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He’s not leaving here alive, is he? Baby P —ep 25
PART ONE:
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.
Baby P, eldest triplet
The babies were incredibly rare as they were conceived naturally and were identical
All 3 were good weight @ 4 lbs each, and were healthy.
But sadly Baby O died June 23rd, when he was just a few days old, Letby allegedly attacked him 3x, injecting him with air and inflicting a traumatic liver injury that led to collapses and his death.
And within just a couple of hours of the death of baby O, it’s alleged Lucy Letby began harming his brother Baby P so because the doctors on the unit had been left shocked and confused about what had caused the death of Baby O , they decided to review both surviving baby triplets, Baby P and his brother.
The jury heard that around 6 pm, so within a few minutes of Baby O’s death, Dr John Gibbs who was on duty examined Baby P. He ordered blood tests, an x-ray and also put him on a course of antibiotics, in case he had an infection.
Lucy Letby was still on duty, and according to the notes, she fed Baby P via tube thru his nose and administered some fluids around the same time —at half seven in the evening, she handed the care of Baby P over to nurse Sophie Ellis, who was on the night shift, but Lucy remained on the unit, writing up notes on Baby O—
And this is significant the prosecution say because at some point between then and 8 pm she allegedly, deliberately injected air into baby P’s feeding tube.
The court heard that the x-ray ordered by Dr Gibbs which was taken shortly after 8 pm showed gas throughout his gut . Dr Owen Arthur’s an expert radiologist at Great Ormond Street hospital was called and gave evidence that this was unusual.
Dr Arthur said infection or a bowel condition in premature babies could potentially explain the air, but he added that another alternative was gas had been administrated down his feeding tube
Over the course of the evening jurors were told Baby P had a couple of episodes where his oxygen levels fell and his heart was low but he was still breathing for himself and he wasn’t poorly
So that night nurse Alice was looking after Baby P, and she gave evidence she tried to give him milk via his feeding tube in his nose every 2 hours but the court heard he was having problems digesting his milk so a decision was taken to temporarily stop his feeds and to closely monitor him.
Now the triplets parents were staying overnight at the hospital but his mother told the court that after losing baby O they barely slept and were feeling anxious for their other two boys
They were awake at 6 am and decided to go and check on their sons.
Nurse Alice told the court she’d withdrawn air from Baby P’s feeding tube at around the same time.
But his tummy was soft, and not swollen, his temperature, breathing and heart rate were also within normal limits and at
7:30 am Lucy Letby came on duty for her shift
Letby was asked to care for baby P who was being looked after in nursery 2.
Christopher Booth, another experienced nurse who was looking after the other triplet,who isn’t part of the case, in the same nursery.
The shift leader, Catherine Percival Calderbank, gave evidence that she put nurse Booth in nursery 2 with Lucy Letby to give her extra support because of what happened to Baby O the day before.
But she also told the court that in general Lucy Letby preferred being in nurseries one and two with the most poorly babies
Nurse Percival called about said Lucy told me it was boring in the other nurseries and she didnt just want to feed babies.
so Lucy Letby just had baby P to look after on this shift and at around 9:30 am, at around 2 hours after she came on duty, registrar Dr Tony Udoko reviewed baby P on his ward round
He noted that baby P’s abdomen was swollen. He also had slightly mottled skin but his heart rate and oxygen levels were fine.
But around 10 minutes later, @ 9:40 am, Baby P suffered a serious collapse—his heart rate and oxygen levels plummeted and a call went out for help.
And this is significant because the prosecution case says between Dr Uduco* reviewing Baby P on his ward round and the collapse just 10 minutes later, Lucy Letby injected air into his feeding tube, which caused his tummy to swell and squash his lungs, prompting a cardiac arrest
* I am not sure of the correct spelling, I cannot understand the speaker---it sounds like Udoco or Uroko ? or ?
Dr Uroko quickly returned to his bedside and he said one of the nurses —he couldn’t remember which one—asked if Dr A, the doctor who Lucy Letby had a close friendship with, could attend
The nurse wanted Dr A in particular he said so Dr A was bleeped and arrived soon afterwards as did Dr B, the senior female consultant on duty
A bag was used to give baby P oxygen and Dr A also decide to put a breathing tube into his mouth so he could be put on a ventilator to help his breathing——but Baby P didn’t respond and @ 9:55 am CPR began
He was also given his 1st shot of adrenaline to help kick start his heart —this was followed by a further 2 doses @ 10:02 and 10:08
Calls were also made to have baby P transferred to a more specialist hospital nearb
He recovered quickly but the court heard that around 11:30 am his oxygen levels fell again.
A note written by Lucy Letby was shown to the jury:
She said his circulation was poor. He remained mottled, his tummy appeared full
CPR was started for a 2nd time [11:40] and a further dose of adrenaline was given
The resuscitation was continued for 6 minutes before his circulation returned and he stabilised
He was also put on an adrenaline drip to try and improve his blood pressure
Dr B told jurors he appeared to recover quickly again and he was fighting against the ventilator so they gave him some medication to paralyse and sedate him
Baby P stabilised and Dr B said that around this time she and colleagues breathed a sigh of relief
She said she thought they were winning because baby P was the best he’d been all day and she was hopeful because the transport time were on their way to take him to the specialist centre
But around this time she remembered Lucy saying something she described as shocking. She told jurors that LL commented that Baby P was not living the Countess alive.
"I remember saying the transport team are going to be here soon, almost thinking out loud...I was literally counting the minutes before they arrived."
Staff nurse Letby said “ He’s not leaving here alive, is he?’
Which I found absolutely shocking art the time.
I turned around and said ’don’t say that.’
All these years , seven years on, that memory is still very much alive in my mind
"We see babies who are very very sick, who are very very unwell even when we know their chances of survival are very poor .personally for me, that’s something I would never let myself think...
It’s that hope that makes you keep trying"
Because baby P had stabilised, Dr B said that she and Dr A decided to go to the tea room on the unit to grab a drink but the kettle hadn’t even had the chance to boil before another staff member called fore them to return to baby P urgently
And when they returned dr B said Lucy Letby WAS WITH BABY P who was crashing
She told the jury she couldn’t remember if anyone else was in the nursery and she said that although he was paralysed [by the meds], it looked as if Baby P had dislodged his breathing tube
So a Dr reintubated Baby P and they began CPR for a third time [ just after 12 noon]
This time Baby P received five doses of adrenaline in 16 minutes as doctors battled to keep him alive the dose in his adrenaline was also doubled and he was given more medicine for his blood pressure
CPR was eventually stopped after 22 minutes when he recovered again at around 12:50 pm
Dr A told the court there was no clearly identifiable cause for what was going on
“We were managing symptoms as they arose—his difficulty with breathing, low cardiac output, low blood pressure”
Around this time doctors also discovered Baby P had a small puncture in his right lung, and a needle was inserted to try t remove some of the air which was causing his lung to collapse
At about 3 pm Dr A inserted a chest drain to try help resolve the puncture and around the same time the transport team led by experienced neonatologist Dr Oliver Rackham arrived to take Baby P to Liverpool Women’s Hospital
Sadly that never happened because minutes later @ 3:14 pm Baby P collapsed and needed CPR for a fourth and final time.
He was given seven more doses of adrenaline over the course of 39 minutes including a high dose shot of the drug @ 3:35 pm but the court heard there was no response
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.
