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

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Defence Case Friday 9th June 2023 - LUCY LETBY'S CROSS-EXAMINATION

Sky News 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

11:00

The jury has filed in​

Court has resumed for this morning.
Proceedings are overseen by Mr Justice Goss.
Representing Letby is Ben Myers KC.
Nick Johnson KC is the barrister for the prosecution.

11:09

Letby's defence admits 'mistake'​

This morning's session has begun with the judge clarifying to the jury something we heard on Wednesday.
Lucy Letby told the court that she disputed the agreed evidence put before the court by Child N's parents about a phone call she made to them.
Agreed evidence means it has been submitted to the court as an agreed "truth".
Child N's father said Letby phoned him, but Letby said: "I have no recollection of speaking to the family on the phone and I would not have put [colleague]'s name on the note if that were not the case."
Letby's defence, Ben Myers KC, says it was a "mistake" that this evidence was agreed before the court, but says it was a legitimate line of questioning for Nick Johnson KC to have taken.

11:26

Letby's 'meltdown' text messages after being suspended from work​

Nick Johnson, the prosecution's barrister, is now continuing with his questioning of Lucy Letby.
Letby previously said she was told she would not be returning to the neonatal unit a day before she had been due to work a shift.
On 27 June 2016, hours before Letby was due to begin a night shift, she was called by a member of staff and told not to come in for her shift.
Texts are now being shown to the court.
Letby to her male doctor colleague on 27 June (17.41): [Colleague] has just phoned telling me not to come in tonight & do days instead. I asked if there was a problem & she said No, just trying to protect me a bit & we can have a chat about tomorrow but now I'm worried.
Letby says she was concerned that "potentially I had done something wrong, that I had made a mistake".
Letby to [Colleague 2] (17.41): But I'm worried I am in trouble or something.
Letby to [Colleague 2] (17.46): I know but worrying incase they think I missed something or whatever. Why leave it till now to ring.
Letby says this was "very late in the day" to call her and tell her now to come in for a shift, especially because management do not work after 5pm.
More messages are shown.
Letby to male doctor (17.50): I can't do this job if it's going to be like this. My head is a mess. Why is she ringing at this time. There must be a problem.
"Were you having a meltdown," she is asked.
"Yes," she replies.
Letby to male doctor colleague (17.55): Messes with your head a bit to be told that at this time, would have sounded more reasonable if it had done earlier which is Why i wonder if it's come from higher up as she usually finishes at 4.
Letby is asked if she was concerned this came from above.
"Yes," Letby says.
The male doctor, who Letby was allegedly sweet on, tried to reassure her.
She replied at 18.00: I can't talk about this now.
Twelve minutes later she sent another message.
Letby to male doctor colleague (18.12): Sorry that was rude. Felt completely overwhelmed & panicked for a minute. We all worked tirelessly & did everything possible, I don't see how anyone can question that. [Colleague] has always been very supportive.
Letby is asked what she was doing in those 12 minutes.
"I can't answer that," she says.
Another message is shown.
Letby to male doctor colleague (18.16): I am having a meltdown++ but think that's what I need to do.
She is asked what grade of a meltdown she was having.
"At this point quite a dramatic one," Letby replies, before adding: "I can't define every emotion I was feeling at that point."

11:38

'If they have nothing or minimal on me they'll look silly'​

The week after Children O and P died, and Child Q collapsed, Letby worked a final three shifts at the Countess of Chester Hospital.
During this time, she reported one child as being at risk of an accidental air embolism because the stoppers were left off their IVs.
Nick Johnson, the prosecution barrister asks Letby why, a few days after "having a meltdown", she was "reporting the risk of an accidental air embolism".
"You had your thinking cap on, didn't you?" he asks.
Letby denies this.
"An insurance policy going on here."
"No," she replies.
"So you can suggest this was a hospital where things were so lax people left the bungs of the intravenous access for these children," says Mr Johnson.
"No that's what I found," Letby replies.
Letby texted a colleague on 15 July that the babies in question became unwell after leaving her care, "or were already acutely unwell when I took over".
She says she began gathering information for her union representative.
Letby to colleague on 15 July (15. 49): Hoping to get as much info together as possible- if they have nothing or minimal on me they'll look silly, not Me.
Letby is then asked if she went on the attack.
"I don't think this was an attack, this was me responding to what was happening to me," she tells the court.
Her union representative advised Letby against pushing to go back on the unit.
Letby to colleague on 8 August (11.25): 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 in the process... Feel a bit like Im being shoved in a corner and forgotten about by the trust. It's my life and career.
Letby says this colleague was her "best friend" and she had been looking for support, despite the fact she had been told not to contact people working on the unit.
Letby to colleague on 8 August (11.31): It's making me feel like I should hide away by saying not to speak to anyone and going on for months etc- I haven't done anything wrong.

11:41

Letby: 'Band of four' colleagues conspired against me​

Letby is now being asked about the "band of four" colleagues she claims were conspiring against her.
She is asked what their motive could have been.
"At this time I did not know what babies they were discussing, or what the allegations were," she tells the court, adding that she feared "anything that went wrong they could have put on to me".
Mr Johnson, the prosecution barrister, asks if she thinks "these doctors' motives were influenced by a conspiracy".
"Yes, that is what I believe," she says.
Mr Johnson asks Letby if she believes it was "above your paygrade to determine what the shortcomings were" in the care for the children involved.
"In the medical profession, yes," she says.
Letby has previously said she doesn't feel the "staffing levels at the Countess of Chester were at the level they should have been".
But Mr Johnson says Letby has failed to raise in each individual case where low staffing levels may have contributed.
"I think some of the babies didn't have adequate care over a period of time," Letby says.

12:00

'Killer' Letby's Facebook searches read out to the court​

Nick Johnson, the prosecution barrister, then goes back through some of Letby's Facebook searches.
Letby has previously been accused of looking up her alleged victims' families online, and a series of searches are being read to the court.
25 June 2015
At 21:50 Letby searched for the parents of Children A and B.
At 21:51 Letby searched for the parents of Child D - Letby previously said she "didn't remember" this baby.
"What was the connection in your mind between those three people," Mr Johnson asks.
"They are babies who have died from being seriously unwell," Letby says.
5 October 2015
At 01:16 Letby searched for mother of Child I.
At 01:17 Letby searched for father of Children E and F.
"What did they have in common?" Mr Johnson asks.
"Again they are babies that had something significant happen to them and they were on my mind," Letby says.
"You were checking up on your victims, weren't you?"
"No."
He later says: "You were a killer who was looking at your victims."
"No," she replies.
Several other examples are read out to the court.
5 November 2015
At 23:40 Letby searched for the mother of Children E and F.
At 23:40 Letby searched for the mother of Child G.
At 23:44 Letby searched for mother of Child I.
Letby denies these families were grouped together for any reason.
25 December 2015
Letby searched for the mother of Children E and F.
"I often thought of [her]," she tells the court.
"She was the person who caught you in the act," Mr Johnson says, adding that this would have been reason enough to remember her.
"No, [we] had a good relationship."
https://news.sky.com/story/lucy-let...ws-blog-12868375?postid=6028744#liveblog-body
12:20

Letby went 'out drinking' with colleagues after suspension, court hears​

Nick Johnson, the prosecution barrister, is now looking at Letby's social life around the time of her suspension from the unit.
He says: "You told the jury you just changed as a person, your mental health deteriorated and you - and these are your words - 'felt very isolated from my friends and family on the unit'."
More of Letby's statement is read out: 'We were a very supportive unit, regardless or not of whether we were friends, we were a very supportive nursing unit.'
Letby was told she could only have contact with a limited number of people from the unit.
"Did you abide by the direction?" Mr Johnson asks.
After a pause, Letby replies: "Yes."
"So you didn't have contact with anyone but the people you were told you could have contact with?"
"At that very beginning part yes but it did change as time went on," Letby says.
The prosecution says Letby was "given a document this morning".
"What's in the document?" Mr Johnson says.
After a pause, she replies: "My social life."
The prosecution says this "disproves" what Letby has previously said about her contact with the unit.
"I disagree," she says.
Letby is asked if she was "looking for sympathy" when she told the jury she had been cut off and isolated from her friends.
"Yes, it was a very difficult time," she says.
"You thought you'd get sympathy by telling a lie," says Mr Johnson.
"No."
"Was it just a mistake?"
"Yes."
The document, the prosecution says, contains examples of Letby "out drinking" and "going on days out" with members of the neonatal unit.
One day she went to London with the male colleague she has previously denied was her boyfriend.

12:21

Letby denies affair with 'married' colleague after being suspended​

The court is now being shown photographs of Letby, taken from her social media and phone.
In one message, the male colleague she denied was her boyfriend exchanged a series of heart emojis via WhatsApp and travelled together to London at least once.
Letby says they had to cancel the second trip.
"[Colleague] was a married man, it's not a relationship at all it's a friendship," she says.
The prosecution says this document is "peppered" with lots of examples of Letby out socialising with people from the unit.
"You had a very active social life, didn't you?" Mr Johnson asks.
"Yes."
"You have deliberately misled this jury about your background," Mr Johnson says.
"No."
He says Letby also "misled [the jury] about your circumstances following your suspension".
"No."

12:23

Letby 'lied' to jury about being taken away in pyjamas​

Letby previously told the jury she was first arrested at 6am and taken away in her nightgown.
"How were you dressed when you left the house?"
"I think I had a nightie on and tracksuit bottoms and trainers," she says.
"You were taken away in a blue Lee Cooper Leisure suit."
"I don't remember, I had a nightie on," she says.
"Do you want me to show you a video of it?"
"No."
The prosecution says Letby wasn't taken away in her pyjamas at all. Letby agrees this was the case.
"Why did you lie to the jury about it?" Mr Johnson asks.
"I don't know."
Mr Johnson calls Letby a "very calculating woman" who "tells lies deliberately".
"No," she replies.
"The reason you tell lies is to try to get sympathy from people," says Mr Johnson.
"No."
He then adds: "Killing these children you got quite a lot of attention."
"I didn't kill these children," Letby replies.
"You are getting quite a lot of attention now, aren't you?"
Silence from Letby.

12:26

'Today is your birthday and you aren't here. And I am so sorry for that'​

The prosecution is now focussing on a note Letby wrote on a yellow post-it note addressed to the three triplet boys.
"I am writing how I was feeling at that time, and it was their birthday and I mentioned all three of them," Letby says.
The note reads: 'Today is your birthday and you aren't here. And I am so sorry for that.'
"Why were you including [the other triplet]?" Mr Johnson asks.
"I've written three names, I also wrote [colleague]."
The prosecution asks the question again.
"I can't answer that," Letby says.
"Is that because in your mind there was a terminal end in store for [other triplet] if he stayed with you?"
"No," she replies.
"Was that your objective to kill all three?" Mr Johnson asks.
"No."

12:31

Prosecution concludes: 'You are a murderer'​

The court is being shown a green note Letby wrote, which includes the words: 'I AM EVIL. I DID THIS.'

"There is a lot going on in this note isn't there?" Mr Johnson asks.

"Yes."

Letby says she wrote this when she "didn't know how this was going to end".

On this note, Letby wrote: 'I will never know what it is like to have a family'.

"That is how I felt at that time, I could not see a future for myself," Letby replies.

Mr Johnson points out that during this time, images on social media show Letby "out on the razz".

"I did have good times in those years, yes," Letby says.

Mr Johnson then concludes his prosecution by saying: "You are a murderer."

"No, I am not," Letby says.

"You have murdered many children," he says.

Letby replies: "I have never murdered a child or harmed any of them."


2m ago14:08

That's all for today​

That's all for our coverage of the trial today.
Read our story below on what happened in court earlier.

'Killer' nurse Lucy Letby denies affair with married colleague after being suspended from work

In June 2016 - the week after two triplet boys died, and another boy collapsed so dramatically he was sent to intensive care - Letby was suspended from work. Documents shown in court depicted her "active" social life at this time.

news.sky.com

https://news.sky.com/story/lucy-let...ws-blog-12868375?postid=6029034#liveblog-body
https://news.sky.com/story/lucy-let...ws-blog-12868375?postid=6028697#liveblog-body

 

[Tortoise]

Defence Case Friday 9th June 2023 - LUCY LETBY'S CROSS-EXAMINATION

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

Dan O'Donoghue

@MrDanDonoghue
·
4h

Lucy Letby will be back in the witness box at Manchester Crown Court this morning. It's the nurse's 14th day giving evidence. Nick Johnson KC is due to wrap up his cross examination today.

Dan O'Donoghue

@MrDanDonoghue
·
4h

Slight delay to proceedings - few legal issues to deal with first. Jury due in just before 11am.

Dan O'Donoghue

@MrDanDonoghue
·
3h

Nick Johnson KC has set out how he will conclude his cross examination (now each child has been dealt with). He said he's going to start with the text messages sent by Ms Letby after her removal from the neonatal unit

Dan O'Donoghue

@MrDanDonoghue
·
3h

He said he will then move to the 'gang of four' doctors , who she has claimed concocted the accusations against her. He will then move to her searches for parents on Facebook, the circumstances in which she said she was isolated from friends and finally her arrest.

Dan O'Donoghue

@MrDanDonoghue
·
3h

Mr Johnson is asking Ms Letby about the 27 June 2016. This followed the collapse of her final alleged victim, Child Q, on 25 June. She was told by the manager of the unit not to come in for her shift, in messages from the time she tells colleagues she is 'panicked'

Dan O'Donoghue

@MrDanDonoghue
·
3h

Mr Johnson puts it to her that she was having a 'meltdown' as she realised hospital bosses had 'sussed out' what she 'had been up to' - 'no' she responds

Dan O'Donoghue

@MrDanDonoghue
·
3h

Mr Johnson pulls up a Datix form, that Ms Letby recorded on 30 June 2016. On this form she noted that a 'bung was open' on one of the lines for a child, JE (not part of this case). She said in a message to a colleague on 5 July that this could have caused air embolism

Dan O'Donoghue

@MrDanDonoghue
·
3h

Mr Johnson says to Ms Letby that after she was told not to come on shift on 27 June she 'had her thinking cap on'....she responds 'no that's what I found with this baby and felt it needed to be documented'

Dan O'Donoghue

@MrDanDonoghue
·
3h

Mr Johnson says 'you removed the port and reported it as a clinical incident didn’t you, to cover yourself so you can suggest this was a hospital so lax that people left bungs off intravenous access?'

'No', she responds

Dan O'Donoghue

@MrDanDonoghue
·
3h

'This covered you for accidental air embolism didn't it', he said.

'No', she responds

Dan O'Donoghue

@MrDanDonoghue
·
3h

Mr Johnson is now turning to the 'gang of four'. She previously told her trial a "gang of four" doctors apportioned "blame" on to her "to cover up failings at the hospital".

