UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #27

[katydid23]

Dan O'Donoghue

@MrDanDonoghue

Mr Myers is now turning to Child K. Despite being born at 25 weeks, Child K was considered to be in a good condition, but as a precaution, arrangements were made to transfer her to Arrowe Park Hospital shortly after her birth in February 2016.

While waiting for transport, she was left in the care of Ms Letby, who, the prosecution said, deliberately dislodged her breathing tube.

A consultant told the court he felt uneasy about Ms Letby being left with the child as the team were aware "of a number of unexpected and unusual events and we were aware of an association with Lucy Letby".

He said "no cause and effect had been ascribed", but he saw Ms Letby standing by the incubator, noticed the breathing tube was dislodged and saw the nurse do "nothing" to help until he arrived. The baby eventually stabilised, but died three days later.

 

[Observe_dont_Absorb]

Are you able to shed any light on how tight the stock management is of these bags? For example, would the hospital be able to identify the reference numbers of the bags which would have been in the fridge on a given date, and then track them to which babies they went to? And so, if there’s a stock bag ‘missing’ then it’s more likely the nurse’s recollection of changing the bag is correct, or alternatively there would be a paper trail of all five bags going to different babies and therefore the original TPN bag was rehung.

It feels like it should be easy to know what happened with the bags, but only if there’s adequate stock management.

When this was discussed weeks / months ago, IIRC it was firmly decided that TPN bags are made up on an individual case by case basis by the pharmacy and only dedicated to the baby in question (ie made up by prescription), therefore *if* that were true (I believe it probably is as the people who commented seemed to know what they were speaking of), the stock would be highly controlled and it would be very obvious if a bag had or hadn't been used.

JMO MOO

 

[notsure]

10:56am
He turns to the case of Child K. He outlines the events and allegation.

He says the allegation "illustrates a good deal wrong with this case".

He says Child K "should not have been at the Countess of Chester Hospital", but should have been treated at a tertiary unit. He says arrangements were being made post-birth.

He says a review carried out at Arrowe Park Hospital said care at the Countess was "sub-optimal". He says the defence acknowledge there is a question whether transporting the mother before birth was possible.

He says Child K should have received surfactant.

11:07am
Mr Myers says Child K was a tiny baby needing complex care. He says Dr James Smith agreed in cross-evidence that an experienced neonatalogist at a tertiary unit would have had more experience than him in looking after babies such as Child K.

A mortality review at Arrowe Park Hospital said Child K's death was "avoidable", Mr Myers says. He says surfactant, to allow babies to breathe properly, should have been administered "straight away" to Child K. He says Child K could not breathe without assistance and it was "inevitable" she would need intubation.

He says the "air leak" recorded "cannot be ignored". He says staff at the Countess "did not seem concerned". He says the defence acknowledge the oxygen saturation was high. He says a tertiary unit consultant had said the pressure [VTE reading] was "too low" and the oxygen saturation reading was "not consistent" with the air leak and pressure readings.

Recap: Lucy Letby trial, June 29 - defence closing speech

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…

www.chesterstandard.co.uk

 

[notsure]

11:12am
Mr Myers says the count is Letby "deliberately did nothing to help" when confronted by Dr Ravi Jayaram, and that by implication, she had harmed Child K. He says Letby did not recall what had happened.

He says the allegation "relies on the credibility and reliability" of Dr Jayaram.

He says the allegation had "morphed" against Letby.

He says tubes can dislodge. He says Dr Sandie Bohin agreed tubes can dislodge even if a baby is sedated. He adds nurse Joanne Williams said Child K was an "active baby".

Recap: Lucy Letby trial, June 29 - defence closing speech

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…

www.chesterstandard.co.uk

 

[Dotta]

I understand what you mean and that is, indeed, how many people will probably take all of the evidence. But it's not necessarily a fair conclusion. Healthcare is never perfect. We have fallible human beings treating other fallible human beings in an environment of financial and resource constraints. Good health care is extremely expensive and yet there is no bottomless pit of money to mine to fund it. At the end of the day, whichever way you pull the blanket it will be short one one way or another. This does not excuse gross negligence, malpractice or indeed, intentional harm, it's that in any health care system there will be inadequacies and insufficiencies and mistakes will be made. These things can be minimised but never eliminated. To borrow Winnicott's phrase from his analysis of mothering, health care needs to be "good enough", but not perfect.

And yet, this Adler Hospital or Arrow Park seemed perfect in comparison during the same time.
Im not sure if I remember the names correctly

Besides, proper discipline (no texting) and high morale work culture cost NOTHING

JMO

 

[notsure]

11:16am
Mr Myers says Dr Jayaram had said Child K was sedated, and that was "a prime basis for blaming" Letby.

He says Child K was not sedated until after the tube was dislodged and she was reintubated.

