Officer Dibble
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That was a horrible read but agree very interesting. JMO
UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #6
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That was a horrible read but agree very interesting. JMO
Officer Dibble
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Hi katydid23, I agree with you 100%. JMO MOO
Sweeper2000
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that’s not what I’m saying in the case of Baby e and f. It also seems those searches stand out compared to the others. Im looking at the other searches and I’m not seeing any nefarious reasons for it, if you are sure there is then I would like to know why?
it’s factual to state that algorithms suggest things you are either interested in or relevant to like the countess hospital So if you work there the algorithm suggests people who search for it. If you are really specific like typing in ”neonatal unit, countess of Chester“ then you further increase the chance of fb suggesting someone who works in that specific place. Those are things patients are likely to do.
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I’m more trying to make sense of why LL would supposedly lie. I can’t see any reason for it and it’s something to further explore. If you can make sense of it, please enlighten me? I think my suggestion is a viable way of doing that. It makes sense to me if you consider the fb searches to be maybe part of a coping mechanism that involves moving on from traumatic events Eventually forgetting them.
A very long time ago, we were in childrens a&e with my daughter, she was about 2 months old at the time, very much not a neonate in any sense of the word! We were there quite a long time through the night and so they offered to attach her to a sats machine (at home we had a nicu supplied breathing monitor, not for health issues) it went off SO MUCH. In the end they turned the sound off!
So we were told within 8-9 hours by a phone call from the pediatrician a probable cause of death. When we went to see him following that phone call we were told we weren’t allowed to touch him because of legalities surrounding a post-mortem.
We learnt after the fact there were worrying signs during the resus attempts that perhaps pointed towards a cause of death. He had lots of post death tests along with the blood test they ran during resus and they felt they were able to ascertain fairly certainly the cause of death from those alone. The coroner got opinions from addenbrookes as the cause was really rare, it was confirmed and we were told they wouldn’t need a post-mortem done after all. The process took maybe a week? We weren’t ever asked if we wanted to go ahead with one anyway, and in fairness, I wouldn’t have done it anyway as I was satisfied with the findings (had we had a more ambiguous cause of death I might have been more vocal about wanting one, I’ve no idea if they would’ve done it though)
Basically, during resus he had a white blood cell count of 757000 (should be 4-11) platelet count of 35 (should be 150-400 which the threshold for blood transfusions around 20) a haemoglobin of 50 (should be 13-18) The medical signs pointed to leukaemia with cns involvement, given his age likely congenital. For him there was, in the coroners opinion, overwhelming evidence that they didn’t need to physically do the post mortem. The wbc alone was enough for a diagnosis. We as parents were given the impression it was being done, right up to the point they told us it wasn’t. We were also given the impression that if the coroner wanted the post mortem, we wouldn’t be able to decline. I actually requested his medical notes a few years after and there are emails between pediatricians discussing whether there was a need for a post mortem, but ultimately the coroner makes the final choice.
Tortoise
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mummyshark
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I'm a newbie. I've been reading through these threads and now that I've finally caught up I thought it was time I registered to reply.
I've had three premature babies (all singletons). My eldest spent 2 months in NICU in a London hospital. During her time there she had a blood transfusion. The amount of blood transfused was 20ml over 6 hours. 15ml seems like a lot of blood for such a small baby to lose so quickly.
Just to add, she had an NG tube for the duration of her stay and regularly pulled them out, partially and fully, and it never seemed to cause any irritation to her throat. Certainly no bleeding. That's not to say it can't happen (I'm not medical so I don't know) but in my experience I haven't seen or heard of it happening in all the months I spent in NICU with three babies.
Tortoise
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Updated Timeline I've produced for baby E which contains a combination of information from the prosecution opening speech (so some events not in evidence yet) and the testimony we've heard yesterday and today:
29 Jul 2015, Wednesday
Identical twin boys Child E and Child F born, prematurely, at 29 weeks.
Child E weighed 2lb 14oz (1.327kg). He was given oxygen then weaned to air and transferred to Room 1. He was at risk of NEC and started on antibiotics, IV fluids and caffeine. He had a nasogastric tube inserted.
Child F was marginally younger, and he required some resuscitation at birth. He was later intubated, ventilated and given meds to help his lungs. He was recorded as having high blood sugar so was prescribed a tiny dose of insulin. His breathing tube was removed and he was given breathing support. He had a long line.
30 Jul 2015, Thursday
A staff debrief into the death of Child A was held.
12.17am – nurse’s note ‘NCPAP commenced at 10.50pm as oxygen requirement increased to 30% and required Neopuff x2 for apnoea.
Mother says she was able to visit the twins in the neonatal unit, from upstairs in the post-natal wards. She said that would take about 5-10 minutes to get from one place to the other, due to having had a C-section, which made the journey time longer. She said she was able to cuddle Child E as he wasn't on CPAP, while Child F was on CPAP.
31 Jul 2015, Friday
6.45am - A chart showing a form of insulin - Actrapid - is administered on several occasions to Child E. The first is on July 31 at 6.45am
1 Aug 2015, Saturday
Mother said Child E was progressing better, of the two twins, over July 30-31, but both were doing "really well" by August 1. She was keen to get home and was keen to transport both babies to a hospital closer to home, and was waiting for two ambulances to be provided. She said she and her partner were under the impression both babies were well enough to travel. By that stage, she had had skin-to-skin contact with both twins, and both were managing "fine". "We were never informed about anything to say they weren't fine."
Time? - Mr Myers says, talking through the chart with the nurse, one Brady happened at August 1, no apnoea is identified, but heart rate dropped to 79bpm and desat reading was '84', and the duration was 45 seconds. That is confirmed by a separate doctor's note, which required 'gentle stimulation' to resolve.
2pm - the rate of insulin administration is lowered at 2pm on August 1
8pm night shift – LL was designated nurse for Child F.
2 Aug 2015, Sunday
2.10am - the rate of insulin administration is increased slightly again at 2.10am on August 2. Mr Driver (prosecution) asks if the insulin prescription are four separate doses, or one continuous administration. The nurse says the first dose is administered at July 31, 6.45am, and that dose remains unchanged until 2pm at August 1, and the dose is reduced. It would be the same infusion, via a syringe of diluted sodium chloride, administered via a computer. The court hears the insulin would be paused in the event of the syringe being emptied or the insulin expiring, and a replacement dose would have been prescribed prior to that. Mr Myers (defence) asks further about the insulin dose. The nurse says, for the dose she administered, (3rd August 3pm) that was a fresh solution. The judge asks if the dose of insulin at 2.10am on 2nd August would have ended after 12 hours, as the insulin would expire thereafter. The nurse says you would have to check the relevant nursing notes for that. She can only say to the court the insulin dose she administered at 3pm on August 3 was a fresh dose, and Child E had not been on insulin.
By August 2, mother says the couple were still waiting for transport. She said on that day, the twins were both out of their incubators by this stage. Child E was breathing "easily" and Child F was "great".
