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

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  • #861
  • #862
11:58am

The judge refers to the case of Child M, who the court had heard was "not an intensive care baby" but put next to Child L on April 9.
At 11am, he had a "small possit", as noted by Mary Griffith, and 1.5ml of bile-stained fluid was aspirated at 12.30pm. Child M was to be 'nil by mouth', a decision made by a registrar.

12:02pm

At 3.45pm, Child M received antibiotics, the prescription by Letby and Mary Griffith, and administered by one of the two nurses.
At 4pm, Mary Griffith had been preparing a 12.5% dextrose infusion for Child L. The parents had left a few minutes earlier. Child M collapsed at this time. Letby said: "Yes, it's an event, it needs to be sorted." and the resuscitation call was put out. Dr Jayaram was crash bleeped.
A nurse colleague said her role was to draw up the resuscitation drugs. She was shown a piece of paper towel referring to entries on clinical notes, for times and medications administered. She recognised her handwriting of adrenaline made. That note was subsequently recovered from a Morrisons bag in Letby's bedroom at the time of her arrest in July 2018, along with a blood gas record for Child M.
The nurse said the practice was to put the note in the confidential waste bin or the clinical waste bin, where it would be incinerated. the judge says it is the prosecution case that Letby recovered the note from the bin afterwards.

 
  • #863
Very disappointed the judge has not included LL being proven by computer records to be right by Baby Ks cot immediately before her second collapse.
It is possible he did and it hasn't made it into the reporting, based on what people have said about the reporting.

Look forward to your report later!
 
  • #864
60?? Is this right?
I wonder if he said 16th? Given that there are 17 cases and the last two were the insulin cases.

Although we know there were 33 + 2 insulin cases talked about, so 60 could be right, but did the 33 relate to individual collapses rather than number of babies?

Questions I know we don't have answers to.
 
  • #865
12:16pm

Child M was not breathing for himself and required doses of adrenaline in the resuscitation, which lasted under 30 minutes. They reached a point, the judge said, where Child M "might not survive", then Child M suddenly picked up his breathing and heart rate.
Dr Jayaram said he saw pink patches/blotches on the abdomen of Child M that moved around. He noticed that He said it was similar to what he had seen with Child A. He first mentioned it in his witness statement. He said his priority at the time was communicating with parents and post-resuscitation care.
He said and his colleagues sat down on June 29, 2016 to discuss the findings. Dr Jayaram said someone mentioned air embolus. He researched it in literature, and he shared that research the following day with colleagues.
In cross-examination, he said he had not appreciated the clinical significance of the skin discolouration at the time. He rejected the assertion he did not note it at the time because it did not happen, or that omitting it was 'incompetence'. He said at the time, "there were other events going on". He agreed that after Child D had died, Dr Stephen Brearey had carried out an informal review of events at that time, and that Letby was associated with those events.
In police interview, Letby denied doing anything to harm Child M. She did not know why Child M desaturated. She said she had been drawing up medications at the time of the collapse. She thought she had taken the paper towel home 'inadvertently', not emptying her pockets. She said the paper towel might have been put to one side. She denied she had kept it to keep a record of the attack.
In evidence, she said Child L and Child M stood out as she had been the allocated nurse for when they were delivered. Child M was not in an allocated space on the nursery, she recalled, and maybe things would have been different if he had been in an allocated space. She did not recall seeing any discolouration, did not recall having any description of skin discolouration being mentioned to her, and any discolouration would have been difficult for her to see.
Letby said her taking home the notes was an "error" and denied taking them from a confidential waste bin. She added she cared for the twins on subsequent days "quite frequently", during which time there were no adverse incidents.

 
  • #866
The Judge is really speeding IMO.
So, he might finish Summing Up today - as was announced earlier.

10th July seems to be start of Jury's deliberations, really!
 
