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

  • #261
Preliminary Timeline for Baby H. (babies G & I included for proximity)



21 Sep 2015, Mon

8am – LL’s day shift – designated baby G

2 x allegations of attempted murder of Baby G, at 10.15am and 3.30pm

LL searched baby G’s parents on Facebook. A few minutes later LL looked at the Facebook of the mother of E&F and another mother of a baby listed in the charges.



22 Sep 2015, Tue

Baby H, a girl, was born at 34 weeks, weighing 5lb 2oz.

6.40pm – H was admitted to the Neonatal Unit, Room 1. She had breathing difficulties shortly after birth. Independent experts say there was an "unacceptable delay" intubating her and administering a protein which helps the lungs, which the prosecution say means the case is complicated by "sub-optimal treatment" at the hospital. Additionally, H "was put on a ventilator, she was not paralysed; she was also left with butterfly needles in her chest for prolonged periods which may have punctured her lung tissues and contributed to further punctured lungs." (Opening Speech)


23 Sep 2015, Wed

LL texts a colleague she's rearranging her shifts, and will be working with her.
LL also texts her mother she's working that night as an extra shift.
LL messages another colleague to say how busy the unit is likely to be that night.



8pm – LL’s nightshift 23rd/24th.

H deteriorated on the night of September 23 and required ventilator support and intubation, followed later by oxygen support. H responded to intervening treatment, but desaturations were "frequent" and "significant". Mr Johnson said all but two events could be explained medically and responded to with routine resuscitative measures. The two events - in the early hours of September 26 and 27, were "uncharacteristic" and required CPR. (Opening Speech)


24 Sep 2015, Thu

Early morning - Dr Alison Ventress testifies she will always remember Child H as she was the first baby she performed a pneumothorax aspiration on (needle in the chest to remove air). Child H had poor blood gas and had a profound desaturation down to 'the 50%s and needed bagging with neopuff'. H slowly recovered and was placed on Bipap (a small machine that pushes air through a mask and into child's airway and lungs). Child H's breathing 'remained gasping pattern'. Dr Ventress says this is 'more serious than grunting' and agrees that it was 'indicative of a serious respiratory problem'

8am – end of LL’s nightshift 23rd/24th.

LL messaged a colleague: "It's completely unsafe ☹ "

LL messaged a friend: “I won’t be able to make it to hula hoop – work mad so doing extra nights x

LL messaged colleague Sophie Ellis: “Oh Soph it was pretty bad – 18 babies, intubating on handover & baby with sugar of 0.1! On again tonight tomorrow & Sat. Not had chance to see Corrie, was it good? Xx



8pm – LL’s nightshift 24th/25th LL designated nurse for H.


25 Sep 2015, Fri

1.14am - Notes from the early hours show another desaturation. At 1:14am Dr Ventress was 'bleeped urgently' as Child H had 'poor chest movement and poor colour'. She was placed on neopuff. She noted that Child H's chest drain, which had been fitted as she had a collapsed lung, was 'no longer functioning, blood-stained fluid leaking from drain'. Dr Ventress says that is 'not uncommon' with chest drains. She says fluid was not indicative of any infection.

1.25am – Dr Ventress’s notes show that at 1.25am Child H had another profound desaturation. Oxygen levels down to 30%. Dr Ventress performed an emergency pneumothorax aspiration, 70ml of air was aspirated – “quite a lot for a baby that size”.

1.40am – X-ray taken.

1.45am – Dr Ventress - Child H's sats improved after the procedure, but there was a further desaturation at 1.45am. Second aspiration was then needed and another butterfly needle inserted into lower chest, this again worked and drained a further 60mls of air - again sats improved.

2.29am – X-ray taken. H diagnosed with punctured left lung. Dr Ravi Jayaram records a desaturation for H and a test was carried out for a collapsed lung.

3am - Dr Alison Ventress – H’s sats remained in the stable range until 3am when she had another profound desaturation, her blood oxygen fell to 26%. 85mls of air aspirated and her sats again improved. A plan was drawn up to insert a further chest drain.

3.07am
LL texted a colleague: "Can I go now??"
Colleague: "Yes. Let's run off together and rescue [colleague] too."


5am – LL’s nursing note recorded the "profound desaturation", with the fingers on the right hand noted to be white, along with a white patch on the abdomen.

8am – end of LL’s nightshift 24th/25th

Time?

LL messaged colleague Ailsa Simpson: “Sorry didn’t reply last night – you’ve certainly picked right week to be on hols! Haha. …Hope you are lucky with Glastonbury. I got tickets for Ellie at Echo xx

Afternoon - The intelligence analyst talks through descriptions of the care being given to H throughout the day on September 25, which includes another desaturation in the afternoon.

4.23pm - The cardiac arrest team is beeped at 4.23pm to attend the neonatal unit. (electronic evidence)


8pm – LL’s nightshift 25th/26th – designated baby H, room 1. No other babies are in room 1. four babies (including G) in room 2, four in room 3 and four in room 4.

Starting about 9.50pm – H had ‘several episodes of desaturation’ according to Dr Ventress’s clinical note at 11.50pm.

11.05pm - A blood transfusion for H begins at 11.05pm.

11.30pm – LL’s nursing note written retrospectively at 4.14am records a desaturation for H. Observations are being taken more regularly due to the blood transfusion.

11.50pm – Dr Ventress records at 23.50 that there had been 'several episodes of desaturation in the previous two hours'.


26 Sep 2015, Sat

Around 1am – Dr Ventress - Child H's ventilation had to be increased, Dr V again suspected a pneumothorax. She called a consultant for further advice.

1.30am – LL administered a morphine bolus to H at 1.30am.

2am - the blood transfusion is recorded by LL as being completed at 2am.

2.15am - Consultant Dr John Gibbs records chest x-ray showed a re-accumulation of H's left-sided pneumothorax (a collapsed lung). A further, third chest drain was inserted to relieve the pressure.

2.50am - LL administered a dose of saline, to run for 20 mins. (Opening Speech)

3.05am - a separate, handwritten paper record shows the blood transfusion having been completed at 3.05am. This separate record is not signed by anyone.

Time? 3.05am? - LL records: 'poor blood gas and 100% oxygen requirement' and a third chest drain was inserted.

3.22am – LL’s nursing note: 'profound desaturation and colour loss to 30%, good chest movement and air entry, colour change on CO2 detector, neopuff commenced in 100% oxygen and help requested. Serous fluid +++ from all 3 drains, became bradycardic. Drs crash called and resus commenced as documented'. 1st attempted murder charge. (Attending doctor concluded the episode was due to hypoxia (shortage of oxygen) - opening speech)

3.24am - An intensive care chart for H, initialled by LL, records: 'blood complete 0324 - RESUS'. Dr Alison Ventress confirms in a clinical record she was crash called at 3.24am as H "had desat requiring bagging...Sats 60s then heart rate down to less than 100 so nurses crash called, wasn't being handled at all, no trigger identified.'
Upon her arrival, H was 'being bagged via ETT, good chest movement, capnograph positive, sats 60%, heart rate 70 down to 50 [beats per minute]'. A test for a collapsed lung was carried out and air was removed. Dr Ventress testifies that while desaturations are not uncommon with babies experiencing these sorts of [lung] problems, arrests are not common.

3.26am - Dr Ventress testimony - CPR was commenced at 03.26 and three doses of adrenaline were administered between 03.30 and 03.39.

3.30am – Consultant Dr John Gibbs was called from home.

