UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #12

[Tortoise]

12:09pm

The court has just had a short break.
Claire Hocknell is now talking the court through the neonatal unit review schedule, which documents that Child K was admitted to neonatal unit nursery room 1 at 2.40am on February 17, 2016.
The designated nurse for Child K was Joanne Williams, who was also a designated nurse for a baby in room 2. Lucy Letby was the designated nurse for two babies in room 2.

Recap: Lucy Letby trial, Monday, February 27

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

Tweets from ITV -

https://twitter.com/MelBarhamITV

I’m covering the trial today of Nurse Lucy Letby who is accused of murdering 7 babies and attempting to murder 10 others. Today the jury are hearing about the case relating to baby K

Lucy Letby is accused of attempting to murder baby K by interfering with an ET tube. Baby K later died but the court heard the prosecution is not alleging it caused the death a few days later. The court has been read a statement from baby K’s mother.

Court now hearing from police analyst detailing some texts messages from Lucy Letby, swipe data showing staff entering the unit at Countess of Chester hospital and medical notes

Lucy Letby was not the designated nurse for Baby K. She was looking after 2 babies in another room that night shift

Swipe data shows Baby K’s designated nurse leaving nursery room 1 to go to labour ward at 03:47. It is after this that the prosecution allege Lucy Letby attempted to murder baby K. At 03:50 there is a sudden deterioration of baby K’s sats and she is bagged via ET tube

Lucy Letby denies all the charges against her

Jury told that 2 years after the death of Baby K, Lucy Letby did a Facebook search on the surname of Baby K. We can’t name Baby K for legal reasons

 

[WaxLyrical]

One thing that has remained in the back of my mind throughout this is that 15 babies died in a period where they normally lost 2 or 3.

Letby is being charged for 7 of them, but that still leaves a situation where there were double/triple the number of deaths on that ward, which they cannot pin on Letby. That still feels like a very significant spike.

I truly hope the jury is going to be provided with the wider context on those deaths, I assume all of them were explainable and not down to failures of care, and not just that Letby wasn’t around for them.

JMO.

 

[JosieJo]

One thing that has remained in the back of my mind throughout this is that 15 babies died in a period where they normally lost 2 or 3.

Letby is being charged for 7 of them, but that still leaves a situation where there were double/triple the number of deaths on that ward, which they cannot pin on Letby. That still feels like a very significant spike.

I truly hope the jury is going to be provided with the wider context on those deaths, I assume all of them were explainable and not down to failures of care, and not just that Letby wasn’t around for them.

JMO.

It's difficult to say isn't it as LL may or may not have been linked to those cases ..its possible she was but the evidence was not strong enough to charge ...or of course could not be

 

[Parker Knoll]

Initially they had absolutely no idea what was going on.

 

[katydid23]

One thing that has remained in the back of my mind throughout this is that 15 babies died in a period where they normally lost 2 or 3.

Letby is being charged for 7 of them, but that still leaves a situation where there were double/triple the number of deaths on that ward, which they cannot pin on Letby. That still feels like a very significant spike.

I truly hope the jury is going to be provided with the wider context on those deaths, I assume all of them were explainable and not down to failures of care, and not just that Letby wasn’t around for them.

JMO.

I'm wondering if they just don't have enough evidence to charge her with the remaining ones, although they might have suspicions.

There are cases where they can pinpoint LL being the last to give the victim their meds or their personal care. But there may be some where other nurses were in that room around same time so they cannot make a solid case against only her?

 

[DickieDumDum]

Thanks to everyone for the updates and analysis. What is the relevance of her searching for the surname on Facebook two years later? Is this part of a pattern?

