UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #9

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Where should it show the moderator identity? I can only see a question mark avatar.

It might be the case that the moderator can choose to have a private profile in which case they probaBly don’t want to be identifiable. But in my example it shows up the same as any other notification. :/
 
I’m wondering because it’s still a thing of frustration that nobody has seen anything and there doesn’t seem to be evidence of anything conclusive of LL guilt or innocence. It seems to me that the strongest evidence the prosecution have is the cases of insulin poisoning. It’s seemingly without a doubt that insulin has been present in the body of the babies when it shouldn’t have been. I’m just speculating as I think the prosecutions angle is that the cases are collectively indicative so one bolsters the next and so on. I just remember that LL asked

"Interestingly, at the end of this part of the interview she asked whether the police had access to the TPN bag that she had connected,".


its Notable to me but I’m not sure what to make of it. It’s kind of difficult to make sense of as I cant see why she would ask this if she hadnt requested for the bag to be checked as I think she said she did? It’s so long after the event she wouldn’t have had a reason to think they did. She would have known of any police involvement or suspicion at the time and that would be a reason IMO

it’s kind of incriminating if she didn’t believe she had requested the check.
 
Officer Dibble asked about the post it notes that were found in Letby's home after her arrest in the last thread.

There are links to articles in the first or second thread but she wrote, "I don't deserve to live, I killed them all on purpose because I'm not good enough."

And, "I AM EVIL, I DID THIS."

"I am a horrible evil person."

She also wrote "HATE" in capitals, and that she doesn't deserve her parents.

I don't know the exact quote but she also wrote that she will never get married or have a family.

If you search "Lucy Letby trial post it notes" you will find a selection of articles.

I hope that helps.

ETA There were also claims of innocence, but I don't think she wrote "Why do I keep doing this?"
Thank you very much MsBetsy. I thought it was in a diary. Now I know to search for post it notes. It seems so long ago I couldnt remember. Thank you again.
 
I’m wondering because it’s still a thing of frustration that nobody has seen anything and there doesn’t seem to be evidence of anything conclusive of LL guilt or innocence. It seems to me that the strongest evidence the prosecution have is the cases of insulin poisoning. It’s seemingly without a doubt that insulin has been present in the body of the babies when it shouldn’t have been. I’m just speculating as I think the prosecutions angle is that the cases are collectively indicative so one bolsters the next and so on. I just remember that LL asked

"Interestingly, at the end of this part of the interview she asked whether the police had access to the TPN bag that she had connected,".


its Notable to me but I’m not sure what to make of it. It’s kind of difficult to make sense of as I cant see why she would ask this if she hadnt requested for the bag to be checked as I think she said she did? It’s so long after the event she wouldn’t have had a reason to think they did. She would have known of any police involvement or suspicion at the time and that would be a reason IMO

it’s kind of incriminating if she didn’t believe she had requested the check.
None of us are seeing everything that the jurors are seeing and hearing each day. The prosecution has been working diligently for many years already, putting together their case, hiring their experts, and witnesses.

I am pretty sure that there has been some evidence put forward in court that is [allegedly] very damning. We have heard snippets of it so far. The medical reports which describe how the various babies had unexplained sudden collapses are very revealing. Especially the ones which describe extreme changes in the babies blood sugars, for no apparent reason. The only medical explanation would be an insulin injection. Circumstances seem to indicate that someone secretly injected them with insulin and in some instances, with air into their lines. The main question remaining is who did these secret attacks.

I think the prosecution has set forth some important data explaining how and when it must have happened [allegedly]. If you look at the entire big picture/timeline, it seems obvious how they came to the conclusion it must have been [allegedly] the defendant.

The case would not have moved forward if there was no evidence to show this, IMO. They wouldn't just pull a name out of their hats. They used a tremendous amount of data to come to this conclusion: medical records, staff interviews, patient interviews, cctv, phone records, family interviews, etc. So although we in the general public may feel there has been nothing conclusive offered, I believe there has been evidence submitted that we aren't privy to yet. JMO
 
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I’m wondering because it’s still a thing of frustration that nobody has seen anything and there doesn’t seem to be evidence of anything conclusive of LL guilt or innocence. It seems to me that the strongest evidence the prosecution have is the cases of insulin poisoning. It’s seemingly without a doubt that insulin has been present in the body of the babies when it shouldn’t have been. I’m just speculating as I think the prosecutions angle is that the cases are collectively indicative so one bolsters the next and so on. I just remember that LL asked

"Interestingly, at the end of this part of the interview she asked whether the police had access to the TPN bag that she had connected,".


its Notable to me but I’m not sure what to make of it. It’s kind of difficult to make sense of as I cant see why she would ask this if she hadnt requested for the bag to be checked as I think she said she did? It’s so long after the event she wouldn’t have had a reason to think they did. She would have known of any police involvement or suspicion at the time and that would be a reason IMO

it’s kind of incriminating if she didn’t believe she had requested the check.
The interesting part is that she made the association with the TPN bag, imo. If she was told child F had been given insulin he shouldn't have had it could have been administered another way.

