UK - Lucy Letby Trial - Media, Maps & Timeline *NO DISCUSSION*

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Defence Case Continued 15th May 2023

Child F continued

10:32am

The trial is now resuming.
Lucy Letby will continue to give evidence on the case of Child F.
She confirms that, in the 10 days since her last day of giving evidence, she has not spoken with her legal representatives.

10:36am

Benjamin Myers KC tells the court Child F had low blood glucose levels throughout the day on August 5, 2015, and had a blood test which, when analysed, showed Child F had returned a very high insulin measurement of 4,657 (extremely high) and a very low C-peptide level of less than 169.

10:38am

A chart is shown for Child F's blood glucose readings on August 5, which were 0.8 at 1.54am and remained low throughout the day, the highest being 2.9 at 5am but most readings were below 2.

10:43am

A neonatal parenteral nutrition prescription chart is shown to the court, which shows Lucy Letby signed for a lipid infusion on August 1, the infusion starting at 12.20am on August 2. Lucy Letby tells the court it lasted just under 24 hours, being taken down at 12.10am on August 3.
There was already a TPN bag (a nutrition bag) in place on August 2, the court hears, as shown by the chart. It was a "continuing 48-hour bag".
Midnight was "around the time" which fluids were changed.
Letby has signed for a TPN bag at August 3, with a co-signer. The new bag is, on the chart, beginning at 12.10am.
TPN bags last 48 hours, and lipid infusions last 24 hours.

10:49am

A further sheet is shown for August 3-4, 2015. The 'continuing 48-hour bag' is signed for, but is not a new TPN bag, the court is told.
That bag was discontinued at 12.25am on August 5.
The chart shows a crossed-out prescription for August 5 for a TPN bag, where there is no lipid infusion. Letby tells the court Child F had been on milk.
"Something changed" with those requirements and a second prescription was made for a TPN bag with lipids to be administered.
The new TPN bag was hung up at 12.25am on August 5.
The bag was the same, the lipids requirements had changed, which meant a new prescription was written up.
Two nurses were involved in hanging up the new TPN bag, the court hears. Letby is one of the two nurses who signed for it.
Two nurses - neither of them Letby - are involved in the new lipid infusion.

10:50am

Mr Myers asks if there is anything Letby did which accounted for Child F's drop in blood sugar at that point.
Letby: "No."

10:58am

A prescription chart is shown to the court, showing Child F received a 3ml, 10% dextrose bolus at 2.05am.
Child F's blood sugar had risen by 2.55am, the court hears.
Another 3ml, 10% dextrose bolus is given at 4.20am, and Child F's blood sugar level rose.
Mr Myers says Letby's night shift would have ended as usual.
A chart is shown for a new TPN bag and lipid infusion for Child F at noon on August 5, which Letby confirms would have been after her shift ended. The TPN bag was hung up and a new long line was inserted as it had been "tissuing".
Letby says if "tissuing" happens, it is "standard practice" to stop the administration, discard everything and start again with a new bag, as the TPN bag would have been sterile.

11:02am

Mr Myers says "even after that", Child F's blood sugar levels remained low throughout the day.
Mr Myers says this is not the same TPN bag Letby had hung up just after midnight. Letby confirms this.
Mr Myers asks why Letby searched for the mother of Child E and F nine times on Facebook between August 2015 and January 2016, and the father on one occasion.
Letby: "Searching people on Facebook is something I would do. Searching for [Child E and F's mum] would be when she was on my mind.
"...That is a normal pattern of behaviour for me."
Asked why Letby had taken a picture of a thank-you card written by the family of Child E and F, Letby replies: "It was something I wanted to remember - I quite often take photos of cards...I receive."

11:06am

Letby said she took a photo of the card at 3.40am one morning in the nursing station, while she was at work. She says there was "nothing unusual" about that.

Recap: Lucy Letby trial, Monday, May 15 - defence continues

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

Dan O'Donoghue

Ms Letby is continuing to give evidence from the witness box. Her defence lawyer Ben Myers KC is taking her back over each allegation. We're currently looking at Child F, Ms Letby's sixth alleged victim

The prosecution say Child F was injected with insulin by Ms Letby. The court has previously heard that shortly after the baby received intravenous nutrients on 4 August 2015, his heart rate surged and his blood sugars plummeted.

Blood samples showed an "extremely high" insulin level and a very low C-peptide level, which a medical expert said had "only one explanation", that being that the child "received insulin from some outside source". Child F eventually made a full recovery.

Mr Myers asks Ms Letby if there was 'anything you did or know of that accounts for (Child F's) drop in blood sugar', 'no' she responds

Ms Letby tells the court that she finished her shift at 8am on 5 August 2015. The TPN bag she hung with another nurse in the early hours was changed around 12:00 (by two other nurses). Asked if she knew why Child F's blood levels continued to remain low that day, she said 'no'

Mr Myers asks Ms Letby why she searched for Child F's mother on Facebook, she said she was 'on my mind' following Child E's death and Child F's collapse. She tells the court searching on social media for people is a 'normal pattern of behaviour for me'

Judith Moritz

Ben Myers KC says during the period of the allegations (June 2015 - June 2016) Lucy Letby made 2,381 Facebook searches, of which 10 were for the parents of baby F. Asked why she regularly searched for people online the nurse says "it was a normal pattern of behaviour for me"

 

[Tortoise]

Defence Case Continued 15th May 2023

Child G

11:06am

Mr Myers now turns to the case of Child G, a baby girl born on May 31, 2015 at 23 weeks + 6 days gestation, weighing 1lb 2oz at Arrowe Park.

The court hears Child G was cared for in the early part of her life at Arrowe Park, being transferred to the Countess on August 13.

11:10am

The events are on September 7, 2015, involving Child G projectile vomiting and having a desaturation. She was transferred to Arrowe Park between September 8-16, returning to the Countess.
Two projectile vomits, a self-resolving apnoea and a desaturation for Child G take place on September 21.
The second incident, a desaturation, also took place on September 21. Lucy Letby says she called for help in this incident. Child G's monitor was off.

11:11am

Letby says she recalls Child G at the time: "She stood out as a baby who had complex needs, and was a very premature baby.
"We all got to know [Child G] and her family quite well."
She says she would have cared for Child G "many times" during her time at the Countess of Chester Hospital.

11:15am

A shift rota for September 6-7 is shown. Lucy Letby was the designated nurse for a baby in room 1. Child G was in room 2, being looked after by another nurse.
Letby says she was in room 1 with colleague Ailsa Simpson shortly before Child G vomited.
"My memory is Ailsa and myself were sat at the nursing station - we had been there for a few minutes...we heard [Child G]'s monitor [alarm] going off, and heard a retching sound.
"We both immediately went in there and found [Child G] vomiting and struggling to breathe."
No-one else was in the nursery room, Letby tells the court.

11:17am

Nursing notes by the designated nurse for Child G, written retrospectively, are shown to the court.
They include 'Abdomen full but soft with no discolouration. Aspirates minimal, partial digested milk....short period of straining/uncomfortable at start of night when having cuddles with dad...Nurse L Letby taken over care following vomit/apnoeic episode at 0200'

11:19am

A feeding chart is shown for 45ml of breast milk at 2am, via the naso-gastric tube.
An acidity test showed 'pH 4' for Child G.
Mr Myers asks if the chart showed the stomach had been aspirated prior to the feed. Letby: "No."

11:22am

Lucy Letby's notes for 2am onwards: '[Child G] had large projectile milky vomit at 0215. Continued to vomit++. 45mls milk obtained from NG tube with air++. Abdomen noted to be distended and discoloured. Colour improved few minutes after aspirating tube, remained distended but soft...'
Letby says she has no memory of, and had not been asked to do the, caring for Child G prior to this incident.

11:29am

A nursing duties chart for the neonatal unit on September 7 is shown to the court.
Letby's first entries are recorded at 2am, carrying out observations and giving a feed for the room 1 designated baby, a process which would take "a matter of minutes", Letby tells the court. She says she was then with Ailsa Simpson for a few minutes.
The court hears, at 2am, Letby's nursing colleague had administered the feed for Child G, as recorded in her nursing note: 'Nurse L. Letby taken over care following vomit/apnoeic episode after 02.00 feed'.
At the time of the event, Child G was seen 'vomiting from her mouth and nose' and 'struggling to breathe'. Letby says she observed this on her arrival.
Child G's abdomen was 'quite firm and distended and red'.
Letby says room 2 would always have lighting on, as a high dependency unit needed to have lights on to be safe, to observe babies.
"We were both quite shocked...we could see vomit on the chair and on the floor - we were very shocked by that."
Letby adds that babies don't vomit like that and it wasn't something she had seen before.
A crash call was put out.

11:34am

Letby says the vomit on September 21 was a "forceful vomit", but not as significant as the one on September 7.
Letby tells the court Child G needed further breathing support and Child G was intubated later that morning.
Letby says she recalled Child G had further desaturations and required intubation, but the problems with oxygen saturation continued. Letby says she does not know why they continued.
She says she confirmed giving care to Child G. She improved after being reintubated.

11:55am

The trial is now resuming after a short break.
Mr Myers asks Letby about the September 21 events for Child G. The first is at about 10am, the second after 3.15pm.
For that day shift, the court is shown the rota, and Lucy Letby was the designated nurse for Child G that day in room 4, along with two other babies. Two of the three members of the management team were on an office-based day, the court hears.
Lucy Letby was also responsible for a fourth baby 'rooming in with parents', which was, the court hears, a baby staying in on-site accommodation with their parents as the family prepared to go home.
Letby said she would periodically be going to that accommodation to check things were ok and answer any questions parents may have.

12:07pm

Letby's notes for that day are shown to the court.
They include... 'at 1015 x2 large projectile milky vomits, brief self resolving apnoea and desaturation to 35% with colour loss. NG tube aspirated - 30mls undigested milk discarded. Abdomen distended, soft. Drs asked to review. Temperature remains low, tachycardiac >18bpm since vomit. Mum states that [Child G] does not appear as well as she did yesterday...'
The court is shown a feeding chart for Child G. A 40ml feed of expressed breast milk was given at 9.15am, signed by Letby.
After the feed, there were 'two projectile milky vomits', Letby noted. Child G also had a large bowel motion.
Letby says she would have tested the stomach pH level prior to a feed, but would not have aspirated the contents. She says that would not have been needed as Child G was a '40-week baby', and would be treated as a full-term baby by this stage.
Mr Myers asks if it would be known how much milk would be in a baby's stomach. Letby says she would not, as there would only be an aspiration to check for the pH levels.
This projectile vomit "did not leave the cot space", Letby tells the court. She says that would have amounted to 10mls.
Letby says she cannot be sure, but believes Child G's mother would have been present at the time. Letby says she, herself, would have been in the room but not at the cotside of Child G when the vomit happened, and would have been alerted to it by the monitor going off.
She says Child G stabilised after that. Letby said she asked if Child G could be seen 'sooner' than usual on the ward round, as room 4 would normally be the last to be seen.
Letby says there was no large-scale medical response to the incident.
Letby explains care was transferred to another nurse as it was identified Child G required a higher level of care, and Letby was already looking after three babies that day.

12:17pm

The court hears evidence about the second incident on September 21.
Letby says parents would be allowed and in the unit at about 3pm that day. Letby says for this incident, she remembers being 'conscious there were other parents' in the room.
Screens were put up as "normal practice" for privacy, as Child G was having cannulation following her event.
The note records: 'Numerous failed attempts then at cannulation. Finally inserted by Dr Gibbs. Without fluid for 6 hours, as [nil by mouth]. Blood sugars were stable throughout....further significant apnoea/brady/desat following cannulation requiring Neopuff and 100% oxygen. Help summoned...'
Letby says she discovered the desaturation, and called for help. She said Child G had been behind the screen for some time, and had been looking after her other designated babies. She says she was aware the cannulation process took some time, but was not present to see it taking place as it was behing the screens.
A long line chart is shown to the court, which noted the cannula was inserted at the 7th attempt.
Letby said she cannot recall why she went in, but saw behind the screen that she was alone. She was 'dusky and blue and not breathing'.
The monitor was "not on".
Letby says Child G was on the 'procedure trolley' - used for procedures such as cannulation. Letby says the baby should not have been left alone on the trolley like that.
She says she picked up Child G and put her back in her cot, applied Neopuff and called for help.
Letby says she did not know why the monitor was off.
The nurse colleague "froze" and got someone else to help. Another nurse, Caroline Bennion, came in.
Letby said she was "very concerned" about three issues - a baby being unattended on a procedure trolley, alone behind screens, and with a monitor switched off.
Letby said she raised those concerns with a nursing colleague, and was keen to file a 'Datix report'. The nursing colleague was less keen, Letby says, to raise the issue, as the procedure had been carried out by Dr Gibbs.
Letby said she "took assurances" the issues would have been dealt with as discussed.

12:24pm

Letby confirms she continued care for Child G after that day.

Recap: Lucy Letby trial, Monday, May 15 - defence continues

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

Defence Case Continued 15th May 2023

Child G

Dan O'Donoghue

We're now moving to Child G. She was born in May 2015 and was the most premature of all the babies and had a number of "septic" or "suspected septic" episodes in the weeks after her birth.

The court heard that in mid-August, she was transferred from Wirral's Arrowe Park Hospital and was "clinically stable" until 7 September, when she projectile vomited at about 02:00 BST.

Prosecutors have alleged that Ms Letby overfed Child G with milk through a nasogastric tube or injected air into the same tube and made two more attempts to kill her on 21 September.

Mr Myers asks Ms Letby if she remembers Child G. She says she does, she says Child G 'stood out' as she was a very premature baby born with 'complex needs'. She said she was the kind of baby they did 'not often care for at the Countess of Chester'

Ms Letby says she cared for Child G 'many times' during her lengthy stay at the hospital

Mr Myers is asking Ms Letby her recollection of Child G's first recorded projectile vomit in the early hours of 7 September 2015. She tells the court she recalls being sat at the nursing station, opposite nursery 2 with another nurse when they heard Child G's alarm sound.

She says the nurses also heard 'a loud retching noise'. She said both 'went very quickly into nursery 2' to check on Child G. They found her 'vomiting and struggling to breath'. Asked if there was anyone else with her, she said 'no'

Mr Myers asks Ms Letby if she recalls 'having any particular contact with Child G prior to the vomiting incident', she responds 'no'

Ms Letby said she and her colleague 'were both quite shocked' by the level of vomit. She described it as a 'forceful vomit' and said it wasn't something she had seen before

We're now looking at the further incidents with Child G on 21 September

Child G had a milky vomit on 21 and stabilised after that, she said there was no large-scale medical response to the incident. Ms Letby explains care was transferred to another nurse as she was already looking after three babies that day

Asked about the second incident on 21 September, Ms Letby recalled seeing Child G was 'dusky and blue and not breathing' and that her monitor was "not on".

Ms Letby said Child G was on a 'procedure trolley' - used for procedures such as cannulation. She says the baby should not have been left alone on the trolley like that. When she discovered this she called for help

Ms Letby says the way Child G was left was 'not good practice at all', she said she was 'very concerned' by the fact she'd been left alone, on a procedure trolley with her monitor off. She raised her concerns with senior nurses

She said she wanted to submit an incident report on DATIX, but there was reluctance on behalf of colleagues to do this as the person responsible was a consultant - Dr John Gibbs

The court has previously heard, from a nursing colleague, that Dr Gibbs was told about this at the time and apologised - in the witness box Dr Gibbs said he could not remember the incident, but accepted the nurse's evidence

Judith Moritz

Lucy Letby is now being asked about baby G, a girl, who she denies attempting to murder on three occasions.

Nurse Letby denies being with baby G before the baby became suddenly ill on the first occasion. She says she and another nurse ran to her when they heard retching and we were both very shocked. "Neither of us had ever seen a baby projectile vomit like that out of the cot before"

Lucy Letby says on the occasion of the 3rd allegation she found baby G unsupervised on a trolley, behind a screen, with her monitor off, and all of this worried her. Says she put her back in her cot and called for help. Denies attempting to murder baby G.

 

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Defence Case Continued 15th May 2023

Child H

12:24pm

The case now moves to Child H, a baby girl born on September 22, 2015, weighing 2.33kg.

The court hears Child H did not receive surfactant [a protein which helps the lungs] until 41 hours after her birth.

Child H required three chest drains, and had a number of desaturations in her first few days.

At 3.22am on September 26, Child H had a profound desaturation to 30%. The following morning, Child H had another desaturation to the 40s at 12.55am on September 27.

Letby tells the court she remembers Child H and her care needs, but not specific details without referring to the notes.

She says for September 2015, the unit "was busy at that time".

12:29pm

A message from Letby on September 24 referred to 'staffing levels on the unit' as being "completely unsafe", the court is told.
In a message to another colleague, Sophie Ellis, Letby says: 'Oh Soph it was pretty bad - 18 babies, intubating on handover & a baby with a sugar of 0.1!'
Letby tells the court the capacity was 16 on the unit.
Mr Myers: "Had the unit always been this busy?"
"No." - Letby said it had been getting increasingly busier. She adds she had never seen a baby with chest drains at the Countess until Child H.
She adds she had never seen a baby with three chest drains, even at a tertiary centre. "The most I had seen was two."
Letby said during this time, doctors had to 'look things up' and discussions were held on how to manage the chest drains.
She says from her experience, chest drains were sutured into the skin, so they didn't move.
"Very few" chest drains were kept on the unit. Arrowe Park couriered out some drains, Letby tells the court.

12:32pm

A nursing handover sheet for September 23, 2015, recovered from Letby's home in the 'Morrisons bag', is shown to the court.
Letby is asked why she had that sheet, and four others with Child H on it. "It has just come back with me inadvertently and was left at home.
"They have not been taken out of my pocket at the end of the shift and I have taken them home."
Mr Myers: "Did you mean to take them home?"
Letby: "No."
Letby adds she did not know she had that many handover sheets at her house. "I did not keep track of them."

12:37pm

The nursing notes by Letby for September 25-26 are shown to the court.
They include: '...x2 chest drains in situ at start of shift - intermittently swinging. Serous fluid++ accumulating.
'2330 bradycardia and desaturation requiring neopuff in 100% to recover. 10ml air aspirated from chest drain...following poor blood gas and 100% oxygen requirement consultant Gibbs attended the unit and inserted a third chest drain. All 3 drains swinging...
'[Child H] desaturating++ on handling - minimal handling observed when possible. At 0322 profound desaturation and colour loss to 30%, good chest movement and air entry, colour change on CO2 detector...Neopuff commenced...Serous fluid++ from all 3 drains. Became bradycardiac. Drs crash called and resus commenced...'

12:40pm

Letby is asked about the chest drains 'swinging' - she says that shows they are working, with fluid moving back and forth the drain as needed.
Serous fluid is naturally occurring fluid in the body.
For September 25-26, Child H was the only baby in room 1, and Letby was the designated nurse that night. She required two nurses on a high level of care, and Letby had a colleague to assist her with drugs for Child H and maintenance of the chest drains.

12:46pm

Letby refers to a note 'at 0200 blood transfusion completed', saying the timing of that is an error, and should be 3am.
A blood transfusion chart shows the transfusion had started at 3pm on September 25, and ended at 3.05am on September 26. The note is co-signed by Letby.
A separate chart, with Letby's handwriting, shows 'chest drain 0210' and a bolus at 0250. The 'blood complete' is sometime after 3am, prior to 3.24am, Letby tells the court.
Letby says the '2am' note error she made was nothing "sinister", and 'just a mistake', and other accessible notes showed the timing the blood transfusion for Child H stopped at 3am.

12:52pm

A message from Yvonne Griffiths, part of the management team, to Letby is shown to the court, in which she commends Letby for her hard work over the previous shifts. The message is on September 26. She adds: 'You composed yourself very well during a stressful situation' and it was good to see her confidence grow.
Letby relayed that message to a colleague.
Letby said this message exchange had followed a disagreement over baptism for Child H. Yvonne Griffiths had felt it was 'not appropriate for that time of night' as Child H had stabilised at that point and the shift was busy.
Further messages between Letby and her colleague are exchanged.
Letby says, for context, she was 'choosing not to have [Child H] due to lack of appropriate support' as she wanted extra staff to assist her in the care of Child H, as Child H had several chest drains for which she had not been familiar with.

12:56pm

Letby's response to Yvonne Griffiths: 'Thank you. That's really nice to hear as I gather you are aware of some of the not so positive comments that have been made recently regarding my role which I have found quite upsetting. Our job is a pleasure to do & just hope I do the best for the babies & their family.'
Letby tells the court there had been frustration about comments made by colleagues that Letby and another nurse were being allocated room 1 shifts on the rotas, and there was frustration about the unit being 'busy'.
Letby agrees the court the frustration was 'particularly prominent at this time' and did not go beyond this period in September 2015.

Recap: Lucy Letby trial, Monday, May 15 - defence continues

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

Dan O'Donoghue

We're now moving onto Child H. The prosecution allege Ms Letby caused the premature girl to collapse on 26 and 27 September 2015, but she survived and went to make a full recovery.