6.20am - The second desat happens on August 2 at 6.20am, with a reading of '83-88', lasting two minutes. The nurse says gentle stimulation is putting a hand on the abdomen gently, or very carefully giving the baby a light tickle. She says if the situation does not improve, the baby's chin would be placed into a neutral position to help the airway, and/or administer oxygen. This episode required, according to a nurse's note, 'facial oxygen was required for a short period - had hiccups at the time'.
Time? - “The third (desat) was a brady and a desat for 30 seconds, which was 'self-correcting'.”
8pm night shift – LL was designated nurse for Child F. Melanie Taylor was designated nurse for Child E.
8pm – Melanie Taylor’s nursing notes record (for Child E): "Self-ventilating in 24% oxygen, resps 6-70, minimal recession evident."
10.34pm – LL’s texts:
From nursing colleague JJ-K to LL: "Hope work ok".
LL: "...yeah it's fine, bit too Q word really."
JJ-K: "Don't complain as Wed and Thurs horrible lol! It will pick up again."
11.50pm - The fourth Brady and desat at 11.50pm on August 2, lasting 45 seconds, requiring gentle stimulation to resolve.
3 Aug 2015, Monday
1am - The fifth and final brady and desat in the '70s', lasting 45 seconds, requiring gentle stimulation to resolve. Mr Driver, for the prosecution, rises to ask a matter of the brady and apnoea chart, which recorded five episodes with Bradys and desats. The nurse did not record any of these episodes. He asks if the episodes recorded on August 1-3 would lead the nurse to adjust her opinion of Child E's stability/well-being. The nurse says the chart is "not a worrying trend of information". Nursing notes by Melanie Taylor record two Brady desats (slow heart rate) at the early hours of August 3, requiring 'gentle stimulation' to correct. One of the Bradys is recorded as lasting 45 seconds. Child E's tummy was 'soft, not distended', had satisfactory blood gas readings and heart/respiratory rate, and fluids were being administered. The bowels were not yet opened.
8am end of night shift - Melanie Taylor's notes said 'feeds tolerated, tummy remains soft'. A family communication note is also made by the nurse: "Mum and dad visiting at start of shift, mum has been 2x with [expressed breast milk] overnight."
Mother says by August 3 the twins were "great - doing really well". "We were absolutely thrilled that both boys were doing so well and we couldn't have asked for any more than that. They were both progressing."
8am to 8pm - nurse who cannot be named (“unnamed nurse”) in court was the designated nurse for E & F.
9am - milk feed - unnamed nurse says the aspirates recorded 1ml partially digested milk at 9am, which was 'replaced [in the NG tube] as [Child E] had worked hard to digest that milk', as 'normal practice'. The nurse explains the 1ml milk was taken out, put back in, and a 1ml additional milk feed was administered.
10.42am - unnamed nurse note regarding family communication: 'mum on unit from 9am onwards, fully updated by myself and reg. Had long periods of skin-to-skin.' she recalled the skin-to-skin contact, and during this shift, Child F was unable to have a 'cuddle', but 'containment holding' instead. Child F remained on CPAP and was not as stable. Child E was breathing by himself, requiring a little supplementary oxygen, and therefore 'could have as many cuddles as they [the mum and Child E] wanted'.
10.50am - unnamed nurse 'top to toe' clinical note: 'self-ventilating in 25% ambient oxygen, no signs of respiratory distress. Heart rate and temperature stable. Pink and well perfused. Cap refill 1 second'. The observations were 'normal'. The nurse added the fluids which were being provided, via a longline infusion. Child E was on a 'cautious feeding regime', based on guidelines in the neonatal unit. Child E, it was also noted, 'handles well'.
11am - milk feed - unnamed nurse notes minimal aspirates
11.45am - A doctor's note records Child E has 'suspected sepsis', 'hyperglycaemia', and was 'off lights' for jaundice, with 'good gases'. Child E was 'tolerating well' expressed breast milk. The baby boy was 'not examined at present as having cuddles with mum'. The plan was to 'examine later' and increase feeds. Aspirates were 'ok'.
1pm - milk feed - unnamed nurse notes minimal aspirates, and a moderately high level of urine recorded.
2.10pm - Dr Emily Thomas made clinical notes: 'examination of [Child E] as having skin to skin on [ward round earlier that day]. Good tone and movements, handling appropriately throughout the day.'
2.38pm - unnamed nurse says the blood sugar (gas) reading was outside the parameter so she consulted a doctor and action was taken following guidelines for insulin to be commenced. The glucose reading of 18.4 was the only 'abnormal' reading recorded, the court hears. Mr Myers (defence) asks about the blood glucose readings, and what the parameters should be. The nurse says the readings should be above 2.6, and the upper limit is not defined in pre-term babies (Mr Myers says the upper limit is 6 for full-term babies). Mr Myers asks if the reading of 18.4 is 'worryingly high'. The nurse agrees. She says the cut-off point for insulin to be prescribed would either be '12 or 14'. She agrees the blood sugar readings of 12.8, 18.4, 13.5, 12.9 are 'at the higher end of normal', with '18.4' being 'particularly high'. Mr Myers suggests the pH reading of 7.293 is outside the normal range of being under 7.3, by being slightly acidic. The nurse says she was trained that anything above 7.25 was normal. Mr Myers suggests that the blood gas readings suggest a case of acidosis. The nurse says the readings taken are within the parameters, and the doctor would, in any case, make the decision.
3pm - milk feed - unnamed nurse records minimal aspirates. A prescription for 3pm on August 3 is made, but then crossed out, then redone with 'a correct dose'. The nurse says the previous, crossed out one, was 'an incorrect dose' of 0.05units/kg/hr. The second is the 'correct dose' of 0.02units/kg/hr. Insulin of a neonatal is a "continual infusion", the nurse tells the court.
To 5pm (24 hr observation chart starting 6pm the day before) - The respiratory rate, the court hears, is 'normal', and the baby boy was said to be stable.
Abt. 5pm – Father left the hospital to go home. Mother was having skin-to-skin contact with Child E, until about 6.30pm.
5pm – milk feed - unnamed nurse notes a 1ml aspirate. That was a normal finding and was replaced.
5.24pm - unnamed nurse’s retrospective note: A CRP reading was 'less than 1', which the nurse explains any reading of less than 10 is 'a good sign'. The antibiotics would 'be reviewed at 36 hours [treatment]'. The blood cultures were 'currently negative' - in absence of bacteria. Child E remained self-ventilating in air, with 'satisfactory' blood gas readings. The nurse says Child E had a blood sugar reading of 18.5mmols, which was "too high". A doctor was informed and insulin was 're-commenced at a rate of 0.02/units/kg/hr'. Feeds were increased as Child E was 'tolerating his feeds'. a 'PKU' was taken with parental consent, which was a neonatal blood screening taken from every baby at about Child E's age [if the parents agree], looking for various potential [inherited] conditions, with results to follow.
6pm - unnamed nurse says the observations recorded (readings) show stable trends, and again at 7pm.
6.30pm to before 7pm – Mother says she changed his nappy and cleaned him around the eyes and neck. She went back up to the post-natal ward to express breast milk and have something to eat, between 7 and 8.30pm.
