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

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  • #681

[Re Criminal Justice Act 2003]​

Defendant Bad Character Evidence​

The Seven Gateways​

The admissibility of evidence that falls outside the definition of bad character within the meaning of section 98 is governed by section 101 of the Act which provides that

“In criminal proceedings evidence of the defendant’s bad character is admissible if, but only if

  1. all parties to the proceedings agree to the evidence being admissible;
  2. the evidence is adduced by the defendant himself or is given in answer to a question asked by him in cross examination and intended to elicit it;
  3. it is important explanatory evidence;
  4. it is relevant to an important matter in issue between the defendant and the prosecution;
  5. it has substantial probative value in relation to an important matter in issue between the defendant and a co-defendant;
  6. it is evidence to correct a false impression given by the defendant; or
  7. the defendant has made an attack on another person’s character.

Important Explanatory Evidence – section 101(1)(c)​

This is an important gateway for the prosecution and there is considerable overlap with evidence that ‘has to do with’ the alleged facts of the offence with which a defendant is charged. It reflects broadly the common law rule under which evidence of background was admitted without which a case would be incomplete – see R v Pettman unreported May 2 1985.

S101(1)(c) should be considered together with section 102 which provides that;

“For the purposes of section 101(1)(c) evidence is important explanatory evidence if –

  1. without it, the court or jury would find it impossible or difficult properly to understand other evidence in the case, and
  2. its value for understanding the case as a whole is substantial.
The requirements of section 102 should be given proper consideration. Evidence that simply “fills out the picture” is not the same as saying that the rest of the picture is either impossible or difficult to see without it – see R v Lee (Peter Bruce) [2012] EWCA Crim 316

There may be an issue about whether evidence of motive is admissible through this gateway. Under the common law, evidence of motive was always admissible to show that it was more probable that it was the accused who had committed the offence and it was generally considered that such evidence would form part of the background and be explanatory evidence. However, the Court of Appeal in R v Sule ante held that such evidence had to do with the facts of the alleged offence and thereby fell within the scope of section 98.

Care should be taken when considering the route to admissibility of bad character evidence not to seek admissibility through this gateway when the proper approach is gateway (d). The case of Leatham and Mallett [2017] EWCA Crim 42 is illustrative of the approach of the Court in the application of section 101(1)(c) and the relationship with section 101(1)(d). In that case, L and M were charged with conspiracy to burgle based entirely on circumstantial evidence. The court admitted evidence of L’s previous convictions for similar offences on the basis it provided an explanation for what were otherwise completely incomprehensible explanations provided by both accused. The commentary in the Criminal Law Review [2017] Crim LR 788 illustrates the difficulties and complexity of the provision and its overlap with section 101(1)(d) – below.

Bad Character Evidence | The Crown Prosecution Service

Note the 7 gateways are either/or, they are not all required to be met, so the defendant doesn't have to agree to it if one of the other provisions is satisfied.
 
  • #682
11:00am

Intelligence analyst Kate Tyndall is now talking the court through what is likely to be the prosecution's final sequence of events, this being the case of Child Q.
Child Q was born at 4.09am on June 22, 2016, in initially poor condition, appearing 'blue, occasional gasp, poor tone'. Inflation breaths were given and oxygen support at 80% O2 was administered.
The 'Apgar scores', indicating a newborn baby's condition out of 10, are '4' at one minute, '7' at five minutes and '9' at 10 minutes.
Registered nurse Amy Davies said child Q cried at deivery, was stabilised and transferred to the neonatal unit, intubated and given antibiotics.
The sequence says Child Q was treated at the neonatal unit between 8.30am on June 22 to 7.40am on June 24.
On June 23, at 5.47pm, Child O died and at 6pm, Child P had an event where his abdomen was distended.

11:02am

The day shift of June 24 is when Child P - triplet brother of Child O - died, prosecutor Nicholas Johnson KC reminds the court.
Child P had a collapse at 9.30am on June 24.

11:09am

The sequence records a series of observations taken for Child Q throughout the day.
Child P's time of death is 4pm on June 24.
Nursing notes for Child Q, written by Amanda MacKenzie, record at 9.06pm: 'Thought to have a few bradycardias in a cluster this morning but seemed to be a loose ECG lead when checked - nnone noted following changing the lead.
'Nystatin not given - very heavy workload on unit'.


 
  • #683


He’s not leaving here alive, is he? Baby P —ep 25



In this episode Caroline and Liz examine what the prosecution say happened to Baby P, the second of two identical triplets allegedly murdered by Lucy Letby at the end of June 2016. The nurse is accused of killing him 23 hours after his brother, by injecting air into his feeding tube and tummy.

PART 2:


Doctors struggled for almost 45 minutes to save Baby P but ultimately all attempts to save him were unsuccessful and he died at around 4 pm.