3.36am – Consultant Dr John Gibbs arrived at the neonatal unit. He saw 'CPR in progress', and H had no pulse when chest compressions stopped. Medications were administered to H.

3.46am - LL's nursing note records, for 3.46am: 'x3 doses adrenaline and x1 dose atropine given...chest compressions stopped at 0346, heart rate 180, saturations >90, placed back on to a ventilator, 30% oxygen'. Dr Ventress testimony - At 03.46 chest compressions were stopped as Child H's heart rate had improved and her colour started improving - treatment was successful.

Early hours – mother describes being woken and told to go to the unit right away. She found them resuscitating baby H.

4.14am – LL wrote up her retrospective note for the 11.30pm desaturation.

4.28am - LL records a family communication: 'Parents visiting at start of shift. Updated on condition and advised to try and rest overnight. Midwife contacted during resus to [help take mum to the unit].'

5.21am – LL noted a conversation between herself, the attending doctor and H’s parents. Parents were concerned about the possibility of brain damage, and H remained poorly and could relapse. Consultant Dr John Gibbs offered a blessing to be administered and the parents accepted the offer. H was then blessed with parents and family members present.

7am - LL recorded 'good blood gas at 0700 - ventilation reduced to 22/4, and rate reduced...in 26% oxygen. [H] appears settled.'

8am – end of LL’s night shift 25th/26th


Just before 9am

Deputy manager Yvonne Griffiths messaged LL: Hope you have a good sleep. I just want to commend you for all your hard work these last few nights. You composed yourself very well during a stressful situation. It’s nice to see your confidence grow as you advance through your career.”

LL showed this message to a colleague and asked her how she should reply. Her colleague expressed surprise. The conversation alluded to a disagreement among the neonatal unit staff regarding a Christening for one of the babies in the unit.

LL to YG: “Thank you. That’s really nice to hear as I gather you are aware of some of the not so positive comments that have been made recently regarding my role which I have found quite upsetting. Our job is a pleasure to do and just hope I do the best for the babies and their family. Thank you to you & [another colleague] for your support x.”

LL to colleague: “I’m still frustrated/upset with what’s gone on but don’t think such rubbish nights & being tired help.”

Colleague: “Good reply as it’s important they know about the bitchiness which is all it is. Yes re tired Anyway you’re a star. You’ve done yourself proud. You’ve given positive memories to the family whatever the outcome. Let’s hope they can tease her in a few yrs about her ‘attention seeking’ ways. Sleep well. xx Always a pleasure to work with you even if we’re a ‘[s***] magnet’ team.


Day - Medical notes record H's parents were present as treatment continued for the baby girl, with further medication administered during the day of September 26.


8pm – LL’s night shift 26th/27th Shelley Tomlins was the designated nurse for H in room 1 - the only baby in that room that night. LL was the designated nurse for two babies in room two, with another nurse, Christopher Booth, looking after G in room 2. Four babies, including baby I, were being looked after in room 3, and four babies were being looked after in room 4.

8.49pm - There is a profound desaturation for H, with a crash call made at 8.49pm. Dr Matthew Neame recorded attending the neonatal unit.

9.31pm
LL, on shift, messaged a colleague to give an update on H's progress throughout the day.

LL messaged Dr Alison Ventress a couple of moments later: [H] had a stable day, and took out the original drain at 8pm, 'just blocked tube, lots of secretions!'.

LL messaged her colleague: “I've been helping Shelley [Tomlins, designated nurse for H that night] so least still involved but haven't got the responsibility”.

Dr Alison Ventress to LL: "Never known a baby block tubes so often!! Glad she's had a stable day..."

Just before 11pm
LL texts a colleague: “I forgot to record strictly tonight x BBC iPlayer doesn’t work on my iPad.”


11pm – H’s mother says she and the father left the unit at about 11pm to go to sleep in a room nearby, but they later received a knock at the door with an almost identical scene as the previous night.


27 Sep 2015, Sun

12.45-12.46am - LL is recorded as being on Facebook at 12.45am and 12.46am, liking a post and photo.

12.55am - H has a 'profound desaturation' timed at 12.55am. Nurse Shelley Tomlins recorded: 'profound desaturation to 40% despite equal bilateral entry and positive capnography'. Staff were crash called to the neonatal unit room 1. [LL’s signatures on medicine administrations, per opening speech]

1.07am - Dr Matthew Neame reintubated H and chest compressions were started at 1.07am. H's heart rate dropped to 40bpm. Adrenaline was administered.

1.13am - Chest compressions were discontinued at 1.13am. A request was made to transfer H to Arrowe Park Hospital. "No explanation" could be found for why H had had such a profound desaturation.

3.30am - H had a further desaturation at 3.30am, and medication was administered. [LL was treating & gave the history to the attending doctor despite not being H’s designated nurse. Pink-tinged secretions around mouth - Opening Speech]. 2nd attempted murder charge.

4.10am - The transport team arrived at 4.10am

4.45am - H was handed to the transport incubator at 4.45am and the handover was completed at 5.20am.

6.10am - H was cared for at Arrowe Park Hospital, returning to CoCH on Sep 30th.

8am – end of LL’s nightshift 26th/27th.


Just after 11am

LL messaged Dr Alison Ventress on Facebook, and another colleague, what had happened to H that night.

2nd colleague: “There’s something odd with [H]”
LL: “Hopefully she’ll sort herself out.”

LL to Dr AV: “[H] had resus again but not as bad/long-lasting as with us. Went to Arrowe.”
Dr.AV: “Oh crap. Do they know why she did it this time? I’m glad she’s been transferred! How are you? Really rough set of nights for you. Xx
LL: “No did exactly what she did for us, desat then didn’t pick up & dropped heartrate. Looked fine again after though but made decision to transfer which I think was sensible! X

LL to 2nd colleague: “None of us had breaks what with [H], transfer and then this. It’s all just so rubbish lately isn’t it. And always seems to happen at night when less people. I think everyone is pretty burnt out and unit been awful. Yvonne working way more than she should.”

LL & 2nd colleague then discuss about looking “at a change of unit”.

LL: “I still think about the women’s, if only it were closer, would make decision much easier.”

1.11pm
DrAV: "Try to think of all the babies you’ve saved and have gone home happily with their parents. You’re a fab nurse. Hope you manage some sleep xx
LL: “Thanks Ali Xx



30 Sep 2015, Wed

8am LL working long day-shift – designated nurse for baby I in room 3.

12.15pm
- H returned to the CoCH.

Afternoon – 1st alleged attempted murder of baby I.

8pm
End of LL’s day-shift


5 Oct 2015, Mon

1.15-1.18am - LL searched on Facebook for the mother of H, as well as the parents of E&F, and I, in the space of three minutes.


9 Oct 2015, Fri

5.05pm - H was discharged

--

Source for additional info Hereford nurse murder trial: baby ‘improved dramatically’ after hospital move

Lucy Letby: Nurse 'commended' for work during 'stressful situation'

Lucy Letby Trial: Medics could find no reason why baby suddenly collapsed | ITV News
 
  • #262
Prosecution evidence, January 19th 2023, Day 41



The evening’s nursing shift leader, who cannot be identified for legal reasons, agreed with Mr Myers that caring one-to-one for a baby such as Child H was “potentially quite a demanding job” for a nurse of Letby’s experience.

But she added: “Lucy was qualified in specialist neo-natal nursing at this time and very competent. She was not a totally inexperienced nurse … and I would trust that she would ask me if she had any problems.”

