UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #10

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  • #461
As a new mum my whole day revolved around feeding ( had my baby at home so no hospital for me ) I knew exactly how much milk had been drunk, when and when the next was due. The mum will not be wrong, it’s ingrained.
 
  • #462
And even more so with baby loss mamas I imagine.
 
  • #463
In WhatsApp messages read to the court, Ms Letby asked a colleague on the afternoon of 14 October if Child I was staying on the unit.
She added: "I'd like to keep her please."
Her colleague, who cannot be identified for legal reasons, replied: "Yes. Staying for now. OK re keeping."
An hour later the colleague messaged: "I've had to re-allocate. Sorry."
Ms Letby said: "Has something happened?"
The colleague replied: "No. Was just asked to reallocate so no one has her for more than one night at a time. Or one shift. Not just night."
Ms Letby responded: "Yeah that's understandable."

I see this (and alot of LL's Comms with colleagues) as coaching type behaviour.
She seems to persistently fluctuate between allowing 'symptoms' to escalate (either by standing there and doing nothing or through sloppy Facebook Comms) and 'fishing' for intel with colleagues, manipulating them to answer questions in a way that substantiates particular views and opinions. JMO
 
  • #464
In WhatsApp messages read to the court, Ms Letby asked a colleague on the afternoon of 14 October if Child I was staying on the unit.
She added: "I'd like to keep her please."
Her colleague, who cannot be identified for legal reasons, replied: "Yes. Staying for now. OK re keeping."
An hour later the colleague messaged: "I've had to re-allocate. Sorry."
Ms Letby said: "Has something happened?"
The colleague replied: "No. Was just asked to reallocate so no one has her for more than one night at a time. Or one shift. Not just night."
Ms Letby responded: "Yeah that's understandable."

Now THIS seems interesting! Do nurses often request who they’re allocated to in this way? Not just requesting an allocation but actively seeking out if the child will be there to be able to be allocated to her.

Equally.. her subsequently being reallocated with the reason given the same person doesn’t have her on concurrent shifts. I wonder if this is a direct consequence of suspicion?
 
  • #465
Now THIS seems interesting! Do nurses often request who they’re allocated to in this way? Not just requesting an allocation but actively seeking out if the child will be there to be able to be allocated to her.

Equally.. her subsequently being reallocated with the reason given the same person doesn’t have her on concurrent shifts. I wonder if this is a direct consequence of suspicion?
It seems like it could be. Here are the Standards notes on children H and I.

For baby H, LL was still on night duty, so they had not switched her over yet. From reviewing the notes below, it makes sense to me they would have been suspicious by the time baby I began collapsing.

LL was the designated nurse for baby H both nights that baby collapsed. So after H was transferred out, 3 days later, LL was placed with the stable babies in room 3. She was designated nurse for I during first collapse, but was not her designated nurse for the 2nd collapse---But she ended up caring for baby I anyway while designated nurse was on break...



Here are some notes on baby H, before the Baby I incident.


The prosecution say Letby attempted to kill Child H on September 26 at 3.24am, and on September 27 at 12.55am.

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.

Letby was on duty for both those night shifts, and was the designated nurse for Child H.

That night, [sept 26] Child H was given a blood transfusion.

At 2.15am, medical notes by a doctor showed a re-accumulation of her left-sided pneumothorax. A further chest drain was inserted to relieve the pressure.

The ICU chart shows that Letby recorded having given Child H a dose of morphine at 1.25am and a dose of saline at 2.50am. The saline bolus was set to run for 20 minutes and would therefore have ended at 3.10am. Lucy Letby would have had the cover of legitimacy for accessing Child H's lines just before she collapsed again.

At 3.22am, Child H collapsed and required CPR. The attending doctor said the cause was unclear. He concluded the episode was 'hypoxia' (shortage of oxygen).


[child was transferred to another hospital and quickly recovered with no more collapses---retirned to COC and was released]

OK, SO CHILD I BEGAN HAVING PROBLEMS 3 DAYS AFTER CHILD H HAD THEIR LAST COLLAPSE BEFORE BEING TRANSFERRED OUT.