Mr Myers has asked Ms Letby what the neonatal unit was like in late September 2015. She says it was 'increasingly busy at this period'. The unit had a capacity for 16 babies, 18 babies were on it at that time

Mr Myers pulls up messages, previously shown to the jury, sent by the neonatal unit manager Yvonne Griffiths to Ms Letby at that time

The manager says: "Hope you have a good sleep. I just want to commend you for all you hard work these last few nights. You composed yourself very well during a stressful situation. It's nice to see your confidence grow as you advance through your career x"

Ms Letby thanked her for the message, but said she was 'still frustrated' with the 'busy' and 'difficult' nights on the overcapacity unit

Judith Moritz

Lucy Letby now being asked about baby H - a girl - who she's accused of attempting to murder on two occasions in Sept 2015.

Court is told that when police searched Lucy Letby's house, they recovered 257 nursing handover sheets of which 31 related to children in this trial.

 

[Tortoise]

Defence Case Continued 15th May 2023

Child H continued after lunch

2:10pm

The trial is now resuming following its lunch break. Benjamin Myers KC is continuing to ask Lucy Letby questions in relation to Child H.
The second event is being discussed. For the night of September 26-27, Lucy Letby was the designated nurse for two babies in room 2. Nurse Christopher Booth was the designated nurse for Child G in room 2, and Nurse Shelley Tomlins was the designated nurse for Child H in room 1.
The court is shown nurse Tomlin's notes for that shift, which include: '...around 2030 [Child H] had profound desat and brady, air entry no longer heard and capnography negative therefore ETT removed and Drs crashbleeped. New ETT sited...on second attempt...'
This event is something, the court hears, Letby is not being blamed for.
'2145 - Desaturation to 40% despite good air entry and positive capnography. ETT suctioned quickly with thick blood-stained secretions noted. [Child H] recovered quickly after...'This was also not an event Letby was blamed for, Mr Myers tells the court.

2:12pm

'0055 - profound desaturation to 40% despite equal bilateral air entry and positive capnography. ET suction yielded nil secretions. [Child H] then went bradycardiac at 0107 to 40bpm and required chest compressions and adrenaline at 0108. Saline bolus given at 0112...'
Letby is asked if she had any involvement with this event.
Letby: "No."

2:14pm

'0330 - profound desaturation to 60s, again requiring neopuffing with no knwon cause for desat....copious amounts of secretions yielded orally, pink tinged. Small amount of ET secretions gained, again pink tinged. Heart rate mainly nomral during desat. Recovered slowly.'
Letby is asked if she had any awareness of any of the events, including at 0055, the event Letby is being blamed for by the prosecution.
Letby: "No."

2:29pm

A neonatal review chart is shown to the court, showing nurses' responsibilities and duties throughout the night of September 26-27.
Lucy Letby confirms from the chart she was involved in the administration of medicine and a 'sodium chloride flush', with Shelley Tomlins, on Child H at 10.12pm. This was recorded on the computer the following minute at 10.13pm. The 'flush' was a normal procedure following the administration of such medicine, the court hears.
The next recorded involvement Letby has with Child H is at 10.38pm. Letby tells the court that was for a morphine infusion. That was recorded on the computer at 10.39pm.
The next recorded involvement on the neonatal chart for Letby is at midnight, when Letby is making an observation for a different baby. Letby says she was not near Child H at this time.
Letby confirms to Mr Myers the next involvement with Child H on the chart is from 3.41am, with the administration of prescriptions. She does not recall what those would have been for.

Recap: Lucy Letby trial, Monday, May 15 - defence continues

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

https://twitter.com/MrDanDonoghue

We're now back after a break for lunch. We're continuing with the case of Child H

Child H suffered two sudden and unexpected episodes of profound desaturation at 00:55 on 26 September and 03:30 on 27 September 2015

Mr Myers asks Ms Letby if she had 'any involvement in this', 'no' she responds

Mr Myers asks her if she is 'able to account for what happened in any' of Child H's collapses that night/morning, 'no' she responds

https://twitter.com/MerseyHack

Court has resumed after the lunch break. Miss Letby’s barrister Ben Myers KC is now asking her about the second alleged incident in relation to Baby H, when she collapsed in the early hours of 27/9/15. Nurse #Letby was not H’s designated carer at the time. @BBCNWT

Baby H suffered 2 “desaturations” [dramatic drops in blood oxygen] that morning. Asked by Mr Myers if she had anything to do with the first, Lucy Letby says “No”. She says she can’t account for what happened in any of the alleged incidents.

 

[Tortoise]

Defence Case Continued 15th May 2023

Child I

2:37pm

Mr Myers moves on to the case of Child I, a baby girl born on August 7, 2015 at Liverpool Women's Hospital at a gestational age of 27 weeks.
She was transferred to the Countess of Chester Hospital on August 18. 'Active problems' noted by Dr Sally Ogden at the time of transfer included 'preterm, [respiratory distress syndrome], establishing feeds, jaundice, suspected sepsis'.
September 5-6, 2015, saw a number of events where Child I deteriorated and she was transferred to Liverpool. Mr Myers says Letby is not being blamed for those events.
Child I was transferred back to the Countess later that month, and on September 30, at 4pm, Child I had vomiting, brady, apnoea and desaturation, followed by a similar event later that day.
Another event happened on October 13 with Child I deteriorating. The following morning, Child I deteriorated and required resuscitation.
She was transferred to Arrowe Park on October 15 before returning to the Countess on October 17. Child I had a desaturation on October 22, and died the following morning.

2:39pm

Letby is asked if she had a recollection of Child I. Letby says she does.
She was a baby "with us for many months and got to know her [and the family] really well."
She had 'complex problems' which required frequent transfer to Liverpool. Child I's abdomen "was always more distended than normal" and there were occasions when that distention would increase, Letby tells the court.
Letby confirms to Mr Myers she looked after Child I on many occasions.

2:42pm

A radiograph from August 23, 2015, is shown to the court. Mr Myers says this had been part of what experts classed as a 'suspicious event', with a clincial note at the time recording 'non-specific gaseous distention of the abdomen which is suggestive of [NEC]' in Child I.
A record of Letby's work shifts shows Letby was not in work that day.

2:52pm

Letby says she was looking after Child I and two other babies in room 3 on her long day shift of September 30. She says she has "some memory" of that day, "but not great detail".
She denies doing anything to cause either of Child I's events that day.
She says at 7.30pm, during the handover, she was giving the handover when Child I became apnoeic. Neopuffing was given, and it was noticed the abdomen was distended.
An NG Tube was inserted and air was aspirated.
Letby reads her notes from that day, including a note that Child I's mum noted the abdomen seemed more distended than yesterday, and Child I had an ongoing low temperature. For the abdomen, it was 'soft to touch', and the bowels had been opened.
The 1500 Drs review noted Child I's abdomen was distended, and she appeared 'mottled in colour'. Letby said she asked for the review upon seeing Child I's mottled appearance.
At 1600 Child I was fed, and at 1630 Child I had a large vomit and desaturation, and Drs were crash called, and Child I was transferred to room 1.
Letby said for the 4.30pm event, she was not at Child I's cotside, but was in the room.
She says: "She had vomited and I went over to her, and needed Neopuffing, briefly."
Child I was placed on an incubator, a cannula was inserted but tissued. 'Colour appeals pale but improved'. There had been no further vomits, the abdomen still appeared distended.
Child I had 'self correcting desaturations to 80s', which Letby says was not a case when the alarm would be needed. "You have to give the baby time - to see if they self correct, which most babies do...in 30 seconds to a minute."
In this case, Letby says, Child I was self-recovering without the need for help.

2:58pm

Letby says she could not say, definitively, whether Child I's mum had left at the time of handover.
Letby's notes add: 'At 1930 [Child I] became apnoeic, - abdomen distended++ and firm. Bradycardia and desaturation followed, SHO in attendance and registrar crash called....'Air++ aspirated'.
Letby says the air was aspirated after the Neopuff device was used.
Brenda [my note this s/b Bernadette] Butterworth's nursing note: 'During handover [Child I] abdo had become more distended and hard she had become apnoeic and bradycardiac and sats had dropped. IPPV given and despite a good seal with Neopuff there was still no chest movement, aspirated NGT air +++ and 2mls of milk obtained, eventually got chest movement and sats and heart rate normalised...'
Letby says she recalls Child I recovered well afterwards.

3:02pm

Text messages are shown to the court from Jennifer Jones-Key to Lucy Letby, in which she complains a colleague had repeatedly, in the unit, commended Letby for her ability to swap shifts. Letby had replied in the messages, saying it was nice to hear as there had been some 'not so positive' comments about her. Letby added everyone is 'tired' on the unit.
Letby tells the court the 'not so positive comments' referred to her being on room 1 shifts when others had felt they needed the experience in room 1. She agrees with Mr Myers everyone had been busy on the unit.

3:07pm

The messages shown to the court -
JJK: Oh it's just [colleague] annoyed everybody last night as she was going on about how amazing you were doing so many swaps and how naughty you weren't taken off today x
LL: Oh was she? Kinda nice to hear something positive tho as been a few not so nice comments X
JJK: It wasn't for us and [expletive deleted] people off. I've done loads of swaps and extras. It was more the fifth time she said it!!! Why won't not nice comments x
LL: Everyone pulling their weight. I think she's just sticking up for me as knows I've had some rubbish said about me w
JJK: No she just sticking up for her friends and winding everybody else up. Shldnt of said anything x
LL: I can't speak for [colleague] & I wasn't there. We've all been working hard. X
LL: That's half the problem, everyone tired x

3:24pm

The trial is resuming after a short break.
Mr Myers refers to the next events for Child I.
Nursing notes by Ashleigh Hudson on October 13 are shown to the court.
The notes include: '...'pale, pink in colour but well perfused.
0322- when in the nursery, neonatal nurse Lucy Letby noticed that [Child I] looked quite pale., when turning the light on for closer examination, we found [Child I] to be very pale in colour and not moving. Apnoea alarm in situ, had not sounded, breathing was shallow and rr appeared low....monitoring commenced....30% neopuff O2 commenced...chest compressions commenced at 0325, no heart rate heard...'
Lucy Letby's note, 'written for care given from 0345' - '[Child I] noted to be pale in cot by myself at 0320, S/N Hudson present. Apnoea alarm in situ and had not sounded...full resuscitation commenced as documented in medical notes'.
A nursing shift rota is shown for October 12-13, with Lucy Letby in room 1, designated nurse for one baby. Ashleigh Hudson was designated nurse for three babies in room 2, including Child G and Child I.
Letby says she cannot recall looking after Child I prior to 3.20am. She recalls going with Ashleigh Hudson the room 2 together, and noticing Child I looked pale.
"Ashleigh was doing something on the worktop...with her back to the cot. I was in the doorway, talking to Ashleigh."
Mr Myers: "What was the illumination level like?"
Letby: "I can see clearly enough that [Child I] was pale in the cot. [Child I] was in front of a window. At no point is any nursery in complete darkness.
"The only time we have that is in room 4, for babies preparing to go home.
"It's important we need to see them visually.
"We need to see the monitors and the babies themselves."
Letby adds the colour level of a baby "is one of the most important things we assess".
"I could see her face and her hands...she just looked very pale.
"I said to Ashleigh she looked very pale and we turned the lights up". Letby says she cannot recall if the light had been on a dimmer switch, but the lighting was turned up.
Child I was "very unwell" so care was given.
The apnoea alarm had not gone off as, Letby says, Child I was 'gasping' and occasionally taking in air.
Letby says she and Ashleigh Hudson called for help.

3:32pm

Letby says she cannot recall, definitively, whether she had turned up the lights before or after seeing Child I. The court hears a police interview with Letby had said she had told them the lights were turned on before.
A subsequent police interview had Letby saying she did not know whether it was before or after seeing Child I that the lights were turned up.
"I know what I saw," Letby tells the court.

3:34pm

The court hears further from the police interview. The officer asks if Letby remembered, exactly, the sequence of events. Letby said she did not. "I thought we put the lights on when we went in the room."
Letby added, in interview: "Maybe I spotted something Ashleigh wasn't able to spot."
Letby tells the court Child I was "in my direct eyeline" when she was at the doorway.

3:39pm

The court is shown photographs of the lighting level in room 2. The photos were taken in August 2020 and form part of the agreed facts.
"Do you recall the room being as dark as this appears to be?"
"No."
"Would you ever have a high dependency unit...as dark as this."
"No."
"Why not?"
Letby tells the court it would not be safe.
Mr Myers asks if it was necessary to turn the lights up afterwards. Letby says it was, as it was necessary for the care of Child I, such as use of syringes.

3:50pm

Mr Myers now moves on to the event for Child I for October 13-14.
Lucy Letby was a designated nurse for Child I in room 1, with Joanne Williams designated nurse for two other babies in room 1.
Mr Myers: "Was there anything you did to make [Child I] feel unwell...on any shift?"
Letby: "No."
Letby's notes from the shift at the beginning: '...aspirate obtained. Abdomen appears full but soft. Some bruising/discolouration evident on sternum and right side of chest, ?from chest compressions. [Child I] pale in colour...'
Letby says the bruising appeared to have come from CPR the previous morning.
Further notes: '...[Child I] tolerating handling better, tone appears improved, remains pale. Abdomen distended but soft...
'At 0500 abdomen noted to be more distended and firmer in appearance with area of discolouration spreading on right-hand side, veins more prominent. Oxygen requirement began to increase, colour became pale...gradually requiring 100% oxygen...blood gases poor as charted...chest movement reduced...continued to decline. Reintubated at approx 0700 - initially responded well. Abdomen firm and [dis]tended. Overall colour pale...'
Letby says she cannot recall this sequence of events from the morning.
Shelley Tomlins: '0730-present. Care of [Child I] taken over...arrived on NNU minutes before arrest. [Child I] had just been retubed when desat/brady occurred and full resuscitation was required to bring her back...[Child I] stable on ventilator...abdomen very large, pale and veiny...area of discolouration noted on right side of abdomen.'
Letby recalls there was discolouration, but not specific details. She says she was not involved in the continued care of Child I, and denies having caused anything which allowed this to happen.

3:55pm

Mr Myers moves to the event of Child I on October 22-23.
Lucy Letby is a designated nurse for a baby in nursery room 2 and one in room 3. Ashleigh Hudson is the designated nurse for Child I in room 1 and one other baby.
Letby says she does not have much independent recollection from the night. She says her memory begins from when Child I was being resuscitated.
She was alerted to Child I being 'unsettled' at some point, but cannot recall during the night when that was.
Child I was 'rooting and appeared hungry', was 'crying and appeared very hungry' - 'sucking on fingers and lipsmacking'. Child I had been 'nil by mouth for a period of time' - Letby cannot recall how long for.

4:01pm

Ashleigh Hudson's notes for that night: '...[Child I] was unsettled and rooting at start of shift, settled with dummy and containment holding. Longline removed due to constant occlusions. Neonatal Lucy Letby unable to flush...
'2357: [Child I] was very unsettled, ?due to hunger as was rooting...'
Child I did not improve with increased Neopuff oxygen requirements and saturation and heart rate dropped. A crash call was put out by midnight, and Child I was intubated.
Child I was later extubated as she was 'working against the ventilator'.

4:08pm

The neonatal schedule chart is shown to the court for October 22, which Mr Myers says does not record Lucy Letby having any involvement with Child I.
Letby says she recalls seeing Child I and seeing she was "upset", but was not sure at which time that was.
Letby says she cannot recall where she was prior to the 01.06am event when Child I became unsettled again.

Recap: Lucy Letby trial, Monday, May 15 - defence continues

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

https://twitter.com/MrDanDonoghue

We're now moving to Child I, who was born prematurely at Liverpool Women's Hospital and transferred to the Countess of Chester on 18 August 2015. On 30 September, she needed emergency attention after she vomited and her heart-rate dropped.

She collapsed again on 13 and 14 October, before a fatal deterioration on 23 October.

A medical expert for the prosecution previousy told the court she had been "been subjected to an infusion of air", which prosecutors said Ms Letby had administered

Mr Myers starts by asking Ms Letby if she has a general recollection of Child I. She says yes, she says Child I was 'a baby with us for many months, we got to know her and her family well during that time'. She said she remembers the baby girl having 'a number of complex issues'

Ms Letby is being asked about the first allegation in relation to Child I (on 30 September). She was working a day shift and she was Child I's designated nurse, asked if she did anything to cause her collapse she said 'no', asked if she ever would, she said 'no'

Mr Myers takes Ms Letby back over what happened at around 19:30 on 30 September. Ms Letby said during handover with another nurse Child I became apnoeic and needed a neopuff. Which she and another nurse did. Afterwards Child I 'recovered well'

Mr Myers asks Ms Letby about the state of the neonatal unit at this time. She says it was 'very busy' and that was starting 'to have an effect on everybody'. Asked if it complied with the BAPEN guidelines, she said 'not at all times no'

We're now moving to the second alleged incident on 12 October

Nurse Ashleigh Hudson has previously told jurors she was Child I’s carer on the night-shift that night but she said she asked Ms Letby or the nursing shift leader to keep an eye on the youngster as she was required to help a colleague with a routine procedure elsewhere

She said that procedure took about 15 minutes and she then walked to a store room to collect Child I’s milk. On her return to nursery room 2 she started preparing the milk for a feed on a counter which faced the lit corridor, she said.

She previously told the court: “I can remember at one point in time Lucy was standing in the doorway. She was leaning up against the frame. She pointed out from where she was that she thought (Child I) looked pale.”

Nurse Hudson said the lights in the nursery were switched off, rather than dimmed, at the time

She explained the lights are 'on for safety', 'it's important that we’re able to see them visually…we need to be able to see the monitors' she said

She said herself and nurse Hudson went over to Child I who was 'gasping' for air and looked 'very' unwell. The pair began neopuffing the infant

Mr Myers is putting to Ms Letby what was said in police interviews in relation to Child I.

Mr Myers has pulled up an image, taken by Cheshire Police, of the nursery where Child I was staying - the light is dimmed on the image. Mr Myers asks if it was as dark as this on that shift, she said 'no'

We're now moving to the fourth event in relation to Child I on the 14 October. First is at 05:00 that day and at 07:00

Asked if she did anything to cause Child I's collapses on that morning, Ms Letby said 'no'

We're on Child I's final and fatal collapse on 22/23 October now - just before midnight Child I became unsettled. Nurse Hudson and Ms Letby attended and she required cardiac compressions

Mr Myers is pausing there for today, he will continue to take Ms Letby back over the case of Child I tomorrow morning.

 

[Tortoise]

Sky Live Updates 15th May 2023 Lucy Letby murder trial - latest: Former nurse tells court why she repeatedly searched for dead baby's mother on Facebook

Defence Case

Child F continued

Case resumes​

The jury is back in the courtroom and the trial, being overseen by judge Mr Justice Goss, is under way.
Lucy Letby, wearing a navy dress and black blazer, is sitting at a small table to continue her evidence.
She is flanked by two guards, and has an iPad in front of her.
Her parents, Susan and John, are watching in court.

Letby's questioning resumes after trial break​

Ben Myers KC, Lucy Letby's defence barrister, tells the court he will pick up his questioning where he left off 10 days ago.
He confirms Letby hasn't spoken with any legal counsel since the court last sat on 5 May - as is the standard procedure when someone is mid way through giving evidence.
"Tune in and get comfortable where at all possible to do that," Mr Myers tells Letby.
Mr Myers is returning to the case of Child F, a twin boy.
The Crown's case is that Letby attempted to murder Child F via insulin poisoning in August 2015, a day after she is alleged to have murdered his elder sibling, Child E.

Letby says she didn't do anything to cause drop in Child F's blood sugar​

The court is shown hospital charts demonstrating how infusion bags would be signed off by staff on the Countess of Chester Hospital neonatal unit.
Lucy Letby was responsible for changing several of Child F's bags in the days leading up 5 August 2015, when the baby's blood sugar dropped unexpectedly shortly before 2am.
"Is there anything that you did or that you know of that accounts for a drop in blood sugar at that time?" Ben Myers KC asks Letby, to which she replies "no".

'Nothing unusual' about repeated Facebook searches for Child E and F's mother, Letby tells court​

Lucy Letby searched for the mother of Child E and F on Facebook nine times between 6 August 2015 and 10 January 2016, the court is told.
Asked why she made the searches, Letby says "searching people on Facebook is something I would do".
"Quite often [Child E and F's mother] was on my mind, if somebody came on to my mind that's what I would do - I would search their name."
Ben Myers KC, for the defence, questions if there is anything unusual about Letby searching for someone online more than once.
"No that's a normal pattern of behaviour for me," Letby says.
The defendant is also asked why she took a picture of a thank you card sent by the parents of Child E and F to the neonatal unit.
Letby tells the court it's "something I wanted to remember", and says the photo was taken while she was working a night shift.