The TPN bag isn't the bag that she later claimed she had asked to be checked, that's what she said about child A's fluids.
 
I’m wondering because it’s still a thing of frustration that nobody has seen anything and there doesn’t seem to be evidence of anything conclusive of LL guilt or innocence. It seems to me that the strongest evidence the prosecution have is the cases of insulin poisoning. It’s seemingly without a doubt that insulin has been present in the body of the babies when it shouldn’t have been. I’m just speculating as I think the prosecutions angle is that the cases are collectively indicative so one bolsters the next and so on. I just remember that LL asked

"Interestingly, at the end of this part of the interview she asked whether the police had access to the TPN bag that she had connected,".


its Notable to me but I’m not sure what to make of it. It’s kind of difficult to make sense of as I cant see why she would ask this if she hadnt requested for the bag to be checked as I think she said she did? It’s so long after the event she wouldn’t have had a reason to think they did. She would have known of any police involvement or suspicion at the time and that would be a reason IMO

it’s kind of incriminating if she didn’t believe she had requested the check.


Aswell as the insulin I feel its a given that someone overfed the baby that projectile vomits across to the floor and chair as following the vomit there was still as much milk left in the stomach as was given by the nurse looking after them.

With the air embolism it's the sudden collapse, skin changes that come and go and the air seen on X Ray's

I agree though I think the number of cases do bolster the case collectively
 
None of us are seeing everything that the jurors are seeing and hearing each day. The prosecution has been working diligently for many years already, putting together their case, hiring their experts, and witnesses.

I am pretty sure that there has been some evidence put forward in court that is [allegedly] very damning. We have heard snippets of it so far. The medical reports which describe how the various babies had unexplained sudden collapses are very revealing. Especially the ones which describe extreme changes in the babies blood sugars, for no apparent reason. The only medical explanation would be an insulin injection. Circumstances seem to indicate that someone secretly injected them with insulin and in some instances, with air into their lines. The main question remaining is who did these secret attacks.

I think the prosecution has set forth some important data explaining how and when it must have happened [allegedly]. If you look at the entire big picture/timeline, it seems obvious how they came to the conclusion it must have been [allegedly] the defendant.

The case would not have moved forward if there was no evidence to show this, IMO. They wouldn't just pull a name out of their hats. They used a tremendous amount of data to come to this conclusion: medical records, staff interviews, patient interviews, cctv, phone records, family interviews, etc. So although we in the general public may feel there has been nothing conclusive offered, I believe there has been evidence submitted that we aren't privy to yet. JMO

what do you think is that “very damning evidence“? I was just thinking of mr Myers saying the “foundation“ evidence is nearly all medical and “he said there was no evidence of her doing harm to any children”


he wouldn’t say that without a reason I think The same I presume as the prosecution wouldn’t build there argument around implausible events.
The interesting part is that she made the association with the TPN bag, imo. If she was told child F had been given insulin he shouldn't have had it could have been administered another way.

The TPN bag isn't the bag that she later claimed she had asked to be checked, that's what she said about child A's fluids.


That got me thinking, apparently the only two routes of insulin application is intravenously or via injection and the evidence really does point to it being in the tpn bag. I’m just wondering if it’s common knowledge in neonatal nursing that there is only two routes of insulin admin.

“Professor Hindmarsh says it is not possible to give insulin by mouth as it is a large molecule, so cannot be absorbed easily and the protein would be broken down by the acid in the stomach. It could not have been administered via the naso-gastric tube for the same reason.”


can’t be transdermal as the molecule is too large to be absorbed by the skin according to what I have read. I thought on the off chance some insulin may have gotten onto the clothes or something else in contact with the babies that caused the fluctuations in blood glucose but apparently not If a babies pores are as similar in function to an adult on which the permeability of insulin on skin is currently thought to be.

“A challenge for transdermal insulin delivery is the inefficient passive insulin absorption through the skin due to the large molecular weight of the protein drug.”


I know it’s unlikely but worthy of consideration IMO. Would fit with a hospital that’s chaotic In a uncontrolled way.

i cant find anything that would suggest a neonatal nurse would know there are only two routes of insulin administration. Most of it as in guidelines of management seems to be in treatment but not in feasibility of methods of application.

im just noticing in my humble opinion that it is a pretty blatant method of causing harm if it was as alleged. Not so inconspicuous as intravenous air embolism. I do think the air into the stomach is pretty blatant as well as aspiration of the ngt tube is routine apparently. I also think just by looking at how often med notes on “aspiration“ feature in the cases that people would notice the excessive air present.

