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

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  • #701
DBM.
 
  • #702
I’ve tried looking at this incident for innocent explanations but not sure if they are valid. Possible factors such as she was young and did not have much experience with grieving parents, or that she was reportedly somewhat awkward in general. Had she ever supported a family at the end of life before? She may not have known better?

I can’t help but wonder if any other young, inexperienced nurses have ever made similar mistakes?

Of course her every action has been looked at under a microscope, and rightfully so. I just, personally, don’t find this one incident very compelling evidence. IMO, if guilty.
But NOBODY forced her to go there!
Quite the opposite
They had to force her to quit!

Really,
and this insistence to call a priest!
It all gives me shivers to be honest :(
 
  • #703
If guilty...

In fact,
I get this vibe of twisted religious madness:
- Fate, insistence on calling a priest, baptisms in hospital, condolence card, house next to a cemetery, her being a Godmother.

JMO
 
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  • #704
It’s all just utter madness.
Buckle up for day 2 folks.
 
  • #705
  • #706
If guilty...

In fact,
I get this vibe of twisted religious madness:
- Fate, insistence of calling a priest, baptisms in hospital, condolence card, house next to a cemetery, her being a Godmother.

JMO
You may be right in general, Dotta, but you've still not understood the godparent bit in English society. I'm a godmother and I'm an atheist. So I'd leave that one out!
 
  • #707
You may be right in general, Dotta, but you've still not understood the godparent bit in English society. I'm a godmother and I'm an atheist. So I'd leave that one out!
Being a Godparent has different meanings to different ppl.

But, literally, it is connected to religion.
The very name indicates it.

JMO
 
  • #708
Being a Godparent has different meanings to different ppl.

But, literally, it is connected to religion.

JMO
Of course. But you can't deduce anything from it about a person's religious beliefs, unless you have more evidence. It's not evidence by itself of religious belief.
 
  • #709
Of course. But you can't deduce anything from it about a person's religious beliefs, unless you have more evidence. It's not evidence by itself of religious belief.
Context is everything.
 
  • #710
Is court back on today?
 
  • #711
  • #712
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  • #713
10:30am

The trial is now resuming.

10:41am

The trial judge turns to the case of Child D. He recalls the baby girl's birth, and that she died 36 hours later on June 22, 2015. The prosecution's case is air was administered intravenously.
He says the guideline was for Child D to be given antibiotics at birth, due to the gestational age, and this had not been done. The prosecution said while Child D died with pneumonia, not of pneumonia. The defence said you cannot be sure of that, and the cause could have been infection.
Dr Sandie Bohin said Child D should have been screened at birth due to her low temperature, which was a sign of infection.
Child D was placed on CPAP. Her heart sounds and capillary refill were normal, abdomen was soft and non-distended, and the chest was clear. The parents were informed it was likely sepsis.
Child D stabilised on CPAP.

10:44am

Child D was intubated and ventilated, after showing signs of acidosis. An x-ray showed 'very little abnormal', according to Professor Owen Arthurs. Child D was given the protein surfactant.
Child D was weened off the ventilator and extubated. Dr Elizabeth Newby said Child D was a little stiff and hard to handle, and felt there was an element of infection. Dr Bohin said Child D had signs of pneumonia, but was recovering.

10:47am

Child D's mother recalled an event when she arrived on the unit and Letby was 'hovering round [Child D], not doing much, holding a clipboard', and she asked if everything was ok. Letby replied everything was "fine".
The mother added: "She just stuck around".
The mother said Letby was told to go away, or words to that effect.
Child D's father did not recall this event. He recalled he was given a Father's Day card on June 21 by the staff. He said nurses were "friendly and warm" and was made to feel welcome when he went to the unit.

10:51am

Prof Arthurs said a radiograph of Child D from the afternoon of June 21 showed the catheter was in the wrong position, and there was a sign of infection, but nowhere near as prevelent as that seen for Child C.
Child D showed 'big improvements' and 'good progress' on June 21 in relation to blood tests and respiratory efforts, although she was 'not stable enough' to have a lumbar puncture. She was 'responding well' and her tone was reasonable. Child D desaturated to the 80s when attempts were made to take her off CPAP. Dr Sarah Rylance was 'happy' with Child D's clinical condition by this stage, 'stable and making good progress'.


 
  • #714
11:02am

The judge says shift leader and designated nurse for Child D in room 1 on June 21-22, was Caroline Oakley. Letby was designated nurse for two other babies in room 1.

Child D was on 'nasal CPAP in air', with 'satisfactory' gases. The readings for 7.30pm-12.30am were all normal and she was 'happy' with Child D, who was "breathing beautifully in air".

