UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #4

[Tortoise]

2:41pm

Mr Myers: "There are dangers with a long line too close to the heart?"
Dr Harkness: "Yes...that was my concern at the time. There was no evidence at the time or subsequently that that long line did any damage."

LIVE: Lucy Letby trial, Thursday, October 20

 

[Tortoise]

2:45pm

Mr Myers refers to the x-ray review from 7.09pm, and the position of the long line at that point.
Dr Harkness noted it was "to be pulled back."
He explained the review took place at 7.10pm - it would have been reviewed during the procedure I was doing."
He said his view the long line was to be pulled back was made 'with his experience and knowledge at the time'.
"It was not a danger then and it's not a danger now. With my experience and knowledge then, that was my assumption. The guidelines and subsequent experience say...it was fine. It's ideal."
Dr Harkness said he likely inserted the long line 'between 6pm and 7pm'.

2:48pm

Dr Harkness explains the x-ray dept takes 15-30 minutes to come to the department with a portable x-ray.
"You wouldn't expect to report these in 30 minutes. An hour would be more likely."
Mr Myers: "Surely if the long line was in the wrong position, you would want to know immediately?"
Dr Harkness says "In an ideal world" the x-ray would have been made available immediately, but "in reality" it was "impossible".
He agrees the x-ray result could have been available more quickly with extra staff and if he had not been treating another patient at the time.
The decision to administer the 10% dextrose was because it was "safe" for all over the body.

2:53pm

Dr Harkness said he was able to review the x-ray as soon as the image was made available from radiology, and fluids were able to be administered at that point, as he wanted to check for the x-ray first.
He says there would be "reluctance" from nurses to administer fluids without having seen an x-ray first.
He says, from his experience, medical staff are "much more keen" to administer the fluids, while nurses would want to see the x-ray result first.
Dr Harkness says the long line was in the right position, and the use of it was appropriate.
The prosecution ask one more qeustion about the "striking discolouration".
Dr Harkness: "Categorically, yes, there was discolouration."
That concludes Dr Harkness giving evidence for Child A.

LIVE: Lucy Letby trial, Thursday, October 20

 

[annpats]

There has been far more discussion on here of the note and the Facebook searches, rather than any medical testimony

Well, that seems quite normal and to be expected.
Generally speaking the majority of Websleuths users are not neo-natal medical professionals - and Websleuths isn't a website for that.
We are just lay-people discussing our thoughts and feelings on the case, while avoiding sub-judice.
So naturally discussions may turns to those subjects which are easiest. We can't discuss in-depth medical procedures if we have no knowledge of it.

 

[Tortoise]

3:07pm

More 'agreed evidence' - evidence which is agreed by both the prosecution and defence - is being read out, via a statement.
The next statement is from a junior doctor, Dr Christopher Wood, who assisted Dr Harkness in the long line procedure by preparing sterile equipment.

3:12pm

He said he did not remember hearing a 'crash bleep' at the time of Child A's collapse, but he was very close by at the time.
Swipe data suggests Dr Wood had previously entered the neonatal unit at 7.40pm.

3:16pm

He said that he was "the least experienced person there", so "took a step back" and began scribing.
All the times on the record had come from a fob watch Dr Wood had, and said scribing was "an important role".
He documented what fluids were administered, as said by Dr Harkness, and which staff members were present, and the events which followed.

LIVE: Lucy Letby trial, Thursday, October 20

 

[Tortoise]

3:21pm

He added he left the room at the conclusion of the resuscitation attempts to give the family of Child A some space and privacy.
He added it was "only natural" doctors would look back and wonder if they could have done anything differently.
He added: "The death came as a shock," saying there had been no concerns "flagged" at the start of the shift for Child A.