Dan O'Donoghue

@MrDanDonoghue
·
2h

Ms Letby repeats that she believes there was a conspiracy against her, she says 'I believe there were shortcomings from the medical team and they put that on me'

Dan O'Donoghue

@MrDanDonoghue
·
2h

Mr Johnson is now turning to Ms Letby's Facebook searches. He's asking why he searched for certain parents and says 'you were checking up on your victims weren't you' - she rejects this

Dan O'Donoghue

@MrDanDonoghue
·
2h

Mr Johnson pulls up various searches made for the parents of the children in this case.

'You are a killer who is looking at your victims aren’t you', Mr Johnson says

'No', she says

Dan O'Donoghue

@MrDanDonoghue
·
2h

Mr Johnson asks Ms Letby to spell the name of a mother she searched for who has an unusual name - she tries and gets it wrong. Mr Johnson says she could spell it because she was using a handover sheet to search for it, 'no' she says

Dan O'Donoghue

@MrDanDonoghue
·
2h

Mr Johnson is now taking the court through various items that were taken from Ms Letby's phone, Facebook records following her removal from the unit - they show various interactions with members of staff on the unit

Dan O'Donoghue

@MrDanDonoghue
·
2h

Mr Johnson says 'it is peppered with you socialising with lots of different people from that unit'

She agrees. Mr Johnson says 'you had a very active social life didn't you', she says yes

Dan O'Donoghue

@MrDanDonoghue
·
2h

There is interactions with a doctor, who cannot be named for legal reasons - the pair went on 'away day' to London together in June 2017. Mr Johnson asks if they stayed over, she says no - he asks if the doctor was her boyfriend

Dan O'Donoghue

@MrDanDonoghue
·
2h

Mr Johnson pulls up messages after the trip were they've exchanged heart emojis - she says '(the doctor) is a married man, it was not a relationship at all it was a friendship'

Dan O'Donoghue

@MrDanDonoghue
·
2h

Mr Johnson focuses his questions now on her arrest. He asks Ms Letby why she told the jury she was taken away in her pyjamas, he says she was in a blue tracksuit when she was taken away

Dan O'Donoghue

@MrDanDonoghue
·
2h

Mr Johnson says 'you’re a very calculating woman aren’t you Lucy Letby, you tell lies deliberately don’t you'

'No', she responds

'The reason you tell lies is to try and get sympathy from people, attention from people' he says

'No', she responds

Dan O'Donoghue

@MrDanDonoghue
·
2h

Mr Johnson is now taking Ms Letby over the various notes she found in her home and workplace. On one she wrote that she would never have a family - he asks why, she says because of her work situation

Dan O'Donoghue

@MrDanDonoghue
·
2h

Mr Johnson says at that time 'you had a house, a car, a boyfriend'

'Yes', she says

Dan O'Donoghue

@MrDanDonoghue
·
2h

Mr Johnson says she felt the way she did and was writing the notes she was because 'you knew you had killed and grievously injured these children...you have murdered these children' 'I have never murdered a child or harmed any of them', she says

 

[Tortoise]

Defence Case Friday 9th June 2023 - LUCY LETBY'S RE-EXAMINATION

Chester Standard Updates - https://www.chesterstandard.co.uk/news/23577991.live-lucy-letby-trial-june-9---cross-examination-continues/

12:28pm

Benjamin Myers KC rises to ask further questions of Letby.
He says Letby has given evidence for 14 court days over the past few weeks.

12:33pm

Mr Myers asks Letby about the increase in documents since giving her defence statement.
Letby agrees it was an increase in "thousands of pages" since then, and the increase has continued throughout the trial.
Letby agrees the increase in evidence served has come when she and the defence team have been in different parts of the country, with her being in custody.

12:38pm

Mr Myers asks questions in the case of Child E, in relation to Letby's defence statement.
In cross-examination, Letby was said not to have made a mention of Child E vomiting in her defence statement, but said it in evidence. Letby tells the court now Child E had vomited.
Mr Myers says Letby's nursing note from August 4, 2015, showed Letby recorded a 'large vomit'.
Letby says that was not included in the defence statement as she had not included every single detail from all the cases in that statement.
The nursing note also incudes a 'mucky' slightly bile-stained aspirate was recorded.

12:40pm

In Letby's defence statement, she said she had wanted to work in nursing since being a teenager.
Letby is asked about her motive in working at the Countess of Chester Hospital neonatal unit: "To provide the best care possible for them and their families."
Letby said she would have looked after "hundreds" of babies during her time at the Countess of Chester Hospital.
BM: "Were you trying to 'get attention' [by attacking babies] in the way it has been put?"
LL: "No."
Letby says the Facebook searches were for parents who were on her mind at the time.

12:42pm

BM: "Can you recall every baby you cared for?"
LL: "No."
BM: "Is there a reason some babies stand out more?"
Letby says there might have been something about some babies that would stand out in her mind, and some babies would be on the unit longer, and she would have got to know some families more than others.

12:43pm

Letby is asked about staffing levels at the unit.
Mr Myers: "Do you know, actually, how every member of staff was affected by staffing pressures?"
LL: "No I don't."
Letby adds she does not know if every member of staff was performing their tasks to the level required throughout.
BM: "Can you say at any given point, what the issue of staffing levels were?"
LL: "No."

12:51pm

Letby adds from a nursing perspective she can comment on that care, but medical care [from a doctor] is a "different realm".
Letby says she can only put a nursing perspective on the issues.
Mr Myers asks about Child E and Child L.
Letby had said, in evidence, insulin was given to Child E unlawfully, but it was not targeted. She said, from the blood results, Child L was poisoned with insulin, but was not targeted.
Letby says for Child L, she accepted the blood results which showed the insulin had come exogenously.
Letby says she does not know how the insulin levels of a blood sample are tested. She says she has never worked in a lab for the purposes of such testing.
Letby says she accepted the results on the basis of the evidence that is presented in the trial.

12:56pm

Letby, in her defence statement, said she was concerned she was blamed for things she was not respnsible for, and was unable to explain how some of the babies had collapsed.
The statement added the higher mortality rate had come from the unit taking on more poorly babies.
For Child Q, Letby says Dr John Gibbs was asking who was on duty at that time and who the designated nurse was.
Letby says, in her statement, Dr Jayaram and Dr Brearey had been "set against her for some time" and did not accept "in good faith" their evidence.
Mr Myers asks if Letby had ever accepted the accuracy or honesty Dr Jayaram's recollection of the incident in relation to Child K.
Letby: "No."
Letby adds she did not recall clearly what happened at that event. She denied interfering or harming Child K at that time.

2:08pm

The trial is now resuming following a lunch break.

2:17pm

Mr Myers continues to ask Lucy Letby questions.
He says there is "not a lot further" to go through.
He says there were "many times" when the prosecution gave evidence, or parts of evidence, to Letby and the jury.
In the case of Child P, he says Child P was the 'worse for wear', and the prosecution said this was similar to the previous night with Child O, which he says was inaccurate.
Letby is asked why she agreed with an inaccurate summary of evidence by the proseuction.
LL: "I can't answer that, I don't know."
Mr Myers says the prosecution had asserted Lucy Letby had 'fallen out' with Melanie Taylor. Letby denies this was the case at any point.
Text messages are shown between Melanie Taylor and Lucy Letby. The exchange is on June 9, 2015, following the death of Child A, and how hard it was going in to back into the unit following such an event.
Letby messaged: "I hope you are ok, you were brilliant" and signs off the conversation "Great see you then xx" to which Melanie Taylor replied "Xx". Letby denies she fell out with Melanie Taylor.

2:19pm

Letby is asked about the prosecution saying she 'fell over herself' to message Sophie Ellis following the death of Child P. Sophie Ellis had been at the races that day on June 24, 2016.
Sophie Ellis messaged Letby first: "Hey Luce, hope your ok? I heard poor little [Child P] has been sent to Liverpool..."
Letby replied the information was 'too much for a text'.
She added: "Actually you are at the races, sorry I forgot. Don't worry about ringing will txt you tomorrow. X"
Letby tells the court she wanted to leave Sophie Ellis alone as she was at the races.

2:21pm

Letby is asked about the 'social folder' she was handed by the prosecution this morning.
Mr Myers said the photos showed her 'out on the razz with friends'.
Letby had said there were times she enjoyed herself.
Mr Johnson had said: "Yes, you felt like this, because you know you killed and grievously injured these children?"
Letby: "No."
Mr Myers says there was nothing to these events other than going for drinks with friends. Letby agrees.

2:29pm

An example is shown of Letby on holiday in Torquay with her dad in July 2016.
Another example is of Letby having drinks with university friends in July 14, 2016. Letby says they were the girls she had been with when she was studying nursing.
Another example is of a picture of a couple of bottles of Prosecco on July 22, 2016. Letby is asked if she was allowed to drink Prosecco at this time. Letby agrees.
Another photo is on August 16, 2016, on a day out in Port Sunlight with her parents who had come to Chester. Letby messaged one of her nursing colleagues - her "best friend", and one she said she was allowed to speak to, about Port Sunlight being 'perfect for a picnic and a stroll'.
A photo is taken of Letby at her back garden to her Chester home in August 2016.
A Whatsapp message Letby sent in a group of nursing colleagues was: "It's too sad" in reference to Jennifer Jones-Key leaving the unit.
Letby says 'around September time' the instructions for Letby not to contact anyone on the nursing unit other than three colleagues had 'changed'.
A message on September 22, 2016 to one of the three colleagues - 'All ok with E [Eirian]. Feel bit more positive knowing she's definitely behind me...'

2:32pm

Letby is seen smiling in a number of photos.
Mr Myers asks why Letby is smiling in the photos when it was around the time she handwrote notes documenting her problems.
LL: "Because despite what is going on, you have to find some kind of quality of life."
December 31, 2016, Letby writes on Facebook: " I'm not the same person I was when 2016 began; but I am fortunate to have my own home. I've met some incredible people and I have family and friends who have stood by me regardless - Thank you to those who have kept me smiling. Wishing Every Happiness for us all in 2017"
Letby says she had changed as a person and had 'lost confidence'

2:35pm

BM: "As far as you understood, were you at least allowed a social life?"
LL: "Yes."
Another photo is of Letby at the Kuckoo bar in Chester.
A holiday photo is shown of Letby with her father in June 29, 2018 in Torquay.
Letby denies killing or harming babies for any reason the prosecution had suggested.
BM: "How content were you before, in life?"
LL: "I had a very happy life."

2:35pm

That now completes Lucy Letby's evidence.

2:37pm

The judge tells the jury of the next steps in the trial, which may have further evidence for the defence case. The next listed day for the jury will be next Wednesday (June 14).




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

Dan O'Donoghue
@MrDanDonoghue
·
2h

Mr Johnson has finished his questioning. Ms Letby's defence lawyer Ben Myers KC is back on his feet, he is now going back over what was said in cross examination

Dan O'Donoghue
@MrDanDonoghue
·
42m

We're back after a break for lunch. Mr Myers is continuing to take Ms Letby back over what was said in cross examination

Dan O'Donoghue
@MrDanDonoghue
·
38m

Mr Myers notes that in cross examination the prosecution had claimed Ms Letby had 'fell out' with colleague Mel Taylor - he asks if she ever fell out with the nurse, she says 'no'

Dan O'Donoghue
@MrDanDonoghue
·
37m

Mr Myers pulls up messages from Mel Taylor to Ms Letby in June 2015 in which the pair are supporting each other after the death of a baby

Dan O'Donoghue
@MrDanDonoghue
·
24m

Mr Myers is going over the social media images/messages sent and received by Ms Lebty after her removal from the unit. The prosecution earlier said during this time Ms Letby was 'out on the razz with friends'

Dan O'Donoghue
@MrDanDonoghue
·
23m

Mr Myers focuses on a number of images showing her on days out with her parents and at meals with university friends

Dan O'Donoghue
@MrDanDonoghue
·
22m

Mr Myers asks why on these images she does not look as sad as the notes found in her home would suggest, she says 'despite what is going on you have to try and find some degree of quality of life'

Dan O'Donoghue
@MrDanDonoghue
·
18m

Court is shown a Facebook post Ms Letby published on 31 December 2016, in which she said ‘I’m not the same person I was when 2016 began but I am fortunate to have my own home. I've met some incredible people and I have family and friends who have stood by me regardless'

Dan O'Donoghue
@MrDanDonoghue
·
17m

Ms Letby said at this time she'd 'lost my confidence, I wasn’t the same person'

Dan O'Donoghue
@MrDanDonoghue
·
16m

Mr Myers asks 'have you ever wanted to hurt any baby in your care?'

Ms Letby 'I have not no'

Mr Myers says: 'How content were you in your life before all this'

Ms Letby says 'I had a very happy life'

Dan O'Donoghue
@MrDanDonoghue
·
16m

That completes Ms Letby's evidence, court is now adjourning - back next Wednesday

Dan O'Donoghue
@MrDanDonoghue
·
3m

Wrap up of today's evidence Nurse Lucy Letby deliberately misled jury, prosecutor says

 

[Tortoise]

She agreed with his assertion that she had had "a very active social life", but denied his subsequent claim that she had "deliberately misled the jury about this background".

[...]

He said Ms Letby was actually wearing a blue Lee Cooper leisure suit at the time.
She said she did not know why she had lied about that detail.

[...]

He asked her why she wrote this when she had "a house, a car [and] a boyfriend".
She agreed had those things, but added: "That's how I felt at the time."
"You felt like this because you knew you had killed and grievously injured these children," Mr Johnson said.
"That is the truth, you have murdered these children."
"I have never murdered a child or harmed any of them," she replied.

Nurse Lucy Letby deliberately misled jury, prosecutor says

Lucy Letby is a "calculating woman" who lied "to try and get sympathy", a prosecutor tells her trial.

www.bbc.co.uk

 

[Tortoise]

Article dated 9th June 2023:

"She previously told Manchester Crown Court that she felt “isolated” and “cut off from my nursing family”, as she was told she could not talk to colleagues – apart from two fellow nurses and a doctor who the Crown says she “had a crush on”.

[...]

Mr Johnson said: “We find times, times and more times of you out drinking with other people from the unit?”

“Yes,” said Letby.

[...]

Mr Johnson said: “All the time really. You had a very, very active social life, didn’t you?”

“Yes,” said Letby.

[...]

She wrote: “I am an awful person…. I AM EVIL I DID THIS.”

Mr Johnson said: “You felt like this because you knew you had killed and grievously injured these children.”

“No,” said Letby.

[...]

Letby’s barrister, Ben Myers KC, asked: “Photographs of you out on the razz with your friends. Drinking fizz, going to the races. Did you have a good time?”

Letby said: “Yes. There were times in those years that I has having a good time.”

[...]

Letby admitted she did go on to have contact with nursing colleagues following her removal from nursing, but it was “purely social”."

[...]

Letby denies she is ‘calculated’ liar who murdered ‘many children’

Accused nurse Lucy Letby has denied she is a “calculated” liar who had murdered “many children” on a hospital neonatal unit.

www.chesterstandard.co.uk

 

[Tortoise]

Episode 39, 'Homicidal activities'

www.mailplus.co.uk

Episode 39, 'Homicidal activities'​

In this episode Caroline and Liz explain what Lucy Letby said when questioned by the prosecution about Babies K to Q.

