UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #20

[JamesMcGillEsquire]

So what was your point?

That the feeds did not necessarily happen at the time they were scheduled for.

 

[IspyWithMyBigEye]

This is part of the mother's of E's witness statement. BBM below - the mother would have also had to make up the explanation for why there was blood - doesn't that seem fairly technical and detailed for a lie? And it can't have been another nurse as the defendant accepts she was with the baby as designated nurse the entire time. Mum would also have had to made up this entire narrative below, which is all evidenced by the phone call to her husband. Given it was an ICU ward (and we've seen how tiny they are), it makes sense no one else was around as it was a restricted area and LL was one of the only ICU qualified nurses.

She said she went up to the post-natal ward to express breast milk and have something to eat, 'between 7pm and 8.30pm'.

She then took the expressed breast milk "straight down" to the neonatal unit where her twins were.

She said she arrived there "a touch before nine o'clock."

The mother had drawn a plan of the neonatal unit layout, as she remembered it, to police. That is now shown to the court.

She tells the court she had gone into room 1, where the twins were, as was Lucy Letby, the only other adult in the room beside the mum.

She said she could her her son crying and it was "like nothing I'd ever heard before".

The mum walked to the incubator, to see blood coming out of Child E's mouth, and panicked as she "believed that something was wrong".

The mum, fighting back tears, tells the court which incubators her twins were located in - both in adjoining ones.

She said she heard "crying" - a sound which "shouldn't have come from a tiny baby. I can't explain what that sound was...horrendous. It was screaming more than crying."

She said she heard it in the corridor in the unit itself, and entered the unit through the door where the twins were.

Lucy Letby was "busy doing something, but she wasn't near [Child E]."

She said she immediately went to Child E and used a 'containment technique' which she had been taught, to make him feel calmer, but "it didn't work".

Child E "continued to make the same noise".

She said she was there for "about 10 minutes" in that room.

She said: "There was blood on his face, around his mouth."

She tells the court she was asked by police to draw, on a drawing of a child's face, where the blood was coming from.

She tells the court the blood was coming "around the mouth"
Lucy Letby was at the workstation at the time, the mum tells the court.

A video of the neonatal unit room one is shown to the court.

The mum, fighting back tears, tells the court which incubators her twins were located in - both in adjoining ones.
he mum said she asked Lucy Letby why Child E was bleeding and what was wrong.

She said Letby replied the feeding tube was rubbing the back of the throat and that would have caused the blood.

The mum said she accepted that explanation, but was concerned about it.

The mum said Letby "told her to go back to the ward", and she did what she was told as Letby "was in authority and knew better than me and I trusted her - completely."

"She said the registrar was on his way and if there was a problem, someone would ring up to the post-natal ward."

She said she accepted that explanation and returned to the post-natal ward.

Upon her return, she rang her husband as "she knew there was something very wrong".

"I knew I needed to speak to him, and tell him."

The court hears the telephone records, including timings, were obtained.

The call to her husband was made at 9.11pm, and lasted 4 minutes and 25 seconds.

She said she rang her husband about her concerns, and remained on the post-natal ward.

Why was LL at the work station when the baby was obviously in distress and bleeding from the mouyh?

ICU nurses are meant to stay by their patent’s bed constantly.

 

[esther43]

Okay so I haven't had a baby in a neonatal unit, but I have had a baby and been on a postnatal ward. I was given my own pumping machine, to use whenever I liked. I don't think there would be any case of needing permission to visit your baby in NICU, LL herself has testified that the policy was that parents could visit whenever they like. you would not need to be given an all clear to visit. Newborn babies are usually expected to be fed every 2 hours. From the evidence we have heard, that feed was due at 9pm. The mother would make her own way there freely, she wouldn't need permission. Midwives are busy people and would not be monitoring where mothers went and at what times. As we've heard, there was no swipe card needed to enter NICU if you were coming from the maternity ward.

I think it's well established in psychological/neuroscience research that people remember what is most salient to them. Most important. Now no one's memory is 100% accurate, as memory is a fallible thing. However seeing your baby with blood around their mouth and screaming is not something someone would forget. Ever. Plus the phone records confirm her account, and her husband said she was inconsolable on the phone about the blood and screaming.

100% These days were no doubt the most impactful of their entire lives. They would surely remember everything. There's no reason to lie, it wouldn't bring their baby back. They are also years on from the experience and will have worked through the anger to an extent and likely supported by loving family and friends to understand what happened. But more than that, the mama instinct. It's strong, she knew something was up but she was vulnerable and disempowered. LL told her to go back to her room. Too sad

 

[Parker Knoll]

Would you expect the mother in this instance to want to be more helpful to the prosecution, or the defence?

