I do remember a few people commenting that we hadn't heard about Baby C s x Ray's
UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #6
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I do remember a few people commenting that we hadn't heard about Baby C s x Ray's
Just for helping to understand this evidence better, re. Child C - from my notes
He was born at 3.31pm on 10th June, weighing 800g.
He collapsed at 11pm and 11.15pm on 13th June.
He was pronounced dead at 5.58am on 14th June.
He was born at 3.31pm on 10th June, weighing 800g.
He collapsed at 11pm and 11.15pm on 13th June.
He was pronounced dead at 5.58am on 14th June.
Oh yes, thanks, I remember now
LadyEdgeworth
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10:53am
An observation was made there was no gas in the rectum area for Child C.
10:56am
Professor Arthurs is now giving evidence for Child D, and has examined radiograph images as part of his report.
The first one, at June 20, 10.22pm, is presented to the court, in which there are no abnormalities seen.
10:59am
A second x-ray image of 'effectively the whole body' is shown the court at June 21, 1.32pm.
Professor Arthurs notes two features - the 'obvious one' being the UVC going up towards the heart, which has been pushed in too far.
The 'subtle' observation was a sign of infection in the child's right lung, but the magnitude was 'nothing like' that seen in Child C's case.
The third x-ray image was taken at June 22, 1.51am, after Child D's first collapse.
The UVC line has been 'withdrawn slightly'.
www.chesterstandard.co.uk
An observation was made there was no gas in the rectum area for Child C.
10:56am
Professor Arthurs is now giving evidence for Child D, and has examined radiograph images as part of his report.
The first one, at June 20, 10.22pm, is presented to the court, in which there are no abnormalities seen.
10:59am
A second x-ray image of 'effectively the whole body' is shown the court at June 21, 1.32pm.
Professor Arthurs notes two features - the 'obvious one' being the UVC going up towards the heart, which has been pushed in too far.
The 'subtle' observation was a sign of infection in the child's right lung, but the magnitude was 'nothing like' that seen in Child C's case.
The third x-ray image was taken at June 22, 1.51am, after Child D's first collapse.
The UVC line has been 'withdrawn slightly'.
Recap: Lucy Letby trial, Friday, November 11
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…
Prof Arthurs is currently talking the jury through an X-ray of Child C taken on 10 June 2015, the X-ray shows 'no abnormality'
An X-ray taken later that day of the same infant shows contains a 'striking abnormality'. The lung on the right is white, meaning 'there's something in the lung' blocking air, Prof Arthurs says. He says in layman's terms, Child C 'has a lung infection'
Another X-ray taken a few hours later shows an 'unusual' amount of gas in Child C's stomach. Asked what he concluded from the radiographs, he said there are 'several potential causes', one of which is 'air administration'
LadyEdgeworth
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Cheers for this, sometimes it's easy to forget with all we've heard. 3 non-fatal collapses and a final fatal one within 3 hours, so so sad.
(edited to clarify the third collapse was actually the fatal one)
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Sorry I wasn't clear - the 3rd collapse was the one she didn't recover from.
LadyEdgeworth
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11:05am
He explains the UVC is 'in a loop', and is 'almost certain to be outside the body'.
He says there is 'nothing unusual' in the appearance, and the diaphragm 'looks pretty clear', indicating a potential infection looks like it had improved.
Professor Arthurs says it is diffuclt to gauge between one x-ray and the other, but it would be consistent with an improving picture for a baby in air throughout that time.
11:07am
A further x-ray image, taken at Alder Hey Hospital after Child D had died, is shown to the court.
The UVC is still in, and a 'black line' just in front of the spine is a 'striking feature'.
Professor Arthurs says "air is present" on what the court hears is the 'main highway' of the circulation.
11:10am
Professor Arthurs says the significance of that is that it is an "unusual feature in babies who have died without an explanation".
He adds that amount of gas is consistent in babies who have died of sepsis, sudden unexpected death in infants, a road traffic collision, and two other babies in the trial. Another was Child A.
