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

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Tortoise said:
I don't think they're related. This is what the prosecutor said in his opening statement -

Medical expert Dr Sandie Bohin agreed the cause of death was air embolus and acute bleeding.
She concluded that the cause of the bleeding was unknown but acknowledged “fleetingly rare” possible natural causes that could not be ruled out in the absence of a post-mortem.
Dr Bohin concentrated on the abdominal discolouration and concluded that air was deliberately introduced via an intravenous line.

Dr Dewi Evans said Child E's death "was the result of a combination of an air embolus and bleeding which was indicative of trauma".
The air embolus was "intentionally introduced" into Child E's bloodstream via an IV line "to cause significant harm".
Click to expand...
So if the air embolus and bleeding weren't related, are the prosecution saying Letby was responsible for the bleeding as well as the embolus, but they just don't know what she did to cause it?

For example the doctors say they don't know what caused the bleeding because of the lack of post mortem. They can't rule out natural causes but say this would be very rare. They don't think it was NEC. But at the same time the mom's testimony says she came into the room and her baby was screaming with blood around his mouth, while Letby stood nearby doing nothing about it. She then falsified her notes to hide the incident and never mentioned the blood around the mouth to anyone. So if this testimony is true, Letby had surely caused the bleeding? Is this the prosecutions case?

If she is accused of attacking baby E by injecting air into his blood at 9pm, why didn't we see a sudden deterioration after this like with the others (or did we and I have misunderstood)?
 
Jazmania said:
So if the air embolus and bleeding weren't related, are the prosecution saying Letby was responsible for the bleeding as well as the embolus, but they just don't know what she did to cause it?

For example the doctors say they don't know what caused the bleeding because of the lack of post mortem. They can't rule out natural causes but say this would be very rare. They don't think it was NEC. But at the same time the mom's testimony says she came into the room and her baby was screaming with blood around his mouth, while Letby stood nearby doing nothing about it. She then falsified her notes to hide the incident and never mentioned the blood around the mouth to anyone. So if this testimony is true, Letby had surely caused the bleeding? Is this the prosecutions case?

If she is accused of attacking baby E by injecting air into his blood at 9pm, why didn't we see a sudden deterioration after this like with the others (or did we and I have misunderstood)?
Click to expand...
I don't think the alleged air embolus and the trauma bleed are related, they seem to be separate alleged attacks, but we'll need to wait to hear from the experts for sure.

eta - prosecution opening

"At 9pm on August 3, 2015, the mother decided to visit her twin sons, and "interrupted Lucy Letby who was in the process of attacking Child E", the prosecution say, although the mum "did not realise it at the time"."
 
magikarpmagikarp said:
Considering the amount of blood that ultimately came up from poor Baby E's stomach.... I am interested to hear the expert testimony and wonder if the experts will suggest there was some sort of physical trauma? :(
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That's what I think they're going to say. Sounds like he had trauma to the throat, considering the mum said that LL told her that the tube was irritating his throat and had caused the bleed.
 
Regarding keeping Letby on admin duties despite suspecting her. I think this was a really good idea. They keep her away from patients, but they don’t give her cause for grievance if she’s innocent. They also keep her occupied, so, if guilty, she has no reason to move to work at a different hospital and start victimising again, which is what Beverley Allitt was believed to have done, but was found not guilty of those other cases.
 
did anyone know the unit was closed six times in 2015 due to staff activity? I’m not sure what this means but it would be interesting to see if it coincided with the times where there were no suspicious events on the ward.

“The maternity service had closed six times during 2015 due to staff activity. This had been managed safely through the escalation policy, which involved working with other local maternity services and emergency ambulance services”


that’s the report for the February inspection in 2016.

apparently cctv was used to monitor access to the maternity unit. I would have assumed this meant they knew exactly when LL ws on the unit and entered it. I might have thought this would also leave no doubt as to when the mum delivering the milk at nine pm actually did turn up.