Child G

Letby says she cared for Child G 'many times' over 'long period'​

Ben Myers KC, for the defence, moves to the case of Child G, a baby girl, whom the prosecution alleges Lucy Letby attempted to murder three times in September 2015.
Child G - the most premature baby of all those on the indictment - was born at a different hospital before being transferred to the Countess of Chester neonatal unit.
Letby says Child G was a "very premature" baby, which the hospital did not "often care for".
The baby had "complex needs", she says, and was on the unit for a "long period of time".
Letby tells the court she looked after Child G "many times".
"We all got to know [Child G] and her family quite well," she says.

Child G transferred into Letby's care after collapse​

Court documents show Child G suffered a collapse in the early hours of 7 September 2015.
Asked to recall what she remembers about this event, Lucy Letby says she was sitting at the nurse's station with another nurse before hearing Child G's monitor alarm.
"She was the only baby in [that nursery] so we knew it was Child G."
Letby says they heard a "loud retching noise" and she and her colleague "went very quickly" to the baby.
She said Child G was found "vomiting and struggling to breathe".
Ben Myers KC asks if Letby had any contact with Child G during her shift before the incident.
"No," she responds.
"Had you been asked to look after Child G before the vomiting incident?"
"No."
"Do you recall what you had been doing before you were at the nursing station?"
"No."
Hospital records show care of Child G was transferred to Letby after she had vomited.

Letby 'shocked' at extent of Child G's vomit​

Lucy Letby says she was "shocked" at the extent of Child G's vomiting during the early hours of 7 September, telling the court it had reached the chair adjacent to the cot.
"None of us had ever seen a baby vomit like that... it's not something I'd ever seen before."
Child G suffered further deteriorations that morning and had to be intubated, the court is told.
She was transferred back to the hospital where she was born on 8 September before returning to the Countess of Chester on 16 September.
The prosecution says Child G "quickly recovered" after leaving the Countess of Chester neonatal unit.

Trial resumes​

The jury has returned to the courtroom and we're back under way.
During questioning by her defence barrister this morning, Lucy Letby insisted there was "nothing unusual" about repeated Facebook searches for the mother of two of her alleged victims.
She has been in the witness box since about 10.30am and has spoken calmly throughout the morning's proceedings, watched by her parents, who have been in court each time she has been questioned.

Letby tells court she wasn't with Child G during second incident​

Child G suffered another projectile vomit after being fed by Lucy Letby during the morning of 21 September - when the prosecution alleges a second murder attempt occurred.
Letby tells the court she doesn't recall how Child G seemed after the feed but that the vomit was "not anywhere near the volume" of 7 September.
She says she wasn't with Child G when she vomited but was with another baby in nursery 4 - where Child G was being cared for.
Child G "self-corrected" and there was no need for a crash call or emergency help, Letby says, adding there were no notable changes in her colour.
"Why was Child G's care changed to another nurse?" Ben Myers KC, for the defence, asks.
"Upon review from doctors she required a high level of care and I had three other babies," Letby says.

Letby 'concerned' at finding Child G alone on hospital trolley​

Lucy Letby says she was "concerned" when she found Child G alone behind a medical screen while "dusky, blue and not breathing" during the afternoon of 21 September - the time of the alleged third murder attempt.
The defendant tells the court Child G was on a procedure trolley - a flat bed with no sides - and her monitor was off.
Asked what she did when she discovered Child G this way, Letby says she "picked her up immediately", put her in her cot and carried out resuscitation.
Letby says Child G's designated nurse "froze" when requested to help and got someone else to assist.
"I was quite concerned that Child G was left in that situation," she said, adding that she and the baby's designated nurse had a discussion about the incident afterwards.
"I took assurances she would deal with it as she said," Letby tells the court.
She says she cared for Child G on occasion after 21 September.

 

[Tortoise]

Sky Live Updates 15th May 2023 Lucy Letby murder trial - latest: Former nurse tells court why she repeatedly searched for dead baby's mother on Facebook

Defence Case

Child H

Letby complains of 'unsafe' staffing levels in text to colleague​

We now move to Child H, another baby girl, whom the prosecution alleges Lucy Letby tried to murder on two separate occasions on 26 and 27 September 2015.
Letby says she remembers Child H in terms of her "care needs" but does not recall "specific details".
The court is shown a text Letby sent to a colleague on 24 September, after Child H was put in her care.
She complains of "unsafe" staffing levels on the unit and says she has reported it to a staff management team member.
In another text to a colleague, she says she had a "pretty bad" shift with many babies needing support.
"Had the unit been as busy as this throughout all the years you had worked there?" asks Ben Myers KC, for the defence.
"No," Letby says.

Letby 'didn't keep track' of hospital documents 'inadvertently' brought home​

The court is shown an image of a hospital handover document found in a plastic bag at Lucy Letby's home after her arrest in 2018.
It was among 257 handover sheets found during the search, 31 of which included the names of babies on the indictment against her.
Five handover sheets featured the name of Child H - who we are hearing about currently.
"Why is it that you have a handover sheet for Child H in that bag when police come to your house several years later?" asks Ben Myers KC.
"It's just come back with me from working and inadvertently left in my home," Letby replies.
On the other handover sheets referring to Child H, Letby says they had not been taken out of her pocket at the end of her shift.
"They've come home with me and I've not disposed of them," she says.
Letby tells the court she didn't keep track of how many documents were in her home.

Colleague praised Letby for 'hard work' after Child H collapsed​

A senior member of staff praised Lucy Letby's "hard work" after Child H collapsed while in her care.
In a text shown to court, sent to Letby on 26 September 2015 hours after Child H had to be resuscitated, the staff member says: "I just want to commend you for all your hard work these last few nights. You composed yourself very well during a stressful situation."
They added that it was "nice to see" Letby's confidence "grow".
In her response, Letby thanks her colleague and says it was "nice to hear" as she had received "not so nice comments" from other staff about her role, which she found "upsetting".
Asked what she is referring to, the defendant tells the court other colleagues were "not happy" with her looking after babies in the intensive care nursery as she was newly qualified.
"They wanted that experience and we had got that," she says.
The comments didn't continue past this time, Letby says.

Letby can't recall second incident with Child H​

Lucy Letby says she has no recollection of a second incident involving Child H in which the baby collapsed in the early hours of 27 September 2015.
The Crown's case is that unexplained collapses on 26 and 27 September were a result of Letby attempting to murder Child H.
Hospital records show Letby was working in a different nursery during the 26/27 night shift and was not Child H's designated nurse.
She tells the court she had nothing to do with Child H's collapse in the early hours and "doesn't recall" any involvement with Child H that night.

Child I

Defence moves to fourth 'murdered' baby​

Ben Myers KC moves to the fourth murder charge against Lucy Letby.
It involves Child I, a girl, who died in the early hours of 23 October 2015. The prosecution alleges that Letby attempted to kill Child I three times before succeeding on her fourth attempt.
Letby tells the court Child I was cared for in the Countess of Chester neonatal unit for "many months" and staff "got to know her and her family well".
She had "ongoing complex issues" and was "regularly transferred to and from the unit", Letby says.
The defendant says she looked after Child I many times - and was responsible for her care on more occasions than those listed in the indictment against her.

Letby 'not with Child I' when she collapsed​

Lucy Letby says she was elsewhere in the nursery where Child I was being cared for during the afternoon of 30 September when the baby collapsed.
The prosecution says this was the day of the first murder attempt of Child I.
"I remember she vomited and I went over to her and she needed [resuscitating]," Letby said.
Child I was transferred to an intensive care nursery where she suffered another collapse later that evening while Letby was handing over to another nurse.
Letby tells the court Child I "recovered well" afterwards.
She denies she did anything to cause Child I's collapse.

Staff 'drained' on 'busy' neonatal unit, Letby says​

Text exchanges between Lucy Letby and a colleague on 30 September 2015 - which have previously been shown to the court - reveal frustration over staffing issues in the unit.
"Lots of staff were drained physically and emotionally," Letby says.
"The unit was very busy, lots of people were doing additional shifts and changing shifts last minute. It did start to have an effect on everybody."
Ben Myers KC, for the defence, asks Letby if the unit always had sufficient staff to cover all babies at the level of need they had.
"Not at all times, no," Letby replies.

Letby says 'darkened' room would have been lit enough to see baby's colouring​

High dependency nurseries in the neonatal unit are never in complete darkness, Letby tells the court, as she recalls how Child I became "pale" before collapsing on the night of 12/13 October 2015.
Jurors have previously been told that Child I's designated nurse left nursery 2, where the baby was being looked after, before returning to find Letby standing in the doorway of the darkened room commenting that Child I looked pale.
The question over the lighting level of the room is a key point for this part of the prosecution's case against Letby.
Letby tells the court she can't recall what lights were on but the nursery would also be "lit from the corridor".
"We have lights on for safety, we need to be able to see the babies. It's a high dependency room so it's important we can see them visually," she says.
Asked for her recollection of events, Letby says she told Child I's designated nurse that she looked pale and they "turned the lights up".
"She wasn't breathing properly, she was gasping and looked very unwell."
The nurses started resuscitation immediately and called for help, Letby says.
The defendant says Child I's apnoea alarm - used to alert medical staff if a baby is breathing less often than expected - wasn't going off because she was gasping.

Defendant denies causing Child I's collapse​

Ben Myers KC, for the defence, now moves to the next incident involving Child I, which the prosecution alleges was Lucy Letby's third murder attempt on 14 October 2015.
It covers two separate collapses at 5am and later at 7am.
"Had you done anything to cause this to happen?" Mr Myers asks.
"No," Letby says.
She says she has no recollection of the incident outside medical notes.

Nurse requested Letby's help with 'unsettled' baby​

We're now hearing about the fourth and final incident - Child I's collapse and death overnight on 22/23 October 2015.
Lucy Letby says she recalls first being asked to help when Child I became unsettled shortly before midnight on 22 October.
"Did you have any awareness of how Child I had been before this time of the evening?" asks Ben Myers KC.
Letby says she didn't - she was not Child I's designated nurse that night.
The baby was crying and "looked very hungry", she tells the court.

Court rises​

That brings an end to today's session.
Ben Myers KC, Lucy Letby's defence barrister, indicates he'll move to the next part of the final incident involving Child I when the case resumes tomorrow morning.
Mr Justice Goss reminds the jurors of their responsibility not to research or discuss the case before the court rises.

 

[Tortoise]

Defence Case continued 16th May 2023 - Lucy Letby's Evidence in Chief

Child I continued

Chester Standard live updates - https://www.chesterstandard.co.uk/news/23524560.live-lucy-letby-trial-tuesday-may-16---defence-continues/

10:38am

Benjamin Myers KC, for Letby's defence, rises to continue asking Lucy Letby questions in the case of Child I.
He asks about the events of October 22-23, 2015, and Letby's involvement in those events.
He asks if she was involved in the efforts to assist Child I after 1.06am. She confirms she did.
She recalls going to see Child I at one point, and helping nurse Ashleigh Hudson settle her, but does not recall at what point that was.
She recalls being present when Child I died, and recalls the parents being there.
She says it was the first time Ashleigh Hudson had experienced a loss as designated nurse, and Letby says she assisted her in the bereavement procedure for the parents.
The funeral of Child I was on November 10, 2015. Letby says "more than two" members of staff attended that funeral, and this was not a usual occasion.
She tells the court she was not at the funeral as she was working. Letby's working shifts rota is shown to the court for November, showing Letby was working a series of nights on November 9-10, 10-11 and 11-12.
Letby said she was advised by other members of staff to send a card to the family, which would be passed to them at the funeral.
Letby's sympathy card is shown to the court. She said she gave it to one of the nurses who was going to the funeral.
She tells the court she took the photo while at work.
She said it was "normal behaviour" for her to take a photo of the card.

10:42am

A photo of another card written by Lucy Letby is shown to the court, of her congratulating her "close friend" on the birth of her daughter.
Letby says she would "regularly" take photos of cards that she would send, and had done so "for many years".
She says she would also take photos of cards she would receive.


Sky Updates - https://news.sky.com/story/lucy-letby-murder-trial-latest-former-nurse-tells-court-why-she-repeatedly-searched-for-dead-babys-mother-on-facebook-12868375

Letby explains why she took photo of sympathy card to Child I's parents​

Ben Myers KC, for the defence, returns to asking Lucy Letby questions about Child I - the alleged fifth murder victim in this case.
Child I's funeral was held on 10 November 2015.
Letby tells the court other staff from the unit attended the funeral but she was unable to as she was in the middle of a run of night shifts.
The court is shown a picture of the sympathy card Letby sent Child I's parents - this has previously been shown to the court.

Judith Moritz BBC Twitter - https://twitter.com/JudithMoritz

The jury is again shown a sympathy card which Lucy Letby sent to the parents of one baby who died. She is asked why she stored photos of it and other cards on her phone. Says “it’s normal behaviour for me”

Dan O'Donoghue BBC Twitter - https://twitter.com/MrDanDonoghue

Mr Myers is continuing to ask Ms Lebty about the events surrounding Child I, the nurse's ninth alleged victim. The court has heard that on 30 September 2015, she needed emergency attention after she vomited and her heart-rate dropped.

She collapsed again on 13 and 14 October, before a fatal deterioration on 23 October. A medical expert for the prosecution told the court she had been "been subjected to an infusion of air"

Mr Myers asks if Ms Letby was involved in the attempt to save Child I on her final collapse in the early hours of 23 October. She says yes. She also says she was there when Child I died and assisted the baby's designated nurse, Ashleigh Hudson, with the process that followed

She said: 'It was Ashleigh's first experience of a death so I assisted her with the bereavement paperwork and process…I supported her with things that needed to be done….I gave her more support because it was her first time'

Ms Letby recalls that following the death there was a funeral for Child I. Several of the nurses on the unit attended - she could not as she was working

The court has previously been shown an image of a condolence card Ms Letby sent to the family of Child I ahead of her funeral on 10 November.

Asked about this, Ms Letby says: 'I was advised by other staff that I could send a card to the family via people going to the funeral and that’s what I did'

She tells the court she took the photo of the card on her phone while at work and said it was 'normal behaviour' for her to take photos of cards she sent/received

 

[Tortoise]

Defence Case continued 16th May 2023 - Lucy Letby's Evidence in Chief

Child J

Chester Standard live updates - https://www.chesterstandard.co.uk/news/23524560.live-lucy-letby-trial-tuesday-may-16---defence-continues/

10:50am

Mr Myers moves on to the case of Child J, a baby girl born on October 31, 2015 at 32 weeks + 2 days gestation, at the Countess of Chester Hospital.
Mr Myers says there were a "number of problems in pregnancy" and Child J was diagnosed with a necrotic and perforated bowel (NEC), and required transfer to Alder Hey for a stoma to be fitted.
Child J returned to the Countess of Chester Hospital on November 10.
Mr Myers refers to the events on the night shift of November 26-27.
Mr Myers says Child J had desaturations at 4.40am and 5.03am on November 27. The designated nurse for Child J that night was Nicola Dennison.
Child J had further "low desaturations" at 6.56am and 7.24am, with "eyes deviated to the left", "stiff arms" and "clenched fists".

10:54am

Letby tells the court she had "very little experience" with stomas, having seen a couple at Liverpool Women's Hospital during training.
Other staff at the neonatal unit had no relevant recent experience of stomas, Letby adds, saying stoma surgery would only be carried out at a tertiary centre such as Alder Hey [the Countess of Chester Hospital was a level 2 centre].
Asked if Countess staff would regularly handle babies with stomas, Letby said: "No."
"I don't recall anybody being overly confident."
She adds Child J's parents "took the lead" as they had the relevant experience from what they had been told at Alder Hey.

11:04am

Letby messaged a friend on November 19: "It's shocking really that they are willing to take the responsibility for things that they have no training or experience etc on. Don't think they appreciate the potential difficulties X"
Asked who she means by 'they', Letby says "the band 4 nurses". Mr Myers asks who would ask them to do it. Letby says it would be up to the shift leader to allocate them.
Asked why they would be asked to look after a baby with a stoma, Letby tells the court: "the unit was so busy at the time".
Letby messaged the same friend at November 25: "Went to las iguanas was really nice. At salsa. Had 3 missed calls they don't know how to give immunoglobulin and I was last person to give so just phoned and told them. [Nurse] said it's mad. Ravi is there. What a nightmare it's all getting they'll have to send babies out?? X"
Letby tells the court it was "mad busy" on the unit, and the staff numbers were not at the level required for the number of babies on the unit.
The night shift rota for November 26-27 is put up. Two band 4 unit nurses are named in the rota.
Child J was in room 4. The designated nurse was Nicola Dennison, a band 4 nurse also looking after one other baby in room 4.
Letby was the designated nurse for two babies in room 3 that night.

11:20am

Letby tells the court she had no involvement in Child J prior to her first desaturation.
A rota of the end of the shift is shown to the court, with Letby having taken on a new arrival to the unit as their designated nurse during the night.
She said that night was "very busy".
Nicola Dennison's nursing notes are shown to the court. they include: 'Shortly after the feed at 0400 [Child J] became unwell and desaturated to the 30s. Initially not apnoeic but then did require some Neopuff to recover. Colour looks pale and mottled...'
A doctor records two 'profound desats', the 1st to 30s, the 2nd to 50s. Both episodes required bagging. 'Since then pale + mottled'.
The apnoea/brady/fit chart is shown to the court, recording two events at 4.40am and 5.03am.
The 4.40am event lasted three minutes, the second lasting two minutes.
Mr Myers: "Did you have any idea this was happening at the time?"
Letby: "No."
Letby is asked if she has recollection of the second pair of events. "Yes." She adds she has independent recollection of those events.
She said, for 6.56am, she heard the monitor alarm in room 4 and Child J was "fitting", "She wasn't breathing properly...her eyes were rolling to one side of her head."
"We both heard the monitor and we [Letby and Yvonne Griffith] went in."
Letby said no-one was in room 4 at the time the alarm first went off. Dr Gibbs arrived "very quickly" and Child J was transferred to room 2.
Letby says for the second event, she was called to help, but does not recall who.
Letby is recorded on the chart subsequently administering an infusion with Mary Griffiths.
Letby says she stayed "a little later" on the unit that day for the end of her shift, but cannot recall when that was.
Letby tells the court she was unaware of the first pair of events for Child J that night, but was aware and involved in the care during the second pair of events.

11:26am

Lucy Letby was the designated nurse for Child J for the following night (November 27-28), the court is shown.
A nursing note for Child J written by Letby from that night is shown to the court.
Mr Myers: "Any issues for [Child J] from that night, in your care?"
Letby: "No."
Letby messages a colleague about the shift of November 27-28 being "much better". Mr Myers asks what she means by that. Letby replies the workload on the unit was much more manageable than the previous night.
Mr Myers asks if a 'nicer,' lighter workload would be what she wanted.
Letby: "Yes."
Mr Myers: "Would you want things to be going wrong?
Letby: "No."
Mr Myers: "Would you want babies to be hurt?"
Letby: "No."


Sky Updates - https://news.sky.com/story/lucy-letby-murder-trial-latest-former-nurse-tells-court-why-she-repeatedly-searched-for-dead-babys-mother-on-facebook-12868375

We now move to the case of Child J, a girl, who the prosecution says survived a murder attempt by Lucy Letby.
She suffered an unexplained collapse during the morning of 27 November 2015.
The prosecution's case is that Letby got herself involved with Child J despite not being her designated nurse.

The court hears how Child J arrived at Countess of Chester hospital with a stoma bag fitted following surgery at a different tertiary hospital.

Letby says she had "very little experience" in dealing with stomas and staff were not "overly confident" about how to handle them.

She tells the court that less experienced band 4 nursery nurses were tasked with changing Child J's stoma bag despite the fact they are not meant to undertake high dependency care tasks.

Asked why this was the case, Letby says the unit was "very busy" and shift leaders had to use staff "wherever they could".

In a text to a colleague sent on 18 November 2015 - previously shown to the court - Letby said the situation was "shocking" and a "safety implication".

"It's potentially dangerous," Letby texted the staff member at the time.

Lucy Letby says her first recollection of being involved with Child J is when her monitor alarm sounded shortly before 7am on 27 November 2015.

Letby tells the court she and another nurse, who were in a different room at the time, went to help.

Child J was "fitting" with her "hands clenched and tight" and "eyes rolling to one side of her head", she says, which are signs of a seizure.

She says nobody was with Child J when they went into the room, so they began using the Neopuff system and called a doctor to review the baby.

Letby says she cared for Child J before and after this shift and was designated to look after her the following night.

"Were there any issues the following night in your care?" Ben Myers KC asks.

"No," Letby replies.



Judith Moritz BBC Twitter - https://twitter.com/JudithMoritz

Ben Myers KC has now moved to asking Lucy Letby about baby J - the 10th of 17 babies she's alleged to have attacked. The nurse denies attempting to murder the baby girl, as well as all the other charges against her.