He says one of the other explanations which needs to be considered is deliberate air injection.
He says the most plausible conclusion was, in the absence of any other explanations, he considered they were 'consistent with, but diagnositic of, deliberate air administration'.
He confirms he has never seen this before in his experience
www.chesterstandard.co.uk
He explains the UVC is 'in a loop', and is 'almost certain to be outside the body'.
He says there is 'nothing unusual' in the appearance, and the diaphragm 'looks pretty clear', indicating a potential infection looks like it had improved.
Professor Arthurs says it is diffuclt to gauge between one x-ray and the other, but it would be consistent with an improving picture for a baby in air throughout that time.
11:07am
A further x-ray image, taken at Alder Hey Hospital after Child D had died, is shown to the court.
The UVC is still in, and a 'black line' just in front of the spine is a 'striking feature'.
Professor Arthurs says "air is present" on what the court hears is the 'main highway' of the circulation.
11:10am
Professor Arthurs says the significance of that is that it is an "unusual feature in babies who have died without an explanation".
He adds that amount of gas is consistent in babies who have died of sepsis, sudden unexpected death in infants, a road traffic collision, and two other babies in the trial. Another was Child A.
He says one of the other explanations which needs to be considered is deliberate air injection.
He says the most plausible conclusion was, in the absence of any other explanations, he considered they were 'consistent with, but diagnositic of, deliberate air administration'.
He confirms he has never seen this before in his experience
Recap: Lucy Letby trial, Friday, November 11
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…
"...a 'black line' just in front of the spine is a 'striking feature'.11:05am
He explains the UVC is 'in a loop', and is 'almost certain to be outside the body'.
He says there is 'nothing unusual' in the appearance, and the diaphragm 'looks pretty clear', indicating a potential infection looks like it had improved.
Professor Arthurs says it is diffuclt to gauge between one x-ray and the other, but it would be consistent with an improving picture for a baby in air throughout that time.
11:07am
A further x-ray image, taken at Alder Hey Hospital after Child D had died, is shown to the court.
The UVC is still in, and a 'black line' just in front of the spine is a 'striking feature'.
Professor Arthurs says "air is present" on what the court hears is the 'main highway' of the circulation.
Recap: Lucy Letby trial, Friday, November 11
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…
Professor Arthurs says "air is present" on what the court hears is the 'main highway' of the circulation."
Where have we heard this before? Baby A.
Prof Arthurs is now talking the jury through X-rays of Child D. An X-ray taken after the infant's death, shows an 'unusual' amount of gas in blood vessels near her spine.
He says this is only usually seen in babies that have suffered overwhelming infection or trauma, like an road traffic. He says it is consistent with 'external intravenous air administration'
LadyEdgeworth
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11:12am
Ben Myers KC, for Letby's defence, is going to ask questions on the baby girl, Child D, first.
He asks if it was correct that, at post-mortem stage, there were normal amounts of gas found in the normal areas, including in the bowel. Professor Arthurs agrees.
11:18am
Mr Myers asks about how often gases are found, post-mortem.
Professor Arthurs says for a quarter of those cases of gases found in the post-mortem examinations at Great Ormond Street Hospital, there were gases found in the great vessels areas, for which there was an explanation of post-mortem gases.
He adds if there is 'overwheming evidence' of infection, that can lead to gases appearing there, or potentially gas being redistributed in the body during prolonged resuscitation efforts.
He says administration of air is one of the explanations.
www.chesterstandard.co.uk
Ben Myers KC, for Letby's defence, is going to ask questions on the baby girl, Child D, first.
He asks if it was correct that, at post-mortem stage, there were normal amounts of gas found in the normal areas, including in the bowel. Professor Arthurs agrees.
11:18am
Mr Myers asks about how often gases are found, post-mortem.
