UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #6

[ShireChe]

I would love to hear more about the time spent on admin duty because I agree with you guys it is really bonkers. A band 6 nurse being placed on admin duties for what, two years? Whilst they investigate her potentially being a serial killer? What did she know at this point or what was she even told during this time, the rumour mill at work had to be crazy. I feel like it would have made anybody quit.

Plus as you guys have all said, just swapping her shift pattern or moving her to admin duty still allows her into the hospital to access patients that she was allegedly targeting. The fact the hospital seemed to just run their own experiment by moving her? But I'm no expert on employment law I know it does seem hard to be sacked by the NHS.

I suspect we'll never hear this as it's not the case on trial now, but the communication between consultants and management surely needs some sort of inquiry if LL receives a guilty verdict.

If the consultants are saying we think something worrying is happening here and have concerns about this nurse and the response is 'ok, we'll move her to the dayshift' that seems hugely negligent.

 

[Tortoise]

https://twitter.com/MerseyHack

Mr Myers suggests that the notes show that although E lost blood and fluid there was no discussion, as there should have been, of replacing fluid or transfusing blood. The doctor says though it’s not in the notes, blood transfusion was discussed.
@BBCNWT

 

[bbsaz]

Really it does. This article mentions the review early on before any allegations. A total of fifteen deaths were investigated but not purely for the unit LL was on but involved still borns as well. Got no idea on if that’s a reasonable number but I can’t see a unit dealing with around six hundred births a year having a number that high. even with 7 of those being alleged murder it’s very high indeed. We can also assume that antenatal care was investigated as well. i don’t think there was a report in the few years prior that gave a good review, it’s always “needs improvement“ and I believe even the most recent one says the same. I’m not sure exactly what those words mean but think it’s safe to say it’s underperforming. It did however consistently perform well on being caring.

‘No single cause’ identified for rise in baby deaths at Countess of Chester Hospital

FAMILIES of 13 babies who died at the Countess of Chester Hospital have now been provided with “full and accurate information” about what…

www.chesterstandard.co.uk

this recent report states the maternity services as being inadequate, it also states the unit was delivering over 2000 babies a year. It would be extremely difficult to remember any particular baby when you are dealing with that many babies in a year.

The Countess of Chester Hospital - Care Quality Commission

www.cqc.org.uk

This report states a total of three stillbirths for a year so I think this number is around what is expected. It really does put that figure of 15 deaths being investigated into a certain light. For that year there should have been less than ten neonatal and stillbirth Deaths. even if 7 of those deaths are murder that still leaves eight deaths on a unit expecting half that number.

I find this stat very interesting... If they deliver 2000 babies a year at this hospital, and 600 go into neonatal care, that is just over 1/3rd of babies born which go into neonatal care! I've seem some comments where people have assumed that the babies were very vulnerable to even be in neonatal care, and so their deaths are less suspicious. But you wouldn't expect 1/3rd of babies born to be at a greater risk of death.

Maybe that makes no sense, just my ramblings...

 

[Tortoise]

https://twitter.com/MerseyHack

Mr Myers suggests the consultant (who was on call) should have gone to the neonatal unit sooner than she did to treat E. “With hindsight I should have attended but I don’t think I would have made any different decisions [from the doctors who were at the unit]”.

Mr Myers: “You should have been there.”
Consultant “Yes.”

 

[Tortoise]

https://twitter.com/MerseyHack

The consultant disagrees with Mr Myers when he suggests the Countess of Chester neonatal unit was “too slow” to intubate* E. (* where a tube is inserted into the windpipe to aid breathing).

 

[Dcflag]

I find this stat very interesting... If they deliver 2000 babies a year at this hospital, and 600 go into neonatal care, that is just over 1/3rd of babies born which go into neonatal care! I've seem some comments where people have assumed that the babies were very vulnerable to even be in neonatal care, and so their deaths are less suspicious. But you wouldn't expect 1/3rd of babies born to be at a greater risk of death.