Mr Myers asked the witness: “Was there an issue with Lucy Letby being relatively junior compared to others and some debate about her going into Nursery One to look after more poorly babies?”

“Sometimes, yes,” she replied.

Mr Myers said: “And sometimes a bit of an under-the-surface dispute about that, is that correct?”

The witness said: “Yes.”

Lucy Letby: Medics could find no reason why baby ‘suddenly collapsed’
 
  • #263
Prosecution evidence, January 19th 2023, Day 41

Text messages


10%

Letby responds to Ms Griffiths: "Thank you. That's really nice to hear as I gather you are aware of some of the not so positive comments that have been made recently regarding my role which I have found quite upsetting.

"Our job is a pleasure to do & just hope I do the best for the babies & their Family. Thank you to you & [another colleague] for your support X".

Letby messages her colleague: "Im still frustrated/upset with what's gone on but don't think such rubbish nights & being tired help"

Her colleague responds: "Good reply as it's important they know about the bitchiness which is all it is. Yes re tired..."

Lucy Letby: Nurse 'commended' for work during 'stressful situation'
 
  • #264
Prosecution evidence, January 19th 2023, Day 41

Child H


https://twitter.com/MrDanDonoghue

I'm back at Manchester Crown Court for the trial of nurse Lucy Letby. We'll be continuing to hear evidence in relation to Child H. The prosecution allege Ms Letby tried to murder the infant on two occasions in September 2015.

Prosecutor Nick Johnson is reading a statement (which is agreed evidence) from Countess of Chester Hospital midwife Deborah Moore. She took Child H's mother to theatre for her emergency C-section

Ms Moore says from reviewing her notes it was an 'uneventful birth and the mother did not require any additional treatment'

Mr Johnson, prosecuting, is continuing to read statements of agreed evidence from medics working on the evening of Child H's first collapse

A member of nursing staff, who can't be named for legal reasons, recalls apologising to the parents of Child H for not informing theme sooner of their daughter's condition.

Child H's mother said yesterday, in a statement, that she and the child's father were "quite annoyed" they had not been informed their daughter's first collapse and said it was a "shock" to see their daughter on a ventilator

The nurse's statement, read to court, said: "We always try to inform the parents as soon as possible, but not if this is going to comprise health of the baby, if we felt the baby was going to die, parents would be informed right away – never felt the case with (Child H)'

Dr Alison Ventress is now in the witness box. She tells the court she will always remember Child H as she was the first baby she performed a pneumothorax aspiration on (needle in the chest to remove air)

Dr Ventress is taking the court back over her notes from the morning September 24 2015. Child H had poor blood gas and had a profound desaturation down to 'the 50%s and needed bagging with neopuff'

The baby girl slowly recovered and was placed on Bipap (a small machine that pushes air through a mask and into child's airway and lungs), the court is told

Her notes from that morning state that Child H's breathing 'remained gasping pattern'. Dr Ventress says this is 'more serious than grunting' and agrees that it was 'indicative of a serious respiratory problem'

Notes from the early hours of 25 September show another desaturation. At 1:14am Dr Ventress was 'bleeped urgently' as Child H had 'poor chest movement and poor colour'. She was placed on neopuff

The medic noted that Child H's chest drain, which had been fitted as she had a collapsed lung, was 'no longer functioning….blood stained fluid leaking from drain'

Dr Ventress says that is 'not uncommon' with chest drains. She says fluid was not indicative of any infection

Her notes show that at 1.25am Child H had another profound desaturation. Oxygen levels down to 30s. Dr Ventress performed an emergency pneumothorax aspiration, 70ml of air was aspirated which was 'quite a lot for a baby that size' she tells the court

Child H's sats improved after the procedure, but there was a further desaturation at 1.45am. Second aspiration was then needed and another butterfly needle inserted into lower chest, this again worked and drained a further 60mls of air - again sats improved

The baby girl's sats remained in the stable range until 3am when she had another profound desaturation, her blood oxygen fell to 26%. 85mls of air aspirated and her sats again improved. A plan was drawn up to insert a further chest drain

We're now looking at Dr Ventress' notes from her next shift on 25 September (going into 26 September). She records at 23.50 that there had been 'several episodes of desaturation in the previous two hours'

At around 1am on 26 September Child H's ventilation had to be increased, Dr Ventress again suspected a pneumothorax. She called a consultant for further advice

We're now looking at Dr Ventress notes from 03:22 when Child H suffered a profound collapse which needed a full resuscitation. CPR was commenced at 03.26 and three doses of adrenaline were administered between 03.30 and 03.39

At 03.46 chest compressions were stopped as Child H's heart rate had improved and her colour started improving - treatment was successful

Ben Myers KC, defending, is now questioning Dr Ventress. The medic agrees that desaturations in babies like Child H are not 'uncommon'. She agrees that Child H was 'clearly unwell'

Mr Myers sets out that Child H had had three chest drains inserted and numerous desaturations in the run up to 26 September, Dr Ventress agrees. He asks whether those medical procedures are 'likely to put strain on a little body like hers', she agrees

Mr Myers asks if it is possible the cumulative impact of those procedures could have resulted in a collapse like the one observed on 26 September, she agrees

A former nursing colleague of Ms Letby, who cannot be named for legal reasons, is now in the witness box. She is taking the court through her notes on Child H from 25 September 2015

Another former nursing colleague of Ms Letby, who cannot be named for legal reasons, is now in the witness box. She is taking the court through her notes on Child H from 23/24/25 September 2015

Asked for her recollections of the events of 26 September, the nurse said she remembers Child H 'became unwell that night and needed some resuscitation'

The nurse is asked about 'a difference of opinion' that occurred that night over whether a baptism should be offered for Child H after her collapse. The baptism was offered to the parents, which was accepted

The nurse and a senior manager disagreed over whether it was the appropriate time for it to be offered

This disagreement arose mainly due to the fact it was early hours of the morning and the unit was busy. The nurse said it shouldn't be 'blown out of proportion'
 
  • #265
Prosecution evidence, January 20th 2023, Day 42

Child H


https://twitter.com/MrDanDonoghue

I'm back at Manchester Crown Court for the murder trial of nurse Lucy Letby. We'll be continuing to hear evidence in relation to two collapses of a baby, referred to as Child H, at the Countess of Chester Hospital in September 2015.

Court now sitting. Jury had made a request for notepads, Judge Goss tells them there is none in the building. 'I don't know if you know much about government procurement, but it's not as simple as going the stationary and buying it', he says

Update on this, a court official has gone to WHSmith - paper has been purchased....

Consultant paediatrician Dr Ravi Jayaram is now in the witness box, he is recalling the events of 26 September 2015. Dr Jayaram was called by junior colleague Dr Alison Ventress in the early hours as medics were having trouble with Child H

Child H needed a numerous procedures to drain air from her chest as she had suffered pneumothorax, this is where air leaks into the space between your lung and chest wall. Dr Jayaram is explaining this condition and how it is diagnosed/treated

Jury are being shown X-rays of Child H, which show excess air in the chest cavity. Child H had a chest drain and two needles (to drain air) in a bid to treat this

Dr Jayaram is currently describing in detail the process of inserting a chest drain

X-rays taken in the early hours of the morning of 25 September 2015 show that Child H's lung had re-inflated after the procedures. Lots of the black (air) present on previous X-rays in the chest area had disappeared

Ben Myers KC, defending, is now questioning the consultant. He asks whether the act of fitting a chest drain can cause stress to a baby, he says it ‘can raise heart rate’

Mr Myers is asking whether a drain could come into contact with internal structures like the heart, Dr Jayaram says he has 'never seen that happen' - he says anatomical he can't see it, as the heart is surrounded by the lungs and the lungs would have to be punctured

Mr Myers puts it to Dr Jayaram, that due to improvements in medicine, pneumothorax is less common. He says 'generally speaking doctors now are likely to have less practice on chest drains', Dr Jayaram says he 'wouldn’t disagree with that'

He says that is why such treatments are more often carried out by consultants, as they're from a generation when they were more common

Mr Myers is asking Dr Jayaram where the optimum space is to insert a chest drain, he puts it to the consultant that the fifth intercostal space is the best area and is standard. Dr Jayaram says 'it doesn’t matter…as long as it is in, it is going to drain air'

Dr Jayaram eventually agrees that 'ideally' the fifth intercostal space is where a drain would be fitted

Discussion in court is currently centring on the use of different drains - a pig tail train and a straight drain. Child H has a pig tail drain fitted first, by Dr Ventress and then Dr Jayaram fitted a straight drain a short time later.

