Baby F - Here is my
draft Timeline for baby F, baby E's twin, from his birth, also including some information about E where his mother visited the neonatal unit on the night E died, when F was in an incubator in the same room but not so far mentioned in evidence.
29 Jul 2015, Wednesday
Identical twin boys Child E and Child F born, prematurely, at 29 weeks, by C-Section. They shared a placenta which can increase the risks for NEC. (consultant’s testimony) Dr Christopher Wood (SHO) was present at the births.
Child E weighed 2lb 14oz (1.327kg). He was given oxygen then weaned to air and transferred to Room 1. He was at risk of NEC and started on antibiotics, IV fluids and caffeine. He had a nasogastric tube inserted.
Child F was marginally younger, and he required some resuscitation at birth. He was later intubated, ventilated and given meds to help his lungs. He was recorded as having high blood sugar so was prescribed a tiny dose of insulin. His breathing tube was removed and he was given breathing support. He had a long line.
30 Jul 2015, Thursday
Mother says she was able to visit the twins in the neonatal unit, from upstairs in the post-natal wards. She said that would take about 5-10 minutes to get from one place to the other, due to having had a C-section, which made the journey time longer. She said she was able to cuddle E as he wasn't on CPAP, while F was on CPAP.
1 Aug 2015, Saturday
Mother said E was progressing better, of the two twins, over July 30-31, but both were doing "really well" by August 1. She was keen to get home and was keen to transport both babies to a hospital closer to home, and was waiting for two ambulances to be provided. She said she and her partner were under the impression both babies were well enough to travel. By that stage, she had had skin-to-skin contact with both twins, and both were managing "fine". "We were never informed about anything to say they weren't fine."
8pm night shift –
LL was designated nurse for Child F.
2 Aug 2015, Sunday
By August 2, mother says they were still waiting for transport. She said on that day, the twins were both out of their incubators by this stage. [E] was breathing "easily" and [F] was "great".
8pm night shift –
LL was designated nurse for Child F. Melanie Taylor was designated nurse for Child E.
10.34pm – LL’s texts with nursing colleague JJ-K:
JJ-K: "Hope work ok".
LL: "...yeah it's fine, bit too Q word really."
JJ-K: "Don't complain as Wed and Thurs horrible lol! It will pick up again."
3 Aug 2015, Monday
Mother says by August 3 the twins were "great - doing really well". "We were absolutely thrilled that both boys were doing so well and we couldn't have asked for any more than that. They were both progressing."
8am to 8pm day shift - “unnamed nurse” [in court testimony] was the designated nurse for E & F.
7.30pm to 8pm night shift – LL is designated nurse for twins E & F in room 1. Nurse Caroline Oakley was the shift-leader. There were 3 babies in room 2, one baby in room 3, and four babies in room 4. There is also a baby in the transitional care unit.
8pm - LL’s nursing note for E (written retrospectively at
4.51am 4/8/15): "Mummy was present at start of shift attending to cares." Defence suggests to the mother that she went down to the neonatal unit at 8pm, at the time of the handover; the mother disagrees.
Just before 9pm – E had blood around his mouth and was “screaming” (mother’s evidence).
Allegation against LL of intentionally inflicting injury to baby E's upper gastrointestinal tract, somewhere between the mouth and the stomach, with bleeding contributing to his death
Mother’s testimony;
Mother took her expressed breast milk down to the neonatal unit, room 1, for E;
Mother heard E “screaming more than crying” from the corridor before she entered the room;
LL was the only other adult in room 1;
LL was not near E’s incubator, she was standing between the two incubators busy at a work station;
There was blood on E’s face around his chin, above his lip and partly on his neck;
Mother was there for about 10 mins and she tried calming him by placing a hand on his head and a hand on his stomach;
Mother asked LL why he was bleeding;
LL told Mother the NGT was rubbing the back of E’s throat;
LL told Mother to go back to her ward, the registrar was on his way and if there was a problem someone would ring up to the ward.
Mother went back to the ward.
9pm – E’s milk feed due (nursing chart). LL made no nursing record of the mother visiting E at 9pm with the milk, or of the bleeding the mother has testified to.
9.13pm – LL made a note in twin F’s records. (opening statement)
11.30pm - Midwife Susan Brookes says she had a call from the neonatal unit to ask the mother to go down
in 30 minutes as E had a bleed and required intubating
Just prior to 11.40pm - Allegation against LL of intentionally injected air into baby E, causing his collapse and death
11.40pm –
Baby E’s 1st collapse (of 3) - with purple-blue blotching over abdomen.
