Judith Moritz
@JudithMoritz
·
1h
Baby E's mother previously gave evidence that Lucy Letby told her to go back to her bed on the maternity ward. Ben Myers KC asks nurse Letby "Did you send her away?" Lucy Letby: "No, that’s not something
we do on the unit. Parents are welcome 24/7"
Reading back to this info from the prosecution makes me think there will be fireworks during the eventual recross. Tghere are some real differences between what LL is assaying now and what the prosecution has said, and they have some witness testimony that backs their version up:
CHILD E
Chester Standard:
12:16pm
Child E - murder allegation
Child E, a boy, was born premature in July 2015.
The prosecution say this is the twin brother of the child poisoned with insulin.
Child E was born, weighing less than 3lbs. He was given oxygen, then weaned to air, and transferred to nursery 1.
12:19pm
The court hears Child E was at risk of a serious gastro-intestinal disorder, NEC, and was started on antibiotics, IV fluids and caffeine.
He had a nasogastric tube inseted. Fluids were inserted the following day via a long line.
He had a "mild, transient high blood sugar" was was corrected with "a very low dose of insulin", then given tiny quantities of milk the following day, every two hours.
The following day after that, he had two small vomits and air was aspirated, but otherwise the feeds were well tolerated and increased incrementally to 2ml every 2 hours.
The nursing notes indicated he was stable, on a tiny dose of insulin to correct high blood sugar.
12:20pm
At 9pm on August 3, 2015, the mother decided to visit her twin sons, and "interrupted Lucy Letby who was in the process of attacking Child E", the prosecution say, although the mum "did not realise it at the time".
Child E was 'acutely distressed' and bleeding from the mouth.
The mum said Letby attempted to reassure her the blood was due to the NGT ittirating the throat.
"Trust me, I'm a nurse," Mr Johnson told the court.
12:22pm
Letby said the registrar would be down to review Child E, and urged her to return to the postnatal ward.
The mum called her husband when she got to the labour ward, in a call lasting four minutes and 25 seconds, at 9.11pm.
Letby made a note in Child F's records (Child F being the twin of Child E), "after she had got rid of" the mum, Mr Johnson said.
The next time the mum visited Child E, he was in terminal decline.
12:28pm
The prosecution say the mum was "fobbed off" by Lucy Letby.
Two records are made at 4.51am, after Child E had died.
The later note records:
"Mummy was present at the start of shift attending to cares. Visited again approx. 22:00. Aware that we had obtained blood from his NG tube and were starting some different medications to treat this. She was updated by Reg xxxxx and contained [Child E]. Informed her that we would contact her if any changes.
Once [Child E] began to deteriorate midwifery staff were contacted. Both parents present during resus."
The prosecution say Letby's note suggests the mum was present at the start of the shift (7.30pm-8pm), and returned at 10pm, when "neither is true".
The prosecution say 9pm was an important time, as it was the time Child E was due to be fed, by his mother's expressed breast milk.
The mum said that is why she attended at 9pm. "She was bringing the milk".
The phone call at 9.11pm to her husband also fits the mum's timing, the prosecution add.
12:29pm
Letby's notes also show: "prior to 21:00 feed, 16ml mucky slightly bile-stained aspirate obtained and discarded, abdo soft, not distended. SHO [Senior House Officer] informed, to omit feed."
The prosecution say the nursing notes made are false, and fail to mention that Child E was bleeding at 9pm.
They mention a meeting that neither the registrar or the mother remember.
12:35pm
A record of feeds - a feeding chart - is shown to the court.
At 9pm, Letby has recorded information to detail the volume of fluids given via the IV line and a line in Child E's left leg, and the 9pm feed is 'omitted'.
In the 10pm column is '15ml fresh blood'.
The SHO said he had no recollection of giving advice to omit the 9pm feed.
He was on the paediatric ward most of that night, until Child E entered a terminal decline. He believes the only time he had anything to do with Child E was in a secondary role to the registrar in an examination at 10.20pm.
12:37pm
The registrar recalled being told Child E had suffered a blood-flecked vomit.
He does not recall seeing any blood on Child E's face, but regarded the presentation as undramatic.
But "around half an hour to an hour later there was a large amount of fresh blood which had come up" Child E's tube.
The prosecution said: "This was the first indication of any serious problem so far as the medical staff were concerned.
"There was a further loss of 13 mls of blood at 23:00 hrs."
"13mls may not sound much, but [the doctor] had never seen a small baby bleed like this."
This was the equivalent to 25 per cent of Child E's blood volume, a figure which the prosecution say is an under-estimate in context.
The prosecution add that at 11.40pm, Child E suffered a sudden desaturation.
His abdomen "developed a striking discolouration with flitting white and purple patches."
CPR was started, but Child E "continued to bleed".
Although Letby was participating in the resuscitation of Child E, she co-signed for medication given to another baby in room 4.
Child E was pronounced at at 1.40am.
The on-call consultant said Child E was a high-risk infant who had shown signs of NEC.
The parents did not wish to have a post-mortem, the consultant did not deem one necessary, and the coroner's office agreed.
The prosecution say: "As subsequent reviews have established – that was a big mistake."
12:42pm
Dr Dewi Evans said Child E's death "was the result of a combination of an air embolus and bleeding which was indicative of trauma".
The air embolus was "intentionally introduced" into Child E's bloodstream via an IV line "to cause significant harm".
12:43pm
Medical expert Dr Sandie Bohin agreed the cause of death was air embolus and acute bleeding.
She concluded that the cause of the bleeding was unknown but acknowledged “fleetingly rare” possible natural causes that could not be ruled out in the absence of a post-mortem.
Dr Bohin concentrated on the abdominal discolouration and concluded that air was deliberately introduced via an intravenous line.
12:46pm
The court is reminded by the prosecution that, once again, only Lucy Letby was "the constant presence" for all of the collapses in Children A-E.
In police interview, Letby said he could remember Child E and he was "stable" at the time of the handover, with nothing of concern "before the large bile aspirate".
She said she and another member of staff had disposed of the aspirate and the advice was to omit the feed.
She said Child E's abdomen was becoming fuller and there was a purple discolouration, so had asked a doctor to review Child E.
She said she had got blood from the NG tube.
She was asked about the 10pm note and said if there had been any blood prior to the 9pm feed, "she would have noted it".
She said it was after 9pm that the SHO had reviewed Child E but could not reall if it was face-to-face or over the phone.
She said she could remember the mum leaving after 'the 10pm visit'.
In a June 2019 interview, she was pressed over a conversation with the SHO.
She said she had no independent memory of it.
Shesaid she could not remember the mum coming into the room at 9pm with milk, nor Child E being upset, with blood coming from the mouth.
She said she would not have told the mum to go back upstairs.
"We have a stark contrast between what the mum says and what Lucy Letby says," Mr Johnson tells the court.
"You know he was due to be fed...breastmilk. You know, we say, that is why [the mum] was there.
"This has been wiped out of the records, by Lucy Letby, because she knows the consequences of [the mum] being right about this."
12:54pm
In a November 2020 interview, Letby is asked why she had sent a text referring to Child E had queried whether he had Down Syndrome.
She said she could not remember whether there had ever been any mention of Downs in the medical notes.
The prosecution say Lucy Letby "took an unusual interest" in the family of Child E. She did social media searches on the parents two days after Child E’s death, and on August 23, September 14, October 5, November 5, December 7, and even on December 25.
The prosecution say there were further searches in January 2016.
Recap: Prosecution opens trial of Lucy Letby accused of Countess of Chester Hospital baby murders