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

[Marantz4250b]

I am very much against the tabloids calling LL “killer nurse”, though, as it goes against the presumption of innocence, and worse, manipulates public opinion.

I think it's more than just the tabloids, to be honest. All the papers seem to be doing it.

They've always done this sort of stuff. They know that it's inappropriate but they also know that they can get away with saying anything they like as long as its a factual quote from something said in court as court proceedings are privileged as regards defamation actions. All they need to do is to put quote marks around it and it's taken as privileged regardless of in what context the papers publish it.

 

[squish]

I hope this isn’t all they have for babies A and B. It’s pretty flimsy if it is.

 

[Powermjp]

Serial killers have been known to do things sometimes spur of the moment, its not always planned out.

Sometimes they are opportunistic for the first one, from what i have seen from others before, then they become more planned out. But each person is different its hard to be certain either way, so i wouldnt think we can rule it out on her not being confident.

 

[JosieJo]

Hi folks! First post, but long time lurker.

Obviously I appreciate we’re only a very short while into a very long trial. From what I gather so far, it all seems to hinge on the unusual discolourations found on the neonates at the time of collapse, and that the causes of death are being considered in retrospect to be air embolus.

If it cannot be reliably concluded that these discolourations are indeed a symptom of air embolus in neonates, then where does this leave things? Can a jury still find LL guilty even without being sure of the specific cause of death, but based on all the other circumstances?

I think there will be more medical witnesses showing other signs and symptoms that fit with air embolus to come.
This is a very complex trial and difficult to tell

 

[JosieJo]

11:34am

The trial is now resuming, with the next witness, Prof Owen Arthurs, consultant paediatric radiologist at Great Ormond Street Hospital, giving evidence.

11:34am

The court hears he has reviewed "many of the children in this case", and will be asked questions about Child A and Child B.

11:43am

Prof Arthurs is asked about a post-mortem x-ray for Child A.
He comments "unusual findings" in gas and air found in the baby boy, including "a line of gas just in front of the spine".

11:44am

He said such a finding is not found in cases of 'natual causes' death in babies.

11:47am

Trapped air such as this, Prof Arthurs explains, could be found in cases such as road traffic accidents, or infection such as sepsis - overwhelming infection in the organs of the body, or "very occasionally" outside of hospital in 'sudden unexpected death in infants'.

Recap: Lucy Letby trial, Friday, October 21

The trial of Lucy Letby, the Countess of Chester Hospital neonatal unit nurse who denies murdering seven babies and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[JosieJo]

11:52am

Prosecution: Have you seen this much gas in a baby before?
Prof Arthurs: "Only in one other case, which I think we'll explain later on [another of the children in the Letby case]."
Prosecution: "What was your final opinion?"
Prof Arthurs: "This was an unusual appearance. In the absence of any other explanation...this is consistent with...air being administered."

11:57am

Ben Myers KC is now questioning Dr Arthurs.
He asks questions about 'air in the body' and analysis of them.
Mr Myers: "Radiographic evidence of air embolus is rare, isn't it?"
Prof Arthurs: "Yes."
"On post-mortem imaging, the presence of air may also be the result of medical procedures or placement?"
"Yes."

12:00pm

Mr Myers asks if the presence of a UVC or long line for some time could lead to air in the system. Dr Arthurs agrees.
Prof Arthurs says the "assumption that an image is needed to prove an air embolus is wrong".

12:05pm

Prof Arthurs says his review of the cases involved him, to give a conclusion of 'unusual', having to look through a number of past cases.
Mr Myers says that translated to similar findings in 25% of the total number of past cases he had gone through.

12:14pm

Mr Myers says Prof Arthurs looked at 500 cases at Great Ormond Street Hospital, which after narrowing down the criteria, amounted to 38 babies aged under two months, and of those, eight had gases in the greater vessels.
Prof Arthurs said there were "no unexplained cases" of gases in that location. The causes found included trauma, a road traffic accident, sudden unexpected death in infants or congential heart disease.
Mr Myers said that does not include many cases of babies in similar circumstances of death of babies aged under four days old.
He says there are "many variables" in such a study.

 

[BuzzC]

I admit it’s difficult to get a full, clear picture of what is going on. But from what we’ve read, it’s interesting that the defence aren’t pushing too hard against the assertion that there was an air embolus (although they haven’t accepted it explicitly either)

They’ve been exploring the possibility that it could’ve been caused by other means such as the insertion of the line, CPR etc.

 

[JosieJo]

12:17pm

Prof Arthurs says air can be 'distributed' in the system during CPR.

12:20pm

For Child A, Mr Myers says "one possibility" of the air seen on the image is air administration.
He says others can be through resuscitation or post-mortem changes.
Prof Arthurs: "Yes."

