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

[Dotta]

at least one of the jurors will have the same thought process as many here do and will be joining the dots in what the judge has said

I bet 12 of them

And they do NOT need a Judge to point it to them.

After all, they have been sitting in this Court for nearly a year and are better experts on this case than anyone of us.
Not even Tortoise

JMO

 

[Tortoise]

2:14pm

The trial is resuming following its lunch break.
The judge describes Prof Sally Kinsey's evidence, in which she had concluded, from the descriptions by dctors and nurses of skin discolouration, that Child A had had an air embolus. The court had been told of how an air embolus affects the body. She confirmed she had not seen one in her experience, but the descriptions provided were "pretty stark".

2:14pm

The judge turns to the case of Child B, and relays the care and events leading up to and the time of her collapse.

2:22pm

A nurse colleague said she had her gloves on, and was drawing up medication, when Child B collapsed at 12.30am. Letby had said Child B was apnoeic [not breathing].
The nurse said Child B 'looked like Child A', with blotchy discolouration; a 'cyanosed appearance' was recorded in the nursing notes. The notes added the colour changed rapidly, to "purple blotches with white patches."
Letby said she had accepted being in room 1 at the time of the collapse. She said the colleague had alerted her to Child B's collapse. Child B had a 'dark mottling', a 'general mottling'. Child B was 'more purple' and she did not see what the nursing colleague had seen.
Letby had accepted she would have had access to the IV lines prior to the collapses of Child A and Child B, but said she did not do anything with them.
Letby, in police interview, said Child B's mottling 'purple, red, rash-like appearance' was more extensive than with Child A, but was "similar".
She recalled Child A and Child B's parents being very upset. She said, in a 2019 police interview, she accepted she may have taken blood gas readings prior to the collapse, but did not do anything to harm Child B. In a 2020 police interview, she said she did not know how Child B collapsed.

2:27pm

Dr Rachel Lambie said the most unusual observation for Child B was a 'dusky, pale grey colour - then developing widespread blotches of a purple/red colour - they would flush up, then disappear, then appear elsewhere - they were flitting all over'.
It took about 90 minutes for the grey colour to disappear and be replaced by pink, she added.
She said this "was a very unusual event" which she had not seen before or since, and Child B recovered quickly.
Blood gas results came back as normal.
Letby said she had been asked to get a camera to get a photo of Child B, but when she had returned, the discolouration had gone.
A female doctor recalled 'purple blotching to the mid-right abdomen and right hand', which she was "puzzled" by.
The rash was "so florid" and "so very unusual", she said, and its quick disappearance was not normal.

Recap: Lucy Letby trial, July 3 - judge's summing up

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

 

[DinerMite]

Judge is doing an excellent job of highlighting inconsistencies and making it known that it was Myers own opinion and not that of a medical expert. Of course the judge has to remain diplomatic and wouldn't ever show any inclination either way but the way he is making note of these things does tell me something

 

[Tortoise]

2:33pm

Dr Evans said Child B was "stable" prior to the collapse, and prone to desaturations. The collapse was either the result of smothering or air embolus. He said if the cause was hypoxia or infection, the effects would stay.
He said the fact Child B survived meant it was likely less air was administered, or it was administered more slowly.
Dr Bohin said Child B was compromised at birth, but responded very well to resuscitation and breathing support measures.
The circumstances of the collapse was "very disturbing" and there were no other warning signs. The dislodging of the nasal prongs for Child B had been resolved.
She based her air embolus conclusion on 'florid' skin colour changes and ruling out other causes.

2:33pm

The defence say it cannot be excluded that Child B's collapse was a natural event.

Recap: Lucy Letby trial, July 3 - judge's summing up

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

 

[Tortoise]

2:36pm

The judge refers to the case of Child C.
He says medical experts found it difficult to conclude the cause of death, but Dr Marnerides said it was air administered into his stomach via the naso-gastric tube.
Letby said she did nothing harmful to Child C, and a cause such as a gastrointestinal blockage cannot be excluded, that Child C should have been treated at a tertiary unit, and there was a failure to react to bile aspirates, vomiting, and an overall lack of care.