Because it has seemed to me in cases like this where children have died, or gone missing, that often the parents will want a conviction more than they even really want the whole truth. The burning desire for punishment far outweights the need for justice.

Totally understandable, I have no problem with it and all the sympathy in the world for the parents in this case. However, in a court of law, up until victim impact statements are to be read for sentencing, feelings shouldn't come into it.

JMO

No I wouldn’t.

 

[marynnu]

That the feeds did not necessarily happen at the time they were scheduled for.

But I still don't see what your point is. A 2pm feed is started at 2, finished 2.10. What would be the significance of that?

 

[WaxLyrical]

That the feeds did not necessarily happen at the time they were scheduled for.

The mum is on a pumping schedule, whatever time the baby drinks the milk is basically irrelevant. At that stage in the game, she’ll have been expressing at least 8 times a day to try and establish a supply for twins. Literally eat, sleep, pump, see babies.

 

[Sweeper2000]

She has an attachment to that memory, because it's the last hours of her baby's life and she wanted to feed him, she was hardwired by very strong maternal needs to nurture her babies. That memory will probably be seared on her brain forever. Nobody else that night had that mother's experience, for them they did not know there would be a need to memorise it, or recall it ever again. Staff do the same thing over and again with all mums, helping to express milk, it's just not memorable, unless it's an event out of the ordinary, like an emergency call is, which then gets recorded in the patient's notes. No one is going to remember the time a mum turned up to feed her baby, it's not a stand out event, especially when she was there earlier and later as well.

There is no one to corroborate LL's notes, which are off by one hour with the feeding regime, and mention cares which the mother had already done before LL's shift started, and mention a doctor on a different ward who has no record of advising LL to omit the feed. If it's a choice between all of those factors weighing in anyone's favour, and corroborated by the call to the father, I know whose account I'm going with. It's not LL's, for all of those reasons.

That’s completely fair enough.

some points though. This was a mother who had not long given birth and in her own words was sore. if I were to try and employ my empathic visualisation of the situation I might think a woman who would have every reason to be tired, worn out, stressed, bruised, battered and perhaps even mentally drained that that same woman would have less reason to be held to the same standards in terms of memory recollection for that period of time. I would sooner expect her to have a less clear recollection than that of one of the many staff members who were presumably less taxed If in my inexperienced opinion I may say so. I do find it strange that the prosecution have not presented any evidence ie door swipe data for the door being opened around that time Or on the contrary to the defence if the door was not opened in the half hour before 10 pm.

the prosecution’s theory only works if the mother attended punctually and I believe there is more than one reason why she wouldn’t be able to deliver milk at 9pm especially with her sadly being new to motherhood. I might also expect some call from one unit to the other to request the mother’s attendanc as per schedule as this is a high security unit.

the prosecution only need one corroborating thing and the case is theirs Imo.
there is also no medical evidence to suggest this baby was harmed before 9pm and I’m not sure but I would think staff would enter that room between 9 and 10. In other cases a painful stimuli could cause a full blown crash for a baby, there is no way for ll to hide such a thing.

imo etc

 

[esther43]

If it wasn't clear, my answer is I don't believe the mother wants to be more helpful to the prosecution or the defence, I don't think she was even aware there was a version that wiped what she experienced/witnessed out of the records, I think she just wants to state the truth about what happened.

If the accused has a different version that's not her business, it's the jury's.

JMO

Well exactly, unlike the defendant the witnesses do not get to see the statements. It's highly likely they did not even know that LL was the suspect or that she entered a not guilty plea.

 

[JamesMcGillEsquire]

The mum is on a pumping schedule, whatever time the baby drinks the milk is basically irrelevant. At that stage in the game, she’ll have been expressing at least 8 times a day to try and establish a supply for twins. Literally eat, sleep, pump, see babies.

So let's say for sake of argument the scheduled 2pm expression actually takes place at 2.10pm
Would the 4pm expression be moved back to 4.10pm, or would the 2hrs become reduced to 1hr 50?

 

[Parker Knoll]

But with respect sweep giving birth is all the things you have mentioned but it doesn’t USUALLY include memory loss.
It’s the single most significant point in most mothers life. You remember everything. My daughter was born 20 + years ago at home. I could take you through the day like it was yesterday. <modsnip>
She’s cunning, crafty and manipulative and fighting for her life here on the stand that’s understandable but she’s changing / forgetting / disputing, eye witness reports, mobile phone data, door swipe data and colleagues recollection of events.
She’s developed amnesia and is contradicting her police interviews and that’s with her own counsel examining her !
We have pathologists, experts, consultants - the list goes on.
These are purely my thoughts as we stand if day 2 of the examination in chief.
MHO

 

[WaxLyrical]

So let's say for sake of argument the scheduled 2pm expression actually takes place at 2.10pm
Would the 4pm expression be moved back to 4.10pm, or would the 2hrs become reduced to 1hr 50?