“Dr Bohin says babies on CPAP can have CPAP belly, and in order to minimise that, they would aspirate the NGT. "It is usual practice to note down the volumes”


I also believe it’s normal for the stomach To be decompressed in resuscitation which LL would presumably know. Although i can’t find anything to support this.
 
Aswell as the insulin I feel its a given that someone overfed the baby that projectile vomits across to the floor and chair as following the vomit there was still as much milk left in the stomach as was given by the nurse looking after them.

With the air embolism it's the sudden collapse, skin changes that come and go and the air seen on X Ray's

I agree though I think the number of cases do bolster the case collectively

definitely. The fact the baby projectile vomited to the degree noticed, to me is shocking. I’m just wondering though if that could be accidental. Would it be possible to feed as normal but not make a note of it and then someone else comes along and feeds the same, in effect delivering twice the normal feed?

I think I remember dr evans saying the “air embolus” was a “strong diagnosis“ but not sure and cant find the quote. The seemingly drastic nature of sudden collapses being so consistent across the cases is remarkable. I don’t see how a stable Baby with no fluctuations in vital signs so long as properly checked would suddenly just collapse like that.
 
definitely. The fact the baby projectile vomited to the degree noticed, to me is shocking. I’m just wondering though if that could be accidental. Would it be possible to feed as normal but not make a note of it and then someone else comes along and feeds the same, in effect delivering twice the normal feed?

I think I remember dr evans saying the “air embolus” was a “strong diagnosis“ but not sure and cant find the quote. The seemingly drastic nature of sudden collapses being so consistent across the cases is remarkable. I don’t see how a stable Baby with no fluctuations in vital signs so long as properly checked would suddenly just collapse like that.
The overfeeding couldn't be accidental.

Firstly, as with all feeds, LL would have recorded the second feed on the feeding chart. The first feed was recorded on the chart by the designated nurse before she went on her break.

Secondly and more importantly, milk is fed through the nasogastric tube by gravity. Baby G's stomach was full after her feed, so another syringe full of milk would not have drained down. The expert said the milk and air must have been forced through the tube with a plunger.
 
what do you think is that “very damning evidence“? I was just thinking of mr Myers saying the “foundation“ evidence is nearly all medical and “he said there was no evidence of her doing harm to any children”


he wouldn’t say that without a reason I think The same I presume as the prosecution wouldn’t build there argument around implausible events.
If you go back to what the defence said:

"The 'foundation' of the case is medical evidence.He told the court: 'What the case will come down to is the medical evidence and what it can safely prove and what it can't and what we can safely conclude.'...He said there are five key issues in the medical evidence: the birth condition of the baby, whether there were any problems in the health or care of the child, whether the evidence proves deliberate harm was done, whether Letby was present at the relevant time, and whether there were failings in care by other people or the unit as a whole."

1. The birth condition of the baby, +2. Whether there were any problems in the health or care of the child:
IMO the medical experts have explained well that although the babies were premature and had various issues associated with that, they were on the whole, doing well and/or were stable despite those issues... until the sudden deteriorations. They've also explained why they've eliminated other possible causes such as infection.
3. Whether the evidence proves deliberate harm was done:
IMO the medical experts have also put forward a strong case that deliberate harm was done with both air embolus and insulin posioning.
4. Whether LL was present at the relevant time
IMO We know from the chart the prosecution referred to, that LL was the only member of staff present at every single relevant time.
5. Whether there were failings in care by other people or the unit as a whole
IMO so far I haven't heard the medical experts confirm that any failings in care could be the cause of the deaths or collapses. In fact where they have noted possible failings such as a delay in giving Baby A fluids, they've said that the delay would not have caused the death

Obviously we only get to hear a summary of the evidence as we're not in court and we are yet to hear all the cases and yet to hear more from the defence, but that's my takeaway so far.

 
That got me thinking, apparently the only two routes of insulin application is intravenously or via injection and the evidence really does point to it being in the tpn bag. I’m just wondering if it’s common knowledge in neonatal nursing that there is only two routes of insulin admin.

“Professor Hindmarsh says it is not possible to give insulin by mouth as it is a large molecule, so cannot be absorbed easily and the protein would be broken down by the acid in the stomach. It could not have been administered via the naso-gastric tube for the same reason.”


can’t be transdermal as the molecule is too large to be absorbed by the skin according to what I have read. I thought on the off chance some insulin may have gotten onto the clothes or something else in contact with the babies that caused the fluctuations in blood glucose but apparently not If a babies pores are as similar in function to an adult on which the permeability of insulin on skin is currently thought to be.

