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

[ColourPurple]

Did we ever hear more about why they decided nobody would have Baby I for more than one shift ?

In WhatsApp messages read to the court, Letby asked a colleague on the afternoon of October 14 if Child I was staying on the unit.

She added: “I’d like to keep her please.”

Her colleague, who cannot be identified for legal reasons, replied: “Yes. Staying for now. OK re keeping.”

An hour later the colleague messaged: “I’ve had to reallocate. Sorry.”

Letby said: “Has something happened?”

The colleague replied: “No. Was just asked to reallocate so no one has her for more than 1 night at a time. Or 1 shift. Not just night.” Letby responded: “Yeah that’s understandable.”

The Crown says Letby, originally from Hereford, murdered Child I in the early hours of October 23.

It was said to be her fourth attempt to deliberately harm the baby after earlier bids on September 30, October 13 and 14.

Lucy Letby trial: Doctor saw ‘unusual’ mottling on baby

A DOCTOR recalled “unusual” skin mottling on a baby girl allegedly murdered by nurse Lucy Letby, a jury heard.

www.chesterstandard.co.uk

 

[DianaWW]

2:15pm

The judge says just before midnight, Ashleigh Hudson said Child I became unsettled and had 'very loud crying' - 'relentless', something she had not heard before from her. Child I was put on her tummy and she became quiet, and there were gaps in the breathing. Child I was turned over again and nurse Hudson called for help.
Letby said, in evidence, she had not heard Child I 'cry like she had not heard before'. She was 'quiet' and 'apnoeic'.
Dr Rachel Chang and Dr Gibbs were called and CPR began on Child I. She was ventilated and recovered - she was pale and mottled (blue) in her trunk. The colour "steadily improved" over five minutes and Child I became pink all over.
It was decided to extubate Child I as she was fighting the ventilator - "a good sign".
Dr Gibbs was unsure what had caused Child I's rapid deterioration. He said he could not understand what natural disease could have caused it.
A 'large stomach bubble' was seen in an x-ray for Child I.
Letby, in cross-examination, was asked about a record for one of her designated babies that night [the Stoke baby]. The baby was noted by Dr Chang to be safe for transfer. Letby had noted, between 10.50pm-10.52pm, to commence 10% glucose for transfer. The IV fluid chart showed the start time altered from 11pm to midnight. In response to the allegation of falsifying records, Letby said the 11pm was an error which she had corrected.

2:19pm

Nurse Hudson said Child I was behaving normally prior to the final desaturation. She did not recall how she was alerted. She said when she arrived at Child I, Letby was already there at the incubator, 'with her hands in, with a dummy, trying to settle [Child I]'. Child I's crying was "loud and relentless" and nurse Hudson was concerned Child I was going to collapse.
The nurse recalled she said something along the lines of 'She's going to do it again, isn't she?' and that Letby replied: 'She just needs to settle, she just needs to settle'.
Child I then collapsed.
Dr Chang arrived at 1.12am and was joined by Dr Gibbs in trying to resuscitate Child I, who had 'mottling of purple and white all over'. Efforts to resuscitate were unsuccessful.

2:23pm

Melanie Taylor said they were all devastated, and it was "pure shock", and this was the second death she had been directly involved in. She was never concerned about the treatment/care that babies received. Ashleigh Hudson was supported by Letby.
The mother of Child I recalled Letby: 'was smiling and kept going on about how she was present at Child I's first bath and how much Child I had loved it'.
Letby had said she was 'trying, in that awful situation', to create a positive memory for the parents.

Recap: Lucy Letby trial, July 5 - 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

 

[DianaWW]

2:28pm

Letby was asked about a sympathy card she had taken a photo of for Child I's family, on the day of Child I's funeral. She searched for the mother on Facebook on October 2015 and May 2016.
Letby said she did not remember if she was present when Child I collapsed, and 'maybe she had gone to her after hearing her crying'. She said the transfer process would have been 'stressful' for Child I, and believed the process was done too quickly.
She said it was "upsetting" losing Child I, and said she regularly took pictures of cards she sent. She did not know why she had searched for Child I's mother on Facebook.
She recalled settling Child I after crying, but did not know if this was after the first or second collapse.

Recap: Lucy Letby trial, July 5 - 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

 

[DianaWW]

I need to pop out for half an hour if anyone is able to take over the Chester Standard updates? If not I'll post them once I get back

 

[ColourPurple]

I need to pop out for half an hour if anyone is able to take over the Chester Standard updates? If not I'll post them once I get back

I can cover till you're back

 

[Parker Knoll]

Thank you CP !

