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

[LadyEdgeworth]

11:14am

The court is now focusing on the nigth shift of August 4-5, in which the prosecution allege Child F was poisoned on this night.
A staff shift rota shows Belinda Simcock was the shift leader, with one nurse being the designated nurse for Child F in nursery room 2, and Lucy Letby being a designated nurse for the other baby in room 2 that night.

11:16am

The court is shown a plan of the neonatal unit and the designated nurses for the babies on the unit that night.
That night, there was one baby being cared for in room 3, twins being cared for in room 4, and two other babies in the unit whose location cannot be established from the records, the court hears.
There were a total of seven babies in the unit and five nurses on duty that night.

11:17am

During the handover period at 7.30-8pm, a message from Letby's colleague Jennifer Jones-Key is sent to Letby's phone, saying: "Hey how's you? x"

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[MsBetsy]

well, this was Dr Harkness's clinical note on the night E collapsed

: 'Sudden deterioration at 11.40pm, brady 80-90bpm, sats 60%, poor perfusion, colour change over abdomen purple discoloured patches'. The note adds, after an improvement in sats, 'purple discolouration in abdomen remained', and a plan of action noted for E. (electronic evidence)

LL's note: 11.40pm became Bradycardiac, purple band of discolouration over abdomen,...

A nursing colleague had referred to 'discoloured abdomen' in a retrospectively written note at 1.30am.


I don't think there was an air embolus narrative at the hospital.

Dr Harkness also testified he has not been in discussions with anyone in relation to these observations.


For baby B, this was the on-call consultant's note -
The court is shown clinical notes made by her, written retrospectively at 2.40am on June 10, 2015.
She was called at home at 12.36am, and arrived at the neonatal unit at 12.50am.
She recorded Child B "went apnoeic [stopped breathing]", followed by "suddenly purple blotching of body all over, with slowing of heart rate."The consultant says the 'purple blotching' would have been the registrar's account of events, relayed to her.The consultant noted, for her observation: "Upon my arrival purple blotching right mid-abdomen and right hand." The baby was "pink and active".
The consultant's notes add: "Spoke to parents. "Purple discolouration almost resolved. "?? cause."
She tells the court: "I think this was something I was puzzled about, and wondering what it would be."
She says other causes were ruled out as such a rash had "come out of nowhere" and had "almost completely gone" a couple of hours later. The consultant says, from looking at her notes, she was "quite puzzled" by that as there were two question marks.The doctor says she was 'puzzled' by Child B's deterioration. Describing the 'rash' that covered her, she said: 'It was so florid, it came out of nowhere. One and a half hour's later it is completely gone'

Dr Evans said [...] his original conclusion was without knowing about the skin discolouration in Child A. I think this shows he hadn't even seen the statements made to the police when he made his diagnosis.
He adds that if you discover additional information, that "simply firms up your diagnosis".

I could go on, finding very similar witness statements for babies C and D.

And it's not just Dr Evans and Dr Bohin coming up with a narrative, Professor Arthurs also says the air on the x-rays available is consistent with air being administered and not consistent with death from natural causes or post mortem changes.



Seen in a cluster of sudden unexpected collapses in babies who were stable and showed no signs of slow deterioration, 'confirmation bias' is not a very convincing strategy, IMO

Melanie Taylor told the court she was struck by the rash seen on Baby D since "you don't really get rashes on babies." In her notes she recorded, "Discoloration to skin observed. Trunk, legs, arms, chin."

A nurse who cannot be named described it as "this purple speckled discoloration all over his body."

It's interesting that after all the talk on the ward about the 'fleeting rash,' Letby allegedly began using other methods such as insulin poisoning or inflicted trauma.

 

[LadyEdgeworth]

11:21am

Letby responds at 8.01pm: "Not so good. We lost [Child E] overnight. x"
[8.02pm] Ms Jones-Key: "That's sad. We're on a terrible run at moment. We're you in 1? X"
[8.02pm] Letby: "Yes. I had him & [another child]
Jones-Key: "That's not good. You need a break from it being on your shift."
Letby replied it was the "luck of the drawer [sic]".
Jones-Key: "You seem to be having some very bad luck though"

11:22am

Letby: "Not a lot I can do really. He had massive haemorrhage which could have happened to any baby x"

11:23am

Jones-Key: "...Oh yeah I know that and it can happen to any baby. Very scary and I have seen one"
Jones-Key: "Hope your be ok. Chin up"
Letby: "I'm ok. Went to [colleague] for a chat earlier on [and with] nice people tonight."