Aspirates found had 'minimal importance to them' as Child D was not being fed at this time.

Caroline Oakley said she assumed she began an infusion at 1.25am, being the designated nurse, but the writing on the infusion note was not hers.

One of the nurses on duty was aware Caroline Oakley had been on her break, and checked Child D, who was fine.

While she was at her computer, she was alerted to alarms, and found the monitor was showing Child D was desaturating at 1.30am. She recalled Letby was there.

She noted Child D had a rash on her trunk and arms, and was 'not a normal rash' - like a 'mosaic', like 'vessels of blood meeting with each other'. She had not seen anything like it before, she said.

She said 'her trunk and legs went a mottling colour, and it was odd'. She discussed it with Dr Andrew Brunton.

Child D settled and discolouration 'seemed to disappear and dissipate'.

Caroline Oakley said the rash was 'different to mottling' and it was 'an unusual rash'. She "had an episode but responded very quickly".

Another senior nurse said she had a limited memory of events. she remembered Child D being stiff and having a rash on her trunk, which was an 'odd, unusual rash'.

 
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  • #715
11:11am

The judge says at 3am, there was a second event. Caroline Oakley said Child D was crying and desaturating, and the skin was discoloured, but less than before. Dr Brunton recalled Child was agitated and upset, and thought it was something to do with the face mask. He saw skin discolouration, but this was 'not as obvious' as before.

A prescribed saline bolus was signed for Child D at 3.20am by Caroline Oakley and Lucy Letby.

Nurse Oakley said they were happy with Child D, and she would be provided with expressed breast milk. She said if Child D was unstable, she would not have changed Child D's nappy. Observations were 'fine' by 3.30am.

At 3.45am, Child D's monitor was alarming. Caroline Oakley found Child D had stopped breathing and was apnoeic. Dr Emily Thomas heard the call for help. She asked a nurse to put out a crash call for Dr Brunton. He ran when he was crash called.

Full resuscitation was carried out on Child D with the assistance of doctors and nurses, including Lucy Letby. There were 'secretions+++' from the nose and mouth. The parents were informed and went to the unit.

After 28 minutes of resuscitation attempts, it was decided to stop.

At 4.50am, Dr Newby had a discussion with Child D's parents on the 'sudden collapse'. She agreed babies can suddenly collapse, but was "surprised" Child D did. She "did not appear to be a baby in extremis".

A nurse had a conversation with Lucy Letby about the drugs administered during resuscitation. Letby asked the nurse how she knew the doses to give. The nurse replied she knew them from her years of experience, and recommended Letby learn them as well.

 
  • #716
11:25am

Dr Andreas Marnerides said pneumonia was likely to be present at birth for Child D.
Professor Arthurs talked of a 'black line' in front of the spine indicating gas in the great vessels, which was "unusual" in children who had died without an explanation. It was present in "two other children", one of whom was Child A. There was "more air" in Child D than Child A. One explanation was someone was injecting air into the child, and the radiograph images were consistent with, but not diagnostic of, externally administered air to Child D.
Dr Marnerides said the presence of air in such a vessel was "significant". He said from a pathology point of view, air embolus could not be proved. He said there was "no other natural disease" that could explain Child D's death. He said in his opinion, Child D died with, not from, pneumonia. He concluded the 'likely explanation' was air embolus.
Dr Dewi Evans said the 1.30am episode was "very surprising and unusual" as Child D had been responding to treatment and was "a stable baby". He said Child D had symptoms of early onset pneumonia and had developed that before birth, but was making a recovery. He said he could not think of any events which would end with unsuccessful resuscitation, and the cause was an air embolus.
Dr Bohin peer-reviewed Dr Evans' reports and conclusions. She said the striking feature of all events was they were sudden and unexpected, and came with mottling of the skin. She said it was a concern that Child D was crying in the second event. She said although antibiotics were given late, there was nothing, clinically, to suggest Child D was going to collapse. "This was not a picture of a baby with pneumonia severe enough" to collapse. She was "clear" infection did not cause the "sudden" collapse. There were episodes of discolouration which was consistent with the limited recorded events of air embolus. She concluded air had been administered intravenously, causing an air embolus.

 
  • #717
11:28am

The judge says Lisa Walker, a band 4 nurse, talked about an event of being in room 3 - a special care unit - where Letby was feeding babies via a naso-gastric tube. The alarm on the portable monitor was going off - the desaturation alarm. Lisa Walker went over to help. Letby stopped the feed and began stimulation for the baby, but was not getting a response.
She saw colleague Kate Bissell walking past, and shouted for help as the baby was not picking up. A doctor working on a computer went over to help.
The baby was given gentle stimulation and picked up.
Lisa Walker said Letby asked her, "quite firmly", why she asked for help. She said Letby was "quite cross" and the band 4 nurse didn't respond.
She said Letby's demeanour was that she would have been fine and didn't need any help.

