UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #21

[katydid23]

And it all seems a bit irrelevant to the case anyway. I don't think any of the medical experts have suggested that Baby J's collapse was due to the stoma not being looked after properly have they?

And yes we know it was busy and they were short staffed at times but the independent review did not find that to be the reason for the collapses and deaths either, which is why the police were involved.

JMO

Prosecution evidence, February 10th 2023, Day 52 - Chester Standard live updates - Recap: Lucy Letby trial, Friday, February 10

Child J

Mother's Evidence

12:44pm

The court will next hear evidence in relation to Child J.

1:46pm

The trial is now resuming after a lunch break, and will hear evidence from the prosecution in the case of Child J.
In the prosecution opening, the Crown say Letby attempted to murder Child J, a baby girl, on the night shift of November 26-27.

1:53pm

The mother of Child J is called to give evidence.
She says she had a difficult pregnancy, and following a difficult operation in London, one of her planned twins was lost.
She said she gave birth to Child J, a baby girl, at 32 weeks and two days gestation on October 31, 2015.
Child J "appeared to be extremely well" and was shown to her after birth, and there appeared to be "no concern" before the baby girl was taken to the neonatal unit.
The mother said she visited Child J later at the unit, she was in an incubator. The baby girl was seen in the 10-minute time there to produce a bit of brown bile.
Child J was then taken to Alder Hey by ambulance. The mother said she was told there were concerns about Child J's bowel at the time.

1:58pm

The mother said it was discussed afterwards that Child J had 'NEC' [necrotising enterocolitis: a serious gastro-intestinal disorder where a portion of the bowel becomes inflamed] and had emergency surgery at Alder Hey.
The bowel was 'cut', 1cm was removed - "a little amount", and the decision was made to give Child J two stomas.
Child J returned to the Countess of Chester Hospital on November 10, and the mother recalls being there frequently., establishing a routine. Child J was "absolutely" progressing well, going from being treated in room 1 (most intensive treatment), to room 2, to room 3, to room 4, over the course of four weeks in November.

1:59pm

Child J's mother recalls there were issues with the baby girl's weight gain, which 'concerned her' and she relayed those concerns "frequently".
She said those concerns were treated "not very seriously - they weren't overly concerned".
There were "quite a lot of challenges" with the stoma management.

2:03pm

Child J's mother says, between November 10-27, there were no major concerns with the stoma management, but the bags were not lasting as long as expected, and breastfeeding was impractical, but attempts at breastfeeding were made as Child J was doing well.
She tells the court the approach of staff at the Countess was different to Alder Hey. While Alder Hey was 'inclusive', the communication did not feel the same at the Countess.

2:07pm

Events leading up to the morning of November 27 are discussed, when Child J collapsed.
Child J's mother said the family were "really excited" to get Child J home, as she was off the heart monitor, and the mother was at the hospital ready to provide daytime cares, having also been involved in the night-time process.
The court hears it was 'a dry run' for life at home.
Overnight on November 25-26, Child J's mother was at the hospital, attending for cares, including stoma bag management.
On November 26, Child J's mother went and stayed home, intending to return as usual at 8am on November 27. She said 8am would be after the handover, and staff preferred parents not to be on the ward at the time of the handover.

2:08pm

The mother recalled receiving a telephone call on the morning of November 27 telling her Child J had collapsed, and to attend hospital as soon as possible. She said that would have been about 7.10am.
The mother attended the hospital as quickly as she could with her husband. Child J was in room 2 in a 'hot cot', connected back up to a monitor and looked "very floppy...pale, yellowy in colour and not very responsive".

2:10pm

Child J's mother said she was "totally and utterly shocked because prior to this, she was extremely well, she was coming home...we were preparing for her to come home.
"Other than the weight gain, everything was fine."
Child J's father spoke to Dr John Gibbs and the mother recalled joining in the conversation, being "very stressed about what I was seeing and experiencing".

2:11pm

After the collapse, Child J's mother said nurses led the care, and the parents stayed overnight.
It was established there was not an infection - it was "unknown at that stage", the mother tells the court, and Child J recovered "quite quickly".
By the afternoon of November 28, Child J was "back up to full feeds", the mother tells the court.