“A challenge for transdermal insulin delivery is the inefficient passive insulin absorption through the skin due to the large molecular weight of the protein drug.”


I know it’s unlikely but worthy of consideration IMO. Would fit with a hospital that’s chaotic In a uncontrolled way.

i cant find anything that would suggest a neonatal nurse would know there are only two routes of insulin administration. Most of it as in guidelines of management seems to be in treatment but not in feasibility of methods of application.
No need to do your own research outside of trial material. Professor Hindmarsh gave evidence about the different methods of administering insulin. The evidence points to it being in the TPN bag but it is never administered that way, (showing this was most definitely foul play), and it took an expert's analysis of the readings over the whole day to determine that this was the way it was administered. LL is not an expert, she would have known how to give insulin via legitimate applications and she would not have known how to interpret the data with a specific method of application, IMO. Even the doctors at the hospital who handled the results didn't suspect anyone tampered with the TPN bags or they would have no doubt called the police in at that stage. Intravenously just means run through the IV line, it doesn't mean via the TPN feed.

Yet LL asked police if they had the TPN bag.


"Professor Hindmarsh says it is not possible to give insulin by mouth as it is a large molecule, so cannot be absorbed easily and the protein would be broken down by the acid in the stomach. It could not have been administered via the naso-gastric tube for the same reason.
The only ways would have been through a skin injection or intraveneously, he says.
For a skin injection, he says the duration of action [for the insulin] of 4-6 hours would not fit with the 17 hours of hypoglaycaemia. It would require multiple injections.
He says an intravenous route "would be the most likely explanation".
The way to do so would be a bolus of insulin - from testing in endrocrinology, the blood sugar level would fall within 90 minutes, then rise back to normal.
To maintain hypoglycaemia "over a protracted period of time" would require multiple insulin boluses "roughly every two hours".
The second route would be via infusion - "probably the most likely way of achieving the blood glucose effect that we have observed".
The infusion would be "continuous", using the bags available, and "fit nicely" with the time course of events.
It would "also be consistent" with the measurements that took place during and after the TPN bag was replaced."

Recap: Lucy Letby trial, Friday, November 25
 
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what do you think is that “very damning evidence“? I was just thinking of mr Myers saying the “foundation“ evidence is nearly all medical and “he said there was no evidence of her doing harm to any children”


he wouldn’t say that without a reason I think The same I presume as the prosecution wouldn’t build there argument around implausible events.

[snipped for focus]

In my experience, any and every defense attorney is going to say " there was no evidence of her doing harm to any children”

That is an automatic, default statement by any good defence attorney. [My Dad and brother were both long time, dedicated defense attorneys and I worked for them for a few years. ]

As to your question, about what I think is very damning evidence---I think we have heard some of it already and there is more to come. I think it has been shown with diligence, that these babies were attacked by someone, who used various harsh methods of forcing them to suddenly collapse.

That seems to have been proven with damning evidence. The main question is 'WHO was the attacker'? They have not set forth all their evidence pertaining to this, but they did set forth the opening arguments, where they showed data about which nurses where were and when, surrounding the incidents. It seems revealing, imho.

And when the administrators began to be suspicious, they moved the defendant around, and changed her shift times, etc, and the inexplicable collapses seemed to follow her, if I understand the data correctly. And they stopped happening when she was taken off the floor. That could be seen as damning evidence in itself. JMO
 
The prosecution's expert opinion is that baby A was injected with air a minute or two before he collapsed.

The prosecution prepared a 7-page document showing all the babies in the unit and where staff were engaged at that time.

In room 1 there were three babies, including the twins A & B.

At the time baby A collapsed, nurse Caroline Bennion was tending to baby B, Dr Harkness was doing a sterilised procedure requiring concentration on the third baby, and nurse Melanie Taylor had been on the computer writing up her notes from the day shift for babies A & B for roughly 10 minutes. She testified that LL was standing by baby A’s incubator while she was on the computer.
 
The prosecution's expert opinion is that baby A was injected with air a minute or two before he collapsed.

The prosecution prepared a 7-page document showing all the babies in the unit and where staff were engaged at that time.

In room 1 there were three babies, including the twins A & B.

At the time baby A collapsed, nurse Caroline Bennion was tending to baby B, Dr Harkness was doing a sterilised procedure requiring concentration on the third baby, and nurse Melanie Taylor had been on the computer writing up her notes from the day shift for babies A & B for roughly 10 minutes. She testified that LL was standing by baby A’s incubator while she was on the computer.

So, names aside, IMO what the prosecution are basically saying is that there were four members of staff who had the opportunity to inject baby A with air in the short time before his collpase. Of the four:
  • One was writing up notes at the compiuter
  • One was looking after Baby B
  • One was performing a procedure on a 3rd baby
  • One was standing by Baby A's incubator.

