Just my 2c before I head off to my bed - I would be interested to know if any other of LL's colleagues ever also looked up their charges' families on FB. Maybe there were sometimes conversations between nurses about how such-and-such's parents or siblings were doing. Which would make LL's actions much less suspicious, IMO.
UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #4
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There is a lot of medical testimony and witnesses being presented about the actual deaths of these poor babies, which personally I find more compelling and relevant to determining guilt and each of those charges has to stand on their own either way, right?
I doubt anyone is using the note and FB searches as proof positive either way. In some respects, they are merely a Rorschach test in this discussion - if you lean towards innocent you will find multiple innocent explanations. If you lean the other way, you will find them strange or even disturbing.
Just a reminder here from the prosecution opening - UK - Lucy Letby Trial - Media, Maps & Timeline *NO DISCUSSION*
"3:36pm
When interviewed by police regarding the circumstances over Child A's death, Letby said she had given fluids to Child A at the time of the change of shifts."
"3:36pm
When interviewed by police regarding the circumstances over Child A's death, Letby said she had given fluids to Child A at the time of the change of shifts."
12:00pm
The court has had a short adjournment while the next witness comes in to give evidence.
12:07pm
The next witness to give evidence is Dr David Harkness.
The court hears that in 2015 he was a paediatric registrar, sometimes based at the Countess of Chester Hospital.
He confirms he has, since then, been interviewed by police, and made witness statements about more than one baby which was a patients at the neonatal unit.
He is being asked about the case of Child A.
LIVE: Lucy Letby trial, Thursday, October 20
The court has had a short adjournment while the next witness comes in to give evidence.
12:07pm
The next witness to give evidence is Dr David Harkness.
The court hears that in 2015 he was a paediatric registrar, sometimes based at the Countess of Chester Hospital.
He confirms he has, since then, been interviewed by police, and made witness statements about more than one baby which was a patients at the neonatal unit.
He is being asked about the case of Child A.
LIVE: Lucy Letby trial, Thursday, October 20
So glad you found this as I thought that was the case so why was the defence trying to say it could have been either of them
Something else that crossed my mind ...LL wrote in the notes the misplaced umbilical catheter was still in place and specifically wrote that the Registrar said not to use it.
This being in situ would give two different avenues where a syringe could be attached to add air
This being in situ would give two different avenues where a syringe could be attached to add air
Yes that was also mentioned in the prosecution opening - (quote below, note this is not in evidence yet)
"3:30pm
Medical expert Dr Dewi Evans suggested Child A's collapse was "consistent with a deliberate injection of air or something else into [Child A]'s circulation a minute or two prior to deterioration," Mr Johnson told the court. Only Letby was present.
Another medical expert said the cause was "not some natural disease process, but a dose of air "deliberately administered".
An independent pathologist described the cause of death was 'unascertained', in that there was nothing in the autopsy that pointed to why Child A had died, but the cause was most likely 'exogenous air administration through the longline or UVC'.
3:31pm
Said explanations are also backed up, the prosecution say, by an independent radiologist."
UK - Lucy Letby Trial - Media, Maps & Timeline *NO DISCUSSION*
12:12pm
He confirms that at the time, he was a registrar and was on duty on the evening of June 8.
His clinical notes, written in retrospect at 9.30pm, record for 5pm: "UVC in situ on my arrival on NICU at 5pm. No definitive access at this point, so I've left in situ with plan to remove if long line sited or pull back to low position is long line not successful."
He said he was looking after children outside of the neonatal unit prior to 5pm, and on his arrival, his "first port of call" was seeing Child A.
12:15pm
He says the UVC is preferred as a feeding method to the long line, and can be moved to a low position as a short-term measure until something better is in place.
The prosecution say a UVC was in place, an x-ray was taken before it was used for purpose of administering fluids.
If it is "imperfect" in position, the options are withdrawing, or adjusting it. The latter would be on a short-term basis. The doctor agrees.
LIVE: Lucy Letby trial, Thursday, October 20
He confirms that at the time, he was a registrar and was on duty on the evening of June 8.
His clinical notes, written in retrospect at 9.30pm, record for 5pm: "UVC in situ on my arrival on NICU at 5pm. No definitive access at this point, so I've left in situ with plan to remove if long line sited or pull back to low position is long line not successful."
He said he was looking after children outside of the neonatal unit prior to 5pm, and on his arrival, his "first port of call" was seeing Child A.
12:15pm
He says the UVC is preferred as a feeding method to the long line, and can be moved to a low position as a short-term measure until something better is in place.
The prosecution say a UVC was in place, an x-ray was taken before it was used for purpose of administering fluids.
If it is "imperfect" in position, the options are withdrawing, or adjusting it. The latter would be on a short-term basis. The doctor agrees.
