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

[Sundial]

Yes. The child was bleeding internally which as far as I know is an emergency that can lead to death in hours. I would expect such an injury in someone hit by a car, not a newborn baby.

He was screaming when the mother rushed into the room, while LL was at the work station doing nothing to help. Good thing she phoned her husband right after the incident.

As completely upsetting as this is; a tiny tot screaming and by what the mum witnessed, I’m surprised it wasn’t heard by anyone else (other staff), which then makes me think, was the door to the room closed prior to the mum walking in? Regardless, this case has such a sad, devastating feel to it.

 

[katydid23]

As completely upsetting as this is; a tiny tot screaming and by what the mum witnessed, I’m surprised it wasn’t heard by anyone else (other staff), which then makes me think, was the door to the room closed prior to the mum walking in? Regardless, this case has such a sad, devastating feel to it.

At night, there is not always a lot of extra staff walking around. Each nurse has their own patients, and hearing loud crying would not necessarily divert them from their own patients, once they saw that a qualified experienced RN was inside the room tending to the situation.

They'd know that IF there was an emergency the RN would push the code button for immediate help.

So the crying may have been heard, but it was assumed it was being handled. JMO

 

[Tortoise]

It's quite interesting to see all the nursing notes LL made in a timely manner, and then this one she typed up at 4.51am - over 3 hours after baby E had died.

From the timeline -

10pm - LL’s nursing notes: "At 10pm large vomit of fresh blood. 14ml fresh blood aspirate obtained from NG tube. Reg Harkness attended. Blood gas satisfactory..." Child E was 'handling well'.

10pm – LL made a further nursing note at 4.51am saying E’s mother had visited the neonatal unit at 10pm.

LL’s further notes: “[Mother] visited again approx. 22:00. Aware that we had obtained blood from his NG tube and were starting some different medications to treat this. She was updated by Reg Harkness and contained [E]. Informed her that we would contact her if any changes. Once [E] began to deteriorate midwifery staff were contacted. Both parents present during resus.”


Also, I noticed this interesting sequence -

c.11pm - Dr H says he is planning to intubate E and do an x-ray to check Child E's lungs and abdomen to try and explain why the baby was deteriorating. The type of intubation was 'elective', which was not on the level of 'an emergency situation'. Dr H testified he planned to discuss the result of the x-ray with surgeons at Alder Hey and seek advice from them.

11.10pm to 11.40pm – Dr H made preparations for the elective intubation and prescriptions were made for a number of drugs for E.

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

11.40pm – Baby E’s 1st collapse (of 3) - with purple-blue blotching over abdomen.



And then there was this in the opening speech - "although LL was participating in the resuscitation, she co-signed for medication given to a baby in room 4."

 

[Dotta]

I "borrowed" this link from Idaho students thread.
The profile of serial killer.
I don't think it is off topic.
Quite the contrary.
Allegedly, of course.

Sign in - Google Accounts

 

[squish]

As completely upsetting as this is; a tiny tot screaming and by what the mum witnessed, I’m surprised it wasn’t heard by anyone else (other staff), which then makes me think, was the door to the room closed prior to the mum walking in? Regardless, this case has such a sad, devastating feel to it.

Unfortunately, babies in NICU go through multiple unpleasant or painful procedures every day. It might be unusual for a parent, but I would imagine screaming is not an uncommon thing for nurses to hear. Anyway, if they did hear, they would assume that Letby was dealing with it.

 

[Tortoise]

Just to let you know my (three part) finalised timeline for baby E is now up in the media and timeline thread

link UK - Lucy Letby Trial - Media, Maps & Timeline *NO DISCUSSION*

 

[5W's]

In addition to this, the hospital contacted the police themselves, even though the review didn’t suggest criminal activity. This would have given them the perfect opportunity to rugsweep, if they wished to.

The hospital have nothing to gain from scapegoating Lucy Letby; this trial is making them look terrible.