Court hears that baby J had a series of seizures during the night of Nov 26/27 2015. Lucy Letby says she does not recall being in the nursery with the baby when any of them happened.




Dan O'Donoghue BBC Twitter - https://twitter.com/MrDanDonoghue

We're now moving onto Child J. She was born prematurely at the Countess of Chester in late October 2015 and transferred to Alder Hey Children's Hospital in Liverpool on 1 November as she had a bowel condition which required surgery.

The baby girl returned to Chester on 10 November, where she remained stable until 27 November, when she suffered two unexplained seizures within a half-hour period.

A medical expert for the prosecution has previously told the court that her collapse could be "consistent with some form of obstruction of her airways, such as smothering"

Mr Myers is starting by asking Ms Letby some general questions about Child J. Mr Myers explains that the baby had a stoma (an opening on the abdomen that can be connected to either your digestive or urinary system to allow waste to be diverted out of your body)

Mr Myers asks Ms Letby if she had much experience of stoma care, she says 'very little'. Asked how much experience other members of staff had, she said 'very similar…a lot of staff had no direct relevant or recent experience with stoma care'

Mr Myers notes that a more junior band 4 nurse was handling and recycling Child J's stoma bags - asked if this should have been happening, Ms Letby said 'no' as she would have been even 'more unfamiliar' with stoma's than the intensive care nurses

Asked why a nursery nurse was doing this, she said 'I think the unit was very busy and we had to use staff where we could'

In a Facebook message sent to a colleague at the time, Ms Letby commented: 'It’s shocking really that they (band 4 nurses) are willing to take the responsibility for things that they have no training or experience on…don’t think they appreciate the potential difficulties'

Ms Letby explains Child J would have been allocated to a band 4 by a shift leader. She says in an ideal world this would not be happening

Ms Letby explains: 'If they don’t have the training and experience to know what they're looking for when dealing with stomas then it’s potentially dangerous. 'It was so busy at the time, they were just trying to use staff wherever they could'

In another message sent on 25 November 2015 to a colleague, Ms Letby says the situation on the unit is 'mad'. She was off duty at the time and had been out for food and salsa lessons

In that message she says: 'Had three missed calls they don’t know how to give immunoglobin and I was last person to give so just phone and told them. (A nurse) said it’s mad. Ravi is there. What a nightmare it's all getting they'll have to send babies out?? X'

Ms Letby said she felt at the time 'they should start sending babies out to other hospitals'. Asked if there was the right level of staffing on the unit, she said 'no'

Ms Letby is currently being asked about her memory of Child J's collapse on nightshift of 26/27 November. She recalls attending to the baby girl with another nurse as she was 'fitting'

 

[Tortoise]

Defence Case continued 16th May 2023 - Lucy Letby's Evidence in Chief

Child K

Chester Standard live updates - https://www.chesterstandard.co.uk/news/23524560.live-lucy-letby-trial-tuesday-may-16---defence-continues/

11:41am

Mr Myers moves on to the case of Child K, a baby girl born on February 17, 2016, weighing 692g at 25 weeks gestation.
Mr Myers says there are three parts to this event, 3.45-3.50am, when a desaturation and a dislodged tube were noted, 6.10-6.15am, and 7.30am.
Dr Ravi Jayaram's notes are shown to the court. He records: 'Initially dusky, floppy, no respiratory effort' for Child K at birth. 'Successfully intubated ~20mins at third attempt by Dr Smith, transferred to NNU'
For 3.50am: 'At 0330hrs 0350hrs sudden deterioration O2 sats dropped to ~40%. Bagged via ET tube with Neopuff...poor chest movement...
'Tube removed and bagged via facemask - Sats recovered quickly...reintubated...'
Nurse Joanne Williams records in nursing notes: '...approx 4-5 minutes later began to desat to 80s. Dr Jayaram in attendance and on examination colour loss visible and no colour change on CO2 detector, ?ETT dislodged, removed and reintubated on second attempt...large amount blood-stained oral secretions.'
A further note by Joanne Williams: 'Baby has had 2 further episodes of apnoea and desaturation with loss of colour. Has been reintubated twice...'
Dr Jayaram's note, written at 7.50am, records: '@0615 began to have lower sats...tube pulled back to 6cm, sats dropped further, therefore extubated...responded to bagging, reintubated. Settled for next 30mins
'0725 - Mean BP dropped to 14...sudden drop in sats, hr dropped to <100...cardiac compressions commenced for 1min. Tube noted to have slipped to 8cm...withdrawn and heart rate picked up immediately.'
Child K was transferred to Alder Hey later that day, but remained unwell and died on February 20.
Mr Myers asks if it was normal for a 25-week baby to be at a level 2 unit. Letby says it was not normal; babies would usually be cared for at a tertiary centre.
She says she does not know why Child K was at the Countess of Chester Hospital.

11:58am

The trial is resuming after a short break.
The layout of the neonatal unit is shown to the courtroom for February 16-17.
Lucy Letby is the designated nurse for two babies in room 2 at the start of the shift. Child K was brought into room 1 during the night shift after her birth.
Letby is asked if she has any independent recollection of Child K.
"I remember it was unusual [seeing a 25-week gestation age baby], and seeing her at some point...but cannot recall any of the contact."
Letby said she would go into room 1 to collect medication, and it was a "frequently used" room.
Two other babies were in room 1, with designated nurse Caroline Oakley.

12:09pm

Mr Myers says there is a point, alleged, when Dr Jayaram sees Letby by Child K, and Child K's tube is dislodged.
Mr Myers: "Did you interfere with [Child K's] tube?
Letby: "No."
Letby denies being at the cotside when Dr Jayaram entered room 1, and says she does not recall any conversation with Dr Jayaram that night.
Mr Myers refers to a police interview with Letby from July 2018. Letby was asked if she remembered Child K's deterioration - "No" was the answer. Letby said she recalled Child K only as she was a 25-week baby, which was unusual on the unit.
Letby was asked by police if she was present when Child K's ET tube dislodged. "I don't remember."
Letby says she signed for morphine to be administered to Child K. She tells the court she had no involvement with Child K beyond that point.
Letby says in police interview she was not by Child K's incubator at the time Dr Jayaram entered room 1.
She told police if the desaturations dropped to 80s, she would expect the alarm to go off for Child K.
She said to police: "I don't know why the alarm would not have sounded."
Letby was asked by police if she had turned off or deactivated the sound on the monitor. "No."
Letby tells the court "it does happen" that a tube can move "with an active baby".
She told police "tubes can slip if not properly attached".
Letby says if she was there, and had seen the observations drop and/or the tube slip she would have summoned help. She denies being there at that point, or having any involvement in the tube being dislodged, or 'just watching'.
She denies Dr Jayaram's report was accurate.

12:26pm

The neonatal schedule for February 16-17 is shown to the court.
Letby is involved in the care of her two designated babies up to 12.30am, plus a baby in room 1 at 12.51am, 'assisting with cares'.
Letby cares for her designated babies up to 2am, and assists in the medication of a fourth baby at 2.04am and 2.14am.
The chart shows Letby's records with her designated babies up to 3.30am, when - at that time - observations are made and a feed given to one of the designated babies.
Letby says 3.30am would be a "rough time" of when it happened. The feed, observations, and a nappy change, could take half an hour - the quickest '20 minutes', the longest "up to an hour".
She says in this case, this could have taken "15-20 minutes".
Letby is asked if, by doing this, she had any reason to be in room 1 at that time. Letby says she would not have had a reason.
Letby is then recorded, on the neonatal schedule, as caring for Child K after the event has taken place. The first recorded activity is for morphine administration, with Joanne Williams signing for the medication and Letby being a co-signer. Letby says this was because Child K was being reintubated and required morphine.
She does not recall being called to the nursery room.
She does not recall being involved in the subsequent events for Child K.
Letby is asked about a Facebook search for the surname of Child K, made on April 20, 2018, at 11.56pm.
Letby says: "You still think of patients you've cared for."
She says she does not recall why she looked up the name at that point.
Letby says that night "was a busy shift" but, asked whether she had done anything that night to merit questions about it years later, Letby says: "No."




Sky Updates - https://news.sky.com/story/lucy-letby-murder-trial-latest-former-nurse-tells-court-why-she-repeatedly-searched-for-dead-babys-mother-on-facebook-12868375

Ben Myers KC, for the defence, moves to the case of Child K and the ninth attempted murder charge against Lucy Letby.

Jurors have previously heard that Child K was brought into the neonatal unit at the Countess of Chester Hospital in February 2016 because of her extreme prematurity.

The hospital would not usually care for babies of 25 weeks gestation.

Letby tells the court she didn't understand why Child K was on the Countess of Chester's neonatal unit as she "should have been born in a tertiary centre".

The Crown's case is that Letby deliberately dislodged Child K's breathing tube moments before a consultant walked in, in an attempt to kill her within hours of her birth.

Child K later died after being transferred to a different hospital, but Letby is not charged with her murder.

The paediatric consultant previously described feeling "uncomfortable" when he noticed a "coincidence between the unexplained deaths and serious collapses and the presence of Lucy Letby".

Lucy Letby says she remembers Child K being on the unit because it was "unusual" due to her extreme prematurity. But otherwise she says she has no independent recollection.

Ben Myers KC, for the defence, puts to Letby the accusation by the paediatric consultant that he walked in to find her standing over Child K, as she was collapsing, and not doing anything.

He also reminds the defendant of the allegation against her that she deliberately dislodged Child K's breathing tube.

"Did you interfere with Child K's tube?" Mr Myers asks.

"No."

"Was there a time when you were in the nursery and [the consultant] came in to find you close to Child K?"

"No."

"Do you recall any incident where you were present when Child K desaturated and the consultant became involved roundabout 3.50am [on February 17 2016]?"

"No."

"Or at any other time?"

"No."

"Did the consultant ever say 'what's going on here, why is the alarm going'?"

"No, I don't recall any conversation with [the consultant] at all that night."


Hospital records are pulled up which show Lucy Letby was involved in the care of several babies other than Child K over the course of the night shift of 16-17 February 2016.

At 3.50am on 17 February, an entry shows Letby prescribing morphine for Child K with another nurse.

Asked why this was given, the defendant explains Child K needed to reintubated following her collapse, with morphine given for pain relief.

Letby tells the court the first incident involving Child K - said to have happened at around 3.50am - would have happened before this time.

Different records show Letby was administering a feed to another baby in her care at 3.30am.

Lucy Letby searched Child K's surname online in April 2018, more than two years after her death.

She tells the court she "can't recall" why she searched the name at this point but had not looked it up before then.

"You still think of patients you cared for," she said.

Asked by defence lawyer Ben Myers KC if from her standpoint "anything out of the ordinary" happened on the night shift of 16-17 February 2016, Letby says no, and denies she did anything to merit being asked questions about it years later.

"It was a busy shift, that's all I can say about it."


Judith Moritz BBC Twitter - https://twitter.com/JudithMoritz


Lucy Letby is now asked about baby K who she's accused of attempting to murder in Feb 2016. The prosecution say a doctor, Ravi Jayaram, interrupted the nurse after she'd dislodged the baby's feeding tube. Lucy Letby says she doesn't recall any conversation with him that night.

Ben Myers KC: Are you accepting that you did have any involvement in the movement of a tube?
Lucy Letby: No. If that’s what Ravi said, that’s what Ravi said"
BMKC: "Did you dislodge baby K's tube?"
LL: "No"
BMKC: "Would you?"
L: "No"

Lucy Letby says she was feeding a different baby at the time it's alleged she moved baby K's breathing tube.

Lucy Letby is asked why she searched on Facebook for baby K's surname, more than two years after the alleged attack. She says "you still think of patients you cared for"


Dan O'Donoghue BBC Twitter - https://twitter.com/MrDanDonoghue

We're now moving to Child K. Despite being born at 25 weeks, Child K was considered to be in a good condition, but as a precaution, arrangements were made to transfer her to Arrowe Park Hospital shortly after her birth in February 2016.

While waiting for transport, she was left in the care of Ms Letby, who, the prosecution said, deliberately dislodged her breathing tube. Dr Ravi Jayaram has previously told the court he felt uneasy about Ms Letby being left with the child

Dr Jayaram told the jury when in the witness box that the team were aware "of a number of unexpected and unusual events and we were aware of an association with Lucy Letby"

He said "no cause and effect had been ascribed", but he saw Ms Letby standing by the incubator, noticed the breathing tube was dislodged and saw the nurse do "nothing" to help until he arrived. The baby eventually stabilised, but died three days later.

Mr Myers asks Ms Letby if it's 'usual' for there to be a 25week old baby at the Countess of Chester. She says: 'no, should be born in a tertiary centre'

Mr Myers asks her what the minimum gestation for a level 2 centre should be, she said: '27 weeks gestation or above 700grams birth weight'. Child K weighed 692g. Mr Myers asks if she knows why Child K was therefore at the hospital, she says 'no'

Ms Letby explains that she was caring for two other babies in nursery two when Child K was born. She says she has no independent recollection of her but says she was aware of her as it was so 'unusual' to have a 25week baby

Child K was in nursery one. Ms Letby is asked if she would have went in to N1 on her shift, she says yes - as this is where a lot of kit was kept

Mr Myers puts what Dr Jayaram said in evidence. That he had entered N1 to find Ms Letby standing near to Child K while she was desaturating - she says 'I don’t recall any conversation with Dr Jayaram that night'

She denies interfering with Child K's breathing tube and denies being present at any desaturation

Mr Myers asks Ms Letby why she searched Facebook for Child K's surname in April 2018 - she said you 'still think of patients that you’ve cared for'

 

[Tortoise]

Defence Case continued 16th May 2023 - Lucy Letby's Evidence in Chief

Twins L & M

Chester Standard live updates - https://www.chesterstandard.co.uk/news/23524560.live-lucy-letby-trial-tuesday-may-16---defence-continues/

12:33pm

Mr Myers moves on to the cases of twins, Child L and Child M, born on April 8, 2016 at 33 weeks and 2 days gestation.
Letby confirms she is still working and caring for babies, working a mixture of day and night shifts, at the hospital, during this time.
She says, in reply to what her intentions were for the babies: "To provide the best care possible."
She estimates she had cared for about "100" babies during these few months.
Child L was born weighing 1,465g. Child L later struggled with low blood sugar.
A blood sample was taken for Child L - the insulin level read 1,099, insulin C-Peptide 264. The insulin was "far higher" than the C-peptide reading, indicating, Mr Myers, insulin had been administered to Child L.
Child M weighed 1,705g. Child M later had a desaturation, which it is alleged Letby had caused.

12:42pm

On April 8, Sophie Ellis messaged Letby: "How's the house pal? "
Letby responds: "Hey, it's feels a bit weird having a whole house but It's good thanks, although stuff everywhere as moved in properly on Tue & been at work Wed Thurs & today . Doing tomorrow as an extra so I'll see you tomorrow night. Won't be such an early start for you now back in Chester!..."
The reply: "Yeah I bet it does, it'll feel more homely once you've sorted everything out. Jeeeez 4 [Long Day shifts] in a row, are you ok?! I know yay and I don't have to pay for petrol, it's cost me a fortune . Yeah they are haven't seen them for a while. What's the unit like? "
Letby: "Yeah I'll get there in time. Petrol & tunnel soon mounts up doesn't it! Can you claim travel expenses? I couldn't for 405. Unit is busy, No one particularly unwell just volume & few people off sick. I prefer 4 days to 4 nights. Least tomorrow is an extra & Sat pay! . Awe that'll be nice hope weather a bit better for you! X"
SE: "Yeah we can. Omg really, how come? That's 7 weeks aswell isn't it? Yeah, 4 nights are awful. Ah that's not too bad then. Think I'd prefer to keep busy. I think it's meant to rain...dammit "
LL: "Eirian said something about the induction being paid for by the trust whereas the 405 comes out of network budget so won't pay as its an expected part of role to progress etc. Mad really & costs a bomb! We've got nice mix of babies at the mo really. Shift goes quick anyway! Grr typical April showers haha. [Colleague] is in Thailand & It's been 44degrees today! X"
Letby said it was a "massive" life moment for her to move into her new house, and her main focus was on "sorting out the house".
Letby says the unit was "still fairly busy" at this point.
On April 11, Letby messages a colleague: "The unit is in dire way with staff..."
She says the unit had 'banker agency staff' and band 5s who did not have the ITU course.
She says the unit being busy was "often discussed by staff".

1:01pm

Letby recalls being involved with the care of the twin boys, and looked after one of the twins in the transfer to the neonatal unit.
The twins were placed in nursery room 1, and Letby cared for Child L that first day.
The following day, April 9, Child M was in a different place in room 1, following admission of other babies overnight. Child L and Child M were in adjacent beds in room 1, the court hears.
Letby tells the court a baby's blood sugar levels are checked "within the first hour of life".
Child L's first blood sugar reading is "low" - 1.9.
The baby would be offered "a milk feed" via a bottle or NG tube, and the blood sugar would be checked after another hour.
This did not happen with Child L, and he was administered 10% dextrose [sugar infusion], which Letby says was outside the guidelines, a decision made by Dr Bhowmik.
Letby's notes: 'Advised by Dr Bhowmik to commence 10% glucose...'
Letby added in the notes that she and the shift leader advised this deviated from the usual policies. A glucose bag was hung up for Child L.
Letby said she cannot recall who hung up the bag - she said it would either have been herself or nurse Amy Davies. Child L had normal blood sugar levels the rest of the day.
She tells the court she would have ended her shift at about 8pm.
Mr Myers says for April 9, 2016, there are no recordings of blood sugar for 3am, 4am or 5am. A 10am reading of 1.9 is "too low". It is 1.6 at noon. 2pm it is 2.
Letby had come on duty at 7.30am. The infusion rate has been changed at noon.
A 10% dextrose bolus is administered at 3.40pm. Letby says she cannot recall who was involved in that administration.
At 4pm, the blood sugar level is 1.5. At 4.30pm, a 12.5% dextrose bag is administered by two nurses including Ashleigh Hudson.
The readings remain "low" up to midnight. On April 10, at 2am, the reading is 2.1, then a new 15% glucose bag is administered. 4am it is 2.3, 6am 2.2, at 2pm it is 3 - "an adequate level", but then drops for the rest of the day.
A 15% glucose bag's rate is changed early on April 11, and a new bag is administered that day. The readings are 2.7, 2.9, 2.8 throughout that morning. At 3pm it is 3.5, and blood sugar is said to have stabilised.



Sky Updates - https://news.sky.com/story/lucy-letby-murder-trial-latest-former-nurse-tells-court-why-she-repeatedly-searched-for-dead-babys-mother-on-facebook-12868375

Ben Myers KC is now asking Lucy Letby about children L and M, twin boys, who she is accused of murdering in April 2016.

The prosecution alleges that Letby poisoned Child L using insulin on 9 April, and harmed Child M by injecting air into his bloodstream at around the time his twin's blood sugar levels were dropping.

Letby had moved into her home in Chester a few days before the incident.

The court has previously heard that by this time, Letby was only meant to be working day shifts due to concern over the correlation between her presence and unexpected deaths and life-threatening episodes on the night shifts.

The court is shown a text from Lucy Letby to a colleague sent in April 2016, where she says the neonatal unit is "in a dire way with staff".

Letby tells the court the unit was "very busy" and "didn't have adequate staffing," with bank staff having to be called in at points.

"Are you the only person who pointed out that it seemed to be very busy?" Ben Myers KC, for the defence, asks.

"No, it was often discussed among the nursing staff," Letby says.

Jurors are then shown a message from a senior member of staff to Letby, also from April 2016, where she asks Letby if she can come in to work that night.

Such an event would happen "regularly", she says.



Judith Moritz BBC Twitter - https://twitter.com/JudithMoritz

The nurse is now being questioned about twin brothers, babies L and M - who she's accused of attempting to murder - via insulin (baby L) and air embolism (baby M). She denies both charges.



Dan O'Donoghue BBC Twitter - https://twitter.com/MrDanDonoghue

We're now moving to the cases of twin boys Child L and M. Ms Letby is accused of adding insulin to at least three of Child L's feed bags in attempt to poison him while on duty in April 2016.

Ms Letby is accused of adding insulin to at least three of the infant's feed bags while on duty at the Countess of Chester Hospital in April 2016.

Ms Letby is accused of trying to kill Child L around the same time she allegedly tried to murder his twin brother, Child M, by injecting air into his bloodstream.