2:14pm

In the following weeks after that, Child J had another collapse around December 16, 2015.
"That was when we really started to see issues with the stomas and the bags", the mother tells the court, with the bags not lasting anywhere near as long as before, and would stop working as they should.
After the second collapse, there were "concerns" when Child J was pressed in the abdomen, she would wince and feel pain, so Child J was transferred to Alder Hey to have the operation reversed and the stomas were closed, the bowel reattached.
On January 5, 2016, Child J returned home.

 

[Penny68]

Interesting that LL states that nursery nurses will have no training in stoma care, while at the same time acknowledging that she has little experience of this herself. Both statements are quite reasonable. But it indicates to me that nobody was really at an advantage here, other than the parents of course. Stomas aren't at all common on NNUs, so where I worked we always had advice from the stoma care nurse. It's not hard to care for them in principle but very tricky to cut the right size hole in the dressings & to get the bags to stick on! A bit of a Blue Peter scenario (one for the Brits!).,
All JMO.

Yes not hard to care for the stoma/s, as long as the correct size hole is cut using a template.

Also not to use anything with a moisturiser on while washing the surrounding area of the stoma when doing the bag change, because the seal will not stick.

Ideally warm water is for the best. I know personally as unfortunately I have two (ileo and uro).

So right about Blue Peter scenario, got a badge years ago.

 

[ColourPurple]

Prosecution evidence, February 10th 2023, Day 52 - Chester Standard live updates - Recap: Lucy Letby trial, Friday, February 10

Child J

Mother's Evidence

12:44pm

The court will next hear evidence in relation to Child J.

1:46pm

The trial is now resuming after a lunch break, and will hear evidence from the prosecution in the case of Child J.
In the prosecution opening, the Crown say Letby attempted to murder Child J, a baby girl, on the night shift of November 26-27.

1:53pm

The mother of Child J is called to give evidence.
She says she had a difficult pregnancy, and following a difficult operation in London, one of her planned twins was lost.
She said she gave birth to Child J, a baby girl, at 32 weeks and two days gestation on October 31, 2015.
Child J "appeared to be extremely well" and was shown to her after birth, and there appeared to be "no concern" before the baby girl was taken to the neonatal unit.
The mother said she visited Child J later at the unit, she was in an incubator. The baby girl was seen in the 10-minute time there to produce a bit of brown bile.
Child J was then taken to Alder Hey by ambulance. The mother said she was told there were concerns about Child J's bowel at the time.

1:58pm

The mother said it was discussed afterwards that Child J had 'NEC' [necrotising enterocolitis: a serious gastro-intestinal disorder where a portion of the bowel becomes inflamed] and had emergency surgery at Alder Hey.
The bowel was 'cut', 1cm was removed - "a little amount", and the decision was made to give Child J two stomas.
Child J returned to the Countess of Chester Hospital on November 10, and the mother recalls being there frequently., establishing a routine. Child J was "absolutely" progressing well, going from being treated in room 1 (most intensive treatment), to room 2, to room 3, to room 4, over the course of four weeks in November.

1:59pm

Child J's mother recalls there were issues with the baby girl's weight gain, which 'concerned her' and she relayed those concerns "frequently".
She said those concerns were treated "not very seriously - they weren't overly concerned".
There were "quite a lot of challenges" with the stoma management.

2:03pm

Child J's mother says, between November 10-27, there were no major concerns with the stoma management, but the bags were not lasting as long as expected, and breastfeeding was impractical, but attempts at breastfeeding were made as Child J was doing well.
She tells the court the approach of staff at the Countess was different to Alder Hey. While Alder Hey was 'inclusive', the communication did not feel the same at the Countess.

2:07pm

Events leading up to the morning of November 27 are discussed, when Child J collapsed.
Child J's mother said the family were "really excited" to get Child J home, as she was off the heart monitor, and the mother was at the hospital ready to provide daytime cares, having also been involved in the night-time process.
The court hears it was 'a dry run' for life at home.
Overnight on November 25-26, Child J's mother was at the hospital, attending for cares, including stoma bag management.
On November 26, Child J's mother went and stayed home, intending to return as usual at 8am on November 27. She said 8am would be after the handover, and staff preferred parents not to be on the ward at the time of the handover.