Child H was the designated patient for LL both nights of their unexplained collapses. Three days later child I begins having problems. SO IF LL WAS NOT ALLOWED TO BE THE CARETAKER EVERY NIGHT, IT IS UNDERSTANDABLE.

CHILD I:

Child I, by late September, had diminshed clinical concerns, and no breathing problems.

For what the prosecution say was the first attempt, Letby was on a 'long day' shift (8am-8pm) on September 30. She was Child I's designated nurse in room three.

According to Child I's mum, Letby expressed concern about the child and indicated Child I would be reviewed by a doctor.

When she made a nursing note, Letby "reversed the concern", and said it was the mum who had raised a concern about the abdomen, saying it was "more distended to yesterday" and Child I was "quiet...not on monitor but nil increased work of breathing”.


[IT IS INTERESTING THAT AFTER CHILD H'S TWO COLLAPSES, LL WAS NOW WATCHING BABIES IN ROOM THREE---WHICH WERE STABLE BABIES, NOT CONSIDERED AT RISK. ]


A review took place at 3pm - over an hour after these notes. Child I appeared mottled in colour with a distended abdomen and prominent veins.

A feeding chart showed 35mls was given to Child I when asleep, but Letby had recorded Child I as "handling well and waking for feeds".

At 4pm, Letby recorded feeding Child I 35mls of expressed breast milk via the NGT.

An emergency crash call was called at 4.30pm as Child I had vomited, desaturated, her heart-rate had dropped and she was struggling to breathe.

Her airway had to be cleared and she was given breathing support, and Child I was transferred to room 1.

An x-ray at 5.39pm revealed a "massive amount of gas in her stomach and bowels" and her lungs appeared "squashed" and "of small volume".

The prosecution say air had been injected into the NGT to give a 'splinted diaphragm'.

A doctor recorded Child I had suffered a 'respiratory arrest' at 4.30pm, struggling to breathe, she was pale and distressed, and the abdomen was 'distended and hard'.

The NGT was aspirated and produced 'air+++ and 2mls of milk', after which Child I improved.

The prosecution says this is at odds with the 35mls of milk Child I was fed with at 4pm.

The prosecution say "removed from the orbit of Lucy Letby," Child I's condition improved.

Child I continued to improve and was in nursery room 2 on the night of October 12 by a designated nurse different to Letby. Letby was looking after a baby in room 1.

Child I was being bottle fed every 4 hours, and at 1.30am took a 55ml bottle of breast milk.

At 3am, the designated nurse left the nursery temporarily and said she asked either Letby or another colleague to listen out for Child I.

The designated nurse, records show, helped another colleague with something in room 1.

The prosecution say it is more likely the nurse would have asked Letby to look out for Child I.

Upon the designated nurse's return to room 2, Letby was "standing in the doorway of the room" and Letby said Child I "looked pale".

The designated nurse switched on the light and saw Child I was "at the point of death". She later recalled the child was breathing about 'once every 20 seconds'.

The prosecution says the jury should consider how Lucy Letby could see a child was looking pale when the room was darkened at 3.20am, with minimal lighting.
 
  • #466
Obviously this is not the main concern, but my goodness, if LL is found guilty of even a fraction of these charges, that hospital is going to get sued into oblivion for negligence for allowing her to continuing working with access to babies for so long after suspicions arose.
 
  • #467
Now THIS seems interesting! Do nurses often request who they’re allocated to in this way? Not just requesting an allocation but actively seeking out if the child will be there to be able to be allocated to her.

Equally.. her subsequently being reallocated with the reason given the same person doesn’t have her on concurrent shifts. I wonder if this is a direct consequence of suspicion?
Well it certainly seems like it to me.:(
 
  • #468
Yet LL accepted it was blood and gave the mum a reason for it
And did not even stir herself to wipe it off the poor little mite's face. :(
 
  • #469
I wonder if the lead nurse normally allocated staff for the following shift on this unit? That's a bit unusual as normally staff are allocated by the person in charge on their shift when they arrive. But it's the only thing which explains the messages. Either way, I wonder who suggested the change in allocation?
It's not unusual to give staff a break from a very difficult patient, but as people have said consistency is also important. Specifying just one shift at a time seems odd to me, especially when a nurse expresses a wish to keep that patient.
 