In the days before the twins were born, Ms Letby moved into her new home in Chester. Mr Myers is taking the court back over messages sent between Ms Letby and colleagues at that time talking about the move

Ms Letby said moving into that house was a 'massive life moment', she said when she wasn't at work she was wanting to focus on 'sorting out the house'

The court is shown a message Ms Letby sent a colleague in April 2016, she says 'the unit is in dire way with staff'. She said to Mr Myers the unit was 'incredibly busy and didn’t have adequate staffing to cater for all the needs of the babies at that point'

She says the unit was relying on agency staff and some of the band five nurses did not have intensive care training

Mr Myers pulls up a message from a nursing manager, messaging Ms Letby on a Sunday morning asking if she can work that night - Ms Letby says this 'would happen regularly'

 

[Tortoise]

Defence Case continued 16th May 2023 - Lucy Letby's Evidence in Chief

Twins L & M continued

Chester Standard live updates - https://www.chesterstandard.co.uk/news/23524560.live-lucy-letby-trial-tuesday-may-16---defence-continues/

2:19pm

The trial is resuming following its lunch break.
Benjamin Myers KC is continuing to ask Lucy Letby questions in the cases of twins Child L and Child M.
The infusion therapy prescription sheet is shown for Child L, with prescriptions for April 8-9.
The first entry is for April 8, 11am, for a 500ml, 10% dextrose infusion, via the IV line. Dr Bhowmik authorised the prescription and the bag additive. Lucy Letby and Amy Davies set up the infusion.
The first two infusion prescriptions have a line through them as, Lucy Letby explains, the rate of infusion was changed twice. It went from 4.2ml/hr to 3.6ml/hr to 4.4ml/hr. The 4.4ml/hr rate was started, using the same bag, at noon.
The bags were stored in a cupboard in room 1. This was in a separate room from the insulin bags in a cupboard in a corridor.

2:25pm

Mr Myers asks how commonly dextrose is used on the unit. Letby says "very commonly", adding that a 10% dextrose solution would be administered 'all the time'. They would be used "for generic use".
Letby sent a message to her mother on April 8: "Think Im going to do tomorrow as an extra but Go in a bit later. Extra money and Sat pay xX"
This was to be Letby's fourth long day shift in a row (April 6-9), the maximum normally allowed for Countess staff at the unit, the court hears.
For the April 9 long day, Letby was designated nurse for two babies in room 1, and Mary Griffith was designated nurse for Child L and Child M, also in room 1.

2:34pm

Child L's 10% dextrose bag was changed on April 9 to a new 10% dextrose bag, at noon, signed by Letby and Mary Griffith.
That bag "would have come from the generic bags in room 1", Letby says. She does not recall who would have put it up for Child L.
The equipment involved in setting it up would come from nursery room 1.
Mr Myers says prior to this, Child L had a blood glucose reading of 1.9 at 10am.
Letby says the initial infusion bag would still have been in place at this time. She says she cannot explain why that reading was low, and did not do anything to cause that low blood sugar reading.
She adds she did not do anything to cause the later recorded insulin levels to be high for Child L.
Mr Myers: "Had you done anything to affect insulin?"
Letby: "No."
Letby says as well as herself and Mary Griffith being the two designated nurses in that day, there were other nurses 'coming and going' in room 1, along with parents "present throughout the day".
Nursing notes for one of Letby's designated babies - a high-dependency baby - are shown to the court. They include: 'Parents visiting carrying out feeds and cares....At 1600 parents were asked to leave the nursery due to a sick baby needing treatment, parents were understanding of this and left for the evening.'
Letby says this was when Child M had deteriorated. She said this would be "common practice" to ask parents to leave in such an event.
Letby adds the visiting times were 24 hours and parents would visit throughout the day.

2:47pm

Nursing notes by Mary Griffith record, for Child M on April 9: '...at 12.15 noted that his stomach was a little distended and his work of breathing was increased. Was then sent for my break and [colleague] did the 12.30 feed...had an aspirate of 5mls...temp returned to normal and baby settled.
'At 1600 baby went apneoic and had a profound brady and desat. Full resus commenced at 1602...care handed over to SN L Letby.'
Letby tells the court Mary Griffith was, at this point, not trained for the type of intensive care Child M required, which was why care was handed over to her.
A prescription chart shows Lucy Letby is involved, with Mary Griffith, in the administration of antibiotics for Child M at 3.45pm. Letby says the line would also be 'flushed' after this is administrated.
Letby says at the time of Child M's deterioration, Child L was requiring further dextrose.
A chart shows Letby was involved in administering a 4.3ml, 10% dextrose bolus at 3.35pm, administered at 3.40pm.
A 12.5% dextrose infusion is made up by nursing staff "in response to ongoing low blood sugars", which begins at 3.35pm and the infusion starts at 4.30pm. The infusion start is administered by Belinda Simcock and Ashleigh Hudson.
Letby says she and Mary Griffith had been "preparing a bag" for Child L. She says Mary Griffith was the "sterile nurse" and Letby was assisting her between 3.45pm and 4pm.
Asked when she first became aware of a problem, Letby said the alarm went off and Child M was "not breathing" and "clearly struggling".
Mary Griffith and another nurse were in there. Letby recalls asking parents to leave.
Letby says she began initiating Neopuff "straight away", but because it didn't reach, the face mask fell on the floor, and Letby asked for another face mask for Child M.
She adds she and Mary Griffith "abandoned" the making up of the bag, and "the focus was on [Child M]". Two other nurses 'started the procedure from the beginning' [of making up a new dextrose bag for Child L].
Letby said that would be "standard practice", to make sure staff were sure the new bag had the correct, required concentrations.

2:56pm

Letby, asked again by Mr Myers, denies doing anything to affect Child L's insulin levels. She agrees Child L's blood sugar levels remained low, and cannot explain why that was the case.
Letby says another nurse and Dr Ravi Jayaram came to assist Child M. She says she cannot recall any observation or discussion of discolouration on Child M's skin.
Letby says she left later than 8pm that night as she had a lot of documentation to file at the end of her shift.
A nursing note for Child M by Letby is recorded as being written between 9.14pm-9.22pm on April 9. Letby said this was after attending to the clinical needs of Child M.
Letby said she would write contemporaneous notes on the back of handover sheets or on paper towels to keep track during the day.
The court is shown a few notes written on paper towels which were recovered from 'the Morrisons bag' at Letby's home by police. There are also medical notes on sheets of paper. They feature notes in the resuscitation of Child M.
Letby says the notes were kept in the pocket of her uniform, and came home in her uniform.
She says she did not have any other use for them.
Also among the notes is a blood gas printout for Child M.
Asked to explain that note, Letby says she had put it in her pocket and taken it home.
Asked by Mr Myers why she hadn't binned it: "That is an error on my part."
She denies having any use for the notes.

3:02pm

Letby confirms she continued to care "quite frequently" for Child L and Child M following their events, until they were both discharged from hospital on May 3.
Nursing and family communication notes by Letby in respect of Child L and Child M are shown to the court on April 16, 17, 24, 25, including when Letby had been their designated nurse.
"I did my best for them," Letby tells the court.


Sky Updates - https://news.sky.com/story/lucy-letby-murder-trial-latest-former-nurse-tells-court-why-she-repeatedly-searched-for-dead-babys-mother-on-facebook-12868375

Lucy Letby tells the court she was advised by a doctor to hang a glucose infusion bag for Child L on 8 April 2016, in what she says was a deviation from normal policy.

She says she can't recall who hung the bag, but it would have been herself or another nurse. Her shift ended at 8pm that day.

The following day, 9 April 2016, when the incidents involving Child L and M occurred, she began her shift at 7.30am.

Child L had very low blood sugar readings throughout the day despite attempts to correct it. The infant also had dextrose bolus (intravenous injection) at 3.40pm, but Letby says she can’t recall who would have administered this.

At 4pm, Child L's blood sugar is still dangerously low, and shortly after this, Child M collapsed.

Child L's blood sugar level did not fully stabilise until 11 April.

Lucy Letby was not scheduled to work on 9 April 2016 but tells the court she was asked to come in the previous evening due to staffing shortages, having already worked three long days shifts.

She says due to the number of babies on the Countess of Chester neonatal unit they needed another intensive care nurse on duty.

Letby says four long days in a row is the maximum a member of staff should do.

"Had you been expecting to?" asks Ben Myers KC.

"No," Letby says.

Lucy Letby is asked by Ben Myers KC, defence lawyer, if she had any involvement with insulin on 9 April as far as Child L and M were concerned.

"No, none at all," she replies.

She says she can't explain why Child L's blood sugar levels were so low when readings were taken

At the time of Child M's collapse at around 4pm on 9 April 2016, Lucy Letby says she was preparing a bag of dextrose for Child L with another nurse.

Asked the first thing she recalls about Child M's deterioration, Letby says she remembers his monitor alarm was sounding.

The defendant says she went over to find Child M "struggling" and not breathing.

Other parents in the room at this point were asked to leave, she says.

Another nurse and a doctor became involved in resuscitation attempts for Child M, Letby tells the court.

Other members of staff started the process of making Child L's dextrose bag from the beginning after it had to be abandoned to care for Child M, she said.

After that bag was eventually hung for Child L, his blood sugar remained low.

"Did you do anything to interfere with that bag?" Ben Myers KC, defence lawyer, asks.

"No," Letby replies.

The court is shown a photograph of handwritten notes on pieces of paper discovered in a police search of Lucy Letby's home after her arrest in 2018 - some which relate to Child M.

Letby says the notes would be in her uniform pocket and would end up going home with her.

She says she had no other use for them.

Another picture shows a blood gas printout for Child M, which Letby also says would have stayed in her pocket.

"The question that arises, Ms Letby, is why it doesn't just go in the bin after that?" says Ben Myers KC.

"That's an error on my part," she says.

Letby says she had no use for any of the hospital records - some of which relate to babies involved in this case - found at her home during the police search.

Lucy Letby says she continued to care for Child L and M "quite frequently" over the weeks that followed the incidents on 9 April 2016.

Asked what kind of care she provided, she says: "I did my best for them".

"Did you want them to be hurt?" Ben Myers KC, defending, asks.

Letby says she didn't.

The twins were discharged on 3 May 2016.


Dan O'Donoghue BBC Twitter - https://twitter.com/MrDanDonoghue

We're back after a break for lunch. Mr Myers is continuing to ask Ms Letby about twins Child L and M

Mr Myers takes the court through Child L's blood sugar readings from April 2016. He asks Ms Letby if she had 'any involvement with insulin' and Child L, she says 'no, not at all'. She says she cannot explain Child L's low blood sugar levels

We're turning to Child L's twin Child M. Who collapsed pretty much at the same time Child L's blood sugar levels fell

Mr Myers asks Ms Letby, who was assisting with treatment of both twins, if she recalled any blotches or patches on Child M's skin - she says 'no'

Jurors have previously heard how an emergency crash call went out to medics to attend Child M at 16:02 on 9 April 2016 after he stopped breathing.

Over 25 minutes senior doctors and nurses gave CPR and administered dose after dose of adrenaline in a battle to stabilise the infant. The baby boy improved at around 16:31 and was placed on a ventilator.

Mr Myers has pulled up documents found in Ms Letby's home on screen. They are prescription charts from Child M's resus, he asks her why she has them at home

She says they were in her uniform pocket and came home with her, she said it was an 'error' on her part

Asked generally about the twins and the care she gave them, Ms Letby says 'I did my best for them'.

Mr Myers pulls up a text message she sent to a colleague at the time in which she conveyed that the babies on the unit were progressing well. He asks if that's what she wanted, 'yes absolutely' she said. He asks if she wanted to hurt them, 'no' she says

 

[Tortoise]

Defence Case continued 16th May 2023 - Lucy Letby's Evidence in Chief

Child N

Chester Standard live updates - https://www.chesterstandard.co.uk/news/23524560.live-lucy-letby-trial-tuesday-may-16---defence-continues/

3:19pm

Mr Myers now turns to the case of Child N, a baby boy born on June 2, 2016, gestational age 34 weeks plus 4 days, weighing 1,670g.
Mr Myers asks Letby how important it was for her to treat these babies.
"Very important - I took the job extremely seriously...we want to make sure the babies go home."
Mr Myers says Child N was born with haemophilia.
Mr Myers says the first event was on June 3, at 1am when Child N was said to be "screaming or crying", desaturating, and was treated with breathing support.
The second event was on the morning of June 15, when Child N had a "profound desaturation", and following from that, there were attempts to intubate him, and blood was found in the oropharynx.
The third event was a "profound desaturation" at about 3pm on the same day and 3ml of blood aspirated from the NG Tube, followed by multiple attempts to intubate Child N. At 7.40pm, as a team arrived from Arrowe Park, there was a further desaturation for Child N.

3:32pm

Mr Myers asks Letby about Child N. Letby says she had not encountered a baby with haemophilia and staff on the unit were "quite panicked" about the prospect of caring for a baby with haemophilia, as they had little/no experience either.
A message Letby sent to a colleague on June 2: "Everyone bit panicked by seems of things although baby appears fine"
The response: "Male?"
LL: "Yeah"
The response: "Factor 8?"
LL: "Not sure I only know what's on handover sheet as Dr etc all in with him doing head scan etc"
Letby said at the time, she did not know what 'factor 8' referred to.
The response: "Lad with haemophilia when worked community with Leighton on placement"
LL: "Ah ok I'll have to Google it later lol don't know much about it"
Response: "Have to b careful with cannula/heel pricks etc
"Give Factor 8 or Factor 9 I think it is dependent on which clotting factor deficiency is
"Have as infusion for rest of life"
LL: "Wow"
Response: "Nearly always make [then corrected to 'male']"
"We were going out supervising parents starting to give the boy his prevention injections themselves
"Wonder if knew antenatally
"Must have done suppose to know now
"Sure boy we went to had it thru port-a-[cath]"
LL: "Complex condition, yeah 50;50 chance antenatally"
Letby says her nursing colleague had more experience, and it was a 50:50 chance that the mother would pass on the condition to the baby. She said it was something she had heard of, but did not know the details of that.

3:46pm

The shift rota for June 2-3 is shown to the court. Lucy Letby is on duty. She says she has no memory of the shift.
A note by Dr Jennifer Loughnane for Child N at 0110: 'desat, unsettled...got upset, looked mottled, dusky, sats down to 40% - 100% O2. On my arrival 40% O2. screaming, poor trace on sats probe, pink, attempt to settle, crashed bleeped away. On return...sats 100%, asleep...'
Letby denies having any involvement in the incident.
A note by nurse Christopher Booth for Child N: '...One episode whilst I was on my break, whereby infant was crying++ and not settling. He became dusky in colour, desaturating to 40s. Responded to facial oxygen within 1-2 minutes. Crying subsided within 30 minutes...'
Letby again denies having any involvement in this event for Child N.
A neonatal schedule for June 2-3 is shown to the court. She tells the court she was doing feed/observations for one baby and assisting in prescriptions for another baby. Neither of them are Child N.
The event is recorded for Child N at 1am. Letby is next recorded on the schedule at 2.30am.
"Did you know there had been an incident with [Child N]?"
"No."
Swipe data is shown that Letby entered the neonatal unit at 1.15am. The court has heard swipe data is collected when staff members enter the unit, not exit. Letby tells the court she may not have been in the unit at 1am.
"The allegations against you are of the most grave nature, aren't they?"
"Yes."
In June 2016, Letby is asked about 'concerns outside of work' - Letby said she had "an active life" with hobbies and friends.
Instant messages are shown to the court, from the morning of June 13, in relation to packing for a holiday Letby took with a friend and a nursing colleague.
The discussion refers to a series of Love Island and who hosted Love Island/Temptation Island. Mr Myers explains to the court who Abbey Clancy is.
Mr Myers asks if Letby was thinking about killing babies during that time. Letby denies that was the case.

4:02pm

A shift pattern for Letby for June 2016 shows Letby worked long day shifts on June 8, 10, 11, 13, 14 and 15.
A doctor colleague says, on June 14: "Am I right in thinking you'll have done 6 long days in the last 8? No wonder you're tired"
Letby says at the end of her June 14 shift, for the handover of Child N's care to Jennifer Jones-Key: "I don't recall there being any concerns at that time" for Child N.
A nursing note by Lucy Letby for June 14 is shown to the court. It includes: '...repeat SBR this morning on downward trend but not yet >50 below treatment line but otherwise ready for home'.
Letby says Child N was being treated for jaundice and required further phototherapy. Once that was complete, he was ready to go home.
Jennifer Jones-Key notes: '...baby very unsettled early part of night. I noticed that just after 0100 feed baby looked very pale, mottled and veiny. Abdomen slightly bigger - seen by NNU nurse Belinda Simcock, advised to place baby on saturation monitor...after 30 mins noted to be having desaturations to low 80s, no intervention required but quite frequent. Rest of observations within range....baby looked worst this morning...10% dextrose commenced...'
Letby agrees Child N deteriorated during the night.
'...at 0715 baby crying and dropped saturations - seen by NNU nurse Lucy. Neopuff given with 100% oxygen...noted to be mottled all over body and blue in colour and cold to touch. Decision made to transfer to nursery 1... At handover baby dropped saturations again and required Neopuff. Care handed over to NNU nurse Lucy Letby'.
Swipe data shows Letby and a colleague entering the neonatal unit before 7.15am, in time for the 7.30am shift.
Letby recalls she went to nursery room 3 to talk to Jennifer Jones-Key "She was a good friend of mine" - as part of getting ready to work. The handover had not yet taken place "not that I'm aware of".
She said the chat happened and "within minutes" Child N's monitor went off and Child N appeared mottled. Letby says Jennifer Jones-Key was tending to another baby. Letby says she was within the doorway and had not entered the room.
Child N was in a cot by the doorway. Letby said she went straight over to him and he was a 'bluish colour' and she called for help.
Letby says Jennifer Jones-Key finished what she was doing and came over to help.
A registrar doctor came over almost immediately to help. Child N recovered from the initial episode but deteriorated again "very quickly".
"His colour was not good, he was mottled, and the decision was taken to move [Child N] to room 1".
Letby says she had been in the unit for "minutes".
The doctor said the decision was made to intubate Child N.
Letby tells the court she got the equipment ready for intubation, including routine drugs.

4:10pm

A neonatal schedule shows Letby assisted in the administration of medication for Child N at 8am-8.06am.
Letby is asked if she saw blood at some point during the intubation process. Letby says she does recall that, but cannot recall at what point that was.
The doctor's notes: 'Attempted intubation x3...using size zero blade. Blood present at oropharynx. Unable to visualise tracheal inlet. Suction did not clear the view. Intubation abandoned due to blood present...oropharynx...trauma due to repeated attempts.'
Letby recorded in her notes: '...unable to intubate - fresh blood noted in mouth and yielded via suction ++'
Letby tells the court her interpretation of the note is the blood would have appeared after the attempt to intubate.

4:17pm

A 3pm note on a fluids chart records '3ml fresh blood' as an aspirate. Letby says she did recall seeing blood in the afternoon. The note is signed by a nursing colleague of Letby - the other hourly observations are signed by Letby.
1ml fresh blood is noted by Letby at 10am and 6pm.
'Blood++' is also recorded by Letby on a note, which the court hears is "after 8am". "Blood in mouth" is recorded at 9am.

4:27pm

Mr Myers refers to police interviews Letby had. Letby says none of what was discussed in the questioning referred to any blood seen on Child N prior to the 8am intubation.
She told police the "airway issue" was from 3pm-4pm, in attempts at intubation, and recalls, from memory, seeing blood prior to 4pm.
Letby denies saying she saw blood prior to 8am.


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We now move to Child N, who the prosecution alleges Lucy Letby attempted to murder on three separate occasions in June 2016.

Letby is accused of using Child N's haemophilia as a "cover to attack him".

She is alleged to have made her first attempt on 3 June before trying twice more 12 days later.

Lucy Letby says staff on the Countess of Chester neonatal unit were "panicked" at having Child N on the ward with his condition.

She tells the court she herself had not encountered a baby with haemophilia before and she "doesn't think anyone" was familiar with how to deal with it.

Ben Myers KC, her barrister, pulls up a text Letby sent to a colleague about Child N on 2 June 2016, where she says: "Everyone bit panicked by seems of things although baby appears fine."

Asked about this, Letby says "all nursing staff, medical staff... were panicked by the condition Child N had and how they were going to manage that"

Court documents show Letby was on duty during the night shift of 2-3 June 2016.

Child N crashed shortly after 1am that night, according to notes from a doctor.

"Was that the result of you performing some sort of attack on the baby?" her barrister Ben Myers KC asks.

Letby replies "no" and says she did not have involvement with Child N. The former nurse adds she did not know there had been an incident with the infant.

"Swipe data" shows Letby entered the neonatal unit at 1.15am on 3 June.

Before moving to the further incidents involving Child N on 15 June 2016, Ben Myers KC asks his client about her life at the time.

"What were concerns in your life? What did you occupy yourself with?"

Lucy Letby says she had "a very busy life" outside of work, where she had "lots of hobbies" and "used to meet with friends a lot".

The court is shown texts between Letby, a colleague and a friend, who had planned a holiday together starting 16 June.

Letby tells the court she was "happy to go to work" before the holiday but was "excited to have the time off".

Mr Myers asks Letby: "In that time were you planning to kill babies?"

"No," she replies.

"That's what the prosecution say."

"That didn't happen," she says.

Lucy Letby says she was on the neonatal unit when Child N collapsed on the morning of 15 June 2016.