 

[Tortoise]

11:01am

The trial is now resuming.

11:03am

Benjamin Myers KC says to the court there is one witness to give evidence in relation to the sanitation of the hospital.

11:07am

Lorenzo Mansutti, who works at the Countess of Chester Hospital, has had many years of experience in plumbing.
He has provided a witness statement.
He says the plumbing in the Countess of Chester Hospital's Women's and Children's Building, between 2015-2016, had been built in the 1960s and 1970s, and says there were "issues with the drainage system".
He says he had to deal with "various blockages" and the cast-iron piping would crack for "a number of reasons" including age.
Asked what would happen if the pipes were blocked, he replies it would come back through the next available point, such as toilets or wash basins. He confirms that would include sewage.

11:11am

He says when alerted to it, it would come through the helpdesk, and it would be rectified "as quickly as possible".
He says he would be called out "weekly" to fix problems.
He says there was an occasion when they had a blockage in the room next door adjacent to the neonatal unit. He says a colleague attended it, the drainage had backed up and the neonatal nursery room 1 hand wash basin had "foul water" coming out of it.
He agrees with Mr Myers that "foul water" would include "human waste...sewage".
He says he is unable to confirm exactly when that happened during 2015-2016.

11:15am

Mr Myers says there were Datix forms presented to Mr Mansutti, one dated January 26, 2016.
It is a 'non-clincial incident' of a 'flood' type.
Nursery 4 was closed at 2.30am 'due to plumbing work/deep cleaning of nursery.' 'Mixer tap was switched on, and sink completely blocked.' 'Floor noted to be completely flooded'. 'Water within sink noted to contain much black debris. Sink still blocked however'.
The nursery was 'noted to be flooded again at approximately 4.30am', with the 'floor almost completely flooded again'.
Nurse Christopher Booth reported the incident.
Mr Mansutti confirms this is an incident different from that which was reported in room 1.

11:24am

A service report of 'blocked drains' is shown to the court.
Mr Mansutti says these service reports are "usually" urgent. The report shown to the court is on July 4, 2015. It happened in the maternity wing of the Countess of Chester Hospital, in the central labour suite [CLS], ward 35.
He says incidents would be delegated to team members.
A second incident is shown reported at August 8, 2015, a 'flood in the CLS' (ward 35), for which Mr Mansutti was called out.
Another is on October 2, 2015, for blocked drains in the CLS.

11:28am

Another is on October 6, 2015, in the neonatal unit, to 'investigate flood'.
Mr Mansutti says it could be a waste pipe, or rainwater.
Another report is on January 26, 2016, a 'leak in the neonatal unit/SCBU'.
Another is on February 24, 2016, a 'burst pipe in sluice' in 'ward 35 CLS'.
Another is on March 18, 2016, in the neonatal unit, nursery room 2 and the kitchen. There were two 'blocked sinks'.
Another is on April 10, 2016, in ward 35 CLS, as 'Sluicemaster and drains blocked'. Mr Mansutti says the Sluicemaster is a bedpan machine.

11:32am

Another report is on June 6, 2016, a 'flood in courtyard' of the neonatal unit. Mr Mansutti says this may have followed a heavy downpour. He does not believe the foul drainage runs that way, so it would more likely be surface water.
Another report is on July 5, 2016, in ward 35/CLS, for 'various plumbing jobs in NNU'.
'Check pall water filters for poor flow'
'Check that all valves in the ceiling void are fully open - NNU and by theatres...'
'Leaking sink in Sluiceroom - please check'.
Mr Myers asks about the last of these jobs.
Mr Mansutti says it is likely a leak in one of the sinks. He says there is not a Sluiceroom in the neonatal unit.

11:37am

Nicholas Johnson KC, for the prosecution, asks Mr Mansutti questions.
Mr Mansutti agrees that one of the problems for the flooding was adults 'putting things down sinks'.
One incident is somebody 'forcing a wipe towel down a sink'. Mr Mansutti accepts an incident did take place.
He says none of the incidents led to no hand washing facilities availability, and there is a system in place.
He says there has been 'sewage floods' in the neonatal unit. He says there was once incident, undated, not on a Datix form, where there was sewage on neonatal unit room 1.
He says he has knowledge of it because of "disgust", and work was done on moving sewage pipes away from the unit room in future, "so it couldn't happen again".
He says, for his recollection, it was a "one-off".
Mr Johnson says half the incidents listed did not take place in the neonatal unit. Mr Mansutti says there would not have been a direct effect on that unit for those days.

11:37am

That completes Mr Mansutti's evidence.
It also completes the evidence presented in the Lucy Letby trial.

11:38am

The trial judge, Mr Justice James Goss, is now giving preliminary directions to the jury.

11:40am

The trial judge says he has to discuss his directions of law with the prosecution and defence before he can deliver them to the jury.
He says those will likely be presented to the jury on Thursday, and the jury will not be present in court 'for very long'.

11:42am

The judge says the week beginning July 3 is when the jury will be expected to go out.
He says it is in the "hope and expectation that nothing untoward occurs", as the trial has had delays and it has gone on longer than expected.

11:43am

He also reminds the jurors of their obligations not to discuss the case with anyone, and not to discuss it amongst themselves until they are sent to deliberate.

11:44am

The jury are now sent home for the day.

Recap: Lucy Letby trial, June 14 - 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]

Episode 40, ‘A very calculating woman’ - The Mail

www.mailplus.co.uk

Episode 40, ‘A very calculating woman’​

In this episode Caroline and Liz explain what Lucy Letby said at the conclusion of her cross-examination.

They discuss the prosecution claims that she was out on the razzle, drinking with colleagues in the months before her arrest. And how it’s alleged that she’s a calculated murderer who killed babies for attention and sympathy.

 

[Tortoise]

“You will naturally feel sympathy for all the parents in this case, particularly those who have lost a child and the harrowing circumstances of their deaths.

“You must, however, judge the case on all the evidence in the case in a fair, calm, objective and analytical way – applying your knowledge of human behaviour, how people act and react, using your common sense and collective good judgment in your assessment of the evidence and the conclusions to be drawn from it.”

Letby jurors told to set aside emotion as baby murders trial winds up

The nurse is accused of murdering seven babies and trying to murder 10 others while working on the neonatal unit at the Countess of Chester Hospital.

www.dailymail.co.uk

Letby jurors told to set aside emotion as baby murders trial winds up

The nurse is accused of murdering seven babies and trying to murder 10 others while working on the neonatal unit at the Countess of Chester Hospital.

www.standard.co.uk

 

[Tortoise]

This was a case in which the prosecution "substantially, but not wholly" relied on circumstantial evidence, he told the jury.
"The defendant was the only member of nursing and clinical staff who was on duty each time that the collapses of all the babies occurred and had associations with them at material times, either being the designated nurse or working on the unit," he said.

Outlining the defence's case, Mr Justice Goss said it was their view that there were "possible causes for many of the collapses other than an intentional harmful act" and the prosecution's expert evidence "could not be relied on".

[...]

snipped for copyright

Letby jury told to judge facts 'calmly and fairly' - BBC News

Nurse Lucy Letby is on trial accused of murdering babies and attempting to kill others at a hospital.

www.bbc.co.uk

 

[Tortoise]

"Mr Justice Goss told jurors it was not their role to “resolve every conflict in the evidence”.

He said: “It would, you may think, be a remarkable and exceptional case in which a jury could say we know everything about what happened in any case and why.

“You are not detectives.

“If you are sure that someone on the unit was deliberately harming a baby or babies, you do not have to be sure of the precise harmful act or acts. In some instances there may have been more than one.

“To find the defendant guilty, however, you must be sure that she deliberately did some harmful act to the baby the subject of the count on the indictment and the act or acts was accompanied by the intent and, in the case of murder, was causative of death.”

He told the jury they also did not need to certain of any motive for deliberately harming a baby.

Mr Justice Goss said: “Motives for criminal behaviour are sometimes complex and not always clear. You only have to make decisions on those matters that will enable you to say whether the defendant is guilty or not of the particular charge you are considering.

[...]

“If you are satisfied so that you are sure in the case of any baby that they were deliberately harmed by the defendant then you are entitled to consider how likely it is that other babies in the case who suffered unexpected collapses did so as a result of some unexplained or natural cause rather than as a consequence of some deliberate harmful act by someone.

“If you conclude that this is unlikely then you could, if you think it right, treat the evidence of that event and any others, if any, which you find were a consequence of a deliberate harmful act, as supporting evidence in the cases of other babies and that the defendant was the person responsible.

“When deciding how far, if at all, the evidence in relation to any of the cases supports the case against the defendant on any other or others, you should take into account how similar or dissimilar, in your opinion, the allegations and the circumstances of and surrounding their collapses are."

[...]

“The defence say that there are possible causes for many of the collapses other than an intentional harmful act, that the prosecution expert evidence cannot be relied on in terms of providing explanations for many of the collapses and that there is insufficient evidence to lead you to the conclusion that these events were related and were a consequence of any harmful act by the defendant rather than a series of unrelated collapses that, in some cases, ended in death.”

When considering the seven counts of murder, Mr Justice Goss told jurors they must be sure Letby deliberately did something to the child that was “more than a minimal cause” of the death.

He said: “The children were all premature and vulnerable, some had mild respiratory distress syndrome of prematurity and some had specific health issues.

“There were also a few cases of delays in the administration of appropriate medicine or other clinical failings. Some of the causes of death were unascertained.

“In the case of each child, without necessarily having to determine the precise cause or causes of their death and for which no natural or known cause was said to be apparent at the time, you must be sure that the act or acts of the defendant, whatever they were, caused the child’s death in that it was more than a minimal cause.

“The defendant says she did nothing inappropriate, let alone harmful to any child. Her case is that the sudden collapses and death were, or may have been, from natural causes or for some unascertained reason or from some failure to provide appropriate care, and they were not attributable to any deliberate harmful act by her.”

[...]

The trial continues on Monday."

Letby jurors told to set aside emotion as baby murders trial winds up

The nurse is accused of murdering seven babies and trying to murder 10 others while working on the neonatal unit at the Countess of Chester Hospital.

www.dailymail.co.uk

Judge tells Lucy Letby trial jurors to set aside emotion

Jurors in the trial of murder-accused nurse Lucy Letby have been told to approach the case in a “fair, calm, objective and analytical way”.

www.chesterstandard.co.uk

Letby jurors told to set aside emotion as baby murders trial winds up

The nurse is accused of murdering seven babies and trying to murder 10 others while working on the neonatal unit at the Countess of Chester Hospital.

www.standard.co.uk

Letby jurors told to set aside emotion as baby murders trial winds up

The nurse is accused of murdering seven babies and trying to murder 10 others while working on the neonatal unit at the Countess of Chester Hospital.

www.expressandstar.com

https://www.itv.com/news/granada/2023-06-15/lucy-letby-jurors-told-to-set-aside-emotion-ahead-of-decision-making

 

[Tortoise]

THE QUESTIONS THE JURY MUST ANSWER TO CONVICT OR ACQUIT LUCY LETBY​

Jurors in the trial of Lucy Letby must ask themselves these questions when considering the allegations she murdered seven babies and attempted to murder 10 others.

On each of the seven counts of murder:

Q1) Are we sure that the defendant did some harmful act or acts to the child who died?

If yes, go to Q2. If no, the verdict on that count should be 'not guilty'.

Q2) Are we sure that the act or acts of the defendant was a substantial cause of the death of that child in that it was more than a minimal cause?

If yes, go to Q3. If no, the verdict on that count should be 'not guilty'.

Q3) Are we sure that when she did the act or acts that caused the death of the child she intended to kill or cause some really serious harm to that child?

If yes, the verdict on that count should be 'guilty'. If no, the verdict on that count should be 'not guilty'.

On each of the 15 counts of attempted murder:

Q1) Are we sure that the defendant intended to kill the child?

If yes, go to Q2 If no, the verdict on that count should be 'not guilty'.

Q2) Are we sure that the defendant did an act or acts that was/were more than merely preparatory to killing the child?

If yes, the verdict on that count should be 'guilty'. If no, the verdict on that count should be 'not guilty'

Judge tells Lucy Letby trial to approach case in a 'fair and calm way'

(BBM)

 

[Tortoise]

PROSECUTION CLOSING SPEECH - Monday 19th June 2023

Morning Session

Recap: Lucy Letby trial, Monday, June 19 - closing speeches

10:29am

The 12 members of the jury are now coming in.

10:32am

The trial judge, Mr Justice James Goss, informs the jury that they will sit no later than 3.45pm tomorrow (Tuesday).
Prosecutor Nicholas Johnson KC says this is "the beginning of the end" of the trial.

10:35am

Documents are now handed out among members of the jury.

10:39am

Mr Johnson asks the jury to look at an agreed fact which has been 'crossed through'. He says, in case jurors enquire, it has become "irrelevant".
He says it has been a long time since October when he introduced the case.
He says the detail given back then is "nothing" compared to what the jury now know about the case.

10:42am

He says the introduction, evidence and cross-examination has been largely chronologically presented. He says the trial judge is likely to be a chronological presentation too.
Mr Johnson says 'drawing together the strands of this case' requires a different approach, and "point out the similarities" and the "evolution" of "Lucy Letby's murderous assaults on these children" and "point out how calculating and devious she has been".
"We suggest that Lucy Letby gaslighted staff at the hospital - professional people with many many years of experience."
Letby "persuaded" staff the incidents were "just bad luck".
The laboratory synthesised insulin found in two babies wasn't "just bad luck", he added.

10:45am

Mr Johnson says Letby picked Mr Mansutti, a plumber, as a defence witness to pick on incidents "which aren't actually relevant" to the case.
He says there may have been one occasion when there was a backed up sink in neonatal room 1, but it did not correlate with any of the incidents heard. If it had, someone would have noted it.
NJ: "His evidence isn't going to help you decide in this case.
"He was called, we suggest, to bolster the tattered credibility of Lucy Letby - and you might ask yourself why."

10:46am

Mr Johnson says Child P's [my note: O's] injuries, combined with the insulin poisonings, had nothing to do with the plumbing.
NJ: "Please do not be distracted."
Letby "got away with her campaign of violence for so long" as it was not contemplated that a nurse could do such acts, he adds.
Mr Johnson says the "similarities" in these cases "shows who this person was".

