UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #23

[katydid23]

Letby’s family is not paying Myers!

But don't they get to choose who represents her?

 

[Parker Knoll]

Myers would of been retained by Letbys Instructing Solicitor ( she’s had the same one since arrest number 1 ) BM appeared on her behalf at her bail applications.
She was at Warrington Mags first then it was sent to Chester Crown Court for the unsuccessful bail apps. It went to Manchester for logistical and judicial reasons.

 

[Blondiexoxo]

IMO - the deterioration of unwell premature babies - could be explained by a combination of medically explainable explanations based on pathological processes and/or non-sinister iatrogenic reasons.

Which is why it is essential to scrutinise each case individually. Conversely, evaluating the cases overall on collective patterns, and attributing an individuals presence as a common denominator - leads to bias and oversights IMO

From a quick look back the only 2 babies that stick out to me as being very premature are baby G and K. Most of the babies were decent birth weights for being premature, baby O weighed just over 2kg which is a brilliant weight for a triplet.

In that setting, a neonatal unit, pretty much every baby in there is considered premature, just because a baby is premature does not mean he/she is critically ill or going to die. The evidence shows that even for a unit filled with premature babies, these deaths were unexpected, unusual and came with little warning. Staff on the unit and specialists who have a career in caring for premature babies also found the collapses and deaths unusual. In that setting the sheer amount of incidents in a one year span was suspicious to many of the staff and those who’ve testified so far. Babies born at 30 weeks have roughly a 95%+ survival rate and will recover and leave hospital. Most babies in NICU are on oxygen at some point, even if just a small amount.

My youngest was born at 35 weeks, for her first 2 days she was in an incubator on oxygen which was weaned down. She was completely healthy other than her temperature 30 mins after birth was slightly low, just the one reading and they whisked her off to NICU where she remained for around 2 weeks. They are extra cautious in NICU and even though she’d taken several feeds she was a lazy baby and took a good half an hour to take her milk so she had an NG tube fitted but this was only used during the night by the night staff, during the day I fed her bottles. She was only there for 2 weeks to establish feeding, because the night staff were using her NG tube as it was quicker and they had lots of babies to tend to (really frustrated me as they wouldn’t allow her home until she’d not been NG fed for 48 hours) while in the day I was there to sit and feed her.

Some babies are described as ‘jaundiced’ which is an extremely common minor ailment in babies. I remember my son (not premature came home 8 hours after birth) being almost bright orange for his first week, I was really worried but the midwife who came out every day from when we brought him home assured me it was nothing to worry about. Now my daughter in NICU was only very slightly tinged with jaundice and they had her under a lamp receiving phototherapy. If she’d have been at home it wouldn’t have been a concern atall, but in the NICU they are so very careful err on the side of caution ‘just in case’.

This is just to try and explain how hearing of some babies having a slightly low temperature or a bit of jaundice etc isn’t unusual really, but because of the setting they are in they are receiving treatment for any and all ailments even if only minor. They have regular obs taken and anything slightly off is noted, sometimes they choose to watch and wait before rushing into any treatment but then some doctors will suggest treating the smaller things straight away, just incase. Also, most babies are put on antibiotics straight away when they get to neonatal. I think that’s sort of routine as a caution against any infection.

I think there’s a common misconception that neonatal units are filled with tiny babies in incubators who are clinging to life which is not true at all. While there are some very small and unwell babies, many are only in there until they’ve either established feeding or have put on enough weight to be allowed home.

Sorry for the long post I just wanted to point out that just because they were on the unit, premature, low weight and had a few issues at birth does not necessarily mean that they were particularly vulnerable or at risk of collapsing. There were also some babies who had been there for quite a while so by all accounts were ‘out of the woods’ so to speak.

All MOO

 

[Parker Knoll]

No the family don’t really get To ” choose “ as such.
If Letby had hated BM they would of got another silk but clearly she was happy with him.
I would of been if it was me tbh - he’s top notch.

 

[Becci]

That doesn't mean they were on the verge of death though. The first four were not fully oxygen dependent nor deemed so fragile or vulnerable that they were considered likely to collapse and die.

Child A​

The court heard he was "stable" and was breathing without support on 8 June, but suffered a rapid deterioration about an hour after Ms Letby came on shift and was pronounced dead half an hour later.

Child B​

Child B, who required some resuscitation at birth but recovered quickly, was the twin sister of Child A and collapsed on 10 June 2015, 28 hours after her brother's death.