If LL is innocent, it’s not because she’s a scapegoat.

See this aids in what I'm talking about the self review systems didn't bring up the real potential problem util it was too late years had passed. This is what upsets me the most. IT COULD HAVE BEEN AVOIDED!!! I just find this an excuse to to pass the buck instead of acknowledging a suspicion.

 

[Marantz4250b]

"yeah I had them both"

I find this reply a little odd, distracting maybe. Colleague is asking about E and LL says she looked after his brother too. In other words, notice I also had one who survived.

IMO

Honestly, I think this is fishing. Even if she's 100% guilty, I get the distinct feeling that people are trying to read guilt into her texts where they simply don't actually imply that.

The one you quoted Is a perfectly reasonable response which an entirely innocent person might make. I see no implication of guilt or general weirdness in it at all.

Guilty or not, LL is in a no win situation as regards that text; she gets criticised for mentioning the other twin but if she hadn't then she'd be criticised by the implication that she's cold hearted and gave no care other than for the one she murdered.

 

[Tortoise]

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'.

-------------------------------------------------------------------------------------------------------------------

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'

 

[Tortoise]

Honestly, I think this is fishing. Even if she's 100% guilty, I get the distinct feeling that people are trying to read guilt into her texts where they simply don't actually imply that.

The one you quoted Is a perfectly reasonable response which an entirely innocent person might make. I see no implication of guilt or general weirdness in it at all.

Guilty or not, LL is in a no win situation as regards that text; she gets criticised for mentioning the other twin but if she hadn't then she'd be criticised by the implication that she's cold hearted and gave no care other than for the one she murdered.

I think it's a little odd.

If a nurse say had two patients to look after, say Peter and Paul, and Paul died, I wouldn't expect the texts to read -

oh I heard Paul died last night, did you have him?
yes I had Peter and Paul.

It's nothing to do with Paul dying.

If she had more than 2 patients on a larger non-intensive care ward, would you expect her to list all of them too?

She did the same again in her later texts with a different colleague -


7.55pm – LL’s texts
JJ-K: "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."

Like how is looking after F relevant to E dying? It seems like a distraction to me.

Anyway, we don't all have to agree

 

[Marantz4250b]

In addition to this, the hospital contacted the police themselves, even though the review didn’t suggest criminal activity. This would have given them the perfect opportunity to rugsweep, if they wished to.

The hospital have nothing to gain from scapegoating Lucy Letby; this trial is making them look terrible.

If LL is innocent, it’s not because she’s a scapegoat.

I've never bought the outright scapegoat theory. They can't manage a hospital wing, let alone a feat of master criminality such as setting someone up as a serial killer!

If she is taking the fall for systemic failings it's because the evidence happens to fit by chance and possibly by investigators getting tunnel vision rather than her being targeted by a team of criminal geniuses, which they clearly are not.

 

[JosieJo]

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'.

-------------------------------------------------------------------------------------------------------------------

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'

Thanks for this it makes it easier to follow next week.

This caught my eye will be interesting to hear more detail

"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)"

LL was not baby Fs nurse ? Why would she be texting results of a baby she was not responsible for to another colleague?

 

[Dotta]

Re "systemic failings" mentioned above

Surely there is some higher authority monitoring situation in national hospitals in all areas of the country, no?
Like the Government Department of Health.

Each hospital is part of a system and the Minister of Health is the ultimate boss responsible for health service in a country.

Moo

 

[JerseyGirl]

U.K. doctor testifies in Lucy Letby 'killer nurse' trial: 'Nothing I've seen before or since'

A doctor in the trial of U.K. nurse Lucy Letby, who is accused of murdering seven babies as a neonatal nurse, testified that he had never seen a baby's condition deteriorate so quickly.

www.foxnews.com

 

[Dotta]

Today - 20th November - is the World's Children's Day.

The day of their RIGHTS.

