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

[Observe_dont_Absorb]

I suppose he can always recall the plumber!

I reckon everyone would be very happy to have the plumber back at this juncture. At least he made sense!

 

[Observe_dont_Absorb]

I think there could be 2 possibilities if guilty as to why the searches seemed to tail off.
Did the Facebook searching stop around the time doc choc came on the scene? Maybe she was preoccupied with him and then if guilty, her motive shifted to being more about getting his attention, getting him on the ward and wanting him to think she was such a wonderful nurse. Instead of spending her time searching for parents on Facebook maybe she was looking him up instead, day dreaming about what their future could be like and planning ways to get him in the ward so she could demonstrate her excellent skills. I still think she fantasised about them having a greys anatomy style romance, bonding over battling to save lives and comforting eachother in the aftermath while he healed praise on her.

Also, if guilty, she went through a spell where her attempts were unsuccessful. Babies J K L M N all survived. Her attempts failed. Maybe if guilty she was more interested in keeping track of the parents of babies she actually killed, maybe she realised that the parents of the babies who died would be more likely to post things on social media about their grief. I doubt there was much to see with the ones who were harmed but survived. I think that could be the most likely scenario IMO only if guilty though. That she had more of an interest in viewing the grief of parents whose babies died, the ones who survived were less significant and although she did search for those parents, she didn’t do so as often as say baby E’s mum for example. If she was also wanting to check if any of the parents felt the death of their child was suspicious, if they were posting about possibly taking it further or requesting an investigation I think she’d be looking for the ones who lost a baby as opposed to the ones whose babies lived. Those parents probably wouldn’t be as likely to be suspicious. All MOO

By the time we got to baby O P & Q the deaths happened in such quick succession and were followed immediately by her removal from the unit, I doubt she had time to even think about searching for the parents, only when it was the anniversary of O & P’s death did she search for their surname. I notice she only made a couple of searches after being removed from the unit, if guilty I think she was aware of how her search history could be looked at, but then curiosity got the better of her a few times and she just had to know if the parents were posting about the investigation or mentioning her name specifically.

All MOO

Good points and also especially that she may have been becoming aware her online behaviour could be called into question if there were to be some form of investigations.

 

[soppppheiie]

A small point - if there is a lot of milk in the aspirate you can't get an acid reaction.

I think I’m confused by the evidence he’s suggesting. As he states in later babies large milky aspirates produced acidic numbers and this is accepted as accurate but in this particular baby the prosecution is using a low ph as proof of an empty stomach/no milk prior to the feed. Is that how you interpreted it?
I have no real knowledge of what reasonable aspirates they could have been expecting as my background is adult ITU where almost every single patient is on a PPE so alteres the aspirates to practically neutral.
Would partially digested milk and stomach acid not produce a low PH?
I’ve always found the over feeding evidence weak as I just don’t feel they could be certain that the previous feed had been absorbed and that the large vomits aren’t just an accumulation of multiple undigested feeds as many times I’ve experienced hours of getting no/minimal aspirate only for the next hour to suddenly get 100’s mls or a patient to vomit.
It would be the case that I could be accused of feeding extra NG feed just because in the previous hour 30mls was given but the aspirate/vomit was 300mls when the reason is obviously the feed just isn’t being absorbed not that I’d given 300ml.

 

[marynnu]

I think I’m confused by the evidence he’s suggesting. As he states in later babies large milky aspirates produced acidic numbers and this is accepted as accurate but in this particular baby the prosecution is using a low ph as proof of an empty stomach/no milk prior to the feed. Is that how you interpreted it?
I have no real knowledge of what reasonable aspirates they could have been expecting as my background is adult ITU where almost every single patient is on a PPE so alteres the aspirates to practically neutral.
Would partially digested milk and stomach acid not produce a low PH?
I’ve always found the over feeding evidence weak as I just don’t feel they could be certain that the previous feed had been absorbed and that the large vomits aren’t just an accumulation of multiple undigested feeds as many times I’ve experienced hours of getting no/minimal aspirate only for the next hour to suddenly get 100’s mls or a patient to vomit.

I can only give you my own experience, that if you aspirate a syringeful of milk it won't test acid. It doesn't matter though as obviously it's in the stomach! The other point is that this baby would be gravity fed. It simply won't flow with a full stomach, and the baby might also begin to dribble milk. This can happen towards the end of a tube feed even on an empty stomach, especially if there are larger-than-normal volumes given to promote weight gain.

 

[May72031]

This week must be infuriating for the families in court.