She tells the court she went to talk to a colleague in nursery three, where Child N was being cared for, and was stood in the doorway when the infant's monitor went off.

Letby says: "He was a blueish colour, he wasn't breathing properly. "

She tells the court she started to try to resuscitate him "straight away" and "called for help".

Child N recovered but the "same thing happened" within "minutes", Letby says.

A registrar made the decision to move Child N to an intensive care nursery and intubate him as he wasn't recovering, she adds.

The court has previously heard how the registrar doctor made three unsuccessful attempts to intubate Child N.

He told jurors at the time he saw blood at the back of Child N's throat as well as swelling.

Letby tells the court it's her interpretation that blood would have appeared after the intubation attempts.

She says she recalls seeing blood in the afternoon but does not remember exactly when.

That brings an end to this afternoon's session.

Defence barrister Ben Myers KC will continue questioning Lucy Letby when proceedings resume tomorrow morning.

Thanks for following our live coverage today.


Dan O'Donoghue BBC Twitter - https://twitter.com/MrDanDonoghue

We're now moving onto Child N. He was born with a blood disorder, which made him prone to bleeding, in early June 2016, but his condition was described as "excellent" by medics.

The prosecution said the disorder gave Ms Letby "cover" to attack him and his three deteriorations in June 2016 were consistent with some kind of "inflicted injury" or him having received an injection of air.

Ms Letby is accused of trying to kill the boy on three occasions. Manchester Crown Court has heard that the first attempt came in the early hours of 3 June. Child N experienced a "sudden deterioration" and was heard “screaming" and crying for 30minutes.

Mr Myers asks if reports of the child screaming were a result of Ms Letby 'performing some sort of attack', she responds 'no it’s not'. She denies causing the baby any harm

Mr Myers asks Ms Letby if she had any involvement with the treatment of Child N at that time in the morning, she says 'no'

Mr Myers asks Ms Letby: 'Did you know that there had been an incident with (Child N)?', she says 'no'. Door swipe data from the time shows Ms Letby enters the unit at 01:15hrs that morning - 10mins after Child N's collapse

Mr Myers is currently asking Ms Letby about what was also happening in her life at the time of these incidents. He pulls up messages to a colleague and a friend, the three were going on holiday together and sending messages about packing

Ms Letby said she and her friends were 'excited' and 'looking forward' to going away to Ibiza. Mr Myers asks, in between planning her holiday if - as the prosecution allege - she was killing babies, 'no, that did not happen' she says

Mr Myers is now asking Ms Letby about the police interviews in relation to Child N

That's all for today, back tomorrow.

 

[Tortoise]

Defence Case continued 17th May 2023 - Lucy Letby's Evidence in Chief

Child N continued

Chester Standard live updates - https://www.chesterstandard.co.uk/news/23527453.live-lucy-letby-trial-wednesday-may-17---defence-continues/

10:39am

Benjamin Myers KC, for Letby's defence, is asking Letby questions for the third event for Child N on June 15, 2016.
Lucy Letby's nursing note on that day, written retrospectively, includes: 'Infant has had periods of apnoea during the morning...improving by afternoon. Observations stable...
'Approx 1450 infant became apnoeic, with desaturation to 44% hr 90bpm, fresh blood noted from mouth and 3mls blood aspirated from NG Tube....Neopuff commenced and Drs crash called...unable to obtain secure airway...[Drs] unable to insert ET Tube...I Gel airway inserted and infant ventilated'
Letby says after this event, she has some memory of it. "It was becoming increasingly chaotic- more and more staff [were called out to assist].
"There was a sense of panic that we weren't sure how we were going to manage [Child N].
"There were loads of people [called to care for him], I would say 10-15.
"[Child N] needed such care that he needed two people to care for him [at all times].
A transport team from Alder Hey was called out to assist, and bring 'Factor 8' "as an emergency".
Letby says Factor 8 was required for Child N, but none was available on the unit.
Mr Myers says it was known Child N required Factor 8, and Child N had been at the unit since his birth.
Letby: "It became a panic then."
"I think baptism was offered to the parents at some point...there was a lot going on in the room.
"The team from Alder Hey came and there was a lot of discussion...the team had brought a lot of specialist equipment over...at this time, handover was taking place [around 7.30pm] and around this time, that was when the episode happened."

10:44am

Doctor's notes record: 'At 1940 desat 80 [down to] 50 [down to] 40% + associated brady. Resus...'
Letby's notes written at 8.53pm recorded: 'Medical team from AHCH arrived approx 1900. Assessed [Child N] and decision made to attempt intubation in CLS theatre...at 1940 profound desaturation (30s) with colour loss. stiff and back arching. Became bradycardiac....mottled++. Drs present. Resus commenced...care handed over. All events took place on NNU prior to moving to CLS theatres. NWTS team arrived 2040.'
Letby says Child N "was the focus of the whole unit" at that point, and there were concerns staff could not get him intubated.
"It was a real concern, we were all worried about him."
"It was something I had never experienced before - I had never seen that many people in the nursery for one baby.
"The concern was if we couldn't get an airway...then we would have to undergo surgery...
"It was frightening...for his safety."


Sky Updates - Lucy Letby trial - live: Ex-nurse in witness box after denying she had killing babies on mind before Ibiza trip

9m ago10:51

Letby describes 'chaos' and 'panic' as staff worked to save Child N​

Lucy Letby says the atmosphere on the Countess of Chester neonatal unit was "increasingly chaotic" as staff made multiple unsuccessful attempts to reintubate Child N after his oxygen levels fell during the afternoon of 15 June 2016.
"More and more staff were coming to try and assist. There was a sense of panic around the unit as we weren't sure how we were going to manage [Child N]."
Asked if she remembers how many people gathered in the nursery where Child N was, she says "loads... 10 to 15".
Letby tells jurors that she was not the only nurse caring for Child N at any point as he had a high-level care need.
A more specialist team from another hospital had to be called in to carry out the intubation, the court hears.
The ex-nurse says she felt stressed and anxious as the situation was something she "had never experienced before".
"We'd never had to have staff from another hospital come in, had never seen that many people in the nursery."
She said the prospect Child N might have needed surgery was "frightening, for his safety, we wanted him to be well".
"The fact we couldn't manage his airway was concerning."

https://twitter.com/MrDanDonoghue

Ms Letby is now in the witness box. Mr Myers is first turning to Child N's final collapse at around 15:00 on 15 June. Medics were crash bleeped as the boy's oxygen levels had fallen to 44%.

Dr Huw Mayberry was first to respond. When he looked into Child N's airway, he saw a “large swelling at the end of his epiglottis”. He previously told the court that he had never seen anything like this before in a newborn baby

The court has previously heard that there were many difficulties intubating Child N. They persisted on June 15

Mr Myers asks what the atmosphere was like on the unit at that time, she said: 'It was becoming increasingly chaotic, more and more staff were coming to try and assist. There was a sense of panic around the unit, we weren’t sure how we were going to manage (Child N)'

Ms Letby says there were around 10-15 people on the unit trying to assist with Child N's care. Situation was complicated by the fact Child N had a rare blood condition. Eventually a specialist team from Alder Hey were called in to assist with treatment

Ms Letby is recalling a further collapse of Child N at 19:40 on June 15. Mr Myers brings up medical notes that show a number of doctors attended to the baby boy at that time as he had desaturated and required resuscitation

Ms Letby is asked how she was feeling at this time, she said she was 'very worried' about Child N. She said she had 'never experienced' so many experienced staff struggling to intubate a baby like that 'It was frightening for his safety', she said

 

[Tortoise]

Defence Case continued 17th May 2023 - Lucy Letby's Evidence in Chief

Triplet O

Chester Standard live updates - https://www.chesterstandard.co.uk/news/23527453.live-lucy-letby-trial-wednesday-may-17---defence-continues/

10:50am

Mr Myers now turns to the case of Child O, one of three triplet brothers born on June 21, 2016, weighing 2,020g, at a gestational age of 33 weeks and 2 days, at the Countess of Chester Hospital.
Child P is another one of the triplet brothers.
Mr Myers recalls the events for Child O, who died at 5.47am on June 23. A post-mortem examination showed damage to the liver.
Lucy Letby says prior to this, she had been abroad on holiday with her nursing colleague and a friend. A rota of Letby's shifts showed she was off June 16-22.
The rota shows she was on long day shifts for June 23-25 and June 28-30.

10:57am

Messages are shown to the court between Letby and Jennifer Jones-Key from June 22,
Letby confirms when she is back in, adding: "Yep probably be back in with a bang lol"
Asked to explain that, Letby says she would be back in a busy shift. Asked by Mr Myers, Letby denies she was planning "anything terrible".
Letby said she was "very available" for work as she had no commitments outside work and lived nearby.
A message from a doctor to Letby: "How was the flight? Unpacked as well - it's the only way!! (washing machine on?) Day has been rubbish . Lots of unnecessary stress for nnu and too much work to fit into one day . I may have (over)filled the unit (again) . SHO's have all been fed & watered and the babies are generally ok - so maybe not as bad as I'm thinking!"
Letby: "Glad it's over but flight was & airport was fine thinks (on 2nd load of washing!!)
"Oh that's not good back to earth with a bump for me tomorrow then!!
"You seem to be quite good at acquiring babies to fill our empty cots....?"
The reply: "It's a skill I've had for years . To be fair, there wasn't a social admission! Yes, you might be a bit busy. Oh - you're right, I made sure they went first. Just realised when I last ate (oops)"
Letby says it was not unusual for the unit to be busy.
She adds there was also discussion, at this time, about removing level 4 unit nurses from the neonatal unit.
A shift rota for June 23 is shown. Letby was designated nurse for the triplets in room 2.
Mr Myers asked if managing three babies in a high dependency was outside the ratio required for nurses to babies. Letby says it is - it should be one nurse to two babies in that room.
In room 1, two nurses are looking after four babies. Letby says the care should be 1:1 [ie one designated nurse to one baby], and the room is full.

11:14am

Notes by Sophie Ellis are shown to the court for the night of June 22-23, recording observations for Child O. They include: 'TPN stopped as reached full feeds of DEBM [donor expressed breast milk], tolerating well, 12mls 2x12. Antibiotics stopped...blood gas completed at 0532 - lactate 2.3'
Letby says that lactate reading is outside the normal range, and she would inform a doctor about that reading.
Sophie Ellis adds: 'Abdo looks full slightly loopy. Appeared uncomfortable after feed.'
Letby says Rebecca Morgan was a student nurse on her first day of placement on the unit, and Letby was the designated mentor.
She tells the court the student nurse would be orientated on to the unit by a senior member of staff, but that was not possible due to the unit being busy, so she carried out the induction process herself.
"On top of looking after three high dependency babies?"
"Yes - I didn't know I was going to be looking after a student [until I arrived at the unit]."
Letby messaged a colleague: "It's busy but no vents [patients on ventilators] anymore. I've got triplets in 2 all ok. But got a student and first day, 2 hourly feeds etc no time to do anything lol and Yvonne f in but said i can show her sound etc x"
The reply: "What?! That's ridiculous. When r u meant to get time to do a proper induction?"
Letby: "No idea, she's nice enough but bit hard going to start from scratch with everything when got 3 babies i don't know and 2 hourly etc. Ahh well."
Letby also messaged a doctor: "My student is glued to me....."
Letby's nursing notes for Child O included: '...abdomen appeared full, but soft and non-distended...reviewed by [registrar] at 1315 - [Child O] had vomited (undigested milk), tachycardiac and abdomen distended.'
Letby says two-hourly observations were required for all three babies in room 2, and the student nurse would also be involved.
A fluid balance chart shows student nurse Rebecca Morgan has completed the reading for 8.30am, and had been doing the feed. For 10am and noon, the court hears Letby has signed the observation, but Rebecca Morgan has filled in the entries for feeds and aspirates.
For Child O's observations chart, Rebecca Morgan has signed and filled in the observations at 8.30am and 10.30am. Letby says she has written in the observations for 1.30pm and 2.30pm.
Letby says the 12.30pm observations have been filled in by Rebecca Morgan, but were not signed "due to human error". She denies there was anything "sinister" in leaving out the initials on the chart.

11:19am

For 1.15pm, Letby recalls being outside room 2 and hearing an alarm going off. She went in and found it was Child O's alarm. She does not recall if any other nurses were in the room at that time.
She recorded: "at 1315 - [Child O] had vomitted (undigested milk), tachycardiac and abdomen distended.'"
Letby said it was "not a concerning vomit" for Child O, who was not moved from room 2.
The notes add: 'approx 1440 [Child O] had a profound desaturation to 30s followed by brady. mottled++ and abdomen red and distended. Transferred to nursery 1...perfusion poor....Drs crash called at 1551 due to desaturation to 30s with brady...reintubated...CPR commenced 1619...'
Letby says, for 1440, she heard "a monitor alarming" and went in, and found it was Child O's alarm. She said she called the doctor who was next door.
"This was more significant as [Child O] needed intervention at this point....he looked different...unwell at this point.
"He appeared mottled...his abdomen was redder than it had been previously.
"Mottling is something we see quite often with babies."
Mr Myers asks if Letby had introduced air into Child O, or any baby in the case.
Letby: "No."

11:38am

The neonatal schedule for June 23, 2016 is shown to the court.
The event is marked for Child O at 2.40pm. At 2.39pm, two medications are given intraveneously to Child O and the records are made on the computer, by Samantha O'Brien and Melanie Taylor.
An infusion for Child O is made at 2.40pm by Lucy Letby and Samantha O'Brien.
Letby says the order, as it appears to the court [before the event], is incorrect - the infusion should be listed in sequence after the event, in response to what had happened.
She says she cannot comment on the 2.39pm medication as she was not there.
Medicine prescription charts are shown to the court for the 2.39pm prescriptions.
Swipe data shows Letby has arrived on the neonatal unit from the labour ward at 2.39pm.
A doctor's notes record for the event: 'Called to see [Child O] at ~1440, desaturation, bradycardiac and mottled. Bagged up and transferred to nursery 1...
'10ml sodium chloride bolus already given'
Letby says the 10% saline bolus is given, as shown on an IV chart, at 2.40pm, in response to Child O's deterioration.
She tells the court that one minute prior, she was not on the unit.
Child O was transferred to room 1 and the decision was made to intubate him. Letby says she cannot recall "with any clarity" the events from then on.
A note from Dr Brearey is shown to the court at 6pm: 'Assisted with initial intubation...small discoloured ? purpuric rash on right chest wall. Good perfusion.'
Letby says this is not something she had observed, or was identified to her at any point.
Letby says she could not recall the next few hours as events for Child O merged into one. She recalls CPR taking place and there being two doctors and two nurses present. She does not recall taking part in the CPR.
The court is shown there were two episodes of CPR at 4.19pm and 5.16pm.
Letby recalls a drain being inserted during resuscitation.
Asked about what the atmosphere is like when a baby dies on the unit, Letby tells the court: "It's completely flat, there is a complete change in atmosphere...to me personally, it's devastating, you want to save every baby in your care.
"You're not supposed...to watch a baby die."
Mr Myers says a post-mortem examination identified an injury on the liver. He asks if Letby knows how that happened. Letby: "No."


11:48am

Text messages between Letby and a doctor from June 30-July 1, 2016 are shown to the court, concerning the liver injury.
Letby recalls a colleague being "very upset" and "was crying" at what had happened.
The doctor had messaged: "I'm not sure where the information has come from.
"It seems that on the SHO grapevine somebody at LWH has said that one of the triplets was found to have a ruptured Liver.
"[Colleague] was upset that this may have been caused by her chest compressions."
Letby: "Oh no, that's awful.
"No wonder she's upset. Were you able to reassure her?"
The doctor replied: "We spent 20 mins in a cubicle going over everything.
The CPR was all at the 5th rib space - between the nipples.
The duoderm on [Child O] was high.
If there was anything it will have been due to fluid volume causing Liver distension.
"I'm not sure I believe it.
"It was a coroners pm.
"It usually takes weeks to get any report."
Letby: "It seems a bit like a rumour mill has gone into overdrive - the boys were only returned today, can't see how info would be out that quick?"
Doctor: "No me neither."
Letby: "Not nice for [colleague] though, can see how it would play on her mind."
Doctor: "This has come at the end of a 7 day run for her. Not a good time."
Letby: "No. It's good that she felt able to tell you"




Sky Updates - Lucy Letby trial - live: Ex-nurse in witness box after denying she had killing babies on mind before Ibiza trip

25m ago11:04

Defence moves to triplet brothers​

Ben Myers KC now moves to the cases of Child O and P, two triplet brothers, who both died within a week of their births in June 2016.
Lucy Letby is accused of both of their murders, which she denies.
Letby was on her first shift back following a holiday on 23 June, when Child O died. Child P died the following day.

17m ago11:13

'I wanted to give best care I could to babies,' Letby tells court​

Lucy Letby says she was responsible for the induction of a student nurse during her day shift on 23 June.
She didn't know she had a student until that morning, she tells the court.
A text from Letby to a colleague - shown to jurors - sent on the morning of 23 June, says: "I've got triplets in [nursery two] all ok. But got a student and first day, 2 hourly feeds etc no time to do anything lol..."
A later message to a registrar doctor on the unit said "my student is glued to me...."
Ben Myers KC says: "The prosecution allege that you intended to kill Child O [on 23 June], is that something you were planning?"
"No," Letby replies.
"What did you intend to do?"
"Give the best care I could to the babies and also support the student nurse."

6m ago11:30

Letby denies introducing air to babies​

Lucy Letby tells the court she heard Child O's monitor bleeping at around 1.15pm on 23 June 2016 and found him vomiting, but added this was "not concerning" or a "significant change" in his condition.
Child O's monitor later went off at around 2.40pm, she says, when he had suffered a "profound desaturation".
Letby recalls that she attended the nursery and called for help from a registrar doctor.
She describes how Child O's "colour had changed, he was more mottled, his abdomen was redder than it had been previously and he generally didn't look as well as he'd looked before".
Her barrister, Ben Myers KC, asks Letby if she did anything which involved air being introduced to Child N [O] at this point - she denies she did for Child N [O], or any other baby involved in the case.

Now11:47

'You're not supposed to watch a baby die'​

Child O suffered a further collapse at around 4.15pm on 23 June which required resuscitation, but efforts to save him were unsuccessful and he died shortly after 5.47pm.
Lucy Letby says the atmosphere in the neonatal unit becomes "completely flat" after a baby dies and "there's a complete change in atmosphere".
Asked how it affects her personally, she said: "It's devastating, you want to be able to save every baby in your care... you're not supposed to watch a baby die."
A post-mortem examination found damage to Child O's liver in multiple locations.
Ben Myers KC, Letby's defence lawyer, asks if she knows how he came to receive that injury.
"No," she replies.



Dan O'Donoghue

We're now moving to Child O. He was one of triplet brothers and was born in good condition in June 2016. The court has heard he was stable up until 23 June, when he suffered a "remarkable deterioration" and was moved to nursery one, where he stabilised.

He later suffered a further fatal collapse. A post-mortem examination found unclotted blood in his body from a liver injury, which led a coroner to conclude his death was due to natural causes.

An independent pathologist, who later reviewed the case, said the boy had suffered an "impact injury" akin to a road traffic collision, while medical experts for the prosecution said he died due to a combination of that injury and air being injected into his bloodstream.