12 midnight - Mother (and father) with midwife returned to the neonatal unit and sat in the corridor while E was being worked on by medics. Midwife left after 10 minutes and mum was eventually allowed in once E had been stabilised.
4 Aug 2015, Tuesday
12.36am – Baby E’s 2nd collapse (of 3).
1.15am – Baby E’s 3rd and final (fatal) collapse –
1.40am – Baby E's time of death was recorded as 1.40am on August 4.
LL’s note for E: 'both parents present during the resus. Fully updated by nursing and medical team throughout. Parents wished for [E] to be baptised, Chaplain attended and carried out baptism and supported parents. Mum and dad held [E]’s hand as he passed away.” “'[E] was bathed by myself and photographs taken as requested, both were present during this. Consent obtained for [hair] and hand/footprints. Both distraught.” (electronic evidence)
4.51am - LL writes her retrospective "fraudulent" and "false" nursing notes for E (prosecution opening speech)
8am –
End of LL’s night shift
8.21am - LL noted at 8.21am: 'Parents resident on unit overnight. Wish to be left alone.' (electronic evidence)
8.58am – LL’s texts
Colleague: "You ok? Just heard about [E]. Did you have him? Sending hugs xx"
LL: "News travels fast - who told you? Yeah I had them both, was horrible."
Colleague responded that she had been informed by someone at the handover 'told me just now'. 'Had he been getting poorly or was it sudden?' ‘Poor you. You’re having a tough time of it.”
LL: E had a 'massive gastrointestinal haemorrhage'.
Colleague: ‘Damn. He’d always struggled feeding. I just feel for his parents and you. You’ve had really tough times recently.’
LL: E was 'IUGR [Intrauterine growth restriction] and REDF [Reversal of umbilical artery end-diastolic flow]' and was 'high risk'. She went on to describe how she felt ‘just awful’ and reported that the parents were distraught, saying "I feel numb".
4pm – Baby F’s bespoke TPN bag was delivered to the neonatal unit. It had to be used within 48 hours of 11.30pm on the 4th. (opening speech)
7.30-8pm - LL night shift starts. Baby F had been moved to room 2. LL was not baby F’s designated nurse. LL was designated a single baby that night, also in room 2. There were 7 babies in the unit that night, and 5 nurses working. (opening speech)
7.55pm – LL’s texts
Jennifer Jones-Key: "Hey how's you?"
LL: "Not so good, we lost [E] overnight."
JJ-K: "That’s sad. You’re on a terrible run at the moment. Were you in room 1?"
LL: "I had him and Baby [F]"
JJ-K: "That is not good, you need a break from it being on your shift."
LL: "It's the luck of the draw unfortunately. Only three trained (nurses), so I ended up having them both."
JJ-K: "You seem to be having some very bad luck though."
LL: "Not a lot I could do really. He had a massive haemorrhage. It could happen to any baby really."
JJ-K says Letby "did everything you could", adding she had seen a haemorrhage in babies before, and was 'horrible' to see.
LL: "This was abdominal. I’ve only seen pulmonary before.”
JJ-K asked after E&F’s parents.
LL: “Ok. Tired. They’ve just gone to bed.”
Dr Wood’s last night shift with the CoCH as he’d come to the end of his 4-month training placement. (Dr Wood's testimony)
5 August 2015, Wednesday
12.10am – In police interview in July 2018, LL confirmed signing for a lipid syringe at 12.10am. The prosecution say she should have had someone to co-sign for it. "She accepted that the signature tended to suggest she had administered it." "Interestingly, at the end of this part of the interview she asked whether the police had access to the TPN bag that she had connected," Mr Johnson added. (opening speech)
12.25am - LL and baby F’s designated nurse signed the prescription chart to record the TPN bag was started and administered via a long line. (opening speech)
Allegation against LL of intentional insulin poisoning of F
In police interview in July 2018 LL confirmed her signature on the TPN form.
