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

[esther43]

2:04pm

The trial is now resuming, with intelligence analyst Claire Tyndall returning to court, to talk through the neonatal unit review schedule in late October 2015.

2:12pm

Nurse Ashleigh Hudson is now being recalled to give evidence in the case of Child I.

2:20pm

The nurse is asked to look at nursing notes she had compiled early on October 22, a summary of the care provided to Child I.
She says Child I's heart rate was normal, the respiration rate was slightly elevated on a one-off reading, while her temperature was stable.
She was in room 1 of the neonatal unit, but "not an intensive unit baby" at this time. She was placed there as "a precaution measure" due to her recent medical history.
She was in an incubator, again as a precautionary measure due to her recent history, the court hears.
The nurse said the oxygen saturation levels, recorded as "96% and above", were "optimal".

2:25pm

Child I was "pink and well perfused", with "minimal aspirates recorded, clear fluid. Abdomen soft and non-distended," according to nurse Hudson's notes.
"She was a very stable baby considering the weeks prior," the nurse tells the court

2:26pm

Child I would still have been classed as an 'HDU' baby [high dependency], as nurses would have had to check the long lines every hour, the court hears.
The nurse says she does not recall anything of note happening during that night shift on October 21-22.

Recap: Lucy Letby trial, Thursday, February 2

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

The nursing colleagues mention of that same “cry” as with the statement from baby Es mother is making me feel quite uneasy
Moo

If guilty, I'm wondering if the relationship between either her and the parents, or her and Baby I had been built up into something significant in her head. Possibly because of how long she had allegedly been trying to kill Baby I before she succeeded. And if that's why she marked the occasion with a card and kept a photograph of it on her phone as a "souvenir" .

If guilty of all the alleged crimes then she had been trying to kill babies since June 2015 but hadn''t "succeeded" since Baby E on August 5th. She had also allegedly made more than one attempt to kill babies G and H . Babies F,G,and H all survived her attempts at the time , so Baby I on 23rd October was her first "successful" murder in a while. And maybe that's why she sent the card.

I am thinking more generally. So in this situation, to hope to alleviate any doubts about her nursing ability in the parents eyes. If they think shes kind, care etc... then she must have done her best etc.. etc... jmo

Imo, she likes to control the narrative, eg with the many texts with colleagues about what she diagnoses is wrong and about what she thinks happened. So this could be an extension of this

Tbh, I agree with this. Its very common after a medical mistake for professionals to seek reassurance from the patients they messed up on IMO.
i can recall an ex client of mine giving an account of a midwife coming to find her on the neonatal ward. The labour had been complicated, the monitors were not picking up the twins heartbeat correctly, client was ignored despite raising concerns, consequently the baby was oxygen deprived. Midwife wanted to 'hug' the client in the corridor. My point is, it's a common behaviour where there is a guilty conscience.

 

[katydid23]

Besides, why wasn't it signed officially: Nurse Lucy Letby?

Why this informal style: Lucy x ?

Very strange and inappropriate.
<modsnip - sub judice>

JMO

'Lots of Love'. ......?

That seems so casual and light hearted for a bereavement message.

 

[Sundial]

Besides, why wasn't it signed officially: Nurse Lucy Letby?

Why this informal style: Lucy x ?

Very strange and inappropriate.
<modsnip - sub judice>

JMO

This too strikes me as odd for someone the mother referred to her as more reserved with the parents. Usually cards such as these are signed something like “from the unit” or “from all the team” etc. It is quite unusual, more so as someone else has pointed out, keeping a photographic copy of your words in that card; why?
JMO

 

[esther43]

“
At 1.50am, Dr John Gibbs records: 'HR to 70, sats 70-80 and no pulse palpable. Cardiac compressions restarted at 1.50am'.
Another dose of adrenaline, the seventh, is made at 1.56am, followed by an eighth at 2am.
Dr John Gibbs records Child I was 'not responding to prolonged resuscitation and although her heart was beating there was no effective circulation.
'2.10am hr 40/min on monitor - no pulse (but heartbeat audible without cardiac compression)'.
Ashleigh Hudson records she and Lucy Letby had spoken to the parents about what had happened, and a decision was made to bathe Child I.
Child I's time of death was recorded as 2.30am on October 23, 2015.”