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[LadyEdgeworth]

11:24am

Letby: "This was abdominal [bleed in Child E]. I've seen pulmonary before"
Jones-Key: "That's not good. It's horrible seeing it.
"Hope your night goes ok"

11:28am

The court is shown medication is being administered to Child F at this time, between 9-10pm.
A blood gas record result at 11.32pm shows a blood glucose level of 5.5.

11:33am

A 48-hour bag prescription of nutrition is signed, solely, by Lucy Letby, recording it ending at 12.25am on August 5.
Two records are shown for the next administration, the first being crossed out.
The second nutrition bag has a higher level of babiven, along with quantities of lipid and 10% dextrose that weren't on the first, crossed out, administration.
The babiven is stated to start at 12.25am, and the lipid administration is signed to begin at 3am.
Letby is a co-signer for both the babiven prescriptions, but not the lipid administration.

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[mart321]

Melanie Taylor told the court she was struck by the rash seen on Baby D since "you don't really get rashes on babies." In her notes she recorded, "Discoloration to skin observed. Trunk, legs, arms, chin."

A nurse who cannot be named described it as "this purple speckled discoloration all over his body."

It's interesting that after all the talk on the ward about the 'fleeting rash,' Letby allegedly began using other methods such as insulin poisoning or inflicted trauma.

That's definitely what I thought aswell. Change of tactic. But if G, the absolute callousness of going back the very next nightshift and trying it on baby F. She must have known the parents were trying to move hospital.

 

[LadyEdgeworth]

11:37am

The 12.25am prescription for the TPN bag starts to be administered at 12.25am.
Child F then suffered a deterioration, the court hears.
A feeding chart shows Child F, for 1am in the 'NGT aspirate/vomit' column, four '+' signs.

11:41am

The nursing note, written retrospectively and timed for 1am, records: "large milky vomit. Heart rate increased to 200-210. [respiration rate] increased to 65-80. [Oxygen saturation levels] >96%. Became quieter than usual. Abdomen soft and not distended. Slightly jaundiced in appearance but no loss of colour. Dr Harkness R/V."

11:44am

An observation chart for Child F is timed at 1.15am.
The heart rate is shown having increased, along with the respiration rate, at this time, into the 'yellow area', which the court has previously heard is something medical staff would note and raise concerns if necessary.
Prosecutor Nicholas Johnson KC says the relevant nurse will be asked to give further details on this in due course.
A blood gas reading for Child F at 1.54am has his blood glucose level as 0.8.

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[LadyEdgeworth]

11:48am

Medication of 10% dextrose is administered intravenously at 2.05am, along with various other medications.
Blood tests are ordered for Child F by doctors at 2.15am and 2.17am.
They are collected between 2.33am and 2.45am.
Child F's blood glucose level is recorded as 2.3 at 2.55am. This is still "below where it should safely have been", Mr Johnson tells the court.

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[LadyEdgeworth]

12:04pm

The trial is now resuming after a short break.
Intelligence analyst Claire Hocknall is continuing to talk through the sequence of events for Child F in court.

12:07pm

The lipid prescription is administered at 3.10am on August 5, with 0.9% saline administered at 3.35am.
A 10% dextrose infusion is recorded at 3.50am.
At 4.02am, Child F's blood glucose reading is 1.9.

12:11pm

The shift handover is carried out at 7.30am, with day shift nurse Shelley Tomlins recording a blood glucose level for Child F as 1.7 for 8am.
Prosecutor Mr Johnson says this is a "dangerously low level".
The subsequent reading, recorded at 11.46am, is 1.4.

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[MsBetsy]

11:21am

Letby responds at 8.01pm: "Not so good. We lost [Child E] overnight. x"
[8.02pm] Ms Jones-Key: "That's sad. We're on a terrible run at moment. We're you in 1? X"
[8.02pm] Letby: "Yes. I had him & [another child]
Jones-Key: "That's not good. You need a break from it being on your shift."
Letby replied it was the "luck of the drawer [sic]".
Jones-Key: "You seem to be having some very bad luck though"

11:22am

Letby: "Not a lot I can do really. He had massive haemorrhage which could have happened to any baby x"

11:23am

Jones-Key: "...Oh yeah I know that and it can happen to any baby. Very scary and I have seen one"
Jones-Key: "Hope your be ok. Chin up"
Letby: "I'm ok. Went to [colleague] for a chat earlier on [and with] nice people tonight."