  • #867
12:33pm

Paediatric neuroradiologist Dr Stavros Stivaros provided agreed evidence in which he said Child M had shown signs of brain damage, likely caused by the collapse on April 9, 2016.
Professor Owen Arthurs viewed radiographic images for Child M and said they could not support or refute an air embolus.
Dr Dewi Evans concluded there were no concerns for Child M prior to the collapse, save for one bilous aspirate for which he was put nil by mouth. He did not believe that caused the collapse, as Child M's stomach was empty. He believed a noxious substance or air was administered to Child M's circulation [ie intravenously], and could not explain a natural cause for Child M's rapid recovery, ruling out infection.
He said, taking into account Dr Jayaram's description of the skin discolouration, the cause for Child M's collapse was an air embolus.
In cross-examination, he accepted there was no imperical research for how air dissipated in the body following a collapse, and based it on physiology, that cardiac massage would dissipate it. He said if the air goes around the abdominal area, it would result in skin discolouration, and if it heads towards the brain, it can cause neurological damage. He said 'very little air' is required to cause collapse.
Dr Sandie Bohin said Child M had no markers of infection. She had to find some way to explain how a baby previously well suddenly collapsed, and had prolonged resuscitation for which he almost did not make it, then recovered rapidly. She said the skin discolouration seen by Dr Jayaram was "compatible" with air embolus.
She said the actual volume to cause a baby to collapse and die is unknown. She said if it was a small volume, it would "take some minutes" to get to Child M in this case, as he was on a slow infusion.
In cross-examination, Dr Bohin accepted most babies die in the case of air embolus, but it was "not inevitable". She could not think of an alternate medical cause from her differential diagnosis. She said the type of cardiac arrest suffered by Child M was "incredibly unusual".

 
  • #868
We have a 4pm finish though today and it will be lunch soon.
I think it will go into Monday morning just slightly.
He will have other legal directions after all the babies to clarify.
 
  • #869
12:36pm

The judge refers to the case of Child N, born on June 2, 2016 at the Countess of Chester Hospital.
He says the prosecution case is Child N had three unexpected collapses in June 2016, that are all attributable to inflicted trauma by Letby, and were acts carried out with the intention to murder him. The defence case is Letby did not harm Child N, that there are inconsistencies in the accounts, and the jury cannot be sure Letby intended to murder Child N.

 
  • #870
12:16pm
He said and his colleagues sat down on June 29, 2016 to discuss the findings. Dr Jayaram said someone mentioned air embolus. He researched it in literature, and he shared that research the following day with colleagues.


I would love to know exactly who was in the meeting as it's a massive coincidence that air embolism was first brought up as a possibility in the meeting on 29th June, and the very next day on 30th June, LL filed a datix for a missing port bung that she was concerned might lead to an accidental air embolism. JMO
 
  • #871
12:39pm

Child N had 'intermittent grunting' and it was recorded at 3.10pm on June 2 that he had a desaturation to 67% for a minute, and was crying, as recorded by nurse Caroline Oakley. He was placed in a hot cot and reviewed by Dr Anthony Ukoh.
The nurse said she had no recollection of events other than that in her notes. There was nothing to suggest the naso-gastric tube was moved after it was placed, or that there were difficulties placing it on Child N.


 
  • #872
We have a 4pm finish though today and it will be lunch soon.
I think it will go into Monday morning just slightly.
He will have other legal directions after all the babies to clarify.
OK
So,
My guess is 10th July AFTER lunch.

I hope they feed the Jury well ;)
After all, ppl get angry when hungry!
Me, for example!
 
  • #873
Oh and me Dotta !
Yes …. I wonder if Doc Choc was at that meeting on the 29th ?
 
  • #874
12:46pm

For the night of June 2-3, Christopher Booth was the designated nurse for Child N. Letby had messaged a colleague to say they had a baby with haemophilia, and in evidence, said staff were panicked by this.
The prosecution say Letby was messaging a colleague 'constantly' from 8pm while feeding a baby in a nursery which was a two-handed job.
She refuted a suggestion, in cross-examination, she had force-fed her designated baby at the time, saying the note of the feed must have happened at a different time.
Dr Jennifer Loughanne reviewed Child N and saw he was 'pink and well perfused', and consideration was given to starting enteral feeds. Christopher Booth had no concerns as he went on his break. He handed over care to a nurse when he went on his break at 1am, but cannot remember who.
The other colleagues cannot recall caring for Child N.
Child N had a deterioration to 40% at 1.05am - "a significant desaturation", and Child N was "screaming", Dr Loughanne had noted. She said she had no direct recollection of that, and said she would not usually have written that word.
At 2am, Child N had recovered was settled, and was asleep.

