UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #5

[Sweeper2000]

I would expect this to be the case if the motive was munchausen by proxy. Not clear on motive yet, but I'm starting to think it may be two-fold.

Would like to hear your suggestions, I’m seeing no correlation between events and LL desiring attention. Most points the other way.

 

[BabaVanga]

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I don't have an opinion as to whether Lucy is innocent or guilty. I am worried that the investigations into LL might have been severely afflicted by bias.

I disagree because when they swapped her to day shift the problems followed.

 

[kittythehare]

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Actually, we quite simply don't know how often an IV line is accidentally disconnected and improperly reconnected, because just about no-one has any interest in finding out the truth. And it would be very difficult indeed to find out the truth. Hence plenty of myths are perpetuated "this can never happen", "such and such an event never ever occurs", which are quite simply wishful thinking and more or less deliberate blindness to evidence which might discredit the myth.

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I was explaining a possible route .
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Do not inject air or permit air to enter an IV line..
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[MsBetsy]

Would like to hear your suggestions, I’m seeing no correlation between events and LL desiring attention. Most points the other way.

It's still not clear to me exactly what prosecution thinks was the motivation, but many here have offered suggestions that I think are possible. That's why I'm thinking there may not be just one motive.

Power and control are sometimes behind motivation, but I'm not sure on that either. I need to hear more from the prosecution.

 

[kittythehare]

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I don't have an opinion as to whether Lucy is innocent or guilty. I am worried that the investigations into LL might have been severely afflicted by bias.

<modsnip>

Where is the evidence that the investigation or and prosecution is contaminated with bias?

 

[Sweeper2000]

It's not impossible. It is just unlikely. On the other hand, less than one in two million nurses per year commit multiple murders while the most common way to die in hospital is due to medical errors made by doctors (not nurses) and very often not admitted (or blamed on the nurses). In the Netherlands, a law was passed which allowed doctors to admit to having made a mistake, without thereby taking on legal responsibility for the damages they caused. The rate of registered medical mistakes in hospitals doubled from one year to the next. From rather large, to very large.

Actually, we quite simply don't know how often an IV line is accidentally disconnected and improperly reconnected, because just about no-one has any interest in finding out the truth. And it would be very difficult indeed to find out the truth. Hence plenty of myths are perpetuated "this can never happen", "such and such an event never ever occurs", which are quite simply wishful thinking and more or less deliberate blindness to evidence which might discredit the myth.

Yeh I have been working with the theory that if guilty as charged it would take a bonafide psychopath to be able to do this and avoid detection and in this case suspicion. IMO. That level of deceit and callousness. Working with that I have been trying to find instances of anything in LL’s Past that might make a diagnosis of psychopathy a greater likelihood. There isn’t much if anything and it’s this absence of past questionable events that makes me doubt she is anything other than normal.

We know it’s a case of largely circumstantial evidence and this in my mind created doubt from the start because there are seemingly no direct and clear instances of LL having done anything particularly suspicious or at least they are not reported and they would be there in so many supposedly connected events. Someone would have seen something or noticed LL in at least one instance. There isn’t anything that would give a clear indication to LL behaving decidedly oddly.
The best the prosecution have to offer by way of suspicious events are fb searches and a non conclusive post it note. All else seems to be speculation with tenuous links.

There is also a high likelihood that bias was at the root of LL being accused. A Dr Ravi is said to be at the root of it, and he only suspected LL because of a paper trail suggesting her presence was the only consistent factor in all of the cases. He was the first to suspect and report suspicions about LL to senior staff. Here is his story.

Lucy Letby trial hears how doctor raised concerns but was told 'not to make a fuss'

Dr Ravi Jayaram, a paediatrician at the Countess of Chester Hospital, also said the unusual skin discolouration of Letby's first alleged victim, a baby boy known as Child A, "didn't fit with anything I had ever seen".

news.sky.com

 

[BabaVanga]

I think justice can be served without a statistician.

Where is the evidence that the investigation or and prosecution is contaminated with bias?

