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

[Legally Bland]

4:09pm

Dr Bohin says babies on CPAP can have CPAP belly, and in order to minimise that, they would aspirate the NGT.
"It is usual practice to note down the volumes of air aspirated to give colleagues an idea [of how much air is coming out of the baby]."
"I couldn't find any evidence of that [in the notes]."
She adds that, for babies not fed, the nursing staff would put the tube on free drainage so air could come out on its own, as well as actively aspirate every four hours or so. She says there was only 'fleeting mention' of free drainage.
If neither of those things happen, Dr Bohin said that would lead to gas accumulation in the stomach.

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]

4:11pm

Dr Bohin said it was not clear from the notes how long the 'free drainage' was in place.
She said one conclusion for Child C's collapse was CPAP accumulation of air, the other being deliberate injection of air.
She said the doctors did not appear to have a concern as they had noted the abdomen to be "soft".

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]

4:14pm

Dr Bohin said Child C died "with his pneumonia, not because of his pneumonia."
She added babies such as Child C do not collapse suddenly and without warning.
She said an infection would not be the cause as that would lead to a gradual deterioration in the baby, not a sudden collapse and no response to resuscitation.

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

 

[Marantz4250b]

Everything seemed to work perfectly fine when Lucy wasn’t around

We don't know that because only situations relating to her have been put forward by the prosecution.

 

[Tortoise]

We don't know that because only situations relating to her have been put forward by the prosecution.

They would have to disclose other similar incidents which didn't involve LL.

 

[notsure]

I wonder how the jury are responding!

The irony!
Mr Myers suggests that Dr Evans has just made up information as he has gone along.

"You keep saying that, and I keep disagreeing."

"And you're not an independent witness at all, are you?"

"And again, that is just being insulting."

Wouldn't it be interesting if this were televised?

 

[Marantz4250b]

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

But, again, these are just the things pertaining to her. How do we know that there weren't still problems on the nightshifts? We don't, to be fair.

Also, did anything else on the shift rota or in hospital practice generally around the same time? Unless her shifts were the only thing which changed then you need to control for any other factors.

I've said it a couple of times that I was stunned when I found out that the hospital changed her shifts in order to test out the fact that she was harming patients. That's what the prosecution said though so I guess we have to accept it. I'm still not convinced though and I'd like to hear their specific words when this point is actually introduced into evidence.

 

[Sweeper2000]

How do you know the jury will be asked to see if the evidence is statistically significant in order to come to a conclusion? I can't think of how they could do this with all of the witness statements, hospital records, autopsy results, the multitude of text messages, the FB searches, the defendants own actions, and the actions of everyone on the ward when the events occurred.

Nooo I was kind of saying the jury or jurors are statisticians themselves as we all are. They will put the evidence together and think if the accused is likely to have done it or definitely done it without a doubt or in other words 100% sure rather than 99%. <modsnip>

 

[MsBetsy]

But, again, these are just the things pertaining to her. How do we know that there weren't still problems on the nightshifts? We don't, to be fair.

Also, did anything else on the shift rota or in hospital practice generally around the same time? Unless her shifts were the only thing which changed then you need to control for any other factors.

I've said it a couple of times that I was stunned when I found out that the hospital changed her shifts in order to test out the fact that she was harming patients. That's what the prosecution said though so I guess we have to accept it. I'm still not convinced though and I'd like to hear their specific words when this point is actually introduced into evidence.

The prosecution said that when Letby was switched to the day shift, they believed she was harming babies? Which staff? I know that a doctor noticed Letby was there for all the collapses, but not that he believed Letby was deliberately harming babies.

Also, by June, the nurses thought it very odd that 3 babies had died in one month, but nothing so far has been said about them believing Letby was responsible.

 

[Marantz4250b]

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

Yet that, essentially, is what they have done. "Constant malavent presence", and all that. The police were apparently drawn to her due to the alleged concerns of a doctor, according to what has been said in court. When the investigation first started it was stated in the press that they were asked to investigate to determine whether any offences had actually been committed. This was after the trust's own investigations. That's not actually the case though as it's clear that they were asked to investigate her, specifically from the outset.

 

[kittythehare]

Wouldn't it be interesting if this were televised?

it might be more coherent.
I don't find it interesting at all.
I would had they chosen to take it case by case though.
I would not like to be on that jury though.
I assume they will have to assess it in the manner in which it is presented.
All cases together, air everywhere..

I truly wish them well.
What a task!

The other very different aspect is the denial of the individual babies' identities.
They're the victims.
But we don't know them at all.

They were little humans and giving them mere letters as ID is doing them a disservice I feel..
Maybe a make up human name would have been more compassionate?

I'm really struggling with it.

 

[notsure]

it might be more coherent.
I don't find it interesting at all.
I would had they chosen to take it case by case though.
I would not like to be on that jury though.
I assume they will have to assess it in the manner in which it is presented.
All cases together, air everywhere..

I truly wish them well.
What a task!

The other very different aspect is the denial of the individual babies' identities.
They're the victims.
But we don't know them at all.

They were little humans and giving them mere letters as ID is doing them a disservice I feel..
Maybe a make up human name would have been more compassionate?

I'm really struggling with it.

I don't mean "interesting" in a ghoulish sense. Just those interactions with the defence counsel today sounded intriguing.