12:48pm

Christopher Booth recorded there had been no further episodes for Child N following that desaturation. The baby remained nil by mouth.
The prosecution case is Letby sabotaged Child N in some way to cause the collapse. Letby said she had no memory and did not know Child N had collapsed. She said she did not believe it was a collapse which required resuscitation. She denied using the absence of Christopher Booth as an opportunity to sabotage Child N.

 
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  • #875
Dbm
 
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  • #876
Oh and me Dotta !
Yes …. I wonder if Doc Choc was at that meeting on the 29th ?
Or was one of the colleagues Dr J discussed the research he'd found on it, the following day (30th June)

He said and his colleagues sat down on June 29, 2016 to discuss the findings. Dr Jayaram said someone mentioned air embolus. He researched it in literature, and he shared that research the following day with colleagues.
 
  • #877
12:56pm

Letby referred to an "active life" in messaging on June 13, planning a holiday.
The prosecution say the second and third events for Child N happened on June 15, 2016.
There had been no concerns for Child N on June 14 at handover for the night shift, by nurse Jennifer Jones-Key. At 1am, Child N was 'pale, mottled and very veiny', with slight abdominal distention. He was reviewed by a doctor, who observed mottling, a potential sign of sepsis, but was otherwise normal. On further observation, Child N had five minor desaturations which had resolved, and the mottling had gone. Child N's oral feeds were stopped, and he was given antibiotics and glucose. The defence say these were signs of Child N deteriorating.
At 7.15am, Child N had another desaturation. The prosecution say Letby, who had arrived early for her day shift, did something to cause the collapse. Letby said she had gone to see Child N as she had had him for the previous day shift.
The 'profound desaturation' caused Child N's heart rate to be affected.

12:59pm

A male doctor had been called to attend Child N and recorded a desaturation to 48%. He decided to move Child N to nursery room 1, and attempted to intubate. He saw blood which prevented him from seeing the airway. The back of Child N's throat "looked unusual" with swelling, and he was not sure where the blood was coming from.
He made three unsuccessful attempts to intubate, and suction 'did not clear the view enough', and he said he did not want to inflict mechanical trauma. He remembered Letby was helping with the attempted intubation.
A chest x-ray confirmed no pulmonary haemhorrhage.

 
  • #878
@Dotta
Ooo, best we all keep on the good side of you.
Passing Dotta a cream bun. :)
 
  • #879
  • #880
Mini update during lunch:

Judge Goss seems like a bumbling sweet grandad and keeps stumbling over his words. Sometimes really badly, including solemnly saying that Baby M did *not* recover from his vigorous resuscitation, when he actually survived.

There was lots and lots of medical detail for Baby M but I’m still none the wiser about Baby N - it’s just not clear to me and I hope it’s clarified after lunch.

The judge referenced the lengthy text conversation when she was supposed to be feeding a baby (not in the charges), and is accused of plunging a feed in order to keep texting. The judge said this conversation included Lucy using the acronym “ffs”, complaining something or other about Melanie Taylor, and a conversation about something said by Dr Choc, which the judge said included the comment about “go commando, which the defendant said she doesn’t know what it means”.

It was quite funny to me because this detail was a bit random and not in keeping with the rest of the medical-type summing up. I guess it’s just to reiterate because LL made a big deal about supposedly not swearing, and she was made to clarify “ffs” under cross exam. And obviously the go commando lie was ridiculous.

The way the judge said it sounded like he was saying Dr Choc commented about “go commando” which is not true, it was a female nurse friend of LL’s.

Court 8 (viewing court) is very busy - more than twice as busy as when I came to view LL’s cross exam. Absolutely packed with fellow trial watchers.

Court 7 looked comparatively empty in the public gallery.

Someone near me smells strongly of garlic and I can smell farts in the vicinity, so I’m aiming to move when I go back in.

Very briefly managed to see LL on screen. Her hair looks even longer than last month and is about bra length. She seemed very relaxed and unbothered and got up with her prison officers to go to lunch like it was a normal and uninteresting day at the office.

Now shamelessly loitering outside court 7.
 
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