2:08pm

The mother recalled receiving a telephone call on the morning of November 27 telling her Child J had collapsed, and to attend hospital as soon as possible. She said that would have been about 7.10am.
The mother attended the hospital as quickly as she could with her husband. Child J was in room 2 in a 'hot cot', connected back up to a monitor and looked "very floppy...pale, yellowy in colour and not very responsive".

2:10pm

Child J's mother said she was "totally and utterly shocked because prior to this, she was extremely well, she was coming home...we were preparing for her to come home.
"Other than the weight gain, everything was fine."
Child J's father spoke to Dr John Gibbs and the mother recalled joining in the conversation, being "very stressed about what I was seeing and experiencing".

2:11pm

After the collapse, Child J's mother said nurses led the care, and the parents stayed overnight.
It was established there was not an infection - it was "unknown at that stage", the mother tells the court, and Child J recovered "quite quickly".
By the afternoon of November 28, Child J was "back up to full feeds", the mother tells the court.

2:14pm

In the following weeks after that, Child J had another collapse around December 16, 2015.
"That was when we really started to see issues with the stomas and the bags", the mother tells the court, with the bags not lasting anywhere near as long as before, and would stop working as they should.
After the second collapse, there were "concerns" when Child J was pressed in the abdomen, she would wince and feel pain, so Child J was transferred to Alder Hey to have the operation reversed and the stomas were closed, the bowel reattached.
On January 5, 2016, Child J returned home.

Thanks for that . So there was an issue with the bags not lasting as long as before but doesnt seem to be related to the collapses.

This is interesting too, that they preferred parents not to be around for handover. Didn't one of the consultants comment on the number of collapses around handover time.

She said 8am would be after the handover, and staff preferred parents not to be on the ward at the time of the handover.

 

[ColourPurple]

Was this the only evidence of ‘other’ photographed cards submitted? If so, I find it interesting that it also relates to a baby

IMO

Good point. You'd expect her to be able to show pics of loads of cards too.

 

[ColourPurple]

Dan O'Donoghue
@MrDanDonoghue
·
Mr Myers asks Ms Letby if it's 'usual' for there to be a 25week old baby at the Countess of Chester.

She says: 'no, should be born in a tertiary centre'

Mr Myers asks her what the minimum gestation for a level 2 centre should be, she said: '27 weeks gestation or above 700grams birth weight'. Child K weighed 692g. Mr Myers asks if she knows why Child K was therefore at the hospital, she says 'no'

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[katydid23]

I have a photo of a card I sent to my other half on my phone. She has one of a card her mum gave her because she wanted to show it to me. It does happen.

LLs constant messaging and taking photos seems to tie in very closely to the whole hording of the hand-over sheets, at least to my thinking it does. She's clearly got some sort of compulsive behavior trait going on - in my totally unqualified opinion, of course.

I agree, it does happen that someone would have a card or two on their cell phone.

But her testimony was that she 'regularly, takes photos of cards sent and received, and 'has done so for many years,'

And that seems like an unusual habit. JMO

 

[ColourPurple]

Dan O'Donoghue
@MrDanDonoghue
·
Ms Letby explains that she was caring for two other babies in nursery two when Child K was born. She says she has no independent recollection of her but says she was aware of her as it was so 'unusual' to have a 25week baby

Child K was in nursery one. Ms Letby is asked if she would have went in to N1 on her shift, she says yes - as this is where a lot of kit was kept

Mr Myers puts what Dr Jayaram said in evidence. That he had entered N1 to find Ms Letby standing near to Child K while she was desaturating - she says 'I don’t recall any conversation with Dr Jayaram that night'

She denies interfering with Child K's breathing tube and denies being present at any desaturation

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[ColourPurple]

11:58am
The trial is resuming after a short break.

The layout of the neonatal unit is shown to the courtroom for February 16-17.

Lucy Letby is the designated nurse for two babies in room 2 at the start of the shift. Child K was brought into room 1 during the night shift after her birth.

Letby is asked if she has any independent recollection of Child K.

"I remember it was unusual [seeing a 25-week gestation age baby], and seeing her at some point...but cannot recall any of the contact."

Letby said she would go into room 1 to collect medication, and it was a "frequently used" room.