 

[Tortoise]

I think I’m confused by the evidence he’s suggesting. As he states in later babies large milky aspirates produced acidic numbers and this is accepted as accurate but in this particular baby the prosecution is using a low ph as proof of an empty stomach/no milk prior to the feed. Is that how you interpreted it?
I have no real knowledge of what reasonable aspirates they could have been expecting as my background is adult ITU where almost every single patient is on a PPE so alteres the aspirates to practically neutral.
Would partially digested milk and stomach acid not produce a low PH?
I’ve always found the over feeding evidence weak as I just don’t feel they could be certain that the previous feed had been absorbed and that the large vomits aren’t just an accumulation of multiple undigested feeds as many times I’ve experienced hours of getting no/minimal aspirate only for the next hour to suddenly get 100’s mls or a patient to vomit.
It would be the case that I could be accused of feeding extra NG feed just because in the previous hour 30mls was given but the aspirate/vomit was 300mls when the reason is obviously the feed just isn’t being absorbed not that I’d given 300ml.

Leaving aside the pH reading, because I have no knowledge of that, and the baby was also receiving Gaviscon, the baby was fed her normal feed via gravity through the NGT, as she was asleep. The expert evidence was that her full stomach wouldn't have accepted more than her usual amount and the rest would not go in, unless it was forced in with a plunger. Her stomach was massively distended, inhibiting movement of her diaphragm.

 

[soppppheiie]

I can only give you my own experience, that if you aspirate a syringeful of milk it won't test acid. It doesn't matter though as obviously it's in the stomach! The other point is that this baby would be gravity fed. It simply won't flow with a full stomach, and the baby might also begin to dribble milk. This can happen towards the end of a tube feed even on an empty stomach, especially if there are larger-than-normal volumes given to promote weight gain.

So a milk aspirate would be produce a ph of more than 5? 7? And a low aspirate would reassure you that all feed is gone from the stomach. This obviously makes sense it just seems as though the defence was suggesting it was accepted acidic ph’s were normal in other cases of large volumes but not in this instance. This was what confused me.
Thank you for your insight about the gravity feed, the example I was thinking of was using a pump so obviously easy to overfill the stomach of a adult that way.

 

[marynnu]

So a milk aspirate would be produce a ph of more than 5? 7? And a low aspirate would reassure you that all feed is gone from the stomach. This obviously makes sense it just seems as though the defence was suggesting it was accepted acidic ph’s were normal in other cases of large volumes but not in this instance. This was what confused me.
Thank you for your insight about the gravity feed, the example I was thinking of was using a pump so obviously easy to overfill the stomach of a adult that way.

Pumps - so continuous feeds - used to be used for tiny babies. This was stopped years ago and replaced by hourly feeding. Oh joy.

 

[katydid23]

I have to confess the actual phraseology was 'avoids physical confrontation' so rely on manipulation to get what they want etc.. I missed out the word physical.

It's just a personal opinion of mine but I think we have seen examples of her avoiding physical confrontation, in the way she uses texting to complain but not directly to the person she is complaining about, in some of her notes to self about other people, and in her demeanour on the witness stand.

It could be said that taking the witness stand is an act of physical confrontation but perhaps, if she does have this style, this was a huge dilemma for her with the stakes as they are; not taking the stand means passing up the opportunity to (as alleged by the prosecution) manipulate and gaslight the jury, and fight these allegations. But, my impression is that on the stand she has been quite clipped with her answers of 'no', has avoided looking at NJ and been fairly disconnected, sometimes withdrawing into silence, which could be because she is used to avoiding confrontation.

As regards interpersonally exploitative, I think that covers gaslighting, and also could be the reason for her friendships with the doctors, if she used those relationships to be trusted when she was allegedly harming the babies and to get inside information and a feel for what the doctor group was thinking about her.

JMO and if guilty.

In essence, 'Avoids physical confrontation' could be seen by , if guilty, her choosing the most vulnerable and the least physically capable victims possible. There is no way she would get any resistance or physical confrontation from tiny newborns.

 

[Tortoise]

Going off topic slightly too; yesterday I also noted BM said LL had sent baby Es mum a condolence card. I don’t recall hearing that previously. Even more interesting, LL had said previously that when she had sent one to baby Is mother (I think it was), it was something she hadn’t done before and it was just this one occasion. Unless I’m completely mistaken of course but I’ve found a lot of the things LL has said (both in police interview and on the stand), seem to be at odds with some of the things BM has said. A lot of conflicting stuff.

