UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #11

[Marantz4250b]

It would be very interesting to hear exactly how much insulin would have to have been administered in terms of ml. I doubt there would be a measuring notice on the vial itself but one might think if it was half a vial it would be noticed. I can’t say for sure though.

Would be interesting to know what size these were? The number ordered isn't really relevant (and may not be relevant anyway) unless they were all the same size.

 

[Sweeper2000]

24 m

Jury is now being read a summary of Ms Letby's police interview in relation to the collapse of Child L. She denied deliberately administering insulin and rejected the notion it could have been administered accidentally.


24 m

When police put it to Ms Letby that insulin was deliberately administered, she said 'that wasn't done by me'


23 m

Kate Tyndall, intelligence analyst employed by Cheshire Police, is now giving evidence. She is going over sequencing evidence (basically a long timeline) for the case of Child M - important to say both Child L and his brother survived the alleged attacks

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computers not copying and pasting properly so trying to fill in the blanks.

 

[Sweeper2000]

29 m

Jury hears in police interview Ms Letby agreed Baby L’s blood sugar levels were low and said you would not necessarily expect that but it was not a huge surprise as it can happen if a baby is distressed at delivery.

27 m

When in a police interview it was suggested to Ms Letby that Baby L may have received insulin as a deliberate act of sabotage, she replied “That wasn’t done by me.’
@BBCNWT

@bbcmerseyside

24 m

Jury now hearing more evidence about Baby L’s twin brother Baby M. Cheshire Police intelligence officer Kate Tyndall is taking them through the sequence of events as shown in medical notes etc relating to Baby M.

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[Sweeper2000]

Would be interesting to know what size these were? The number ordered isn't really relevant (and may not be relevant anyway) unless they were all the same size.

Very difficult to say really. I wouldn’t know if a single drop of insulin could cause fluxes like this as well. Hazarding a guess I might think the vials come in a standard 100 ml vial and the prescription filled out accordingly as per need. I’m not reading that these children needed ongoing insulin either so the number of vials limits what options a would be poisoner would have to draw it from. I’m not sure we have heard how long it would be stored either or processes for disposing it after no longer needing it.

 

[LadyEdgeworth]

“That wasn’t done by me.’

Why would you word it like that? Not 'that didn't happen' but “That wasn’t done by me.’ which you could take to mean it did happen, it just wasn't me.

 

[marynnu]

Would be interesting to know what size these were? The number ordered isn't really relevant (and may not be relevant anyway) unless they were all the same size.v

All views below are mine only.

I recall the vials are quite small - about 2 mls? A very small amount, less than 1 ml, is mixed with 50mls of saline then infused slowly, typically 0.1-0.8mls/hr depending on the blood glucose readings.

As you can see, this is very diluted indeed, yet still has a marked effect very quickly.

JMO

 

[Marantz4250b]

“That wasn’t done by me.’

Why would you word it like that? Not 'that didn't happen' but “That wasn’t done by me.’ which you could take to mean it did happen, it just wasn't me.

It sounds like a perfectly reasonable response given the context though. It had already been put to her that it would not have happened accidentally which she'd accepted. "That wasn't done by me" is a natural statement.

If she said "that didn't happen" it makes it look like shes challenging the police and is obviously flatly denying something which she'd agreed could not happen any other way.

 

[marynnu]

It would be very interesting to hear exactly how much insulin would have to have been administered in terms of ml. I doubt there would be a measuring notice on the vial itself but one might think if it was half a vial it would be noticed. I can’t say for sure though.

All views below are mine only.

I recall the vials are quite small - about 2 mls? Some are supplied as 10mls too I believe. A very small amount, less than 1 ml, is mixed with 50mls of saline then infused slowly, typically 0.1-0.8mls/hr depending on the blood glucose readings.

As you can see, this is very diluted indeed, yet still has a marked effect very quickly.

JMO .

 

[LadyEdgeworth]

It sounds like a perfectly reasonable response given the context though. It had already been put to her that it would not have happened accidentally which she'd accepted. "That wasn't done by me" is a natural statement.