I think we’re all missing a HUGE part of Baby I’s case here. LL didn’t intrude on the parents bathing their deceased child, what she actually did was intrude on the parents with their dying child.

It seems clear to me today that when they decided to stop resus and give baby I to the parents to bathe, there was an audible heartbeat. Subsequently the time of death was recorded as 2.30am. Around 20 minutes after they decided to hand baby over to the parents for bathing. “The decision was made to bathe child I” ie; child I was alive, but resus attempts were stopped to allow the parents to spend their final moments.

She quite literally inserted herself into that precious moment to watch Baby I die (in my opinion of course!)

Well all on the back of supporting nurse Hudson during her first bereavement of course.
Interesting that another nurse came in to 'take over' the bereavement JMO

 

[ColourPurple]

Regarding keeping a photo of a card...

In the say 15yrs its been common to have a camera phone, Ive only photographed the message I had written on a card once.

I was sending someone a deeply personal thank you and goodbye. I was very attached to that person, probably too much, and I wanted to be able to re-read what my last communication was with them as I wouldnt see them again. This wasnt a romantic relationship, it was a professional relationship where I almost saw them like a surrogate Mum.

I kept a record of the message because they meant alot to me, as did the relationship. I thought about them alot, for many years afterwards. If they were on social media, I probably would have looked them up, years down the line.

I know LL might have completely different reasons for keeping a photo of the message to me, but I cant help but think that the relationship she felt they had must have meant alot to her to do that. IMO

Your situation makes sense, and it was a thank you card rather than a sympathy card.

It'ss coming across like this was a one sided "relationship" that meant far more to LL than to the parents.

 

[esther43]

If guilty, I'm wondering if the relationship between either her and the parents, or her and Baby I had been built up into something significant in her head. Possibly because of how long she had allegedly been trying to kill Baby I before she succeeded. And if that's why she marked the occasion with a card and kept a photograph of it on her phone as a "souvenir" .

If guilty of all the alleged crimes then she had been trying to kill babies since June 2015 but hadn''t "succeeded" since Baby E on August 5th. She had also allegedly made more than one attempt to kill babies G and H . Babies F,G,and H all survived her attempts at the time , so Baby I on 23rd October was her first "successful" murder in a while. And maybe that's why she sent the card.

Depends whether you think to cause death/ killing was the intended impact or an unwanted side effect ( If LL is guilty)
Suppose killing was the intention then I would imagine the pause in 'killings' would be like an itch that you can't scratch, a compulsion, something one MUST do in order to feel a particular way.
But if the motive was attention, sympathy and/or heroism then there may have been other ways that LL filled this void, for example through exaggerating or falsifying other things to reinforce her role as a 'rescuer'

 

[Sundial]

Im not a nurse, so it would be interesting to gain the insight of one about the issue of discussing babies stats, condition, activities when off duty.

As a non nurse, I cant help think I would find it annoying. Im off duty, I dont want to hear a run down of my patients when Im not at work. I would want to mentally clock off

I can’t say specifically with babies; but from my own experience regarding patients; no.

It is highly unprofessional and breaches all sorts of confidentiality laws and also the (UK) registry body; nursing and midwifery council (Nmc) guidelines. It can have serious consequences such as being removed from the register/banned from practice and legal action. Not only this but the type of work you are engaged in as a nurse is extremely humbling and I don’t know why any nurse would think this acceptable, to gossip and discuss their patients and their families. Quite honestly, she should be ashamed of this factor alone even if not guilty.