Child C​

Child C was in a "good condition" and stable after his premature birth in early June 2015, but stopped breathing without warning on 13 June while being treated in the unit's nursery one

Child D​

The prosecution accepted the failure to give antibiotics was a "legitimate target of criticism", but Child D had been "responding well to treatment and was not expected to deteriorate".
However, on 21 and 22 June, she collapsed several times and despite resuscitation attempts, she was pronounced dead.

For child D i don't think the baby was responding well really.
21st June

10.15am: Kate Bissell, in a subsequent nursing note, said a blood gas reading at 10.15am was subseqently taken and the results showed signs of respiratory acidosis, so Child D was put back on CPAP.

12.15pm:The blood gas was repeated two hours later and 'showed further deterioration with increasing metabolic acidosis'. Child D's perfusion was 'poor' and a doctor approved a decision to administer medication.

Dr Ahmed Chowdhury recorded a UVC and a UAC were inserted.
5.53pm: A 'family communication' note is made at 5.53pm - "Dad visiting most of the day, he is up to date with the plan of care. Mum has visited this evening."

Both parents were 'anxious' about the levels of care provided.

7.15pm: A nursing note at 7.15pm said attempts were made to get Child D off CPAP, but breathing was still 'shallow' off that, so CPAP resumed.

7.26pm: Swipe data showed Lucy Letby arrived at the neonatal unit at 7.26pm.

 

[Lincoln34]

That doesn't mean they were on the verge of death though. The first four were not fully oxygen dependent nor deemed so fragile or vulnerable that they were considered likely to collapse and die.

Child A​

The court heard he was "stable" and was breathing without support on 8 June, but suffered a rapid deterioration about an hour after Ms Letby came on shift and was pronounced dead half an hour later.

Child B​

Child B, who required some resuscitation at birth but recovered quickly, was the twin sister of Child A and collapsed on 10 June 2015, 28 hours after her brother's death.

Child C​

Child C was in a "good condition" and stable after his premature birth in early June 2015, but stopped breathing without warning on 13 June while being treated in the unit's nursery one

Child D​

The prosecution accepted the failure to give antibiotics was a "legitimate target of criticism", but Child D had been "responding well to treatment and was not expected to deteriorate".
However, on 21 and 22 June, she collapsed several times and despite resuscitation attempts, she was pronounced dead.

My youngest child was sent to the unit post c- section. He had been grunting and I knew what that meant - Transient tacyponea - might have spelt that incorrectly ! - he went on for 02 for 3 hours and was then brought back to
Me. . This was way before LL was on the unit at the Countess.he was full term at birth. X

But don't they get to choose who represents her?

Usually the solicitor selects. That’s why barristers are Really Really nice to those instructing them. Same for Civil as Criminal. If I got a high value brain injury case I’d be lining up best barrister as a first point. You chose your tools . Before the other side can get to them! Best criminal
Silks - KCs now - will act for both - Defence and prosecution. Same in civil - you don’t want someone who always defends. They lack perspective. IMO

I have had only one criminal trial. It was complex and so I instructed London counsel - which can be a risk as they might not know the court or area as well. However it was the right decision in that case . All IMO but from experience.

 

[Bethan]

Sorry just to add on to my above post. I found this article interesting, particularly when it comes to this quote about possible red flags exhibited by other HCSK’s.

Taken from:

Nurses Who Kill Babies Exploit Systems of Trust

An ongoing trial of a nurse accused of killing babies spotlights both motive and the need for improved safeguards for the most vulnerable patients.

www.psychologytoday.com

From several of these studies and additional cases, we now know that nurses who endangered or killed a number of patients had multiple red-flag behaviors (Ramsland, 2007). They might have gained macabre nicknames from patients or staff; were in rooms where unexpected deaths occurred (and weren’t assigned there); were secretive or deceptive about innocuous things; liked to “predict” that a patient would die; were associated with suspicious incidents at different institutions; craved attention; hung around after a death to experience the reactions; lied about credentials; or falsified their work records or medical access reports. They didn't operate fully under the radar. Colleagues noticed them.

I think we’ve heard at some points throughout the trial that LL exhibited most if not all of these ‘red flag’ behaviours at numerous points throughout 2015-2016.

MOO

Thank you……interesting article!