Two other babies were in room 1, with designated nurse Caroline Oakley.

Recap: Lucy Letby trial, Tuesday, May 16 - defence continues

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[Blondiexoxo]

Strange how LL’s memory has returned and she now remembers a lot of detail that seems to throw all her colleagues and the hospital under the bus. I don’t think this will do her any favours IMO when the jury have already heard what she said in her police interview, whilst knowing her legal rights which I am sure will have been given to her at the beginning of the interview:
‘You do not have to say anything, but it may harm your defence if you do not mention when questioned something which you later rely on in court…’.

 

[ColourPurple]

12:09pm
Mr Myers says there is a point, alleged, when Dr Jayaram sees Letby by Child K, and Child K's tube is dislodged.

Mr Myers: "Did you interfere with [Child K's] tube?

Letby: "No."

Letby denies being at the cotside when Dr Jayaram entered room 1, and says she does not recall any conversation with Dr Jayaram that night.

Mr Myers refers to a police interview with Letby from July 2018. Letby was asked if she remembered Child K's deterioration - "No" was the answer. Letby said she recalled Child K only as she was a 25-week baby, which was unusual on the unit.

Letby was asked by police if she was present when Child K's ET tube dislodged. "I don't remember."

Letby says she signed for morphine to be administered to Child K. She tells the court she had no involvement with Child K beyond that point.

Letby says in police interview she was not by Child K's incubator at the time Dr Jayaram entered room 1.

She told police if the desaturations dropped to 80s, she would expect the alarm to go off for Child K.

She said to police: "I don't know why the alarm would not have sounded."

Letby was asked by police if she had turned off or deactivated the sound on the monitor. "No."

Letby tells the court "it does happen" that a tube can move "with an active baby".

She told police "tubes can slip if not properly attached".

Letby says if she was there, and had seen the observations drop and/or the tube slip she would have summoned help. She denies being there at that point, or having any involvement in the tube being dislodged, or 'just watching'.

She denies Dr Jayaram's report was accurate.

Recap: Lucy Letby trial, Tuesday, May 16 - defence continues

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[katydid23]

Prosecution evidence, February 27th 2023, Day 62 - live updates Chester Standard LIVE: Lucy Letby trial, Monday, February 27


Child K


8:59am

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is expected to continue today (Monday, February 27).
We will be bringing you updates throughout the day.

10:21am

The trial, which is now in its 18th week before a jury, is due to resume at 10.30am.

10:27am

Having given evidence in the cases of twins, Child L and Child M, today the court is expected to go back, chronologically in the case, to Child K, who was born in February 2016.
It is the prosecution's case that Lucy Letby attempted to murder Child K, a baby girl, on February 17. The defence deny this.
Child K remained unwell and died on February 20.

10:33am

The 12 members of the jury have come into court, and the trial is now resuming.
Prosecutor Nicholas Johnson KC is reminding the jury of its case for Child K.

Mother's Statement

10:38am

The court is now hearing a statement from the mother of Child K, who described being thrilled at the news she was pregnant.
At the 12-week scan at the Countess of Chester Hospital, an issue was identified - Child K had a build-up of fluid at the back of her neck. At the 15-week scan, she was reassured everything was normal.
She had regular scans, and further check-ups showed the fluid was disappearing gradually.
At 18-20 weeks, it was discovered Child K had a pocket of fluid at her lungs, but follow-up checks saw this had gone.
Just before 25 weeks, the mum recalls waking up with 'a few niggles and pains'. She was still working at this time.
The midwife was called, and she advised to call the labour ward at the Countess of Chester Hospital - she was advised to attend.
She was informed by a midwife there she had gone into labour "we couldn't believe it".

10:41am

The mother stayed at the hospital and received treatment.
Discussion took place over transferring the mother to a tertiary centre, but the nearest one, Arrowe Park, was full.
On February 16, the mother was given further steroids, and the possibility of a C-section birth was discussed.
There were "no indications of any concerns" of Child K, who was showing no signs of any distress. The decision was made to leave things as they were at that time.
That evening, the mother recalls waking up in pain, and the button was pressed to alert medical staff.
Child K, a baby girl, was born at 2.12am. Staff worked on Child K for 30-45 minutes. The mother later found she had been born weighing 692g - 1lb 8oz.