LIVE: Lucy Letby trial, Thursday, October 20
Brilliant thank you.
Imo it would be far easier and quicker to administer air through the UVC that had nothing attatched.
12:19pm
A note by Dr Harkness at 7pm: "Long line inserted at 1st attempt."
A sticker confirming the insertion of the long line is placed.
An x-ray review sticker is also placed, timed 7.09pm.
Dr Harkness said he was junior at the time, so would have recommended the long line be moved back slightly, as outlined in his recorded note, but now he would say the long line was in the right position.
LIVE: Lucy Letby trial, Thursday, October 20
A note by Dr Harkness at 7pm: "Long line inserted at 1st attempt."
A sticker confirming the insertion of the long line is placed.
An x-ray review sticker is also placed, timed 7.09pm.
Dr Harkness said he was junior at the time, so would have recommended the long line be moved back slightly, as outlined in his recorded note, but now he would say the long line was in the right position.
LIVE: Lucy Letby trial, Thursday, October 20
12:24pm
Dr Harkness said because the night of June 8 was a "traumatic event", his memory of entering the unit room was "quite fresh" and he explains there were three babies in the nursery room 1 - the intensive care unit, at the time, and two of them would have been Child A and Child B. He describes which incubators they would have been in, which are adjacent to each other.
A video of the layout of the nursery room one is played to the court and Dr Harkness confirms where Child A and Child B would have been located.
12:31pm
Dr Harkness's x-ray review said at the time the x-ray was available to review, he was "scrubbed inserting a line into another patient", which meant he had to adhere to sterilised conditions, he explains.
The doctor's opinion at the time was the position of the long line was "less than perfect", the prosecution said.
Dr Harkness said that following consultation and in accordance with guidelines, the position of the longline was "actually correct".
12:35pm
He said he was "just about finished with [another baby]" when he was called to Child A at 8.26pm.
Bagging was started "via Neopuff immediately".
The saturations, which "should be in the 90%'s", were in the '70s-80%'s'. The heart rate was "slightly on the lower side", Dr Harkness records.
He said he can remember the events.
12:37pm
He said he was called "by nursing staff" over problems with Child A's breathing.
A junior doctor took on the responsibility of making contemporaneous notes for Dr Harkness during the event, the court hears.
12:39pm
He said it was "most likely nursing staff" who started the Neopuff bagging process by the time he arrived.
"Good chest movement seen" meant there was not a blockage, Dr Harkness explains.
LIVE: Lucy Letby trial, Thursday, October 20
Dr Harkness said because the night of June 8 was a "traumatic event", his memory of entering the unit room was "quite fresh" and he explains there were three babies in the nursery room 1 - the intensive care unit, at the time, and two of them would have been Child A and Child B. He describes which incubators they would have been in, which are adjacent to each other.
A video of the layout of the nursery room one is played to the court and Dr Harkness confirms where Child A and Child B would have been located.
12:31pm
Dr Harkness's x-ray review said at the time the x-ray was available to review, he was "scrubbed inserting a line into another patient", which meant he had to adhere to sterilised conditions, he explains.
The doctor's opinion at the time was the position of the long line was "less than perfect", the prosecution said.
Dr Harkness said that following consultation and in accordance with guidelines, the position of the longline was "actually correct".
12:35pm
He said he was "just about finished with [another baby]" when he was called to Child A at 8.26pm.
Bagging was started "via Neopuff immediately".
The saturations, which "should be in the 90%'s", were in the '70s-80%'s'. The heart rate was "slightly on the lower side", Dr Harkness records.
He said he can remember the events.
12:37pm
He said he was called "by nursing staff" over problems with Child A's breathing.
A junior doctor took on the responsibility of making contemporaneous notes for Dr Harkness during the event, the court hears.
12:39pm
He said it was "most likely nursing staff" who started the Neopuff bagging process by the time he arrived.
"Good chest movement seen" meant there was not a blockage, Dr Harkness explains.
LIVE: Lucy Letby trial, Thursday, October 20
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There has been far more discussion on here of the note and the Facebook searches, rather than any medical testimony, which is where the emphasis should be.
So far, I personally haven’t seen anything compelling to determine guilt and given the early stages of a trial this long, I don’t expect to.
12:44pm
Dr Harkness said as far as he was concerned the longline was the last thing which was inserted, so he removed it at 8.27pm.
He said: "That was my immediate thought. In hindsight...there was no possible link [between its insertion and the collapse]."
He said if the long line had been moved further in, towards the heart, it could have caused a significant increase in the heart rate, or other heart complications. There was no evidence then, or since, which had supported that, he explains.
Help was called at 8.27pm.
Child A was "intubated at the first attempt".