Dr A was asked by prosecutor Barrister Simon Driver, “you were involved in the care of baby P from birth to death—were you able to understand the course his life took, over those few days?”


No, he simply replied.


Jurors were told that baby P’s parents were on the unit while all this was going on. They’d arrived soon after his first collapse just before 10 am.


In her statement to the court his mother described watching an almost identical scene as the one the day before.


In her words:


“When we got down to the neonatal unit it was like Deja Vu. Everyone was running around again, It was chaotic. The same doctors and Lucy the nurse were all there again. Due to the amount of people inn the nursery unit I sat outside in the corridor for long periods of time while the medical staff worked on baby P.


At one point a young female doctor was sitting at a small computer outside Nursery two, googling what looked like a relatively simple procedure inserting a line into the chest.


They needed to perform this procedure because baby P’s lungs had collapsed during CPR.Naturally this alarmed me.


She was relaying this information to the other doctors. At some point they told my partner they were looking to transfer Baby P to Liverpool Women’s Hospital



They appeared to be trying to stabilise baby P but he kept collapsing. He looked very similar to baby A * with a discolouration and prominent veins. His treatment continued for hours.


The transport team arrived headed by a young male consultant from Arrow Park Hospital called Dr Oliver Rackman.


The reaction from staff was incredible to watch. This guy just took over. The staff just did what he said. I immediately felt reassured upon his arrival. He was calm whereas everyone else seemed panicked. He decided Baby P shouldn’t be resuscitated anymore


When baby P passed away around 4 pm Dr Rackman brought him over to me and was so apologetic. He said he couldn’t believe what had happened he stayed with me for some time.


My partner and I begged him to take our surviving son with him. Eventually he agreed.


After baby P passed away, Lucy was extremely upset and emotional. She was in pieces and was almost as upset as we were. She brought baby O and baby P down to see us in a Moses basket


Before we left for Liverpool she dressed Baby P and took pictures of both boys. She was in floods of tears.



* Baby A—[ she must be referring to her surviving baby, not Baby A from this case]



The triplets father told police in his video interview that Lucy Letby was upset after their second son died.


The following exchange begins with the detective:


Q: What do you remember with baby P?


Father: I just remember going down and when we got there it was just like pandemonium. It was absolutely mental. Worse than the day before obviously because of what happened the day before. They were bloody hell we can’t let this happen again. There seemed to be more people on the unit


Q: you mentioned before baby O had a [inaudible] belly ?


Father: with baby P there was none of that. The only discomfort I remember with him you could see him struggling for his life but I can’t remember seeing his belly swell


Q: What reason did the medical staff tell you was wrong with baby P?


Father: Again, I don’t think we got any reason


Q: at what point did the transport team arrive?


Father: Quite later on. Must have been early evening they fought with baby P for not long, maybe 10 to 15 minutes. Not long after they arrived Baby P passed away and they couldn’t


do any more…while they were there we begged them to take our surviving son …we said there’s no way he’s staying at this hospital…you’ve got to take him otherwise we are taking him ourselves, but obviously he was too small….they agreed to take him over.


I am pretty sure it was Lucy Letby who rolled the 2 boys down to see us in a cold box


I’m sure it was her 110%…it was her, she said how sorry she was..she was very tearful and very upset …


I’m pretty certain Lucy Leyby dressed the pair of them because we’d picked out little matching outfits for them , stood the boxes for us, she went out of her way to get an SD card that goes into a camera so we had plenty of memory to take plenty of pictures “





But Dr B told jurors something slightly about Lucy Letby’s behaviour after Baby P’s death


She told jurors she remembered Lucy being quite excited and animated when they went to see his parents soon afterwards



In Dr B’s words:



After Baby P passed away, myself and Senior Nurse Letby went down to speak to the parents. I remember feeling I don’t know how to face them. The parents were sitting there and I told them Baby P was going to need a post mortem


Nurse Letby was behind me and one of the things I found unusual was she was almost sort of very animated ——‘Do you want me to make a memory box for him, you know like I did for Baby O yesterday?


I remember thinking this is not a new baby this is a dead baby—what are you so excited about this? I found that was very inappropriate —not what was said, just how she said it.?




And the doctor told the court that like the triplets parents she also wanted the surviving brother to be transferred out of the Countess


Yes, she told jurors that she thought to herself that Lucy Letby was a danger to him, and leaving the hospital was the only way that he was going to live

Mr Meyers, for the defense, accused Dr B of dramatising what happened for the benefit of the jury, and suggested Lucy Letby’s comments had been taken out of context in what was a distressing situation for all staff.