Recap: Lucy Letby trial, June 29 - defence closing speech

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…

www.chesterstandard.co.uk

 

[Becci]

And yet, this Adler Hospital or Arrow Park seemed perfect in comparison during the same time.
Im not sure if I remember the names correctly

JMO

My sister got appendicitis when she was about 12.
She caught sepsis & alderhey saved her life.

 

[katydid23]

Dan O'Donoghue
@MrDanDonoghue

Mr Myers is now turning to Child K. Despite being born at 25 weeks, Child K was considered to be in a good condition, but as a precaution, arrangements were made to transfer her to Arrowe Park Hospital shortly after her birth in February 2016.

While waiting for transport, she was left in the care of Ms Letby, who, the prosecution said, deliberately dislodged her breathing tube.

A consultant told the court he felt uneasy about Ms Letby being left with the child as the team were aware "of a number of unexpected and unusual events and we were aware of an association with Lucy Letby".

He said "no cause and effect had been ascribed", but he saw Ms Letby standing by the incubator, noticed the breathing tube was dislodged and saw the nurse do "nothing" to help until he arrived. The baby eventually stabilised, but died three days later.

Dan O'Donoghue

@MrDanDonoghue

Mr Myers says the implication of Dr Ravi Jayaram's evidence - that he saw Ms Letby standing by Child K and doing nothing - was that she had sabotaged the baby. Mr Myers says Ms Letby does 'not accept that is something she did'

'She does not and has never accepted doing something to harm these children', Mr Myers says

Mr Myers says 'Dr Jayaram did his best to support the allegation he made by saying (Child K) was sedated when get into this case we discover she was not'

He says when the case was 'opened it was based on (Child K) not being mobile because she was sedated and therefore couldn’t be responsible for moving the tube'

Mr Myers says 'that's all wrong, because when we get to the evidence it became clear (Child K) had not been sedated until after the tube movement'

Mr Myers says if Dr Jayaram had 'really saw that do you think he would have taken his eyes off Ms Letby for one moment from that point on, seriously? We say the most striking feature is how he did nothing despite what he claimed to the police over a year later'

 

[SleepyJoe]

And yet, this Adler Hospital or Arrow Park seemed perfect in comparison during the same time.
Im not sure if I remember the names correctly

Besides, proper discipline (no texting) and high morale work culture cost NOTHING

JMO

No hospital is perfect, and I've worked in lots! But yes, some are run better than others. In my experience it is extremely difficult to get (especially younger) staff to stop using their phones and texting while working. Despite repeated admonitions and threats, some still are relentlessly active on their phone. Drives me batty and IMO is unacceptable. Unfortunately it still happens.

 

[notsure]

11:25am
Mr Myers says Letby's presence on the unit allows the prosecution to "say what you like".

He says if it is alleged she was 'caught in the act' by Dr Jayaram, she would not have gone back to dislodge the tube twice more the same morning, as is alleged by the prosecution.

He says if Dr Jayaram had seen things in the way he told them, he would not have taken his eyes off Letby for the rest of the shift. "He would have been watching her like a hawk".

He says the allegation is "not worthy of belief".

He asks why Dr Jayaram, if he had seen what he had said, did not contact the police or 'whistleblow', or file a Datix report. He said he did "nothing".

Recap: Lucy Letby trial, June 29 - defence closing speech

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…

www.chesterstandard.co.uk

 

[JosieJo]

Exactly this. The absence of proof that a second bag was used has puzzled me from the start. It should be conclusive, as everything given by nurses has to be prescribed. No prescription = no new bag.
Quite a few nurses on other sites have expressed the same opinion, that the same TPN was used throughout.

My thoughts too

 

[katydid23]

Dan O'Donoghue
@MrDanDonoghue

Mr Myers says the implication of Dr Ravi Jayaram's evidence - that he saw Ms Letby standing by Child K and doing nothing - was that she had sabotaged the baby. Mr Myers says Ms Letby does 'not accept that is something she did'

'She does not and has never accepted doing something to harm these children', Mr Myers says

Mr Myers says 'Dr Jayaram did his best to support the allegation he made by saying (Child K) was sedated when get into this case we discover she was not'

He says when the case was 'opened it was based on (Child K) not being mobile because she was sedated and therefore couldn’t be responsible for moving the tube'

Mr Myers says 'that's all wrong, because when we get to the evidence it became clear (Child K) had not been sedated until after the tube movement'

Mr Myers says if Dr Jayaram had 'really saw that do you think he would have taken his eyes off Ms Letby for one moment from that point on, seriously? We say the most striking feature is how he did nothing despite what he claimed to the police over a year later'

If things happened the way he tells us there’s absolutely no way he would allow this to happen twice more, in front of him, it’s unbelievable. He would be watching her like a hawk', he said

Mr Myers notes that Dr Jayaram never called the police - despite seeing what he said he did - something he said was 'incredible'


Mr Myers says Dr Jayaram - and the other consultants who said they were concerned - didn't even fill out at Datix report on the incident. The medic said he 'wasn't convinced' Datix was 'the correct way to investigate' this'

 

[marynnu]

When this was discussed weeks / months ago, IIRC it was firmly decided that TPN bags are made up on an individual case by case basis by the pharmacy and only dedicated to the baby in question (ie made up by prescription), therefore *if* that were true (I believe it probably is as the people who commented seemed to know what they were speaking of), the stock would be highly controlled and it would be very obvious if a bag had or hadn't been used.

