Prosecution evidence, April 27th 2023, Day 87 - live updates LIVE: Lucy Letby trial, Thursday, April 27
Lucy Letby Police Interviews Cont.
10:30am
The courtroom in Manchester Crown Court has filled up with legal representatives, press and members of the public. Lucy Letby is, as has been the case throughout the trial, present.
The judge, Mr Justice James Goss, has now arrived.
10:36am
Members of the jury have now come into court.
There are, the judge tells the jury, "an unfortunate set of circumstances" which mean the next two weeks of the trial will only see the trial sitting for two days each.
Child Q
10:40am
The read through the interviews continues with Child Q.
Letby recalls the medical observations/procedures carried out at the neonatal unit.
She recalls that Mary Griffith was the other nurse in room 2, and there was a concern Child Q had a low temperature, but was 'well enough to be left'.
She recalls she had been in room 1, returned to room 2, and saw Child Q had had 'an intervention' and she recorded Child Q having a 'mottled' skin appearance.
10:44am
Letby said she believed she told Mary Griffith when she was leaving room 2. She recalls the other nurse was at the incubator.
She said she came back from room 1 and saw there was at least one nurse treating Child Q when she returned, and there was administration of Neopuff by the other staff.
She said she did not see Child Q vomit, but it would have been described to her.
Letby said she was unsure why Child Q would have vomited. She says sometimes babies do vomit and that can lead to a desaturation.
Letby tells police she does not recall if she aspirated Child Q.
When asked about the excess air aspirated from his stomach, she suggested babies sometimes gulp air when they vomit.
10:47am
Letby says she believes she continued to look after Child Q as her designated baby following the desaturation.
In a follow-up interview, Letby said she did not cause Child Q's collapse. She said she had taken observations and raised Child Q's incubator temperature.
She said Child Q was "stable" before she left room 2.
She denies being responsible for Child Q's collapse, or injecting air into Child Q.
10:52am
In a third police interview, Letby says she did not give Child Q anything prior to the collapse.
She denies leaving the room so the blame for the collapse could be put on another member of nursing staff.
Asked about a text message she sent to a doctor colleague about whether she should feel 'worried' about what Dr John Gibbs had been saying, Letby said: "I became aware of Dr Gibbs asking where I was - it was discussed then, obviously...I was concerned that I was going to be a problem"
Asked if she was seeing reassurance from the doctor she had messaged, Letby agrees.
She adds: "I wouldn't have just left a baby unattended," having said Mary Griffith was also in room 2.
Other Matters
11:02am
The interviews now move on to more general, 'overarching' questions including questions on exhibits found at Letby's address.
Letby was asked about a post-it note: "I just wrote it as everything had gone on top of me."
"I felt people were blaming my practice...and made me feel guilty...they made me stop talking to people.
"I was blaming myself, not for what I've done, but [for the way people were blaming me]."
Asked about the underlined 'not good enough' note, Letby replies that was what people felt she was in terms of her competence.
She says she did not know how to feel or what to do.
"It just felt like it was all happening out of my control."
Letby says she received some anti-depressants from her GP.
She said she had been told she may have to redo her clinical care 'competencies' as part of the process, and she would not be the only member of nursing staff to do so.
Letby said she had concerns over the raised mortality rate in the neonatal unit, saying there were more babies with more complex needs, and this was "unusual".
After being removed from the unit in July 2016, she believed other staff felt she was not competent, and "they were going to think I had done something wrong", "that the police would get involved and I would lose my job".
She added that she "loved her job".
Asked about why she thought the police would get involved, Letby replies: "I don't know, I just panicked."
She said she thought she would be referred to the NMC - [the Nursing and Midwifery Council] - and they would refer it to the police.
She said she felt 'so isolated and alone', as she could only speak to two friends, and had written a 'kill myself' note.
She said she believed she had not done anything wrong, but was worried they would believe she was not good enough.
11:16am
She said she believed the trust and consultants - Dr Ravi Jayaram and Dr Stephen Brearey - were blaming her in harming the babies.
She felt she had had a good working relationship with the two consultants.
She said: "They were trying to make it my problem, because I was there."
She said she did not have any issues with the two consultants, and had a professional relationship with them.
She had spoken to her 'best friend', a nursing colleague, about some of the issues, but not about the 'kill myself' feelings she had.
Letby said she had been banned from contacting anyone, and the redeployment to another unit in the hospital 'would have gone on her record'.
Letby said she had "lost everything", and had lost being part of a "good nursing team", who were "like a family".
She said the note was a way of getting her feelings on paper, and this note was written "all in one session".
Letby adds: "I didn't kill them on purpose."
She said she was worried: "Other people would perceive me as evil if I had missed anything".
"I felt so guilty that they [mum and dad] had to go through this."
Asked about the 'kill them on purpose' note, Letby replies: "I didn't kill them on purpose."
Letby said at the time she felt there may have been practices and competencies in clinical care which she may have missed, which led to the deaths of babies. She said, having reviewed her practices, she did not feel she had failed on the competencies.
She said she was the first member of her family to go to university, and her parents were disappointed she had been removed from the neonatal unit. She confirms she had told him.
She said she was "career focused" and was worried that the investigation would lead to her losing her job and "change what people would think of me".
Asked about the 'I AM EVIL I DID THIS' note: "That's how it all made me feel at the time...not intentionally, but I felt if my practice was not good enough, then it made me feel like an evil person..."
She adds she 'wouldn't deserve to have children' on the basis she had been redeployed to another unit.
She said the trust had redeployed her as they felt her competencies were an issue.
She said she felt, at the time, she had caused the disappointments. She asked 'Why me' on the note as she wondered why she was the only one to undergo the redeployment.