Maybe that makes no sense, just my ramblings...

I think it sounds.. correct? There are lots of reasons for a baby to end up in nicu aside from any obvious prematurity. Gestational diabetes for example is not just common but rising in numbers, and any baby born to a gd mother that then fails is glucose Screenings after birth will go to nicu. Statistically these babies are at higher risk of complications, illness and death. I generally think that there’s lots of reasons for a statistically higher risk for complications, illness and death (being rh+ springs to mind as well).

Also, coch was a level 2. It’s clear there were unwell babies in their nicu, but these aren’t the “most vulnerable” of nicu babies. These will also include babies who need any testing or medical care around birth (for example I had one baby in nicu for a few hours as the newborn screen picked up a heart murmur) and any meeting the threshold are transferred.

 

[Tortoise]

https://twitter.com/MerseyHack

Mr Myers suggests the consultant is “minimising the impact of a late blood transfusion” for E. Consultant: “I am minimising it as I don’t think a late blood transfusion led to [E’s] collapse and death.”
@BBCNWT

 

[merrypason]

I can see BM's defence strategy for each case now. He knows the layperson hears 'sub optimal' and 'vulnerable' and sees that doctors didn't do something perfectly - and would think the death was due to negligence, or that there's reasonable doubt.

But really it would be like saying, you had a minor allergic reaction to nuts and ended up in hospital where your vitals less than ideal (and you were more vulnerable at that time to death as a result of the allergy). But the doctors treated you with an epi pen and you started improving and feeling well again. Then died very suddenly and unexpectedly. It would feel suspicious because you don't expect a person with a minor allergic reaction to end up in hospital and die, in modern times. Especially if they were treated and got better.

And an expert witness says the death could only be caused by someone inserting air and causing an embolism. And that despite having an allergic reaction, the allergy didn't kill you. Because allergies don't start off minor, show signs of improvement, then suddenly kill.

But the defence says it must be the allergy because doctors didn't give you the epi pen immediately. And the doctors say, it doesn't matter the epi pen was given a bit later because the reaction was minor - and anyway it was given within accepted parameters. But the defence maintain anything less than 'immediately' is sub optimal, you were already vulnerable to death because of your allergy - and that is what caused the death because SUB OPTIMAL.

It's a clever strategy for sure.

 

[Tortoise]

https://twitter.com/MerseyHack

Mr Myers says the consultant should have ensured that Baby E had a post mortem. She says “I apologise to them [E’s parents] that I didn’t push for that.” @BBCNWT

 

[Tortoise]

I expect the parents wouldn't have told the doctors/consultant that the mother had seen blood from the baby's mouth at 9pm, because the parents would have assumed they already knew and the nurse would have told them.

I think the doctors maybe never realised how much blood E had lost until the parents were interviewed by police and that part of the evening came to light.

IMO

 

[Dcflag]

https://twitter.com/MerseyHack

Mr Myers says the consultant should have ensured that Baby E had a post mortem. She says “I apologise to them [E’s parents] that I didn’t push for that.” @BBCNWT

This has to be a moot point really? There were discussions, a cause of death certified and signed off by the dr and coroner. At the immediate time they were satisfied with the cause of death. Is Myers saying that drs should be pushing all parents of deceased infants to have a post mortem? Because I’m pretty sure that a) the onus isn’t on the parents to push for one, it’s on the medical experts of the case to decide and b) if it’s not mandatory, a post mortem is a choice. It’s surely unethical to ever push a choice onto a parent in this way? Like, you can only say ‘this is what we know, this is what we think, we suspect a post mortem will confirm what we think therefore we don’t see the need for one. But the choice is yours to make and not mine to push either for or against?’

 

[BabaVanga]

Where could all the blood have come from? Stomach? Tubes? What caused the blood? I’m confused about that.