The consultant explained that the gestational age of 25 weeks meant there would be a medical team solely to look after Child K, who would be placed into an incubator. Once stable, she would be transferred to the special care on the neonatal unit.
A female nurse came in and told the parents Child K was "fine and stable", and if they wanted to see her.
The nurse offered to take photos of the three of them, on the father's phone.
The pictures are timestamped at 4.31am on February 17, making Child K only a few hours old.
The mother was woken up later informing a bed had become available at Arrowe Park. At 9am, the transfer team arrived at the Countess of Chester Hospital. They explained what was going to happen. The process took "some time" as the team had difficulty stabilising her. It was then when the parents considered a name for Child K.
At noon, it was "now or never", for Child K to be transferred to Arrowe Park. The mother had not been discharged at this point, and the medical team "desperately" tried to make it possible so she could be allowed to go to Arrowe Park, which was done at 2pm.
The parents arrived at Arrowe Park at 2.30-2.45pm. Later, arrangements had been made for the parents to stay at the purpose-built accommodation.

10:50am

The mother recalled "the strangest feeling which she could not describe" on the morning Child K died.
At the neonatal unit, parents had no restrictions on visiting times. They went in
As soon as she walked in, she could see the readings, including saturations, were low. She knew straight away things weren't great.
A doctor was in the room at the time. "I looked and said, she's not good is she?" The doctor "confirmed the worst," explaining Child K had been fighting all night.
The parents had a long conversation with the doctor, and the decision was made to switch off life support machines.
Child K passed away in her father's arms.

10:51am

A cot was brought into the room to allow the parents time privately with Child K, who had died on February 20.

 

[katydid23]

Prosecution evidence, February 28th 2023, Day 63 - live updates Chester Standard - LIVE: Lucy Letby trial, Tuesday, February 28
Child K

Dr Ravi Jayaram

12:14pm

The next witness to give evidence is Dr Ravi Jayaram.

12:17pm

Dr Jayaram confirms he would have been on call as a consultant on the night shift of February 16-17, 2016.
He says he would have been called at home, and would have been called to come in for the delivery of a 25-week gestational age baby such as Child K, as the hospital would be aware there could be complications.
He tells the court, until the early 2000s, there was less structure, but in more recent times, if possible, mothers are taken to tertiary centres [such as Arrowe Park] to give birth. If that is not possible, babies can be cared for in the short term at level 2 centres such as the Countess of Chester Hospital.

12:18pm

He says, on balance, the risk would have been too great to transfer Child K and the mother for the birth at a tertiary centre.
He adds he was present at Child K's birth.

Dr Jayaram says it is significant, when talking through the medical notes he had written retrospectively, the mother had a 'spontaneous rupture of membranes' 48 hours before birth, as that could lead to a risk of infection.
He said it was relevant there were 'no fevers' recorded.
The medical notes record Child K was 'initially dusky, floppy, no respiratory effort'. Dr Jayaram said that was significant and in this situation, a pathway is followed including 'inflation breaths', which stimulates the baby's first gasps.
He says it is like blowing a balloon up for the first time - the lungs are difficult to inflate for the first time as they are filled with fluid.
The inflation breaths are completed after two cycles, and Dr Jayaram says the chest is then seen to be moving up and down.
The heart rate is then above 100 beats per minute, recorded two and a half minutes after birth.
Gasps are recorded after three minutes. Dr Jayaram said Child K would have initially been 'a little stunned', but the gasps are what the medical staff are looking for.
Oxygen saturation levels of 'above 85%' at six minutes are 'satisfactory'.

12:28pm

The initial intubation process is discussed.
Dr Jayaram says it can be difficult and risky, and it is important the oxygen saturation levels are high before starting the procedure.
A doctor has 30 seconds to attempt the intubation procedure. The court hears the intubation was done on the third attempt, with a smaller, size 2, ET tube.
He says, "ideally", a 2.5 ET tube would be used, but in these circumstances a size 2 tube was sufficient.