11:18am
Asked about 2016 as a whole, Letby said nursing staff morale fell during the year as the unit continued to have sick babies.
"We were seeing more babies with complex needs and chest strains...stomas...quite a few extreme prematurity babies with congenital defects...we had the twins and the triplets."
11:22am
Letby says a lot of staff were "feeling the strain, physically and emotionally", and staff were not offered enough support, and there were issues with equipment availability on the unit.
"I felt there wasn't a good management support structure...that was my personal opinion."
She said the unit was "quite bottom heavy" with a lot of new starters, plus staff on sick leave.
She says no staff intentionally gave poor care at the unit.
Letby says while equipment availability was an issue, it was not the cause of any initial collapses of the babies.
She said if staffing was "better" in terms of numbers, the care could have been better. Child Q was an instance, Letby says, where she was stretched between caring for babies in room 1 and 2.
She says for one of the babies, it was "quite chaotic" when resuscitating.
11:24am
Letby said she was made aware in May 2016, formally, of the higher mortality rate among babies, and that was when she was moved to day shifts.
She said she first noted it was unusual to have a high mortality rate on the unit in June 2015, when three babies died.
11:30am
Letby agrees she felt people's attitudes changed towards her when she was moved to day shifts in April 2016 and she felt she doubted her abilities.
Letby is asked if she had taken any paperwork home in relation to the babies, Letby denies she has taken papers home, then adds: "I don't know - I might have taken some handover sheets accidentally. Not medical notes.
"They [the handover sheets] might have been taken [home] in my pocket."
Asked about another of the notes, which has the word 'HATE' in a circle in bold letters, Letby said she had just been removed from the job she loved and she had been prevented from talking to people.
She said about the note: 'they thought I was doing it in purpose - not that I felt I did do it on purpose'.
She adds: "I am very hard on myself...I felt as though I wasn't good enough."
Police ask: "Lucy, were you responsible for the deaths of these babies?"
Letby: "No."
11:36am
In a third overarching interview, Letby is asked about the handover sheets.
She said, 'ideally', the handover sheets should be put in the confidential waste bin at the end of her shifts.
She said that at times, they would come home with her.
She is asked about 'a large quantity of handover sheets' at Letby's home address. She replies there was "no specific reason" why she had taken them home.
She said she would have been aware she still had the handover sheets when she got home, and put them in a folder in the spare room.
She said she "didn't know how to dispose of them" and no-one else had seen them.
She said she would have seen those handover sheets at home "hardly ever".
She said she did not have a shredder and those sheets were at home 'inadvertently'.
Other paperwork at home would have been policy sheets from different hospitals, in relation on how to care when a patient presents with various symptoms.
11:41am
Letby said she 'had just not done anything' about the handover sheets when she got home.
Asked about the mobile phone she used in 2015-2016, she said she would have used the phone at work, and not have let anyone else use it.
There was one nursing colleague she would have contacted often, Letby says, using Whatsapp, FB Messenger and text messages.
The messages would discuss patients, relaying information if they were unwell or had passed away.
She said she had a "support network" and it was "helpful to speak to a colleague" in relation to babies.
She added she would speak to her mum each day. She would not speak in as much detail if a baby had passed away to her, as she would to nursing colleagues, but would talk for support.
Letby says she had reassurance from a doctor colleague, and was "close to him in the later stages".
11:47am
Letby said after a diffiult day at work, she would 'seek reassurance', including a doctor colleague, and she would seek information about some debriefs when babies had died in which she had been involved in their care.
Letby says she had started working on a neonatal unit in January 2012. She continued her training across a range of skills over the following years.
In May 2015 there was a course for medicine administration via a bolus at the hospital, where - under supervision from a doctor - nurses would be able to administer medication via a long line.
She said it was "different", and a "lot more risk", and said she was "competent" having done that training.
11:49am
Letby confirms she attended resuscitation training for infants, a course which is done every four years.
She says there was no training she had failed, that she was aware of.
11:51am
Letby is asked about air embolism training. Letby says she did not have training for that, and was only aware of air embolisms in adults, after people had had a pulmonary embolism.
Asked if air embolisms had been an issue in the neonatal unit, Letby replies it had not.
11:58am
The final overarching interview saw Letby identify her personal diaries, and confirmed only she wrote and had access to those diaries.
Letby says she does not recall, in what way, why she had written the names of babies in her diary on particular dates.
She said: "I just internalise things and think about them in my own time."
She says she would have written them to note which babies she was looking after and how many babies she was the designated nurse for them.
Asked about the 'kill me' note, she said she 'hated' working in the office and had 'lost everything'.
She said, about on the of the notes, it had 'become a doodle thing', having started out as a note.
Asked why she had kept the 'doodle note', she replies she was "not sure". Although undated, the note being in the 2016 diary meant the note could have been written after Letby had been redeployed away from the neonatal unit in July 2016. Letby agrees that would be the case.
Cross-Examination
12:04pm
Benjamin Myers KC, for Letby's defence, is now asking Cheshire Police detective Danielle Stonier, who has read out the interviews, a few questions.
The detective confirms Letby and her legal representative, in advance of the interviews, would have received 'advanced disclosure', which would include a number of the documents police had, such as key nursing notes, feeding charts and observation charts "but not a detailed suite" of all the documents featured throughout the course of the trial.
As an example, Letby had provided details of a particular shift for one of the babies, having had sight of relevant nursing documents for that child.
12:13pm
Mr Myers asks about one day when Letby asked for the interview to stop as she was tired.
He says on that day, Letby had been asked about a large number of babies, in interviews spanning several hours.
12:30pm
A round-up piece from the first session in court:
Lucy Letby wrote note because ‘everything got on top of me’
amp.theguardian.com
