11:18am
The judge says the mother of Child Q said the baby was in and out of hospital about three times a year, and had a weakened immune system, and was diagnosed with developmental delay, and would require appropriate support.
Professor Owen Arthurs reviewed radiograph images for Child Q. A single loop of dilated bowel was seen in the first, which was 'slightly normal', and gas in the bowel which had gone to the bowel wall. They were 'signs of NEC', but 'not diagnostic' of NEC.
"Things were settling" at the time of the third x-ray, taken at Alder Hey.
Dr Dewi Evans and Dr Sandie Bohin had considered the possibility of NEC.
Dr Evans said although there were markers of Child Q having infection, from the bile aspirates and 'not really tolerating feeds', it did not explain the 'sudden collapse' at 9.10am, with a 'very significant deterioration', and it was 'not clear how to put it all together'.
The suspicion of NEC was 'perfectly reasonable', as was putting Child Q on CPAP.
He said Child Q would not have vomitted anything at all, unless 'a lot' of clear fluid had been forced down the NGT, possibly with air as well.
He said once Child Q had vomitted, he recovered. He said in relation to the air+++, there was very little Neopuffing taking place. He said when babies vomit, they do not swallow air.
In cross-examination, he accepted he had initially concluded Child Q had received air, and not fluid. The air++ was 'noteworthy'. Dr Evans refuted he had 'added' the liquid element to support the case. He said the evidence he had heard from the people looking after Child Q had been "a great help" in forming his opinion. He said the presence of NEC or otherwise could not be discounted, but that would not cause a sudden collapse, and noted the rapid recovery of Child Q, and no further gastro-intestinal problems until his discharge from the Countess hospital in July 2016.
Dr Bohin noted the aspirates were 'not uncommon' for Child Q prior to the collapse. She did not know where the fluid+++ came from for Child Q, from the notes. Child Q's intermittent air was unlikely to cause the 'air++' aspirated. She concluded Child Q had been given air down the NG Tube, which had distended the abdomen so much, squashing the lungs, causing mottling. In cross-examination, she agreed 'mucus+++' being aspirated could cause problems with breathing. She said there was not a cause of where the 'mucus+++' would have come from.
She refuted the possibility of any baby sucking in air during a vomit. She added aspirates was a sign of NEC, as well as other factors. She said it was not a diagnosis of NEC. She said Child Q 'got better too quickly for it to have been mild NEC'.
11:20am
Letby was enquiring with a male doctor about what Dr Gibbs had been saying about leaving Child Q unattended. The doctor reassured Letby.
After Letby was taken off nursing duties, she filed a grievance with the hospital in September 2016. She said that time was emotionally difficult and had left her feeling isolated.
11:22am
The judge says agreed evidence says searches of Letby's home in Chester and Hereford were carried out in 2018 and 2019 respectively.
He said there were various papers collected, including 'NOT GOOD ENOUGH' and 'I am a horrible evil person'.
The defence says these were notes written by someone who was 'distraught' at what was happening and was being 'unfairly targeted'.
The prosecution say the notes are by 'a troubled person' who was 'in part confessing to what she had done'.
11:24am
257 handover sheets were found at Letby's Chester and Hereford homes, 21 of which in relation to babies in the indictment.
www.chesterstandard.co.uk
The judge says the mother of Child Q said the baby was in and out of hospital about three times a year, and had a weakened immune system, and was diagnosed with developmental delay, and would require appropriate support.
Professor Owen Arthurs reviewed radiograph images for Child Q. A single loop of dilated bowel was seen in the first, which was 'slightly normal', and gas in the bowel which had gone to the bowel wall. They were 'signs of NEC', but 'not diagnostic' of NEC.
"Things were settling" at the time of the third x-ray, taken at Alder Hey.
Dr Dewi Evans and Dr Sandie Bohin had considered the possibility of NEC.
Dr Evans said although there were markers of Child Q having infection, from the bile aspirates and 'not really tolerating feeds', it did not explain the 'sudden collapse' at 9.10am, with a 'very significant deterioration', and it was 'not clear how to put it all together'.
The suspicion of NEC was 'perfectly reasonable', as was putting Child Q on CPAP.
He said Child Q would not have vomitted anything at all, unless 'a lot' of clear fluid had been forced down the NGT, possibly with air as well.
He said once Child Q had vomitted, he recovered. He said in relation to the air+++, there was very little Neopuffing taking place. He said when babies vomit, they do not swallow air.
In cross-examination, he accepted he had initially concluded Child Q had received air, and not fluid. The air++ was 'noteworthy'. Dr Evans refuted he had 'added' the liquid element to support the case. He said the evidence he had heard from the people looking after Child Q had been "a great help" in forming his opinion. He said the presence of NEC or otherwise could not be discounted, but that would not cause a sudden collapse, and noted the rapid recovery of Child Q, and no further gastro-intestinal problems until his discharge from the Countess hospital in July 2016.
Dr Bohin noted the aspirates were 'not uncommon' for Child Q prior to the collapse. She did not know where the fluid+++ came from for Child Q, from the notes. Child Q's intermittent air was unlikely to cause the 'air++' aspirated. She concluded Child Q had been given air down the NG Tube, which had distended the abdomen so much, squashing the lungs, causing mottling. In cross-examination, she agreed 'mucus+++' being aspirated could cause problems with breathing. She said there was not a cause of where the 'mucus+++' would have come from.
She refuted the possibility of any baby sucking in air during a vomit. She added aspirates was a sign of NEC, as well as other factors. She said it was not a diagnosis of NEC. She said Child Q 'got better too quickly for it to have been mild NEC'.
11:20am
Letby was enquiring with a male doctor about what Dr Gibbs had been saying about leaving Child Q unattended. The doctor reassured Letby.
After Letby was taken off nursing duties, she filed a grievance with the hospital in September 2016. She said that time was emotionally difficult and had left her feeling isolated.
11:22am
The judge says agreed evidence says searches of Letby's home in Chester and Hereford were carried out in 2018 and 2019 respectively.
He said there were various papers collected, including 'NOT GOOD ENOUGH' and 'I am a horrible evil person'.
The defence says these were notes written by someone who was 'distraught' at what was happening and was being 'unfairly targeted'.
The prosecution say the notes are by 'a troubled person' who was 'in part confessing to what she had done'.
11:24am
257 handover sheets were found at Letby's Chester and Hereford homes, 21 of which in relation to babies in the indictment.
Recap: Lucy Letby trial, July 10 - judge's summing up, jury out
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…