10:51am

Mr Johnson refers to Dr Stephen Brearey's evidence in court.
NJ: "Lucy Letby had used ways of killing babies...that didn't leave much of a trace.
"Her behaviour persuaded many of her colleagues that most of the collapses were 'normal' - they couldn't see the wood through the trees.
"No-one - no-one, was contemplating the possibility of foul play."
Mr Johnson says Dr Brearey said, in relation to 'confirmation bias', that senior nursing staff "didn't believe this could be true", but the year was spent "with increasing suspicion with each incident...none of us wanted to believe it either."
"Then we stopped to take a step back, to think about it...the unexpected collapses...the unusual rash on a number of occasions, the association with Lucy Letby.
"Each time it became more statistically improbable."
Mr Johnson says Dr Brearey didn't know about the liver injury or the insulin poisonings at that time.
Dr Ravi Jayaram had said it was an "unprecedented" situation - "it seems utterly preposterous, then more and more happens.
"It seems easy to see things which aren't there."
"We are taught to think about common things, less common things, rare things. We do not generally consider unnatural causes or deliberate things."

10:54am

Mr Johnson refers to the 'gang of four conspiracy theory'.
He says in Letby's defence statement, there is a suggestion that the collapses and deaths were a product of staff shortages, or mistakes, or insufficiently qualified staff.
Mr Johnson says Letby said that was a "medical opinion", but the jury have not had any 'medical opinion' to back that up.
NJ: "The only things that matter is to concentrate on the issues in this case. Concentrate on the 17 children in this case...and see if there are any shortcomings.
"We suggest that was an uncomfortable exercise for Lucy Letby."

10:56am

Mr Johnson says for Child A, Letby said there were issues with the long line, and "if we agree" it was an air embolus, that Melanie Taylor would have done so.
Mr Johnson says Child A did not die of dehydration, and it was not Melanie Taylor who supplied the air embolus.
For Child B, nothing. For Child C, nothing.

11:02am

For Child D, Letby said there was a delay in antibiotics - but Child D did not die from an infection, Mr Johnson says.
For Child E, it was delay in response to the bleeding. Mr Johnson asks where did the bleed come from in the first place.
For Child F, nothing.
For Child G, initial blame with a colleague, but Letby went back on that.
For Child H, 'some of the drains were not securely put in', and 'potential incompetence'. Mr Johnson says Letby uses the word 'potential a lot'.

11:06am

For Child I, nothing on event one or three. For event two, Ashleigh Hudson was blamed for not full monitoring after Child I was taken off antibiotics within 48 hours, but Child I had been off antibiotics for 'much longer'.
In the fourth event, 'potential medical staff issues' with doctors being absent may have contributed.
For Child J, nothing.
For Child K, nothing.
For Child L, nothing.
For Child M, the 'unit was very stretched' and Child M was not in a proper bed.
For Child N, the unit was 'very busy', but Child N was due to go home.
For child O, nothing.
For child P, concern overnight for Child P's condition - but there was no medical record of this.
For Child Q, nothing.
Mr Johnson adds: "Do you really think the [gang of four] would say things to get Lucy Letby convicted?"
He says: "What did the doctors say that wasn't true?"

11:08am

Mr Johnson says the 'gang of four' didn't do a very good of scapegoating Lucy Letby, as they missed the insulin evidence - "the best bit of evidence".
He says "all the clues point in one direction, don't they? She's sitting in the back of court."
He says the four "didn't even know" about the "wildly out of kilter" insulin readings when they "blew the whistle".

11:13am

"Lucy Letby, we say, put a lot of effort in trying to pull the wool over your eyes."
He says Letby spent a lot of time talking about being isolated from her friends.
He refers to the 'I AM EVIL I DID THIS' notes - he says "we will come back to them at the end", but says "there are more important things in this case".
He says it was established Lucy Letby was "not isolated" and was "still in contact" with people she had "not been allowed to contact".
"Even though she knew what we had from our phone, she did repeat the lie.
"We went to the spreadsheet and the lie was exposed, wasn't it?
"She thought that if she said something often enough...it would be accepted.
"We suggest that Lucy Letby was an opportunist - she used their vulnerabilities as camouflage."
He says the misperception of the vulnerabilities "gave her away".
He says Letby thought Child A and Child B had an inherited blood disorder, and that allowed her the cover to target them.
"If she had left it there- she probably would have got away with it."

11:17am

"Her ignorance of insulin c-peptide...and the ratio [to insulin]...allowed her to poison [Child E and Child L].
"What she didn't know about the disconnection [between the insulin and insulin c-peptide ratio] leaves a biological footprint which leaves foul play.
"She would have got away with that - if police hadn't...referred the cases to Dr [Dewi] Evans."
He says Letby returned from a holiday in June 2016 and embarked on a "killing spree", with Child O and Child P killed and attempting to murder Child Q.
He says Letby put in 'false data [my note: Datix] sheets' to cover her tracks, and first put in the theory of an air embolus at June 30, 2016.

11:21am

Mr Johnson says he will look at five cases in one go - twins Child E&F, twins Child L&M, and Child K.
He says for E&F and L&M, one twin was poisoned with insulin and the other deliberately administered air. The cases were months apart. "What are the chances of that?"
He says Letby "invented" other cases of problems where none existed. With Child K, it was that she was a 'serial tube dislodger', but Child K had been "sedated".
For the two poisoned with insulin, they were "deliberately targeted".
Mr Johnson says when Letby was "interrupted" for Child E, she 'invented' that Child E really did have a problem.

11:22am

Mr Johnson refers to Child E and Child F's mother's evidence, given several months ago, for events from July 30, 2015.
Mr Johnson says the mother was a "very very important" witness.
He says the evidence was that providing milk was a big priority for her twins, as it as the only thing she could do.
Child E was crying 'like nothing she had ever heard before' - 'it was horrendous, more of a scream than a cry'. Mr Johnson says screaming was also recorded for Child I and Child N.

11:26am

Mr Johnson says the mother described Child E's blood around the mouth - 'like a goatee beard'.
Letby had said the blood came from the NG Tube and the registrar was 'on his way'. Letby told the mother to go back to the post-natal ward, and had done so by 9.11pm.
NJ: "This is a head-on credibility contest between [the mother] and Lucy Letby."
"You can be sure Lucy Letby is lying on this - plainly, as any parent will understand, provision of milk and food to any newborn infant is important, and 2100 was [Child E's] feeding time."
"Crying like nothing I'd heard before - it was a sound which shouldn't have come from a tiny baby, it was horrendous...
"You may think [the mother] would have a very good reason to remember this.
"Either she saw blood or didn't - why would she make it up?"
If she did see blood at 2100, then Letby's nursing notes are "false", Mr Johnson says.

11:27am

Dr Sandie Bohin says the NG Tube for Child E had been in place from July 29 to August 3, 2015. Mr Johnson says that was never disputed.
He asks why the tube was the cause of the bleed, as said by Letby.
NJ: "It was a panicked reaction, told to a mother who knew no better, and it was designed to cover her tracks."

11:32am

Mr Johnson refers to the '1ml bleed' Letby recorded for Child N.
Letby, interviewed on that, had said the tube insertion 'can cause a bleed' - "just a small amount".
Mr Johnson says the mother of Child E recorded a small amount of blood at 9pm. He says if that was the case, then Child E was 'producing lots of blood' by 10pm.
He says Letby 'falsified' nursing notes for Child E.
He says the jury "can be sure" the mother was telling the truth, as the mother rang her husband, and the phone call record "proves that" at 9.11pm, in a call lasting over 4 minutes. He says the father's evidence backs up the mother's evidence on the content of the phone call.
"Have [the parents] made that up, to get at Lucy Letby? Are they in on it? Are they a sub-gang of two?"

11:40am

Mr Johnson says of all the things to see in your life, "you would remember" seeing your son "in terminal decline", as the mother recalled returning later to see efforts to save Child E's life.
He says if the parents are telling the truth, then Letby's account is a "lie".
He says there is a "fundamental difference" between the mother's "compelling account" and Letby's "lie" in the notes.
Dr David Harkness's note for 11pm, Mr Johnson says, coincides with the telephone call from the midwife at 10.52pm to the father of Child E, in a call which lasts over 14 minutes.
Letby's family communication note records 'both parents present during the resus.'
Mr Johnson says the pieces of the jigsaw 'fit only one way' and the parents' recollection is at odds with Letby's.
Mr Johnson says the prosecution say Letby attacked Child E and was interrupted first time, then attacked again.
He says of the mother's account: "It's powerful evidence - independent of the medical evidence - that Lucy Letby murdered [Child E]."

11:44am

Mr Johnson says Dr David Harkness, in evidence, gave a chronological sequence of what happened.
He says he accepted he had been on the neonatal unit from 9.30pm.
A fluid balance chart for Child E is shown to the court. '15ml fresh blood' is written in the 10pm column, accepted it was written in Letby's handwriting.
Mr Johnson says it was signed by Belinda Simcock [Williamson] deliberately so Letby could 'disassociate' herself on the paperwork from the incident, "so it looked" that someone else was there at the time.
Letby had said she "assumed" it came after Belinda Simcock's documentation.
Mr Johnson refers to a case in Child I, where Letby 'altered the timing' for her designated baby that was due to be transferred to Stoke.

11:47am

Mr Johnson says Letby needed an "innocent reason" for why Child E's 9pm feed was omitted, and does so by suggesting Dr David Harkness was on the unit earlier in the shift.
Dr Harkness had suspected a gastrointestinal bleed for Child E, but all the observations were 'good' and did not point to that.
Dr Harkness was "insulted" at the suggestion, in evidence, he was "out of his depth".

11:51am

NJ: "None of these doctors suspected sabotage - they all looked for a natural cause.
"It was not a level playing field - there was no natural cause."
Dr Harkness had said something had been "interfering" with Child E's oxygen flow into the bloodstream. He said Letby had been looking
"A strange pattern over the tummy area which didn't fit with the poor perfusion - there were these strange kind of purple patches.
"There were patches in one area, then in another...it was unusual for a baby [in Child E's condition]."

12:08pm

Dr David Harkness had said he had not seen these patches - "no smaller than 1-2cm", "didn't remain constant", outside of the babies in this case - Child A and Child E.
DH: "It was something that was so unusual it's hard to give a clear description".
Mr Johnson says this was what a doctor had said. He says Dr Harkness was "traumatised" by what he had seen, in the way Child E had bled in the way he did.
He said Letby, by comparison, on the day Child E died, texted "one of those things"; "nothing to see here," Mr Johnson adds. He says Letby was "gaslighting her colleagues".

12:12pm

Mr Johnson says Dr Harkness was not one of the 'gang of four'. He asks the jury if Dr Harkness was lying. He says one of Dr Harkness's colleagues, also a doctor, recalled Dr Harkness was "animated" when describing the discolouration. He says if Dr Harkness is lying, then the doctor colleague is also lying. "How deep does this conspiracy go?"
He says Letby had described 'strange discolouration' on Child E, with 'red horizontal banding' around the stomach.
Mr Johnson says if Letby agrees there was discolouration on Child E, why was Dr Harkness taken to task for describing it in cross-examination? He suggests it was an attack on Dr Harkness.

12:23pm

"No-one now suggests seriously [Child E] had [gastrointestinal disorder] NEC." A doctor had since expressed regret that they agreed a post-mortem examination was not necessary, Mr Johnson tells the court.
A medical expert had excluded the possibility of a congenital blood disorder.
Dr Dewi Evans said stress for Child E had been ruled out, and the "graphic" skin discolouration provided by Dr Harkness was 'clear evidence' of air administered into Child E's system.
Mr Johnson says there is only one person who could have been responsible for administering air into Child E.
He says, for the bleed, "this was no naturally occurring bleed".
Dr Sandie Bohin said Child E had been "incredibly stable" prior to the deteriorations. The 16ml aspirate at 9pm "struck" her as "really odd" in that context. She was "at a loss to explain where this had come from".
Mr Johnson says this discrepancy is also seen in Child N and Child G - and the similarities are "all down to Lucy Letby's behaviour", he adds, pointing to Letby in the dock.

12:24pm

Dr Bohin had agreed with Dr Evans to say air had been injected.
The haemhorrhage seen by babies such as Child E on this scale was "vanishingly rare".
The purple patches, Dr Bohin said, "didn't fit with any explanation other than air embolus".

12:29pm

Dr Bohin rejected a suggestion that stress in Child E caused excess stomach acid which caused the bleeding, Mr Johnson adds.
Mr Johnson says Child E declined within about an hour of Letby coming on duty that night.
"What are the chances of that?"
Mr Johnson says the point of circumstantial evidence is pointing at the threads of evidence, and the collapses "always happen" when Letby is in the neonatal unit.
He adds: "There are no innocent reasons for [Child E's] collapse and death."

12:33pm

He says the level of insulin in Child L was double that found in Child F several months earlier.
NJ: "That tells you a lot about intention, doesn't it?"
He says for Child A, Letby was interviewed about it and said in the aftermath she had 'asked for the [dextrose] bag to be kept' in June 2015. It was put in a sluice room, and a colleague had confirmed this was done.
He says that Letby knew no-one subsequently examined the bag.
He says Letby "taunted the police" by repeatedly asking the question if police 'had the bag' [which had insulin in].
"She thought the fact they didn't have the bag would give her a free pass.
"But she was wrong, because what she didn't know was insulin c-peptide."

12:36pm

Mr Johnson says experts had given evidence from the laboratory to show results [indicating insulin and insulin c-pep levels] from there were "reliable", and Letby had accepted this in evidence.
Mr Johnson said it was ruled out that insulin could have been applied to the nutrition bag in the pharmacy prior to its arrival on the ward. Evidence had been heard by one of the pharmacy team to this effect and it was not challenged.

12:39pm

Mr Johnson says the 'murderer' had to have been working both night shifts for Child F and Child L.
"Only three" people were working both shifts. One was a nursery nurse and would not have been in room 1. Another was Belinda Simcock, and the third was Lucy Letby, who 'hung up the bag for Child F'.
Child L got "more than one poisoned bag of insulin".
Mr Johnson: "These are not random poisonings".
He says it's "obvious" who is responsible, as there is only one person who could be responsible.

12:42pm

Mr Johnson shows to the court a "tiny vial of insulin", which had been added by someone who had access to the nutrition bags in the fridge, of which there were "a limited number of candidates".
Mr Johnson says "we have heard from all of them" and there is only one candidate left.
Mr Johnson says it does not need to be found "how it was done", as the evidence shows "it was done". "Anyone, if they wanted to, could inject 0.6ml of insulin into that bag.
"A tiny amount of insulin could have fatal consequences.
"What is the state of mind of someone who does that? Is it someone who watches someone freshly born desaturating [for up to half a minute - in the case of Child K].
"Is it a sick person?
"This was a targeted attack."

12:45pm

Mr Johnson says "we know from evidence" that insulin is "never put into a TPN bag".
The case of Child F had been referred to medical experts as the events for Child E were "suspicious".
He says the first contaminated bag was put up for Child F at 12.25am, and Child F vomited less than an hour later. A medical expert said this was a symptom of low blood sugar, as a self-defence mechanism for the body. There was also a 'sudden rise in heart rate' as the body produced adrenaline to combat it. The blood sugar level of 0.8 was a "life-threatening situation for [Child F]."