You’d still do it on the hour. Lactation is a supply and demand thing, removing the milk stimulates the breasts to produce more milk, so the aim is to remove as much milk as possible as often as possible.

 

[marynnu]

So let's say for sake of argument the scheduled 2pm expression actually takes place at 2.10pm
Would the 4pm expression be moved back to 4.10pm, or would the 2hrs become reduced to 1hr 50?

The process starts every 2 hours. Where are you going with this?

 

[JosieJo]

That’s completely fair enough.

some points though. This was a mother who had not long given birth and in her own words was sore. if I were to try and employ my empathic visualisation of the situation I might think a woman who would have every reason to be tired, worn out, stressed, bruised, battered and perhaps even mentally drained that that same woman would have less reason to be held to the same standards in terms of memory recollection for that period of time. I would sooner expect her to have a less clear recollection than that of one of the many staff members who were presumably less taxed If in my inexperienced opinion I may say so. I do find it strange that the prosecution have not presented any evidence ie door swipe data for the door being opened around that time Or on the contrary to the defence if the door was not opened in the half hour before 10 pm.

the prosecution’s theory only works if the mother attended punctually and I believe there is more than one reason why she wouldn’t be able to deliver milk at 9pm especially with her sadly being new to motherhood. I might also expect some call from one unit to the other to request the mother’s attendanc as per schedule as this is a high security unit.

the prosecution only need one corroborating thing and the case is theirs Imo.
there is also no medical evidence to suggest this baby was harmed before 9pm and I’m not sure but I would think staff would enter that room between 9 and 10. In other cases a painful stimuli could cause a full blown crash for a baby, there is no way for ll to hide such a thing.

imo etc

The neonatal units do not phone up for the mothers attendance...as LL said today the parents are welcome anytime

 

[katydid23]

I’m surprised we didn’t hear anything about LL’s personal life around the time of all the attacks too. I really thought there would be a significant event like a break up or something going on around the time. We haven’t heard from anyone close to LL apart from colleagues. I am surprised that the prosecution didn’t offer a motive, in a more direct way. This case has been very strange all round IMO, we’ve heard all the evidence but haven’t heard a theory of WHY?

We have speculated whether if guilty, it was for attention, or enjoying the drama, simply boredom with the babies who were ‘just feeding’ as she put it. Or if there was something else going on. Was she punishing the parents for some reason, was she going through other stresses in her life, was there some jealousy or a need to make people feel sorry for her with all her ‘bad luck’

I know, in some cases there is no motive, no rhyme or reason. I would have liked to hear what the prosecution believed the motive, if guilty, was. Or maybe there just isn’t one.

All JMO

If it was because she was suffering from Munchsausen by proxy, or Factitious disorder by another, like other caretaker murderers have been diagnosed with, would the prosecution be able to suggest that, since they probably have nor been able to see any medical or mh records of hers...?

 

[Jazmania]

Do we know whether the mother of babies E & F had received any type of epidural?
Or other procedure that could have potentially made her memory less reliable?

Are you actually a troll? The mother walked to the neonatal unit. If she had an epidural it had worn off.

 

[Sweeper2000]

Anyone know if for some reason the milk itself was not able to be expressed in time for the 9pm visit it would be recorded? Someone said it plays a part in prevention of nec so I would guess important enough to be documented? I don’t remember anything being presented that might mean the 9pm visit wasn’t able to be met on time. Thus making the out of sync 10pm visit more likely.

imoo this case is particularly horrifying.

eta I can see why it could not be on the proper notes

 

[Xanadu62]

5.24pm: A nursing note at 5.24pm said Child E was 'self ventilating in air', blood gas reading was 'satisfactory', and feeds were increased.

7pm: An observation chart is shown for Child E.

The 'cares' row has one tick, recorded at 7pm, signed by Letby's colleague from the day shift.

7.30pm Dr Emily Thomas made clinical notes, with a CRP reading less than 1, Child E was on 23% oxygen, and antibiotics were 'likely to stop at 36 hours as improving'.

8pm: Letby's note for 8pm at August 3 is written, written at 4.51am retrospectively, to say: "Mummy was present at start of shift attending to cares."

A further Letby note reads: 'Prior to 9pm feed, 16ml 'mucky' slightly bile stained aspirate' recorded for Child E.