Dr Jayaram concedes that it would have been easier to fit a second pig tail drain, but there were none available

Mr Myers shows the jury an X-ray of the two drains in Child H. The first as established was in the 'ideal' fifth intercostal space. The second fitted by Dr Jayaram, is not in the fifth intercostal space (his notes written at the time say it is)

Dr Jayaram agrees it is 'clearly' not in there but says the drain is still in a 'good position'. He says it is in the plural cavity and that it is working

Mr Myers is repeatedly putting it to the consultant that the chest drain is in the wrong place. 'No it’s in the plural cavity, you’re focused on process rather than outcome. It needed to be put in. It isn’t going to have any great effect on heart function'

Mr Myers puts it to the medic that the tip of a drain that close to the heart could cause bradycardia if it moves, 'it could' Dr Jayaram says

Mr Myers says if the baby moves, is handled, when it breaths - can all cause the drain to move. Dr Jayaram agrees, but disputes the inference of the questions. He says any movement would be minimal

Mr Myers puts it to Dr Jayaram that he inserted the chest drain in a sub-optimal position and that this contributed to Child H's desaturations in the hours and days that followed. The consultant rejects this, he says the drain was not in the wrong place

He accuses Mr Myers of being focused on process over outcomes, he says the drain was inserted to drain air which it did.


Dr John Gibbs, who was a consultant paediatrician at the Countess of Chester in 2015, is now in the witness box

Dr Gibbs' notes from around 5pm on 25 September show that the drain inserted by Dr Jayaram that morning had moved. Dr Gibbs fixed the drain more securely to stop it moving any further

Dr Gibbs is asked if there's any consequence to the drain moving, he says: 'The main worry is it moving out completely and falling out and being useless'

Asked if there would be any internal consequence, Dr Gibbs says: 'Not that I’m aware of…you wouldn’t want to keep pulling and pushing, that would be rubbing against the lung. Pushing very far in would push against the heart…

'I wouldn’t expect it to cause any trauma or damage to (Child H)at all', he said

Dr Gibbs is now taking the court back over his notes from the early hours of 26 September, when Child H suffered a serious collapse which required CPR and three doses of adrenaline

Dr Gibbs' notes from the time say that it was 'unclear' why the infant went into cardiac arrest. His notes say the likely cause was hypoxia - low oxygen levels - but not clear what had caused that

Ms Letby's defence counsel, Mr Myers is now questioning Dr Gibbs

Mr Myers puts it to Dr Gibbs that against the backdrop of all Child H had been through - the insertion of multiple chest drains - it was 'no surprise' she had a collapse on 26 September. Dr Gibbs says he 'was surprised' by her collapse as she had been stable

The judge has asked Mr Myers to clarify whether he is suggesting Child H's collapse came as a consequence of the procedures (chest drains/intubations etc), he says yes

He says, with particular reference to the drain fitted by Dr Jayaram, that he wants the jury to look 'where it goes and what it could have done'

Court has now adjourned, back Monday.
 
  • #266
However, in the early hours of 25 September more air had accumulated and Dr Ventress sought assistance from consultant paediatrician Dr Ravi Jayaram.

Dr Jayaram arrived on the neonatal unit shortly before 02:00 BST and took the decision to insert a second drain.

[...]

"It wasn't in the wrong place," he said.
"You very much focus on process, we have to look at outcome which was the crucial thing at the time. This made (Child H) more stable."

[...]

The consultant [Dr John Gibbs] sketched out possible reasons for the collapse in his notes and suggested it could be a "result of trauma from chest drains against the heart", but he told the court subsequent ultrasounds "showed that had not happened".

Lucy Letby: Doctor rejects chest drain claim, trial told
 
  • #267
Chest compressions from nursing staff were under way when consultant paediatrician Dr John Gibbs arrived to the first collapse.

Three doses of adrenaline were administered to help stimulate the heart of the youngster and her heart rate eventually rose to a safe level after 22 minutes of resuscitation.

Philip Astbury, prosecuting, asked the now retired doctor: “Was the use of adrenaline in those circumstances a commonplace occurrence?”

Dr Gibbs replied: “No. It was becoming more common as events continued on the unit with repeated collapses of babies. Until 2015, uncommon.”

Adrenaline for babies in cardiac arrest rare until 2015, nurse trial told | ITV News
 
  • #268
Mr Myers: 'For an experienced doctor, it's in the wrong place, isn't it?'

Dr Jayaram: 'No, it's in the pleural cavity. You're concentrating on process rather than outcome. This drain needed to go in, and it actually made more sense to put it in lower down rather than in the same place'.

The barrister put to him that an x-ray taken 10 hours later showed that the drain had moved up close to the pigtail one inserted earlier. 'The one you put in could have been moving, couldn't it?'

The paediatrician replied: 'But it's not flapping up and down. It just shows the pneumothorax has continued to resolve'.

He went on: 'I'm struggling to understand the mechanism you're proposing – that it's moving up and down…It may move around to a small extent, but it would be very difficult to move a chest drain that's been sutured in'.

Mr Myers suggested it might if it hadn't been secure, if it had not been stitched in properly. He then asked: 'You sutured this one, didn't you?'

Dr Jayaram replied: 'Yes'.

TV doctor in Lucy Letby trial denies wrongly inserting lung drain
 
  • #269
Prosecution evidence, January 23rd 2023, Day 43 - no live updates

Child H - Sep 27th 2015 collapse


The first emergency crash bleep was received after a "profound" drop in Child H's blood oxygen levels and heart rate as medics discovered her breathing tube was blocked with secretions, the court heard.

Several hours later at 00.55am on September 27, Child H suffered more profound desaturations while on a ventilator - but this time her breathing tube contained no secretions. [...]

In his discharge letter to Arrowe Park, [registrar Dr Matthew] Neame wrote: "Thank you for accepting this baby who has had two significant episodes of bradycardia (low heart rate) requiring resuscitation, adrenaline and CPR in the last 24 hours with no clear precipitating factors.

"Her care has been complicated by the development of respiratory distress syndrome and pneumothoraces (collapsed lung) but the acute episodes with desaturation and bradycardia do not seem to be directly related to the respiratory problems."

Doctor had 'no explanation' why baby suffered second collapse, Letby trial told
 
  • #270

In this episode, Caroline and Liz examine what happened to Baby H, a baby girl, who Lucy Letby allegedly tried to kill twice in 24 hours. In the early hours of September 26, 2015, Baby H collapsed and didn’t have a heartbeat for twenty-two minutes while staff battled to save her life. Jurors were told the doctors were so worried that they urged her parents to have her baptised in case she didn’t make it.
 