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

LL's responses to her colleague are not what I'd expect. An unusual amount of deaths occurred over her shift but she doesn't seem surprised. Her colleague keeps pointing out her bad luck, since all the patients died so tragically.

But instead of saying, yes it was horrible, she replies, "not a lot I can do, really."

It's as if she ignored the suggestion that she needed a break from the night shift because she had no interest in being moved to the day shift.

 

[LadyEdgeworth]

12:16pm

Dr Ogden records a blood glucose level at 10am for Child F as '1.3'.

12:21pm

Prior to this reading, Letby has been messaging the night-shift designated nurse for Child F, saying: "Did you hear what [Child F]'s sugar was at 8[am]?"
The nurse replies: "No?"
Letby: "1.8"
The nurse replies: "[S***]!!!!", adding she felt "awful" for her care of Child F that night.
Letby: "Something isn't right if he is dropping like that."
The nurse responds: "Exactly, he had so much handling. No something not right. Heart rate and sugars."
Letby: "Dr Gibbs came so hopefully they will get him sorted.
"He is a worry [though]."
The nurse replies: "Hpe so. He is a worry."
Letby responds: "Hope you sleep well...let me know how [Child F] is tonight please."
The nurse replies: "I will hun".

12:22pm

Child F's blood glucose level is recorded by a doctor as 2.4 at 12pm.
Further medication administrations are made throughout the morning.
A new long line is also inserted at this time.

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[LadyEdgeworth]

12:27pm

Child F's blood glucose level is recorded as being 2.4 at noon, 1.9 at 2pm and 1.3 at 3.01pm.
More dextrose is administered.
The blood glucose level is still "very low", the court hears, at 1.9 at 4pm.

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[mart321]

12:16pm

Dr Ogden records a blood glucose level at 10am for Child F as '1.3'.

12:21pm

Prior to this reading, Letby has been messaging the night-shift designated nurse for Child F, saying: "Did you hear what [Child F]'s sugar was at 8[am]?"
The nurse replies: "No?"
Letby: "1.8"
The nurse replies: "[S***]!!!!", adding she felt "awful" for her care of Child F that night.
Letby: "Something isn't right if he is dropping like that."
The nurse responds: "Exactly, he had so much handling. No something not right. Heart rate and sugars."
Letby: "Dr Gibbs came so hopefully they will get him sorted.
"He is a worry [though]."
The nurse replies: "Hpe so. He is a worry."
Letby responds: "Hope you sleep well...let me know how [Child F] is tonight please."
The nurse replies: "I will hun".

12:22pm

Child F's blood glucose level is recorded by a doctor as 2.4 at 12pm.
Further medication administrations are made throughout the morning.
A new long line is also inserted at this time.

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

Baby F wasn't her designated baby that night but she knows all about what's going on with this baby. From the texts she definitely wanted to stay informed of what was going on

This definitely seems tactical to me. It wouldn't look as bad on her maybe if other peoples babies were coming down ill aswell.

Obviously in hindsight we can see that she is the common denominator in every collapse but that definitely wouldn't have been apparent at the time.

 

[LadyEdgeworth]

12:28pm

At that time (4pm), Letby's phone receives an invitation from an estate agency firm confirming a viewing for a property in Chester, near the hospital. This home would be the address where Letby stayed until her 2018 arrest.

12:31pm

Child F's blood glucose level is recorded as being 1.3 at 5.56pm.
A blood test is recorded for insulin to the Royal Liverpool Hospital at 5.56pm. The court hears those results did not come back for a week.
Child F's blood glucose level is recorded as 1.9 at 6pm.

12:36pm

Letby messages a colleague at 6pm to ask: "Hi! Are you going to salsa tonite?"
The colleague responds: "Should do really as I haven't been for ages."
After confirming she will, Letby responds with an 'ok' emoji.
Letby adds: "Need to try and find some sort of nites energy", before clarifying "post nites"
She adds, to conclude the conversation: "Hasta luego".

12:39pm

A nursing note records there was a change from the TPN/lipid and 10% dextrose administration to 'just 15% dextrose with sodium chloride added'.
The new fluids were commenced at 7pm.

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[LadyEdgeworth]

1:02pm

The designated nurse for the previous night shift returns to care for Child F on the night shift for August 5-6.
She messages Letby to say: "He is a bit more stable, heart rate 160-170."
The long line had "tissued" and Child F's thigh was "swollen".
It was thought the tissued long line "may be" the cause of the hypoglycemia.