Exactly. A statistician in a case like this is purely white noise. Her actions speak volumes in my opinion and I’m sure more will be revealed about how she acted in front of staff and parents that will blow statistics out the way. Her character is unravelling.

 

[kittythehare]

Exactly. A statistician in a case like this is purely white noise. Her actions speak volumes in my opinion and I’m sure more will be revealed about how she acted in front of staff and parents that will blow statistics out the way. Her character is unravelling.

Yeah.
Bigly..

 

[Sweeper2000]

The understanding that it is just LL being present that makes her suspicious is a possible bias.

Think of it this way. In a batch of medically unexpected or unexplained events the likelihood that someone is held under suspicion is higher because it’s ”we have no other explanation for these events so have to blame someone rather than explore other possibilities. Then they look through the medical notes and see someone specific was present in all of them and that becomes the strongest link as is the case with this trial seemingly. It’s also reasonable to assume that someone will be present in all of them because it’s their job to be there. if you look through medical notes to find the person who is there most often you will find one, it’s a guarantee. Someone has to fit the bill for constant presence but constant presence is not necessarily indicative of guilt considering it is their job to be present.

That being said I will assume as others have said that the weight of evidence is in addition to LL being the most likely suspect which seems to be the root of the trial.

 

[Legally Bland]

2:05pm

The trial is now resuming after the court adjourned for a lunch break.
Dr Dewi Evans will continue to give evidence.

2:07pm

Dr Evans continues to discuss the 'realistic risks' Child C could have faced.
One was feeding; Dr Evans says all premature babies require naso-gastric feeding.
If the babies cannot tolerate that, then it is clinical practice to administer nutrition via TPNs, via IV.
Child C was fed via the latter method, which was "the right thing to do".

2:09pm

Dr Evans said aspirates would be taken from the stomach prior to feeding.
He said dark bile aspirates could be a symptom of NEC or an obstruction, but it would need to be taken in context with other signs such as the baby's abdomen condition, and the general condition of the baby - and signs of a problem would be whether the heart rate would increase, the breathing rate would increase, and/or whether the oxygen would need to be increased.

2:15pm

Dr Evans said medical staff were aware to monitor Child C's abdomen and make regular notes.
He says there is one entry made in the nursing notes of 'black fluid' - not necessarily bile, but discoloured blood. That was to be 'monitored' and to 'keep an eye' on the baby's condition. It would not, in itself, be a concern.
For the 'one-off' vomit reading, Dr Evans says if there was something 'serious' going on, it would happen more often than once.
The four dark bile aspirate readings, each 0.5ml, are 'a tiny amount', Dr Evans tells the court.
"The good news is it's only 0.5ml. The other good news is the bile aspirate is not increasing [per reading].
"That is an indication the baby is not getting worse."
He said increasing readings would point to an obstruction, as would a distended abdomen.
Dr Evans says Child C's status was "under control".

2:18pm

Dr Evans says Child C was well for a '30-weeker' (in terms of gestational age).
A blood test for CRP had increased from 1 to 22-23 - 'not particularly high', the clinical was 'aware of this' and Child C was placed on antibiotics.
Child C's platelet count had fallen - which 'on their own don't tell you very much', but in combination with an x-ray was a 'non-specific marker pointing to an infection'.

2:21pm

Blood gas readings taken were 'within acceptable values', Dr Evans tells the court, and in terms of metabolic readings, Child C was a 'stable little baby'.
Dr Evans said all premature babies develop symptoms of jaundice.
"The good news with [Child C] is the jaundice levels were very satisfactory".
If Child C had signs of severe jaundice, he would have required phototherapy, Dr Evans explains.