Child K was transferred to the neonatal unit, on a ventilator.
Dr Jayaram describes Child K required around 60% oxygen. He says he could hear air going in and out of the baby girl's lungs.
The initial blood gas readings are taken, and it is acceptable for a 'little bit of leeway' on carbon dioxide levels.
Child K was given surfactant at 2.45am, Dr Jayaram had recorded in the notes.
A blood culture test was taken to screen for infection, as a routine test, and the baby girl would be treated on the assumption she already had an infection and would be treated with antibiotics.

12:35pm

A morphine infusion is recorded on the medical notes.
Mr Astbury asks when that would be administered. Dr Jayaram says he does not recall when that would have been, but it would not be immediately after transfer to the neonatal unit nursery room 1.
Dr Jayaram said he could hear Child K's heartbeat, and air going in and out of both lungs.
He said, for a 25-week gestation baby, he was "happy" with Child K's progress.

12:38pm

Dr Jayaram said he was happy the ventilator was working, as observed by Child K's chest moving, and being in good colour.
He tells the court that at this point, he informed the transport team about the situation, and they had advised there was a bed at Arrowe Park Hospital, and they advised for a UVC line to be inserted prior to transport.

12:41pm

Dr Jayaram is now being asked about Child K's desaturation at 3.50am.
A plan of the neonatal unit layout is shown to the court.
Dr Jayaram said he was "happy" with how Child K was "very very settled", having had to make only minor adjustments to the ventilator settings.
An infusion chart for the morphine is shown to the court, with a start time of 3.50am. He confirms that 3.50am would be the time that would be administered.



Dr Jayaram says he was aware Joanne Williams was going to the labour ward to update the parents on Child K.
He said he was sitting at a desk, around the corner from the entrance to nursery room 1. He says he was writing in notes, or waiting for the transfer team to come back to him regarding arrangements.

He said he had been told Lucy Letby would be 'babysitting' at the time - a common term used by the hospital to describe a neonatal nurse temporarily looking after a baby in the absence of its designated nurse.
He says, at this point, in February 2016, he was aware of 'unexpected/unusual events' that had happened recently, and that Lucy Letby had been present.
He said: "I felt extremely uncomfortable [with Lucy Letby being there alone in the room with Child K]
"You can call me hysterical, completely irrational, but because of this association...
"This thought kept coming into my head. After two, two and a half minutes...I went to prove to myself that I was being ridiculous and irrational and got up.
"I think it was 2.5, 3 minutes after Jo had gone to the labour ward.
"I had not been called to review [Child K], I had not been called because alarms had gone off - I would have heard an alarm. I got up and walked through to see [Child K]."
Dr Jayaram entered nursery room 1 through the entrance doors closest to his desk. Child K was at the far side of the nursery room, with Lucy Letby present.
He said: "I saw Lucy Letby standing by the incubator. I saw her, and looked up at the monitor, and K's saturations were dropping, in the 80s and continued to drop. The ventilator was not giving out an alarm.
"I recall looking up and saying 'what's going on?' and Lucy said something along the lines of 'She's having a desaturation'."
Asked what Letby was doing, Dr Jayaram replied: "Nothing."
He says Letby didn't say anything to Dr Jayaram until he had walked over and he had asked her what was going on.



Dr Jayaram said he was looking at Child K. He disconnected the ventilator from the ET Tube and he tried to give breaths via the ET Tube, but Child K's chest was not moving.
He said he switched into 'professional mode' to resolve the situation, and it 'didnt make sense why the tube was dislodged'
He said he removed the tube - which wasn't blocked - and put a face mask to ventilate Child K. As soon as that was done, Child K's chest went up and down, without too much difficulty.
He says he does not remember anything else Lucy Letby said. He says he was probably telling her to bring equipment.

12:53pm

Dr Jayaram says the original tube was not blocked, and there would be no reason for that to have been blocked, for the time it had been on Child K.
Dr James Smith reintubated Child K, and the same ventilator settings were selected, indicating - Dr Jayaram tells the court - Child K had not been declining.

12:57pm

Dr Jayaram's notes are shown to the court, where he had described it as a 'sudden desaturation'.
The oxygen saturation levels fell to 40%.
The tube was removed, Child K was bagged via a face mask, and 'sats recovered quickly'.
A size 2.5 ET tube was placed. 'Ventilator settings as previously'.
The size of the tube "did not have an impact" on the previous ventilation, Dr Jayaram tells the court, as Child K was "ventilating effectively" and did not have an impact on the "sudden deterioration".