Some forget about this day

World Children's Day, Universal Children's Day 2022:
The date 20 November marks the day on which the UN Assembly adopted the Declaration of the Rights of the Child, in 1959, and the Convention on the Rights of the Child, in 1989.

Every child has the right to be included and protected against all forms of discrimination and ABUSE.

On Sunday's #WorldChildrensDay, let's celebrate every child, everywhere and recommit ourselves to protecting their rights.

 

[ColourPurple]

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) .

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)

So are they saying ...
Baby F was the only baby on the ward on insulin and a bespoke TPN bag was delivered before LL's shift (and presumably stored in the fridge)
At 12.10am LL signed for and probably administered a lipid syringe to Baby F (even though she wasn't his designated nurse)
At 12.25am LL and Baby F's nurse signed for and administered the bespoke TPN bag (but LL says she has no recollection of that but that she did give Baby F glucose injections?)
After LL finished her shift she texted an off duty colleague Baby F's blood sugar levels.(despite not being the designated nusrse)
Also after LL finished her shift Baby F's blood sugar levels dropped, So the long line to the TPN bag was disconnected while they administered dextrose. They changed the long line and then either reconnected the same TPN bag or a new one out of the fridge and Baby F's blood sugars dropped again. Baby F had a very high insulin reading that indicated somebody had given him too much synthetic insulin.

And that LL's defence is that the nurses must have used a new TPN bag out of the fridge and it must have been contaminated (with extra insulin) and she had nothing to do with the new bag? Which wouldn't explain why his blood sugars were dropping even before they changed the TPN bag (if they did change it).

I have a couple of questions
1.What relevance/significance is the lipid syringe? Or are they suggesting that was a cover to get other medication/insulin? Or is a "lipid syringe" the same thing as a TPN bag, or something usually administered at the same time as a TPN bag? Or something that could be added to a TPN bag?
2.Why was LL giving Baby F glucose injections?
3.Could it be that the TPN bag was already causing low blood sugar (and high insulin levels) while LL was on shift and she was aware of that and was controlling it with glucose injections. Then once she finished her shift the low blood sugar was no longer controlled by glucose injections, as nobody else was even aware of it ? Meaning the impact of the contaminated TPN would only become apparent once she had gone off shift and stopped counteracting the effect with glucose injections
4. Also was the colleague LL texted with Baby F's blood sugar readings definitely off duty? Just wondering if it may have been a colleague who was on shift and witnessing Baby F's sudden blood sugar drop (or alternatively whether it could have been Baby F's designated nurse if she'd been told about the blood sugar drop)

 

[Legal]

Re "systemic failings" mentioned above

Surely there is some higher authority monitoring situation in national hospitals in all areas of the country, no?
Like the Government Department of Health.

Each hospital is part of a system and the Minister of Health is the ultimate boss responsible for health service in a country.

Moo

Yes, there is. There was the Healthcare Commission until 2009 and now there is the Care Quality Commission, to my knowledge. The problem is, in my opinion, there is a culture at the highest levels of everyone covering their backs, not wanting to lose their jobs or get in trouble, so unfortunately, those that do care about making positive changes are thrown under the bus. See the article below from the Guardian. (A friend of mine worked there and experienced being silenced first hand). I don't work for the NHS so others may have different views, but without getting too political, the NHS has been underfunded for years, and in particular, the last 12 years of Tory rule have brought it to its knees.

NHS watchdog faces investigation as concerns mount over patient care

NHS insiders questioning whether the Care Quality Commission, set up by Labour in 2009, is fit for purpose

www.theguardian.com

 

[magikarpmagikarp]

I have a couple of questions
1.What relevance/significance is the lipid syringe? Or are they suggesting that was a cover to get other medication/insulin? Or is a "lipid syringe" the same thing as a TPN bag, or something usually administered at the same time as a TPN bag? Or something that could be added to a TPN bag?