12:28pm

For Child B, the radiograph image shown from June 10, about 40 minutes after the time of the non-fatal collapse.
Mr Myers: "On that image, there are no features which support an air embolus diagnosis?"
Prof Arthurs: "Yes."
He clarifies from a question by the prosecution that it could not be concluded either way.
Prof Arthurs says his observational study was from "a large body of evidence".
The judge, Mr Justice Goss, asks about the study as the jury has not seen it.
Prof Arthurs said the study was carried out for children (up to 18 years old) in 2015 and looked at 35 cases, with 10 having some gas in the larger vessels. The study was published, peer-reviewed and available in literature.
He tells the court "probably none" were of premature babies.
The study was performed independently of the trial, the court hears, and was prior to Prof Arthurs' own review, for babies, carried out later at Great Ormond Street Hospital, involving hundreds of cases.

12:32pm

The court is now adjourning for an early lunch break.

Recap: Lucy Letby trial, Friday, October 21

The trial of Lucy Letby, the Countess of Chester Hospital neonatal unit nurse who denies murdering seven babies and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[JosieJo]

1:43pm

The trial is now resuming.

1:47pm

The next witness to give evidence is senior neonatal practitioner Caroline Bennion, who was present for the delivery of Child A and Child B in June 2015.

1:49pm

She recalls that Child B required assistance at birth, and that support was given for her. She explains more support was required for her than Child A.

1:53pm

Child B "recovered well" and, after review, she was tried off the ventilator as she was "vigorous" and was breathing by herself.

 

[JosieJo]

2:04pm

She is now being asked about "the significant event" for Child A on the evening of June 8. Child A suffered a collapse and died during that evening.
She says she was in the room when that collapse happened. She knew that she had taken the handover - a "comprehensive update" from the day-time shift staff - from 7.30pm, and carried out equipment checks.

2:07pm

She said, from reading her statement, she was "next to [Child B]" and "still doing" her checks and completing observations and safety checks at the time.
She said she "wouldn't have left" Child B.
She said she remembered Lucy Letby asking for help on Child A.
"When it became more obvious she needed assistance and [Child B] was safe, I went over to help."
She said she did not have a recollection whether the alarm went off.

2:08pm

She said it was a "busy evening" with babies having long lines put in, and the nursery was "quite full" with the cross-over of day and night staff.
She also said Dr Harkness was in at the time.

2:09pm

She recalled she helped Lucy Letby give some ventilation breaths via the Neopuff device.

2:10pm

She said there was no crash call put out as the doctors were already in attendance.

Recap: Lucy Letby trial, Friday, October 21

The trial of Lucy Letby, the Countess of Chester Hospital neonatal unit nurse who denies murdering seven babies and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[JosieJo]

2:12pm

The nurse recalls drawing up the emergency drugs required during Child A's emergency treatment.
Child A passed away following a series of resuscitation attempts.
The nurse said she then returned to treatment of Child B.

2:17pm

The court is shown the nurse continued to take hourly observations for Child B.
She confirms "nothing unusual" was noted during the rest of that night shift for her.

2:21pm

Questioned by the defence's Ben Myers KC, the nurse says she had many years of experience in neonatal care.
She is asked about if there were challenges in staffing levels.
The nurse replies: "We were always very fortunate to have a lot of senior staff."
"There were occasions where we had busier periods, but that is the nature of a neonatal unit."

2:24pm

The nurse agrees the babies were "vulnerable" and "could deteriorate very rapidly".
She agrees 'it was known' a deterioration could happen when a baby was almost ready to go home.

 

[JosieJo]

2:28pm

Ms Bennion is asked about medication that is given to babies who would 'otherwise be at risk of infection'.
For Child A, she is asked about such a prescription, and a 'clinical indication' is for 'suspected sepsis' on June 7 at 10pm.
The administration of the dose is dated at June 7, 10.46pm.

2:38pm

Ms Bennion is being asked about blood gas records for Child A. The blood gas machine was "on the unit" in the next room, taking about 3-4 minutes, providing an automatic read-out to be attached to the chart.


2:47pm

Ms Bennion is shown a copy of the neonatal record chart, about how some of the tasks and times are shown taking place on the hour, when they might be around that time.
My Myers says that as some tasks take some time, it could give the impression a member of staff was 'in two places at once'. The nurse agrees.

2:52pm

Ms Bennion is now being asked about Child A's collapse, and that Lucy Letby had called for assistance.
She said: "We have an emergency buzzer which could be pulled, but there were so many staff that a nurse can call for assistance.
Mr Myers: "That would be appropriate?"
"Yes."

2:54pm

Ms Bennion is asked if there was any 'formal support' for nurses, particularly for dealing with incidents such as when an infant died.
She said there was no formal support, but said of the nursing team: "We were very supportive of each other."