JMO MOO

Stock bags are not individual to a particular baby, they're a generic bag which contains basic nutrients.

 

[katydid23]

If things happened the way he tells us there’s absolutely no way he would allow this to happen twice more, in front of him, it’s unbelievable. He would be watching her like a hawk', he said

Mr Myers notes that Dr Jayaram never called the police - despite seeing what he said he did - something he said was 'incredible'


Mr Myers says Dr Jayaram - and the other consultants who said they were concerned - didn't even fill out at Datix report on the incident. The medic said he 'wasn't convinced' Datix was 'the correct way to investigate' this'

There's no way he could have called the police. What's he going to say? I walked in and a nurse was just standing there?

Dr J said from the start that he wasn't sure and didn't know if he should believe it or not. He was watching her, but didn't have any real evidence, so what could he really do?

A datix saying what? There was no evidence at that time.

 

[marynnu]

There's no way he could have called the police. What's he going to say? I walked in and a nurse was just standing there?

Dr J said from the start that he wasn't sure and didn't know if he should believe it or not. He was watching her, but didn't have any real evidence, so what could he really do?

A datix saying what? There was no evidence at that time.

And I'm not sure what BM is indicating by this. Is he saying Dr. J didn't really think there wasa problem? Or that he did but didn't act? I can't see what this shows.

 

[WaxLyrical]

When this was discussed weeks / months ago, IIRC it was firmly decided that TPN bags are made up on an individual case by case basis by the pharmacy and only dedicated to the baby in question (ie made up by prescription), therefore *if* that were true (I believe it probably is as the people who commented seemed to know what they were speaking of), the stock would be highly controlled and it would be very obvious if a bag had or hadn't been used.

JMO MOO

Yes, to be clear I’m talking about the stock bag from the fridge used when the line tissued and before a new bespoke bag could be produced by the pharmacy for this particular baby.

From what Mary has responded it seems the stock bag would have required a prescription by a doctor too, and so the absence of a prescription is significant.

 

[JosieJo]

Yes, to be clear I’m talking about the stock bag from the fridge used when the line tissued and before a new bespoke bag could be produced by the pharmacy for this particular baby.

From what Mary has responded it seems the stock bag would have required a prescription by a doctor too, and so the absence of a prescription is significant.

Yes thats exactly it ..even the stock bag would need to be prescribed..plus when put up the nurses would have to sign for it on the prescription and write the batch number on ...the lack of this speaks volumes to me

 

[notsure]

11:30am
Mr Myers says nurse Joanne Williams recalled Dr Jayaram had asked her what had happened, and who was in the room when the alarms went off. He asks why Dr Jayaram would ask her that if he had been in the room at the time, seeing Letby in there.

He refers to a note on the transport team: "Call received from Dr Jayaram baby dislodged the tube and had to be re-intubated".

11:34am
Mr Myers refers to the case of Child L. He says it is the second of the two insulin counts, where Child L had low blood sugar for a period of 53 hours, as identified by Professor Peter Hindmarsh. He says the laboratory result, if accurate, shows artificial insulin administered exgoneously.

11:37am
Mr Myers says Letby was seeing friends, going on holiday, enjoying salsa, a win at the Grand National. He says it is important to keep in mind the person who these allegations are aimed at. He says at this time, her main concern was moving house "and this was on her mind". Text messages are shown to the court showing conversations with Letby about her new home in Chester, having been at hospital residence.

Recap: Lucy Letby trial, June 29 - defence closing speech

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…

www.chesterstandard.co.uk

 

[notsure]

11:51am
Mr Myers says it is important to consider each count separately.

He says it is not accepted Letby has committed this offence.

He says there was a delay in getting the sample taken from Child L sorted, and was outside the 30-minute guidance, whether it was taken at noon or 3.45pm. He says the Countess of Chester Hospital Pathology department records the lab specimen report notes it was received at 6.26pm.

He says Dr Anthony Ukoh says the sample was taken at noon.

Recap: Lucy Letby trial, June 29 - defence closing speech

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…

www.chesterstandard.co.uk

 

[notsure]

I have to stop now, if anyone would like to take over the Chester Standard updates.

Recap: Lucy Letby trial, June 29 - defence closing speech

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…

www.chesterstandard.co.uk