9pm: The neonatal fluid chart for the 9pm column records, under milk feeds, 'omitted', and the word 'discarded' is in a non-specific line. For aspirates, the note '16ml mucky' is made.

[From police interview - She said it was after 9pm that the SHO had reviewed Child E but could not recall if it was face-to-face or over the phone.]

10.10pm: Dr David Harkness records readings from 9.40pm, written at 10.10pm, 'asked to see patient re: gastric bleed'.

'Large, very slightly bile-stained aspirate 30 mins ago.' 14ml of blood vomit is also recorded.

Letby records: "At 10pm large vomit of fresh blood. 14ml fresh blood aspirate obtained from NG tube. Reg Harkness attended. Blood gas satisfactory..."

Child E was 'handling well'.

Letby's further note: 'Mum visited again approx 10pm. Aware that we had obtained blood from his NG tube and were starting [treatment]...'

1. Defendant's first note of the shift (8pm) is written retrospectively the next day even though she was only looking after babies E&F in nursery 1. And she has written the mum had visited the babies and was attending to cares, so defendant could easily have written the note at the time (as baby was apparently with mum).
2. So after feeds were increased at 5.24pm, the defendant notes the 9pm feed was omitted because of the large bile aspirate.
3. She says the SHO reviewed the child E over the phone or in person after 9pm (can't remember, and hasn't noted it down anywhere) and asked to omit the 9pm feed. Can't remember if a doctor visited the baby in person or not at 9pm, but can remember with certainty the mum did not.
4. But apparently the mum (who had nothing else to do but feed and care for her baby) didn't show up at 9pm as scheduled, instead only showed up at 10pm.
5. No one other than the defendant observed or saw this bile aspirate pre 9pm

 

[Jazmania]

That’s completely fair enough.

some points though. This was a mother who had not long given birth and in her own words was sore. if I were to try and employ my empathic visualisation of the situation I might think a woman who would have every reason to be tired, worn out, stressed, bruised, battered and perhaps even mentally drained that that same woman would have less reason to be held to the same standards in terms of memory recollection for that period of time. I would sooner expect her to have a less clear recollection than that of one of the many staff members who were presumably less taxed If in my inexperienced opinion I may say so. I do find it strange that the prosecution have not presented any evidence ie door swipe data for the door being opened around that time Or on the contrary to the defence if the door was not opened in the half hour before 10 pm.

the prosecution’s theory only works if the mother attended punctually and I believe there is more than one reason why she wouldn’t be able to deliver milk at 9pm especially with her sadly being new to motherhood. I might also expect some call from one unit to the other to request the mother’s attendanc as per schedule as this is a high security unit.

the prosecution only need one corroborating thing and the case is theirs Imo.
there is also no medical evidence to suggest this baby was harmed before 9pm and I’m not sure but I would think staff would enter that room between 9 and 10. In other cases a painful stimuli could cause a full blown crash for a baby, there is no way for ll to hide such a thing.

imo etc

Giving birth makes you tired, sore, emotional. It doesn't make you imagine fictitious events. Now no one's memory is 100 percent accurate. Memory doesn't work like a camcorder. But you wouldn't imagine you had heard your baby screaming if he wasn't. You wouldn't hallucinate blood where there was no blood. The father hadn't just given birth. He remembered the phone call just after 9 and corroborated the moms account.

Many people have explained that there was no swipe card for accessing Nicu from the maternity ward.

 

[Jazmania]

Anyone know if for some reason the milk itself was not able to be expressed in time for the 9pm visit it would be recorded? Someone said it plays a part in prevention of nec so I would guess important enough to be documented? I don’t remember anything being presented that might mean the 9pm visit wasn’t able to be met on time. Thus making the out of sync 10pm visit more likely.

imoo this case is particularly horrifying.

eta I can see why it could not be on the proper notes

No you would not document how much or when you expressed milk. This is something a mom would do privately unless she was struggling and asked for help.

 

[Xanadu62]

Anyone know if for some reason the milk itself was not able to be expressed in time for the 9pm visit it would be recorded? Someone said it plays a part in prevention of nec so I would guess important enough to be documented? I don’t remember anything being presented that might mean the 9pm visit wasn’t able to be met on time. Thus making the out of sync 10pm visit more likely.

imoo this case is particularly horrifying.

I feel like you aren't understanding the 9pm feed would have been agreed with knowledge of the mother's expressing pattern. Missing the feed by an hour is just not a possibility. It's a neo natal ward intended to look after the babies and by that token the mum - they aren't going to let a baby miss its feed for an hour/go hungry because the mum can't express. She would have had support to express if a struggle, or they would used donor milk (like she did initially when struggling). She was on the post natal ward after all.