I’ve only personally encountered this level of unprofessional misconduct from colleagues on one or two occasions and I was troubled by it enough to raise it further. It is a huge no-no IMO

 

[esther43]

Any time positive pressure is given, lots of air goes into the bowel. That is not unusual.

Did they get a gas between intubation and extubation I wonder? It is very unusual to extubate a baby like that, IMO.

I don't see clear information given on how they are alleging she harmed baby I. Is it spelled out and I've missed it?

I struggle with people assigning motivation to out of context texts and messages. While they can be interpreted in the worst possible light if she is guilty, if she is innocent (which should be the assumption) none of them are concerning at all, IMO.

I do agree that the text messages form relatively weak evidence and once the defence come in, I am sure they will have their own narrative.
When you look at the messages simplistically they seem relatively normal, when you add the idea of a 'baby killer' to them, understandably they take on a different tone.

 

[Kemug]

I feel exactly the same. Just why, why not be more diplomatic and professional about it rather than treating like some school playground gossip. Extremely unprofessional.

And if she must comment, she could have said something about being glad the parents could comfort each other.

 

[Sundial]

And if she must comment, she could have said something about being glad the parents could comfort each other.

Well really she didn’t need to comment at all. If she was concerned about it, she could and should have asked to discuss it (as a private matter) with her manager. Even if that *was* what they were allegedly doing, it’s being shared quite descriptively (what she was wearing) and openly to the point of (imo) almost to humiliate them. It’s as if she has no filter on anything she shares; be it patients details, parents information etc.

The other thing I also thought; perhaps they were actually asleep and in a disoriented state, were cluttering out of bed in an unfamiliar environment- which the accused LL just happens to be the one that discovers this and states that’s what they were doing; even if they weren’t.
JMO

 

[Dotta]

LL just happens to be the one that discovers this and states that’s what they were doing; even if they weren’t.
JMO

As we say in my country:

"The hungry always think of bread"

 

[ColourPurple]

I do agree that the text messages form relatively weak evidence and once the defence come in, I am sure they will have their own narrative.
When you look at the messages simplistically they seem relatively normal, when you add the idea of a 'baby killer' to them, understandably they take on a different tone.

The text messages are useful for seeing what was going on in the "background" . For example the ones where LL appeared desperate to be back working in room 1 the shift after Baby A's death and had not been allowed. And these recent ones where it's revealed that somebody had apparently made the decision that no nurse should have baby I for two shifts in a row.(not sure if this only applied to Baby I , or other babies too)

 

[Tortoise]

No

Okay, so going by today's report I'm confused as to why baby I is on another pause in feeds at this point when it's been suggested that he had made a recovery since returning to CoC and had even since progressed on to bottles. To me this reads that the bowel problem hadn't gone away but had flared up again IMO.
Also, on arrival at the level 3, it is claimed in last week's evidence that the unit declared that child I did not have NEC but it's noteworthy that he was on significant breathing support (ventilation) and was treated for NEC imo. (A pause in feeds and two strains of antibiotics) after which child I progressed on to CPAP.
The results of the contrast study (dye in the bowels) was referenced today but not interpreted.

mini timeline

18 Sep - 6 weeks old - mum says she looked like a full term baby.

30 Sep - 1st alleged attempted murder baby was being fed by bottle (& NGT when asleep). Doctors were suspicious of NEC because of bowel distention so they put her nil by mouth. A lot of air was aspirated. They prescribed antibiotics. Next day she had improved so by evening they restarted her feeds with caution.

13 Oct - 2nd alleged attempted murder - baby was now on 4 hrly bottle feeds. LL pointed out baby was pale in her cot. She collapsed, CPR performed. x-ray showed gaseous distention of abdomen & bowel. She was put on a ventilator.