 

[Parker Knoll]

Wild speculation on my part but I am guessing the delayed start this morning could have been down to a little Letby temper tantrum.
JMO

 

[ColourPurple]

2:52pm
Prof Arthurs reviewed all the radiographic material. He said lungs were normal prior to the final collapse, and it was quite unusual to see 'massive dilation of the stomach', which could cause splinting of the diaphragm. The post-mortem imaging showed dilation in the bowel, and he said that was present before she died.

He said there are not many conditions which cause dilation of all the bowel. He said one of the explanations was air deliberately administered down the NG Tube, and that was his inference.

Dr George Kokai carried out a post-mortem examination of Child I. Dr Andreas Marnerides was dependent on the report.

Dr Marnerides said Child I did not have NEC. He was "very sceptical" that Child I died of natural causes.

He said the collapses were more likely to be excessive air administered to the stomach, via the NGT.

The defence say a similar event happened for Child I on August 23, a day when Letby was not on duty.

Dr Evans said Child I's weight gain could have been better, and atributed that to her illnesses. He formed the view Child I had received a large volume of air down the NGT. He said it would have had to have been sizeable to cause splinting of the diaphragm. He refuted suggestions he had taken events from September to support a prosecution case, saying at the time of his reports, no-one had been arrested.

Dr Bohin said she, too, thought abdominal distention had splinted the diaphragm in the first event. She discounted NEC.

Dr Evans said the second event was more serious. He refuted suggestions he had been 'looking for evidence to support the prosecution'.

Dr Bohin said she was not sure if an NGT was in place at the time - there was no clinical need for one, but it was practice to keep one in place 'just in case'. She accepted in her report that she said Child I did not have an NGT. She considered air in the vein was a possibility, due to the subsequent discolouration findings. In cross-examination, Dr Bohin was accused of 'backing up' Dr Evans. She refuted that, saying she was independent and had disagreed with Dr Evans on some conclusions. She said she had seen air embolus twice in babies in her career, and explained what the symptoms were, saying the clincial presentation was 'wide and varied'. She agreed there was nothing specific about discolouration that made it diagnostic of air embolus, but it was consistent with air embolus.

Recap: Lucy Letby trial, July 5 - 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

 

[Dotta]

Wild speculation on my part but I am guessing the delayed start this morning could have been down to a little Letby temper tantrum.
JMO

"The best remedy for a short temper
Is long walk"

Oh wait!

She is in Court dock....

 

[ColourPurple]

3:03pm
Dr Evans said for the third event, he came to the conclusion of a large volume of air administered via an NGT into the stomach. The response to Child I's resuscitation was not what he would expect. In cross-examination, Dr Evans said this was a separate event, not a continuation of an existing event.

Dr Bohin concluded it was an air embolus caused by excessive air administration.

For the fourth event, Dr Evans said Child I was 'a stable baby' prior to the collapse. He said he thought air was administered, on this occasion, via the blood. He thought the relentless crying, as described, was of a baby in pain and distress, and there was no explanation. In cross-examination, he denied he was 'gonig for whatever mechanism that could support his explanation'. He said if air was injected in the stomach as well, that was something he could not rule out.

It was at that point, the judge says, Benjamin Myers KC, for Letby's defence, cross-examined Dr Evans on a family court judgment's report which criticised the medical expert, with "strong views" by Lord Justice Jackson. The defence said the 'inconsistencies' in Dr Evans' evidence undermined his case and the judge's criticism was 'relevant'.

The judge says it is up to the jury to consider the evidence, and they know no more about that case - and the judge's summary report - than the agreed evidence which was presented to them.

Recap: Lucy Letby trial, July 5 - 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

 

[Parker Knoll]

She’s going nowhere fast.
JMO

 

[ColourPurple]

3:14pm
The trial is resuming after a short break.

The judge refers to the case of Child J, born at the Countess of Chester Hospital on October 31, 2015.

Recap: Lucy Letby trial, July 5 - 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

 

[Dotta]

She’s going nowhere fast.
JMO

I like your way of thinking

 

[ColourPurple]

3:17pm
After a short time, Child J produced some brown bile, and was transferred to Alder Hey Children's Hospital for surgery. She had a perforated bowel and was fitted with a stoma.

She returned to the Countess of Chester Hospital on November 10, and progressed well, moving into nursery room 4 (special care). She had issues with gaining weight, but hospital staff were not overly concerned. Nursery nurse Nicola Dennison said babies with stomas don't tend to grow very well.

Child J's mother had stayed with Child J, giving cares, prior to leaving on the night of November 26-27.

Recap: Lucy Letby trial, July 5 - 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

 

[ColourPurple]

3:20pm
Letby was messaging a colleague, prior to this night shift, about how nursery nurses should not be caring for babies with stomas, and there were issues with staffing, saying they would have to send some babies out [to other hospitals].