7pm – milk feed - unnamed nurse says the observations recorded (readings) show stable trends. A minimal aspirate is recorded, urine was recorded and E had opened his bowels. Her (overall) assessment is E was doing well on that shift, apart from the high blood sugars. “It can be a worrying factor it could be a stress response”. “cares” row on the observation chart has a tick signed by the nurse.
7.30pm - Dr Emily Thomas made clinical notes, with a CRP reading less than 1, Child E was on 23% oxygen, and antibiotics were 'likely to stop at 36 hours as improving'. A series of other observations are made.
8pm nightshift – LL is designated nurse for twins E & F in room 1. Nurse Caroline Oakley was the shift-leader.
8pm – LL’s barrister suggests the mum went down to the neonatal unit at 8pm, (not with the breast milk at that time) at the time of the handover. The mother disagrees. LL’s nursing note for 8pm written retrospectively at 4.51am: "Mummy was present at start of shift attending to cares."
Just before 9pm – Mother says; she took her expressed breast milk down to the neonatal unit, room 1; LL was the only other adult in room 1; mother heard Child E “screaming more than crying” from the corridor before she entered the room; LL was not near Child E’s incubator, she was busy doing something, standing between the two incubators at a work station; there was blood on his face around his mouth; she was there for about 10 minutes; she asked LL why he was bleeding; LL told her the NGT was rubbing the back of his throat; LL told her to go back to her ward and the registrar was on his way and if there was a problem someone would ring up to the ward. The mother went back to the ward. Mother agrees with LL’s barrister that no other staff came into the room when Child E was screaming. LL’s barrister says the screaming was not as bad as the mother describes. Mother disagrees. LL's notes: "prior to 21:00 feed, 16ml mucky slightly bile-stained aspirate obtained and discarded, abdo soft, not distended. SHO [Senior House Officer] informed, to omit feed." Pros says these notes are false.
9pm – LL recorded information to detail the volume of fluids given via the IV line and a line in Child E's left leg, and the 9pm feed is 'omitted'. The SHO said he had no recollection of giving advice to omit the 9pm feed. He believes the only time he had anything to do with Child E was in a secondary role to the registrar in an examination at 10.20pm.
c.9.10pm – Large v.slightly bile-stained aspirate is reported as happening at 9.10pm, to Dr Harkness at 9.40pm.
9.11pm – Child E’s mother phoned her husband in a call lasting 4 mins 25 secs. She says she knew there was something very wrong. Father confirms that the mother was upset and very worried about bleeding from Child E’s mouth in this call. He said he was sure the medical staff knew what they were doing and she was panicking over nothing.
9.11pm to 10.52pm – mother was waiting to hear about Child E, panicking and talking to the midwife. Mother had not seen this midwife before. She confirms the first name of the midwife was Susan. She was later told by a midwife to call her husband.
9.13pm – LL made a note in twin F’s records.(opening statement)
9.40pm - Dr David Harkness records readings from 9.40pm, (written at 10.10pm), 'asked to see patient re: gastric bleed'. 'Large, very slightly bile-stained aspirate 30 mins ago.' (my note - that would be 9.10pm). 14ml of blood vomit is also recorded. Dr Harkness noted Child E was 'alert, pink, well perfused', with an abdomen which was 'soft, not distended' and no bowel sounds. The note adds 'G I [gastrointestinal] bleed ? Cause'
9pm - 10pm - LL’s barrister asks Dr Wood (SHO, GP trainee) if he recalls receiving a report of a bile-stained aspiration on the neonatal ward. He doesn’t recall. He says he probably would not have received a call from Dr Harkness about it. He says he was on the paediatric unit by himself and it was his understanding that Dr Harkness would have been on the neonatal unit at some point during the evening. Dr Wood tells the court that had he received such a call from a nurse he would have taken action and recorded it in his notes and would have sought advice from the registrar.
10pm – LL’s barrister suggests that the mother went to the neonatal unit with her breast milk. “The mother absolutely disagrees.” LL’s barrister suggests LL never mentioned the feeding tube irritating Child E. Mother disagrees. LL’s barrister asks if there was a conversation between LL a doctor and her, regarding medication. Mum disagrees and says she was told (at 9pm visit) a doctor would be down to see Child E.
10pm - In the 10pm column of LL’s nursing notes for aspirates: '15ml fresh blood'. LL’s notes: "At 10pm large vomit of fresh blood. 14ml fresh blood aspirate obtained from NG tube. Reg Harkness attended. Blood gas satisfactory..." Child E was 'handling well'. LL’s further note: 'Mum visited again approx. 10pm. Aware that we had obtained blood from his NG tube and were starting [treatment]...'
10.20pm - SHO believes the only time he had anything to do with Child E was in a secondary role to the registrar in an examination at 10.20pm. - per opening speech, not mentioned in evidence today
Bef.10.52pm – neonatal unit contacted the midwife and told of deterioration. (also see 11.30pm midwife's evidence??)
10.52pm – the midwife called the father telling him to come to the hospital, after the neonatal unit rang the maternity ward. LL’s barrister suggests this is the call where the mother told her husband about Child E bleeding, and the mum was not as worried at the 9.11pm call as she was at 10.52pm. mother disagrees. Father says this call was split between the midwife and the mother and he was told not to panic but to get over here now. He tells LL’s barrister the bleeding was not referred to in this call.
11pm - A neonatal fluid balance chart is shown to the court, with no name or notes for the 11pm column. LL’s retrospective nursing notes said: 'NG tube on free drainage. Further 13mls blood obtained by 11pm. Beginning to desaturate and perfusion poor. Oxygen given via Neopuff'. Child E was said by LL to be 'cold to the touch' and was beginning to 'decline'.
Time? 11pm? - Dr Harkness noted '13ml blood-stained fluid from NGT on free drainage.' Child E's blood pressure was 'stable' and saturates' remained 60-70%', and 'making good respiratory effort', and was 'crying'. A plan of action, including x-rays and medication, was made.
11.30pm - A note for 11.30pm on the observation chart has blood pressure and respiratory rate recorded, no record of a heart rate made, and blank readings for cot temperature, and no initials recorded.
11.30pm - midwife Susan Brookes says she had a call from the neonatal unit to ask the mother to go down in 30 minutes as E had a bleed and required intubating. “very poorly” the mum was upset and asked to go sooner.
11.40pm – Child E collapsed. LL recorded, retrospectively: "11.40pm became Bradycardiac, purple band of discolouration over abdomen, perfusion poor, CRT 3secs. "Emergency intubation successful and placed on ventilator..." Further notes by LL: 'Required 100% oxygen, saturations 80%, SIMV 22/5 rate 60. Further saline bolus and morphine bolus given. 2nd peripheral line sited..." "Once [Child E] began to deteriorate, midwifery staff were contacted." The latter note is written, retrospectively, at 4.51am.
11.40pm - Dr Harkness records, in clinical notes at this time, written retrospectively, 'Sudden deterioration at 11.40pm, brady 80-90bpm, sats 60%, poor perfusion, colour change over abdomen purple discoloured patches'. The note adds, after an improvement in sats, 'purple discolouration in abdomen remained', and a plan of action noted for Child E.