  • #271
Prosecution evidence, January 23rd 2023, Day 43 - no live updates

Child H - Sep 27th 2015 collapse


Nurse Lucy Letby, 32, attacked baby girl twice in 24 hours, court told

Medication for Baby H was signed for by both Miss Tomlins and Letby in accordance with hospital protocol.

Miss Tomlins admitted she would likely have 'popped' out of the intensive care room from time to time to go to the toilet, go on a break or to organise drugs, and it was usual to ask a colleague to cover.

The court also heard from another nurse, shift leader Chris Booth, who described Letby as a 'conscientious, excellent and hard-working' member of staff who was always willing to change shifts or work extra hours at short notice.
 
  • #272
Prosecution evidence, January 24th 2023, Day 44 - no live updates

Child H - Sep 26th & Sep 27th 2015 collapses - MEDICAL EXPERT OPINION



"Details of the mistakes emerged at Manchester Crown Court as two paediatric experts said they could find no medical reasons for Baby H to suffer cardiac arrests on successive days in September 2015.

[...]

Today Dr Sandie Bohin, one of two paediatric experts brought in by the prosecution, was questioned in detail about the drain fitted by Dr Jayaram.

[...]

'But although it had moved, it hadn't moved after the x-ray on September 26, so I don't think that drain can be the cause of the collapses. By then it had been secured'.

[...]

She rejected Mr Myers' suggestion that the explanation for Baby H's two mystery collapses might have been the cumulative effect of a series of procedures she had been through.

'A baby will desaturate as the result of an event, but it's not cumulative and it certainly doesn't cause a cardiac arrest'.

[...]

He [Dr Dewi Evans] added: 'I can't explain the (two) collapses, but the fact that she recovered so well before she left for Arrowe Park is a marker of clinical wellbeing and, retrospectively, an indicator that the care she had was satisfactory'."

Medics left needle inside baby's chest, Lucy Letby trial hears
 
  • #273
Prosecution evidence, January 25th 2023, Day 45 - Chester Standard Live Updates

Child I

Mother's Statements (x2)


10:29am

It is expected the case will begin delivering detailed evidence in the case of Child I today.
Previously, the prosecution said in their opening that Child I, a baby girl, was murdered by Letby in October 2015, on Letby's fourth attempt at trying to kill her. The defence deny this.

10:33am

The judge, Mr Justice Goss, has entered the courtroom.
The trial will resume shortly.

10:36am

Nicholas Johnson KC, prosecuting, is reminding the jury of the prosecution's case for Child I, which has one count of murder.
He tells the jury this case, which the prosecution says involves four attempts to murder the baby girl, will be the longest to be heard in this trial.

10:39am

Child I was born in Liverpool Women's Hospital on August 7, 2015, weighing 2lbs 2oz. She was transferred to the Countess of Chester Hospital on August 18.
The prosecution say Lucy Letby attempted to kill Child I on September 30, on October 12, on October 14 and on October 22, the last date being Child I's death.

10:43am

The court is now hearing a statement from the mother of Child I, who describes her pregnancy, and found she was having a girl at a 16-week scan.
She said at no time during any of the scans were there any concerns. She had "breezed through" past pregnancies, but five weeks after her last scan, her waters broke.
She went to the Countess, who conducted some tests to prove her waters had broken.
She was transferred to the Manchester Royal Hospital, with more blood tests conducted. She was told the baby girl would be born prior to 34 weeks and was 'safer inside' at this point.
She was sent home, with advice to go to the Countess every 2-3 days for blood tests.
After the first of those appointments, she was told not to leave due to the blood results. She was transferred to Liverpool Women's Hospital and was continually monitored.

10:46am

On the 7th, the mother was in labour, and needed to get to the ward.
She was informed by a midwife she was not in labour, but the mother said she was in contractions.
She was not happy and so spoke to another midwife at the hospital she knew.
A doctor physically examined her, and she was transferred to the labour ward.
The mother said she was "too scared to push", and at some point she was told the baby was in distress, so she pushed.
Child I was born at 9.02pm, following an hour-long labour.

10:51am

Child I was "doing really well" when born and was brought to the mum, before going to the neonatal unit.
The mother was later told that, as Child I only weighed 2lbs, staff were having difficulty 'getting lines in', requiring scans every time.
The mother was later able to see Child I, who was on a ventilator.
The following day, the parents saw her and she was still in an incubator, but no longer on a ventilator - she was now on CPAP.
A nurse asked if the mother wanted to handle Child I, and the mother accepted, but the saturation levels dropped once the baby went out of the incubator, and the mother was told it was a 'little too soon'.
Over the following days, Child I was 'doing really well', although the mother was informed it would depend whether Child I would pull through, which left her 'petrified'.
However, Child I continued to do 'fine'.

10:54am

At five days old, Child I was transferred to a high dependency unit at the neonatal unit in Liverpool.
The following day, the family were told Child I could go back to Chester.
The mother said: "We panicked, [Liverpool] was spotless, and [Child I] was settled there.
"At the same time we had heard a virus had broken out among ward 2, so we were then relieved."
Child I was transferred to the Countess of Chester Hospital on August 18.
At first, the mother said they had reservations about Child I's care at the CoCH as the staff didn't seem to have the time for them, as they seemed so busy.

10:59am

The mother said: "I felt that Chester and Liverpool had different methods (Chester concentrated on feeding, helping babies grow, Liverpool concentrated on getting babies off oxygen support). All the time, the nurses would explain why they were doing this."
Child I was on CPAP, but the mother said the mask was too big for her, and cotton pads were used to fill the gap, and this left marks on her, which left the mother "annoyed".
Child I was moved to room 2 at the neonatal unit, where the mother met the mother of another baby [Child G].
She was very annoyed at a nurse who appeared to have a cold, which she had had for 'days' and even doctors were aware of, and was in the room. The mother said she did not want her baby to get an infection.

11:02am

The mother was at home when she received a call about Child I deteriorating in health, and she was transferred to Liverpool.
Staff at the Countess suspected Child I had NEC as her stomach had swelled. She was transferred to Liverpool Women's so she would be close to Alder Hey, if surgery was required.
When the parents arrived, they were informed Child I did not have NEC, and she improved. The mother was 'not happy' that no test was taken to categorically rule out NEC as that could have informed her future care.
Child I was transferred back to the Countess.
The constant stays in hospital were 'beginning to take a toll' on the parents, so they split their time at the hospital.

11:04am

The mother says she was changing Child I's nappy and was told by Lucy Letby that the baby girl's stomach looked swollen.
Letby said she would keep an eye on it.
That night, the mother was at home when she was informed Child I had deteriorated again and to come to the hospital.
When they arrived, resuscitations were being carried out on Child I.
The swelling to Child I's stomach had 'now gone down' and she was 'doing better', the mother was told by one of the nurses.
Child I was then taken back to room 2.

11:06am

The mother recalled Child G had also been poorly 'a number of times' at this time in mid September.
Child I was 'looking different' and was looking around, looking like 'a full-term baby', like 'she should be at home in her bed'.
The mother had seen so many people 'not washing their hands and then touching things', so she wanted to get Child I home.
Lucy Letby offered advice on how to bathe Child I, to the mother. She offered to take photos using Child I's mother's mobile, to which the mother agreed.
Letby always appeared 'reserved' compared to other nurses, the mother added.