14 Oct - 3rd alleged attempted murder - baby had been stable evening before. 5am LL noted distended abdomen & discolouration. oxygen requirement increased. x-ray showed widespread gaseous distention sufficient to splint the diaphragm. 7.45am - baby collapsed & required 13 minutes of resuscitation. LL texted asking to have baby I again that night - she was refused. Dr Harkness reviewed baby at 4pm - she had improved - says suspected NEC. blood gases on poor side. suggestion of collapsed lung. blood tests awaited for signs of infection. planned for 2 weeks down the line for barium enema.

15 Oct - transferred to Arrowe Park with suspicion of NEC - still on ventilator - nil by mouth - TPN feeds. 7 days antibiotics. taken off ventilator, but on breathing support when discharged - no longer needed to be at Arrowe by 17th.

17 Oct - transferred back to Countess. Mum says baby was looking through her now.

22/23 Oct - alleged murder - LL had been off work, returned on 22nd. pink, alert etc gaining weight. end of day very hungry. Ashleigh Hudson designated nurse (same nurse as 13 Oct - who said LL noted baby was pale in the dark) - baby was awaiting barium enema at another hospital which was urgent but non-emergency. optimal readings. not on ventilator. removed long line because it was not flushing, TPN moved to peripheral line. Just before midnight very unsettled & atypical loud crying. baby collapsed - 5 mins CPR - then placed on ventilator. she was soon fighting it so taken off. x-ray showed large stomach bubble. purple mottling. she then started crying again same loud relentless crying while nurse was out of the room & LL was at the incubator. LL said she just needs to settle. collapsed & given 8 doses of adrenaline and 30 mins of chest compressions followed by another 20 mins. baby died.

post mortem showed no NEC.

 

[sapphireminds]

I do agree that the text messages form relatively weak evidence and once the defence come in, I am sure they will have their own narrative.
When you look at the messages simplistically they seem relatively normal, when you add the idea of a 'baby killer' to them, understandably they take on a different tone.

I think for nearly every person, if you take their texts/comments/messages out of context and accuse them of a horrific crime, you'll find messages that would be seen as "chilling" or whatever, in that context.

I think the reason I am uncomfortable with the way they are analyzed by most is that they are only looked at with the assumption of guilt. If you do not assume guilt, they just are normal texts.

 

[Kemug]

I totally agree. I can't think of a logical or innocent reason for keeping a photo on your cell of the bereavement card you just sent. ...supposedly to people you barely knew.

I had been thinking that the photo was of the front of the card - some nice picture of flowers, etc. Which I didn't see as too bad. But now, learning that the photo was of what LL wrote on the card, it changes things for me. Really weird, IMO.

 

[Sundial]

I think for nearly every person, if you take their texts/comments/messages out of context and accuse them of a horrific crime, you'll find messages that would be seen as "chilling" or whatever, in that context.

I think the reason I am uncomfortable with the way they are analyzed by most is that they are only looked at with the assumption of guilt. If you do not assume guilt, they just are normal texts.

I find myself somewhat agreeing but only to a certain point. I find it difficult to ignore similar testimonies of these parents and now the nurse. The crying, the timing, the possible (alleged) falsifying of medical notes is really quite worrying.

Whilst we have still a lot more of the trial to hear, and she might genuinely be innocent (as valid point you raise), what I am really concerned by, is disregard for patient confidentiality and misconduct going on here whether guilty or not (or whether others on the unit are doing the same thing to these families) and that is not right. It is in complete violation with nursing register requirements supposed to be upheld by the nursing and midwifery council IMO.

Standards

NMC Standards for nurses and midwives in the UK

www.nmc.org.uk

 

[Tortoise]

I think for nearly every person, if you take their texts/comments/messages out of context and accuse them of a horrific crime, you'll find messages that would be seen as "chilling" or whatever, in that context.

I think the reason I am uncomfortable with the way they are analyzed by most is that they are only looked at with the assumption of guilt. If you do not assume guilt, they just are normal texts.

I don't think anyone here is assuming anything. In the main, at WS, we apply logic, reason and argument to make considered opinions, not assumptions. Just like the jurors will be doing.