• The layout and security detection arrangements meant mothers and babies weren’t always monitored, however access to the unit was monitored by close circuit television at key points across the unit, and access was restricted either by a staffed reception or swipe access door.
 
Sweeper2000 said:
did anyone know the unit was closed six times in 2015 due to staff activity? I’m not sure what this means but it would be interesting to see if it coincided with the times where there were no suspicious events on the ward.

“The maternity service had closed six times during 2015 due to staff activity. This had been managed safely through the escalation policy, which involved working with other local maternity services and emergency ambulance services”


that’s the report for the February inspection in 2016.

apparently cctv was used to monitor access to the maternity unit. I would have assumed this meant they knew exactly when LL ws on the unit and entered it. I might have thought this would also leave no doubt as to when the mum delivering the milk at nine pm actually did turn up.

• The layout and security detection arrangements meant mothers and babies weren’t always monitored, however access to the unit was monitored by close circuit television at key points across the unit, and access was restricted either by a staffed reception or swipe access door.
Click to expand...

Regarding the maternity being "closed" due to staffing..they imo likely means closed to new admissions...many hospitals do it. Its the safest thing to do ..its only usually for a short time sometimes just one shift
 
JosieJo said:
Regarding the maternity being "closed" due to staffing..they imo likely means closed to new admissions...many hospitals do it. Its the safest thing to do ..its only usually for a short time sometimes just one shift
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I thought It might be something like that, couldn’t see a vital and busy unit being abandoned without serious reasons and they would have mentioned the reason if serious. Are you sure they meant staffing by “staff activity”? I knew staffing was a problem at the hospital and apparently the nhs generally sometimes only running at 90% of what was recommended for the unit but thought it would have to be more than that to justify its closure to new admissions?

<modsnip - sleuthing family is not allowed>
 
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Sweeper2000 said:
I thought It might be something like that, couldn’t see a vital and busy unit being abandoned without serious reasons and they would have mentioned the reason if serious. Are you sure they meant staffing by “staff activity”? I knew staffing was a problem at the hospital and apparently the nhs generally sometimes only running at 90% of what was recommended for the unit but thought it would have to be more than that to justify its closure to new admissions?

<modsnip - sleuthing family is not allowed>
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I've not had chance to read the report as yet but does it say "staffing activity" or staffing Acuity"
 
LadyEdgeworth said:
Speak for yourself I've been dying to know about the plumbing situation this whole time as it's so key to the whole case.....
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Well I've been thinking about airborne and water borne diseases that circulate in old hospitals and wipe out the frail and elderly. It would need to be ruled out that there isn't an issue of some form of contamination or such that nurses were encountering unwittingly.
 
Mr Myers went on to suggest that a blood transfusion was given too late during the resuscitation efforts, something the consultant also denied.

He added gastro-intestinal bleeds could happen when babies are under stress, but the consultant said that had not been the case and Child E was "making excellent progress" before his sudden decline.

10%
Lucy Letby trial: Consultant tells of baby post-mortem decision regret
 
Observe_dont_Absorb said:
Well I've been thinking about airborne and water borne diseases that circulate in old hospitals and wipe out the frail and elderly. It would need to be ruled out that there isn't an issue of some form of contamination or such that nurses were encountering unwittingly.
Click to expand...
Babies A, C and D had post mortems, and there were no such findings.
 
Observe_dont_Absorb said:
Well I've been thinking about airborne and water borne diseases that circulate in old hospitals and wipe out the frail and elderly. It would need to be ruled out that there isn't an issue of some form of contamination or such that nurses were encountering unwittingly.
Click to expand...
This is the report on infection and control from the 2016 report, looks like they were performing well.