 

[merrypason]

<modsnip - no link from an approved source for 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.

What do you think of this published in the RSS report then on Harold Shipman?

https://rss.org.uk/RSS/media/File-library/News/2022/Report_Healthcare_serial_killer_or_coincidence_statistical_issues_in_investigation_of_suspected_medical_misconduct_Sept_2022_FINAL.pdf

In light of this grim episode, there were calls for improved monitoring of adverse medical outcomes, to allow dangerous medical misconduct to be detected earlier. For example, statistician David Spiegelhalter and colleagues suggested that statistical monitoring of patient death rates would have raised red flags about Shipman’s misconduct years earlier, thereby saving lives (see Spiegelhalter, D. et al., 2003)

Out of curiosity, do you then think that in any industry where a person is internally investigated for having a larger than normal set of adverse outcomes, it is severely affected by bias and shouldn't be done? How do you suggest managers and organisations conduct performance management then to ensure cases like Beverley Ailitt and Harold Shipman never carry on as long as they do? How many patients do you think Beverley would have killed if they hadn't picked up on her adverse outcomes and decided to investigate?

As an example - retail theft and fraud. So are we saying that if one cashier is seen to have an underbalanced till more often than everyone else, we shouldn't be investigating why that is? And if it is found that he's been stealing from the tills, he shouldn't be charged? Because there's severe bias?

 

[kittythehare]

I don't mean "interesting" in a ghoulish sense. Just those interactions with the defence counsel today sounded intriguing.

I knew you didn't mean it that way .
I've been following as it's coming in and it's quite outrageous in spots!
No way to know how jury are perceiving it though.

 

[Marantz4250b]

The prosecution said that when Letby was switched to the day shift, they believed she was harming babies? Which staff? I know that a doctor noticed Letby was there for all the collapses, but not that he believed Letby was deliberately harming babies.

Also, by June, the nurses thought it very odd that 3 babies had died in one month, but nothing so far has been said about them believing Letby was responsible.

That's exactly what the prosecution said in their opening statement. We discussed it the other day as I said I didn't believe it but it was definitely said and another poster provided the relevant part of the statement to prove it.

 

[MsBetsy]

Yet that, essentially, is what they have done. "Constant malavent presence", and all that. The police were apparently drawn to her due to the alleged concerns of a doctor, according to what has been said in court. When the investigation first started it was stated in the press that they were asked to investigate to determine whether any offences had actually been committed. This was after the trust's own investigations. That's not actually the case though as it's clear that they were asked to investigate her, specifically from the outset.

Well, hasn't the prosecution already established she was there for all 22 incidents? Why would the trial take five more months if that's all there is to it?

 

[Sweeper2000]

I don't understand the assumption that this case was formed because Letby was present for every collapse. The staff working with her didn't even seem to know someone was deliberately harming babies at first.

A summary from the defence. Lucy Letby trial: 'Sub-optimal care at Countess hospital' a factor in baby collapses, defence say

Includes direct reference to “Mr Myers addressed the issue of Letby being present at all the apparent collapses and deaths.

He said: “We say there are many occasions when Lucy Letby was simply not there when she had to be present if she was doing the deliberate harm alleged.

“She was a young woman with no immediate family commitments and someone who built her life around her work in a neonatal unit.

“Someone in that position is more than likely to be looking after the more clinically challenged babies and more likely to be there when deterioration happened, but it doesn’t mean she made it happen.”

It’s also stated by dr Ravi that they had no hard evidence that LL was doing anything when concerns about her were first raised. He only suspected her because of the paper trail and he did state that somewhere.

It is also a fact in this case that two independent organisations came to no correlation found conclusions in regards to the cases which were escalated and it was then that the police were called to help rule out foul play. However LL was suspended or onto clerical duties June/July 2016 around the same time as babies p,q and o.

This is the very reason I keep banging on about someone must have seen something. looking at the best the prosecution has to offer which we have seen, there isn’t anything else. IMO.

 

[Tortoise]

it might be more coherent.
I don't find it interesting at all.
I would had they chosen to take it case by case though.
<rsbm>

Just on this one point - they are working through the cases in date order, they have concluded the evidence for A and B and are now on C.

 

[merrypason]

Some more information on David Spiegelhalter for anyone interested in statistics being used to detect anomalies

Statistics could have spotted mass murderer

Statistical methods usually employed as industrial quality-control measures might have allowed authorities to catch mass-murdering UK doctor Harold Shipman much earlier than he was, according to a new study. The method, which can also be used to uncover awful surgeons or poorly-performing...

www.newscientist.com

Now David Spiegelhalter of the UK Medical Research Council’s Biostatistics Unit, Cambridge, UK, has applied an industrial quality-control technique to data on the death of Shipman’s patients to see if his heinous crimes could have been detected any earlier.

Spiegelhalter’s is now working alongside the Healthcare Commission to adapt the technique to hospital performance monitoring.

 

[Powermjp]

In my opinion the circumstantial evidence is very strong in this case.

I have seen people who have been convicted in the UK, with less circumstantial evidence than we have seen in this case.

Some people seem to think that this kind of evidence can't be good or reliable. I'm sorry but it's very effective at securing a conviction. We shall see won't we.

And those cases were without the amount of experts we have in this case. Which the defence has not really disproven in any effective manner to be honest.

Obviously each case is separate and on its own merit.