11:09am

Child I was put on antibiotics 'as a precaution'. She could go from normal to 'almost dying' within a matter of seconds, the mother recalls.
She says staff 'made a big deal' of Child I's stomach. A test was carried out for cystic fibrosis.
The mother had felt the atmosphere in the hospital 'had changed' and she had concerns whether Child I would be able to go home. She asked a nurse if that could be the case, and the nurse replied 'We'll see - she comes off antibiotics on Wednesday, so we'll see'.

11:13am

One day, the mother was sitting there by Child I, when suddenly Child I's oxygen monitor started bleeping. The nurse - not Letby - said it was nothing to worry about, and began fiddling with the monitor.
The mother said when she left that night, things 'didn't feel right', as these had been signs before Child I became very poorly.
The mother was informed overnight Child I's monitor had been switched off as she didn't need it, and her temperature had dropped.
Child I later deteriorated and needed to be resuscitated 'at least 7 or 8 times'.
The hospital believed Child I had a bowel problem. She was not found with a swollen stomach, but was not breathing. The mother believed if the monitors had been kept on, then the situation could've been more closely monitored.
Child I recovered, but with swelling to her stomach and bruising under her left breast bone.
She 'kept being resuscitated' and the parents were informed about Child I's deteriorations 'every day'.
A doctor told the parents they were concerned Child I 'wouldn't be able to make it.'

11:20am

A couple of days later, Child I had 'picked up, but was told by a nurse that Child I's heart rate was 'still too low', and it was suggested that Child I would be Christened.
The mother said she felt that by Christening her, it would be like giving up, but they didn't.
Following the Christening, Child I's stats dropped and she was transferred by ambulance to Arrowe Park on October 15.
Arrowe Park then told the parents there was 'nothing wrong with her'. The mother felt the staff were 'being rude' and she felt she had to defend the Countess staff as they had to save Child I's life 'time and time again'.
The Arrowe Park doctor told the mother he 'couldn't understand what she was saying'. The nurse said she was going to give Child I some milk, and the mother said 'no, she's nil by mouth'. The nurse apologised and said she hadn't read the chart. The mother was angry at this.
The mother was told Child I was fine, but when the baby was turned over, she collapsed. The mother screamed at the doctor to do something.
The mother said the journeys between the hospitals would 'take it out of' Child I.
Child I improved and was transferred back to the Countess on October 17.
Child I 'didn't look herself' and it was like she was 'looking through me', the mother said to her mother.

11:23am

At 12.30am on October 23, the mother woke up to find she had a missed call from the hospital. She rang through to a nurse and Child I had 'a little turn' and had been put on a ventilator.
The mother said she had to get to the hospital as she wasn't happy about Child I being back on a ventilator after all this time.
After ringing back, she was told to get to the hospital 'as soon as she can'. When they arrived, they found staff including Letby were trying to resuscitate Child I. That had been done for 20 minutes.
After some time, the mother said to them: "You can't keep doing this any more."
Resuscitation efforts ceased and Child I was passed into the arms of the mother, and Child I died shortly afterwards.

11:24am

Two nurses, including Letby, asked if the mother wanted to bathe Child I.
While bathing, Letby was "smiling and kept going on about much she was present at [Child I]'s first bath and how much [Child I] had loved it.
"I wished she'd just stop talking. i think, eventually, she realised. It wasn't something we wanted to hear right now.
"I remember it was Lucy who packaged up [Child I]'s belongings."

11:29am

The mother was told a post-mortem examination would need to be carried out for Child I, as the cause of death was not known.
In a subsequent statement, the mother clarified a few points from her original statement.
It was at the time she met Letby as she was changing Child I's nappy, and Letby remarked on Child I's stomach.
She said she would normally attend hospital at 9am each day and do the same thing, checking on Child I, speaking to staff, and feed (if Child I was not on a feeding tube). She would also meet family in the canteen.
At around 3pm, Letby walked in and stood by the window, about 6ft away from mother and baby.
She said: "I've noticed her belly is extended today, I'll go and check with the doctor."
The mother agreed. A medical staff member checked the belly and noted it was soft, and it would be examined.
For the October 14 incident, the mother recalls she was staying overnight at the hospital, woken up as Child I was poorly.
On each occasion they were called to the neonatal unit. she does not recall holding Child I's hand as this would have been impossible with so many staff working on Child I.

LIVE: Lucy Letby trial, Wednesday, January 25
 
  • #274
Prosecution evidence, January 25th 2023, Day 45 - Chester Standard Live Updates

Child I

Electronic Evidence - for September 30th 2015


11:31am

Mr Johnson says the court will now be going through the sequence of events for Child I.
Additional documents are now being presented to the jury.

11:33am

Intelligence analyst Claire Hocknall is recalled to talk the jury through the sequence of events for Child I.

11:34am

This sequence of events will focus on 'the first event' for Child I, which happened on September 30, 2015.

11:41am

Child I was born at a gestational age of 27 weeks at 8.47pm on August 7, 2015.
She was transferred to the Countess of Chester Hospital on August 18, being cared from 8.30pm.
She was transferred back to Liverpool on September 6, before going back to Chester on September 13, at 11pm.
On September 21, Letby was working a long day shift. During that day, Child G suffered a significant deterioration at 10.15am.
Letby worked a number of night shifts on September 23, 24, 25 and 26. during this time, Child H suffered two significant deteriorations.
Letby then had a few days off work before returning on September 30.

11:47am

A note by the day shift nurse, Shelley Tomlins, gave a brief update on Child I for September 29, recording the mother had been present for 'cares', and regular 35ml feeds of expressed breast milk and fortifier were administered every three hours.
A subsequent note recorded Child I 'remains pale but managing to complete bottles (slow to feed as windy).'

11:51am

The overnight shift nurse, Jennifer Jones-Key, said Child I continued to be fed regularly, with her tummy 'full but soft', and the father present for cares.

12:08pm

The court is now resuming after a short break.
The sequence of events is now going on to the day shift of September 30, 2015, which has Lucy Letby as a designated nurse.

12:11pm

Letby was looking after three babies in room three that day, including Child I.
Child G was in room 2, with two other babies.
Two babies were in room 1.

12:14pm

Consultant paediatrician Dr Elizabeth Newby records, as part of an inspection for Child I as part of a 'grand round', for feeds to continue.
Feeds are continued for Child I during the day at 10am, 1pm and 4pm, of 35mls expressed breast milk and fortifier. The 10am feed is by bottle, the 1pm and 4pm are via naso-gastric tube with Child I being recorded as asleep for the latter two feeds.

12:20pm

On September 30, at 12.15pm, Child H is transferred back to the Countess of Chester Hospital.
At 1.36pm, Letby records Child I's temperature in the hotcot.
She adds, after a note on the 3x8 feeds: "'Abdomen appears full and slightly distended. Soft to touch, [Child I] straining++. Bowels have been opened. Mum feels it is more distended to yesterday and that [Child I] is quiet. Appears generally pale. Not on monitor...[will continue to monitor situation]"
1.48pm: "Mummy visiting, carrying out feeds and cares".

12:22pm

A note for the feed at 1pm is read out to the court - 'EBM+fortifier, NGT, vomit aspirated 5ml, ph5'. It is signed by Letby.

12:24pm

Letby records, for 3pm: 'Reviewed by Drs as [Child I] appeared mottled in colour with distended abdomen and more prominent veins. Advised to continue. Temperature within normal range with hot cot at 38 degrees. Full monitoring recommenced. within normal range.'
Observations are commenced more regularly for Child I, the court hears.