2:25pm

Dr Evans says Child C had a lung infection, of pneumonia, which was "very common" in premature babies, and he was placed on antibiotics in advance of any test results.
Mr Johnson: "Did breathing issues have any direct cause for [Child C's] death?"
Dr Evans: "No."
Mr Johnson: "Did any feeding issues cause his collapse?"
Dr Evans: "No, that cannot explain his collapse either."
Mr Johnson: "Did the infection of pneumonia cause it?"
Dr Evans: "No - the infection was under control and being treated."
Dr Evans explains if the pneumonia treatment was not working, a number of markers would be shown. There would be an increase in heart rate (which did not occur, he says), an increase in respiratory rate - but that stayed the same.
Oxygen saturation levels stayed "absolutely where they should be", whereas in worsening pneumonia conditions those levels would fall.

2:28pm

Mr Johnson: "Did the jaundice/glucose issues cause his collapse?"
Dr Evans: "None at all."
Dr Evans says there were "no worrying trends" recorded in the notes.
"What was the cause of [Child C's] catostrophic collapse and death?"
Dr Evans says, initially, he did not have a conclusion to Child C's death.
He adds one complication is if the abdomen is filled with air.
Dr Evans: "If you get a significant injection of air into the stomach, it can cause splintering of the diaphragm."
As a result, a baby could collapse pretty quickly as they would suffocate.
Dr Evans says that was his conclusion for Child C.

2:31pm

Dr Evans says if the diaphragm is unable to move effectively, the lungs are unable to get fresh oxygen, and that causes the collapse.

Recap: Lucy Letby trial, Tuesday, November 1

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

www.chesterstandard.co.uk

 

[JosieJo]

The jury can only make a decision based on evidence that is presented in court.
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[MsBetsy]

The understanding that it is just LL being present that makes her suspicious is a possible bias.

Think of it this way. In a batch of medically unexpected or unexplained events the likelihood that someone is held under suspicion is higher because it’s ”we have no other explanation for these events so have to blame someone rather than explore other possibilities. Then they look through the medical notes and see someone specific was present in all of them and that becomes the strongest link as is the case with this trial seemingly. It’s also reasonable to assume that someone will be present in all of them because it’s their job to be there. if you look through medical notes to find the person who is there most often you will find one, it’s a guarantee. Someone has to fit the bill for constant presence but constant presence is not necessarily indicative of guilt considering it is their job to be present.

That being said I will assume as others have said that the weight of evidence is in addition to LL being the most likely suspect which seems to be the root of the trial.

Investigations like this are incredibly methodical and meticulous. I can't imagine any prosecutor bringing this case to trial based on one person's presence for every murder, or the nurses notes, or hospital records. Imo

 

[Legally Bland]

2:48pm

After a short adjournment, Ben Myers KC, for Letby's defence, is now asking Dr Dewi Evans questions in relation to Child C.

Recap: Lucy Letby trial, Tuesday, November 1

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

www.chesterstandard.co.uk

 

[arrogantcat]

<modsnip - no link from an approved source to multiple statements>

I don't have an opinion as to whether Lucy is innocent or guilty. I am worried that the investigations into LL might have been severely afflicted by bias.

Tremendously glad to have you here in this discussion sharing your insights. I share your concerns and am interested to hear your thoughts on the case as it progresses.

 

[Legally Bland]

2:53pm

Mr Myers says Dr Evans has had the case material for Child C for about four and a half years, and has provided such conclusions.
"Beofre today, you have never suggested that [the collapse on] June 13, the splintering of the diaphragm, is the cause of the death, have you?"
"That is correct."
Mr Myers suggests that Dr Evans's opinion alone would not have reached this conclusion.
Dr Evans said the death could not be explained from the usual causes babies get. He said, taking into account all the other evidence and information from experienced medical people's reports, and reading the pathology report, the splintering of the diaphragm was now his conclusion.
He said he was functioning as a clinican. "The fact is this baby has collapsed having previously been stable, and one has to explain that."
Mr Myers suggests Dr Evans had been influenced into supporting this conclusion.
He says Dr Evans had not provided this 'splintering of the diaphragm' conclusion in his eight previous reports.