And the member of staff that was standing by Baby A's incubator was also the person :
  • Who was present at the relevant time for every single other attempted murder or murder charge.
  • Who had medical notes for some of the babies at their home.
  • Whose move from night shift to day shift, coincided with the collapses moving from night shift to day shift.
  • Whose move to clerical duties coincided with the suspicious collapses and deaths stopping completely.
IMO
 
I was going back to reads about the opening days of the trial, both prosecution and defense---and saw an interesting snippet:

Oct 13th
2:34am

The judge has arrived in court. Proseuctor Nicholas Johnson KC will resume the prosecution case outline shortly.
Firstly, discussions on the use of iPads that the jury will use are taking place.

The iPads will not have internet access, and have bespoke passwords for each juror, and will only store the evidence in the case for them to access.


I thought that ^^^ was good to see that each juror has an iPad full of case evidence to go through.
 
I wanted to look at the final babies that she was accused of harming, to see what happened, right before they took her off their floor for good.
Babies O, P, and Q.

The prosecution also told of Child O, one of three triplet brothers, who was allegedly murdered.

Child O weighed 2.02kgs, which was good for a premature triplet. He was in good condition and made good progress.

He was stable up to June 23, when he suffered what medical expert Dr Dewi Evans said was a “remarkable deterioration” and died.
7:16am

Child O - murder allegation

Child O and Child P were two of three triplet brothers, the court hears.

Child O weighed 2.02kgs, which was good for a premature triplet. He was in good condition and made good progress.

He was stable up to June 23, when he suffered what Dr Evans said was a “remarkable deterioration” and died.

Between June 15 and June 23, Lucy Letby had been on holiday in Ibiza.

Child O's body was examined after his death and an injury to his liver was found.

Letby was working the day shift on June 23 and was the designated nurse for Child O and P, in room 2, with another child.

The prosecution say this "gave her an open opportunity to sabotage the babies".
The third of the triplets was in room 1, the doctors believing he was the most needy of the triplets.

Letby also had the responsibility of supervising a student nurse that day.

The designated nurse recorded 'no nursing concern - observations normal' for Child O.

There are three records of feeds by Letby, at 8.30am, 10.30am, and 12.30pm - the earliest signed by the student nurse, the latter two signed by etby.

In a note made by the doctor at 1.15pm, there was '1x vomit post feed' with 'abdomen distended'.

Child O was put on to IV fluids as a precaution.

Child O's heart rate was 160-170, blood gases were low, and raised CO2 level.

The doctor recorded the results as 'not normal' for a child breathing on their own and treated for suspected 'NEC'.

It was thought down to Child O's swallowing of air or the passing of a stool earlier.

An x-ray taken at the time showed a moderate amount of gas in the bowel loops throughout the abdomen

Letby noted at 8.35pm - 'reviewed by registrar at 1.15pm - [Child O] had vomited (undigested milk) tachycardic and abdomen distended. NG tube placed on free drainage … 10ml/kg saline bolus given as prescribed along with antibiotics. Placed nil by mouth and abdominal x ray performed. Observations returned to normal”.

Prior to Child O's collapse, a colleague said of Child O: "“he doesn’t look as well now as he did earlier. Do you think we should move him back to [room] 1 to be safe?"

Letby did not agree.[she was designated to be in room 2 at the time]

The prosecution say this echoes the final, fatal collapse of Child I.

Letby had taken Child O's observations at 2.30pm as 100% oxygen saturations and normal breathing rates.

From her phone, she was on Facebook Messenger at the time, and at 2.39pm, the door entry system recorded her coming into the neonatal unit.

Within a few minutes of that, Child O suffered his first collapse.

Letby called for help, having been alone with Child O in room 2 at the time.

Child O's heart rate and saturations had dropped to dangerously low levels. A breathing tube was inserted by the medical staff and he was successfully resuscitated. He was kept on a ventilator.

At 3.49pm, Child O desaturated again. doctors removed the ET and replaced it "as a precaution". Letby's written notes suggest she was the one who called for help.

Child O suffered a further collapse at 4.15pm which required CPR. Those efforts were unsuccessful and Child O died soon after treatment was withdrawn at 5.47pm.

A consultant doctor noted Child O had an area of discoloured skin on the right side of his chest wall which was purpuric.

He noted a rash at 4.30pm, which had gone by 5.15pm, and did not consider it purpura, but unusre what it was or what had caused it.

The doctor was particularly concerned about Child O's death as he was clinically stable before these events, his collapse was so sudden and he did not respond to resuscitation as he should have.

After the shift, Letby sent a series of messages to the doctor on Facebook, and to her colleague. She suggested Child O "had a big tummy overnight but just ballooned after lunch and went from there."

