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

[ColourPurple]

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.

That video was really helpful thank you!

So are they suggesting LL added insulin to the TPN, the lipids or injected it straight into Baby F?

 

[ColourPurple]

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.

Thanks, so they don't know how the insulin was administered, they just know that it was, and that it's not something that would be done accidentally.

 

[Tortoise]

Thanks, so they don't know how the insulin was administered, they just know that it was, and that it's not something that would be done accidentally.

I think they think it was via the TPN bag, or a stock bag.

 

[BabaVanga]

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.

There’s nothing hostile about it tbh

 

[JosieJo]

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.

What causes are you suggesting? That are spontaneous and without any signs or symptoms prior to sudden collapse.

Do you feel the Ward Dr's and the two medical expert witnesses all purposely discarded other reasonable possibilities? If so why would they all do that ?

 

[JosieJo]

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.

Can I ask?
Are the lipids normally infused over a period of time ?

 

[crowmarsh]

Being accused of insulting a grieving mother is not hostile ? I will take it as an invitation to friend the poster on facebook then.

 

[Anxala]

Usually, in my country, such controversial defendants undergo complex psychiatric examinations before a trial.

Moo

^ I wonder about that too.

I'm reluctant to assume anything here but LL surely would have undergone intense psychiatric examination over the intervening period between her arrest and imprisonment and the advent of her trial in order for her to be deemed mentally and emotionally 'fit' enough to attend her trial?

 

[magikarpmagikarp]

Can I ask?
Are the lipids normally infused over a period of time ?

Yes, a specific dose is prescribed and then administered over 20-22 hours.

 

[Tortoise]

^ I wonder about that too.

I'm reluctant to assume anything here but LL surely would have undergone intense psychiatric examination over the intervening period between her arrest and imprisonment and the advent of her trial in order for her to be deemed mentally and emotionally 'fit' enough to attend her trial?

LL was interviewed by police many times, and it seems she understood and gave lucid answers to the questions she was being asked. Her employers and colleagues and no doubt family and friends would also have been interviewed. She has been observed also in prison by prison staff.

LL's barrister would be the first to say if LL was unfit to stand trial, whereupon a mental evaluation would probably be ordered.

Personality disorders, if present, are not defined as insanity, or accepted as a defence, in any case.

IMO

 

[JosieJo]

Yes, a specific dose is prescribed and then administered over 20-22 hours.

I wonder why they have never suggested that the insulin could have been in the lipids ?

 

[MissMarbles]

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.

Thank you, that's really helpful in understanding what these procedures look like - lots of steps to follow, lots of checks. It was interesting about the TPN fluid needing to be fresh. And also tubing having to be changed to prevent build up of bacteria due to the glucose.

 

[MissMarbles]

Thanks, so they don't know how the insulin was administered, they just know that it was, and that it's not something that would be done accidentally.

I do know there are different types of insulin, some are slow acting, some fast (I remember my type 1 Diabetic son having to use both when he was a child). However whether there are different types available on such a neonatal ward I don't know, but it's interesting to consider IMO.

 

[Kemug]

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?

Maybe she knew that her colleague had been caring for Baby F and was worried about him, and so she checked up on him, to let the colleague know how he was doing.

 

[Supernovae]

I wonder why they have never suggested that the insulin could have been in the lipids ?

Would it have something to do with the timing or the need to explain how the second bag became contaminated?

 

[Parker Knoll]

Somehow I think it’s more likely to be in the bag … didn’t letby ask the police if they still had it as evidence ? It could of been in the second bag ( unsure of timing as so blinking complicated ) but if it binds to the bag she would have no idea how much of it would go through the line.

 

[Kasmeer]

I'm really struggling to keep up with all this info (finally caught up on the thread tonight having been at least a day behind all week), but thank you to all the people posting the updates; those and Tortoise's great timelines are so good for letting us get all the info in one place!

Still on the fence, but leaning towards a different side than I was originally; I can clearly see why this case has been brought, and that it really doesn't look good for LL based on what we've seen so far. I don't agree on all things being seen as suspicious though, some of her text messages etc seem perfectly normal to me, and while I certainly get an impression of someone who gets involved more than necessary (more than professional at times), that in itself isn't evidence of murder; plenty of perfectly normal non-murderous people act in similar ways.

The medical bits are what will really prove it, and those are sounding bad right now, yet we haven't heard the defence version, if they have any experts with counter theories as to causes of death, then that introduces doubt. In fact the prosecution witness introduced one counter theory themselves with the very rare haemorrhage (Dieulafoy's lesion UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #7 ) - yes, it's extremely rare, but then how many causes of deliberately induced gastric trauma in a hospital have ever been recorded? Probably not many more.

I do get that it's the confluence of so many rare/unlikely events that's the crux of the case, and the weight of those is definitely making my fence-sitting have a distinct lean to it, but if there's alternative possibilities for more of these events, it could become less certain. I'll be very interested to see the explanation for the insulin poisoning hours after she was last on duty, when the bag had been changed meanwhile (unless I'm misunderstanding what I've read); hopefully the evidence will make that one clearer soon as at the moment, either I'm being very stupid or she couldn't have done it, and if one of the few clear causes of death/collapse cases couldn't be her, that undermines the whole lot.

 

[squish]

Apparently the Daily Mail podcasts on this trial are far more detailed, and people who’ve listened to them (I haven’t) have said the prosecution’s case sounds stronger in the podcasts. They are doing one podcast for each baby, and are a bit behind time and up to Baby D. Has anyone on here listened to them yet?

 

[Eloise]

Apparently the Daily Mail podcasts on this trial are far more detailed, and people who’ve listened to them (I haven’t) have said the prosecution’s case sounds stronger in the podcasts. They are doing one podcast for each baby, and are a bit behind time and up to Baby D. Has anyone on here listened to them yet?

I haven't yet but I have been intending on it. It wouldn't surprise me if a podcast is more detailed though, as I don't think tweets and tweet-like reporting can really go into the detail that the testimony actually would.

 

[Tortoise]

Prosecution opening speech -

Medical experts Dr Dewi Evans and Dr Sandie Bohin said the hormone levels were consistent with insulin being put into the TPN bag prior to Child F's hypoglycaemic episode.
"You know who was in the room, and you know who hung up the bag," Mr Johnson told the jury.

Professor Peter Hindmarsh said the insulin "had to have gone in through the TPN bag" as the the hypoglycaemia "persisted for such a long time" despite five injections of 10% dextrose.

Professor Hindmarsh said the following possibilities happened.
That the same bag was transferred over the line, that the replacement stock bag was contaminated, or that some part of the 'giving set' was contaminated by insulin from the first TPN bag which had bound to the plastic, and therefore continued to flow through the hardware even after a non-contaminated bag was attached.
"There can be no doubt that somebody contaminated that original bag with insulin. Because of that...the problem continued through the day."

Recap: Prosecution opens trial of Lucy Letby accused of Countess of Chester Hospital baby murders