11:32am

Letby, in police interview, denied doing anything deliberately harmful to Child D. She said she could not remember doing Facebook searches for the parents of Child D three days after Child D's death.
She said she could not recall why she said Child looked like having 'overwhelming sepsis' or that there was 'an element of fate' in babies.
In evidence, Letby said she "didn't really remember" the night shift. She said she would have been caring for her designated babies and assisting colleagues with other babies.
She did not remember being called in to room 1 at 1.25am, Child D desaturating at 3am or Child D collapsing at 3.45am.

 
  • #718
11:33am

The trial judge refers to the case of twin boys Child E and Child F, dealing with Child E first.

11:39am

Both twins were born "in good condition", the jury is told. Child E died less than six days later.
The court had been told Child E was very premature. A doctor agreed Child E was capable of dramatic changes in his condition.
The day after Child E was born, the mother went to cuddle Child E, as he was on CPAP.
On July 30, the boys were 'progressing really well', and due to a high blood glucose level, Child E was given a low dose of insulin.
The twins were 'doing well' and stable on August 1, with time out of his incubator.
On the day of August 3, a nurse said the mother was on the unit with long periods of skin-to-skin contact, and Child E could have 'as many cuddles' as he liked. Child E was 'pink and well perfused' with regular circulatory system and a cautious feeding regime. "Everything remained well". Intravenous caffeine was given as prescribed.

 
  • #719
11:50am

The trial is now resuming after a short break.


11:56am

The judge says Dr Emily Thomas said she had examined Child E and there were no signs he was unwell, and observations were normal, with a soft, non-distended abdomen and no suspicious aspirates. He was "well and stable".
A nurse noted Child E's blood sugar was higher than normal, and his insulin infusion was restarted at a lower dose. Antibiotics were given as prescribed.
A doctor said the observations were normal and not a cause for concern, and the high blood sugar level was relatively normal for a neonate and would not lead to the sort of collapse seen hours later.

12:06pm

Child E's mother recalled giving cares to Child E, then going upstairs to provide milk between 7pm-8.30pm, the latter being the time of the night shift handover.
Letby was the designated nurse for Child E and Child F in room 1. Letby said the 9pm feed was omitted because of 16ml mucky, bile-stained aspirate, discarded, and the SHO was informed, and told to omit the feed. She said the doctor's name was not always made on nursing notes.
She accepted she got '15ml fresh blood' from Child E at 10pm. She denied she had got Belinda Williamson [Simcock] to write in the 10pm entry.
Dr Christopher Wood was the on-call SHO and was asked if he recalled receiving a call about an aspirate. He said he didn't recall it, and didn't definitely rule it out. He said if he had received a call, he would make his assessment, and make it in clinical notes, and seek advice from a registrar.
Dr David Harkness said it was his recollection that during the review, there was a fresh blood vomit and 14ml aspirate. He says there was a discussion with a doctor about a blood transfusion.

 
  • #720
12:18pm

Child E's mother recalled going to see Child E and Child F, at 9pm.
Letby was there at the workstation, the mother said. She added child E was crying like nothing before - 'horrendous', and saw 'blood coming out of his mouth'. It was 'not on, or going on to anything else', 'like a dribble pattern - it was blood'.
"It was smudged, and didn't look completely dry, it was darker [than normal]."
The mother said she was panicking and asked Letby why Child E was bleeding, She said Letby said the NGT had been rubbing at the back of the throat.
Letby did not recall saying this. In cross-examination, she said she did not tell the mother and would not tell parents to go away. She accepted that in the interview for Child N, she had said an NGT could cause bleeding.
The mother said she accepted what Letby had said, and did as she was told to go back to the post-natal ward as Letby was an authority figure, but she was concerned. She said she made a call to Child E's father. The judge refers to phone call data at 9.11pm. The father said the mother was upset at the time of this call.
Midwife Susan Brookes recalled Child E's mother had said to let her know if there were updates overnight from the unit, as one of the twins 'had deteriorated slightly'.
She had recalled at 11.30pm the neonatal unit rang to bring Child E's mother to the unit in 30 minutes, as Child E had a bleed.
Letby said in police interview, she could not recall the events with Child E's mother, and could not remember any specific bleed. She said the 14ml bleed later, after 10pm, was "very concerning" and, in evidence, that was when she said she first saw bleeding on Child E.
The judge says there are "significant conflicts" between Letby's evidence and that of the parents. He says the defence say the mother's evidence is "unreliable" in relation to timings.

 
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