 

[Tortoise]

12:29pm

An agreed statement is now being read from Dr Jonathan Ford, a former registrar at the Countess of Chester Hospital.
He reviewed the mother of Child K before the baby girl was born, and discussed the issues of extreme prematurity.
He said the longer the pregnancy could be, and delaying of the birth, the better.
He reviewed the mother again at 9pm on February 16, and it was agreed for 'conservative management'.
She was called back on February 17 at 1.20am, when the mother was 'in pain, in active labour'.
It later became 'inevitable' the mother would give birth. He delivered the baby. The birth was "uneventful" and Child K was passed over to the paediatricians.
It was noted, at the 14-week scan, Child K had a cystic growth at the back of her neck.
A detailed scan at week 16 and week 20, that was resolving, and there were no problems with how Child K's heart looked.

12:39pm

The next witness to give evidence in court is Dr James Smith, who was employed at the Countess of Chester Hospital in February 2016 as a specialist registrar.
Dr Smith recalls he did have a memory of Child K. He recalls being notified there would be a delivery of a '25-weeker' baby.
He recalls being present at the birth, and the baby girl was born in 'expected condition'. The Apgar scores of 4, 9 and 9 are 'good'.
Asked about the 'dusky, floppy, no resp effort' note, Dr Smith says the gestation presentation can be variable, but a good/reasonable sign is a heart rate, 'no resp effort' is not unexpected and the baby would present as 'floppy' as there had yet to be any breathing support supplied by medical staff.

12:40pm

He tells the court full airway breathing resuscitation support would be required, but that would 'not be unexpected' for a baby as premature as Child K.

Recap: Lucy Letby trial, Monday, February 27

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

 

[JosieJo]

Thanks to everyone for the updates and analysis. What is the relevance of her searching for the surname on Facebook two years later? Is this part of a pattern?

She searched many of the alleged victims families sometimes more than once ..sometimes a group of them together

 

[Tortoise]

Thanks to everyone for the updates and analysis. What is the relevance of her searching for the surname on Facebook two years later? Is this part of a pattern?

well it happened 2 years after she was no longer doing nursing, and a couple of months before her arrest. She apparently remembered the baby despite her only being in the hospital for a matter of hours before LL went off shift, and not being her designated nurse.

The defence has said she also searched parents of babies not included in the charges, but I'm not sure when that stopped.

 

[Tortoise]

12:49pm

Dr Smith describes the procedures he would have taken to stabilise a baby such as Child K in this scenario.
He says Child K's heart rate improved to 100bpm within two and a half minutes, and she was making respiratory gasps. The decision is then made to intubate.
The intubation is "technically difficult", he tells the court, due to the baby's size, and can take multiple attempts. He says Child K was stabilised after each attempt, and he had no worries about doing the procedure himself, without needing to hand over the procedure to the consultant, Dr Ravi Jayaram.
He successfully intubated Child K on the third attempt with a size 2.0 tube.

Recap: Lucy Letby trial, Monday, February 27

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

12:53pm

He tells the court if he had seen any signs of trauma, such as bleeding, on Child K at the time of intubation, he would have passed the procedure on. To the best of his recollection, he did not see any signs of trauma.
He tells the court there is nothing in the notes of any sign of trauma at this point.
The general clinical picture was Child K's signs were 'good', the resuscitation 'had gone successfully' and the first blood gas record was 'good - reasonable for the first reading'.

12:57pm

He tells the court that for all babies of this prematurity, antibiotics would be administered.

Recap: Lucy Letby trial, Monday, February 27

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

 

[esther43]

I'm not saying they couldn't experience a fall in oxygen, but the typical pattern for an event is desaturation, followed by slowed heartrate. If you have good sats and can't keep the heartrate up, that's a sign that it is not respiratory based and would be a clear sign that it is something out of the ordinary.

In other words, a desat doesn't mean it couldn't be an embolism, but it would be more telling if they could keep the sats up but the HR was not responding. So it would be clearer that there was an issue that was out of the ordinary.

Why do you think it would cost that much more to keep the baby on a real monitor instead of just an apnea monitor?