Recap: Lucy Letby trial, July 3 - judge's summing up

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

 

[Tortoise]

2:47pm

Child C was "born in good condition" and was 'on the margins' of being treated at the Level 2 Countess of Chester Hospital neonatal unit, the jury is told.
The judge recalls the events leading up to Child C's death on the morning of June 14.
"Nothing stood out as worrying" for Child C from observations, but there was caution for his care.
Prof Arthurs said radiographs for June 12 showed left-sided chest infection, and marked dilation of the bowel. Symptoms of this included CPAP belly, NEC, sepsis or air embolus.
Bile was later noted on Child C's blanket on June 13, and 2ml of black-stained fluid was obtained on aspirates. No desaturations were observed.
Bile aspirates was a "concern" in neonates, but not that unusual for them, and "not a major cause of concern", the court had heard.
Dr Gibbs said the bile for Child C was "a worry", but the aspirates "were not increasing", and "his overall observations were satisfactory". An obstruction would have been found post-mortem.

2:52pm

"Black bile was not normal, but not unknown in premature babies", the court had been told.
Dr Sally Ogden said the bilous observations were a "concern", and the x-ray showed a "loopy bowel". Child C was still pink and well perfused and he had "no concerns with breathing" and the abdomen was soft to touch, which was "reassuring".
Dr Gibbs had "no particular concerns" about Child C that day on June 13. Babies with [gastrointestinal disease] NEC develop a hardened abdomen, the jury was told.

Recap: Lucy Letby trial, July 3 - judge's summing up

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

 

[Tortoise]

3:06pm

Messages showed Letby wanted to 'throw myself back in' to the neonatal unit - She said that meant getting back in to looking after babies as that was what she was taught at Liverpool Women's.
The messages included Letby saying: "From a confidence point of view, I need to take an ITU baby soon."
Sophie Ellis, a band 5 nurse - not intensive care unit trained - was supported by a band 6 nurse that night shift to be the designated nurse for Child C that night in room 1.
At the start of the night shift, there was a hope to start Child C on feeds. He was "pink, well perfused, active and alert".
At 10.34pm, Letby said she had 'done a couple of meds in 1', and believed Sophie Ellis didn't have the skill in caring for premature babies.
Sophie Ellis was alerted to Child C's desaturation. She said she had been alerted to the desaturation by Letby, who had said 'he's just dropped his HR and saturations'. This was something she had not put in the nursing notes, but something she said to police. She said she did not do so at the time as it was ultimately a traumatic event.
She said she didn't do anything to Child C, and didn't see anything being done to him. Letby was "stood at the incubator at the far side".
A nursing colleague said she believed she saw Melanie Taylor and Sophie Ellis by Child C. Child C was not breathing, "very blotchy", and was not aware if Letby was in the room.
Melanie Taylor said in evidence when she approached the incubator, Letby was already there. She said in police interview, she was in room 1 feeding another baby, and was called over by Sophie Ellis, not mentioning Letby.
Letby said she had "very little independent memory" of events. She said she had given evidence on Child C's collapse having been "placed" there in the room by Sophie Ellis' account.

Recap: Lucy Letby trial, July 3 - judge's summing up

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

 

[Tortoise]

3:17pm

The trial is resuming after a short break. The judge says we will finish before 4pm, at the conclusion of the case of Child C. The case of Child D will be referred to tomorrow.

Recap: Lucy Letby trial, July 3 - judge's summing up

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

 

[Tortoise]

