UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #26

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  • #461
11:38am

Mr Johnson says Dr Dewi Evans was justifiably criticised for not giving a cause of death for Child C in written evidence, then giving a cause in the witness box.
He says if anyone was aught by surprise, he returned to give evidence on 14 more occasions.
Mr Johnson says Dr Evans's evidence can be disregarded if there had been any confusion for this case, as Dr Marnerides had given more detailed evidence on this.
Dr Bohin excluded the possibility of a bowel obstruction.
Dr Marnerides said there was "nothing unusual" about Child C's bowel. He concluded Child C died "with pneumonia not from pneumonia" and the gas in the bowel could not be explained by infection or an abonormality in the bowel.
He said "air must have been injected into the nasogastric tube", splinting the diaphragm, which would have compromised Child C's breathing and killed him.
He added: "I have never in the past 10 years, come across even a suggestion that 'CPAP belly' would lead to the deterioration of a baby, let alone this gastric distention that would lead to [a baby's death]."
Mr Johnson says Child C came off CPAP 12 hours before his collapse, and "did so well" after kangaroo care he was put on to Optiflow, a 'much less invasive method of breathing support, and his NG Tube had been aspirated shortly before his collapse, and no air was found.
Dr Marnerides described "massive" gastric distention, using the word "ballooning".

 
  • #462
11:46am

Mr Johnson says Letby's interviews are very important in this case.
Letby had said her only involvement with Child C was with his resuscitation. She said she did not remember being the nurse who fed him. She claimed she was not the person who discovered Child C collapsing. She said rough notes on the resuscitation would be transposed into medical notes and then disposed of.
She confirmed she had contact with Child C's family when Child C was dying.
She would not accept Sophie Ellis's account of her 'standing over' Child C.
When asked why she would have been in room 1, Letby said perhaps she was checking the resus trolley, or getting drugs for her baby, or using the computer.
Mr Johnson says 'why would you be checking the resus trolley?' and 'why would you use a computer in the dark'?
Letby was asked about the text message conversation with Jennifer Jones-Key. NJ: "She claimed, unbelievably, she didn't know what that conversation was about or where she was [when that text conversation took place].
"We say that is incredible, that is not believable."
Of the message 'being in 3 is eating me up', Letby accepted she was frustrated she was not in nursery 1.
NJ: "She [Letby] accepted she was in room 1 at the time of the collapse, that she was the only staff member there, and she was feeling frustrated and upset."
In the 2020 police interview, Letby said she did not remember being involved with Child C's family after Child C's collapse. She said she "wasn't sure" why she had searched for Child C's family on Facebook.
She said she "didn't specifically remember what she was thinking" prior to the collapse of Child C.

 
  • #463
For me personally, this case epitomises the analogy of circumstantial evidence being like a jigsaw where you have no idea what the picture is supposed to be. It's hard work putting it together and at first it makes no sense, but gradually a picture emerges. Even if a few pieces are missing you can still see what it is.
All JMO.
 
  • #464
11:50am

Mr Johnson says the collapse and death is "inconsistent" with all natural causes, according to the medical evidence.
Letby was in her own interview 'angry and frustrated' about not being in room 1.
NJ: "She started the interview process by lying about where she was and the reasons for being in room 1"
Child C had "massive ballooning of the stomach" and "it's obvious what happened" even without the context of the other cases.
NJ: "It's as plain as the nose on your face that Lucy Letby injected air via the nasogastric tube [into Child C].
"It was one of her favourite ways of trying to kill children in this case."
Mr Johnson says there is a "constellation of coincidences" that can make the jury sure Child C did not die of natural causes and that Lucy Letby killed him.

 
  • #465
Dan O'Donoghue

Mr Johnson says, from the evidence, 'it is plain as the nose on your face that Lucy Letby must have injected air down (Child C's) NG tube…it was one of her favourite ways of killing and trying to kill children in this case'
 
  • #466
12:06pm

The trial is now resuming after a short break.
Mr Johnson turns to the case of Child D. He says letby "didn't really remember" the baby girl, as she had said that in police interview.
He says the absence from the paperwork of her involvement would "give her plausible deniability".
He says "thanks to the hard work of the police", they can put her in the room.
He says Letby's interview is undermined by the rota diagram putting her in room 1 on the night shift [with Child D], and for her searching for the parents' names on Facebook. He says Letby could have got the names from the handover sheets - but the handover sheets do not have the parents' names on them.
Mr Johnson says this is similar to Child K, when Letby searched for the parents on Facebook 26 months after Child K's time on the neonatal unit. Letby said she could not explain it. Mr Johnson says that is a lie.
NJ: "Why won't she tell you the truth?"

