UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #13

[Tortoise]

Dan O'Donoghue

@MrDanDonoghue
·
29s

The doctor tells the court that on that morning he took the decision to intubate Child N and put him onto a ventilator. He recalls seeing 'unusual' swelling and blood in the back of the baby boy's throat

 

[Tortoise]

Dan O'Donoghue

@MrDanDonoghue
·
4m

After three unsuccessful attempts to intubate, the doctor abandoned the procedure. His note from that morning states: 'intubation abandoned due to blood present at oropharynx and likelihood of trauma due to repeated attempts'

Dan O'Donoghue

@MrDanDonoghue
·
4m

Child N was then placed on non-invasive respiratory support

 

[katydid23]

Dan O'Donoghue
@MrDanDonoghue
·
4m

After three unsuccessful attempts to intubate, the doctor abandoned the procedure. His note from that morning states: 'intubation abandoned due to blood present at oropharynx and likelihood of trauma due to repeated attempts'

Dan O'Donoghue
@MrDanDonoghue
·
4m

Child N was then placed on non-invasive respiratory support

So some have been speculating that the blood and swelling happened because of the many attempts at intubation.

But the way I am reading it, the difficulties in completing the intubation was because of the swelling and bleeding which was present from the start?

 

[LorriB]

So something unusual was going on with baby N before LL started her shift. The mottling is noted first of all at 1am.

 

[Tortoise]

Dan O'Donoghue

@MrDanDonoghue
·
3m

Ms Letby's defence lawyer Ben Myers KC is now questioning the doctor.

 

[katydid23]

So something unusual was going on with baby N before LL started her shift. The mottling is noted first of all at 1am.

1 am on which day?

 

[LorriB]

1 am on which day?

June 15th


1am nurse Jones-Key records Child N 'very unsettled' and was 'pale, mottled and veiny' with slight abdominal distension. Blood test performed

 

[Tortoise]

Rivetting cross-examination!

 

[WaxLyrical]

So some have been speculating that the blood and swelling happened because of the many attempts at intubation.

But the way I am reading it, the difficulties in completing the intubation was because of the swelling and bleeding which was present from the start?

We need to find out when these intubation attempts happened. This is the baby that LL is alleged to have done something when she walked in the room at 7:15am? (Please correct me if I’m wrong I’m finding this case tricky to keep track of).

So what we know now is that there were intubation attempts that morning, some swelling and blood was noted at the throat (back of mouth), and three attempts were made despite this. So it does seem to me that the swelling down at the vocal cords sufficient that they could not be visualised is more likely to have occurred as a result of this intubation attempt.

I think it just needs cleared up either way. The opening speeches had us believing that LL did something to cause horrendous swelling low in the throat, but not sure that’s the case. JMO.

 

[Tortoise]

Dan O'Donoghue

@MrDanDonoghue
·
7m

Myers is asking the doctor when he saw the blood in Child N's throat. He said 'I believe blood was there at insertion attempt number one' Myers puts it to him that 'if you can't see, you wouldn't attempt it?' He replies:'You can do, if quite certain of position'





Dan O'Donoghue

@MrDanDonoghue
·
2m

Mr Myers has just quoted the doctor's police statement from 2018. In this he says he was 'not sure' if the bleeding was his 'fault' due to his attempts to move the tongue with a medical implement to intubate

 

[JosieJo]

We need to find out when these intubation attempts happened. This is the baby that LL is alleged to have done something when she walked in the room at 7:15am? (Please correct me if I’m wrong I’m finding this case tricky to keep track of).

So what we know now is that there were intubation attempts that morning, some swelling and blood was noted at the throat (back of mouth), and three attempts were made despite this. So it does seem to me that the swelling down at the vocal cords sufficient that they could not be visualised is more likely to have occurred as a result of this intubation attempt.

I think it just needs cleared up either way. The opening speeches had us believing that LL did something to cause horrendous swelling low in the throat, but not sure that’s the case. JMO.

The swelling was there at attempt one I thought?

 

[DinerMite]

We need to find out when these intubation attempts happened. This is the baby that LL is alleged to have done something when she walked in the room at 7:15am? (Please correct me if I’m wrong I’m finding this case tricky to keep track of).

So what we know now is that there were intubation attempts that morning, some swelling and blood was noted at the throat (back of mouth), and three attempts were made despite this. So it does seem to me that the swelling down at the vocal cords sufficient that they could not be visualised is more likely to have occurred as a result of this intubation attempt.

I think it just needs cleared up either way. The opening speeches had us believing that LL did something to cause horrendous swelling low in the throat, but not sure that’s the case. JMO.

From what I gather the attempts were AM and PM.

So in a nutshell:

June 14th
LL finishes day shift and hands over to JJK. N is recorded by LL as being ready for home.