Mr Myers has asked Ms Letby what was going on in her life in the week prior to Child O's collapse and death - she tells the court she was on holiday in Ibiza with a colleague and a friend

Mr Myers pulls up text messages sent at that time, in one message (after she arrived back in the UK and was told about the birth of triplets on the unit) she said 'back in with a bang lol'

Mr Myers asks Ms Letby what she meant by that message, she said 'that I’d come back and be straight back on a busy shift' - asked if she was planning anything 'dramatic and terrible' upon her return, she said 'no'

Mr Myers is now focusing on June 23, the day Child O died. He notes that Ms Letby had a student nurse with her that day. He asks Ms Letby if she was planning to kill Child O that day, she says 'no' and that she was planning to 'give the best care that I could for the babies'

Mr Myers is currently taking the jury back over observation charts for Child O, they show that a student nurse (who was on shift with Ms Letby that day) carried out a large proportion of the obs that day

At around 13:15 Ms Letby heard Child O's alarm and went to check on him in nursery two - he had vomited undigested milk. A doctor was called to review and he was deemed stable at that point

At around 14:40 Child O had a 'profound desaturation' and was transferred to nursery one. He needed resuscitation. He had a further collapse at 16:15 hrs which again required resuscitation including cardiac compressions. Those efforts were unsuccessful he died soon after

Mr Myers asks Ms Letby if she introduced air into Child N's [O's] system or did anything to harm him, she says 'no, never'

Door swipe data shows Ms Letby enters the neonatal unit at 14:39 from the labour ward - the same time that two other nurses are administering medications to Child N [O] (who collapsed at 14:40)

Ms Letby is recorded as giving Child N [O] a sodium chloride bolus at 14:40, she says this is in response to the baby's collapse. On a timetable, produced by police, it has Ms Letby administering this before the collapse

Mr Myers is now asking Ms Letby about her recollections of Child O's resuscitation. She says there was more than one round of CPR and this was rotated among the doctors present

Mr Myers asks Ms Letby how she felt after Child O's death. She said: 'it’s devastating, you want to be able to save every baby in your care…you’re not supposed to watch a baby die'

Mr Myers asks Ms Letby about the findings of an expert pathologist - that Child O had a liver injury. She is asked if she knows what caused this, she says 'no'


https://twitter.com/MrDanDonoghue

 

[Tortoise]

Defence Case continued 17th May 2023 - Lucy Letby's Evidence in Chief

Triplet P

Chester Standard live updates - https://www.chesterstandard.co.uk/news/23527453.live-lucy-letby-trial-wednesday-may-17---defence-continues/

12:25pm

The trial is resuming after a short break.
Mr Myers is now turning to the case of Child P, who weighed 2,066g.
Mr Myers says there was "mild abdominal distention", recorded in Child P's clinical notes at 6pm on June 23, with "milk and air aspirates" recorded overnight.
At about 9.40am on June 24, Child P had desaturation, distended abdomen, mottling. At 12.28pm, there was a further desaturation and bradycardia. Around that time, a pneumothorax was identified on the chest x-ray. At 3.14pm Child P collapsed, and later died at 4pm.
A shift rota for June 23 is reshown to the court. Letby was designated baby for Child O and P and one other baby in room 2.
Letby says the focus was on Child O that afternoon, and does not recall anything significant for Child P at that time.
Her nursing notes from June 23: '...nursed in an incubator, observations within normal range, continues with 2hourly feeds...minimal aspirates obtained. Abdomen appears full but soft and non-distended...difficulty obtained IV access - secured after numerous attempts...'
Letby says there was nothing concerning regarding Child P at this time.
A doctor's note that afternoon for Child P records: 'Abdomen full; mildly distended'
Letby tells the court there was "nothing unusual" about that.
An abdominal x-ray for Child P is taken at 8.09pm, after Letby had stopped giving care for Child P. Letby tells the court she had stopped at 2pm that day "officially", as her care was focused on Child O that afternoon, and care of Child P was handed over.
The x-ray report included: '...Gas-filled bowel loops throughout the abdomen...'
Letby says student nurse Rebecca Morgan was still involved in the care of Child P.
An observation chart for Child P for June 23 is shown. Letby says she signed at 8am and co-signed at 10am, with the observations filled in by the student nurse, Rebecca Morgan. The court hears Rebecca Morgan signed and filled in observations for noon, 2pm, 4pm and 6pm. Sophie Ellis records observations from 8pm onwards.
The feeding chart is shown for June 23. Letby says she has co-signed at 8am, 10am, noon, and 2pm and 4pm, while Rebecca Morgan has signed and completed the entries.
'Trace' aspirates are recorded for Child P throughout the day, other than a 'small vomit' at noon.
Letby says "other nurses" and Rebecca Morgan were looking after Child P by 6pm.
Letby says after the overnight shift, Sophie Ellis said she was "quite concerned" for Child P due to the abdomen exam and following the events for brother Child O, and Child P was placed nil by mouth as a precaution.
Nursing notes by Sohpie Ellis on June 23-24 included: 'observations have been within limits. Did have 1 desat into 80s and 1x brady into high 90s. Self corrected, no intervention required. Does at times have a low lying HR between high 90s and 110. SHO aware.
'Feeding...14ml part digested milk aspirate gained at 2000 feed. Nurse in charge informed...continued with feed. 0000 feed, 20ml part digested milk aspirate obtained. Abdo is full but soft...
In an addendum: 'Abdo has been soft and non distended. 25ml of air aspirated...NGT placed on free drainage.'
Letby says the 14ml aspirate at 2000 was "a change", following "trace aspirates". A 20ml aspirate was taken and discarded at midnight.
Letby says that was a sign the baby "was not digesting the milk", and that was a "decline" in the baby's health.

12:34pm

Letby says she would have expected the stomach for Child P to be empty at that point.
Child P, from midnight onwards, was nil by mouth and was put on 10% dextrose fluids.
25mls of air was aspirated from Child P at 4am.
Letby: "That is a very large volume of air.
Mr Myers: "Should it be there?"
Letby: "No."
5ml of air and 2ml of milk is aspirated at 7am. Letby tells the court that is something you would not expect to find at that time for a baby nil by mouth, and said there had been a "noticeable decline" in Child P's health.
The day shift for June 24 is shown to the court. Student nurse Rebecca Morgan is on the rota. Letby is the designated nurse for a baby in room 2. The other surviving triplet is also in room 2, with designated nurse Christopher Booth.
Letby said she was asked to continue looking after Child P. Asked for her opinion on that by Mr Myers, Letby said: "I felt that was the right thing to do, for the parents to have that continuity."
Letby recalls, for the morning of June 24: "I was conducting my safety checks...noticed [Child P's] abdomen was quite loopy - you could see the stomach had changed, was raised. I spoke to the nurse in charge about this and wait for the [doctors to review]."
"Very soon" after the doctors reviewed Child P, Child P had an apnoea "that needed attention".
Letby says herself, Dr [Anthony] Ukoh and Rebecca Morgan were in the room at the time of the deterioration.
"[Child P] was apnoeic...I went out to call for help."
Other doctors were in room 1 as part of their ward round and came to assist, the court hears.
Child P stayed in room 2 - Letby: "at this point room 1 was busy and it was felt safer to keep him in room 2"

12:45pm

Letby's nursing note for June 24, written at 9.18pm and finished at 10pm, is shown to the court. It includes: '...[Child P] nursed in an incubator...abdomen full - loops visible, soft to touch.
'Reg Ukoh arrived to carry out ward round - '[Child P] had apnoea, brady, desat with mottled appearance requiring facial oxygen and neopuff for approx. 1 min. Abdomen becoming distended'
'Shortly after acute deterioration...'.
Letby says Child P was intubated and "seemed stable at this point".
Child P had a further desaturation at 11.30am - he was given adrenaline and he was paralysed with a drug to aid ventilation.
Letby says there was no issue with a tube dislodging, or one recorded in the notes. She recorded a pnemothorax, which had been identified in Child P after the collapse.
Asked, outside of the notes, to recall Child P the rest of June 24: "I just remember there being a general decline through the rest of the shift."
Letby said she "gave a lot of medication" to Child P. She said, for her nursing note written at the end of the day, notes were written contemporaneously on a piece of paper.
Letby does not recall a distinct change in colour for Child P that afternoon.
"There was an increasing sense of anxiety [on the unit]...and a huge sense of relief when the transport team did arrive [from Arrowe Park, a tertiary centre]"
Five Countess staff were there throughout the day, and one of the doctors "frequently left the building to have a cigarette", which the court hears was something they would normally do.
Child P's medical needs were "beyond our level of care", Letby said. She tells the court that "potentially", she may have said words to the effect of "he’s not leaving here alive is he?".
Letby says she was present when Child P died. She says support was given afterwards to the family. She remembers dressing Child O and Child P.
Asked about the atmosphere in the unit after the second triplet died, Letby says: "It was completely flat atmosphere - everybody was shocked, devastated. The whole unit was just flat, generally. It wasn't the usual positive atmosphere we would have normally.
"I was really upset - two days in a row, to imagine what the parents had gone through, it was harrowing."

1:01pm

The family communication note for Child P, by Letby, is written retrospectively at 10pm.
'I have dressed [Child P] at their request and taken photos of [Child O and Child P] together. Support++ given to parents and extended family. Time spent on lavender suite as a family.'
Letby says the note was written "so late" as she had gone to A&E herself for a needle-stick injury. One of the needles for Child P had pricked her finger, the court hears.
Letby says there was a pathway she had to follow, and she had to take boosters and vaccinations.
She said she was "unwell - I had fainted" - she said from the stress of the day, she hadn't eaten. "The enormity of the past two days had taken its toll."
Letby confirms she completed her notes after her A&E visit, for Child P.
Letby says a doctor she had been messaging had offered her a lift home, having been aware she had gone to A&E, and would be otherwise walking home alone at night.
The doctor gave her a lift, and Letby tells the court he then drove home.
The court is shown handover sheets for June 25, 2016, recovered from Letby's home by police in 2018. Various notes were written on the back of that, the court hears.
Asked to explain why this, and ones for June 23-24, were found at her home: "They have come home in my uniform, and I have not done anything with them."
The handover notes also include other babies Letby was the designated nurse for.
A message from Letby to a doctor on June 23 said: "I lost my handover sheet - found it in the donor milk freezer!! (clearly i should still be in Ibiza)"
Letby is asked to explain a search for the surname of Child O and Child P on June 23, 2017. Letby said the date was the anniversary: "they were on my mind.
"It was such a harrowing eperience seeing parents lose two of their children.
"In two days running, you don't forget something like that."
This note is shown to the court:



The note, the court hears, is a reference to the anniversary of Child O and Child P's death. Letby adds her writing also was how she felt at the time of writing the note.



Sky Updates - Lucy Letby trial - live: Ex-nurse in witness box after denying she had killing babies on mind before Ibiza trip

7m ago12:15

Letby questioned about second 'killed' triplet​

We now move to count 21 on the indictment against Lucy Letby involving Child P, one of two triplets the prosecution alleges was killed by the former nurse.
Child P died on 24 June 2016 - one day after the death of his brother Child O.
He suffered multiple collapses as he was being prepared to be transferred to a different hospital.
A medical expert for the prosecution said the likely explanation for Child P's collapse was the injection of excessive amounts of air into his stomach.
Letby denies murdering the infant.

4m ago12:37

Child P's health declined after Letby's shift ended​

Lucy Letby says Child P was fed by a student nurse with her observation throughout the day on 23 June 2016.
She tells the court she was not aware of any conditions or problems with the baby when she ended her shift.
Letby recalls a nurse being "concerned" at a "noticeable decline" in Child P's condition overnight when she arrived at the unit the following day.
"Was that anything like the condition he'd been in when you and [the student nurse] were looking after him day before?" asks Letby's defence lawyer Ben Myers KC.
"No", she says.

Now12:53

Staff 'acutely anxious' about Child P after brother's death​

Lucy Letby tells the court Child P became apnoeic after being reviewed by a doctor on the morning of 14 June 2016 and needed intervention.
She says she called for help as the doctor used the Neopuff on him, but doesn't remember if this involved a crash call. He later stabilised.
The former nurse says she doesn't have any independent recollection of Child P's further collapses shortly before 12.30pm and at 3.15pm.
He suffered a "general decline" in his health throughout the day, she tells jurors.
There was an "acute sense of anxiety" on the unit and staff were particularly worried about Child P because of what had happened to Child O the previous day, she says.
"Did you voice concerns that Child P wouldn't make it, or make it out?" asks Ben Myers KC, defence lawyer.
Letby says she doesn't recall making a comment like that but it could "potentially" have happened.

1m ago12:59

'Harrowing' to think of what triplets' parents went through, Letby says​

Following the deaths of Child O and P, Lucy Letby was responsible for providing bereavement support to their parents as the babies' designated nurse.
Asked what kind of support she gave them, Letby says she dressed the two triplets at the parents' request.
"Can you convey to us what the atmosphere was like on the unit, when a second triplet had died like this?" Ben Myers, Letby's defence lawyer, asks.
"It was a completely flat atmosphere, everybody was shocked, devastated," she says.
Recalling how it affected her personally, the former nurse adds: "I was really upset about this, to have [two babies die] two days in a row, to imagine what those parents had gone through to lose two of their babies, it was harrowing."

1m ago13:22

Letby explains why she searched triplets' surname on anniversary of their deaths​

Lucy Letby searched the surname of Child O and P online on 23 June 2017, one year after the triplet boys died.
She says she doesn't remember the search taking place but it would have been done on that date as it was the anniversary of their deaths.
"They were on my mind," she says.
"Were [Child O and P] something that did stay on your mind?" asks Ben Myers KC, for the defence.
"Yes."
"Why was that?"
"It was such a harrowing experience to see parents lose two of their children and to have that happen two days running, you don't forget something like that."


Dan O'Donoghue BBC Tweets - Dan O'Donoghue

We're now moving to Child O's triplet brother, Child P. He was put under observation as a precaution after his sibling's death.

At 09:35 BST on 24 June 2016, a registrar found he was "self-ventilating in air" and stable, but 15 minutes later, he collapsed and required breathing support. He collapsed several more times, before being pronounced dead at 16:00.

A medical expert for the prosecution said the collapses were consistent with an "additional amount of air being given to this baby"

Mr Myers is taking the jury back over observation charts for Child P - they show that on the evening/night before his collapse and death he was being cared for by a student nurse on the day shift and another nurse on night shift

Ms Letby was designated nurse for Child P on morning of 24 June. She recalls being told in the nursing handover that there was concerns for the boy, given what had happened to his brother - so as a precaution he had been placed nil by mouth for a period

Ms Letby says she recalls that morning seeing Child P with a 'loopy bowel', she said that a decision was taken with a more senior nurse to wait for a doctor to review him. The doctor reviewed the boy and around 15mins later he suffered an apnoeic episode

The baby boy required neopuffing and stabilised - but shortly after required emergency intubation

 

[Tortoise]

Defence Case continued 17th May 2023 - Lucy Letby's Evidence in Chief

Child Q

Chester Standard live updates - https://www.chesterstandard.co.uk/news/23527453.live-lucy-letby-trial-wednesday-may-17---defence-continues/

2:09pm

The trial will resume shortly. Mr Myers will be asking Lucy Letby questions in the case of Child Q, the final of the 17 babies in the trial. Child Q, a baby boy, was born on June 22, 2016, weighing 2,076g.

2:21pm

Child Q was born at 31 weeks and 3 days gestation at the Countess of Chester Hospital.
Mr Myers tells the court there was one event for Child Q on the morning of June 25, vomiting, desaturation, bradycardia, with "air++" aspirated from the NG Tube.
A doctor gave a diagnosis of "probable NEC" the following day and Child Q was transferred to Alder Hey on June 27, returning to the Countess of Chester Hospital the following day.
A handover sheet for June 28, 2016 is shown to the court, in which Lucy Letby is deisngated nurse for three babies, not Child Q, that day, in room 3.
Letby said she was "drained and emotionally exhausted" by June 25, following the events for Child O and Child P.
A day shift for June 25 is shown. Rebecca Morgan is on duty as a student nurse. Letby tells the court she was no longer the mentor as she had said she could not give her that time to do so, and so Ms Morgan was overseen by other nurses.
Letby is the designated nurse for Child Q in room 2 and a baby in room 1.
Letby tells the court: "You'd have to split yourself between the nurseries" when given designated care for two babies in two different nursery rooms.
Nursing notes for June 24-25: '...[Child Q] self ventilating in air...feet pink and warm. New lipid syringe put up overnight...having trophic feeds of donor ebm, 0.5mls 2 hourly due to moderate aspirates. Abdomen full but soft.'
Letby says the 'trophic feeds' are to get a baby's digestive system going. The aspirates indicated Child Q was not ready to tolerate larger feeds yet.

2:43pm

A feeding chart for June 23 is shown to the court for Child Q.
A '2ml milky' aspirate is recorded at 2030. At this point, the court hears, Child Q had received a total of 3.5ml of milk.
Letby said "you would hope" the aspirates would be decreasing throughout this time.
A 3ml aspirate is recorded at 3am on June 24. Letby says it "wouldn't be of great concern...but ideally we would want the aspirate [to be] the least possible".
At the time of the handover on the morning of June 25, Letby said she noticed from the observation chart he was "on the cold side" and she would want him reviewed by a doctor before the 9am feed.
Letby said she was concerned about the temperature, Child Q was "on the borderline" of being too cold on the chart, and the incubator temperature was increased from 30.2C to 32C throughout the day. The temperature remained low which Letby said "was a concern".
Letby said she should not feed Child Q until the doctors had reviewed him at 9am.
Letby said she was also caring for an intensive care baby in room 1. She said for cares to be given in room 1, she would have to ensure a nurse remained present in room 2. She informed two nurses when she said she needed to go to room 1.
One nurse was sat at the nursing station and the doctors were starting their ward round at about 9am. Letby said she went to room 1 just after 9am. She does not recall how the room 1 baby was doing.
A neonatal schedule for June 25 is shown to the court. Letby is recorded as making observations at 9am for Child Q. Letby assists a nurse in room 1 for medication at 9.04am.
Letby says she was in room 1 for "a few minutes" and could hear something going on outside the nursery.
"I went out through the door and I could see down the corridor"
Letby went to Child Q's cotside, where there were two nurses present. Letby heard from a colleague Child Q had vomited a 'mucusy vomit'. He had stopped and "recovered" by the time Letby arrived.
Letby's notes: '[0800]...observations as charted - temperature low, incubator increased x2. Tachycardiac. Active and alert...abdomen soft and non-distended.
'0910 [Child Q] attended to by S/N Lappalainen - he had vomited clear fluid nasally and from mouth, desauration and bradycardia, mottled++. Neopuff and suction applied. Reg attended. Air++ aspirated from NG Tube.'
Letby says all this was relayed to her, and not from her observation.
Nurse Minna Lappalainen wrote: 'Baby found to be very mucousy, clear mucus from nasopharynx oropharynx removed. Clear fluid+++ O2 via Neopuff...Dr...emergency to attend...NGT used to aspirate stomach by nurse Lucy Letby.'
Letby confirms the description of the type of fluid was the only one she heard. She did not administer the Neopuff breathing support.
Letby confirms she continued to care for Child Q after he was transferred to room 1.

2:48pm

Mr Myers asks, in the context of the trial and every day at the hospital, whether this had been a significant event.
Letby: "This wasn't a significant event - this is something we deal with on a routine basis. Not that it's not important...he needed minimal intervention."
Mr Myers: "And in the course of the day, did [Child Q] have any further collapse?"
Letby: "No."
Lety's notes: '...respiratory rate declining...and intermittent pauses in breathing...blood gas stable but on downward trend and [Child Q] appearing 'tired'. Oxygen requirement developing. Discussed with consultant Gibbs and decision made to electively intubate...uneventful intubation...care handed over'
Letby says, other than Child Q requiring CPAP, there were no other outstanding issues for him.
A nursing note by Lucy Letby for Child Q is shown for June 29 and June 30. Letby confirms she was Child Q's designated nurse for those days. She does not recall, outside of the notes, being the designated nurse for Child Q those days.

2:53pm

Messages are shown between Letby and a doctor: "Do I need to be worried about what Dr Gibbs was asking?"
Letby said she had become aware during the shift on who was present in the nursery when Child Q had his episode. She said she was worried she would be blamed for leaving him alone in the nursery.
Letby messaged: "I walked into equipment room, he was asking Mary who was present in room and how quickly someone had gone to him as I wasn't in the room.
"He asked who was there, I said I had popped out of room but Mary was in room and Minna at the desk."
The reply: "All he was doing was checking that there wasn't a delay and that a room had been left empty.
Was he HDU level because of uvc?
There is nothing to worry about."
Letby: "Ok. Was worried because I Wasn't with him at time, but Mary was in room and Minna outside, I had B in 1.
ITU because of uvc"
Letby tells the court Child Q had not been left unattended, but felt she may have been accused of leaving him unattended, and/or that she should not have left room 2.
Letby did not work on the unit after June 30, 2016.



Sky News Lucy Letby trial latest: 'You're not supposed to watch a baby die' - defendant in witness box with iPad in front of her

5m ago14:26

Defence moves to final alleged victim​

Lucy Letby's defence barrister is now moving to the former nurse's 17th and final alleged victim - Child Q, a boy, who the former nurse is accused of attempting to murder.
The prosecution alleges that Letby injected him with air during a day shift on 25 June 2016.
He deteriorated shortly after 9am and needed breathing assistance but recovered through the day; however, staff noted he looked tired towards the evening.
He was transferred to a different hospital on 26 June over the possibility of needing surgery, where he "quickly stabilised", before returning to the Countess of Chester Hospital on 28 June.
Letby denies she attempted to murder the Child Q - as well as all other charges.

4m ago14:44

Letby says she was in a different nursery when Child Q deteriorated​

Lucy Letby says she felt "emotionally drained and just exhausted" on 25 June 2016 following the deaths of triplet boys Child O and P in the previous days.
She was Child Q's designated nurse on this shift - he was being looked after in nursery two of the Countess of Chester neonatal unit.
Letby tells the court that at the time of Child Q's deterioration at around 9.10am she was caring for another baby in intensive care nursery one, and had asked a different nurse to keep an eye on Child Q.
Defence barrister Ben Myers KC pulls up hospital records which show Letby and another nurse giving medication to another baby at 9.04am.
Letby recalls she first became aware something was happening with Child Q when she "heard something happening" outside nursery one.
"I walked through door and as I went out, I could see down corridor to nursery two and saw [two other nurses] with Child Q."
Letby says she was informed Child Q had vomited and could see he was still receiving "pressure" from a Neopuff but "had otherwise recovered".
She says she had no involvement in the steps taken to assist Child Q.