Apnea monitors are not considered accurate because they rely on abdominal/chest movements and so it might miss an apnea because the baby was moving or struggling to breathe, or even sometimes they can pick up the heartrate, mistaking that for breathing. So it can miss life-threatening events, but pick up if non-events due to positioning as well. Apnea monitors alone are not used really any more at all in the US and Canada, not without HR monitoring. If the baby has to be sent home with monitoring, we'll usually just send them with a saturation monitor which will capture the HR as well as the saturations. Very rarely they will be sent home with a full monitor - I've never seen it.

Additionally, saturations and HR are much better markers of distress and issues than just an apnea alone. If the baby needs to be monitored, we would want it to be accurate and actually do something. As opposed to what has been suggested, that a child could be near death in their crib for an extended period of time but not picked up because their HR/sats weren't monitored.

Why would you spend the money for any monitoring that wasn't accurate or useful?

 

[Tortoise]

12:59pm

Dr Smith tells the court he would have been, to an extent, guided by advice from Arrowe Park Hospital in the treatment of a baby of this prematurity at the Countess of Chester Hospital.

Recap: Lucy Letby trial, Monday, February 27

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

 

[sapphireminds]

12:49pm

Dr Smith describes the procedures he would have taken to stabilise a baby such as Child K in this scenario.
He says Child K's heart rate improved to 100bpm within two and a half minutes, and she was making respiratory gasps. The decision is then made to intubate.
The intubation is "technically difficult", he tells the court, due to the baby's size, and can take multiple attempts. He says Child K was stabilised after each attempt, and he had no worries about doing the procedure himself, without needing to hand over the procedure to the consultant, Dr Ravi Jayaram.
He successfully intubated Child K on the third attempt with a size 2.0 tube.

Recap: Lucy Letby trial, Monday, February 27

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

Three attempts with a 2.0 tube is a lot and shows he was struggling to intubate and the consultant should have been doing it, IMO. In many hospitals, they will not let someone who isn't an expert intubator try for a micropreemie because of how difficult it is and the ease in injuring their airway. Usually though, it's 2 tries and done if they allow someone to try.

A baby that size/gestation typically would have a 2.5 ETT. The only times I've seen 2.0 used is with babies 400g and less.

 

[Dotta]

What is the relevance of her searching for the surname on Facebook two years later? Is this part of a pattern?

(Alleged)

Chronicle of Sudden Deaths

JMO

 

[GoodDayToYouSir]

11:51am

On Saturday, February 20, 2016, the decision is recorded to withdraw life support from Child K. The time of death is recorded as 5.28am.
The doctor records, as the cause, 'extreme prematurity' and 'severe respiratory distress syndrome'.
Lucy Letby made a Facebook search on April 20, 2018, at 11.56pm, for the surname of the family of Child K.

Recap: Lucy Letby trial, Monday, February 27

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

Ok, that is potentially interesting. She just searched the “surname”, not the full name of the parent(s). When they said searching the names, I assumed she was searching full names (eg “Malcolm tucker”, not just “tucker” so that there was fairly little doubt about the individual who she was looking for.

But given that it is a common surname in the Midlands and northern part of England, I wonder how they can be sure that she was searching for baby k’s parents?

 

[ColourPurple]

Ok, that is potentially interesting. She just searched the “surname”, not the full name of the parent(s). When they said searching the names, I assumed she was searching full names (eg “Malcolm tucker”, not just “tucker” so that there was fairly little doubt about the individual who she was looking for.

But given that it is a common surname in the Midlands and northern part of England, I wonder how they can be sure that she was searching for baby k’s parents?

How do we know it's a common surname?

 

[marynnu]

<modsnip: Quoted post was removed> ...IMO it's very easy to stray away from the core question of what happened to cause the crisis in the first place.

 

[JosieJo]

<modsnip: Quoted post was removed> ... IMO it's very easy to stray away from the core question of what happened to cause the crisis in the first place.

I agree you also have to consider why LL told mum that the blood was due to the NGT rubbing and that the Dr was going to review ..yet did not call Dr for a further 40 mins

Dr Bohin concluded air embolism because of the pink fleeting blotches on abdomen