She had no recollection of having had involvement with administering the TPN bag contents to Child F, but confirmed giving Child F glucose injections and taking observations. (prosecution opening speech)
The defence say Child F's TPN bag was put up by LL in August 2015 and hours later there were blood sugar problems. That bag was replaced, in the absence of LL, but the problems continued. The sample taken [at 5.56pm] came from "the second bag", the defence say. (defence opening speech)
8am –
LL’s night shift ended. LL texted Baby F’s blood sugar levels to an off-duty colleague. In police interview LL was asked about the text, and she said she must have looked on his chart. (opening speech)
Time? – Baby F suffered an unexpected drop in his blood sugar levels and surge in heart rate. (source opening speech, ITV). A doctor instructed the nursing staff to stop the TPN via the long line, provide dextrose, and move the TPN to a peripheral line while a new long line was put in. (opening speech, Chester Standard)
11am – All fluids were interrupted while a new long-line was put in. (opening speech)
Time? – Baby F’s blood glucose increased, before falling back. (opening speech)
Noon – A TPN bag was re-fitted to Baby F. This was either the same bag that was interrupted at 11am, which LL had signed for, or a stock bag from the fridge. (opening speech)
Time? - Baby F’s low blood sugar continued. (opening speech)
4pm – A new bespoke TPN was delivered to the unit for Baby F. (opening speech)
5.56pm – Baby F's blood sample at 5.56pm had a very low glucose level, and after he was taken off the TPN and replaced with dextrose, his blood glucose levels returned to normal by 7.30pm. He had no further episodes of hypoglycaemia. "These episodes were sufficiently concerning" that medical staff checked Child F's blood plasma level. The 5.56pm sample recorded a "very high insulin measurement of 4,657". Child F's hormone level of C-peptide was very low - less than 169. "That, we say, means that somebody gave Child F synthetic insulin - somebody poisoned him." "All experienced medical and nursing members of staff would know the dangers of introducing insulin into any individual whose glucose values were within the normal range and would know that extreme hypoglycaemia, over a prolonged period of time, carries life threatening risks. "No
other baby on the neonatal unit was prescribed insulin at the time." (prosecution opening speech) In a June 2019 police interview, LL agreed with the idea that insulin would not be administered accidentally. (opening speech)
6 August 2015, Thursday
7.58pm - LL did social media searches on the parents of E&F, as well as on August 23, September 14, September 21st, October 5, November 5, December 7, 11.26pm on December 25 and twice in January 2016. The last search was January 10th 2016. (opening speech and electronic evidence)
7 August 2015, Friday (about, a few days after giving E’s parents a memory box)
LL gave the mother a photograph of [F] 'holding' E's teddy.
The mother had just made one of her daily visits to the hospital's chapel of rest. 'Lucy Letby told me 'I got this picture. I thought it was so amazing I took a picture for you'. She was suggesting F had rolled over and cuddled the bear'.
9 August 2015, Sunday
LL gave an account to JJ-K of saying her goodbyes to the [E&F’s] parents. She told JJ-K that both parents had cried and hugged her: ‘
saying they’d never be able to thank me enough for the love and care I gave them'.
JJ-K: 'It’s heart-breaking, but you have done your job to the highest standard with compassion and professionalism. 'When you can’t save a baby you can try to make sure that the loss of their child is their only regret. You should feel very proud of yourself'.
LL
: 'I just feel sad that they’re thinking of me when they’ve lost him'.
Abt Nov 2015 - LL was told that the parents of Baby E and Baby F had come into the neonatal unit with a 'gorgeous huge hamper' for the staff. She was also told their surviving son looks 'fab'.
LL texted: '
Oh gosh, did they? I wish I could have seen them. That will stay with me forever'.
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Attempted Murder charge Child F – by alleged insulin poisoning
Prosecution Opening speech – Chester Standard
Recap: Prosecution opens trial of Lucy Letby accused of Countess of Chester Hospital baby murders
Prosecution Opening speech – ITV
Who are the children alleged to have been murdered by Lucy Letby? | ITV News
Defence opening speech -
Lucy Letby trial recap: Prosecution finishes outlining case, defence gives statement
Dr Wood (SHO)’s testimony –
Recap: Lucy Letby trial, Tuesday, November 15
Mother’s testimony for baby E –
Recap: Lucy Letby trial, Monday, November 14
Unnamed nurse’s testimony (day shift 3 Aug) –
Recap: Lucy Letby trial, Tuesday, November 15
Electronic evidence –
Recap: Lucy Letby trial, Monday, November 14
Supplementary text details Daily Mail
Colleagues of Lucy Letby told her she was 'terrible run of bad luck'