Professor Arthurs says for a quarter of those cases of gases found in the post-mortem examinations at Great Ormond Street Hospital, there were gases found in the great vessels areas, for which there was an explanation of post-mortem gases.
He adds if there is 'overwheming evidence' of infection, that can lead to gases appearing there, or potentially gas being redistributed in the body during prolonged resuscitation efforts.
He says administration of air is one of the explanations.
Recap: Lucy Letby trial, Friday, November 11
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…
LadyEdgeworth
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11:22am
Professor Arthurs is being asked about Child C.
He agrees the left lung infection is a 'significant factor' from the first radiograph image.
He says the second image has a possibility of gas in the bowel wall, which is a possibility of NEC.
He says, as far as he knows, no NEC was found in Child C.
11:26am
Mr Myers says Child C, at four days old, did not have his bowels open, and a bowel obstruction could be considered
11:30am
Professor Arthurs, asked by the prosecution about a bowel obstruction, says if the bowel was blocked at a particular point, it would give a 'marker' of where the obstruction was.
He says the image shows no such marker, and as bowel obstructions are a 'common clinical occurrence', it would be diagnosed and babies would go to theatre for an operation.
He says there is no evidence of a bowel obstruction on the imaging, on the clinical notes, or in an autopsy.
Referring to the possibility of a twisted bowel, which he says 'can happen in small babies' and result in a blockage. He says that is often a surgical emergency, and would be documented as such, and found post-mortem if there is such a finding.
www.chesterstandard.co.uk
Professor Arthurs is being asked about Child C.
He agrees the left lung infection is a 'significant factor' from the first radiograph image.
He says the second image has a possibility of gas in the bowel wall, which is a possibility of NEC.
He says, as far as he knows, no NEC was found in Child C.
11:26am
Mr Myers says Child C, at four days old, did not have his bowels open, and a bowel obstruction could be considered
11:30am
Professor Arthurs, asked by the prosecution about a bowel obstruction, says if the bowel was blocked at a particular point, it would give a 'marker' of where the obstruction was.
He says the image shows no such marker, and as bowel obstructions are a 'common clinical occurrence', it would be diagnosed and babies would go to theatre for an operation.
He says there is no evidence of a bowel obstruction on the imaging, on the clinical notes, or in an autopsy.
Referring to the possibility of a twisted bowel, which he says 'can happen in small babies' and result in a blockage. He says that is often a surgical emergency, and would be documented as such, and found post-mortem if there is such a finding.
Recap: Lucy Letby trial, Friday, November 11
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…
merrypason
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Child D might be the strongest case so far because the radiologist has said once again the large amount of air is consistent with 'external intravenous air administration' and he can't see what else could have caused it.
The defence's opening statement as to alternative cause of death, was "For Child D, the defence say the hospital "failed to provide appropriate care", and this was "beyond dispute" as the prosecution accepted care was sub-optimal.
Child D "was never able to breathe unaided" and there was a "strong" possibility of infection, and evidence of pneumonia after death."
However, the pneumonia, according to the radiologist did not explain the large amount of air by the spine.
The defence also suggested it happened post mortem - which doesn't explain the rash (again, as with baby A) and the radiologist has said that only happens with overwhelming infection, that this baby did not have.
So, if the experts conclude, " 'consistent with, but diagnostic of, deliberate air administration"
And the defence have no other viable explanation, and LL is the only person who immediately treated both A and D just before they collapsed and showed the rash....
The defence's opening statement as to alternative cause of death, was "For Child D, the defence say the hospital "failed to provide appropriate care", and this was "beyond dispute" as the prosecution accepted care was sub-optimal.
Child D "was never able to breathe unaided" and there was a "strong" possibility of infection, and evidence of pneumonia after death."
However, the pneumonia, according to the radiologist did not explain the large amount of air by the spine.
The defence also suggested it happened post mortem - which doesn't explain the rash (again, as with baby A) and the radiologist has said that only happens with overwhelming infection, that this baby did not have.