LIVE: Lucy Letby trial, Thursday, October 20
Dr Harkness said as far as he was concerned the longline was the last thing which was inserted, so he removed it at 8.27pm.
He said: "That was my immediate thought. In hindsight...there was no possible link [between its insertion and the collapse]."
He said if the long line had been moved further in, towards the heart, it could have caused a significant increase in the heart rate, or other heart complications. There was no evidence then, or since, which had supported that, he explains.
Help was called at 8.27pm.
Child A was "intubated at the first attempt".
LIVE: Lucy Letby trial, Thursday, October 20
There's going to be more disagreement further down the line, between what LL said in her police interviews regarding child K being sedated, and her Advocate, who disputed this, in his opening speech. I was looking at it yesterday, it was the case where the breathing tube was dislodged.
12:56pm
The note records intubation was at 8.28pm.
Child A's heart rate fell to 60-70 the same minute, it was noted. Dr Harkness had said ideally the heart rate should be above 100, and chest compressions are started when the heart rate is at 60.
Chest compressions were started and fluids including adrenaline are administered.
The court hears while air was still getting into the lungs, "unfortunately" there was no heart rate detected at about 8.33pm.
Further chest compressions and medicinal doses are given up to 8.49pm.
A heart rate of 50-60 is noted at 8.50pm, and a further adrenaline dose is given, but then there is no heart rate again, and CPR continues until 8.57pm.
At that point a review was carried out by Dr Ravi Jayaram in attendance, and no heart rate was present.
Dr Harkness says: "It was felt the kindest thing to do was to stop resuscitation."
LIVE: Lucy Letby trial, Thursday, October 20
The note records intubation was at 8.28pm.
Child A's heart rate fell to 60-70 the same minute, it was noted. Dr Harkness had said ideally the heart rate should be above 100, and chest compressions are started when the heart rate is at 60.
Chest compressions were started and fluids including adrenaline are administered.
The court hears while air was still getting into the lungs, "unfortunately" there was no heart rate detected at about 8.33pm.
Further chest compressions and medicinal doses are given up to 8.49pm.
A heart rate of 50-60 is noted at 8.50pm, and a further adrenaline dose is given, but then there is no heart rate again, and CPR continues until 8.57pm.
At that point a review was carried out by Dr Ravi Jayaram in attendance, and no heart rate was present.
Dr Harkness says: "It was felt the kindest thing to do was to stop resuscitation."
LIVE: Lucy Letby trial, Thursday, October 20
1:17pm
Dr Harkness said the circumstances of Child A's death were "very unusual and very unexpected."
He said: "It was very surprising to be called back [to Child A] at this time [as he had been stable].
"It was very unusual - the skin [patterns] I had never seen before, and I have only seen again at the Countess of Chester Hospital.
"I was faced with a baby unexpectedly deteriorating."
Dr Harkness noted there was "unusual skin colouring."
1:20pm
Dr Harkness said he had only ever seen this "patchy" skin colouring and pattern in one other baby at the Countess of Chester Hospital, when dealing with the case of Child E and F.
1:56pm
Dr Harkness said he could not remember the exact pattern of the skin at the time as he was "busy trying to save [Child A's] life" at the time, but "it was unusual enough for me to make notes and document it."
He added he had, with his experience of being a doctor, "unfortunately" seen dying or dead children patients and the type of skin blotching and patterns that would be found, "but not a pattern like this".
LIVE: Lucy Letby trial, Thursday, October 20
Dr Harkness said the circumstances of Child A's death were "very unusual and very unexpected."
He said: "It was very surprising to be called back [to Child A] at this time [as he had been stable].
"It was very unusual - the skin [patterns] I had never seen before, and I have only seen again at the Countess of Chester Hospital.
"I was faced with a baby unexpectedly deteriorating."
Dr Harkness noted there was "unusual skin colouring."
1:20pm
Dr Harkness said he had only ever seen this "patchy" skin colouring and pattern in one other baby at the Countess of Chester Hospital, when dealing with the case of Child E and F.
1:56pm
Dr Harkness said he could not remember the exact pattern of the skin at the time as he was "busy trying to save [Child A's] life" at the time, but "it was unusual enough for me to make notes and document it."
He added he had, with his experience of being a doctor, "unfortunately" seen dying or dead children patients and the type of skin blotching and patterns that would be found, "but not a pattern like this".
LIVE: Lucy Letby trial, Thursday, October 20
I think this is really very significant evidence.
The only two times in his career he has seen this skin colouring on dying babies, and the same nurse is involved in the babies 'care'.
ETA - The agreed evidence of the mother of babies A and B was that she said a different consultant said the exact same thing in regards to baby B and wanted to take a photograph.
Last edited:
2:11pm
The court has had its lunch break, and the trial is ready to resume with Dr Harkness giving further evidence.