Cleanliness and Infection control
• Clinical areas at the point of care were visibly clean; however, we did identify some cleanliness issues in urgent and emergency services, outpatients and in non clinical areas specifically related to an area within maternity services.
• The trust had infection prevention and control policies in place, which were accessible to staff and staff were knowledgeable on preventing infection.
3 The Countess of Chester Hospital Quality Report 29/06/2016

Summary of findings
• There was enough personal protective equipment available, which was accessible for staff and staff used this appropriately.
• Staff generally followed good practice guidance in relation to the control and prevention of infection in line with trust policies and procedures.
• Between April 2015 to December 2015, there were two cases of MRSA bacteraemia reported across the trust. Lessons from all cases were disseminated to staff for learning across directorates.
• The hospital undertook early screening for infections including MRSA during patient admissions and preoperative assessments. This meant that staff could identify and isolate patients early to help prevent the spread of infection.


one might think plumbing or moisture is pretty important when it comes to ensuring hygiene in a hospital. Especially when hospitals are known as breeding grounds for superbugs.
www.nhs.uk

MRSA

Find out what MRSA is, how you get it, what the symptoms are, and how it's treated.
www.nhs.uk www.nhs.uk


these are all the reports from the care quality commission covering a decade Since 2012.

All inspections: The Countess of Chester Hospital - Care Quality Commission

www.cqc.org.uk www.cqc.org.uk
 
Jazmania said:
So if the air embolus and bleeding weren't related, are the prosecution saying Letby was responsible for the bleeding as well as the embolus, but they just don't know what she did to cause it?

For example the doctors say they don't know what caused the bleeding because of the lack of post mortem. They can't rule out natural causes but say this would be very rare. They don't think it was NEC. But at the same time the mom's testimony says she came into the room and her baby was screaming with blood around his mouth, while Letby stood nearby doing nothing about it. She then falsified her notes to hide the incident and never mentioned the blood around the mouth to anyone. So if this testimony is true, Letby had surely caused the bleeding? Is this the prosecutions case?

If she is accused of attacking baby E by injecting air into his blood at 9pm, why didn't we see a sudden deterioration after this like with the others (or did we and I have misunderstood)?
Click to expand...
I'm wondering if the bleeding was caused by inflicted trauma rather than an air injection at 9:00 pm. Babies C, G and N also had fresh blood in their throats. A pathologist thought the liver injuries in child O were a result of "impact type trauma."

There was also trauma seen in Child N, whose throat was so swollen the Doctor could not view the back of it. He was not able to get the breathing tube down his throat as in Child's C, E and G.

Could the injuries have been caused by the tube being manipulated somehow? More than once a nurse had walked in to see a baby's tube dislodged. Can moving the tube around cause such internal injuries, if done with some force?
 
Thanks Tortoise for your updates today and the brilliant timelines you have put together, very appreciated.

In terms of the reporting I've stumbled across another for today:
https://twitter.com/x/status/1592862029928615936

The accounts aren't very different on a quick skim read, however Judith reports the witness nurse looking directly at the parents when she apologies for not pushing for a post mortem which I don't recall in the earlier account from Merseyside
 
Left Thoughts said:
Thanks Tortoise for your updates today and the brilliant timelines you have put together, very appreciated.

In terms of the reporting I've stumbled across another for today:
https://twitter.com/x/status/1592862029928615936

The accounts aren't very different on a quick skim read, however Judith reports the witness nurse looking directly at the parents when she apologies for not pushing for a post mortem which I don't recall in the earlier account from Merseyside
Click to expand...
Thank you, yes I posted that journalist's tweets in the media thread today and forgot to copy them over here.
 
BabaVanga said:
Where could all the blood have come from? Stomach? Tubes? What caused the blood? I’m confused about that.
Click to expand...

Tortoise said:
That's what I think they're going to say. Sounds like he had trauma to the throat, considering the mum said that LL told her that the tube was irritating his throat and had caused the bleed.
Click to expand...
I’ve read speculation, and I can’t stress enough this is speculation that is not from medical professionals, that a bowel perforation could cause such a bleed.
 
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