as to causation.

 

[Marantz4250b]

I hadn't picked up on this but there were apparently other notes containing her claims of innocence. It puts this note into a different context.

The notes were among other papers and post-it notes which also contained "many protestations of innocence", the jury was told.

Lucy Letby trial: Nurse accused of murder 'cared deeply about babies'

Lucy Letby was a "dedicated nurse" who "in no way wanted to harm" babies in her care, a court hears.

www.google.com

 

[notsure]

I hadn't picked up on this but there were apparently other notes containing her claims of innocence. It puts this note into a different context.

The notes were among other papers and post-it notes which also contained "many protestations of innocence", the jury was told.

Lucy Letby trial: Nurse accused of murder 'cared deeply about babies'

Lucy Letby was a "dedicated nurse" who "in no way wanted to harm" babies in her care, a court hears.

www.google.com

It's worrying how reality can be edited to produce a desired effect on a jury/the general public.

 

[merrypason]

I'd like to know if the two experts worked independently when they formulated their opinions.

I'd also like to know if more than two experts were consulted and if there were opinions not used. I have a feeling they'd have to present that though.

Yes, they would have if done correctly - and I imagine they would for something this serious and high profile.

Previously I used to manage clinical investigations but I don't work within the NHS or health care at all. I used to be brought in as an unbiased outsider from the private sector to project manage these reviews because normally clinicians don't have the management experience to do it themselves. External medical experts are chosen and both work completely separately to the other - I would run the team to co-ordinate their interviews with staff, get them the medical notes and files, document their reports and finding etc. And ensure they weren't communicating or interacting with each other. Easy to do because they'd normally be reviewing separate files at a time, in separate locations and conducting interviews at separate times too. None of my cases involved deaths so police were never involved, they were usually negligence. I did have cases where a review was launched because one particular member of staff had a high number of complaints or a much higher number of critical surgeries conducted than the average. In those cases, not every case file on the unit was investigated but also my reviews only lasted 1-2 years max. Since this has taken 6 years, and cost millions of pounds with police, medical experts and civilians and is still ongoing till 2025 at least, I imagine they have actually reviewed every case file in that unit. Especially since it's such a small unit.