 

[katydid23]

For child D i don't think the baby was responding well really.
21st June

10.15am: Kate Bissell, in a subsequent nursing note, said a blood gas reading at 10.15am was subseqently taken and the results showed signs of respiratory acidosis, so Child D was put back on CPAP.

12.15pm:The blood gas was repeated two hours later and 'showed further deterioration with increasing metabolic acidosis'. Child D's perfusion was 'poor' and a doctor approved a decision to administer medication.

Dr Ahmed Chowdhury recorded a UVC and a UAC were inserted.
5.53pm: A 'family communication' note is made at 5.53pm - "Dad visiting most of the day, he is up to date with the plan of care. Mum has visited this evening."

Both parents were 'anxious' about the levels of care provided.

7.15pm: A nursing note at 7.15pm said attempts were made to get Child D off CPAP, but breathing was still 'shallow' off that, so CPAP resumed.

7.26pm: Swipe data showed Lucy Letby arrived at the neonatal unit at 7.26pm.

Obviously there are some medical issues in a NICU. But LL had been working there for a few years with ZERO babies dying. And then she begins to lose babies, in small clusters, back two back to back ? It doesn't make any sense that all of these babies are collapsing----22 incidents in one year.

Baby D's death was not consistent with the mild symptoms beforehand.

Lucy Letby trial: Air was injected into baby's blood

A paediatric radiologist tells jurors gas could be seen in front of the baby's spine on an X-ray.

www.bbc.com

Expert medical witness Dr Sandie Bohin told the jury that despite having pneumonia at birth, Child D was "improving" and was "stable".
She said there was "nothing to indicate that death was imminent".
She added: "I would be surprised if an infection alone could cause that catastrophic a collapse."

Asked to give an assessment of Child D's fatal collapse, she said: "Taking into account the suddenness of the collapses and quick recovery, I was clear that this was not the infection.
"I was looking at something else and that something else had to be unusual, something odd."

She concluded: "(Child D) had air administered to her and that was the cause of the collapses."


Jurors were told that Dr Arthurs, professor of radiology at London's Great Ormond Street Hospital, had been instructed to review X-rays taken of the baby, known as Child D, when alive and after death, as well as other babies in the investigation.

Dr Arthurs said the amount of gas present in Child D's X-rays was consistent with babies that had died of sepsis, complications with a breathing support system, a severe trauma such as a road traffic collision or the direct administration of air into the body.
Dr Arthurs said he had never come across a child dying in such circumstances where there was no such explanation.

He told jurors the most plausible conclusion was, in the absence of any other explanation, "external intravenous air administration".
Dr Arthurs added that he knew of only two other babies dying in similar circumstances, both of whom also form part of this case.
------------------------------

 

[Parker Knoll]

My youngest child was sent to the unit post c- section. He had been grunting and I knew what that meant - Transient tacyponea - might have spelt that incorrectly ! - he went on for 02 for 3 hours and was then brought back to
Me. . This was way before LL was on the unit at the Countess.he was full term at birth. X

Usually the solicitor selects. That’s why barristers are Really Really nice to those instructing them. Same for Civil as Criminal. If I got a high value brain injury case I’d be lining up best barrister as a first point. You chose your tools . Before the other side can get to them! Best criminal
Silks - KCs now - will act for both - Defence and prosecution. Same in civil - you don’t want someone who always defends. They lack perspective. IMO

I have had only one criminal trial. It was complex and so I instructed London counsel - which can be a risk as they might not know the court or area as well. However it was the right decision in that case . All IMO but from experience.

PLC we used to all it back in the day - proper London counsel !

 

[marynnu]

My youngest child was sent to the unit post c- section. He had been grunting and I knew what that meant - Transient tacyponea - might have spelt that incorrectly ! - he went on for 02 for 3 hours and was then brought back to
Me. . This was way before LL was on the unit at the Countess.he was full term at birth. X

Usually the solicitor selects. That’s why barristers are Really Really nice to those instructing them. Same for Civil as Criminal. If I got a high value brain injury case I’d be lining up best barrister as a first point. You chose your tools . Before the other side can get to them! Best criminal
Silks - KCs now - will act for both - Defence and prosecution. Same in civil - you don’t want someone who always defends. They lack perspective. IMO

I have had only one criminal trial. It was complex and so I instructed London counsel - which can be a risk as they might not know the court or area as well. However it was the right decision in that case . All IMO but from experience.