If she said "that didn't happen" it makes it look like shes challenging the police and is obviously flatly denying something which she'd agreed could not happen any other way.

Agree to disagree, if I was completely innocent and they suggested that someone I work with may have purposefully tried to harm a baby I'd be very shocked and say that nobody at work would do that on purpose especially not me. That snippet doesn't seem to say she did accept it was done on purpose just they suggested it had been done, although the reporting is not great over twitter so it may have been said elsewhere that she did accept this could have only happened on purpose.

 

[Marantz4250b]

Agree to disagree, if I was completely innocent and they suggested that someone I work with may have purposefully tried to harm a baby I'd be very shocked and say that nobody at work would do that on purpose especially not me. That snippet doesn't seem to say she did accept it was done on purpose just they suggested it had been done, although the reporting is not great over twitter so it may have been said elsewhere that she did accept this could have only happened on purpose.

24 m

Jury is now being read a summary of Ms Letby's police interview in relation to the collapse of Child L. She denied deliberately administering insulin and rejected the notion it could have been administered accidentally.

She rejected the notion it could be accidental so accepts that it was deliberate. In that context "...it wasn't me.." or similar is a perfectly normal statement, imo.

I get what you are saying as regards expressing shock at the idea that the police are suggesting that someone did it but, again, we don't know the full context of these interviews; we do know that she was arrested three times and held for the maximum time each time (3 days, apart from the last one where she was charged) so how she would react is going to depend on circumstances. If she'd had three days of the police telling her that she or someone else was killing babies then it's not likely, imo, that she'd react with shock and confusion each time.

 

[LadyEdgeworth]

24 m

Jury is now being read a summary of Ms Letby's police interview in relation to the collapse of Child L. She denied deliberately administering insulin and rejected the notion it could have been administered accidentally.

She rejected the notion it could be accidental so accepts that it was deliberate. In that context "...it wasn't me.." or similar is a perfectly normal statement, imo.

I get what you are saying as regards expressing shock at the idea that the police are suggesting that someone did it but, again, we don't know the full context of these interviews; we do know that she was arrested three times and held for the maximum time each time (3 days, apart from the last one where she was charged) so how she would react is going to depend on circumstances. If she'd had three days of the police telling her that she or someone else was killing babies then it's not likely, imo, that she'd react with shock and confusion each time.

Thanks, I had missed that! I do agree that every person reacts differently and I don't think she needs to insist she's innocent to every single question they ask of course, as you say she had been interviewed multiple times. I'm sure I remember one of her other answers about a TPN bag saying something like 'perhaps it wasn't what we thought it was' so at some point she does seem open to the idea that someone on the ward is doing nefarious things/tampering with things.

 

[marynnu]

That wou

I wonder if the records show who ordered them? Presumably it would be someone in a managerial/doctor type role rather than just nurses?

That would be unusual in my opinion. Any trained nurse can order stock medications. But yes, there will be a paper trail.
EDIT doctors don't order stock drugs.

As ever, JMO.

 

[Sweeper2000]

it’s very difficult to read actually. I can’t even say for sure she means it must have been put in with the intent to harm rather than someone confusing insulin with something else.

 

[ColourPurple]

Agree to disagree, if I was completely innocent and they suggested that someone I work with may have purposefully tried to harm a baby I'd be very shocked and say that nobody at work would do that on purpose especially not me. That snippet doesn't seem to say she did accept it was done on purpose just they suggested it had been done, although the reporting is not great over twitter so it may have been said elsewhere that she did accept this could have only happened on purpose.

I was interested in the wording too and the exact wording the police used (which we dont know AFAIK)

"When police put it to Ms Letby that insulin was deliberately administered, she said 'that wasn't done by me'

If she's innocent then it doesnt seem too unusual a response IMO BUT also ...

If the police did specifically use the word "administered" ... if guilty, and if LL "only" put the insulin in the bag/glucose solution and then let the other nurse actually set it up and "administer" it, then her response would technically be truthful , that she hadnt administered it.