It's not a very well-reasoned argument, if one is undecided, to say that everyone else is assuming anything.

We are over halfway through the trial and have heard a lot of evidence, for five deaths and many more collapses. We already have the defence case for eight of the babies - it's been articulated in opening speech and in the cross-examination of the prosecution experts. There will be no surprises pulled out of the hat, that's not how our trials work. Cards are on the table throughout every examination of every witness. The defence case has to be put to the expert witnesses so that they can explain to the court if and why they disagree.

I think most would agree that this case is about determining whether what happened to these babies was natural or usual, through hearing what scores of treating nurses, doctors, consultants and experts have to say. That's a whole lot of medical training and decades of experience packed into one place.

One's interpretation of the texts and the notes will be viewed through the lens of one's opinion of the evidence that has been led, not out of context at all, or through the lens of what any old Joe would write. IMO

 

[katydid23]

I think for nearly every person, if you take their texts/comments/messages out of context and accuse them of a horrific crime, you'll find messages that would be seen as "chilling" or whatever, in that context.

I think the reason I am uncomfortable with the way they are analyzed by most is that they are only looked at with the assumption of guilt. If you do not assume guilt, they just are normal texts.

IDK. Even if she is innocent, as assumed, some of the texts are not really so normal, imo.

Like the ones where she insists on going right back into the room for critical care, even immediately after 2 or 3 babies died unexpectedly in succession. Even if innocent, I'd think she would want a break to process some grief and figure out what was happening. Maybe clear her head a bit?

But she insisted she needed to stay in there and when others pointed put her run of 'bad luck' she'd quickly deny it and say it was fate or coincidence.Or she'd quickly blurt out a quick diagnosis for the mysterious deaths. It seemed a bit off to me. JMO

 

[MsBetsy]

The text messages are useful for seeing what was going on in the "background" . For example the ones where LL appeared desperate to be back working in room 1 the shift after Baby A's death and had not been allowed. And these recent ones where it's revealed that somebody had apparently made the decision that no nurse should have baby I for two shifts in a row.(not sure if this only applied to Baby I , or other babies too)

Yes, after the head nurse suggested she needed a break from rm 1, Letby told her she thought it would be good for her to see a living baby in the space a dead one had been.

Later in a text she mentions something about already having gone into room one to give medications. About 20 minutes after the conversation, Baby C collapsed.

I do think the text messages help put everything into context. They give the jury a glimpse of what was going on inside Letby's mind as the incidents were occurring.

 

[GoodDayToYouSir]

I find myself somewhat agreeing but only to a certain point. I find it difficult to ignore similar testimonies of these parents and now the nurse. The crying, the timing, the possible (alleged) falsifying of medical notes is really quite worrying.

Whilst we have still a lot more of the trial to hear, and she might genuinely be innocent (as valid point you raise), what I am really concerned by, is disregard for patient confidentiality and misconduct going on here whether guilty or not (or whether others on the unit are doing the same thing to these families) and that is not right. It is in complete violation with nursing register requirements supposed to be upheld by the nursing and midwifery council IMO.

Standards

NMC Standards for nurses and midwives in the UK

www.nmc.org.uk

I think this is a really important point. The fact that LL is talking about patients in text messages to colleagues is in no way to me evidence of her being a murderer. It seems that a significant number of staff at the hospital (just based on what we’ve seen of the text messages discussed so far) also talk about patients in text messages . I can’t remember which baby it was for, but I recall text messages being presented in court where another nurse was texting LL to give her an update on a particular baby when she wasn’t on shift . So other members of staff were initiating conversations in which patients were discussed with LL.

In addition to this, in relation to the cases where LL appears to initiate the text message conversation regarding a particular patient, none of the members of staff with whom she is texting seem to shut her down, or refuse to participate in the discussion on the basis that it is unprofessional and in breach of patient confidentiality.