 

[ColourPurple]

12:26pm
The neonatal schedule for February 16-17 is shown to the court.

Letby is involved in the care of her two designated babies up to 12.30am, plus a baby in room 1 at 12.51am, 'assisting with cares'.

Letby cares for her designated babies up to 2am, and assists in the medication of a fourth baby at 2.04am and 2.14am.

The chart shows Letby's records with her designated babies up to 3.30am, when - at that time - observations are made and a feed given to one of the designated babies.

Letby says 3.30am would be a "rough time" of when it happened. The feed, observations, and a nappy change, could take half an hour - the quickest '20 minutes', the longest "up to an hour".

She says in this case, this could have taken "15-20 minutes".

Letby is asked if, by doing this, she had any reason to be in room 1 at that time. Letby says she would not have had a reason.

Letby is then recorded, on the neonatal schedule, as caring for Child K after the event has taken place. The first recorded activity is for morphine administration, with Joanne Williams signing for the medication and Letby being a co-signer. Letby says this was because Child K was being reintubated and required morphine.

She does not recall being called to the nursery room.

She does not recall being involved in the subsequent events for Child K.

Letby is asked about a Facebook search for the surname of Child K, made on April 20, 2018, at 11.56pm.

Letby says: "You still think of patients you've cared for."

She says she does not recall why she looked up the name at that point.

Letby says that night "was a busy shift" but, asked whether she had done anything that night to merit questions about it years later, Letby says: "No."

Recap: Lucy Letby trial, Tuesday, May 16 - defence continues

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[ColourPurple]

Dan O'Donoghue
@MrDanDonoghue
·
Mr Myers asks Ms Letby why she searched Facebook for Child K's surname in April 2018 - she said you 'still think of patients that you’ve cared for'

We're now moving to the cases of twin boys Child L and M. Ms Letby is accused of adding insulin to at least three of Child L's feed bags in attempt to poison him while on duty in April 2016.

Ms Letby is accused of adding insulin to at least three of the infant's feed bags while on duty at the Countess of Chester Hospital in April 2016.

Ms Letby is accused of trying to kill Child L around the same time she allegedly tried to murder his twin brother, Child M, by injecting air into his bloodstream.

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12:33pm
Mr Myers moves on to the cases of twins, Child L and Child M, born on April 8, 2016 at 33 weeks and 2 days gestation.

Letby confirms she is still working and caring for babies, working a mixture of day and night shifts, at the hospital, during this time.

She says, in reply to what her intentions were for the babies: "To provide the best care possible."

She estimates she had cared for about "100" babies during these few months.

Child L was born weighing 1,465g. Child L later struggled with low blood sugar.

A blood sample was taken for Child L - the insulin level read 1,099, insulin C-Peptide 264. The insulin was "far higher" than the C-peptide reading, indicating, Mr Myers, insulin had been administered to Child L.

Child M weighed 1,705g. Child M later had a desaturation, which it is alleged Letby had caused.

Recap: Lucy Letby trial, Tuesday, May 16 - defence continues

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

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Dan O'Donoghue
@MrDanDonoghue

In the days before the twins were born, Ms Letby moved into her new home in Chester. Mr Myers is taking the court back over messages sent between Ms Letby and colleagues at that time talking about the move

Ms Letby said moving into that house was a 'massive life moment', she said when she wasn't at work she was wanting to focus on 'sorting out the house'

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12:42pm
On April 8, Sophie Ellis messaged Letby: "How's the house pal? "

Letby responds: "Hey, it's feels a bit weird having a whole house but It's good thanks, although stuff everywhere as moved in properly on Tue & been at work Wed Thurs & today . Doing tomorrow as an extra so I'll see you tomorrow night. Won't be such an early start for you now back in Chester!..."