11.40pm - Dr Christopher Wood (junior to Dr Harkness) SHO working in the paediatric unit immediately attended upon a crash call for baby E. He doesn’t recall being in the neonatal unit that night before 11.40pm. he signed a prescription for morphine for E. The accompanying medical note by Dr Wood says Sats 60-70%, morphine bolus – sats improved to 80%. He says resuscitation had already begun upon his arrival. He recorded notes. He recorded staff present – a team of 6 – including himself, Dr Harkness, another doctor, and three senior nurses including LL.
12 midnight - Mother (and father?) with midwife returned to the neonatal unit and sat in the corridor while Child E was being worked on by medics trying to resuscitate him. Midwife left after 10 minutes and mum was eventually allowed in once E had been stabilised.
4 Aug 2015, Tuesday
12.15am - A further observation reading for Child E, made by LL, is taken at 12.15am, with a heart rate 'down from where it had been earlier', and a drop in temperature, recording he was on 100% oxygen.
12.25am - A consultant paediatrician arrived at the neonatal unit.
12.27am - An x-ray is taken at 12.27am, relating to the chest and abdomen.
12.30am - Shortly after 12.30am Child E was placed on breathing support and given medication after resuscitation.
12.36am - A further, 'acute deterioration' for Child E, is noted by Letby at 12.36am. 'Resus commenced as documented'. The consultant paediatrician noted CPR commenced, along with ventilations, and medications.
12.37am – Dr Wood recorded efforts to resuscitate E from 12.37am. 5 does of adrenaline were administered.
12.50am - A blood transfusion is started for Child E at 12.50am, and several adrenaline doses are administered.
1.01am - LL's note, for 1.01am, reads 'chest compressions no longer required'. Dr Wood recorded chest compressions stop at 1.01am, with ventilations continuing.
1.15am - LL notes 'further decline, resus recommenced'. Dr Wood recorded E’s heart rate fell again and CPR recommenced.
1.23am - CPR was discontinued at 1.23am - 'resus discontinued when [Child E] was given to parents. [Child E] was actively bleeding...' Dr Wood recorded CPR stopped and E was cleaned.
1.24am - Dr Wood recorded ventilation efforts stopped and E was given to his parents.
1.40am – The time of death was recorded as 1.40am on August 4. No post-mortem was conducted.
LL’s note: 'both parents present during the resus. Fully updated by nursing and medical team throughout. Parents wished for [Child E] to be baptised....
'Child E was bathed by myself and photographs taken as requested, both were present during this. Consent obtained for [hair] and hand/footprints... 'Both distraught...'
The official documented report for the incident is made by LL - 'unexpected death following gastrointestinal bleed. Full resus unsuccessful'.
Time? - The mum says the husband asked a few questions and they were told by the (female) doctor a post-mortem "wouldn't tell them much" more than what they had already been told by the doctor, and it would delay the transfer back home.
"We just wanted to take him home."
Time? – Mother says LL bathed Child E and dressed him in a white gown. LL gave the parents a memory box. Baby E's mum says that after he died "Lucy Letby gave us a memory box, which totally surprised me.. it had footprints, a lock of his hair, a candle, a teddy. I was so overcome by emotions that this had been provided for me as I had no other memories other than that".
4.51am - LL made “fraudulent” (per opening speech) retrospective nursing notes, failing to mention that his throat was bleeding at 9pm, and falsely claiming the mother had visited at the start of the shift and later at 10pm, and that there had been a meeting between the mother and the registrar.
8am – End of LL’s night shift
8.21am - LL noted at 8.21am 'Parents resident on unit overnight. Wish to be left alone'.
8.58am – LL’s texts
Colleague: "You ok? Just heard about [E]. Did you have him? Sending hugs xx"
LL: "News travels fast - who told you? Yeah I had them both, was horrible."
Colleague responded that she had been informed by someone at the handover 'told me just now'. 'Had he been getting poorly or was it sudden?' ‘Poor you. You’re having a tough time of it.”
LL responds E had a 'massive gastrointestinal haemorrhage'.
Colleague: ‘Damn. He’d always struggled feeding. I just feel for his parents and you. You’ve had really tough times recently.’
LL responds that E was 'IUGR [Intrauterine growth restriction] and REDF [Reversal of umbilical artery end-diastolic flow]' and believed E was 'high risk'. She went on to describe how she felt ‘just awful’ and reported that the parents were distraught, saying "I feel numb".
7.55pm – LL’s texts
Jennifer Jones-Key: "Hey how's you?"
LL: "Not so good, we lost [E] overnight."
JJ-K: "That’s sad. You’re on a terrible run at the moment. Were you in room 1?"
LL: "I had him and Baby [F]"
JJ-K: "That is not good, you need a break from it being on your shift."
LL: "It's the luck of the draw unfortunately. Only three trained (nurses), so I ended up having them both."
JJ-K: "You seem to be having some very bad luck though."
LL: "Not a lot I could do really. He had a massive haemorrhage. It could happen to any baby really."
JJ-K says Letby "did everything you could", adding she had seen a haemorrhage in babies before, and was 'horrible' to see.
LL: "This was abdominal. I’ve only seen pulmonary before.”
JJ-K asked after E’s parents.
LL: “Ok. Tired. They’ve just gone to bed.”
8pm - LL night shift starts
Dr Wood’s last night shift with the CoCH as he’d come to the end of his 4-month training placement.
7 August 2015, Friday (about - a few days after giving E’s parents a memory box)
LL gave the mother a photograph of [F] 'holding' E's teddy.
The mother had just made one of her daily visits to the hospital's chapel of rest. 'Lucy Letby told me 'I got this picture. I thought it was so amazing I took a picture for you'. She was suggesting F had rolled over and cuddled the bear'.
9 August 2015, Sunday
LL gave an account to JJ-K of saying her goodbyes to the [E&F’s] parents.
She told Ms Jones-Key that both parents had cried and hugged her: ‘saying they’d never be able to thank me enough for the love and care I gave them'.
JJ-K: 'It’s heart-breaking, but you have done your job to the highest standard with compassion and professionalism. 'When you can’t save a baby you can try to make sure that the loss of their child is their only regret. You should feel very proud of yourself'.
LL: 'I just feel sad that they’re thinking of me when they’ve lost him'.
Abt Nov 2015 - LL was told that the parents of Baby E and Baby F had come into the neonatal unit with a 'gorgeous huge hamper' for the staff. She was also told their surviving son looks 'fab'.
LL said: 'Oh gosh, did they? I wish I could have seen them. That will stay with me forever'.
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Murder charge Child E – air (allegedly) injected into bloodstream and bleeding indicative of trauma.
Supplementary text details Daily Mail Colleagues of Lucy Letby told her she was 'terrible run of bad luck'
29 Jul 2015, Wednesday
Identical twin boys Child E and Child F born, prematurely, at 29 weeks.
Child E weighed 2lb 14oz (1.327kg). He was given oxygen then weaned to air and transferred to Room 1. He was at risk of NEC and started on antibiotics, IV fluids and caffeine. He had a nasogastric tube inserted.
Child F was marginally younger, and he required some resuscitation at birth. He was later intubated, ventilated and given meds to help his lungs. He was recorded as having high blood sugar so was prescribed a tiny dose of insulin. His breathing tube was removed and he was given breathing support. He had a long line.