Now14:55

Child Q's deterioration not a standout event on unit, Letby says​

Child Q's deterioration was not a clinically "significant event", Lucy Letby tells the court, adding that it's something the Countess of Chester neonatal unit would deal with on a regular basis.
"He needed minimal intervention," she says.
She agreed that until the evening the incident didn't seem to lead to any further complications.

1m ago15:00

Letby says concern over colleague's enquiries was due to leaving baby​

The court has previously heard how a doctor on the unit had made enquiries about who was present at the time of Child Q's collapse on 25 June 2016.
In a text to another registrar doctor sent that evening, Lucy Letby said: "Do I need to be worried about what [the doctor] was asking?"
"What would there be to be worried about?" her defence barrister Ben Myers KC asks about the text.
"I was worried I shouldn't have left him in the nursery," Letby says.



Dan O'Donoghue BBC Tweets https://twitter.com/MrDanDonoghue

We're back after a break. Mr Myers is now turning to Child Q. He was born in late June 2016 and was "initially stable" after his birth, but jurors have heard he deteriorated and needed breathing support shortly after 09:00 on 25 June.

The prosecution say Ms Letby injected air and fluid into the boy's stomach via a nasogastric tube. A medical expert for the prosecution said vomit found on Child Q was evidence that liquid had been given to him and his respiratory problems were likely caused by the fluid

Ms Letby tells the court she was caring for three babies in nursery three on 24 June (day before Child Q's collapse). Asked how she was feeling she said 'emotionally drained and just exhausted'

On 25 June, Ms Letby was Child Q's designated nurse. Asked how she felt the baby boy was doing at the start of her shift, she said: 'He was on the cold side, in view of his aspirates, I decided I would prefer to have (Child Q) reviewed by the doctors before he was fed at 9am'

Ms Letby says she went to assist another nurse with cares for a baby in nursery one at around 9am. A colleague agreed to keep an eye on Child Q. A few minutes later, the boy's monitor alarms activated

Ms Letby says she recalls being in nursery one and 'could hear something going on outside'. She left, looked down the corridor and saw two nurses with Child Q - she said he had vomited

By the time I got there, the vomit had ceased', she said

Mr Myers asks Ms Letby how significant an event - medically - this was. She said it was 'something we do deal with on a routine basis…not that’s not important but it doesn’t require a level of intervention that is high'

Mr Myers asks Ms Letby if Child Q needed any further intervention that day, she said 'no'. Asked if he had a further collapse, she said 'no'.

The following day medical staff noted Child Q had a mildly dilated loop of bowel and raised the possibility of NEC and surgery. Consequently, he was transferred to Alder Hey where he quickly stabilised. He returned to CoCH on the 28th June

Jury once again being shown messages Ms Letby sent to a colleague after her shift on 25 June. In those messages she asked if she needed to be "worried" about what consultant Dr John Gibbs was asking on the unit

Ms Letby explained that she'd 'become aware during the shift the Dr Gibbs was making enquires as to who was present in the nursery when (Child Q) had this episode'. She said she was 'worried that I shouldn’t have left him in the nursery'

She said she felt Dr Gibbs was 'implying I shouldn’t have left the nursery or that (Child Q) had been left unattended'. She says Child Q was not left unattended, as she had asked another nurse to keep an eye out while she attended to another child

 

[Tortoise]

Defence Case continued 17th May 2023 - Lucy Letby's Evidence in Chief


Chester Standard live updates - https://www.chesterstandard.co.uk/news/23527453.live-lucy-letby-trial-wednesday-may-17---defence-continues/

3:06pm

Letby says for the annual leave on July 4-6, 2016, she was on a family holiday.
She recalls, the day before she was due to go back to work, she received the news she was going to a meeting with Eirian Powell. She would not be going back to the unit 'for the time being', the court hears.
Further messages between Letby and the doctor are shown to the court: "Did you manage some sleep?
Back on nnu....They want to send [Child Q] back as a medical NEC.
Not sure if the unit is open for transfers. Few managers / medical director around this morning."
Letby: "Yes got some sleep , did you?
Good news about both. Hope they don't rush [Child Q] back…"
Letby tells the court other babies had been brought back to the Countess too soon, including Child I and Child G.
The doctor: "Got about 3 hours, coffee is good!
It was odd - he's only been there for 14 hours, I think this is a sign of how AH it's going to be.
They are so short of beds that they can only accommodate emergency patients. It's not good holistic care, and it's rubbish for his parents."
Letby says 'they' refers to Alder Hey, and Child Q was 'no longer an emergency baby', so was sent back.
Letby's messages between herself and a nursing colleague are shown, for June 27: Letby: 'I reckon there's going to big meetings etc about what's gone on with unit being closed, lack of staff etc'.
Letby tells the court the unit being 'closed' was closed to new arrivals.
Letby had messaged: 'were way over capacity, and its skill mix too.' - Letby tells the court it was "an ongoing issue".
Late that day, Letby messaged her: "E just phoned telling me to do days this week and not Go in tonight as trying to protect me "
Response: "What's that mean?"
LL: "I don't know. Asked if there was a problem and she said No just trying to protect me as had a difficult run just before holidays, less people on nights etc and we can have a chat etc tomorrow.
"But Im worried Im in trouble or something"
Letby said "it seemed an unusual thing to do".
Response: "Don't worry, how can you be in trouble you haven't done anything wrong
"Just very unfortunate"
LL: "I know but worrying in case they think i missed something or whatever. Why leave it til now to ring."
Letby says she thought she might have overlooked something. She tells the court getting things right in her work "was my life, my job".
Letby is asked why a Datix report is on her phone - Letby said this was something she needed to do for Child O and Child P. Letby says she cannot recall if she did these tasks.

3:19pm

The email from Yvonne Griffiths on July 15 is shown to the court referring to Letby's redeployment to an office-based role in the hospital.
Letby said she "wasn't happy" about the move, and it had been imposed on her.
She said she was aware that, by this time, the Countess neonatal unit had been redesignated to a level 1 unit.
Letby's message on August 8 to a nursing colleague: "Tony phoned. He's going to speak to Karen and insist on the review being no later than 1st week of Sept but said he definitely wouldn't advise pushing to get back to unit until it's taken place. Asked about social things and he said it's up to me but would advise not speaking with anyone in case any of them are involved with the review process. Thinks I should keep head down.and ride it out and can take further once over.
"Feel a bit like Im being shoved in a corner and.forgotten about by.the trust. It's my life and career.
"He's not been.given any information about the evidence he asked for.which is good. He's not sure what the external people.are going to look at in relation to me but we are in the process now.so have to ride it out"
Reply: "Ok well just have to take his advice then suppose
""
LL: "Still can't believe this has happened.
"It's making me feel like I should hide away by saying not speak to anyone and going on for months etc - I haven't done anything wrong."
Letby said she was expected to lie about things going on, that she was 'happy' to be redeployed elsewhere.
After the email was sent about secondments, Letby said: "Omg She's sent email about secondments!"
Reply: " [three laugh cry emojis]
"Email is on fire!"
LL: "Bloody hell fuming
"Im in email and makes it sound like my choice"
The court hears Letby had filed a grievance procedure against the hospital.
Letby tells the court that by this point: "I didn't know what to do - it was having a massive imapct on all aspects of my life.
"It was emotionally very difficult, I was lonely...I didn't know what was going on."

3:45pm

The court is resuming after a short break.
A picture from Letby's office is shown to the court. Letby says she would not have written it all at once.
The writing is at various angles. Asked about it: "That is what I do...I write things down."
It includes Letby's signature - "doodling".
Letby says "she couldn't say" if this was at the time she was being blamed.
There are repeated 'Everything is manageable', written six times.
A lady in the occupational department had said that to Letby, which 'resonated' with her.
The love hearts are "just doodling".
Various names including a doctor, Karen Rees - "director of nursing", Minna,
"They were important people to me at that time - they were the main people I could talk to."
Also written is "I can't do this any more"
Letby said she was "fighting for my life, my job"
Also written is "HELP ME" and "Please help".
Letby says "at this point I had lost everything...I just wanted someone to help me. I couldn't understand how all this was happening to me."
Another sheet is shown to the court. It has densely-packed handwriting at different angles.
The allegations were, Letby said: "beyond comprehension"
Mr Myers: "Could you cope with it?"
Letby: "No."
The note: "I really can't do this any more - I just want to be as it was I want to be happy in the job that I loved...Really I don't belong anywhere - I am a problem to those who know me..."
The note adds "Please help me [doctor] LOVE PLEASE HELP ME [doctor] You were my best friend [doctor]."
Becoming tearful, Letby denies causing harm or there was any truth in her intending to kill babies, in administering insulin.
"I only ever did my best."
That concludes Mr Myers questions.


Sky News Lucy Letby trial latest: 'You're not supposed to watch a baby die' - defendant in witness box with iPad in front of her

7m ago15:18

Letby says job was her 'life'​

Lucy Letby recalls how she was told at the last minute not to go in for her night shift on 27 June 2016.
In a message to a registrar doctor, she said she was "worried" about the request.
In different messages to another nurse, Letby said: "I'm worried I'm in trouble or something", and was concerned "in case they think I missed something".
Asked why the request not to work worried her, Letby says it was "unusual" for a shift to be cancelled so soon to starting but that she wasn't made aware there was any problem.
"How much did you want to get things right?" asks Ben Myers KC, defence lawyer.
"That's the aim... you do your best," Letby says.
"How much did getting things right matter to you?"
"It was everything - it was my life, my job."

1m ago15:32

Letby texted colleague saying she felt 'shoved in a corner' after move from neonatal unit​

The defendant didn't work on the Countess of Chester neonatal unit beyond 30 June 2016.
The court has previously heard how Lucy Letby was moved to the hospital's risk and patient safety office in July 2016 after concern was raised over her possible link to incidents with babies on the neonatal unit.
Letby says she "wasn't happy" about the decision at the time.
Her barrister, Ben Myers KC, pulls up messages sent by Letby to a nurse in August 2016 about the hospital's internal review process. She had taken advice from a union representative not to talk to anyone about the situation.
"Feels a bit like I'm being shoved in a corner and forgotten about by the trust, it's my life and career," she texted a colleague on 8 August.
In a later message she says: "Still can't believe this has happened.
"It's making me feel like I should hide away by saying not speak to anyone and going on for months etc."
Recalling how this was making her feel at the time, Letby says it was "very hurtful".
"I had to pretend I wanted to leave the unit and work in a different area," she said.

Now15:55

Letby was 'fighting for life' when she wrote note found during police search​

The court is shown an annual leave request form on which Lucy Letby has scrawled notes in small handwriting from top to bottom, including love hearts, her signature and the phrase "everything is manageable" repeatedly.
Asked why she had written the note, she says "that's what I do, I write a lot of things down".
Letby also wrote "I can't do this anymore".
"What does that mean?" Ben Myers KC asks his client.
"I was fighting for my life really, fighting for my career, my job, everything."
As Mr Myers finishes his questioning of Letby, he asks if she has committed the crimes she is accused of.
"No," she replies, and says it was "beyond comprehension".
Letby becomes emotional as Mr Myers once again puts to her the prosecution's case that she murdered and attempted to murder babies.
"Is there any truth in the allegation you deliberately harmed babies?" Mr Myers asks.
"No."
"Or intended to kill them?"
"No."

https://news.sky.com/story/lucy-let...vidence-12868375?postid=5928414#liveblog-body


Dan O'Donoghue BBC Tweets https://twitter.com/MrDanDonoghue

Mr Myers is now turning to events following Child Q. Ms Letby went on annual leave after his collapse - for a family holiday. She tells the court her last shift on the neonatal unit was 30 June. She was told the day before she was due to return that she would be in a new role

The court has previously heard that Ms Letby was moved to the Countess of Chester Hospital's "risk and patient safety office" in July 2016 after doctors raised concerns over her alleged involvement in baby deaths on the unit

Mr Myers is taking the court back through messages between Ms Letby and colleagues sent in late June 2016. In those messages Ms Letby and colleagues are discussing how the unit is overcapacity and that there are not enough staff

In one message exchange with a nursing colleague, the pair are discussing that there had been an issue with Child O's UVC line. It states in the messages that there was a port left open on the line

Ms Letby said in those messages 'I thought it's a massive infection risk and risk of air embolism, don't know how long it had been like that'

Mr Myers asks if knowing about air embolism was unusual - she says no and that it is 'part of training' and that nurses 'would be expected' to be aware of the dangers of air embolism

Mr Myers is now taking the court through messages sent in August 2016 (after Ms Letby has been moved off the unit). In those messages to a colleague Ms Letby said 'Feel a bit like I'm being shoved in a corner and forgotten about by the trust. It's my life and career'

In September 2016, Ms Letby began a grievance procedure against the hospital. She said at this time she felt 'completely isolated' she said she felt she was 'expected to lie about the things going on, I had to pretend I wanted to leave the unit and work in a different area'

Asked how she was coping emotionally, she said 'Emotionally very difficult, I was lonely, I was worried, I didn’t know what was going on'

Mr Myers has pulled up a document, found by police in Ms Letby's hospital office when it was searched in 2018. It is covered in writing and doodles. Asked why she has done this, Ms Letby says 'that’s what I do, I write a lot of things down'

On the sheet she has written her signature repeatedly along with the names of colleagues, asked why she says 'they were important people to me at that time...they were the main people that I could talk to'

In one section Ms Letby has written 'can't do this anymore'. Asked why, she says 'I was fighting for my life really, my career, my job everything'

Mr Myers asks Ms Letby what it was like when she discovered the allegations against her...she said it was 'devastating to have that allegation upon you, it’s beyond comprehension, I just could not understand how it was happening'

Ms Letby wept as Mr Myers asked her if she had every harmed any babies - she said no, she had only ever did her best for them

 

[Tortoise]

Defence Case continued 17th May 2023 -

Lucy Letby's CROSS-EXAMINATION


Chester Standard live updates - https://www.chesterstandard.co.uk/news/23527453.live-lucy-letby-trial-wednesday-may-17---defence-continues/

3:46pm

Nicholas Johnson KC, for the prosecution, begins the cross-examination by asking why Letby becomes tearful when talking about herself, and not when the subject is about babies who have died.
Letby says she has been tearful for babies that have died.
Mr Johnson asks if there is anything Letby wishes to change about her evidence in the last few days. Letby says she cannot think of anything.

3:58pm

Mr Johnson provides Letby with a copy of her defence statement - "quite a long document", running to 20 pages.
Mr Johnson says Letby has been served with documents over the past few years.
He says in that time, Letby would have had time to look back on her police interviews in 2018, 2019 and 2020, and had in her statement accepted those interviews as being accurate.
Mr Johnson asks if Letby ever said Dr Ravi Jayaram was a "liar who was inventing".
"When was the first time you said that?"
LL: "I can't recall"
J: "I'm going to suggest a date to you - yesterday."
There is a silence. Letby then says she had never accepted in police interview Dr Jayaram's version of events.
Mr Johnson accuses Letby of saying Dr Jayaram had been deliberately misleading a jury when giving evidence.
He says that was never put to Dr Jayaram by the defence.
"Was Mr Myers suggesting to Dr Jayaram that he never saw you looking over [Child K]?"
"It is very difficult to remember everything over a seven-month trial."
Letby denies she is lying now by not remembering.
Mr Johnson asks about handover sheets. He suggests that when Letby moves from property to property, she took the handover sheets with her.

4:04pm

Mr Johnson says Letby completed a three-year nursing course, during which time Letby confirms she was living in student accommodation in Chester, in more than one place, changing each academic year.
Letby says she began her employment in January 2012. Before that time, she went back to her parents' place in Hereford, and then moved to Ash House when obtaining her job.
She then went to a flat of one of her colleagues, living there alone from March 15, 2014 to June 1, 2015, then back to Ash House. She moved to her Westbourne Road home in April 2016.
Mr Johnson asks who provides the uniforms: "The hospital," says Letby.
The staff launder the uniforms, and Letby says she launders them every time they are used. There is a rotation of three uniforms.
Mr Johnson says when laundering, the pockets would be emptied. He asks where the items would be placed. Letby: "I would accumulate papers in [random] places in my home."

4:07pm

The computerised records are discussed.
Mr Johnson says two people are involved in the administration of medication - one is the 'user' and the other is the 'co-signer'. Letby agrees.
Mr Johnson asks if the record shows who created the record. Letby says you would have to log on to the 'Meditech' system with your login details.
"It requires two people to sign".
She says either of the nurses would fill in the details of the medication. The co-signer would verify the information.

4:21pm

Mr Johnson says Letby was a "mentor to students". Letby gives details of what that would involve.
Mr Johnson asks for paperwork, what would their responsibilities be - if one of them was given a handover sheet, what would they do with it? Letby says they would dispose of it, although student nurses would not have handover sheets in the first place.
Mr Johnson asks why Letby kept bringing handover sheets home. Letby said it was a few.
Mr Johnson: "Well, 250 times, it isn't"
Letby: "That is over many years"
Mr Johnson: "Well even if it's 50, that's over five years."
Mr Johnson: "What is your normal practice?"
Letby: "With handover sheets? To dispose of them - they have come home with me."
Mr Johnson: "You have taken them home."
Letby: "Not with the intent of keeping them."
Mr Johnson says what would Letby's responsibilities be with sensitive data such as handover sheets?
Letby: "To keep it confidential."
Mr Johnson asks what would the hospital do, in disciplinary terms, if they found Letby had over 250 handover sheets?
Letby: "I don't know the full details - they were at my home address, but they were held in confidence."
"In a bin bag in your garage?"
Letby: "I was the only one in the house."
Johnson: "And the ones in your parents' house?"
Letby says the parents would not have access to the box in what would have been her bedroom.
Mr Johnson: "Do you obey the rules when it suits you?"
Letby: "No."
Mr Myers rises says it was put to Dr Jayaram that he had not been challenged on his account in evidence. He said in his evidence he had put it repeatedly to Dr Jayaram on his account, althought the word 'liar' might not have been used.
The judge says, from his recollection, it was not put directly to Dr Jayaram if Letby was present in the nursery room.

5:09pm

A round-up story from today in court: Lucy Letby: Loss of babies on neonatal unit was 'harrowing'

Sky News - Lucy Letby trial latest: Defendant cries in court at final defence question - and now faces prosecution lawyer for first time over alleged baby murders

1h ago15:56

Prosecution begins questioning of Letby​

Nick Johnson KC, for the prosecution, has now begun his cross-examination of Lucy Letby.
"Ms Letby, is there any reason why you cry when you talk about yourself but don't cry when you talk about seriously injured children?" he asks the defendant.
"I have cried when talking about some of the babies," she says.
"That's your answer, is it?"
"Yes."

1h ago16:11

Letby questioned on denial that colleague saw her standing over baby's cot​

Nick Johnson KC, for the prosecution, puts to Lucy Letby that she suggested a doctor, who recalled seeing the defendant standing over Child K's cot as she desaturated in February 2016, was not telling the truth in court.
"Did you in police interviews ever suggest that [the doctor] is a liar who invented seeing you standing over Child K?"
Letby says she didn't.
"When was the first time you said that, Lucy Letby?" he asks, to which the defendant says she wouldn't know a definitive date.
"I'm going to suggest a date to you - yesterday."
Mr Johnson adds: "I am going to suggest to you that when [the doctor] was cross examined by [defence barrister Ben Myers KC] on your behalf, that suggestion was never made."

51m ago16:28

Prosecution probes handover sheets found at Letby's home​

Nick Johnson KC probes the issue of the hospital handover sheets found at Lucy Letby's Chester home following her arrest in July 2018, which the defendant has previously said came home with her in error.
He asks Letby if the three nursing uniforms she was provided with would be washed after every use - she agrees.
"What did you do with the contents of the pockets?" Mr Johnson asks.
"They were put aside in random places in my house," she says.
"Such as?"
"I can't say, I would accumulate paper in various areas of my home."
Letby tells the court her responsibility for sensitive personal data is to keep it confidential.
Mr Johnson asks what disciplinary action she would have faced if hospital management staff knew she had over 250 handover sheets at her home.
"I can't answer that, I don't know the policy," she said.
"Have you ever been interested in the policy on managing personal sensitive data?"
"I don't know."
"You're not bothered, are you?"
"I don't know the details, these handover sheets were held at my address but they were held in confidence," Letby says.
"In a bin bag in your garage, that's held in confidence, is it?"
Letby says she was the only one living at her home.

44m ago16:35

Court adjourned​

That brings an end to proceedings today.
The case will resume at 10.30am tomorrow when Nick Johnson KC will continue his cross-examination of Lucy Letby for the prosecution.
Thanks for following our live coverage today.

Lucy Letby trial latest: Defendant cries in court at final defence question - and now faces prosecution lawyer for first time over alleged baby murders