3:27pm

Dr Gibbs said efforts to intubate were unsuccessful due to swollen vocal cords.
Sophie Ellis said she got upset at the situation, after Child C's mother arrived, as it was "overwhelming" and she had not been in that kind of situation before. Lucy Letby said to her: "Do you want me to take over?" Sophie Ellis said yes, left room 1 for a short break, then went to look after babies in room 2.
Dr Katherine Davis said "even the smallest, sickest babies" would respond to resuscitation, but Child C did not. Dr Gibbs said he could not find anything that would allow to restart long after resuscitation had stopped, and could not understand that from a natural disease process.
The mother said, in an agreed statement, she recalled CPR being performed on Child C, and the heart rate had fallen unexpectedly and rapidly. She says she did not grasp the gravity of the situation and was shocked when asked by a nurse if she wanted a priest. She asked if Child C was going to die - the nurse, described to be in her mid 20s, replied "Yes, I think so".
The father of Child C said a nurse, who he later believed to be Letby [based on her picture appearing in the newspaper] had said to the parents in the family room 'you've said your goodbyes now, do you want to put him in here?', referring to a basket for Child C. He said Child C's mother said "He's not dead yet", and the nurse then backtracked.
Letby had accepted she had made searches for Child C's parents on Facebook 10 hours after, but could not remember doing so, or why. She questioned whether she was the nurse who said the 'you've said your goodbyes...' comment, and did not recall saying it. She said she was very sad for the parents.
In evidence, she said she did not recall any specific contact with the parents. She said the search for the parents were as they were 'very much on her mind' at that time, as 'you don't forget' events like those which had happened to Child C.

Recap: Lucy Letby trial, July 3 - judge's summing up

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

 

[Tortoise]

3:35pm

The nursing colleague recalled asking Letby "more than once" to look after her designated babies that night, and it was not part of her responsibilities to be in the family room, as that was for Melanie Taylor.
Dr George Kokai carried out a post-mortem examination for Child C. He noted a distended colon, which Dr Marnerides said was "not an abnormality". He said the potential complication was a twisted colon that would lead to "obvious" symptoms of pain.
There was evidence of "acute pneumonia". Dr Marnerides said one could die of pneumonia or with penumonia. He said the former was plausible, but upon hearing further clinical evidence, he reviewed his opinion. He said babies dying of pneumonia experience gradual deterioration, which was not the case here. He said he revisited the cause of death, viewing images of a distended stomach, and no evidence of NEC.
Prof Arthurs said the small bowel was dilated. Dr Marnerides observed a dilated stomach and bowel, and noted Child C had been off CPAP for over 12 hours. No air had been obtained from aspirates before the collapse. He had never known CPAP belly being the cause of an arrest in a baby in his years of experience.
He said, in his opinion, the cause of Child C's collapse was of excessive air administered into the stomach via the naso-gastric tube.

Recap: Lucy Letby trial, July 3 - judge's summing up

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

 

[Tortoise]

3:44pm

The judge says Dr Evans said the pneumonia infection did not cause Child C's collapse.
The cause was "difficult to explain". Initially, he said it was unexplained. He said excessive air in the stomach can cause 'splinting of the diaphragm'.
The judge [said] he had not given that conclusion before giving evidence, and it was not advanced in his eight reports. Dr Evans denied he was 'coming up with things now to support an allegation of harm'. Dr Evans said from an academic point of view, air embolus could not be excluded. The judge says Mr Myers was critical of this late conclusion.
Dr Bohin had said her conclusion of the 'bubble in the stomach' was if the NGT was not on free drainage, then it could have been accumulation of gas by CPAP. The alternative was the deliberate administration of air via the NGT.
She said Child C died with pneumonia, but not because of pneumonia, and that would have made Child C less responsive to resuscitation. In reaction to questions about bowel obstructions, she said Child C would have had a distended abdomen, and normal bowel sounds would not have been heard. The judge said Dr Bohin had added: "There were no clinical indicators of obstruction".

Recap: Lucy Letby trial, July 3 - judge's summing up

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

 

[Diddly1]

The judge seems to be putting MyersKC in the corner with a cone decorated with a D, but it’s early days

 

[marynnu]

My heart goes out to Sophie Ellis. What a terrible experience, especially for a junior member of staff.

 

[Tortoise]

I think that might be it for today.

 

[ColourPurple]

I think that might be it for today.

Thanks for all the updates!