30 Jul 2015, Thursday
A staff debrief into the death of Child A was held.
12.17am – nurse’s note ‘NCPAP commenced at 10.50pm as oxygen requirement increased to 30% and required Neopuff x2 for apnoea.
Mother says she was able to visit the twins in the neonatal unit, from upstairs in the post-natal wards. She said that would take about 5-10 minutes to get from one place to the other, due to having had a C-section, which made the journey time longer. She said she was able to cuddle Child E as he wasn't on CPAP, while Child F was on CPAP.
31 Jul 2015, Friday
6.45am - A chart showing a form of insulin - Actrapid - is administered on several occasions to Child E. The first is on July 31 at 6.45am
1 Aug 2015, Saturday
Mother said Child E was progressing better, of the two twins, over July 30-31, but both were doing "really well" by August 1. She was keen to get home and was keen to transport both babies to a hospital closer to home, and was waiting for two ambulances to be provided. She said she and her partner were under the impression both babies were well enough to travel. By that stage, she had had skin-to-skin contact with both twins, and both were managing "fine". "We were never informed about anything to say they weren't fine."
Time? - Mr Myers says, talking through the chart with the nurse, one Brady happened at August 1, no apnoea is identified, but heart rate dropped to 79bpm and desat reading was '84', and the duration was 45 seconds. That is confirmed by a separate doctor's note, which required 'gentle stimulation' to resolve.
2pm - the rate of insulin administration is lowered at 2pm on August 1
8pm night shift – LL was designated nurse for Child F.
2 Aug 2015, Sunday
2.10am - the rate of insulin administration is increased slightly again at 2.10am on August 2. Mr Driver (prosecution) asks if the insulin prescription are four separate doses, or one continuous administration. The nurse says the first dose is administered at July 31, 6.45am, and that dose remains unchanged until 2pm at August 1, and the dose is reduced. It would be the same infusion, via a syringe of diluted sodium chloride, administered via a computer. The court hears the insulin would be paused in the event of the syringe being emptied or the insulin expiring, and a replacement dose would have been prescribed prior to that. Mr Myers (defence) asks further about the insulin dose. The nurse says, for the dose she administered, (3rd August 3pm) that was a fresh solution. The judge asks if the dose of insulin at 2.10am on 2nd August would have ended after 12 hours, as the insulin would expire thereafter. The nurse says you would have to check the relevant nursing notes for that. She can only say to the court the insulin dose she administered at 3pm on August 3 was a fresh dose, and Child E had not been on insulin.
By August 2, mother says the couple were still waiting for transport. She said on that day, the twins were both out of their incubators by this stage. Child E was breathing "easily" and Child F was "great".
6.20am - The second desat happens on August 2 at 6.20am, with a reading of '83-88', lasting two minutes. The nurse says gentle stimulation is putting a hand on the abdomen gently, or very carefully giving the baby a light tickle. She says if the situation does not improve, the baby's chin would be placed into a neutral position to help the airway, and/or administer oxygen. This episode required, according to a nurse's note, 'facial oxygen was required for a short period - had hiccups at the time'.
Time? - “The third (desat) was a brady and a desat for 30 seconds, which was 'self-correcting'.”
8pm night shift – LL was designated nurse for Child F. Melanie Taylor was designated nurse for Child E.
8pm – Melanie Taylor’s nursing notes record (for Child E): "Self-ventilating in 24% oxygen, resps 6-70, minimal recession evident."
10.34pm – LL’s texts:
From nursing colleague JJ-K to LL: "Hope work ok".
LL: "...yeah it's fine, bit too Q word really."
JJ-K: "Don't complain as Wed and Thurs horrible lol! It will pick up again."
11.50pm - The fourth Brady and desat at 11.50pm on August 2, lasting 45 seconds, requiring gentle stimulation to resolve.
3 Aug 2015, Monday
1am - The fifth and final brady and desat in the '70s', lasting 45 seconds, requiring gentle stimulation to resolve. Mr Driver, for the prosecution, rises to ask a matter of the brady and apnoea chart, which recorded five episodes with Bradys and desats. The nurse did not record any of these episodes. He asks if the episodes recorded on August 1-3 would lead the nurse to adjust her opinion of Child E's stability/well-being. The nurse says the chart is "not a worrying trend of information". Nursing notes by Melanie Taylor record two Brady desats (slow heart rate) at the early hours of August 3, requiring 'gentle stimulation' to correct. One of the Bradys is recorded as lasting 45 seconds. Child E's tummy was 'soft, not distended', had satisfactory blood gas readings and heart/respiratory rate, and fluids were being administered. The bowels were not yet opened.
8am end of night shift - Melanie Taylor's notes said 'feeds tolerated, tummy remains soft'. A family communication note is also made by the nurse: "Mum and dad visiting at start of shift, mum has been 2x with [expressed breast milk] overnight."
Mother says by August 3 the twins were "great - doing really well". "We were absolutely thrilled that both boys were doing so well and we couldn't have asked for any more than that. They were both progressing."
8am to 8pm - nurse who cannot be named (“unnamed nurse”) in court was the designated nurse for E & F.
9am - milk feed - unnamed nurse says the aspirates recorded 1ml partially digested milk at 9am, which was 'replaced [in the NG tube] as [Child E] had worked hard to digest that milk', as 'normal practice'. The nurse explains the 1ml milk was taken out, put back in, and a 1ml additional milk feed was administered.
10.42am - unnamed nurse note regarding family communication: 'mum on unit from 9am onwards, fully updated by myself and reg. Had long periods of skin-to-skin.' she recalled the skin-to-skin contact, and during this shift, Child F was unable to have a 'cuddle', but 'containment holding' instead. Child F remained on CPAP and was not as stable. Child E was breathing by himself, requiring a little supplementary oxygen, and therefore 'could have as many cuddles as they [the mum and Child E] wanted'.
10.50am - unnamed nurse 'top to toe' clinical note: 'self-ventilating in 25% ambient oxygen, no signs of respiratory distress. Heart rate and temperature stable. Pink and well perfused. Cap refill 1 second'. The observations were 'normal'. The nurse added the fluids which were being provided, via a longline infusion. Child E was on a 'cautious feeding regime', based on guidelines in the neonatal unit. Child E, it was also noted, 'handles well'.
11am - milk feed - unnamed nurse notes minimal aspirates
11.45am - A doctor's note records Child E has 'suspected sepsis', 'hyperglycaemia', and was 'off lights' for jaundice, with 'good gases'. Child E was 'tolerating well' expressed breast milk. The baby boy was 'not examined at present as having cuddles with mum'. The plan was to 'examine later' and increase feeds. Aspirates were 'ok'.
1pm - milk feed - unnamed nurse notes minimal aspirates, and a moderately high level of urine recorded.
2.10pm - Dr Emily Thomas made clinical notes: 'examination of [Child E] as having skin to skin on [ward round earlier that day]. Good tone and movements, handling appropriately throughout the day.'