LIVE: Lucy Letby trial, Thursday, October 20

 

[Tortoise]

3:35pm

Countess of Chester Hospital neonatal nurse assistant Lisa Walker said, in her agreed evidence statement, she was not working in the neonatal room 1, but knew it was "very busy" that night.
She said she could "recall the sadness in the atmosphere in the unit" that night.
She added she could recall an increase in the number of neonatal unit deaths at the time, and prior to that, in her 10 years, "there was only news of a couple of deaths".
She added: "I remember thinking, 'what on earth is happening?'" in relation to the increased number of neonatal unit deaths.
The witness concludes, in her statement, that she had a lot of interaction with Child B as she recovered in the weeks following her non-fatal collapse and subsequent relocation to nursery room 4, and was in contact with the mother.

LIVE: Lucy Letby trial, Thursday, October 20

 

[Imnothere]

Do we have pictures of the rooms?

 

[Tortoise]

3:42pm

Further 'agreed evidence' statements are being read out by the prosecution, made by Countess of Chester Hospital staff.

LIVE: Lucy Letby trial, Thursday, October 20

 

[Tortoise]

Do we have pictures of the rooms?

I don't know if there have been pictures in any pre-trial reporting, but I haven't seen any in the trial reports.

 

[Noseyposy76]

Well, that seems quite normal and to be expected.
Generally speaking the majority of Websleuths users are not neo-natal medical professionals - and Websleuths isn't a website for that.
We are just lay-people discussing our thoughts and feelings on the case, while avoiding sub-judice.
So naturally discussions may turns to those subjects which are easiest. We can't discuss in-depth medical procedures if we have no knowledge of it.

I fully expect that is the reason why these two things keep being discussed. I actually typed out, but deleted a whole paragraph on how the majority of us on here and the jury will not be medically minded, therefore will have difficulty understanding most of the testimony.
But this is exactly my point, I do not see how anyone can just assume guilt based on an ambiguous note and Facebook searches alone!

 

[Tortoise]

3:53pm

Joanne Williams explains she was the designated neonatal unit nurse for Child B, who was in room 1.
The shift on June 9 was not "unusually busy", but they were "always busy".
The screens were put up for the family following the loss of Child A the previous night.
She assisted the mum with skin-to-skin contact, and taking "lots of photos". Child B became tired so was placed back in the incubator.
Throughout the shift, Child B was "stable" and "nothing significant happened". She was "breathing for herself".
Ms Williams said she tried to keep the atmosphere "calm and relaxed" for the family.
"Although I had no dealing with [Child A], [the death] had come as a shock."
She adds: "Throughout the shift, [Child B] was progressing well," with a slight rise in her breathing rate, which she put down to Child B being ti[r]ed after being taken out of the incubator.
Child B was "doing relatively well". Although she said nurses "can never become complacent", there were "no obvious signs that caused any concern" when she went off the shift that night.
When she arrived for her next shift, the reventilation of Child B "came as a bit of a shock".
She added that babies "can deteriorate quickly".

3:55pm

That concludes the evidence for today.
The trial will resume tomorrow (Friday, October 21). We will continue to bring updates throughout the day.

LIVE: Lucy Letby trial, Thursday, October 20

 

[ConcernedThirdParty]

So far, with regard to Baby A, it feels like the only thing they have going is that it was unexpected, LL had just taken over care, the doctor remembered an unusual symptom which was so unusual and striking he made no note of it and completely forgot about it until being questioned about another baby long after the fact - the second baby also didn't seem to jog his memory.

It seems a little surprising to me that she would take her first victim minutes after arriving on the ward, while it was pretty busy and the previous nurse was still very close by, and also this was a shift she hadn't expected to be on.

We have learned a few other things, while one doctor claims to have it burned into his memory, the other nurse involved in the baby's care couldn't remember a lot of details and another nurse on the ward hardly remembered anything specific at all. So not remembering specific things in interview is not a smoking gun.

LL completed notes at the end of her shift, but many others also completed notes much later and the nurse on the stand had to do them the following day - I don't think the prosecution have suggested anything about that, but some in this forum have - again it seems commonplace.