A post-mortem examination found free un-clotted blood in the peritoneal (abdominal)space from a liver injury. There was damage in multiple locations on and in the liver. The blood was found in the peritoneal cavity. He certified death on the basis of natural causes and intra-abdominal bleeding.

He observed that the cause of this bleeding could have been asphyxia, trauma or vigorous resuscitation.

The prosecution say no-one would have thought a nurse would have assaulted a child in the neonatal unit.

Dr Dewi Evans concluded Child O's death was the result of a combination of intravenous air embolus and trauma. The liver injury was not in his view consistent with vigorous CPR. His view was that the liver damage would have occurred before the collapse and contributed to it and was probably the reason for his symptoms through the morning. As for the air in the bowel loops, Dr Evans concluded that that was consistent with excessive air going down via the NGT.

Dr Bohin concluded concluded that together with the chest wall discolouration seen by the doctor that was indicative of air having been injected into Child O's circulation. She agreed that the abdominal distension was due to excess gas via the NGT.


Dr Andreas Marnerides, the reviewing pathologist, thought that the liver injuries were most likely the result of impact type trauma and not the result of CPR.

He thought that the excess air via the NGT was likely to have led to stimulation of the vagal nerve which has an effect on heart rate and would have compromised Child O's breathing.

He could not say whether it was either of these factors in isolation or in combination which caused Child O's death.

He certified the cause of death to be “Inflicted traumatic injury to the liver and profound gastric and intestinal distension following acute excessive injection or infusion of air via a naso-gastric tube” and air embolus.

In police interview, Letby said she had responded to child O's alarm at 1.15pm and found he had vomited.

She responded first at 2.40pm and discovered mottling all over with purple blotches and red rash. She said that his abdomen just kept swelling and suggested thatsometimes babies can gulp air when they are receiving assistance from Optiflow, as Child O was.

A year later, on the anniversary of Child O's death, Letby carried out a search on Facebook on the surname of the child.



SO THIS^^^ WAS THE DEATH OF CHILD O, WHO WAS A TRIPLET. HIS BROTHER, P, WAS MURDERED THE NEXT DAY.


2:38am

Child P - murder allegation
The prosecution allege Child P was murdered the following day from brother Child O.
 
what do you think is that “very damning evidence“? I was just thinking of mr Myers saying the “foundation“ evidence is nearly all medical and “he said there was no evidence of her doing harm to any children”


he wouldn’t say that without a reason I think The same I presume as the prosecution wouldn’t build there argument around implausible events.
<respectfully snipped>

I won't reply as regards an opinion about the accused, because that isn't permissible, but I will state what I think is particularly damning evidence of murder and attempted murder.

It is the rarity of everything - the rarity of air embolisms, the rarity of unexplained gas in the great vessels, the rarity of the appearing and disappearing florid discolouration that doctors and nurses with many combined years of experience had never seen before, and the rarity of babies with stable observations, normal heart-rate and conditions since birth responding positively to treatments, suddenly not breathing and not responding to resuscitation - which makes no sense in a cluster.

In my opinion, it's futile for the defence to suggest that a cluster of babies not in declining health suddenly stopped breathing and presented with the hallmarks of air embolisms, but each had a different causation.

In the case of baby A, a "pink", "stable" baby with normal heart-rate, receiving dextrose fluids, the defence say he suddenly stopped breathing and died within 30 minutes because of 'lack of fluids or because either his UVC or his long line had the potential to interfere with his heart-rate'. He'd been x-rayed an hour earlier and his lines were in a safe position. The medical experts said his heart-rate was normal and there is no way a few hours without fluids would have killed him.

Why would the defence not accept he, or the other babies, died because of air embolisms?

Why would the defence not accept that baby G was over-fed by force-feeding?

I would suggest that other than the question of timing and opportunity, it is because this sudden cluster of cases cannot be explained by accidental administration, inexperience, or equipment malfunction. The defence's denial of air embolisms in the face of many medical expert witnesses covering the fields of neonatology, radiology and haematology, speaks to the prosecution's identification of one common denominator, IMO. I would say the insulin poisoning of baby F cannot be viewed in isolation, because it happened less than 24 hours after the sudden, unexpected, and allegedly unnatural, death of his twin, baby E.

MOO
 
I was going back to reads about the opening days of the trial, both prosecution and defense---and saw an interesting snippet:

Oct 13th
2:34am

The judge has arrived in court. Proseuctor Nicholas Johnson KC will resume the prosecution case outline shortly.
Firstly, discussions on the use of iPads that the jury will use are taking place.

The iPads will not have internet access, and have bespoke passwords for each juror, and will only store the evidence in the case for them to access.


I thought that ^^^ was good to see that each juror has an iPad full of case evidence to go through.
Yes, I think they've saved a few forests in this trial.
 