2.38pm - unnamed nurse says the blood sugar (gas) reading was outside the parameter so she consulted a doctor and action was taken following guidelines for insulin to be commenced. The glucose reading of 18.4 was the only 'abnormal' reading recorded, the court hears. Mr Myers (defence) asks about the blood glucose readings, and what the parameters should be. The nurse says the readings should be above 2.6, and the upper limit is not defined in pre-term babies (Mr Myers says the upper limit is 6 for full-term babies). Mr Myers asks if the reading of 18.4 is 'worryingly high'. The nurse agrees. She says the cut-off point for insulin to be prescribed would either be '12 or 14'. She agrees the blood sugar readings of 12.8, 18.4, 13.5, 12.9 are 'at the higher end of normal', with '18.4' being 'particularly high'. Mr Myers suggests the pH reading of 7.293 is outside the normal range of being under 7.3, by being slightly acidic. The nurse says she was trained that anything above 7.25 was normal. Mr Myers suggests that the blood gas readings suggest a case of acidosis. The nurse says the readings taken are within the parameters, and the doctor would, in any case, make the decision.
3pm - milk feed - unnamed nurse records minimal aspirates. A prescription for 3pm on August 3 is made, but then crossed out, then redone with 'a correct dose'. The nurse says the previous, crossed out one, was 'an incorrect dose' of 0.05units/kg/hr. The second is the 'correct dose' of 0.02units/kg/hr. Insulin of a neonatal is a "continual infusion", the nurse tells the court.
To 5pm (24 hr observation chart starting 6pm the day before) - The respiratory rate, the court hears, is 'normal', and the baby boy was said to be stable.
Abt. 5pm – Father left the hospital to go home. Mother was having skin-to-skin contact with Child E, until about 6.30pm.
5pm – milk feed - unnamed nurse notes a 1ml aspirate. That was a normal finding and was replaced.
5.24pm - unnamed nurse’s retrospective note: A CRP reading was 'less than 1', which the nurse explains any reading of less than 10 is 'a good sign'. The antibiotics would 'be reviewed at 36 hours [treatment]'. The blood cultures were 'currently negative' - in absence of bacteria. Child E remained self-ventilating in air, with 'satisfactory' blood gas readings. The nurse says Child E had a blood sugar reading of 18.5mmols, which was "too high". A doctor was informed and insulin was 're-commenced at a rate of 0.02/units/kg/hr'. Feeds were increased as Child E was 'tolerating his feeds'. a 'PKU' was taken with parental consent, which was a neonatal blood screening taken from every baby at about Child E's age [if the parents agree], looking for various potential [inherited] conditions, with results to follow.
6pm - unnamed nurse says the observations recorded (readings) show stable trends, and again at 7pm.
6.30pm to before 7pm – Mother says she changed his nappy and cleaned him around the eyes and neck. She went back up to the post-natal ward to express breast milk and have something to eat, between 7 and 8.30pm.
7pm – milk feed - unnamed nurse says the observations recorded (readings) show stable trends. A minimal aspirate is recorded, urine was recorded and E had opened his bowels. Her (overall) assessment is E was doing well on that shift, apart from the high blood sugars. “It can be a worrying factor it could be a stress response”. “cares” row on the observation chart has a tick signed by the nurse.
7.30pm - Dr Emily Thomas made clinical notes, with a CRP reading less than 1, Child E was on 23% oxygen, and antibiotics were 'likely to stop at 36 hours as improving'. A series of other observations are made.
8pm nightshift – LL is designated nurse for twins E & F in room 1. Nurse Caroline Oakley was the shift-leader.
8pm – LL’s barrister suggests the mum went down to the neonatal unit at 8pm, (not with the breast milk at that time) at the time of the handover. The mother disagrees. LL’s nursing note for 8pm written retrospectively at 4.51am: "Mummy was present at start of shift attending to cares."
Just before 9pm – Mother says; she took her expressed breast milk down to the neonatal unit, room 1; LL was the only other adult in room 1; mother heard Child E “screaming more than crying” from the corridor before she entered the room; LL was not near Child E’s incubator, she was busy doing something, standing between the two incubators at a work station; there was blood on his face around his mouth; she was there for about 10 minutes; she asked LL why he was bleeding; LL told her the NGT was rubbing the back of his throat; LL told her to go back to her ward and the registrar was on his way and if there was a problem someone would ring up to the ward. The mother went back to the ward. Mother agrees with LL’s barrister that no other staff came into the room when Child E was screaming. LL’s barrister says the screaming was not as bad as the mother describes. Mother disagrees. LL's notes: "prior to 21:00 feed, 16ml mucky slightly bile-stained aspirate obtained and discarded, abdo soft, not distended. SHO [Senior House Officer] informed, to omit feed." Pros says these notes are false.
9pm – LL recorded information to detail the volume of fluids given via the IV line and a line in Child E's left leg, and the 9pm feed is 'omitted'. The SHO said he had no recollection of giving advice to omit the 9pm feed. He believes the only time he had anything to do with Child E was in a secondary role to the registrar in an examination at 10.20pm.
c.9.10pm – Large v.slightly bile-stained aspirate is reported as happening at 9.10pm, to Dr Harkness at 9.40pm.
9.11pm – Child E’s mother phoned her husband in a call lasting 4 mins 25 secs. She says she knew there was something very wrong. Father confirms that the mother was upset and very worried about bleeding from Child E’s mouth in this call. He said he was sure the medical staff knew what they were doing and she was panicking over nothing.
9.11pm to 10.52pm – mother was waiting to hear about Child E, panicking and talking to the midwife. Mother had not seen this midwife before. She confirms the first name of the midwife was Susan. She was later told by a midwife to call her husband.
9.13pm – LL made a note in twin F’s records.(opening statement)
9.40pm - Dr David Harkness records readings from 9.40pm, (written at 10.10pm), 'asked to see patient re: gastric bleed'. 'Large, very slightly bile-stained aspirate 30 mins ago.' (my note - that would be 9.10pm). 14ml of blood vomit is also recorded. Dr Harkness noted Child E was 'alert, pink, well perfused', with an abdomen which was 'soft, not distended' and no bowel sounds. The note adds 'G I [gastrointestinal] bleed ? Cause'
9pm - 10pm - LL’s barrister asks Dr Wood (SHO, GP trainee) if he recalls receiving a report of a bile-stained aspiration on the neonatal ward. He doesn’t recall. He says he probably would not have received a call from Dr Harkness about it. He says he was on the paediatric unit by himself and it was his understanding that Dr Harkness would have been on the neonatal unit at some point during the evening. Dr Wood tells the court that had he received such a call from a nurse he would have taken action and recorded it in his notes and would have sought advice from the registrar.
10pm – LL’s barrister suggests that the mother went to the neonatal unit with her breast milk. “The mother absolutely disagrees.” LL’s barrister suggests LL never mentioned the feeding tube irritating Child E. Mother disagrees. LL’s barrister asks if there was a conversation between LL a doctor and her, regarding medication. Mum disagrees and says she was told (at 9pm visit) a doctor would be down to see Child E.
10pm - In the 10pm column of LL’s nursing notes for aspirates: '15ml fresh blood'. LL’s notes: "At 10pm large vomit of fresh blood. 14ml fresh blood aspirate obtained from NG tube. Reg Harkness attended. Blood gas satisfactory..." Child E was 'handling well'. LL’s further note: 'Mum visited again approx. 10pm. Aware that we had obtained blood from his NG tube and were starting [treatment]...'