12:55pm

No other child on the unit was receiving TPN bags that day, in the case of Child F. The turnover of TPN bags was "very low" according to evidence by Yvonne Griffiths.
The bag "was only ever going to one child, isn't it?"
"It's so sly, isn't it?" Mr Johnson says the insulin-contaminated bag was going to be administered when 'the poisoner' was not on duty, to be administered by "an unsuspecting colleague" - "a member of her 'family'".
"What does that tell you about the mindset?"
"It shows you a cynical, cold-blooded" planner, Mr Johnson says.
The amount of insulin in the two bags was 'about the same', which showed there had been thought put into the preparation.
Mr Johnson says Letby "told some interesting lies" about Child F in police interview. "She claimed she hadn't been aware of any concerns about [Child F's] blood sugar."
He says Letby otherwise had a very good memory.
"You know she is lying [from] the text messages she sent to [a nursing colleague]."
Police broke the news of insuin c-peptide to Letby in November 2020, Mr Johnson adds.
The 'surreptitious' searching of Child E&F's mother on Facebook was "never properly explained."
Mr Johnson says Letby was "Cold, calculated, cruel and relentless."

 

[Tortoise]

PROSECUTION CLOSING SPEECH - Monday 19th June 2023

Afternoon Session

Recap: Lucy Letby trial, Monday, June 19 - closing speeches

2:18pm

Mr Johnson refers to the cases of Child L and Child M, the twins.
He says fluids were calculated for Child L by Dr Sudeshna Bhowmik. Letby had recorded 'myself and shift leader A.Davies have discussed this with Reg. Bhowmik as it does not follow the hypoglycaemia pathway'.
Amy Davies had not recalled this conversation.
Mr Johnson says Letby was "setting up an issue" for Child L.
Child L's blood sugar level had improved so monitoring was not required. Nurse Tracey Jones said she didn't change the dextrose bag during her shift.
Mr Johnson says for the day shift on April 9, 2016, Mary Griffith was the designated nurse for Child L and Child M, on a "busy shift". Mr Johnson says if people were "very busy", then they might ot have the time to monitor what Letby was up to.
Mary Griffith was "certainly out of the room" by 9.30am as she was in room 4 administering medication to children in there, Mr Johnson says.
He says that means Lucy Letby would have been "alone" with Child L at that time. He says that would be when insulin was put into Child L's dextrose bag, as Prof Hindmarsh, in evidence, said it had to be by 9.30am.
A blood sample taken for Child L taken at 10am showed an increase in the amount of dextrose given but a drop in the level of blood sugar - "when the opposite should have been true".
Mr Johnson says the "fingerp[r]int of evidence" is the ratio between insulin and insulin c-peptide later recorded.
The 'podding' of the blood sample was delayed due to Child M's collapse, Mr Johnson says, and the timing of the sample taken must be taken from several accounts. He says it "must have been taken about 3.45pm".

2:23pm

The blood sample "would have been treated as urgent" and the nurse said she had been distracted by "an emergency" with Child M, which was timed at 4pm.
The blood was put into a vial and envelope and labelled.
The request for the blood test was entered at 3.45pm on a 'lab specimen internal inquiry' form at the Countess of Chester Pathology. The form is shown to the court.
The process and analysis were "interrupted" by "Lucy Letby's attack on [Child M]," Mr Johnson adds.

2:30pm

An infusion therapy sheet for a 10% dextrose prescription is at 3.40pm. Mr Johnson says this explains why the lab result shows a slightly higher blood sugar reading for Child L than the other readings, and that the blood sample was taken at 3.45pm.
Dr John Gibbs said the low blood sugar level should have meant the level of insulin in Child L was also low. He said it had "never occurred to him" that someone was administering insulin to Child L.
He said he had never received the lab results for Child L - they went to junior doctors who "didn't appreciate its significance" at the time.

2:34pm

Mr Johnson said scientist Dr Sarah Davies had phoned through the results to the hospital "as they were so unusual".
The lab at Liverpool was "performing very well" and Mr Johnson says it can be discounted as a possibility that the lab results were in any way "misleading".
He adds "it speaks volumes" that the levels of insulin were double that found for Child [F] months earlier.
"The poisoner, Lucy Letby, upped the dose for [Child L]."
He says, for timings, the insulin was put in "after the bag was hung" for Child L.

2:41pm

Mr Johnson says Letby was co-responsible for hanging up the bag for Child L at noon on April 9, and had also co-signed for the previous bag on April 8 at noon.
Prof Hindmarsh says the bag was "not poisoned" before midnight on April 8/9, as the blood sugar readings are "following an upward trend" for Child L.
Insulin "must have been put in" between midnight at 10am on April 9.
Mr Johnson says insulin went into the bag sometime before or at 9.36am, given insulin's half-life of 24 minutes.
Mr Johnson says it "had to have been a targeted attack", and is "not a random poisoning".
He says "whoever is responsible" must have been on duty between midnight a[nd] 9.36am.
Mr Johnson says the jury must ask if it could have been a different person. He says "it must have been the same person", and they could "get away with it" as long as "they didn't do it too often".
He says Letby came on duty between 7.30am-8am on April 9

2:43pm

The insulin that poisoned Child L "was put into more than one bag" and all the staff on duty said they were not responsible for that.
Mr Johnson says the first poisoning was when the bag was already hanging, and the second one was administered to Child L as well.
He says at 9.30am on April 9, Mary Griffith was in room 4. She was not working on the day when Child [F ]was poisoned.

2:49pm

A third bag was being put together for Child L at the time Child M collapsed.
"Somebody also spiked that bag," Mr Johnson says. He says it was "spiked" sometime after it was hung up at 4.30pm.
Mr Johnson asks if somebody did this to "frame" Lucy Letby, and if she didn't do this, then somebody also targeted Child [F], and targeted Lucy Letby to take the blame.
"We suggest that is not a reasonable possibility - that is why all the other cases are so important, they are not coincidences."

2:51pm

Mr Johnson moves to Child M, who was "a picture of health" after his birth, and "was doing just fine".
"The fact that his twin was poisoned puts his case into sharp relief.
"What are the chances of a healthy baby boy collapsing in such an extreme way? The evidence, as you have heard from the doctors, is not very big.
"What are the chances of this happening at the same time his brother was poisoned...and [point] you to the identity of the attacker?"

2:54pm

Mr Johnson says "circumstantial evidence" can be "very very powerful", and this is a case where it is.
Child M suffered a "profound collapse", from which "he made a miraculous recovery" - "how many times have you heard that before [in this case[?]]"
He said this was "entirely out of natural process".

2:59pm

Dr Anthony Ukoh had noted there were issues with aspirates and a slightly distended abdomen for Child M, "but nothing to indicate he was to become seriously unwell".
On April 9 at 3.30pm he was put on to 10% dextrose, co-signed by Lucy Letby and Mary Griffith. He did not get a bag with insulin in, Mr Johnson tells the court.
Mr Johnson says Mary Griffith was about to take a blood sample for Child L and make up a 12.5% dextrose solution, which would take time.
Mr Johnson says Letby would have administered this 10% dextrose infusion for Child M.
The parents of Child L and Child M had given evidence to say one of the doctors was "pressing [Child M's] chest" '10 minutes after we had left the boys'.
Child M had gone from "fine" to "life-threatening emergency CPR" and the father was left "praying", Mr Johnson says.
He says it can be discounted this was all 'unlucky coincidence'.

3:08pm

Mr Johnson refers to a paper towel on the resuscitation notes for Child M "which found its way, under its own steam, to Letby's home".
NJ: "It 'quote', "came home with me" - sounds like a dog following home, doesn't it?
"Her explanation - I collect paper.
"How long has Lucy Letby had to come up with a reason? Here we are now, 7 years later, and her best reason is 'I collect paper'."
"Most collectors know what they collect - [it's] absolute nonsense."
He adds: "Somebody sabotaged [Child M], didn't they?"
The attacks were "almost signature" as Child M deteriorated, and six adrenaline doses were given.
"It is a signature of the consequences of many of these attacks."
Child M was "at the very edge of life" and the resuscitation "took 30 minutes with no response". 20 minutes is "the usual watershed", according to Dr Ravi Jayaram.
Dr Jayaram had the 'difficult conversation' with the parents, but Child M had a "miraculous recovery."
Mr Johnson says Dr Jayaram 'wasn't sure what we had done' [to make Child M recover].
Dr Jayaram had noted skin discolouration on Child M, that "flitted around" "appearing and disappearing".
Dr Jayaram said: "Because [Child M] was darker skinned, it was more obvious." He added: "I have never seen this before [Child A]."
Letby, in interview and cross-examination, had suggested the lighting in room 1 was 'not very good' and that was a possible reason why she could not see what Dr Jayaram had seen.
Mr Johnson refers to Child I, when Letby could see in very poor lighting what her condition was.

3:14pm

Dr Jayaram had asked, in cross-examination, if he was being accused of making things up.
"What is Lucy Letby's case, if Dr Jayaram is making things up?"
Mr Johnson said it had been suggested Dr Jayaram had, in cross-examination, 'added dramatic detail' by mentioning the skin discolouration descriptions but not recording it contemporaneously in notes at the time, and had been accused of 'dramatic detail' when he said a 'shiver had gone down his spine' when he first read about the effects of air embolus.
NJ: "We suggest that not only is Letby murdering babies, she is also prepared to trash the reputations of professional people in order to get away with it."

3:30pm

Mr Johnson says after the collapse of Child M, the night-shift of April 9/10 happened, and a Countess doctor described there was a plan to remove Child M's ET tube, following an "astonishing" recovery. He was put on to 'bi-pap' within 12 hours, and there was "no cause for concern" for a child who had had "such a devastating collapse".
Dr Gibbs had queries NEC and sepsis at the time, but those could be excluded by following evidence. Child M required a dose of caffeine for a slowing breathing rate at the end of the following day.
Dr Stavros Stivaros later said Child M had suffered a brain injury. Mr Johnson says this was as a result of the collapse.
Mr Johnson says 'a fairly typical picture' in this case is of babies collapsing rapidly and unexpectedly, and recovering just as quickly.
Medical expert Dr Dewi Evans said there had been no reason to do blood tests for infection, and subsequent tests ruled that out in any case. Dr Evans and Dr Sandie Bohin had said the cause of the collapse was an air embolus.
Mr Johnson says there had been "evolving means of attack" by Letby.

3:38pm

Mr Johnson says there is only one conclusion, as said at the beginning of the trial - "there was a poisoner at work" in the Countess of Chester Hospital's neonatal unit.
He says it has not been suggested by Letby or the defence that anyone was responsible for poisoning Child F and Child L.
Child F was poisoned with two bags, and Child L was poisoned "with at least two bags", until the 15% dextrose bag was fitted and he began to improve.
"Lucy Letby and Belinda [Simcock] were the only ones present when both [Child F and Child L] were poisoned."
Mr Johnson says: "You can dismiss the possibiliy that two murderers were working in the same unit at the same time."
Mr Johnson says Letby has 'rowed back' from disputing the accuracy of the insulin readings between her defence statement and giving evidence, and says it will be 'interesting' how the defence get her out 'of that particular creek'.

3:40pm

Mr Johnson moves to the case of Child K. He recalls the evidence heard by Dr Ravi Jayaram that Lucy Letby was "standing over" Child K as the alarm was not sounding and she did nothing. Mr Johnson says Letby had displaced Child K's ET Tube.
The Child K case "shines a bright light" for what happened in Child E, Mr Johnson says, when Letby "was almost caught red-handed".

3:49pm

Mr Johnson says nurse Joanne Williams said it was "strange" Child K desaturated two further times, and the second and third incidents saw Child K 'well sedated'.
The 6.15am desaturation (the second incident), happened between 6.07am and 23 seconds, and 6.15am, Mr Johnson says.
An x-ray, timestamped at 6.07am and 23 seconds, shows Child K's x-ray, with a report the ET Tube was 'in satisfactory position'.
By 6.15am, Child K was desaturating, Mr Johnson says. The tube had "gone down her throat" then had to be removed.
"How on earth had that happened in a 25-week-old [gestational age] baby who had been on morphine?"
Mr Johnson says Letby had no memory of this. He says Letby had been responsible for the admission process for Child K.
He says the cross-examination at this time was a "somewhat tortuous process". He relays the cross-examination of this, in which he concluded he got told off for saying they 'danced the dance' in arriving at the point.
He says they got there, 'in the end', in that Letby was in room 1 to obtain the medical notes for Child K to input the admission details on the computer, in a record between 6.04am-6.10am on the computer. He says those notes would have to be returned to the cotside in room 1 afterwards.

3:50pm

He says the coincidence between Letby's presence and Child K's desaturation "is not an innocent one".
He says the third event for Child K happened at handover, which Mr Johnson says was not the only occasion.

3:54pm

Mr Johnson says once Child K's ET Tube was moved to the correct position, 'she picked up immediately'.
Mr Johnson says after nearly being caught red-handed, like in Child E, she 'pressed home her advantage' and tried to create more of a problem for Child K which led her to desaturate again, by moving her ET Tube.

3:56pm

Mr Johnson refers to police interviews with Letby, in which she said Child K's tube had slipped earlier in the shift.
Mr Johnson says Letby had, in interview, 'created the impression' of 'innocent tube movement' for Child K.

4:02pm

Mr Johnson says Joanne Williams had left at 3.47am to see Child K's mother, and had left Lucy Letby 'babysitting' room 1, Letby having fed a designated baby.
It had been suggested to Dr Jayaram he was 'inventing' an allegation for Lucy Letby, to cover for shortcomings in Child K.
"What did Dr Jayaram invent? What was it that was so offensive to their case?"
Mr Johnson says Dr Jayaram said Joanne Williams had left and Letby was 'babysitting'. Dr Jayaram was 'suspicious' - "Letby can't say what was on his mind."
Dr Jayaram walked into room 1 and saw Letby by the incubator. NJ: "What was Letby's case here?"
Mr Johnson says he can't help the jury as Letby was saying one thing and then said another.
He says if the jury is confused, then they have to ask why - he says the reason is because Letby won't commit herself. He asks if that is the case, then why?
Dr Jayaram said Child K's observations dropped - there was no dispute about that. The alarm was not on, and that was not disputed.
He said the cause was a displaced tube - that was not disputed.
"Is Dr Jayaram a wicked liar to make up allegations about one of his colleagues?...or is he telling the truth?"
Mr Johnson adds: "What lie did Dr Jayaram tell? We suggest it's all smoke and mirrors, that all these doctors are bad, that they tell lies, that they stitch her up."

4:05pm

Mr Johnson says evidence was heard to say a nurse would not leave a baby unattended without checking the tube was secure. Joanne Williams had checked the equipment and made sure the tube was secure, Mr Johnson said.
A 'big play' was made of the 'high air leak' on the ventilator. It had been accepted the ventilator was sub-optimal, but said the oxygen saturations were 'optimal'. Mr Johnson says the leak was not having any impact on Child K.