 
  • #467
For me personally, this case epitomises the analogy of circumstantial evidence being like a jigsaw where you have no idea what the picture is supposed to be. It's hard work putting it together and at first it makes no sense, but gradually a picture emerges. Even if a few pieces are missing you can still see what it is.
All JMO.
Remember when we kept getting all these reporter's tweets full of random messages between Lucy and various friends and
colleagues? And we all were trying to understand why they were included in the trial?

And now they are like the glue that holds some of this story together. :oops:
 
  • #468
Remember when we kept getting all these reporter's tweets full of random messages between Lucy and various friends and
colleagues? And we all were trying to understand why they were included in the trial?

And now they are like the glue that holds some of this story together. :oops:

I was talking about this to an ex-colleague a few days ago. The messages, handover sheets, the relationship with Dr. A - what was all that about? Now we know it all fits together into a whole.
 
  • #469
12:13pm

Mr Johnson says there is "no doubt" Child D and her mother suffered sub-optimal care, but her progress went "upward" upon her transfer to the neonatal unit.
Child D was "stable" with "minimal" oxygen support, and "responding well to treatment". The court had previously heard evidence Child D was on CPAP, "responsive when handled" and her "chest was clear" with "regular respiratory effort". He abdomen was "soft and non-distended".
Mr Johnson turns to the night shift on June 21-22, 2015. Mr Johnson says June 22 was Father's Day that year.
Child D's designated nurse Caroline Oakley also had a designated baby in room 2. Child D was in room 1. Letby's designated baby in room 3 from the Child C case was now in room 1, again as Letby's designated baby (along with one other baby in room 1).
Child D's observations were "all completely normal" according to Caroline Oakley, and she was "breathing beautifully in air", with 100% oxygen saturation - "the highest they can be". Mr Johnson says this couldn't be better for a child with pneumonia.

 
  • #470
Dan O'Donoghue

@MrDanDonoghue
·
5m

We're now moving to Child D. On 21 and 22 June 2015, she collapsed several times and despite resuscitation attempts, was pronounced dead. Medical experts for the prosecution agreed her deterioration and an unusual rash were caused by an injection of air

Mr Johnson says Ms Letby 'claimed to you (the jury) that she doesn’t really remember (Child D)…she said that to you because that’s what she told police in interview, she said that because she thought the absence of her name on paperwork gave her plausible deniability'

What she didn’t realise is the fact that through the hard work of the police, they can put her in the room', he said
 
  • #471
12:19pm

Dr Andrew Brunton said the plan was for Child D to start receiving milk.
Mr Johnson says there were no problems until Caroline Oakley left the room for a break. He cites other cases when this happened of staff members who left and babies collapsed.
The alarm went off and when Kathryn Percival-Ward arrived, she found Letby in room 1. She said, in cross-examination, she "couldn't be certain".
Mr Johnson says who else could it have been? Who else had children to care for in that room?
He says it wasn't any of the other nurses on duty that night - one was looking after babies in room 2, and another was Elizabeth Marshall, a nursery nurse, who said she saw Letby doing chest compressions on Child C in room 1.
Kathryn Percival-Ward said the rash on Child D was "something she had never seen before". In cross-examination, she was accused of "adding detail" to the skin discolouration description. Mr Johnson says it was in the original recording she had made to police, a "mosaic, a mottling colour of blotchiness".
Caroline Oakley recalled being called back to room 1 by Kathryn Percival-Ward and Lucy Letby.


 
  • #472
“ Breathing beautifully in air “
That statement makes me so sad.
 
  • #473
12:27pm

Mr Johnson had asked Letby, in cross-examination, why she was writing in Child D's chart.
Letby said she "could not comment" if she had been in room 1 throughout.
The timing on the neonatal schedule, shown to the court, says the note was made at the time of Child D's collapse.
Mr Johnson says an observation reading for Child D is timed 1.15am on June 22, written by Caroline Oakley. Those details were "told to her by the girls". Mr Johnson asks who 'of the girls' would have provided those readings.
Mr Johnson says Letby did not want the paperwork to attach her to the case of Child D, and that was why she minimised her involvement in police interview.
A blood gas chart for Child D at 1.14am is not signed. Letby, in cross-examination, said: "I don't know" when asked if it was in her writing. Letby accepted the elevated '14' on '0114' is in her style of writing.
Letby said the lack of a signature was an "error", and said the following entry was also unsigned, and happens "from time to time".
Mr Johnson says it's the timing of this absent signature which is "the power of circumstantial evidence".