I think either he misspoke or it was misreported. The card on LL's phone to do with baby E was a thank you card sent by the parents to the ward and pinned on a noticeboard. LL had a photo of it on her phone.

 

[soppppheiie]

Leaving aside the pH reading, because I have no knowledge of that, and the baby was also receiving Gaviscon, the baby was fed her normal feed via gravity through the NGT, as she was asleep. The expert evidence was that her full stomach wouldn't have accepted more than her usual amount and the rest would not go in, unless it was forced in with a plunger. Her stomach was massively distended, inhibiting movement of her diaphragm.

Thank you for your explanation about the milk not going in. I guess I assumed that the babies feeds wouldn’t have been so much volume that the stomach was completely full following a feed (I have no idea the volume babies stomach can hold vs the feeds they are prescribed) and that it would be possible that there was room for multiple feeds to be there at once.

 

[Diddly1]

I really do not know how the parents are coping with cruel interpretation of the defence. (MOO) They must feel absolutely tortured again. I have had to scan MyersKC’s closing as it repels and utterly repulses every sense of honour and dignity that I try to live by. My heart heart aches more and more for the babies and the families with every tragic twist and bending of previous evidence heard. It is almost like listening to the babies attacked and murdered again MOO only my musings

 

[Parker Knoll]

I do wish there was a “ Mmmmm okaaayyy “ button for the CS and Twitter feeds until Friday. It would be very helpful.
Again another super strange day.
JMO

 

[WaxLyrical]

I’ve been away a while, but been keeping up with the live reporting as much as I’ve been able to. Glad we are nearing the end finally!

On the Baby G case, I’ve never been persuaded it’s a very strong case, especially when a later baby showed acidic ph when milk was aspirated, as that significantly weakened the testimony about milk ‘buffering’ in my opinion.

On the gravity feeding, stomach capacity point. Are we sure that baby G’s stomach capacity would not be (at least) 100mls? This is less than 4oz, and at the point she was full-term size. 4oz is usually the normal feed size of a baby who’s a couple of weeks old.

 

[katydid23]

Re 'russian dolls of improbability' well maybe he raises an interesting point here...

That if the perpetrator was tampering with the TPN bags before they were allocated to any baby, they were indeed playing russian roulette as it would be fairly (altho not totally) random to know which baby it might go to.

But then I recall we discussed how the TPN bags are made up in pharmacy uniquely and individually for each baby IIRC? Maybe wrong. And that it was ruled out that anyone in the pharmacy could be tampering with them. Did I remember that correctly?

IIRC, none of the other babies were on TPN at that time. So no Russian Roulette involved.

 

[marynnu]

I’ve been away a while, but been keeping up with the live reporting as much as I’ve been able to. Glad we are nearing the end finally!

On the Baby G case, I’ve never been persuaded it’s a very strong case, especially when a later baby showed acidic ph when milk was aspirated, as that significantly weakened the testimony about milk ‘buffering’ in my opinion.

On the gravity feeding, stomach capacity point. Are we sure that baby G’s stomach capacity would not be (at least) 100mls? This is less than 4oz, and at the point she was full-term size. 4oz is usually the normal feed size of a baby who’s a couple of weeks old.

Was she full-term size though?

 

[Tortoise]

I’ve been away a while, but been keeping up with the live reporting as much as I’ve been able to. Glad we are nearing the end finally!

On the Baby G case, I’ve never been persuaded it’s a very strong case, especially when a later baby showed acidic ph when milk was aspirated, as that significantly weakened the testimony about milk ‘buffering’ in my opinion.

On the gravity feeding, stomach capacity point. Are we sure that baby G’s stomach capacity would not be (at least) 100mls? This is less than 4oz, and at the point she was full-term size. 4oz is usually the normal feed size of a baby who’s a couple of weeks old.

She was 4lb 6oz at that date.
Recap: Lucy Letby trial, Thursday, December 1

 

[WaxLyrical]

Was she full-term size though?

I thought I read that, but perhaps I’m confusing her with another baby. She was 100 days old though, so I imagine must’ve been close at least to full term.

 

[WaxLyrical]

She was 4lb 6oz at that date.

Ahhhh ok, apologies, I’m confusing her for a different baby then. Thanks.

 

[WaxLyrical]

Other question in relation to the insulin readings. Can we expect the judge to clear things up during his summing up, on whether NJ or BM is correct on which baby had higher amounts of insulin, or is it possible for a witness to be recalled still to clear things up?