4:11pm

A note was made of 'large blood-stained oral secretions' by Joanne Williams, but she could not confirm she had been present to see that.
A doctor had said if he had seen blood stains during reintubation of Child K, he would have noted it and made Dr Jayaram aware of it.
Mr Johnson says that note of 'large blood-stained oral secretions' had 'only come from Lucy Letby', and was "entirely typical behaviour by Lucy Letby".
He says in Child K's remaining days before she passed away, the ET Tube did not dislodge again.
Mr Johnson counts the number of seconds, each one, up to 30, for a 25-week-gestational age baby desaturating, which he says was the sight Letby saw from Child K's cotside.
NJ: "It's uncomfortable isn't it? Even talking about it is uncomfortable.
"That is why it's attempted murder."

5:02pm

A round-up story from today: Lucy Letby ‘gaslighted’ hospital staff over baby collapses

5:02pm

The Standard will be back in court for further live coverage of the prosecution's closing speech tomorrow (Tuesday).

 

[Tortoise]

Episode 41, The end of the evidence - The Mail

www.mailplus.co.uk

Episode 41, The end of the evidence​

In this episode Caroline and Liz outline the conclusion of the defence case and the end of the evidence.

They also explain the judge’s directions to the jury and how they should decide whether Lucy Letby is guilty or innocent of the charges she faces.

 

[Tortoise]

TWEETS - PROSECUTION CLOSING SPEECH - Monday 19th June 2023

Morning Session

Dan O'Donoghue

@MrDanDonoghue
·
22h

I'm back at Manchester Crown Court for the trial of nurse Lucy Letby, we're expecting prosecution/defence closing speeches this week. Ms Letby has been on trial since October last year for the murder of seven babies and the attempted murder of 10 more. She denies all charges

Dan O'Donoghue

@MrDanDonoghue
·
22h

Jury are now in, prosecutor Nick Johnson KC is on his feet. Addressing the panel of eight women and four men directly he says 'this is the beginning of the end as far as I’m concerned, you’ll be glad to know'

Dan O'Donoghue

@MrDanDonoghue
·
22h

Mr Johnson says to the jury that it 'probably seems an awful long time ago, that date in October when I stood here and introduced you to this case'

Dan O'Donoghue

@MrDanDonoghue
·
22h

Mr Johnson is explaining how he will approach his closing speech, he says 'what we want to do is point out similarities' of the cases and 'point out the evolution of Lucy Letby's murderous assaults on these children and point out how calculating and devious she has been'

Dan O'Donoghue

@MrDanDonoghue
·
22h

He says Ms Letby 'gaslighted the staff at the countess of chester' by persuading them the baby deaths at the facility were 'just a run of bad luck'

Dan O'Donoghue

@MrDanDonoghue
·
22h

Mr Johnson says the defence decision to call plumber Lorenzo Mansutti as a witness last week, to talk about sewage issues at the hospital, was a 'distraction' to 'bolster the tattered credibility of Lucy Letby'

Dan O'Donoghue

@MrDanDonoghue
·
22h

He says Ms Letby 'got away with her campaign of violence for so long' because people couldn't contemplate a nurse was trying to kill babies

Dan O'Donoghue

@MrDanDonoghue
·
22h

Mr Johnson says Ms Letby's claim that senior doctors apportioned blame on her for shortcomings at the hospital is a 'conspiracy theory' and says she offered no evidence, beyond 'general allegation' for this

Dan O'Donoghue

@MrDanDonoghue
·
21h

Mr Johnson is currently giving brief summaries of what was said by Ms Letby in relation to each baby in this case and what the evidence has shown

Dan O'Donoghue

@MrDanDonoghue
·
21h

Mr Johnson asks the jury to consider 'where is the evidence for the 'shortcomings alleged in defence'.

On the 'gang of four' theory, he asks them to consider 'what was their motive for scapegoating Lucy Letby, she didn't give you specifics...she hasn't told you the evidence'

Dan O'Donoghue

@MrDanDonoghue
·
21h

He says 'ask yourself the question, why would the doctors do that…do you really think, Dr Brearey, Dr Gibbs, Dr Jayaram (and another doctor) said things that were not true to get Lucy Letby convicted?'

Dan O'Donoghue

@MrDanDonoghue
·
21h

Mr Johnson says when he asked Ms Letby specifically about each doctors evidence 'there was very little if anything' that she said was not true

Dan O'Donoghue

@MrDanDonoghue
·
21h

Mr Johnson says Ms Letby was a 'opportunist' who targeted ill babies. He said she tried to use their vulnerabilities as 'camouflage' her actions

Dan O'Donoghue

@MrDanDonoghue
·
21h

He says she 'probably would have got away with it if she stopped' after some of the earlier children in this case. But in the case of the babies poisoned with insulin, she showed her 'ignorance' of how synthetic insulin works and the 'biological footprint' it leaves

Dan O'Donoghue

@MrDanDonoghue
·
21h

He says 'when she thought she was rumbled (in June 2016) she did her best to create the impression the neonatal unit was dysfunctional by putting in false datix sheets'

Dan O'Donoghue

@MrDanDonoghue
·
21h

Mr Johnson is going back over some of the cases in more detail. He focuses on Child E and the recollection of his mother, she said in evidence that she went to the unit to feed her son and heard him making 'horrendous' screams. Ms Letby was on the unit at the time

Dan O'Donoghue

@MrDanDonoghue
·
21h

Child E's mother said she found her son with blood around his mouth. The mum said Ms Letby told her that it had been caused by an NG Tube and told her to go back to the ward

Dan O'Donoghue

@MrDanDonoghue
·
21h

Mr Johnson points out that the NG tube had been in place since 29 July 2015 (this incident was on August 3). He says her comment was a 'panicked' response to a mother 'who knew no better'

Dan O'Donoghue

@MrDanDonoghue
·
21h

Ms Letby in her evidence disputed this - Mr Johnson asks the jury to consider why Child E's mother would make this up

Dan O'Donoghue

@MrDanDonoghue
·
21h

He also notes that after the incident, phone records show Child E's mother called her husband - she said in evidence she was distressed and communicated what she had seen. Again this is disputed by Ms Letby

Dan O'Donoghue

@MrDanDonoghue
·
21h

Mr Johnson asks 'are they in on it, are they a sub gang of two' who are trying to pin blame on Ms Letby

Dan O'Donoghue

@MrDanDonoghue
·
21h

Mr Johnson says there's a 'fundamental difference' between (Child E's mother's) 'compelling account' of what happened and Ms Letby's. He says this is 'a head on credibility contest' and either Child E's mother is 'lying' or Ms Letby is 'lying'

Dan O'Donoghue

@MrDanDonoghue
·
20h

Mr Johnson is continuing to go over the specifics of each child and was just drawing parallels between the cases of Child F and L who were both poisoned with insulin.

He describes Ms Letby's actions as 'cold, calculating, cruel and relentless'

 

[Tortoise]

TWEETS - PROSECUTION CLOSING SPEECH - Monday 19th June 2023

Afternoon Session

Dan O'Donoghue

@MrDanDonoghue
·
19h

We're due to resume in 5mins or so. Wrap of this morning's proceedings here

Lucy Letby trial: Nurse 'gaslighted colleagues to hide baby murders'

Nurse Lucy Letby is accused of being a "calculating and devious" opportunist who killed babies.

www.bbc.co.uk

Dan O'Donoghue

@MrDanDonoghue
·
19h

Mr Johnson is back on his feet. He's going over the cases of Child L and M, twin boys born in April 2016.

Dan O'Donoghue

@MrDanDonoghue
·
18h

The court has previously heard that in the hours that followed Ms Letby's arrival on shift on 9 April, Child L's glucose levels fell to abnormally low and he had to be given glucose in an attempt to correct hypoglycaemia.

Dan O'Donoghue

@MrDanDonoghue
·
18h

The prosecution said blood tests revealed a very high level of insulin, which they said had been caused by the administering of synthetic insulin in a "deliberate act of sabotage" by Ms Letby.

Dan O'Donoghue

@MrDanDonoghue
·
18h

Mr Johnson is taking the jury back over various medical charts and documents for Child L from this time.

He says they show a 'a fingerprint of the introduction of manufactured insulin, in other words - somebody poisoned (Child L)'

Dan O'Donoghue

@MrDanDonoghue
·
18h

Mr Johnson asks the jury, 'did somebody do this to frame Lucy Letby? 'That's the only alternative to her being the person responsible and if Lucy Letby didn’t do it, then whoever did also targeted (Child F) and targeted Lucy Letby to take the blame'

Dan O'Donoghue

@MrDanDonoghue
·
18h

Mr Johnson adds 'we suggest that this is not a reasonable possibility….it just doesn’t work'

Dan O'Donoghue

@MrDanDonoghue
·
18h

Mr Johnson references the nursing notes found in Ms Letby's home. Some of which releated to this child. He says Ms Letby has said 'it came home with me'...he dismisses this

'Like a dog following behind, these are inanimate objects'

Dan O'Donoghue

@MrDanDonoghue
·
18h

He says her explanation was 'I collect paper'

'How long has Lucy Letby had to come up with a reason, here we are now, seven years later. The best reason is I collect paper'

Dan O'Donoghue

@MrDanDonoghue
·
18h

Mr Johnson adds 'avid collectors are usually sad old men like me, most collectors know what they’ve got in their collection….its absolute nonsense'

Dan O'Donoghue

@MrDanDonoghue
·
18h

Mr Johnson references the case of Child M. During his collapse, Dr Ravi Jayaram noted skin discolouration on that 'flitted around' and appeared and disappeared

Dan O'Donoghue

@MrDanDonoghue
·
18h

Ms Letby, in her police interview and cross-examination, had suggested the lighting in room one was 'not very good' and that was a possible reason why she could not see what Dr Jayaram had seen

Dan O'Donoghue

@MrDanDonoghue
·
18h

Mr Johnson says 'we suggest not only is Lucy Letby prepared to kill babies, but also prepared to publicly trash the reputations of professional responsible people in an effort to get away with it'

Dan O'Donoghue

@MrDanDonoghue
·
17h

On the insulin cases, Mr Johnson quotes what Ms Letby initially said vs what she said in the witness box. He says the nurse 'rowed back' and accepted the two children had been somehow poisoned with insulin, as to deny it would make her look 'silly'

Dan O'Donoghue

@MrDanDonoghue
·
17h

But he says by accepting the children were poisoned, it has placed her in a difficult position - he tells the jury to watch how the defence 'pilot Lucy Letby out of that particular creek'

Dan O'Donoghue

@MrDanDonoghue
·
17h

Mr Johnson says if the jury accepts that Ms Letby poisoned those two children with insulin, 'it puts all the other cases into a very clear context'

Dan O'Donoghue

@MrDanDonoghue
·
17h

Mr Johnson is now turning to Child K. The court has previously heard that Dr Jayaram felt uneasy about Ms Letby being left with the baby as the team were aware "of a number of unexpected and unusual events and we were aware of an association with Lucy Letby".

Dan O'Donoghue

@MrDanDonoghue
·
17h

Mr Jayaram previously told the court "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.

Dan O'Donoghue

@MrDanDonoghue
·
17h

In the witness box, Ms Letby said of this alleged incident "I don’t believe it did happen, but I have no direct memory of it."

Dan O'Donoghue

@MrDanDonoghue
·
17h

Mr Johnson has just taken the jury back over one of his exchanges with the nurse in cross examination, in which he established Ms Letby was in nursery one to obtain the medical notes for Child K. This is logged between 6.04am-6.10am on the computer

Dan O'Donoghue

@MrDanDonoghue
·
17h

Mr Johnson says the coincidence between Ms Letby's presence and Child K's desaturation is not an 'innocent one'. He says she was caught 'red handed' by Dr Jayaram trying to attack Child K

Dan O'Donoghue

@MrDanDonoghue
·
17h

Mr Johnson says Ms Letby has been vague in her recollection of this incident as her tactic is 'all smoke and mirrors' to 'give the impression these doctors are bad, they tell lies, they’re stitching her up'

Dan O'Donoghue

@MrDanDonoghue
·
17h

That concludes proceedings for today, back tomorrow

 

[Tortoise]

[...]

“Lucy Letby got away with her campaign of violence for so long because people didn’t contemplate the remotest possibility of a nurse trying to kill tiny babies.”

Mr Johnson said the “similarities” of many of the cases involved showed a single person was sabotaging the children.

[...]

“Several post-mortem examinations in isolation didn’t raise the alarm because no-one – no-one – was contemplating the possibility of foul play.”

[...]

He said: “What was their motive, the gang of four, for scapegoating Lucy Letby?

“It has been suggested that these people have invented evidence to persuade you that ultimately she is guilty. When you are considering whether that suggestion has any credibility, you might ask yourself the question ‘why would the doctors do that?’

“One advantage you have had is seeing many of these alleged conspirators over and over again. Do you really think Dr Brearey, Dr Gibbs, Dr Jayaram and (the unnamed doctor) would say things they knew were not true to get Lucy Letby convicted?”

[...]

Murder-accused nurse `gaslighted´ hospital staff over baby...

Lucy Letby is alleged to have murdered seven children and attempted to murder 10 others on the Countess of Chester Hospital´s neonatal unit.

www.dailymail.co.uk

[...]

"She evaded detection for a year because none of her trusting colleagues could initially contemplate the possibility that a member of their neonatal 'family' was working against them.

On occasion Letby, now 33, made calculated attempts to put suspicion onto fellow nurses, or else cover her tracks by persuading them to sign observation charts that she would alter later.

Sometimes she would wait for either parents or medics to leave a baby's cot-side before launching a renewed, 'opportunist' attack on the infant.

Nick Johnson KC, prosecuting, told the jury at Manchester Crown Court that when they drew together the various strands of the nine-month trial they would conclude that she had murdered seven infants and attempted to kill a further ten.

[...]

He suggested it gave an insight into the state of mind of the attacker, and the degree of cruel, cold-blooded planning' she was using."

[...]

Neonatal nurse Lucy Letby was 'cold, cruel & relentless', court hears

Lucy Letby was 'cold, calculating, cruel and relentless' in the way she set about trying to murder a succession of tiny babies at the Countess of Chester Hospital, the jury at her trial was told today.

www.dailymail.co.uk

 

[Tortoise]

PROSECUTION CLOSING SPEECH - Tuesday 20th June 2023

Day 2 - Morning Session

Recap: Lucy Letby trial, June 20 - prosecution closing speech

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

10:32am

The trial is now resuming.
Nicholas Johnson KC is turning to the cases of Child O and Child P.

10:34am

He says the evidence of Dr Andreas Marnerides is uncontested, that Child O had a significant liver injury.
That injury and the "lacerations" in the surface of the liver are "the best evidence you could ever have" of someone "inflicting a violent injury on a small child", he tells the court.

10:37am

Lucy Letby's 'HELP' post-it note is shown to the court. Mr Johnson says it began with the note to all three triplets: 'Today is your birthday, but you aren't here + I am so sorry for that...I'm sorry that you couldn't have a chance at life...
'I can't do this any more. I want someone to help me but they can't. What's the point in asking. Hatemylife.'
Mr Johnson says this note would have been written in June 2017 or June 2018. The note was found in Letby's handbag.