12:33pm

Mr Johnson says Letby gave an IV infusion to Child D 5 minutes before the baby collapsed. It was signed for by her and Caroline Oakley. Ms Oakley said she couldn't explain the signature as she was on her break.
She described the rash on Child D as something she had not seen before oin her 20+ years of working with neonates. She described it as: "a deep red brown - different from mottling, different to what I had seen before".
Dr Emily Thomas said in agreed evidence that Child D came out in a rash, which faded after treatment. Mr Johnson says the description she provided was "remarkably similar" to that provided by others, but wasn't challenged on it.
Dr Brunton said Child D had "developed a rash". In his notes: 'Nurses noted that became extremely mottled +++
'Also noted to have tracking lesions - dark brown/black across trunk.'
Mr Johnson says this explains "I don't remember". He says if Letby had remembered Child D, she would also have to admit it was either her or somebody else in the room with her that gave this description to Dr Brunton.
Letby had said, several times: "I don't remember that being discussed at the time."
Mr Johnson says it was recorded here.

12:36pm

Dr Brunton said the collapse was " a completely unusual situation I had never seen before", with changes in the skin colour which could not be explained.
Dr Elizabeth Newby described two 'bruised areas' on Child D's abdomen, 'like evolving purpura'.

 
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  • #474
The injury to the baby's liver has my mind running through a series of grim scenarios as to how it could have possibly happened. All of them are far more directly violent (punches?) and animalistic than the other methods mentioned in the cases. It makes shivers run down my spine.

Recent news story . Obviously another nurse in another hospital , but still . Awful.
 
  • #475
  • #476
12:46pm

Mr Johnson says the similar descriptions given by the doctors and nurses of the discolouration because the causes of the collapses was the same.
Child D's discolouration had gone by 2.35am.
Dr Brunton noted the skin discolouration "reappeared" at the second collapse.
Mr Johnson: "What are the chances?"
At 3.45am, Child D had a third and fatal collapse. Dr Thomas said she was with another baby, when he was alerted by a nurse 'with brown hair' and believed she was the designated nurse for Child D, and believed she had also been the designated nurse for Child A.
Dr Thomas said Letby had said: "This is my second baby this has happened to me," and was upset. Mr Johnson says even here, Letby was associating what happened to Child D with what happened to Child A.
Dr Brunton had "never seen a baby behave like this" prior or since.
Dr Brunton was "struck" by Child D's rapid collapses and recoveries.
Mr Johnson says Dr Brunton say, because he didn't know, that the collapses were similar to other children in this case.
Mr Johnson says 'it tells you' Child D was sabotaged, and Letby was lying when she said she didn't remember.

 
  • #477
From the Chester Standard post above
'Dr Brunton was "struck" by Child D's rapid collapses and recoveries.
Mr Johnson says Dr Brunton say, because he didn't know, that the collapses were similar to other children in this case.'

I'm guessing 'say' should be 'said that' or similar.

PS No, I think marynnu's suggestion below is better.
 
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  • #478
12:51pm

Mr Johnson says Letby's interviews were unremarkable, but said of babies' deaths in evidence: "You don't forget things like that, they stay with you.
Mr Johnson asks if this is the same case as someone who doesn't remember a baby collapsing three times and dying. He asks if Letby was trying to gain sympathy from the jury.
Mr Johnson said Letby said in police interview if the events of Child D upset her: "I honestly can't remember"

12:58pm

Letby said in a message to a colleague on June 22, 2015: '[Child D] collapsed & had full resus. So upsetting for everyone. Parents absolutely distraught, dad screaming'. Mr Johnson says this was on Father's Day.
He says Letby, from the text messages, did remember Child D.
Prof Owen Arthurs said, in evidence, the minor infection in Child D was improving. He added one of the lines of gas, in the post-mortem examination, was "highly unusual" and had similar findings in Child A and Child O. He said he had 'never seen so much air' [in the great vessels].
Another medical expert, Dr Marnerides, had ruled out sepsis, and concluded Child D was killed by an air embolus.
Dr Sandie Bohin said Child D was recovering from penumonia, and the speed of the collapse was "very unusual and not indicative of infection". She concluded the cause of the collapse was air embolus. Child D's distress and rash description supported her opinion. She rejected the evidence that taking Child D off CPAP caused her death.
Dr Dewi Evans viewed the case as one where the air embolus was the "only viable cause" of death. He was cross-examined about the blood gas record for Child D. Mr Johnson says Dr Bohin had given evidence to say that blood gas record was "satisfactory".

 
  • #479
From the Chester Standard post above
'Dr Brunton was "struck" by Child D's rapid collapses and recoveries.
Mr Johnson says Dr Brunton say, because he didn't know, that the collapses were similar to other children in this case.'

I'm guessing 'say' should be 'said that' or similar.

Maybe 'Dr. Brunton didn't say....:?
 
  • #480
Maybe 'Dr. Brunton didn't say....:?
Oh yes - that's more plausible! I was tempted to nitpick the comma after 'know', but it would be correct in that case.
 
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