  • #470
In WhatsApp messages read to the court, Ms Letby asked a colleague on the afternoon of 14 October if Child I was staying on the unit.
She added: "I'd like to keep her please."
Her colleague, who cannot be identified for legal reasons, replied: "Yes. Staying for now. OK re keeping."
An hour later the colleague messaged: "I've had to re-allocate. Sorry."
Ms Letby said: "Has something happened?"
The colleague replied: "No. Was just asked to reallocate so no one has her for more than one night at a time. Or one shift. Not just night."
I wonder if in fact this colleague had second thoughts after agreeing to LL's request - maybe she was busy at the time, but when she had more time to think about it she remembered some suspicions she had heard, and decided to not grant LL's request. But tactfully blamed someone else.
 
  • #471
I wonder if the lead nurse normally allocated staff for the following shift on this unit? That's a bit unusual as normally staff are allocated by the person in charge on their shift when they arrive. But it's the only thing which explains the messages. Either way, I wonder who suggested the change in allocation?
It's not unusual to give staff a break from a very difficult patient, but as people have said consistency is also important. Specifying just one shift at a time seems odd to me, especially when a nurse expresses a wish to keep that patient.
Is it normal in your experience for nurses to asked to be assigned to a specific patient like LL did with baby I ? Or is it not the done thing?
 
  • #472
Is it normal in your experience for nurses to asked to be assigned to a specific patient like LL did with baby I ? Or is it not the done thing?
It's perfectly normal in my experience.
 
  • #473
Good morning guys,

looks like chester standard is there today for live updates

Unfortunately I won't be able to do them today, I've got a new job!!! Very good news but does mean less messing around on my computer with no oversight lol.
 
  • #474
Obviously this is not the main concern, but my goodness, if LL is found guilty of even a fraction of these charges, that hospital is going to get sued into oblivion for negligence for allowing her to continuing working with access to babies for so long after suspicions arose.
I hope not. Depleting an underfunded hospital of much-needed revenue is hardly the best idea, is it? We don't want to turn into a litigation culture like the US.
 
  • #475
  • #476
Good morning guys,

looks like chester standard is there today for live updates

Unfortunately I won't be able to do them today, I've got a new job!!! Very good news but does mean less messing around on my computer with no oversight lol.
Hooray for the Chester Standard! And hooray for your new job! congrats!

Boo! that you won't be able to do the updates anymore. :D
 
  • #477
Here is what happened in court yesterday (Wednesday): Lucy Letby trial: Doctor saw ‘unusual’ mottling on baby

10:26am

The courtroom at Manchester Crown Court is beginning to fill up with lawyers and members of the press, while Lucy Letby has also arrived.

10:32am

The judge, Mr Justice James Goss, has entered the courtroom. The jury will now enter, and the prosecution will continue delivering evidence in the case of Child I.
The prosecution allege that Lucy Letby tried to kill Child I four times, murdering her on the fourth attempt. The defence deny this.

10:35am

An 'agreed facts' statement is read out from nurse Shelley Tomlins, who recalls Child I.
She said she was the first one who looked after her upon her arrival, and looked after her multiple times.
She recalls Child I "definitely" had feeding and gut problems, and problems with a distended abdomen.
She said "it was like" there were blockages in her bowel.
For September 29, 2015, she was the designated nurse on a long day shift. Child I was "mottled" in appearance, with blotchy skin. She said some babies looked like that "all the time", and for some it was a sign they were not well.
She says she cannot say for certain, but the mottled appearance was "probably" all over her body.


10:37am

She says Child I had a cardiac arrest "as we were looking at her".
Resuscitation attempts began and the family arrived, along with Dr Ravi Jayaram, consultant doctor.
The nurse describes the procedures done to stabilise Child I.

10:42am

The nurse recalls a point when the bowels went "massive" and caused another collapse, as it impacted the lungs.
The nurse says the shift was significant for her as it was her last ever shift at the hospital, leaving the hospital a few days later.