10:37am


The note shown to the court.

10:42am

Mr Johnson says Dr John Gibbs had given evidence to say if he had seen Letby 'in the act', he would have reported it to police at the time.
He said the deaths of Child O and Child P were a "tipping point" that something was "very wrong" on the neonatal unit.
He had been asked, in cross-examination, why he hadn't reported that to the police.
He said: "At that stage, I didn't know two children had been poisoned with insulin."
"At the time of the events I had never seen before which were unusual and unexpected - that's what raised the concern.
"Medicine is not an exact science...just occasionally a patient dies, and [a post-mortem examination does not give an answer].
"But this was happening again and again on our unit. And that cannot be just coincidence or bad luck. There must be a cause.
"That's when...one common cause was identified."
Mr Johnson tells the jury they have one advantage is they know two children were poisoned with insulin, and knew who hung up the bags.

10:45am

There had been "no concerns" for Child O or Child P on the shifts prior to the deterioration, Mr Johnson says. Letby had, in evidence, said concerns had been raised by Sophie Ellis and were not dealt with.
Mr Johnson says Letby is "trying to persuade" the jury that a problem existed when there was none available.

10:52am

Dr Huw Mayberry "remembered" Child O and he was "very well" with a "mildly distended abdomen" but all observations within normal limits.
Mr Johnson says Letby's 'issue' for Child O did not exist. He says Letby pointed out that Dr Mayberry did not make a note.
Mr Johnson says there were two occasions when Letby made up notes for doctors. One was a telephone call in the case of Child E, and another was the 'imaginary examination' of Child I by a doctor.
Mr Johnson says Sophie Ellis's notes record that 'Reg Mayberry' was involved in being informed and 'reviewed' on June 23, 2016 for Child O. That was the difference, Mr Johnson explains, as Letby's notes do not attribute any doctor.

10:54am

Mr Johnson says student nurse Rebecca Morgan was on her first day on the ward, fed Child O, and got a trace aspirate. Shift leader Melanie Taylor said there were no concerns for Child O at the start of the shift. "She did not expect [Child O] to collapse."

10:58am

An examination of child O's abdomen revealed "no concerns" and this situation was "uncomplicated", and ruled out the possibility of liver haematomas at that stage. Had there been one, Child O would have had symptoms of deteriorating.
Mr Johnson said it was accepted by Letby that Child O's liver injury happened during her day shift, and accepted the evidence of Dr Andreas Marnerides.

11:00am

Mr Johnson says Letby was missing a doctor colleague and had been in a text conversation with him: "Bit rubbish that you couldn't stay on nnu". He said at 10.36am he should be finished on clinic duty in an hour. He then went to observe Child Q on his arrival. He then saw Child O.
Letby recorded 'no problems' at 12.30pm. Mr Johnson says it is "obvious" Child O was "deliberately overfed" by Letby at this stage. There was "an issue" at 1.15pm.

11:05am

Mr Johnson says Child O had been 'supposedly' fed 13ml of milk. By this stage he had vomited and his abdomen was distended.
Letby was 'fulfiling two objectives', Mr Johnson says, by 'sabotaging' Child O and 'attracting the attention' of the doctor at the same time.
Letby had recorded Child O was 'tachycardiac', which Mr Johnson says was 'an exaggeration'.
Samantha O'Brien had said, in agreed evidence, Child O had a distended abdomen but looked otherwise normal.
Letby messaged: "Blew up abdomen think it's sepsis" to a nursing colleague at 9.15pm and, for Child P the following day: "Just blew tummy up and had apnoeas, downward spiral. Similar to [Child O]."
Mr Johnson says the 1.15pm vomiting by Child O was 'unusual', as observed by a doctor, but Mr Johnson says this is not so much in the context of Child E, Child F, Child G and Child L.

11:09am

Mr Johnson says Letby made a false reading for Child O at 1.20pm on the blood gas chart. "Even by the standards of misrecording information, this is right up there."
He says the note Child O was put on to CPAP from Optiflow was "a lie", and it had been spotted by Dr Sandie Bohin.
Mr Johnson says someone looking at the paperwork, retrospectively, might conclude this note could form an innocent explanation as to why Child O had died.
Letby had said in evidence 'he wasn't on the full CPAP machine, he may have been receiving CPAP via Neopuff, I don't know.'
A doctor had noted Child O's abdomen was distended. Mr Johnson says this was because Letby had pumped Child O full of air.

11:12am

Nurse Melanie Taylor had said to Letby 'I don't think he looks as well as he did before', and queried if Child O should be moved to nursery room 1. Letby had said no, to leave Child O in room 2 with his brother.
NJ: "Lucy Letby was so insistent, Melanie Taylor felt put out - she felt undermined."

11:16am

Mr Johnson explains Facebook messages were exchanged between Letby and a doctor. Child O collapsed a few minutes after the last message Letby sent.
The collapse was a sign for Child O of a cardiac arrest if there had been no intervention by medical staff, the doctor had said in evidence.
Professor Arthurs said the gas in Child O's bowel, as shown in an x-ray from that afternoon, was more than there should be. The causes were NEC - which Mr Johnson says had been ruled out - or someone injecting air down the NasoGastric Tube.
Mr Johnson says this is "even after a vomit", which would decompress the stomach.

11:19am

Mr Johnson says the liver injury for Child O had "been inflicted by about this stage", and this was "long before" CPR.
A '"small rash" had been seen on Child O's chest, a "purpuric rash - which is very, very rare in a neonatal infant", similar to a sign of meningitis. Dr Stephen Brearey, who had noted it, thought at the time it could have been a sign of sepsis.

11:25am

Two doctors entered the NNU at 3.53pm and saw Child O 'being bagged by the nurse', and Child O was "very unwell".
A female doctor was "shocked by what she saw" as it had been "completely unexpected".
The doctors said there had been "good air entry" but Child O's saturation levels "were not improving", Mr Johnson says. Child O was reintubated and cannulated.
Dr Brearey was called to help. Child O had been resuscitated. Spontaneous circulation had been re-established - "a miraculous recovery", Mr Johnson tells the court. "But [Child O's] perfusion was not as good as before."
Dr Brearey said the rash was "perplexing" and something he had never seen before, Mr Johnson explains. An experienced doctor said the series of collapses were also like nothing she had seen before.
Mr Johnson tells the jury: "You know the reason for it, don't you?"
Mr Johnson says Child O's mother gave a description of the rash. The father said of Child O: "You could see his veins, all bright blue, changing colour...
"You could see something oozing through his veins."

11:32am

During Child O's resuscitation in his final collapse, a doctor had said efforts were made to decompress Child O's abdomen.
In cross-examination it had been suggested this was the cause of the liver injury.
Dr Brearey and Dr Marnerides had rejected this, Mr Johnson tells the court.
An x-ray was taken of Child O, and Professor Owen Arthurs had explained the bowel gas which was "unusual" and showed an NG Tube in situ and no presence of NEC. Child O and Child P didn't have bowel obstructions, and Prof Arthurs said you are left with injection of air by the NG Tube.
Dr Brearey said all triplets had been born in good condition and were "following a healthy path", and these events were "exceptionally unusual", and the type of rash was 'something he had never seen before or since'.
NJ: "All natural causes were excluded...even with the benefit of all the years that intervened."
Another doctor said it was "incredibly unexpected".

11:34am

Mr Johnson says Letby took Child O to his death. He says Letby was "sowing the seeds" for Child P the following day.
The message sent by Letby to a nursing colleague at 9.33pm on June 23, 2016: "Worry as identical".

11:39am

A conversation between the doctor and Letby is shown to the court. The doctor said he hoped he was able to help.
Letby replied: "Yes you did++"
NJ: "Two plusses was the best he was going to get."
A Datix form is shown to the court, recorded by Letby, which Mr Johnson says was inaccurate in the 'peripheral access lost' note. Dr Brearey said "it's not correct".
Mr Johnson says "it's a lie".
He says Letby is trying to invent evidence that peripheral access was lost. If it was, Mr Johnson say, then air could not be injected into the infant. He says if that note was accepted, it would support her case that this was not air embolus.
Mr Johnson asks the jury to find why Letby was lying - "to cover up what she had done...we are sure this was air embolus."

11:41am

Dr Dewi Evans was "taken to task" for changing his opinion while writing his numerous reports in cross-examination, Mr Johnson says, having come up with a number of theories.
Mr Johnson says more information came to light during the course of writing his reports between 2017-2019. One was Dr Brearey's note about the purpuric rash 'disappearing'. It was established there had been no mention in medical notes of the rash disappearing, and he was only informed about it by Dr Brearey's witness statement in 2019.
Mr Johnson says is the impression by the defence to say Dr Evans "doesn't know what he's talking about?"
He says it would be "astonishing" if Dr Evans hadn't changed his mind when handed new information.

11:54am

Mr Johnson says Dr Evans said in court: "Inevitably, one amends one's opinion as a result."
Dr Evans was asked about chest compressions for Child O. He had said he had known no case that chest compressions had resulted in a liver haematoma as seen in the case of Child O.
A doctor had said chest compressions were carried out correctly for Child O.
Dr Bohin had "spotted that lying entry in the gas chart". She had taken all the evidence into account, including that of Child O's father, of the description of the veins, like 'prickly heat', Mr Johnson tells the court.
Mr Johnson said it had been suggested Prof Arthurs had ruled out air embolus as a cause. NJ: "Nothing could be further from the truth."
He says Prof Arthurs said the air in the great vessels could be from a number of causes, including air injected, or CPR or trauma. Mr Johnson asks the jury why CPR was required for Child O - he says it was because of air embolus. Prof Arthurs was 'deliberately not doing' what the jury can do, and was treating the cases independently.
Prof Arthurs added radiographic evidence of air embolus is "very rare".

12:00pm

Dr Andreas Marnerides' evidence is "compelling and uncontroverted", Mr Johnson says. He says the conclusions were that "significant" force was applied
It was "certainly not" an injury formed by CPR. He had never seen, heard of or read of this kind of injury caused by CPR. Mr Johnson says the idea this is the only time this has happened by CPR is "truly fanciful".
He says there is no corresponding puncture injury from a needle. The outer surface injury was likely caused after death as there was no 'active circulation' for Child O.
There was 'profound gastric and intenstinal distention' - ie they were 'blown up with air'.
Dr Andreas Marnerides concluded it was by injected air and air embolus.
Mr Johnson says this case was among the most violent carried out by Letby.
He adds: "Of all the offences, all the appalling examples - some of the earliest were less violent but no less devastating." He cites the case of Child E as one of the early, violent examples.
He says Letby had "misplaced confidence" following her return from Ibiza.
He adds: "Frankly, by this stage, she was completely out of control, and was determined to mete out [the same kind of attack to Child P] the very next day."

12:21pm

Mr Johnson turns to the case of Child P, who was 'doing well'.
His case "caused confusion" with several witnesses as to when he came off breathing support, he says.
Child P was breathing in air from 6.30am on June 23, 2016 and his antibiotics were stopped, and he was put on expressed breast milk. His observations were 'unremarkable'. A further examination at 6pm was carried out.
Dr Gibbs said, following Child O's death: "Oh no, not another one". He said he had become increasingly concerned about the number of incidents on the neonatal unit, and that Letby had been involved in all of them. Child P's abdomen was 'full...mildly distended'.
Letby had said the student nurse had fed Child P that evening. Mr Johnson says this was a lie.
Child P was "remarkably well - excellent for a triplet baby". Blood tests were taken as a precaution at 6.45pm, showing "no evidence of infection". As a precaution, Child P was put on to antibiotics.
Dr Gibbs said the abdominal distention was 'CPAP belly', but he said he had 'misread the chart' - Child P had not had CPAP for two days, and had been taken off Optiflow.
"That was not CPAP belly," Mr Johnson tells the court.
Mr Johnson says Letby overfed Child P just before she left her shift so she could give the impression this was a child who was deteriorating.

12:29pm

Mr Johnson says what happened here "mirrors" what happened with Child N earlier that month in June 2016.
He says Letby did not leave the unit until 9pm that night on June 23. A message sent by Letby to a doctor colleague said she was finishing up notes for Child O.
Emphasis had been put on a good blood gas reading for Child P at 8.27pm on June 23 by the defence, Mr Johnson says, but Sophie Ellis gave evidence to say Child P desaturated and had a '14ml part digested milk aspirate' at the 8pm feed.
Mr Johnson asks what possible other cause is there other than Letby overfeeding Child P for the baby's last feed before the end of her shift? Mr Johnson says that is why Letby says the last feed was done by the student nurse.
Overnight, another large part-digested aspirate was obtained and Child P's [feeds] were stopped as a precaution. The NG Tube was placed on free drainage.
Kathryn Percival-Ward [Calderbank] said Child P was "a well baby" but his abdomen was distended, so she decided to aspirate the stomach. This was recorded at 4am. A further 5mls of air and 2mls of milk were aspirated by Sophie Ellis at 7am.
Mr Johnson says the problem Letby had created had been "resolved by proper nursing care" by the two night-shift nurses.

12:39pm

Child P had been, quote, "a little angel overnight", as said in agreed evidence.
Letby came on duty, and Child P collapsed shortly afterwards.
Mr Johnson says this was Letby at her most malevolent.
The 'worry as identical' was "gaslighting at its very best - or worst", as Letby had been laying the lines for what would happen to Child P the next day, Mr Johnson says.
"There was nothing wrong with [Child P] at the end of that night shift".
Mr Johnson says Letby 'decided to use the template from the day before'. Letby recorded in notes: 'Abdomen full - loops visible, soft to touch.'
Mr Johnson says that note wasn't written until 13 hours later, and was a "fabricated note" to give the impression of what had been happening earlier that day for Child P.
He says Sophie Ellis recorded for Child O - 'abdo looks full, slightly loopy'.
Mr Johnson says this is the equivalent of copying someone's work.
He says this observation "happened out of nowhere" for Child P, for a child on free drainage, having been stable. He says if that was observed, Letby would have escalated it immediately, in light of what had happened the previous day.
Mr Johnson says instead Letby was texting a doctor colleague at 8.04am. 'I'll be watching them both like a hawk. I''m ok. Don't want to be here really. Hoping I may get the new admissions...'
She also mentioned 'I've got [other triplet] and [Child P], [Child P] has stopped feeds as large asps.'
Mr Johnson says there is no mention of a loopy bowel for Child P, by Letby to her doctor colleague, as "there is no problem".