I wanted to look at the final babies that she was accused of harming, to see what happened, right before they took her off their floor for good.
Babies O, P, and Q.

The prosecution also told of Child O, one of three triplet brothers, who was allegedly murdered.

Child O weighed 2.02kgs, which was good for a premature triplet. He was in good condition and made good progress.

He was stable up to June 23, when he suffered what medical expert Dr Dewi Evans said was a “remarkable deterioration” and died.
7:16am

Child O - murder allegation

Child O and Child P were two of three triplet brothers, the court hears.

Child O weighed 2.02kgs, which was good for a premature triplet. He was in good condition and made good progress.

He was stable up to June 23, when he suffered what Dr Evans said was a “remarkable deterioration” and died.

Between June 15 and June 23, Lucy Letby had been on holiday in Ibiza.

Child O's body was examined after his death and an injury to his liver was found.

Letby was working the day shift on June 23 and was the designated nurse for Child O and P, in room 2, with another child.

The prosecution say this "gave her an open opportunity to sabotage the babies".
The third of the triplets was in room 1, the doctors believing he was the most needy of the triplets.

Letby also had the responsibility of supervising a student nurse that day.

The designated nurse recorded 'no nursing concern - observations normal' for Child O.

There are three records of feeds by Letby, at 8.30am, 10.30am, and 12.30pm - the earliest signed by the student nurse, the latter two signed by etby.

In a note made by the doctor at 1.15pm, there was '1x vomit post feed' with 'abdomen distended'.

Child O was put on to IV fluids as a precaution.

Child O's heart rate was 160-170, blood gases were low, and raised CO2 level.

The doctor recorded the results as 'not normal' for a child breathing on their own and treated for suspected 'NEC'.

It was thought down to Child O's swallowing of air or the passing of a stool earlier.

An x-ray taken at the time showed a moderate amount of gas in the bowel loops throughout the abdomen

Letby noted at 8.35pm - 'reviewed by registrar at 1.15pm - [Child O] had vomited (undigested milk) tachycardic and abdomen distended. NG tube placed on free drainage … 10ml/kg saline bolus given as prescribed along with antibiotics. Placed nil by mouth and abdominal x ray performed. Observations returned to normal”.

Prior to Child O's collapse, a colleague said of Child O: "“he doesn’t look as well now as he did earlier. Do you think we should move him back to [room] 1 to be safe?"

Letby did not agree.[she was designated to be in room 2 at the time]

The prosecution say this echoes the final, fatal collapse of Child I.

Letby had taken Child O's observations at 2.30pm as 100% oxygen saturations and normal breathing rates.

From her phone, she was on Facebook Messenger at the time, and at 2.39pm, the door entry system recorded her coming into the neonatal unit.

Within a few minutes of that, Child O suffered his first collapse.

Letby called for help, having been alone with Child O in room 2 at the time.

Child O's heart rate and saturations had dropped to dangerously low levels. A breathing tube was inserted by the medical staff and he was successfully resuscitated. He was kept on a ventilator.

At 3.49pm, Child O desaturated again. doctors removed the ET and replaced it "as a precaution". Letby's written notes suggest she was the one who called for help.

Child O suffered a further collapse at 4.15pm which required CPR. Those efforts were unsuccessful and Child O died soon after treatment was withdrawn at 5.47pm.

A consultant doctor noted Child O had an area of discoloured skin on the right side of his chest wall which was purpuric.

He noted a rash at 4.30pm, which had gone by 5.15pm, and did not consider it purpura, but unusre what it was or what had caused it.

The doctor was particularly concerned about Child O's death as he was clinically stable before these events, his collapse was so sudden and he did not respond to resuscitation as he should have.

After the shift, Letby sent a series of messages to the doctor on Facebook, and to her colleague. She suggested Child O "had a big tummy overnight but just ballooned after lunch and went from there."

A post-mortem examination found free un-clotted blood in the peritoneal (abdominal)space from a liver injury. There was damage in multiple locations on and in the liver. The blood was found in the peritoneal cavity. He certified death on the basis of natural causes and intra-abdominal bleeding.

He observed that the cause of this bleeding could have been asphyxia, trauma or vigorous resuscitation.

The prosecution say no-one would have thought a nurse would have assaulted a child in the neonatal unit.

Dr Dewi Evans concluded Child O's death was the result of a combination of intravenous air embolus and trauma. The liver injury was not in his view consistent with vigorous CPR. His view was that the liver damage would have occurred before the collapse and contributed to it and was probably the reason for his symptoms through the morning. As for the air in the bowel loops, Dr Evans concluded that that was consistent with excessive air going down via the NGT.

Dr Bohin concluded concluded that together with the chest wall discolouration seen by the doctor that was indicative of air having been injected into Child O's circulation. She agreed that the abdominal distension was due to excess gas via the NGT.