Transient tachypnoeia of the newborn - which is why it's referred to as TTN, unsurprisingly!!

 

[Lincoln34]

That could be how Meyers got his job in this case as well....What if he offered his services to LL's family when he heard about the arrest? Would that mean he wasn't fit to take on the job, if offered?

Nope. Almost certainly the solicitor picked the barrister IMO . It’s like selecting from a tool set. You chose the right spanner for the nut ( case) x

Edited for typo

 

[Becci]

Obviously there are some medical issues in a NICU. But LL had been working there for a few years with ZERO babies dying. And then she begins to lose babies, in small clusters, back two back to back ? It doesn't make any sense that all of these babies are collapsing----22 incidents in one year.

Baby D's death was not consistent with the mild symptoms beforehand.

Lucy Letby trial: Air was injected into baby's blood

A paediatric radiologist tells jurors gas could be seen in front of the baby's spine on an X-ray.

www.bbc.com

Expert medical witness Dr Sandie Bohin told the jury that despite having pneumonia at birth, Child D was "improving" and was "stable".
She said there was "nothing to indicate that death was imminent".
She added: "I would be surprised if an infection alone could cause that catastrophic a collapse."

Asked to give an assessment of Child D's fatal collapse, she said: "Taking into account the suddenness of the collapses and quick recovery, I was clear that this was not the infection.
"I was looking at something else and that something else had to be unusual, something odd."

She concluded: "(Child D) had air administered to her and that was the cause of the collapses."


Jurors were told that Dr Arthurs, professor of radiology at London's Great Ormond Street Hospital, had been instructed to review X-rays taken of the baby, known as Child D, when alive and after death, as well as other babies in the investigation.

Dr Arthurs said the amount of gas present in Child D's X-rays was consistent with babies that had died of sepsis, complications with a breathing support system, a severe trauma such as a road traffic collision or the direct administration of air into the body.
Dr Arthurs said he had never come across a child dying in such circumstances where there was no such explanation.

He told jurors the most plausible conclusion was, in the absence of any other explanation, "external intravenous air administration".
Dr Arthurs added that he knew of only two other babies dying in similar circumstances, both of whom also form part of this case.
------------------------------

The experts over rule a pathologist.
I feel sorry for the pathologist because he's been made to look ermm not very good at his job imo

Child D

Original pathology: The coroner gave the cause of death as "pneumonia with acute lung injury."

Reviewing pathology (Dr Andreas Marnerides): The “likely explanation” for the death of Child D, a girl, was an air embolism into her circulation.

 

[katydid23]

The experts over rule a pathologist.
I feel sorry for the pathologist because he's been made to look ermm not very good at his job imo

Child D

Original pathology: The coroner gave the cause of death as "pneumonia with acute lung injury."

Reviewing pathology (Dr Andreas Marnerides): The “likely explanation” for the death of Child D, a girl, was an air embolism into her circulation.

I am not sure they are conflicting explanations. The pathologist describes an acute lung injury. Dr M. fills in the blanks of how it probably occurred?

also, the pathologist said:
He told jurors the most plausible conclusion was, in the absence of any other explanation, "external intravenous air administration".

 

[katydid23]

I am really curious to see if LL climbs back on the witness stand today. I hope so but I have concerns.

I feel like she has kind of painted herself into a corner with her 'Gang of Four' accusation.

It's weird because I think a lot of people were on the fence, with doubts about some of the medical experts conclusions and she had a good chance to walk away.

But this risky accusation by her pits her against a lot of colleagues and coworkers---and even some of the grief stricken parents. It is going to be hard to accept that so many people coordinated and engaged in an elaborate conspiracy to take down a sweet, innocent nurse.

If it was one boss or supervisor that was allegedly lying, it could be seen as a possibility. It is harder to imagine a large coordinated effort. Especially because they began reporting their suspicions to management pretty early on. [by Feb 2016 at least]

If they were going to frame someone, would they be asking for a formal investigation so early?

I think she felt very anxious and upset at her last court appearance and I am not sure what happens next. What if she refuses to continue?

 

[Lincoln34]

Transient tachypnoeia of the newborn - which is why it's referred to as TTN, unsurprisingly!!

Thanks!

 

[JosieJo]

I am really curious to see if LL climbs back on the witness stand today. I hope so but I have concerns.

I feel like she has kind of painted herself into a corner with her 'Gang of Four' accusation.