During the shift, Child J had two sets of sudden and unexpected desaturations, which required resuscitations, and in the latter, there were symptoms of a seizure, something Child J had not had before or since. Dr Bohin said there was no cause for the events. Dr Evans said infection could not be ruled out.

The prosecution said Letby did something or things to cause deliberate harm. The defence say in the absence of any identifiable cause, the jury cannot be sure Letby did anything to harm Child J.

Recap: Lucy Letby trial, July 5 - 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

 

[ColourPurple]

3:30pm
Mary Griffith recalled an event at 5-6am when she heard an alarm go off in nursery 4. She saw nurse Dennison had Neopuff on Child J, as she had desaturated.

Dr Kalyilil Verghese recalled attending once, at 5.15am. Swipe date showed him entering the unit at 5.03am. He said he was told what had happened, that Child J had two 'profound desaturations', the first to the 30s, the second to the 50s. In the later, Child J was pale and mottled. He said at least one of those events was "significant".

Apart from Child J's increased efforts to breathe, Child J had recovered well.

Child J was moved to room 2, where Letby was.

Letby said it was 'widely talked about' that nursery nurses were doing stomas when they shouldn't. She said it was a very busy time.

She said she had no idea these events were happening.

Dr Gibbs was on the unit when Child J desaturated again, this time with a falling heart rate. He said he assisted nurses Griffith and Letby.

Dr Gibbs noted Child J had desaturations to 'unrecordable levels', the first at 6.56am, the second at 7.24am, plus bradycardia - they were associated with stiff arms, clenching of hands, and on the second occasion the eyes deviated to the left; these were symptoms of seizures. The first took 10 minutes to settle, and the perfusion was poor. The second took five minutes to settle. Both events required ventilation.

Dr Gibbs could not explain the desaturations, and Child J had not presented with these symptoms before. He would say there were caused by a drop in oxygen, but the cause of that was not known

Recap: Lucy Letby trial, July 5 - 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

 

[ColourPurple]

3:38pm
Prof Arthurs reviewed the images for Child J. After the last collapse, the image was unremarkable - it could not assist in an explanation for this event.

In polcie interview, Letby recalled Child J as she had a Broviac line and stoma. She thought she only treated Child J after the collapse. She said she had administered medication as Nicola Dennison was a nursery nurse, and not qualified to administer such medications.

She accepted searching for Child J's parents, but could not recall doing so.

In evidence, she said she was aware of the second pair of events, that she and Mary Griffith heard the alarm, and saw Child J fitting when they arrived. No-one else was present.

Child J recovered. Dr Stephen Brearey noted no blood glucose abnormalities to explain the seizures, and there was nothing of concern in blood results. Abdominal x-rays did not raise concerns. He had no concerns, and said it was a "remarkable reovery" for her. He did not understand why Child J had been hypoxic.

Letby was the designated nurse for Child J the following night and there were no concerns raised.

Recap: Lucy Letby trial, July 5 - 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

 

[ColourPurple]

3:43pm
Dr Evans said the collapses were unexpected, the second pair were more serious, and 'indicative of something wrong with the brain', and indicative of loss of oxygen to the brain, and could not explain any natural process that had caused that hypoxia.

Dr Bohin said infection was not responsible for Child J's collapses, and did not come to any major conclusion other than the deteriorations were sudden and unexpected.

Recap: Lucy Letby trial, July 5 - 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]

3:38pm

Letby was the designated nurse for Child J the following night and there were no concerns raised.

Recap: Lucy Letby trial, July 5 - 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

Oh yes, that'll be when the parents were there.

 

[ColourPurple]

3:48pm
The trial judge begins referring to the case of Child K, born at 2.12am on February 17, 2016, weighting 1lb 8oz. She was transferred to the neonatal unit prior to transfer to a tertiary unit - Arrowe Park Hospital, where her condition continued to deteriorate, and the mother agreed, in the "most heartbreaking decision" of her life, to end life support for Child K on February 20.

The prosecution say Letby attempted to kill Child K within two hours of her being born, interfering with the breathing tube, causing her to collapse. There were two further collapses and the prosecution allege there was sabotage by Letby, but they are not the subject of charges.

There is no expert opinion in Child K's case, and the evidence is circumstantial, the judge says. The prosecution urge the jury to rely on inferences. The defence, the judge says, point to Child K's extreme prematurity, and no 'direct evidence' of harm caused. Child K was given surfactant late, and witness Dr Ravi Jayaram's evidence is "tainted and unreliable".

Letby had no recollection of events, but believed the ET Tubes were not secured correctly.

Recap: Lucy Letby trial, July 5 - 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