So, if the experts conclude, " 'consistent with, but diagnostic of, deliberate air administration"
And the defence have no other viable explanation, and LL is the only person who immediately treated both A and D just before they collapsed and showed the rash....
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The senior nurse might have had suspicions and was questioning the dire situation---but maybe she didn't want to confront the Letby with her concerns yet. I am pretty sure the senior nurse did begin looking into the horrid situation, but not in the texts with the person she was feeling suspicious about. JMO
LadyEdgeworth
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Sorry if my post wasn't clear, I mean LL was the person not being suspicious of anyone else or seemingly drawing connections like others were. It's as if she already knows why this is happening, when nobody else does.
LadyEdgeworth
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11:50am
After a short break, the trial is now resuming with Dr Sandie Bohin being recalled to give evidence.
11:52am
Medical expert witness Dr Bohin is giving evidence on Child D, and confirms she has made a report on her, having had access to relevant medical reports and images from the Countess of Chester Hospital and Alder Hey, plus other medical experts.
She confirms her role was to peer-review Dr Dewi Evans's conclusions from his report.
www.chesterstandard.co.uk
After a short break, the trial is now resuming with Dr Sandie Bohin being recalled to give evidence.
11:52am
Medical expert witness Dr Bohin is giving evidence on Child D, and confirms she has made a report on her, having had access to relevant medical reports and images from the Countess of Chester Hospital and Alder Hey, plus other medical experts.
She confirms her role was to peer-review Dr Dewi Evans's conclusions from his report.
Recap: Lucy Letby trial, Friday, November 11
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…
LadyEdgeworth
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11:55am
Dr Bohin says there is now an advantage in delaying the cutting of the umbilical cord by two minutes, if the baby is in good condition, which is true in premature babies.
However, if the baby is 'in extremis', the priority is on saving the life and cutting the umbilical cord immediately is the priority.
Dr Bohin said the cord was cut for Child D after two minutes.
11:58am
She says Child D was in some respiratory distress due to 'grunting', which started when she was taken to the post-natal ward.
It had been noted by the parents Child D was floppy and dusky in colour. Upon similar observations by medical staff, Child D was taken to the neonatal unit.
Dr Bohin noted Child D was put on to CPAP with 40% oxygen, and during the night she had improved but was 'still not normal'.
She tells the court there were still signs of respiratory distress for Child D.
www.chesterstandard.co.uk
Dr Bohin says there is now an advantage in delaying the cutting of the umbilical cord by two minutes, if the baby is in good condition, which is true in premature babies.
However, if the baby is 'in extremis', the priority is on saving the life and cutting the umbilical cord immediately is the priority.
Dr Bohin said the cord was cut for Child D after two minutes.
11:58am
She says Child D was in some respiratory distress due to 'grunting', which started when she was taken to the post-natal ward.
It had been noted by the parents Child D was floppy and dusky in colour. Upon similar observations by medical staff, Child D was taken to the neonatal unit.
Dr Bohin noted Child D was put on to CPAP with 40% oxygen, and during the night she had improved but was 'still not normal'.
She tells the court there were still signs of respiratory distress for Child D.
Recap: Lucy Letby trial, Friday, November 11
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…
LadyEdgeworth
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12:03pm
Dr Bohin confirms she has noted what medical staff noted during their observations and records.
She noted the skin discolouration observations for Child D at the time of the first collapse at 1.30am on June 22.
12:04pm
Dr Bohin says she would have been 'surprised' if an infection was the sole cause behind Child D's 'catastrophic collapse'.
www.chesterstandard.co.uk
Dr Bohin confirms she has noted what medical staff noted during their observations and records.
She noted the skin discolouration observations for Child D at the time of the first collapse at 1.30am on June 22.
12:04pm
Dr Bohin says she would have been 'surprised' if an infection was the sole cause behind Child D's 'catastrophic collapse'.
Recap: Lucy Letby trial, Friday, November 11
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…
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