12:28pm

A 35ml feed at 4pm for Child I has an aspirate of 3ml, with Child I 'asleep'. It is signed by Letby's initials.
Letby notes: 'did not wake for feed at 1600 therefore NG Tube feed given'.
Child I then suffers a deterioration at 4.30pm.

12:28pm

4.30pm on the feed chart records, for Child I, 'large vomit and apnoea - nil by mouth'. It is not signed by anyone.

12:32pm

Letby notes: 'At 1630 [Child I] had a large vomit from mouth and nose++ suction given. Became apnoeic with bradycardia and desaturation (30s). Help summoned and IPPV given for approx 3min in 100% oxygen to recover. Drs were crash called.
'Transferred to nursery 1...'
A doctor [who cannot be named] records he is crash called. He notes 'Chest clear... Abdomen distended, active bowel sounds all zones'

12:35pm

Letby's mentor replies to a message Letby had sent earlier, expressing birthday wishes, at 5.23pm: 'Ah thank you so much. You ok? x'

12:37pm

An x-ray is taken of Child I at 5.39pm, with the radiologist recording: 'There is splinting of the diaphragm due to bowel distension...there is moderately severe bowel distention which is thought to involve both large and small bowel.
'The appearances are suspicious of NEC...'

12:39pm

Medication of glucose and sodium chloride is co-signed by Letby at 5.45pm and 6pm.
A CRP blood reading for Child I is 'less than 1'.

12:47pm

Child I suffered another deterioration at 7.30pm.
Letby's notes, written in retrospect at 8.26pm, record: 'At 1930 [Child I] became apnoeic - abdomen distended++ and firm. Bradycardia and desaturation followed, SHO in attendance and registrar called...
'Nil by mouth. NG tube on free drainage. Cannula inserted but tissued during saline bolus (5mls given).
'Colour appears pale but improved from earlier in shift. Abdomen appears full and distended. Veins more prominent. Not further vomits. Responsive but quiet on handling.'
For the family communications: 'Mummy present when reviewed by Drs. Had left unit when [Child I] had large vomit and transferred to nursery 1. [Mother] up to date with current plan...'
Nurse Bernadette Butterworth, who took over care of Child I for the night shift, records: 'During handover [Child I] abdo became more distended and hard she had become apnoeic nad bradycardiac and sats had dropped. IPPV given and despite a good seal with Neopuff there was still no chest movement...'

12:48pm

The doctor records 'ticks' for temperature instability and apnoea for Child I at 8pm.

12:50pm

Letby's final note from 8.26pm: '[Child I] is now very pale and quiet.'

12:52pm

Letby responds to her mentor: 'Yes thank you. Hope you are enjoying your celebrations. X'

1:04pm

The court is shown a series of text messages sent to and from Letby's phone from that night.

2:11pm

The text messages related to one of Letby's female colleagues having an argument with another nurse who 'snapped at her'.
Letby messages Jennifer Jones-Key to say: "I am a bit up and down. Have not had nice shifts and not been feeling supported by some people."
Letby messages another colleague: "Let's run away!!!" and the subject turns to moving away to New Zealand, which one of the nurses is planning to do.
Letby said she could not do so as it would mean leaving her parents behind, they would be "completely devastated".
She said she had come to Chester for university and did not go back to Hereford, and added: "I feel guilty being so far away often", but it was what she wanted.


2:14pm

Letby messages colleague Alison Ventress at 10.09pm: "Families are tough aren't they!" followed by two sad face emojis.
Alison Ventress replied: "Some more than others!..."


2:17pm

Letby messages Jennifer Jones-Key to say she had been originally taken off the September 30 shift for working the previous Wednesday night, but was later put back on the shift.

LIVE: Lucy Letby trial, Wednesday, January 25
 
  • #275
Prosecution evidence, January 25th 2023, Day 45 - Chester Standard Live Updates

Child I

Electronic Evidence - October 1st 2015


2:19pm

The sequence of events relays medications which were given to Child I throughout the night shift, along with regular observations.

2:23pm

For the day shift on October 1, Ashleigh Hudson was the designated nurse, who continues to record observations for Child I.
Bernadette Butterworth inputs an incident, written at 8.30am for 8.30pm the previous night, about administering an antibiotic infusion over 10 minutes instead of 30 minutes. 'Although correct dose was given it was delivered at a faster rate.
'When aware of mistake, infusion was adjusted. Reg and shift leader informed'.

2:26pm

Bernadette Butterworth recorded Child I, at 8.44am, was 'handling much better without desats/Bradys'.
'Was initially very pale colour has improved, abdo remains distended and firm but less distended than at beginning of shift'.
The parents were made aware of the plan of care.
A doctor, during the ward round, said it was considered to restart feeds for Child I. The parents were concerned Child I may be lactose intolerant, and that had possibly led to abdominal distention.

2:28pm

Letby messages her mother on October 1 to say she has arranged her shifts so she will be off for Christmas, and will be visiting her parents at that time. The mother replies: "That's fab, I could cry"

2:30pm

Ashleigh Hudson records, at 1.36pm: [Child I] appears pale but pink and well perfused...' followed by a number of medical notes.

2:33pm

The sequence of events goes to the end of October 1, with Ashleigh Hudson recording at 7.48pm: Review by Paeds SHO...abdomen is softer and less distended, ? start cautiously feeding...'
Both parents were updated on the plan of care.
Letby searches for the mother of Child I on Facebook at 1.16am on October 5.

2:35pm

On November 5, 2015, Letby searches for the mother of twins Child E and Child F at 11.41pm, then searched for the mother of Child G at 11.44pm and, in the same minute, a search for the mother of Child I.
Letby also searched for the mother of Child I at 11pm on May 29, 2016.


2:41pm

Benjamin Myers KC, for Letby's defence, is asking Claire Hocknall questions.
He asks about the feeding chart in connection with nursing notes by Lucy Letby at 1.36pm on September 30, with addendum at 1.48pm.
The nursing note was written at 1.36pm, covering 8am-1.36pm, and the family communication is timed at 1.48pm 'mummy visiting, carrying out feeds and cares'.
Mr Myers says the feeding chart for 8am-1.48pm shows one event of mother coming for feed that morning.
He says the family communication isn't timed, and can refer to the period of 8am-1.48pm, not the time the note was written at 1.48pm.

2:47pm

Mr Myers refers to hourly observation charts which on occasions are not signed. He refers to two which happened in the case of Child C, where there was an hour which was not signed. The nurses who signed for each hour either side of that are not Lucy Letby, but signed by her colleagues.

2:48pm

Observation charts which are not signed by initials are also shown for Child I, with three in a row not initialled.

LIVE: Lucy Letby trial, Wednesday, January 25
 
  • #276
Prosecution evidence, January 25th 2023, Day 45 - Chester Standard Live Updates

Child I

Electronic Evidence - Liverpool Women's Hospital


2:54pm

Kate Tyndall, intelligence analyst, has now returned to talk the jury through neonatal reviews for Child I.

3:07pm

A statement from a consultant neonatalogist at Liverpool Women's Hospital is being read out.
She gives details of Child I's birth, and said Child I was born in 'very good condition'.

3:08pm

Child I was 'stabilised very quickly' with no concerns, before being admitted to the neonatal unit after being allowed to be shown to her mother.

3:12pm

Child I had 'very good gases' after being put on breathing support device CPAP.
There were readings consistent with an infection, but Child I was on antibiotics. A lumbar puncture and phototherapy were commenced.
Feeds were commenced, using expressed breast milk, on August 8 and Child I continued to be 'very stable, in spite of having an infection'.