12:46pm

At 9.35am on June 24, Dr Anthony Ukoh did a ward round and examined Child P, finding a mildly distended abdomen with bloating. Letby had said looping was visible at this time, and Dr Ukoh had noted this. Mr Johnson says the note was checked and it was not noted. The abdomen was 'soft', he recorded.
A consultant doctor noted nothing of concern, other than a distended abdomen.
Mr Johnson says there is another case of Letby falsifying notes here. A nursing note by Letby said Child P had been 'Neopuffed for a minute before being examined by Dr Ukoh'.
Mr Johnson says it is suggested this is a deliberate misrecording, minutes before Child P's collapse around 9.40am. He says it is a way of 'covering what she did', by 'pumping [Child P] full of air.'
Child P 'crashed', stopped breathing and his heart stopped. He was 'dusky and mottled', according to a witness.
A doctor was alerted to Child P in room 2 at 9.50am, it was 'not an emergency, but something he should be called to'. Letby was "not in the room" according to student nurse Rebecca Morgan. Mr Johnson says the jury should consider why that would be the case, as Letby didn't have any designated babies outside of room 2.

12:48pm

Dr Ukoh said Child P "appeared very different" from earlier.
He added: "Whoever was doing the Neopuff was very keen on getting [the doctor] in".
Mr Johnson says to the jury it's clear who that would be, that Letby wanted this doctor colleague to be present.
NJ: "For some reason, she enjoyed these situations, and he was there."

12:53pm

Mr Johnson says the second deterioration happened at 11.30am, and CPR was required.
One female doctor said Child P was "vigorous" and fighting the ventilator, something which was unusual as it would not fit the sign of a baby fighting infection.
Mr Johnson says Child P was being sabotaged - blood tests excluded infection for Child P.
An x-ray at 11.57am showed a pnemothorax and air in the bowel. Just after noon, a female doctor saw several nurses including Letby, and told the people there the transport team would be there soon.
The doctor said: "I was thinking out loud" - and, Mr Johnson says, Letby replied "He's not leaving here alive is he?"
This is something which was not disputed by the defence, and Letby had said in cross-examination it was said out of concern.
In police interview, Letby said she could not remember saying that, Mr Johnson adds.

12:56pm

Letby had agreed in cross-examination it was "not the done thing" to say such a thing, then she had said she couldn't remember saying it.
Mr Johnson says it was not disputed she had said it, the question was "Why?"
NJ: "She was controlling things - she was enjoying what was going on and happily predicting what was going to happen - she was 'playing god'."
The female doctor had said: "Don't say that." in response.
The comment was "highly unusual" and "shocking", the female doctor said.

1:01pm

Child P's 12.28pm collapse should be thought in the context of Child K, Mr Johnson says.
Two doctors had taken a break when a shout for help happened at this time. When they returned, Lucy Letby was in the room. A doctor said it looked like Child P had "dislodged his ET Tube".
Mr Johnson says if the tube was blocked, it had done so in a short period of time, having only been put in hours earlier.
Mr Johnson says this collapse happened "at the precise moment" the two doctors had left the room, and Letby was present, and the ET Tube dislodged in Child K, when Letby was present, doing nothing. He says the jury should take that all into account.
He says the jury can also take account of Letby's remark "He's not getting out of here alive is he?" made shortly before this collapse.
Mr Johnson says the ET Tube was not blocked, Letby had dislodged it. Child P was reintubated and further resuscitation efforts began.
Dr Bohin said the pnemothorax was a contributory factor in the collapse of Child P, but not the overall cause.

1:03pm

Dr Stephen Brearey reviewed the circumstances of Child P's death, and regarded the events that day as "exceptional", and could not find a cause.
A doctor could not identify any cause as to what had gone on. He thought it 'highly unlikely' the death was complications over the pnemothorax'.

 

[Tortoise]

PROSECUTION CLOSING SPEECH - Tuesday 20th June 2023

Day 2 - Afternoon Session

LIVE: Lucy Letby trial, June 20 - prosecution closing speech

2:10pm

The trial judge, Mr Justice James Goss, says as the day will end a little earlier than usual, this afternoon will be one extended session without a break.
Mr Johnson describes what happened for the final collapse for Child P, after the transport team had arrived.
He says despite Child P's situation, there was good air entry and the ET Tube was in a good place. There was "no explanation" for why Child P's condition had changed, according to a doctor.

2:14pm

At 4pm, it was determined the resuscitation attempts were futile. The father said the circumstances for Child P's death were similar to Child O, but could not recall seeing a veiny appearance for Child P (as he had done with Child O).
The mother said the third triplet had no problems and was discharged after 11 days. Mr Johnson says that should have been the case with all three.
A female consultant said Letby was "animated" and "so excited" asking about a memory box and her behaviour was "inappropriate". In cross-examination, the 'talking enthusiastically' was said that it would 'soften the blow' for the grieving parents who had lost two of the three triplets.
NJ: "We suggest that is absurd. Lucy Letby was enjoying the drama, the control, the extremity of grief that she was causing to other people."
The father, in the aftermath of Child P's death, was "sobbing" and begged doctors to transfer the third triplet to be taken with the transport team. The female doctor said what had happened was "not normal".

2:17pm

Mr Johnson: "Something was seriously wrong. They just couldn't put their finger on it."
The female doctor had said in cross-examination she was not dramatising anything, the situation was dramatic enough as it was.
Mr Johnson says nothing was identified medically as the cause of Child P's death.
Dr Brearey said the deaths of Child O and Child P caused him great concern. The rash, he had not seen before or since.
At the debrief, Dr Brearey asked Letby how she was feeling, and suggested she needed time off, "but she didn't seem upset", and was due to work the next day. Mr Johnson said that caused Dr Brearey "real concern".

2:23pm

Dr Andreas Marnerides did not look at the cases in the context of any other.
There was "no natural cause" for Child P's death. He concluded Child P had "excessive air injected into the nasogastric tube".
Dr Evans said there was no natural cause, and the cause was air administered.
Dr Bohin pointed out a discrepancy between Letby's 'Neopuff' note and it not being mentioned to Dr Ukoh when he examined Child P, Mr Johnson says.
Mr Johnson says this is "yet another false example" in the notes, designed to create the impression Child P had an ongoing problem.

2:27pm

Dr Bohin also said Child P had been injected with air, Mr Johnson says.
Mr Johnson says if the jury conclude Child O received a liver injury through some inflicted trauma, then Child P's liver injury the following day can be explained by Letby's actions.
NJ: "Lucy Letby predicted [Child P's] death when Dr Brearey thought it was under control. How could she have known?"
"The number of coincidences here is all too much. [Child O and Child P] were murdered by Lucy Letby."

2:30pm

Mr Johnson says Letby had said she had taken one note/handover sheet home deliberately as it contained information to write up as nursing notes when she returned to work. Mr Johnson says the note only included 'caffeine', so her reason for keeping it was 'a lie'.
Mr Johnson says one of the handover sheets contained a name of one of the baby's parents, a difficult to spell name, that she could research on Facebook later.
He says Letby's explanations for keeping the handover sheets don't stand up "to any sensible analysis".

2:34pm



Mr Johnson refers to this note. He says the words 'I AM EVIL I DID THIS' should be taken literally.

He says the 'anguish', as the defence said was Letby's frame of mind, needs to be taken into context. He says Letby introduced the suggestion she was "isolated" to explain the notes and her behaviour.

On the final day of cross-examination, the contents of Letby's phone, diary and photographs "set out her social life" from July 2016- July 2018.

Letby "accepted" she had "a very, very active social life" with incuded "socialising with many of her former colleagues" including "those she had been forbidden from having contact with".

She said she was "at least allowed a social life". Mr Johnson says it was "never our suggestion" that she wasn't allowed to have a social life. He says Letby was "deliberately trying to mislead you" and trying to invoke "pity" from the jury.

NJ: "We say she is a liar, she lied to you, and the lie is proved by analysis of her social life."

2:37pm

Mr Johnson recaps the seven baby's cases he has dealt with so far, of the total 17.
He says if they are all taken into context, the "picture is crystal clear".
He says he will take the next cases in chronological order, with twins Child A and Child B.

2:40pm

Mr Johnson says the judge directed that the questions given by counsel are not the evidence, but the answers.
He asks if Dr Jayaram and Dr Harkness 'made up' their observations for Child A and Child B to blame Letby.
He says before the cases of Child A and Child B, Letby had completed a course on IV lines, which highlighted the dangers of air embolus. Mr Johnson asks if that was a "coincidence".





2:44pm

Mr Johnson says Child A had been doing well and was on hourly observations, and handling well.
Child A crashed minutes after Letby came on duty. Mr Johnson says there is no doubt Letby had been involved with Child A's care.
He says the evidence was that Lucy Letby was "literally standing over him" at the time of the collapse.
He says the circumstances of the collapse are similar to that of Child L and Child M, with Letby "operating in plain sight".

2:50pm

Mr Johnson says despite air going in and out, Child A's saturation levels and heart rate were falling.
He says Dr David Harkness described "very unusual patches of skin [discolouration]" which he had "never seen before" and only saw once again with Child E.
He described "patches of blue, purple, red and white" that didn't fit with Child A's condition, and the rash "flitting around". He said he was too busy trying to save Child A's life to get a full description. He was criticised in cross-examination for not noting it down.
It was suggested by the defence that he had been influenced to apply this description to Child A, and not putting this in his statement. Mr Johnson asks what the implication was - that he didn't see anything? It was suggested discussions had deep-set in his mind.
Dr Harkness said he had seen it in Child A and Child E, that made him realise how significant this discolouration was. He was "animated" in the latter case, Mr Johnson says.
Dr Ravi Jayaram had said Child A's heart trace showed "no problem" with the baby's heart.

2:52pm

Dr Jayaram had described 'pink patches that appeared mainly on the torso that appeared and disappeared - I had never seen anything like this before,' Mr Johnson says.
He had said it "doesn't fit with any disease process I had seen or read about".

3:01pm

Dr Jayaram was 'taken to task' by the defence, Mr Johnson says, as he had not mentioned the discolouration in notes. He said he had not realised the significance of it at the time, and only realised it when later examples came up in other babies.
Mr Johnson says the accusation by the defence that Dr Jayaram had made it up is "smoke and mirrors" to distract jurors from the truth.
He says there is other evidence, not disputed, to back Dr Jayaram's account.
He refers to Letby's July 2018 police interview. Letby had referred to the rash for Child A as a 'rash like' 'reddy-purple' 'more on the side that had his line in - it was his left'.
NJ: "How did Lucy Letby remember that? Because it wasn't actually in her notes - just like Dr Jayaram and Dr Harkness."
Mr Johnson says Letby referred to it as 'normal mottling' and Child A was 'more pale than mottling'. Mr Johnson says that is "a lie".
Mr Johnson says if Letby accepts that as "unusual", it "causes real problems for her defence". He says Letby used the word 'blotchiness' for Child A in police interview. Letby had said 'mottling' and 'blotchiness' were interchangeable.

3:06pm

Mr Johnson says Letby had said in cross-examination, if it was agreed Child A had died of an air embolus, then it would have been administered by colleague Melanie Taylor, and not by her.
NJ: "We suggest Lucy Letby was as good as accepting that [Child A] died of an air embolus.
"But it doesn't end there."
Mr Johnson says Letby's nursing colleague, a friend, came into the unit when Child A collapsed and did CPR for Child A, and noted a 'strange skin discolouration' she had "never seen before". He says the colleague described "blotchiness" - the same word Letby had used in her defence.
The colleague was challenged on the description for Child A's skin discolouration, that it might have been mixed with the description for Child B.
She said she had not been influenced by what anyone had said.
Mr Johnson says the nursing colleague was not accused of making it up. He says it is the defence's case to picture the "doctors are bad".

3:11pm

Dr Rachel Lambie had described 'blotchy' 'purple' marks which would appear and disappear on Child A, Mr Johnson said.
She said she had "never seen anything like it before", with "flushes of what looked like bruising underneath" "that would appear for 10 seconds, go, then appear somewhere else", Mr Johnson adds.
Mr Johnson says all the other colleagues had proved what Dr Harkness and Dr Jayaram was saying was the truth. He asks the jury if that is the case, then what purpose is the attacks on their integrity?
He says the purpose was to deflect the jury from the evidence, to make it about personalities, to destabilise Dr Jayaram "who has been an important witness in many cases", including for Child K.
NJ: "Lucy Letby knows how devastating his evidence is in the case of [Child K]."
He says it is the defence's case that the nurses are overworked and the doctors are "bad", that there is a "medical conspiracy" involving the "gang of four", and an unnamed police officer 'tipped off' Dr Evans about air embolus.

3:13pm

Mr Johnson says after Letby got home, she advised Melanie Taylor about an administrative note, then searched for the mother of Child A on Facebook.

3:22pm

Mr Johnson turns to the case of Child B.
Mr Johnson says "we know that Letby didn't like" being in nursery room 3, and there are "many" text messages sent between Letby and four people over the course of two hours.
Five minutes after Child B desaturated around midnight on the June 9-10 shift, Mr Johnson says, Letby turned up in room 1 as she co-signed for medication. No-one signed for the observation readings for Child B at midnight. Letby has signed for a blood gas reading for Child B at 12.16am. Child B had collapsed at 12.30am.
The mother of Child A and Child B said it was "a very similar situation to [Child A]", and the consultant asked for pictures to be taken of the mottling as she had "never seen it before". By the time a camera had been sourced, the mottling had disappeared.
Dr Lambie had made a note of the discolouration at the time.
A nursing colleague said Child B "suddenly looked very ill - like her brother the night before", with the discolouration. Mr Johnson says the colleague had said: "Oh no, not again", and made a note of it, which read "changed rapidly to purple blotchiness with white patches".

3:28pm

Mr Johnson says Letby had used the words a 'rash-like appearance' as it looked like a rash on Child B, and it was "unusual".
"Lucy Letby, we suggest, could not keep out of nursery 1. She elbowed her mate...out of the way."
Letby signed for a blood gas record for Child B at 12.51am while Child B was being resuscitated, and signed for a 1am observation reading, and co-signed for a morphine administration at 1.10am.
NJ: "She was relentless, ladies and gentlemen - she thought she had the cover of antiphospholipid syndrome [for Child B]."
Letby searched for Child A and Child B's mother again on Facebook on June 12 and September 2, 2015.

3:34pm

Mr Johnson says the presence of air was the cause of, or the need for, resuscitation.
Prof Arthurs says the gas was "not diagnostic" of air embolus, but added it was "the most pragmatic conclusion", Mr Johnson says. He adds the only time he saw that much gas was in the case of Child D.
Mr Johnson says medical expert evidence from Dr Andreas Marnerides had shown an air bubble was found in Child A's brain, which was "highly suggestive" of air embolus.
He found "no evidence of any natural disease" and "took the view" that the most likely cause was "air embolus".
Mr Johnson says the picture is clear, from the witnesses' accounts - including Letby's, that air embolus was the cause of Child A's death, and if that is the case, then Letby was responsible.

3:39pm

Dr Dewi Evans says, for Child A, the baby was "perfectly stable" prior to the collapse. He cited air embolus as the cause, and that conclusion was reached even before Dr Jayaram's account, as Dr Jayaram's description had not been in the notes.
He said for Child B, there was nothing that could account for that baby's collapse. He said the rapid appearance and disappearance of the skin discolouration was significant in his conclusion of air embolus.