But Dr B insisted the comments Lucy made were highly unusual and she said she was not exaggerating anything—Honestly that’s how I felt at the time. I’ve no intention of dramatising anything, it’s tragic enough as it is
 
  • #684
She said Child Q was born on June 22, 2016 at 04.09am.
She describes her pregnancy as "difficult" and pushed for a 9-week scan at the Countess of Chester Hospital.
Outside the womb, a problem was found. One twin was inside the womb, the other was outside the womb. She was sent for surgery and Child Q's twin was removed.




Interesting that Baby Q was originally a twin too! And that the parents had lost the other twin during the pregnancy!
 
  • #685
11:11am

The medication for nystatin is prescribed at 11pm.
A Facebook message sent from a doctor to Lucy Letby at 11.49pm: 'Did you talk to Belinda about allocation for tomorrow?'
Letby: 'Yes, she's going to try and give me a lighter workload...'
Letby adds this will be difficult given there are only five on the staff rota.

11:16am

Child Q was noted as having small levels of bile in his aspirates from the fluid chart, but these were not enough to stop him being fed as normal.
Nurse Samantha O'Brien recorded, within her nursing notes at 5.20am on June 25: 'Having trophic feeds of donor expressed breast milk, 0.5mls 2 hourly due to moderate aspirates. Abdomen is full but soft.'
No respiratory distress was observed.

11:18am

Letby messages a nursing colleague at 6.36am enquiring about the night shift.
The reply begins 'OK', before giving details of what was done that night and babies in the unit.

 
  • #686
  • #687
11:22am

Nurse Samantha O'Brien records at 7.30am a blood gas test result was 'not as good' as the one previously, but still 'acceptable'.
The day shift handover takes place at 7.30am. Lucy Letby is a designated nurse for Child Q, in room 2, and a baby in room 1.
Three babies are in room 1, two in room 2, three in nursery 3 and four in room 4.
One nurse is looking after two babies in room 1, one nurse is looking after four babies in rooms 2-4, and another nurse is looking after four babies in rooms 3-4.

11:24am

An observation chart is shown for Child Q for June 24-25. The heart rate and breathing rate are shown as being in the normal range up until 9am, when Child Q collapsed. Both then increase to an area out of the normal range at the time of the collapse.
Child Q had been 'in air' prior to the collapse.

11:29am

A fluid balance chart is shown for Child Q.
The 9am reading is not initialled, and do not record a feed at that time.
Child Q collapsed at 9.01am.


 
  • #688
11:22am

Nurse Samantha O'Brien records at 7.30am a blood gas test result was 'not as good' as the one previously, but still 'acceptable'.
The day shift handover takes place at 7.30am. Lucy Letby is a designated nurse for Child Q, in room 2, and a baby in room 1.
Three babies are in room 1, two in room 2, three in nursery 3 and four in room 4.
One nurse is looking after two babies in room 1, one nurse is looking after four babies in rooms 2-4, and another nurse is looking after four babies in rooms 3-4.


Ah this confirms that she did also have a baby in room1 ( which is the reason she told the doc for leaving Baby Q)
 
  • #689
11:35am

An apnoea/brady/fit chart is shown to the court - the brady is '98', desat '68', fit '?', duration '3 minutes intermittently'.
'Baby found to be very mucousy, clear mucous from nasopharynx oropharynx, clear fluid+++ , O2 via Neopuff, given post-suctioning. Dr...emergency called to attend. 'NGT used to aspirate stomach by nurse Lucy Letby'.
The prosecution say Child Q had been fed 1.5mls of milk from the night, and had been due to be fed at 9am.
Lucy Letby, in a nursing note, records: '0910 ...Child Q had vomitted clear fluid nasally and from mouth. Desaturation and brady, mottled++. Neopuff and suction applied. Air++ aspirated from NG Tube...'
The doctor called to the unit records 'called to NNU @ 0917 desaturation Had just vomited and then desaturated to low 60s. Minor bradycardia. Bagged with Neopuff circuit...'

11:35am

Child Q was transferred from nursery room 2, the high dependency unit, to nursery room 1, the intensive treatment unit.



 
  • #690
11:41am

Medication is administered to Child Q during the morning.
Child Q is x-rayed and the report notes: 'Respiratory deterioration now needing CPAP'.
The x-ray records nothing unusual, the prosecution say.
Letby writes notes for child Q, written retrospectively at 12.53pm: 'Septic screen carried out....NG Tube on free drainage. -3mls milk/mucous aspirate. Abdomen soft and non-distended. Perfusion improved...intermittent episodes of tachypnoeia...'

11:44am

Letby records for family communication at 1pm: 'Parents visited shortly after [Child Q] had been screened and commenced on CPAP. Mum upset++ and dad has since stated mum upset that she was not contacted on postnatal ward about need for intervention.'
Letby adds she explained the situation and apologies were given.

11:46am

Letby messages a nursing colleague about the situation on the neonatal unit, adding: 'All going on lol'
Letby also messages a doctor colleague between 12.18-1.16pm.