Our knowledge of medicine is very far from complete, and even if that weren't the case, we can't observe everything going on in a specific body - so any doctor should be comfortable saying "sometimes people get sick and we don't know why". The nurse seemed to have that understanding in an earlier interview, and that doesn't mean you don't look for reasons, but her response makes it seem like she maybe disagrees with that now. Which to me sounded a bit like she'd been around this case so long it has affected her views - as most medical professionals I know only tend to become more aware of how much is guesswork or unknowable as they gain experience.

If the medical experts are able to show that the strange skin discolouration is particularly indicative of air embolism, and that it is exceedingly unlikely that this could have happened via any non-deliberate cause, even then, in isolation, it's not a lot. And we always have to bear in mind the unknown unknowns.

If they can establish there was definitely something going on with later cases and this one looks the same, then maybe?

 

[Music2022]

the doctor remembered an unusual symptom which was so unusual and striking he made no note of it and completely forgot about it until being questioned about another baby long after the fact - the second baby also didn't seem to jog his memory.

There was a different dr who worked on baby B who wanted to take photos of baby B skin and asked for a camera. Dr Harkness wasn't a consultant back then, it was the consultant who wanted the photos done.

 

[Music2022]

It seems a little surprising to me that she would take her first victim minutes after arriving on the ward, while it was pretty busy and the previous nurse was still very close by, and also this was a shift she hadn't expected to be on.

That seems odd to me too. If she was a calculated killer would she have rushed into doing it first thing into her shift? not sure.

 

[JosieJo]

There was a different dr who worked on baby B who wanted to take photos of baby B skin and asked for a camera. Dr Harkness wasn't a consultant back then, it was the consultant who wanted the photos done.

Yes at least 2 Dr's felt the skin was very unusual...the Dr on the stand said he's never seen it since these babies..the other requested medical photography attend

 

[ConcernedThirdParty]

Yes at least 2 Dr's felt the skin was very unusual...the Dr on the stand said he's never seen it since these babies

So we do have records in other cases, but not all, and in this case the doctor says he now remembers it happening in this case but no one made a note of it at the time and he didn't remember it until much later than one would expect. It's hardly reliable.

It's also at this stage not clear if it's even important. I assume the medical experts are going to say it's specific to air embolism. But they'll need to present a strong case for that.

And in that case, we suspect the babies with that symptom died of air embolism, we don't have evidence for how it happened. But we have to be careful that people don't remember wrongly after the fact and we add another to the air embolism column based solely on a symptom that wasn't noted or remembered until a police interview years later.

 

[Tortoise]

That seems odd to me too. If she was a calculated killer would she have rushed into doing it first thing into her shift? not sure.

There's a higher likelihood of the collapse being attributed to a decline that started/or an intervention near the end of the previous shift, the closer it is in time to the handover. Plus everyone is extra busy and probably not noticing what everyone around them is doing. IMO

 

[Charlot123]

I know its in persute of the truth but I really feel for these medical staff having their practice and the unit questioned in court in trying to look for anything to distract the jury no matter how trivial..jmo

However, I do think the trainee needs to be asked if anyone was present when he was inserting the cannula. It is probably like residency, but an attending should observe the process.

 

[MissMarbles]

Something I've been wondering is this - is it ever possible for a vacuum to naturally form whilst inserting a tube or long line, which then draws more air in?

 

[JosieJo]

So we do have records in other cases, but not all, and in this case the doctor says he now remembers it happening in this case but no one made a note of it at the time and he didn't remember it until much later than one would expect. It's hardly reliable.

It's also at this stage not clear if it's even important. I assume the medical experts are going to say it's specific to air embolism. But they'll need to present a strong case for that.

And in that case, we suspect the babies with that symptom died of air embolism, we don't have evidence for how it happened. But we have to be careful that people don't remember wrongly after the fact and we add another to the air embolism column based solely on a symptom that wasn't noted or remembered until a police interview years later.

The mothers statement also mentions that the Dr asked permission for photography of the rash.

To be honest I feel there is enough evidence to be sure there was an unusual rash that no one had seen before ..its where this leads that has to be further clarified imo