 

[Sweeper2000]

That wou
That would be unusual in my opinion. Any trained nurse can order stock medications. But yes, there will be a paper trail.
EDIT doctors don't order stock drugs.

As ever, JMO.

Really interesting post about the 2 ml vial. I would not have guessed it would be such a minute amount of liquid. That’s like a drop. I’m wondering what would happen if someone put a larger amount than that if only 1 ml is needed. I would have thought 5 ml would show more extreme consequences and not be treatable really but that’s a guess from someone without a clue really. If it is such a small vial how was there any spare for a poisoning ? I always thought it would be a jar with plenty to spare but that doesn’t fit with it being a controlled substance.

im wondering if that creates scope for potential cross contamination. If it’s such a small amount it might be conceivable that a nurse wouldn’t even notice its presence in a syringe or something else. Despite all preventive measures.

 

[Marantz4250b]

Thanks, I had missed that! I do agree that every person reacts differently and I don't think she needs to insist she's innocent to every single question they ask of course, as you say she had been interviewed multiple times. I'm sure I remember one of her other answers about a TPN bag saying something like 'perhaps it wasn't what we thought it was' so at some point she does seem open to the idea that someone on the ward is doing nefarious things/tampering with things.

The whole thing is just so convoluted and confusing to be honest.

A quick one, if anyone knows; do British courts produce verbatim transcripts as US courts seem to do? I'm sure they don't, however, I think they did years back, before the modern Crown Court system, I seem to think.

 

[LadyEdgeworth]

The whole thing is just so convoluted and confusing to be honest.

A quick one, if anyone knows; do British courts produce verbatim transcripts as US courts seem to do? I'm sure they don't, however, I think they did years back, before the modern Crown Court system, I seem to think.

As far as I'm aware you can apply to get the transcript but they can deny your request

 

[Marantz4250b]

That wou
That would be unusual in my opinion. Any trained nurse can order stock medications. But yes, there will be a paper trail.
EDIT doctors don't order stock drugs.

As ever, JMO.

Thanks for that.

So, given that it hasn't been mentioned, I think that we can take it as read that the insulin orders were not placed by LL. I cannot imagine that that fact would have been left out of the prosecution's case were it actually the case.

 

[Tortoise]

I had a quick look back at Professor Hindmarsh's evidence for baby F, to see if any amounts were stated :



"Professor Hindmarsh says a rate of about 0.56ml/hr of insulin would have been required to lower Child F's blood sugar levels on the TPN bag."

"Overall, the infusion [rate] has essentially stayed the same.
"I can't be absolutely sure...but it's safe to assume that the glucose infusion rate did not change, which would imply that the amount of insulin around would be similar throughout the 17-hour period - allowing for the breaks when the infusion was discontinued."

By my reckoning that is 0.56ml x 17 = 9.52mls.

Professor Hindmarsh is shown a 10ml bottle of insulin, which normally comes with an orange, self-sealing cap.
To extract the liquid from the bottle, to administer 'therapeutically', a medical professional would have to use a syringe, the court hears. Mr Johnson says by 'therapeutically', Professor Hindmarsh means 'legitimately'. Professor Hindmarsh agrees, and says the dose would have to be measured out carefully.

Recap: Lucy Letby trial, Friday, November 25

It sounds to me like virtually a whole 10ml bottle was used on baby F, unless that's not how you calculate it.

 

[Marantz4250b]

I was interested in the wording too and the exact wording the police used (which we dont know AFAIK)

"When police put it to Ms Letby that insulin was deliberately administered, she said 'that wasn't done by me'

If she's innocent then it doesnt seem too unusual a response IMO BUT also ...

If the police did specifically use the word "administered" ... if guilty, and if LL "only" put the insulin in the bag/glucose solution and then let the other nurse actually set it up and "administer" it, then her response would technically be truthful , that she hadnt administered it.

Hmmm, I'm not sure I'd agree there. If you poison a bag with something but someone else gives it to the patient then you kind of did administer it, you just did it by a rather circuitous route. At best you "caused" it to be administered.

I can certainly see how a guilty person might use that rationale to absolve themself of blame, though.