 

[merrypason]

This has to be a moot point really? There were discussions, a cause of death certified and signed off by the dr and coroner. At the immediate time they were satisfied with the cause of death. Is Myers saying that drs should be pushing all parents of deceased infants to have a post mortem? Because I’m pretty sure that a) the onus isn’t on the parents to push for one, it’s on the medical experts of the case to decide and b) if it’s not mandatory, a post mortem is a choice. It’s surely unethical to ever push a choice onto a parent in this way? Like, you can only say ‘this is what we know, this is what we think, we suspect a post mortem will confirm what we think therefore we don’t see the need for one. But the choice is yours to make and not mine to push either for or against?’

It's part of his strategy to get the doctor to apologise for doing something wrong, and he hopes the jury will then doubt that she did anything right. Because human nature to question how good someone is if they make even one mistake.

Even though the post mortem has absolutely nothing to do with baby's cause of death - but it's been deflected nicely to show SUB OPTIMAL behaviour.

 

[Dcflag]

Also, I might be being a thick here so excuse me if I am. Where does the potential embolus fit into baby e timeline?

 

[Supernovae]

I find this stat very interesting... If they deliver 2000 babies a year at this hospital, and 600 go into neonatal care, that is just over 1/3rd of babies born which go into neonatal care! I've seem some comments where people have assumed that the babies were very vulnerable to even be in neonatal care, and so their deaths are less suspicious. But you wouldn't expect 1/3rd of babies born to be at a greater risk of death.

Maybe that makes no sense, just my ramblings...

The 600 may also include babies born at other local hospitals without that level of NICU or who would have been born at other hospitals if they weren't likely to need neonatal care.

 

[Tortoise]

Also, I might be being a thick here so excuse me if I am. Where does the potential embolus fit into baby e timeline?

I think it would be just before the first collapse at 11.40pm -

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.


I don't know if it's suggested there were further injections of air before the second and third (final) collapses, we might have to wait to hear from the experts on that.

 

[merrypason]

Also, I might be being a thick here so excuse me if I am. Where does the potential embolus fit into baby e timeline?

So the medical experts said the air embolism happened via IV. And I can see that at 9pm LL did an IV? Also the time the mum saw blood on baby's face.

So I think it was 9/10pm? But I'm not sure. Wonder if doing it by IV means it was a slower process than when previously done by long line/UVC - I don't know enough about the difference?

At 9pm, Letby has 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'.

In the 10pm column is '15ml fresh blood'.

The SHO said he had no recollection of giving advice to omit the 9pm feed.

He was on the paediatric ward most of that night, until Child E entered a terminal decline. 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.
The registrar recalled being told Child E had suffered a blood-flecked vomit.

He does not recall seeing any blood on Child E's face, but regarded the presentation as undramatic.

But "around half an hour to an hour later there was a large amount of fresh blood which had come up" Child E's tube.

The prosecution said: "This was the first indication of any serious problem so far as the medical staff were concerned.

"There was a further loss of 13 mls of blood at 23:00 hrs."

"13mls may not sound much, but [the doctor] had never seen a small baby bleed like this."

 

[May72031]

I don't think that someone can just 'suspect' a nurse is doing harm, and then can 'remove them from the premises.' It is more complicated than one just having suspicions.

Especially when coroners have already indicated there were medical explanations for the deaths.

I think removing them from working with patients and giving them paperwork duties was a good temporary solution. It also prevented them from quitting their job and relocating to another hospital to continue on unnoticed.

Indeed, but we know LL referenced (in her texts to a colleague) the fact that an investigation was going to be launched by the hospital in June 2015, after the unexpected collapses and deaths that month. So, despite what coroners said, the hospital thought an investigation was necessary at that point.

 

[YaYa_521]

This thread is now closed. Click below to continue in Thread #7.

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

Sky News link: Healthcare worker arrested on suspicion of murdering eight babies Media, Maps & Timeline *NO DISCUSSION* thread Thread #1 Thread #2 Thread #3 Thread #4 Thread #5 Thread #6

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