 
  • #691
Letby messages a nursing colleague about the situation on the neonatal unit, adding: 'All going on lol'
Letby also messages a doctor colleague between 12.18-1.16pm.

Is this "lol" in the message as laughing????:mad:
 
  • #692
11:11am

The medication for nystatin is prescribed at 11pm.
A Facebook message sent from a doctor to Lucy Letby at 11.49pm: 'Did you talk to Belinda about allocation for tomorrow?'
Letby: 'Yes, she's going to try and give me a lighter workload...'
Letby adds this will be difficult given there are only five on the staff rota.

11:16am

Child Q was noted as having small levels of bile in his aspirates from the fluid chart, but these were not enough to stop him being fed as normal.
Nurse Samantha O'Brien recorded, within her nursing notes at 5.20am on June 25: 'Having trophic feeds of donor expressed breast milk, 0.5mls 2 hourly due to moderate aspirates. Abdomen is full but soft.'
No respiratory distress was observed.

11:18am

Letby messages a nursing colleague at 6.36am enquiring about the night shift.
The reply begins 'OK', before giving details of what was done that night and babies in the unit.

I wonder if that was Dr choc that asked about her shift the next day and where his concern was directed.
 
  • #693
I wonder if that was Dr choc that asked about her shift the next day and where his concern was directed.


I think we heard on either the podcast or elsewhere that it was him and he sent it the night before her Baby Q shift.
 
  • #694
12:01pm

A correction is being made to the sequence of events - the timing of Child Q's collapse should not read '09.01am'. The court had heard the time of the collapse has been noted as 9.10am.

12:05pm

Further observations are made for Child Q during the afternoon.
Letby notes: 'Observations stable, continues to ahve low respiratory rate with minimal effort at times. Appears plethoric++ this afternoon....Remains on free drainage...'
For the family communication note, Letby notes: 'Midwife phoned on behalf of mum to express concern that staff had not contacted parents when [Child Q] needed CPAP. Expained reasons for this and encouraged mum to visit...'
The parents visited the unit.
Letby adds: 'Apologies were given for not updating them but...[treating Child Q] was priority at the time. Mum appears happier...'

12:08pm

Letby messages a nursing colleague via Whatsapp at 6.40pm 'Girls all rushing around outside', adding one of the nurses was 'stressing', and the situation was 'madness lol'.
Further medication is administered to Child Q in the evening.

 
  • #695
  • #696
What is it with all the messaging? I don't usually focus on this, as normally I find it insignificant, but it sounds like a lot of serious stuff was going on with her patient so I can't understand how LL has the time or the inclination to be texting.
 
  • #697
Letby messages a nursing colleague via Whatsapp at 6.40pm 'Girls all rushing around outside', adding one of the nurses was 'stressing', and the situation was 'madness lol'.
Further medication is administered to Child Q in the evening.


Do we know what was going on around 6.40pm for girls to be rushing around outside?
 
  • #698
12:12pm

A deterioration is noted in Child Q which required his intubation. The notes are recorded by a doctor.
Letby notes before the shift handover at 7.30pm: 'Respiratory rate declining (15-19bpm) and intermittent pauses in breathing. Blood gas stable but on downward tred and [Child Q] appearing 'tired'.
'Oxygen requirement developing....decision made [following consultation with doctor] to electively intubate. Drugs given as prescribed...'

12:18pm

Care of Child Q was handed over to staff nurse Amy Davies.
A record of Facebook messages between Letby and a doctor colleague is recorded between 4.11pm and 8.31pm.
Letby then adds: 'Wow, I think I might be almost finished' to the doctor. She also messages her mother.
Colleague Minna Lappalainen then messages: 'Thank you for being a good friend today', adding a heart emoji.
Letby: 'Don't need to thank me Minna, I'm always here for you. Please don't feel you're alone...'
Lappalainen: '...But really I'm really happy u were there for me....'
Letby: 'Take care, hope you sleep well, see you tomorrow'.
Sophie Ellis messages Letby: 'Hope your feeling ok today'
Letby: 'Thanks Soph, another busy day today but ok today and off tomorrow....'
Ellis: 'I think you deserve more than a day off...'
Letby: '...It's been awful but we'll be ok'.

12:20pm

Nurse Amy Davies, in her nursing notes, records Child Q was '...unsettled at the beginning of the shift but has settled. Temperature is elevated, humidity and incubator temp altered accordingly. HR is elevated up to 208 at times. Dad has visited...'
Observations are taken for Child Q.


 
  • #699
So
Almost all survivors are left brain damaged, unable to fend for themselves, robbed of fullfilling life.

This case is a nightmare.

If she is found guilty, I will never watch any documentary/ programme about this monstrosity.

I will try to erase the name from my memory :(
 
  • #700
I've got to pop out for about an hour if anybody can take over until about half 1? :)
 
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