It's weird because I think a lot of people were on the fence, with doubts about some of the medical experts conclusions and she had a good chance to walk away.

But this risky accusation by her pits her against a lot of colleagues and coworkers---and even some of the grief stricken parents. It is going to be hard to accept that so many people coordinated and engaged in an elaborate conspiracy to take down a sweet, innocent nurse.

If it was one boss or supervisor that was allegedly lying, it could be seen as a possibility. It is harder to imagine a large coordinated effort. Especially because they began reporting their suspicions to management pretty early on. [by Feb 2016 at least]

If they were going to frame someone, would they be asking for a formal investigation so early?

I think she felt very anxious and upset at her last court appearance and I am not sure what happens next. What if she refuses to continue?

Yes I'm curious too

Will it be a case of

Had a rest back in the witness box as normal....or not?

 

[DickieDumDum]

I think she'll be back on the stand today, I don't really see that she has a realistic alternative other than to change her plea. If she wants to continue defending her case she's going to have to continue to give evidence.

 

[Legal]

Yes I'm curious too

Will it be a case of

Had a rest back in the witness box as normal....or not?

Everyone's waiting on tenterhooks! Must be very difficult for the babies' families unless they get prior notice if things are not going to go as planned.

 

[Marantz4250b]

I think she'll be back on the stand today, I don't really see that she has a realistic alternative other than to change her plea. If she wants to continue defending her case she's going to have to continue to give evidence.

It's just too close to call, imo. On balance I think she'll continue but I don't think that anything in this case would surprise me at this point!

 

[katydid23]

Here is where we left off last week. Part 1:

BBC Blog - https://www.bbc.co.uk/news/live/uk-65602988

Letby asked next about baby D​

Judith Moritz
Inside the courtroom
Nick Johnson KC now turns to asking Lucy Letby about the next baby, baby D, a girl, who the nurse is charged with murdering in June 2015.
When she gave evidence earlier in the trial, the mother of baby D told the court that Letby had been there when her daughter was being resuscitated, and was holding a phone to the ear of a doctor who was trying to save the baby.
Today, Letby says she has no memory of that.
Johnson asks if she disputes that it happened. She says she has no memory of it.

I can't comment on what other nurses saw, says Letby​

Judith Moritz
Inside the courtroom
Nick Johnson KC now begins asking Lucy Letby about a rash which other nurses reported seeing on baby D.
Letby says: "I can't comment on what they did or didn't see."
Johnson asks: "Do you dispute it?"
Letby replies: "It’s the term 'dispute' I am a little unsure of. I can't comment on what anyone else says they saw."
Johnson then challenges her: "Well, you were there weren’t you?"
She replies: "I wasn’t there for the whole event, no."

Do you remember baby D, prosecutor asks​

Judith Moritz
Inside the courtroom
Prosecutor Nick Johnson now asks Letby: "Do you still not remember baby D?"
She replies: "I didn’t recall her at the time of my police interview, no."
Johnson responds: "Do you remember her now?"
Letby says: "Yes."

11:42

Court shown text about 'absolutely distraught' parents​

Judith Moritz
Inside the courtroom
The court is shown a text message that Lucy Letby sent to another nurse, the morning after baby D died.
She wrote: "Parents absolutely distraught, dad screaming."
Nick Johnson KC challenges Letby: "When you said that you didn’t really remember baby D, that was a lie wasn’t it?"
She replies: "No, I didn’t have any great recollection of the events."
Johnson adds: "This was a dramatic and shocking incident wasn’t it?"
To which Letby responds: "Yes."
The prosecutor continues: "You remembered it very well when you spoke to the police didn’t you?"
"No," Letby says.
Johnson: "You’re enjoying all of this aren’t you Lucy Letby?" Letby: "No."

Prosecution resumes questioning about baby D​

Judith Moritz
Inside the courtroom
The court is resuming. The judge is in place, Lucy Letby is back in the witness box, and the jury are in. Nick Johnson KC is back on his feet, continuing to ask the nurse about baby D.
Johnson tells Letby that he's been told to keep his voice up, as the proceedings are being beamed to other courtrooms.
He asks her if she'll say if she finds it intimidating, as that's not intended. Very quietly, she replies: "Yes."
Letby is speaking very quietly. She's not looking at Johnson, who's standing at a right angle to her. Instead she's looking straight ahead of her, towards the jury.