In babies, TPN is usually prescribed along with lipids. The TPN comes in a bag with clear, yellow fluid. It contains sugar, protein, vitamins and minerals. The fats are delivered separately, either in a bag or syringe. It contains a thick white fluid, and this is referred to as "lipids."

This video is a pretty good demonstration of what administration is like. It's done with a simulated adult patient.

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Accept third party cookies

 

[Tortoise]

So are they saying ...
Baby F was the only baby on the ward on insulin and a bespoke TPN bag was delivered before LL's shift (and presumably stored in the fridge)
At 12.10am LL signed for and probably administered a lipid syringe to Baby F (even though she wasn't his designated nurse)
At 12.25am LL and Baby F's nurse signed for and administered the bespoke TPN bag (but LL says she has no recollection of that but that she did give Baby F glucose injections?)
After LL finished her shift she texted an off duty colleague Baby F's blood sugar levels.(despite not being the designated nusrse)
Also after LL finished her shift Baby F's blood sugar levels dropped, So the long line to the TPN bag was disconnected while they administered dextrose. They changed the long line and then either reconnected the same TPN bag or a new one out of the fridge and Baby F's blood sugars dropped again. Baby F had a very high insulin reading that indicated somebody had given him too much synthetic insulin.

And that LL's defence is that the nurses must have used a new TPN bag out of the fridge and it must have been contaminated (with extra insulin) and she had nothing to do with the new bag? Which wouldn't explain why his blood sugars were dropping even before they changed the TPN bag (if they did change it).

I have a couple of questions
1.What relevance/significance is the lipid syringe? Or are they suggesting that was a cover to get other medication/insulin? Or is a "lipid syringe" the same thing as a TPN bag, or something usually administered at the same time as a TPN bag? Or something that could be added to a TPN bag?
2.Why was LL giving Baby F glucose injections?
3.Could it be that the TPN bag was already causing low blood sugar (and high insulin levels) while LL was on shift and she was aware of that and was controlling it with glucose injections. Then once she finished her shift the low blood sugar was no longer controlled by glucose injections, as nobody else was even aware of it ? Meaning the impact of the contaminated TPN would only become apparent once she had gone off shift and stopped counteracting the effect with glucose injections
4. Also was the colleague LL texted with Baby F's blood sugar readings definitely off duty? Just wondering if it may have been a colleague who was on shift and witnessing Baby F's sudden blood sugar drop (or alternatively whether it could have been Baby F's designated nurse if she'd been told about the blood sugar drop)

I know it says 'no other baby' on the ward was prescribed insulin at the time, but I get the impression from the little we do know about baby F that he was prescribed a tiny dose of insulin after birth but had stopped needing it by this time. It doesn't say too much insulin was administered for example. I think the case could be that there was no legitimate reason for any nurse to have touched the insulin in the fridge.

" "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)"

Also, it was explained at some point that insulin is never added to the TPN bag, because it binds to the plastic and the amount going into the baby would be unreliable. So it's not a case of extra insulin being added to a bag.

 

[crowmarsh]

The experts could only find one potential non-traumatic cause of bleeding, which is an extremely rare condition involving an artery of the stomach. So rare, that only six cases have been documented. That is not “many medical reasons for bleeding”.

That is pretty insulting to the mother’s intelligence. I’m sure that her memory of her dying, screaming, bloodied baby will remain fresh in her memory for the rest of her life.

I am puzzled by the hostile tone of this reply to my comment. There are lots of non-traumatic causes of bleeding and I would like to know how the doctor eliminated all (apart from the rare one he quoted) when he a) had no input into the clinical care of the baby and b) there was no post mortem where they could be definitively excluded. And with regard to the mother, I do not wish or intend to insult anyone. Maybe some posters on this forum will view as insulting any comment that questions the motive and content of a parents testimony. If the parents are untouchable then let me know and I will just have to accept that they have perfect recall of the most traumatic and stressful time of their lives.