10.20pm - SHO believes the only time he had anything to do with Child E was in a secondary role to the registrar in an examination at 10.20pm. - per opening speech, not mentioned in evidence today
Bef.10.52pm – neonatal unit contacted the midwife and told of deterioration. (also see 11.30pm midwife's evidence??)
10.52pm – the midwife called the father telling him to come to the hospital, after the neonatal unit rang the maternity ward. LL’s barrister suggests this is the call where the mother told her husband about Child E bleeding, and the mum was not as worried at the 9.11pm call as she was at 10.52pm. mother disagrees. Father says this call was split between the midwife and the mother and he was told not to panic but to get over here now. He tells LL’s barrister the bleeding was not referred to in this call.
11pm - A neonatal fluid balance chart is shown to the court, with no name or notes for the 11pm column. LL’s retrospective nursing notes said: 'NG tube on free drainage. Further 13mls blood obtained by 11pm. Beginning to desaturate and perfusion poor. Oxygen given via Neopuff'. Child E was said by LL to be 'cold to the touch' and was beginning to 'decline'.
Time? 11pm? - Dr Harkness noted '13ml blood-stained fluid from NGT on free drainage.' Child E's blood pressure was 'stable' and saturates' remained 60-70%', and 'making good respiratory effort', and was 'crying'. A plan of action, including x-rays and medication, was made.
11.30pm - A note for 11.30pm on the observation chart has blood pressure and respiratory rate recorded, no record of a heart rate made, and blank readings for cot temperature, and no initials recorded.
11.30pm - midwife Susan Brookes says she had a call from the neonatal unit to ask the mother to go down in 30 minutes as E had a bleed and required intubating. “very poorly” the mum was upset and asked to go sooner.
11.40pm – Child E collapsed. LL recorded, retrospectively: "11.40pm became Bradycardiac, purple band of discolouration over abdomen, perfusion poor, CRT 3secs. "Emergency intubation successful and placed on ventilator..." Further notes by LL: 'Required 100% oxygen, saturations 80%, SIMV 22/5 rate 60. Further saline bolus and morphine bolus given. 2nd peripheral line sited..." "Once [Child E] began to deteriorate, midwifery staff were contacted." The latter note is written, retrospectively, at 4.51am.
11.40pm - Dr Harkness records, in clinical notes at this time, written retrospectively, 'Sudden deterioration at 11.40pm, brady 80-90bpm, sats 60%, poor perfusion, colour change over abdomen purple discoloured patches'. The note adds, after an improvement in sats, 'purple discolouration in abdomen remained', and a plan of action noted for Child E.
11.40pm - Dr Christopher Wood (junior to Dr Harkness) SHO working in the paediatric unit immediately attended upon a crash call for baby E. He doesn’t recall being in the neonatal unit that night before 11.40pm. he signed a prescription for morphine for E. The accompanying medical note by Dr Wood says Sats 60-70%, morphine bolus – sats improved to 80%. He says resuscitation had already begun upon his arrival. He recorded notes. He recorded staff present – a team of 6 – including himself, Dr Harkness, another doctor, and three senior nurses including LL.
12 midnight - Mother (and father?) with midwife returned to the neonatal unit and sat in the corridor while Child E was being worked on by medics trying to resuscitate him. Midwife left after 10 minutes and mum was eventually allowed in once E had been stabilised.
4 Aug 2015, Tuesday
12.15am - A further observation reading for Child E, made by LL, is taken at 12.15am, with a heart rate 'down from where it had been earlier', and a drop in temperature, recording he was on 100% oxygen.
12.25am - A consultant paediatrician arrived at the neonatal unit.
12.27am - An x-ray is taken at 12.27am, relating to the chest and abdomen.
12.30am - Shortly after 12.30am Child E was placed on breathing support and given medication after resuscitation.
12.36am - A further, 'acute deterioration' for Child E, is noted by Letby at 12.36am. 'Resus commenced as documented'. The consultant paediatrician noted CPR commenced, along with ventilations, and medications.
12.37am – Dr Wood recorded efforts to resuscitate E from 12.37am. 5 does of adrenaline were administered.
12.50am - A blood transfusion is started for Child E at 12.50am, and several adrenaline doses are administered.
1.01am - LL's note, for 1.01am, reads 'chest compressions no longer required'. Dr Wood recorded chest compressions stop at 1.01am, with ventilations continuing.
1.15am - LL notes 'further decline, resus recommenced'. Dr Wood recorded E’s heart rate fell again and CPR recommenced.
1.23am - CPR was discontinued at 1.23am - 'resus discontinued when [Child E] was given to parents. [Child E] was actively bleeding...' Dr Wood recorded CPR stopped and E was cleaned.
1.24am - Dr Wood recorded ventilation efforts stopped and E was given to his parents.
1.40am – The time of death was recorded as 1.40am on August 4. No post-mortem was conducted.
LL’s note: 'both parents present during the resus. Fully updated by nursing and medical team throughout. Parents wished for [Child E] to be baptised....
'Child E was bathed by myself and photographs taken as requested, both were present during this. Consent obtained for [hair] and hand/footprints... 'Both distraught...'
The official documented report for the incident is made by LL - 'unexpected death following gastrointestinal bleed. Full resus unsuccessful'.
Time? - The mum says the husband asked a few questions and they were told by the (female) doctor a post-mortem "wouldn't tell them much" more than what they had already been told by the doctor, and it would delay the transfer back home.
"We just wanted to take him home."
Time? – Mother says LL bathed Child E and dressed him in a white gown. LL gave the parents a memory box. Baby E's mum says that after he died "Lucy Letby gave us a memory box, which totally surprised me.. it had footprints, a lock of his hair, a candle, a teddy. I was so overcome by emotions that this had been provided for me as I had no other memories other than that".
4.51am - LL made “fraudulent” (per opening speech) retrospective nursing notes, failing to mention that his throat was bleeding at 9pm, and falsely claiming the mother had visited at the start of the shift and later at 10pm, and that there had been a meeting between the mother and the registrar.
8am – End of LL’s night shift
8.21am - LL noted at 8.21am 'Parents resident on unit overnight. Wish to be left alone'.
8.58am – LL’s texts
Colleague: "You ok? Just heard about [E]. Did you have him? Sending hugs xx"
LL: "News travels fast - who told you? Yeah I had them both, was horrible."
Colleague responded that she had been informed by someone at the handover 'told me just now'. 'Had he been getting poorly or was it sudden?' ‘Poor you. You’re having a tough time of it.”
LL responds E had a 'massive gastrointestinal haemorrhage'.
Colleague: ‘Damn. He’d always struggled feeding. I just feel for his parents and you. You’ve had really tough times recently.’
LL responds that E was 'IUGR [Intrauterine growth restriction] and REDF [Reversal of umbilical artery end-diastolic flow]' and believed E was 'high risk'. She went on to describe how she felt ‘just awful’ and reported that the parents were distraught, saying "I feel numb".
7.55pm – LL’s texts
Jennifer Jones-Key: "Hey how's you?"