3:14pm

Child I later had desaturations and bradycardias, so a second line of antibiotics was begun. The CRP infection marker was low, but the white blood cell count was elevated. A programme of five days of antibiotics began, and after a short gap in feeds, Child I continued to be fed.
Child I was stable when taken off CPAP for short periods of time.

3:16pm

On August 18, Child I was stable on CPAP, having four hours off it. She was tolerating feeds "very well". She had "normal tone, posture and movement".

3:19pm

The team at Liverpool had to wait until a bed became available at Chester before transfer was authorised on 'day 11', when Child I weighed 90g more than her birth weight, which "was good", as it was expected that babies would drop in weight in the days after birth.
"We expected [Child I] would continue to improve at Chester".

3:23pm

Upon Child I's return to Liverpool Women's Hospital, her blood gases and heart rate were "normal".
It was thought that Child I had suspected sepsis rather than NEC, and a course of antibiotics began to cover for both possibilities.
Child I was kept nil by mouth but was "stable" on the night of September 6.
There was a "mechanical obstruction" in the ET tube on September 7 and Child I was re-incubated. After this she "had normal gases and improved very well".

3:25pm

Feeds were gradually increased and the course of antibiotics ended after five days.

3:32pm

Child I continued to tolerate and build up feeds, which was a sign the baby girl did not have NEC.
The expectations were that Child I would return to the Countess of Chester Hospital and continue to improve.

LIVE: Lucy Letby trial, Wednesday, January 25
 
  • #277
Prosecution evidence, January 25th 2023, Day 45

Child I


After Child I was pronounced dead, her parents were moved to a private room at visiting time. They then agreed to bathe their daughter’s body.

She said: “Lucy brought the bath in. She said she could come in and take some photos which we could keep. While we were bathing her, Lucy came back in. She was smiling and kept going on about how she was present at the first bath and how [Child I] had loved it.

“I wished she would just stop talking. Eventually she realised and stopped. It was not something we wanted to hear. I remember it was Lucy who packaged up [Child I’s] belongings to go home.”

Guardian - Lucy Letby: nurse offered to take photos of baby she had killed, court hears



Earlier in her statement, she also described how she had never had "much to do with" Ms Letby.
"She always appeared reserved and never interacted with the other parents," Child I's mother added.

BBC - Lucy Letby: Nurse murdered baby on fourth attempt, court told



"I asked Dr Gibbs how long had they been doing this, to which he said 20 minutes. I could see every time they were pumping her stats would go up, but when they stopped she flatlined every time.
"I remember thinking they can't keep doing it. I said to Dr Gibbs 'You can't do any more'."

"Dr Gibbs mentioned about having an autopsy.
"I said I didn't want one because I wanted her leaving alone.
"He said I didn't have a say because her death was unexpected and the results would be needed to clear the hospital."

Shropshire Star 'Smiling' Lucy Letby offered to take photos of baby she had murdered, court told
 
  • #278
Prosecution evidence, January 25th 2023, Day 45

Child I


On the evening of September 30 2015, Letby responded to a text message from a colleague, Dr Alison Ventress, who was planning to travel to New Zealand, the court heard.

Dr Ventress wrote: “Defo come to NZ then! I could use a friendly face!!”

Letby replied: “Haha not brave enough to up & leave everything.

“I couldn’t leave my parents. They would be completely devastated. Find it hard enough being away from me now and it’s only 100 miles.”

Dr Ventress responded: “Aww where are they based?”

Letby said: “Hereford. I came here to uni & didn’t go back. They hate it & I feel very guilty for staying here sometimes but it’s what I want.

“Families are tough aren’t they!”

The next day she texted her mother, Susan: “Guess who will be coming home for Christmas 🤬🤬🤬

Susan Letby replied: “That’s fab I could cry x”

Letby said: “Doesn’t take much! Nights 21st 22nd 23rd then Nights new years eve & day. Don’t tell Dad yet though xx”

Susan Letby said: “Ok he’ll be pleased, also Jane x”

Nurse Lucy Letby ‘offered to take photos of baby soon after murdering her on fourth attempt’
 
  • #279
Prosecution evidence, January 26th 2023, Day 46 - no live updates

Child I

Unnamed nurse - re. night shift 22nd/23rd Oct 2015 -


“Mum came in and asked why I had dressed her and I explained I wanted to see if it settled her.

“I don’t remember saying to her that (Child I) didn’t die of prematurity. I only remember the babygro part of the conversation.”

Bernadette Butterworth - designated nurse night shift 30th Sep 2015 - re. handover from LL day shift

Miss Butterworth noted Child I’s swollen tummy and asked Letby to aspirate her nasogastric feeding tube, which obtained a “fair amount of air” and 2ml of milk.

She told the court: “She settled down. She came back to normal, her heart rate and respiratory rate.”

Doctors suspected a bowel problem as they prescribed antibiotics and ordered blood tests and X-rays.

On the afternoon of October 1, Letby messaged a colleague: “(Child I) was found gasping in cot, full resus and vented. Don’t know why. Wasn’t nice.”

Unnamed nurse - re Sep/Oct 2015 period

She said it was “mainly Lucy doing a lot” of extra shifts as she was qualified to carry out emergency care if required.

The nurse added: “Lucy was young, living in a doctors’ halls of residence and saving to buy a house.

“She was single and was willing and wanting to do extras.”


LL's Text 1st Oct 2015 -

On the afternoon of October 1, Letby messaged a colleague: “(Child I) was found gasping in cot, full resus and vented. Don’t know why. Wasn’t nice.”

---

"It is alleged she harmed [Child I] by either injecting air into her feeding tube and bloodstream, or overfeeding her with milk.

The defence say Child I's clinical problems 'may have been inevitable given her extreme immaturity'."



10% from each -
ITV - Nurse could not remember saying baby didn’t die of prematurity, Letby trial told | ITV News
Daily Mail - Nurse gives evidence over child's death at trial of Lucy Letby
BBC - Lucy Letby keen to work extra shifts, trial hears - BBC News
Shropshire Star - Lucy Letby murder trial: Other nurse 'can't recall premature birth comment'
Chester Standard - Lucy Letby trial: Court hears nurse was keen to work extra shifts
 
  • #280
Prosecution evidence, January 27th 2023, Day 47 - no live updates

Child I

GP Dr Lucy Beebe, CoCH


"Giving evidence on Friday, [GP] Dr Beebe said: "I remember Lucy crying with another nurse and it was very much of the gist of 'it's always me when it happens, my babies, it's always happening to me a lot'."
Prosecutor Philip Astbury asked: "Who was saying that?
Dr Beebe replied: "Lucy."
Mr Astbury said: "You can't remember precisely when that was?"
"No," said the witness.

[...]

Dr Beebe said: "I recall (Child I) because it was unusual that she was seemingly well and then became unwell.

"In my memory I felt like she was shipped out to a tertiary centre, made a rapid recovery and then was brought back very quickly.
"It certainly stuck in my memory because it had never happened to a baby I had been involved in the care of before or since, at any of the neo-natal units I worked at."
Asked about her reaction to Child I's death, she replied: "Shock and frustration at the time because on reflection I felt there was something else going on with (Child I) that we were not getting to the bottom of."

'It's always me when it happens': GP tells murder trial of Lucy Letby's tears

Lucy Letby: Accused nurse in baby murder trial cried 'it's always me when it happens', court hears

Nurse accused of baby murders said ‘it’s always me when it happens’ | ITV News
 

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