2:54pm

Dr Evans says while Child C was at 'constant' risk of a number of conditions, he was under continual observation and was in a neonatal unit.
He confirms his initial conclusion from 2017 was 'one may never identify the cause of his collapse'.

Recap: Lucy Letby trial, Tuesday, November 1

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

www.chesterstandard.co.uk

 

[Legally Bland]

2:58pm

Mr Myers said Dr Evans 'could not rule out infection' in his 2017 conclusion.
Dr Evans said infection was "a factor" in Child C's short life.
"It is possible to suggest that...his pneumonia was under control, he was requiring hardly any oxygen. It was my role, investigating this unexpected collapse, to give an impartial view of all the issues. I don't prepare partisan reports."
He says infection was a part of Child C's status. He adds it did not cause Child C's death.

Recap: Lucy Letby trial, Tuesday, November 1

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

www.chesterstandard.co.uk

 

[arrogantcat]

Investigations like this are incredibly methodical and meticulous. I can't imagine any prosecutor bringing this case to trial based on one person's presence for every murder, or the nurses notes, or hospital records. Imo

We know it has happened before, so it’s certainly not impossible.

Lucia de Berk case - Wikipedia

en.wikipedia.org

 

[Legally Bland]

3:04pm

Dr Evans tells the court the process in accumulating information in reaching his conclusions.
He says while Child C had an infection, he was recovering from it, as he had gone off CPAP support, on to Optiflow.
"Respiratory wise, he didn't stay the same, he was improving."
Mr Myers says up until the evidence of today, he had not provided in his reports an allegation of harm.
Mr Myers: "You are coming up with things to support an allegation of harm."
Dr Evans: "I am coming up with clinical evidence."
Dr Evans says he has read varying reports, but had not read a single medical report that said "I'm wrong, [Child C] died of something else."
Dr Evans says this case "will always be a challenging case" for any clinican as it is difficult to separate the pathological problems from an event where Child C "was placed in harm's way by some kind of deliberate act."

Recap: Lucy Letby trial, Tuesday, November 1

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

www.chesterstandard.co.uk

 

[Sweeper2000]

The jury can only make a decision based on evidence that is presented in court.
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<modsnip>

Investigations like this are incredibly methodical and meticulous. I can't imagine any prosecutor bringing this case to trial based on one person's presence for every murder, or the nurses notes, or hospital records. Imo

Yeh that’s my thinking as well. The prosecution will undoubtedly have allot of stuff that points at LL but if it was bias that made them look that way?

Think the AE theory will have the most weight as it seems to be difficult to treat and also makes resuscitation efforts “difficult” which is in addition to LL being present.

You mentioned upthread a possibility that power and control may be possible motivations. It’s very true as far as I know that in previous SK that’s nearly always a motive. Most violence done by psychopaths is for money etc but in serial killers power and control feature so often, IMO . The emotional high is the reward and that fits this case if she is guilty but what’s your theory and how did you get there?

 

[JosieJo]

3:04pm

Dr Evans tells the court the process in accumulating information in reaching his conclusions.
He says while Child C had an infection, he was recovering from it, as he had gone off CPAP support, on to Optiflow.
"Respiratory wise, he didn't stay the same, he was improving."
Mr Myers says up until the evidence of today, he had not provided in his reports an allegation of harm.
Mr Myers: "You are coming up with things to support an allegation of harm."
Dr Evans: "I am coming up with clinical evidence."
Dr Evans says he has read varying reports, but had not read a single medical report that said "I'm wrong, [Child C] died of something else."
Dr Evans says this case "will always be a challenging case" for any clinican as it is difficult to separate the pathological problems from an event where Child C "was placed in harm's way by some kind of deliberate act."

Recap: Lucy Letby trial, Tuesday, November 1

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

www.chesterstandard.co.uk

Based on the snippets we are hearing I'm struggling to understand how he has only just come to the conclusion of the damaged diaphragm being his conclusion?
I can understand that none of the existing factors might cause collapse but are we missing what new piece of evidence allowed him to come to a conclusion? Or am I misunderstanding?