June 15th
1AM - JJK notes mottling and distension. Unnamed Doctor orders a blood test to rule out infection.

7AM - LL comes on shift and at 07:15 N suffers a desat and is moved to Room 1 and now assigned to LL. (Alleged that possible trauma to throat occurred here)

9AM (approx) - Unnamed Doctor attempted to intubate 3x but couldn't due to blood seen in mouth.

3PM - Dr. Mayberry performs intubation but is unsuccessful due to blood seen in mouth.


19:40 PM - Further desat, two consultants failed to attempt to intubate.

All sourced from the reporting of N these past few days.

Edited to add in the 19:40 event.

So I imagine there were 3 isolated occasions throughout the day where intubation was attempted.

 

[katydid23]

So something unusual was going on with baby N before LL started her shift. The mottling is noted first of all at 1am.

LL was the designated nurse for baby N on the previous shift. She handed him over on the 14th around 8 pm, and he was ready to be released to go home that day on the 15th.

At 1 am he was suddenly mottled and distended?

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

10% BBC - Lucy Letby: Nurse denied dislodging baby's breathing tube, trial hears "In a police interview, Ms Letby said the baby's designated nurse would not have left unless she was stable and the tube was in place. [...] Mr Johnson said: "Expert evidence is admitted into a criminal trial to...

www.websleuths.com

 

[WaxLyrical]

From what I gather the attempts were AM and PM.

So in a nutshell:

June 14th
LL finishes day shift and hands over to JJK. N is recorded by LL as being ready for home.

June 15th
1AM - JJK notes mottling and distension. Unnamed Doctor orders a blood test to rule out infection.

7AM - LL comes on shift and at 07:15 N suffers a desat and is moved to Room 1 and now assigned to LL. (Alleged that possible trauma to throat occurred here)

9AM (approx) - Unnamed Doctor attempted to intubate 3x due to another desat but couldn't due to blood seen in mouth.

3PM - Dr. Mayberry performs intubation but is unsuccessful.

All sourced from the reporting of N these past few days.

If it’s the same doctor then I don’t think he was working the day shift of the 15th, so I’m not sure these intubation attempts could have been 9am or later?

 

[LorriB]

LL was the designated nurse for baby N on the previous shift. She handed him over on the 14th around 8 pm, and he was ready to be released to go home that day on the 15th.

At 1 am he was suddenly mottled and distended?

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

10% BBC - Lucy Letby: Nurse denied dislodging baby's breathing tube, trial hears "In a police interview, Ms Letby said the baby's designated nurse would not have left unless she was stable and the tube was in place. [...] Mr Johnson said: "Expert evidence is admitted into a criminal trial to...

www.websleuths.com

Yep, no reports of mottling between 8pm and 1am, only notes to say demand feeding. So it seems to have just appeared during the night shift.

 

[DinerMite]

If it’s the same doctor then I don’t think he was working the day shift of the 15th, so I’m not sure these intubation attempts could have been 9am or later?

Lucy Letby records, in a not written at 1.53pm for care at about 9am: 'Unable to intubate - fresh blood noted in mouth and yielded via suction ++.'

11AM LL texts Doctor: "Sorry if I was off during intubation...I like things to be tidy & calm (Well, as much as possible!).

Same doc, happened at approx 9. First attempt to intubate, hence why his testimony is key.

 

[Tortoise]

If it’s the same doctor then I don’t think he was working the day shift of the 15th, so I’m not sure these intubation attempts could have been 9am or later?

If they were working chronologically through the evidence this morning, together with electronic evidence already received, the sequence is -

he ordered a blood test (this is in notes at 1am)
mottling resolved but kept desaturating over following hours
he did a septic screening (this is in text before 5.10am)
desaturation and crying, & JJ-K testified she thinks he stopped breathing, at 7.15am - baby given neopuff
by 8am mottling returned - moved to nursery 1
attempted intubation sometime in the hour between 8am and 9am
9am LL's note - unable to intubate

 

[Sweeper2000]

All JMO

I think Dr. Evans was suggesting that air was injected into the giving set (tubing) via the port near the baby. This would take some time to reach the bloodstream, as infusions for small newborns are typically quite slow - maybe 3-5mls an hour. The port is normally used for drugs such as antibiotics, and you have to flush the port afterwards for that very reason.

I know nothing about AE!

so do they know exactly what equipment was used for treatment here? Or is it all standardised? or given as routine.

im wondering if this port was noted as present from get go. Also if it’s used for anti bio is there a holding capacity in ml?

 

[Tortoise]

https://twitter.com/MrDanDonoghue
Dan O'Donoghue

@MrDanDonoghue
·
10s

We're back after a short break. Retired consultant paediatrician Dr John Gibbs is now in the witness box. He was called to attend Child N at around 16:00 on June 15

 

[Tortoise]

let's hope tonight's papers catch us up properly on what's happening in court today.