The reply: "Yeah I bet it does, it'll feel more homely once you've sorted everything out. Jeeeez 4 [Long Day shifts] in a row, are you ok?! I know yay and I don't have to pay for petrol, it's cost me a fortune . Yeah they are haven't seen them for a while. What's the unit like? "

Letby: "Yeah I'll get there in time. Petrol & tunnel soon mounts up doesn't it! Can you claim travel expenses? I couldn't for 405. Unit is busy, No one particularly unwell just volume & few people off sick. I prefer 4 days to 4 nights. Least tomorrow is an extra & Sat pay! . Awe that'll be nice hope weather a bit better for you! X"

SE: "Yeah we can. Omg really, how come? That's 7 weeks aswell isn't it? Yeah, 4 nights are awful. Ah that's not too bad then. Think I'd prefer to keep busy. I think it's meant to rain...dammit "

LL: "Eirian said something about the induction being paid for by the trust whereas the 405 comes out of network budget so won't pay as its an expected part of role to progress etc. Mad really & costs a bomb! We've got nice mix of babies at the mo really. Shift goes quick anyway! Grr typical April showers haha. [Colleague] is in Thailand & It's been 44degrees today! X"

Letby said it was a "massive" life moment for her to move into her new house, and her main focus was on "sorting out the house".

Letby says the unit was "still fairly busy" at this point.

On April 11, Letby messages a colleague: "The unit is in dire way with staff..."

She says the unit had 'banker agency staff' and band 5s who did not have the ITU course.

She says the unit being busy was "often discussed by staff".

Recap: Lucy Letby trial, Tuesday, May 16 - defence continues

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

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What's a 405?

LL: "Eirian said something about the induction being paid for by the trust whereas the 405 comes out of network budget so won't pay as its an expected part of role to progress etc. Mad really & costs a bomb!

ETA I think it might be her ICU course

ENB 405 (Special and Intensive Care of the Newborn)

 

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Dan O'Donoghue
@MrDanDonoghue
The court is shown a message Ms Letby sent a colleague in April 2016, she says 'the unit is in dire way with staff'. She said to Mr Myers the unit was 'incredibly busy and didn’t have adequate staffing to cater for all the needs of the babies at that point'

She says the unit was relying on agency staff and some of the band five nurses did not have intensive care training

Mr Myers pulls up a message from a nursing manager, messaging Ms Letby on a Sunday morning asking if she can work that night - Ms Letby says this 'would happen regularly'

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[Jazmania]

12:26pm
The neonatal schedule for February 16-17 is shown to the court.

Letby is involved in the care of her two designated babies up to 12.30am, plus a baby in room 1 at 12.51am, 'assisting with cares'.

Letby cares for her designated babies up to 2am, and assists in the medication of a fourth baby at 2.04am and 2.14am.

The chart shows Letby's records with her designated babies up to 3.30am, when - at that time - observations are made and a feed given to one of the designated babies.

Letby says 3.30am would be a "rough time" of when it happened. The feed, observations, and a nappy change, could take half an hour - the quickest '20 minutes', the longest "up to an hour".

She says in this case, this could have taken "15-20 minutes".

Letby is asked if, by doing this, she had any reason to be in room 1 at that time. Letby says she would not have had a reason.

Letby is then recorded, on the neonatal schedule, as caring for Child K after the event has taken place. The first recorded activity is for morphine administration, with Joanne Williams signing for the medication and Letby being a co-signer. Letby says this was because Child K was being reintubated and required morphine.

She does not recall being called to the nursery room.

She does not recall being involved in the subsequent events for Child K.

Letby is asked about a Facebook search for the surname of Child K, made on April 20, 2018, at 11.56pm.

Letby says: "You still think of patients you've cared for."

She says she does not recall why she looked up the name at that point.

Letby says that night "was a busy shift" but, asked whether she had done anything that night to merit questions about it years later, Letby says: "No."

Recap: Lucy Letby trial, Tuesday, May 16 - defence continues

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

So on the one hand she's saying it would be normal for her to be in room 1 to collect items, and on the other she's saying she had no reason to be in 1 because she was caring for her babies in a different room at the time. So she's kind of hedging her bets by simultaneously saying she could have been in 1 for an innocuous reason, but also saying that Dr Ravi is making the entire episode up. Seems unlikely.

Also, she said before that she barely recalled child K and had very little to do with their cares, but she also said she searched for child K's mother over 2 years later because you 'still think of the patients you've cared for'.