2:16pm
Dr Harkness is asked to examine a clinical note.
During the time he was looking at a third baby in the room, he was scrubbed up and sterilised for a procedure which "takes a lot of concentration."
"Typically, you are left to your own devices."
He said it was shortly after that (about 1-2 minutes), he was urgently called to Child A.
LIVE: Lucy Letby trial, Thursday, October 20
The court has had its lunch break, and the trial is ready to resume with Dr Harkness giving further evidence.
2:16pm
Dr Harkness is asked to examine a clinical note.
During the time he was looking at a third baby in the room, he was scrubbed up and sterilised for a procedure which "takes a lot of concentration."
"Typically, you are left to your own devices."
He said it was shortly after that (about 1-2 minutes), he was urgently called to Child A.
LIVE: Lucy Letby trial, Thursday, October 20
2:35pm
Dr Harkness is now being asked questions by the defence.
Mr Myers says what happened was "a tragic event".
He said "You have given us a description of skin evidence which was unusual."
Dr Harkness agrees the skin patches of purple, blue, red and white were "very striking", but adds he was not forensically analysing the skin at the time.
Mr Myers refers to notes retrospectively written at 9.20pm-9.30pm and attributed to Dr Harkness, which does not refer to skin condition.
"You could have put anything you wanted in these notes?
"Nowhere do you make reference to skin colour."
Dr Harkness said the "significance" of the skin colour changes was noted later, following conversations and the non-fatal collapse of Child B.
The defence asks Dr Harkness if he had been "influenced" in his recollections, that had led him to form the impression of the skin pattern in Child A.
He said at the time it was an "emotional" time, as it was "one of the first" neonatal deaths he had seen in his experience, and he had found it "greatly upsetting".
He added that at that time his documentation may not have been as detailed.
The defence say the skin patterns are also not referenced in Child A's inquest report from October 2016, but "pale and poor peripheral perfusion".
Dr Harkness admits it's "not clearly documented" but he would still have been in an emotional state.
Mr Myers asks that by the time of the police statement, his impression had been formed.
Dr Harkness says his statement of observations in the cases of Child E and F had jogged his memory for Child A's skin patterns.
LIVE: Lucy Letby trial, Thursday, October 20
Dr Harkness is now being asked questions by the defence.
Mr Myers says what happened was "a tragic event".
He said "You have given us a description of skin evidence which was unusual."
Dr Harkness agrees the skin patches of purple, blue, red and white were "very striking", but adds he was not forensically analysing the skin at the time.
Mr Myers refers to notes retrospectively written at 9.20pm-9.30pm and attributed to Dr Harkness, which does not refer to skin condition.
"You could have put anything you wanted in these notes?
"Nowhere do you make reference to skin colour."
Dr Harkness said the "significance" of the skin colour changes was noted later, following conversations and the non-fatal collapse of Child B.
The defence asks Dr Harkness if he had been "influenced" in his recollections, that had led him to form the impression of the skin pattern in Child A.
He said at the time it was an "emotional" time, as it was "one of the first" neonatal deaths he had seen in his experience, and he had found it "greatly upsetting".
He added that at that time his documentation may not have been as detailed.
The defence say the skin patterns are also not referenced in Child A's inquest report from October 2016, but "pale and poor peripheral perfusion".
Dr Harkness admits it's "not clearly documented" but he would still have been in an emotional state.
Mr Myers asks that by the time of the police statement, his impression had been formed.
Dr Harkness says his statement of observations in the cases of Child E and F had jogged his memory for Child A's skin patterns.
LIVE: Lucy Letby trial, Thursday, October 20
2:39pm
Dr Harkness says "there was no evidence" for the long line to have moved in Child A.
"This has been proved on the post-mortem."
Mr Myers says would the long line have still been in there at the time of the post-mortem?
Dr Harkness: "No, and there was no damage [found] there [where the long line had been]."
Dr Harkness said the long line was removed at 8.27pm as a "theoretical" concern "based on no evidence at the time". He said the last new thing, as far as he could know, was the addition of the long line at the time of the collapse.
He adds: "The logical thing was to remove it."
LIVE: Lucy Letby trial, Thursday, October 20
Dr Harkness says "there was no evidence" for the long line to have moved in Child A.
"This has been proved on the post-mortem."
Mr Myers says would the long line have still been in there at the time of the post-mortem?
Dr Harkness: "No, and there was no damage [found] there [where the long line had been]."
Dr Harkness said the long line was removed at 8.27pm as a "theoretical" concern "based on no evidence at the time". He said the last new thing, as far as he could know, was the addition of the long line at the time of the collapse.
He adds: "The logical thing was to remove it."
LIVE: Lucy Letby trial, Thursday, October 20
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