10:47am

Nurse Joanne Williams, in a brief agreed facts statement, recalls being involved in chest compressions for Child I.
Laura Eagles, in her agreed facts statement, was also asked about the October 13-14 event for Child I. She recalls from the notes the collapses happened at 7am and 7.45am. She said Lucy Letby was the designated nurse, from looking at the notes.
She recalls who else was on shift and the other babies on that night, and that it was "very busy".
She recalls CPR began at 7.45am, and the 7.45am collapse was more or less a continuation of the 7am collapse.
She said from her memory, Child I was ill for a long time, and it was difficult to separate one event from another in her recollection.

LIVE: Lucy Letby trial, Thursday, February 2
 
  • #478
10:51am

Dr David Harkness, in his statement, said October 13-14 was "quite an eventful night" for Child I.
He said Child I deteriorated and required CPR in the early hours.
His next recorded entry was on a ward round later on October 14. He said it was suspected Child I had NEC. She had had two "quite prolonged" cardiac arrests and was on a ventilator. Blood gases were "acceptable but not fantastic, and on the poor side".
There "had been a suggestion of a collapse of the left lung", which would explain why there were problems ventilating her.
Child I's bowels were open, which was a "good sign". Blood culture tests were awaited, for signs of an infection.

10:53am

Further tests were sought to check for NEC and to monitor Child I's bowels. If the signs were worsening, then surgery would be carried out.
Plans for 1-2 weeks down the line were to insert radioactive dye into the bowels to test for bowel obstructions.
By 4pm on October 14, Child I's signs had improved.

11:00am

Dr Harkness says NEC is difficult to diagnose without carrying out surgery, and suspected NEC is usually treated with antibiotics.
He says he remembers Child I's death, and the parents coming back a few times over the following year.
The next statement is from a consultant doctor at Arrowe Park Hospital. The doctor recalls Child I was transported to the unit on October 15, with suspected NEC/inflammation of the gut, which is "not uncommon" in pre-term babies.
The intention was that Child I would be "conservatively managed" at Arrowe Park.
There was previously discussion on whether Child I should be transported to Liverpool Women's Hospital, but the decision was made to keep Child I in Chester. The following day, following further desaturations, Child I was transferred to Arrowe Park.

LIVE: Lucy Letby trial, Thursday, February 2
 
  • #479
11:11am

Child I was "pink, warm and well perfused" and her vital signs were "within normal limits". She was ventilated with oxygen, nil by mouth, on IV fluids then with TPN bags. There was also sedation medication administered.
The plan was to stabilise Child I and continue antibiotics, with seven days of antibiotics and nil by mouth.
An x-ray showed tubes and a long line were in reasonably good positions.
At the end of the shift, Child I was "stable" until a "sudden desaturation" and bradycardia at 12.16am on October 16. She was 'Neopuffed', but there was no chest movement.
A test concluded the breathing tube had potentially moved, so it was removed. At the end of the tube was dark blood, likely from Child I's previous collapse in Chester.
Child I improved in the early hours of October 16 and notes showed no fresh bleeding, and a different form of breathing support began.
Child I was stable in 35% oxygen breathing support, with "no issues" in breathing and it was "reassuring" the tummy looked fine, and the abdomen was soft.

LIVE: Lucy Letby trial, Thursday, February 2

(my note - I think child I was at Arrowe Park for this part of the medical evidence?)

edited to add the mother's testimony about this -

Following the Christening, Child I's stats dropped and she was transferred by ambulance to Arrowe Park on October 15.
Recap: Lucy Letby trial, Wednesday, January 25
 
Last edited:
  • #480
11:15am

Child I was moved to a high-dependency unit at Arrowe Park and her oxygen support requirements were diminishing.
There was "no longer a need" for tertiary requirement care, so Child I could be transferred back to the Countess of Chester Hospital.
A surgical plan was discussed for Child I, with a dye inserted into Child I to check for bowel obstructions, which would show on an X-ray.
On October 17, the transfer back to the Countess of Chester Hospital was confirmed, with Child I being transported back at 11am.
LIVE: Lucy Letby trial, Thursday, February 2
 
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