1:04pm

The colleague added: "Changed long line but sugars still 1.9 all afternoon. Seems like long line tissued was not cause of sugar problem, doing various tests [to find the source of the problem].
Letby responds: "Oh dear, thanks for letting me know"
The nurse colleague replies: "He is def better though. Looks well. Handles fine."

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[magikarpmagikarp]

I've been thinking more about what would make hypoglycemia persist [even after changing the allegedly contaminated bags]. I wonder what the expert testimony will be there. I am curious to know if it's possible that single very large overdose (rather than a continuous infusion) could lead to many hours of refractory hypoglycemia. My guess is yes, but I don't know this and I'm not sure how the different methods of administration would affect the number of hours of hypoglycemia. I am curious if it makes a difference whether the insulin was given intravenously or subcutaneous. (Subcutaneous would lead to a reservoir of insulin in the body).

 

[LadyEdgeworth]

1:16pm

Letby replies: "Good."
At 9.17pm, Child F's blood glucose level is recorded as being 4.1.
Letby later adds, at 11.58pm: "Wonder if he has an endocrine problem then. Hope they can get to bottom of it.
"On way home from salsa feel better now I have been out."
The colleague replies: "Good, glad you feel better. Maybe re endocrine. Maybe just prematurity."
Letby replies: "How are parents?"
Colleague: "OK. Tired. They've just gone to bed."
Letby: "Glad they feel able to leave him."
Colleague: "Yes. they know we'll get them so good they trust us."
Letby: "Yes.
"Hope you have a good night."

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[Blue182]

Obviously no one can know what they would have thought in a situation like this unless they were in it... but I think I would have assumed it was medical error or incompetence before I ever assumed it was deliberately inflicted harm. The cognitive dissonance you'd have to overcome to suspect a colleague of deliberately harming someone you have an ethical and legal duty to protect is.... huge.

Agreed - especially within nursing staff it must be incomprehensible that someone would do these things deliberately

 

[MsBetsy]

12:16pm

Dr Ogden records a blood glucose level at 10am for Child F as '1.3'.

12:21pm

Prior to this reading, Letby has been messaging the night-shift designated nurse for Child F, saying: "Did you hear what [Child F]'s sugar was at 8[am]?"
The nurse replies: "No?"
Letby: "1.8"
The nurse replies: "[S***]!!!!", adding she felt "awful" for her care of Child F that night.
Letby: "Something isn't right if he is dropping like that."
The nurse responds: "Exactly, he had so much handling. No something not right. Heart rate and sugars."
Letby: "Dr Gibbs came so hopefully they will get him sorted.
"He is a worry [though]."
The nurse replies: "Hpe so. He is a worry."
Letby responds: "Hope you sleep well...let me know how [Child F] is tonight please."
The nurse replies: "I will hun".

12:22pm

Child F's blood glucose level is recorded by a doctor as 2.4 at 12pm.
Further medication administrations are made throughout the morning.
A new long line is also inserted at this time.

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

So if they inserted a new long line at 12:00 pm, the insulin must have been in the TPN bag? Meanwhile LL has been texting the designated nurse to keep her updated on his progress through the night.

At 10:00 am the baby's glucose level falls to 1.3.

 

[LadyEdgeworth]

1:40pm

Child F's blood glucose levels rose to 9.9 at 1.30am on August 6, a repeat 9.9 reading being made at 2am.
Letby made the first of nine Facebook searches for the mum of Child E and F at 7.58pm on August 6. The searches were carried out between August 2015 and January 2016, and included a search on Christmas Day. One other search was carried out for the father of Child E and F on Facebook at 1.17am on October 5.

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk

 

[LadyEdgeworth]

1:52pm

Letby sent a message to the designated nurse for Child F from those two night shifts, on August 9 at 10.17pm, saying: "I said goodbye to [Child E and F's parents] as [Child F] might go tomorrow. They both cried and hugged me saying they will never be able to thank me for the love and care I gave to [Child E] and for the precious memories I've given them. It's heartbreaking."

1:53pm

The nurse colleague replies: "It is heartbreaking but you've done your job to the highest standard with compassion and professionalism. When we can't save a baby we can try to make sure that the loss of their child is the one regret the parents have. It sounds like that's exactly what you have done. You should feel very proud of yourself esp[ecially] as you've done so well in such tough heartbreaking circumstances. Xxxx"

Recap: Lucy Letby trial, Tuesday, November 22

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…

www.chesterstandard.co.uk