 

[Diddly1]

I really hope by the end of the judge’s summing up that as well as the pointy D hat, the judge makes MyersKC write lines, hopefully with a dirty rag from the plumber

 

[Dotta]

I really hope by the end of the judge’s summing up that as well as the pointy D hat, the judge makes MyersKC write lines, hopefully with a dirty rag from the plumber

I guess wearing a D hat is the equivalent of hitting the palms with a ruler in FORMER times.

We never had such hats in schools in my country, but the ruler caused terror!

But it was before I was even born
Thank Goodness!!!

 

[DinerMite]

Defense summary on Child C:

He says when cross-examined, Dr Ogden said it was "a worrying sign", and agreed it could be a sign of some gut obstruction.

Mr Myers says on all the evidence, Child C 'merited closer care and attention than he received'.

Dr Gibbs said, in cross-examination, intestinal obstruction 'could be one explanation'.
Link

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Judge summary of Child C:

The judge said Dr Bohin had added: "There were no clinical indicators of obstruction".
Link

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I'm glad the Judge is clarifying. Myers is very clever in how he frames "possibilities" to introduce doubt imo. It reminds me of that brilliant analogy:

"Dr Marnerides compared it to the hypothetical discovery of a dead man in the desert with a pot next to him, saying it could be "possible" that a helicopter flew over and dropped the pot on his head, but that it was not "probable"

 

[katydid23]

IMOO - The defences strategy appeared to be consistent with your initial point i.e., proving that theories (e.g., by the prosecution) do not stand up to scrutiny’.

Whereas, your claim that the defences scrutiny held no water with the expert witness, is inaccurate, since on numerous occasions during questioning, and restated during closing - the defence highlighted e.,g, issues, gaps, holes, contradictions, and apparent biases, with many of their (I.e., expert witnesses) findings. Their main argument many had in response, was to state that e.g., in their opinion X or Y was more likely’

Furthermore, a member asked me yesterday why Myers has not brought his own expert witnesses; I did not know the answer - I had queried the same fact of late, and believed he absolutely should have.

But, upon reflection I think he is intentionally avoiding introducing new material that would likely generate long drawn out arguments, and instead chose to focus on weaknesses in the defensives theories; which he supported with scientific references, and evidence he/ his team have previously submitted (e.g., he referred on numerous occasions to an evidential document available to the jury). JMOO

"But, upon reflection I think he is intentionally avoiding introducing new material that would likely generate long drawn out arguments, and instead chose to focus on weaknesses in the defensives theories; which he supported with scientific references, and evidence he/ his team have previously submitted (e.g., he referred on numerous occasions to an evidential document available to the jury"

The fact remains, that Meyers is NOT a medical expert himself. So when he refers to passages in a medical research paper, and tells the jury what that reference means, I have to question that. I don't think he has the medical knowledge or experience to make those kinds of conclusions. That is what medical experts are for, to reliably make those kinds of medical assumptions and conclusions. He is a very biased defense attorney and not a medical expert.

 

[nyvictoria]

3:35pm

The nursing colleague recalled asking Letby "more than once" to look after her designated babies that night, and it was not part of her responsibilities to be in the family room, as that was for Melanie Taylor.
Dr George Kokai carried out a post-mortem examination for Child C. He noted a distended colon, which Dr Marnerides said was "not an abnormality". He said the potential complication was a twisted colon that would lead to "obvious" symptoms of pain.
There was evidence of "acute pneumonia". Dr Marnerides said one could die of pneumonia or with penumonia. He said the former was plausible, but upon hearing further clinical evidence, he reviewed his opinion. He said babies dying of pneumonia experience gradual deterioration, which was not the case here. He said he revisited the cause of death, viewing images of a distended stomach, and no evidence of NEC.
Prof Arthurs said the small bowel was dilated. Dr Marnerides observed a dilated stomach and bowel, and noted Child C had been off CPAP for over 12 hours. No air had been obtained from aspirates before the collapse. He had never known CPAP belly being the cause of an arrest in a baby in his years of experience.
He said, in his opinion, the cause of Child C's collapse was of excessive air administered into the stomach via the naso-gastric tube.

Recap: Lucy Letby trial, July 3 - judge's summing up

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

If guilty and IMO the evidence for Child C is some of the most damning!