UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #14

[Tortoise]

Lucy Letby trial: ‘Unusual’ amount of gas detected in baby

AN “unusual” amount of gas was detected in a baby just hours after his brother was allegedly murdered by nurse Lucy Letby, a court heard.

www.chesterstandard.co.uk

snipped for copyright

[...]

Dr Arthurs came to the same conclusions regarding an X-ray of Child O, captured hours before his death.

He said: “This shows a lots of gas in his stomach, small and large bowel. This is more than what would be expected in a normal baby.”

Dr Arthurs agreed with Ben Myers KC, defending, that another possible explanation for Child P’s dilation was an “unidentifiable cause”.

[...]

Ahead of the shift a doctor, who cannot be identified for legal reasons, messaged Letby: “Are you OK? It’s rubbish not to sleep well in the middle of 3 long days. Hope your day goes OK.”

Letby replied: “Hmm maybe. I’ll be watching them both (Child P and the surviving triplet) like a hawk.

“I’m OK. Just don’t want to be here really. Hoping I may get the new admissions.”

 

[esther43]

interesting indeed

They said in opening speech she sent the student with a baby going for an MRI at around 8.30am and the problems started for baby P.

I noticed this too.
Previously said student was “glued to her” (which I’ve actually heard others who mentor say similar things; one went on to elaborate one of her students even followed her to the loo!). A student needing reassurance or is unsure is not necessarily unusual.
That said, could it be possible even the student might have picked up something wasn’t right (as did the nursing colleague who said LL undermined her over moving one of the triplets)?

Then… LL is mentioning not having the student because she wasnt in the right frame of mind. Which is really odd because she didn’t want to take time off, and previously appears to point out she’s fine, doesn’t need counselling etc; really odd imo.

I've noticed that in many of the cases included there were either new starters, new responsibilities or new students.
When there have been more experienced staff around, they seem to be on breaks.jmo

 

[Sundial]

interesting indeed

They said in opening speech she sent the student with a baby going for an MRI at around 8.30am and the problems started for baby P.

Reminds me of the mother who reported that LL told her to go back to the ward (baby E?? I think).. getting rid of the mother, getting rid of the student.. parents going home, away from the ward, to eat, staff on their break etc
MOO

 

[Phoenix Lazarus]

They deal with the last alleged victim next week, don't they?

 

[magikarpmagikarp]

I am going belabor the embolism point again... history is so important in figuring out what is going on. In order to have suspected an air embolism in the situations that existed and CoC they would have had to have suspicion of someone deliberately harming babies and/or withholding important information. This was not a case of inadequate knowledge. And it was a situation where additional knowledge could not be gained.

If on the other hand, collapse A happens and the nurse calling the doctor says, "Doctor, we had just started the IV fluids and the baby became tachycardic and hypoxic. Then we noticed that the line was not fully primed so we stopped the infusion..." and the baby needed CPR.... that's a bingo air embolism. No rash needed. There's actually a journal article out there that details this exact situation, except they didn't have the IV tubing to examine. What happened is only known because someone told the truth. Then, the doc at the head of bed for that resus could say, "Hey, that baby with the air embolism had a weird fleeting blue, red and white rash; I bet that was related. I bet that was caused by air disseminated throughout the venous circulation" because that's a really easy deduction to make if you have all or even some of the information. Otherwise, you could say, "Hmm this perfectly well patient about to be discharged tomorrow collapsed after the PICC was removed and we tried for 30 minutes and we couldn't resuscitate them." (Or we tried for 30 minutes and suddenly got a heart rate back!) You don't even need the rash to say, I wonder if that could have been an air embolism. The rash is a distraction. It's cool, it's a cool little sign but without a history suggestive of air embolism, you will still have to make the leap to: "Someone did this on purpose."

At CoC other staff began worrying about the association between the accused and the collapses a full year before she was taken off duty. IMO administration needs to listen to the people on the ground more.

 

[Tortoise]

“I’m OK. Just don’t want to be here really. Hoping I may get the new admissions"

Quoted text ^ by LL.

Hmm. I wonder why she would point out disinterest in the babies she is looking after...

JMO

 

[Dotta]

Reminds me of the mother who reported that LL told her to go back to the ward (baby E?? I think).. getting rid of the mother, getting rid of the student.. parents going home, away from the ward, to eat, staff on their break etc
MOO

Some say that "creative" work demands solitude, no?

 

[magikarpmagikarp]

If anything this case has shown the NHS needs more robust processes in place for staff to safely express concerns or blow the whistle without being dismissed.

And I think this is the real takeaway.

 

[DianaWW]

Letby replied: “Hmm maybe. I’ll be watching them both (Child P and the surviving triplet) like a hawk.

“I’m OK. Just don’t want to be here really. Hoping I may get the new admissions.”

Snipped for focus.

If she 'really didn't want to be here' you'd think she'd have jumped at the chance to take the weekend off when offered. I get the feeling her answer to her Dr friend is more what she thinks she'd be expected to say, rather than how she actually feels. Or perhaps I'm overthinking it JMO.