Dr Andreas Marnerides, the reviewing pathologist, thought that the liver injuries were most likely the result of impact type trauma and not the result of CPR.

He thought that the excess air via the NGT was likely to have led to stimulation of the vagal nerve which has an effect on heart rate and would have compromised Child O's breathing.

He could not say whether it was either of these factors in isolation or in combination which caused Child O's death.

He certified the cause of death to be “Inflicted traumatic injury to the liver and profound gastric and intestinal distension following acute excessive injection or infusion of air via a naso-gastric tube” and air embolus.

In police interview, Letby said she had responded to child O's alarm at 1.15pm and found he had vomited.

She responded first at 2.40pm and discovered mottling all over with purple blotches and red rash. She said that his abdomen just kept swelling and suggested thatsometimes babies can gulp air when they are receiving assistance from Optiflow, as Child O was.

A year later, on the anniversary of Child O's death, Letby carried out a search on Facebook on the surname of the child.



SO THIS^^^ WAS THE DEATH OF CHILD O, WHO WAS A TRIPLET. HIS BROTHER, P, WAS MURDERED THE NEXT DAY.


2:38am

Child P - murder allegation
The prosecution allege Child P was murdered the following day from brother Child O.

Here is a quick summary of the above long post:



Between June 15 and June 23, Lucy Letby had been on holiday in Ibiza.

on June 23rd, LL returns to work. [presumably no collapses or deaths in that week]

Child O weighed 2.02kgs, which was good for a premature triplet. He was in good condition and made good progress.

He was stable up to June 23, when he suffered what medical expert Dr Dewi Evans said was a “remarkable deterioration” and died.

Letby had fed him last @ 12:30 pm and signed off on that feeding.
In a note made by the doctor at 1.15pm, there was '1x vomit post feed' with 'abdomen distended'.

A colleague suggested that O be moved to room 1, and LL resisted that move and wanted him to stay with her in rm 2.

at 2.39pm, the door entry system recorded her coming into the neonatal unit.

Within a few minutes of that, Child O suffered his first collapse.

Letby called for help, having been alone with Child O in room 2 at the time.

A breathing tube was inserted by the medical staff and he was successfully resuscitated. He was kept on a ventilator.

Child O suffered a further collapse at 4.15pm which required CPR. Those efforts were unsuccessful and Child O died soon after treatment was withdrawn at 5.47pm.

A consultant doctor noted Child O had an area of discoloured skin on the right side of his chest wall which was purpuric.



SO THIS^^^ WAS THE DEATH OF CHILD O, WHO WAS A TRIPLET. HIS BROTHER, P, WAS MURDERED THE NEXT DAY, in a very similar fashion.

So two babies, both doing very well, considered healthy and doing well, for the week prior , both died unexpectedly and suddenly, the day LL returned from vacay.
 
Here is a quick summary of the above long post:



Between June 15 and June 23, Lucy Letby had been on holiday in Ibiza.

on June 23rd, LL returns to work. [presumably no collapses or deaths in that week]

Child O weighed 2.02kgs, which was good for a premature triplet. He was in good condition and made good progress.

He was stable up to June 23, when he suffered what medical expert Dr Dewi Evans said was a “remarkable deterioration” and died.

Letby had fed him last @ 12:30 pm and signed off on that feeding.
In a note made by the doctor at 1.15pm, there was '1x vomit post feed' with 'abdomen distended'.

A colleague suggested that O be moved to room 1, and LL resisted that move and wanted him to stay with her in rm 2.

at 2.39pm, the door entry system recorded her coming into the neonatal unit.

Within a few minutes of that, Child O suffered his first collapse.

Letby called for help, having been alone with Child O in room 2 at the time.

A breathing tube was inserted by the medical staff and he was successfully resuscitated. He was kept on a ventilator.

Child O suffered a further collapse at 4.15pm which required CPR. Those efforts were unsuccessful and Child O died soon after treatment was withdrawn at 5.47pm.

A consultant doctor noted Child O had an area of discoloured skin on the right side of his chest wall which was purpuric.



SO THIS^^^ WAS THE DEATH OF CHILD O, WHO WAS A TRIPLET. HIS BROTHER, P, WAS MURDERED THE NEXT DAY, in a very similar fashion.

So two babies, both doing very well, considered healthy and doing well, for the week prior , both died unexpectedly and suddenly, the day LL returned from vacay.
Also, I want to add to this:
So two babies, both doing very well, considered healthy and doing well, for the week prior , both died unexpectedly and suddenly, the day LL returned from vacay.

Not only that, but LL had already aroused suspicion, which is why she had been sent to day shifts instead of night.
So this was 16 victims and a full year later that this was allegedly happening.
 
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