Recap: Lucy Letby trial, Friday, October 21

The trial of Lucy Letby, the Countess of Chester Hospital neonatal unit nurse who denies murdering seven babies and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[JosieJo]

2:56pm

She said there was "no formal procedure or form for everyone to fill in."
She added: "Under the direction of the medical staff, a debrief would always be offered. We have a supportive management team and...in the network of our close unit [if a nurse did not want to return to room 1 for the following shift following a traumatic event the previous shift], that can be provided."
"Even after a tragic event, you have to remain professional in the care you give."

3:00pm

Ms Bennion adds, from a follow-up quesion from the prosecution, that simultaneous observation of two babies would not happen, even if the documentation would appear as simultaneous on the records.
She is asked about the "speed of the deterioration" of Child A. Ms Bennion said it was "very rapid, very sudden".
"It's like a jigsaw, you're putting in observations, but there was nothing to say [Child A was going to collapse].
"However it has happened, and it can happen."

Recap: Lucy Letby trial, Friday, October 21

The trial of Lucy Letby, the Countess of Chester Hospital neonatal unit nurse who denies murdering seven babies and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[JosieJo]

3:17pm

The next witness is someone who was also working at the Countess of Chester Hospital, as a neonatal nurse in June 2015.
She describes, on staffing levels: "There were definitely periods when we were short-staffed, periods when we were ok."
For shifts when they were 'short on numbers', they would look to bring staff and swap on the rota, or if anyone could do an extra shift.
Agency or bank nurses were a possibility, but didn't happen very often.

3:28pm

The nurse was the shift leader at the neonatal unit on the night-shift for June 8. Lucy Letby was one of the designated nurses.

3:35pm

The nurse remembers walking by the neonatal unit room 1 and seeing Dr Harkness in there at the incubator for Child A.
Swipe data showed her coming into the neonatal unit at 8.20pm.
She said: "I was like, something has happened.
"With my experience, I was thinking he was having a sort of 'episode' that babies can have."
She believed it was down to one of a number of medical conditions.
She recalls seeing who else was in the room.

3:37pm

She recalls the Neopuff device was being used to give Child A breaths, as he had "stopped breathing".
She recalled being told it had happened "suddenly".

3:40pm

She recalled being involved in the resuscitation attempts, and was physically holding Child A at the time.

 

[JosieJo]

3:43pm

She recalled she had "never seen a baby look that way before", with a skin discolouration on a pattern she had "never seen before".
Asked to describe the discolouration, she said he was "white with purple blotches", with a bit of "blue", and it had "come on very suddenly".
"Just very unusual, it was," she added.

Recap: Lucy Letby trial, Friday, October 21

The trial of Lucy Letby, the Countess of Chester Hospital neonatal unit nurse who denies murdering seven babies and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[JosieJo]

I think its starting to become clearer now why this case is in court...albeit slowly
I feel the prosecution have had a "good day"

It's now very clear baby A had "very unusual" skin discolouration..the nurse also now saying she had never seen anything like it.

The Profesor from Great Ormond St (who would have had a lifetime of extremely sick children) had never seen that much air ..only in this trial.
His conclusion after reviewing all the evidence was "administration of air"

 

[JosieJo]

3:54pm

The nurse will continue to give evidence next Monday.
The court is now adjourning for today.
We will continue to provide live updates next week.

Recap: Lucy Letby trial, Friday, October 21

The trial of Lucy Letby, the Countess of Chester Hospital neonatal unit nurse who denies murdering seven babies and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[merrypason]

I think its starting to become clearer now why this case is in court...albeit slowly
I feel the prosecution have had a "good day"

It's now very clear this baby had "very unusual" skin discolouration..the nurse also now saying she had never seen anything like it.

The Profesor from Great Ormond St (who would have had a lifetime of extremely sick children) had never seen that much air ..only in this trial.
His conclusion after reviewing all the evidence was "administration of air"

Yes, I think the defence suggesting the air found was a result of the post mortem exercise, or CPR or long line doesn't explain the blotchiness. CPR, long lines are common hospital treatment so if it caused blotchiness like this, someone would have seen it previously. Post mortem process creating gas in abdomen doesn't explain the blotchiness either as it existed before then. If administered air is the only way you get the blotchiness than the Prof's conclusion that the air in abdomen was administered makes sense.

 

[BuzzC]

This case is harrowing. Amongst all the medical evidence, it’s easy to forget that these are young lives that have been lost leaving devastation behind them.

I hope they get justice - whatever outcome that requires.

I hope the jury get the support they need during and afterwards too.

 

[Charlot123]

Yes, I think the defence suggesting the air found was a result of the post mortem exercise, or CPR or long line doesn't explain the blotchiness. CPR, long lines are common hospital treatment so if it caused blotchiness like this, someone would have seen it previously. Post mortem process creating gas in abdomen doesn't explain the blotchiness either as it existed before then. If administered air is the only way you get the blotchiness than the Prof's conclusion that the air in abdomen was administered makes sense.

About the blotchiness, nothing can be explained IMHO if no one made photos of it. They were making photos of arms and legs for parents, how come no one made photos of the blotchiness?