 

[magikarpmagikarp]

According to what I have read there is an option to actually remove the bubble mechanically but I think that assumes you know what it is. Involves actually putting something in and drawing the gas bubble out of the vessel. Wouldn’t see why that wouldn’t work with a solid blockage.

Sweeps, I missed this! Yes, apparently that is an option. There's an article about a kid who developed AE after cardiac surgery and had a carduac arrest... they re-opened the chest, could literally see the bubbles, and aspirated the air right out of the superior vena cava! They had to put the baby on cardiac bypass for half an hour. Really cool. IDK how feasible this would be without a cardiac surgeon at the bed, tho. Maybe something ultrasound guided as a last resort? IDK, pure speculation on my part.

<modsnip - quoted post and response removed; sub judice>

 

[Sweeper2000]

<modsnip quoted post and response removed; sub judice>

yeh said something like that about removing the bubbles. I can’t remember if it said they opened them up or inserted something down an artery. Thought it would be less invasive to go through the arteries but I think there’s so little time I don’t know what’s reasonable to expect to be able to do. On a neonate I’d be clueless.

 

[magikarpmagikarp]

<modsnip>

yeh said something like that about removing the bubbles. I can’t remember if it said they opened them up or inserted something down an artery. Thought it would be less invasive to go through the arteries but I think there’s so little time I don’t know what’s reasonable to expect to be able to do. On a neonate I’d be clueless.

I think they reopened the chest because they had just been in the chest, so that's the logical place to look for problems. And I guarantee no one is doing that in a NICU during a code. Maybe some kind of ultrasound guided needle procedure as a last resort. That would not be a standard practice though and it would be difficult to study.

 

[Sweeper2000]

I think that you’re on the right lines regarding psychological assessment, but nearly everyone has thoughts, maybe intrusive thoughts, of a disturbing nature. There is no chance (usually) of carrying things out.

Many people will not admit to such thoughts.

It’s much more nuanced when apprehending true evil in a person, I think.

True evil being a genuinely rare thing is difficult to study. They would ofc have to answer honestly and one of the things about the most heinous acts you have ever heard of are what’s often a spine wracking level of commitment behind them. they Will often move heaven and hell to get whatever they want. No lie is too big. In all honesty I think probably all of the literature written about this kind of thing is done after confinement so difficult to intercept really. Very different from someone going on a rampage.

tbh after reading all the evidence involved in this has given me no doubt that any medical personnel dealing with this kind of work should probably have routine assessments. Not out of doubt but to ensure that staff are as well looked after as possible. Shouldn’t really be left to someone suggesting they just shrug off the stress etc

 

[Theomumx14]

Is anyone still unsure like me?? I just can't wrapped my head around y n how not noticed sooner.... Beverly allitt was caught in 2 months

 

[LorriB]

Is anyone still unsure like me?? I just can't wrapped my head around y n how not noticed sooner.... Beverly allitt was caught in 2 months

I think it's foolish to be sure either way at the moment as we haven't had both sides of the story and we are only getting very small snippets of conversation to base it on.

 

[LorriB]

"He said potential causes were infection or necrotising enterocolitis (NEC), a common bowel disorder in premature-born babies."

Interesting that a prosecution called expert considers NEC as a potential cause.

 

[DianaWW]

Is anyone still unsure like me?? I just can't wrapped my head around y n how not noticed sooner.... Beverly allitt was caught in 2 months

From the last few days of evidence it seems that people did notice sooner. It was the fact that senior management refused to believe it and take any action, that seems to be the reason this continued as long as it did.

But there is absolutely nothing wrong with being unsure. We haven’t heard all of the evidence, and are not hearing it in its entirety in any case. JMO.

 

[katydid23]

I've never worked in the public sector and certainly no where as sensitive as a medical environment but I don't see that there would be many reasonable objections if there was no way in which the video could be viewed unless under very specific circumstances which would be laid down in the Act.

I think the real stumbling block would be the cost; you'd potentially need cameras covering every bed, in every pharmacy, in every store room where medications or equipment could be fiddled with, in every operating theatre, over every ward door etc, etc, etc. The cost would be immense!

And even with all those cameras, it could still miss any crime once the perp knew about the cameras. I think someone could still taint TPNs and leak air into a tube, without being seen actually doing anything wrong. JMO

 

[squish]

Is anyone still unsure like me?? I just can't wrapped my head around y n how not noticed sooner.... Beverly allitt was caught in 2 months

Beverley Allitt was not very bright and blatantly mentally ill, so it didn’t take long at all for her to mess up. She was compulsively attention seeking by causing catastrophes, with little thought to her victims and only very short term planning.

Whereas Lucy Letby seems intelligent (or at least not dim), hardworking and superficially appears very normal. If guilty, her methods have been far more varied, sneaky and well planned. If guilty, her purpose would have been to harm the babies for fun, whereas for Allitt, the harm to the children was incidental to her extreme attention seeking.

 

[katydid23]

One might think that would actually be a good way to differentiate between sick babies collapsing and completely unexpected events. If she is around and a perfectly healthy baby collapses then that’s a big question mark. Again though we have to assume they could get the replacement staff in, she was a valued indivisual with high tier training.

There were perfectly healthy babies that collapsed and even died. That's why we are all here. JMO