LL: "Not so good, we lost [E] overnight."
JJ-K: "That’s sad. You’re on a terrible run at the moment. Were you in room 1?"
LL: "I had him and Baby [F]"
JJ-K: "That is not good, you need a break from it being on your shift."
LL: "It's the luck of the draw unfortunately. Only three trained (nurses), so I ended up having them both."
JJ-K: "You seem to be having some very bad luck though."
LL: "Not a lot I could do really. He had a massive haemorrhage. It could happen to any baby really."
JJ-K says Letby "did everything you could", adding she had seen a haemorrhage in babies before, and was 'horrible' to see.
LL: "This was abdominal. I’ve only seen pulmonary before.”
JJ-K asked after E’s parents.
LL: “Ok. Tired. They’ve just gone to bed.”
8pm - LL night shift starts
Dr Wood’s last night shift with the CoCH as he’d come to the end of his 4-month training placement.
7 August 2015, Friday (about - a few days after giving E’s parents a memory box)
LL gave the mother a photograph of [F] 'holding' E's teddy.
The mother had just made one of her daily visits to the hospital's chapel of rest. 'Lucy Letby told me 'I got this picture. I thought it was so amazing I took a picture for you'. She was suggesting F had rolled over and cuddled the bear'.
9 August 2015, Sunday
LL gave an account to JJ-K of saying her goodbyes to the [E&F’s] parents.
She told Ms Jones-Key that both parents had cried and hugged her: ‘saying they’d never be able to thank me enough for the love and care I gave them'.
JJ-K: 'It’s heart-breaking, but you have done your job to the highest standard with compassion and professionalism. 'When you can’t save a baby you can try to make sure that the loss of their child is their only regret. You should feel very proud of yourself'.
LL: 'I just feel sad that they’re thinking of me when they’ve lost him'.
Abt Nov 2015 - LL was told that the parents of Baby E and Baby F had come into the neonatal unit with a 'gorgeous huge hamper' for the staff. She was also told their surviving son looks 'fab'.
LL said: 'Oh gosh, did they? I wish I could have seen them. That will stay with me forever'.
-------------------------------------------------------------------------------------------------------------------
Murder charge Child E – air (allegedly) injected into bloodstream and bleeding indicative of trauma.
Supplementary text details Daily Mail Colleagues of Lucy Letby told her she was 'terrible run of bad luck'
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merrypason
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I really don't understand this message she's sent. Why does she believe they are thinking of her, when they've lost him??? I'm getting the impression the attention and gratitude she craved was from the parents (standard saviour complex), not her colleagues or family. I did wonder why she searched E's mum more than anyone else - and wonder if she was looking for a tribute to herself (LL) on the FB page.
ETA - A bit like you search an ex's page to see if they make any mention of you or subtle references to you.
Also this message -
"She told Ms Jones-Key that both parents had cried and hugged her, 'saying they'd never be able to thank me enough for the love and carer I gave them'."
How traumatic for the mum to know that this nurse who she felt so grateful to is now denying her version of events re: the 9pm feed.
MOO
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Tortoise
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Thanks, let's hope they have this all nicely organised on their iPads. By the end it's going to be a lot to digest.
Mind you it will be so much more memorable for them as they are forming impressions by seeing and hearing the witnesses. This is like reading a film script with bits missing, and imagining the characters, for us, instead of watching the film.
Tortoise
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MT had baby E the night before.
ColourPurple
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Not sure if anybody else has mentioned this but it's bugging me...
LL taking a picture of baby F, showing it to the parents after Baby E's death and suggesting or implying that Baby F had rolled over/moved over/moved to hug/touch Baby E's teddy bear:
1. Why on earth was she taking pictures of other people's babies on the ward, presumably on her own phone???
2. Did she do this often. Did she have pics of other babies on her phone?
3. I've never heard of a full term baby rolling over or moving over to hug a teddy, let alone a premature one. It just doesn't ring true.
LL taking a picture of baby F, showing it to the parents after Baby E's death and suggesting or implying that Baby F had rolled over/moved over/moved to hug/touch Baby E's teddy bear:
1. Why on earth was she taking pictures of other people's babies on the ward, presumably on her own phone???
2. Did she do this often. Did she have pics of other babies on her phone?
3. I've never heard of a full term baby rolling over or moving over to hug a teddy, let alone a premature one. It just doesn't ring true.
JosieJo
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I agree with this being over zealous and I can't really believe the baby rolled over towards the bear it feels staged.
It is often the case though that there is an instant camera on the unit to produce photos
I know I’in nicu there’s these octopus thing you can get the idea being the baby will fiddle with it opposed to any wires. Probably not the same thing though. I actually assumed she posed the photo tbh.
It’s hard, I feel like if I were leaving my baby’s care to nicu for the majority of the day, I’d appreciate the photo. I think it seems weird after the fact but it I were the parent and it was my baby I think I’d be happy to have that particular photo.
ColourPurple
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that’s not what I’m saying in the case of Baby e and f. It also seems those searches stand out compared to the others. Im looking at the other searches and I’m not seeing any nefarious reasons for it, if you are sure there is then I would like to know why?
it’s factual to state that algorithms suggest things you are either interested in or relevant to like the countess hospital So if you work there the algorithm suggests people who search for it. If you are really specific like typing in ”neonatal unit, countess of Chester“ then you further increase the chance of fb suggesting someone who works in that specific place. Those are things patients are likely to do.
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I’m more trying to make sense of why LL would supposedly lie. I can’t see any reason for it and it’s something to further explore. If you can make sense of it, please enlighten me? I think my suggestion is a viable way of doing that. It makes sense to me if you consider the fb searches to be maybe part of a coping mechanism that involves moving on from traumatic events Eventually forgetting them.
On their own the facebook searches don't mean an awful lot. Can you make sense of why LL had medical notes from the hospital at her home? That's one thing I'm really struggling to understand.
JosieJo
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JMO and of course this could change as the trial goes on .. but ..this could all be about wanting to involve themselves in others grief ..I feel its possible it's more about the parents than the children
The details in the text :
Dad was crying on the floor when we took the baby
The parents hugged me
The parents thinking about her not their loss
Involving themselves in other nurses bereaved relatives
Telling a mother repeatedly that she gave her baby their first bath
Sending sympathy cards to a parent
Keeping a photo on their phone of said bereavement card
Searching repeatedly for parents on Facebook
Potentially posing a baby with their brothers teddy to give to mum
The details in the text :
Dad was crying on the floor when we took the baby
The parents hugged me
The parents thinking about her not their loss
Involving themselves in other nurses bereaved relatives
Telling a mother repeatedly that she gave her baby their first bath
Sending sympathy cards to a parent
Keeping a photo on their phone of said bereavement card
Searching repeatedly for parents on Facebook
Potentially posing a baby with their brothers teddy to give to mum
ColourPurple
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Yes, I think on one hand I might be grateful for the photo if it did show a genuine touching moment, but on the other hand I'd be thinking why on earth are nurses taking photos of my baby.
PS yes it makes more sense that she'd staged the pic, but staging the pic and then implying to the bereaved parents that it all happened naturally would be... I don't even know what it would be tbh.
Dotta
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