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

[ColourPurple]

It's not that it would mean there was no insulin in the first bag; there clearly was so that's not a question in my mind - it's that it could mean there was also insulin in the second bag, which was prepared when LL wasn't present. In other words, the insulin poisoner couldn't be her in that situation (I'm sure people can come up with complicated theories to explain it, but not being present for 4/8 hours before the change is very clear "reasonable doubt" IMO). And since it seems clear that someone caused such a high level of insulin to occur, what chance is there of there being two people with murderous intent in the same hospital at the same time?

Which makes it extremely important to determine if or when the bag was changed - and if it was, how long that much insulin would continue having an effect inside baby F after the source is removed. It may well be the second bag is a red herring, either there never was one, or it wouldn't have shown an effect in that much time anyway (assuming it was benign), in which case, case very near proved.

Hopefully there can be some clarity on that from future witnesses, as it seems so important to me, as in, make or break the entire case level of importance. So, no doubt there'll be no confirmation either way and we'll be left to speculate for the rest of the trial

Ah ok. I thought the second bag (if there was one) would have been stored in the fridge that LL, like everybody else, had access to. Nobody's mentioned a prescription being made for a second bag on the day shift. The two prescriptions mentioned (one crossed out) were both done before LL finished her shift, so yes maybe it is a red herring.

ETA I should have read all the other posts first too lol THink we're all on the same page about the lack of evidence of a "second" bag.

 

[Tortoise]

Ah ok. I thought the second bag (if there was one) would have been stored in the fridge that LL, like everybody else, had access to. Nobody's mentioned a prescription being made for a second bag on the day shift. The two prescriptions mentioned (one crossed out) were both done before LL finished her shift, so yes maybe it is a red herring.

ETA I should have read all the other posts first too lol THink we're all on the same page about the lack of evidence of a "second" bag.

The idea of a "second bag" probably came from the defence, IMO.

 

[Kasmeer]

The bag that was fitted after the line was changed must have been either the same bag or a stock bag from the fridge. I think it's unlikely to have been a stock bag if there is no doctor's note to discard the bespoke bag and use a stock bag until a new one could be prescribed.

The nurse's text to LL later that night says the line was changed, not the TPN, because they thought the line was causing the problem, although this didn't happen on her shift.

"She messaged LL: "He is a bit more stable, heart rate 160-170." (The long line had "tissued" and F's thigh was "swollen". It was thought the tissued long line "may be" the cause of the hypoglycemia.)
Colleague: "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 try to find answers”

The professor said it must have been the same bag, [and?] a contaminated stock bag, or the hardware was contaminated from the first bag.

If it was a stock bag it wouldn't explain the problems starting when the first bag was connected by LL.

IMO

(Italics by me to show the part I'm responding to)

It doesn't really need to "explain" it though, just provide reasonable doubt. I'm relying on some assumptions which may be proved wrong by those more knowledgeable (but unless they're explained in court, the jury will be laypersons with similar knowledge to myself):

- a "stock bag" sounds like one of several? So to poison it in advance requires luck to get the correct one.
- The reporting said that the original bag was prescribed for 48 hours, so it wouldn't be expected to be changed in that time?
- A "stock bag" is not a bespoke one, so could be used on any baby in need of it?

Based on those, poisoning a second bag would be probably unnecessary, could take some luck to hit the right bag, and would be more likely to poison random other babies than the intended target. Now so far we've been presented with what appear to be highly targetted attacks; pre-poisoning a bag that could hit any random baby does not at all fit with the MO shown thus far.

So, to my logic, if a stock bag was poisoned, that would indicate someone present at the time it was fitted doing the poisoning, to maintain the targetted attack (I don't buy the contaminated hardware theory; it's not an allergy where trace amounts can cause immense harm, the dilution that a clean bag of liquid would surely produce would be bound to show improvements - from a lay person's opinion, of course!). And that to me, if I were on the jury, would result in me voting "not guilty", probably on all the cases, given it's all about the weight of evidence adding up to prove it was LL - a clearly deliberate attack which is equally clearly NOT her would be a strong indicator that they have the wrong person in the dock.


Of course all of the above is IF there was a second bag at noon; I'm in agreement that there probably wasn't one, and as such, Baby F is much more clear evidence against her... but IF there was it really doesn't matter how the first one caused problems, it still creates all the reasonable doubt the defence need. If there's reference numbers to prove it either way those should be produced to confirm this (perhaps the court has been told but we haven't?)


(All my opinion only, and most of the above is opinion only in the case that the second bag exists!)

 

[Dotta]

LL explicitly asked Police about 1 bag.

Besides, it was mentioned in this WS forum that residues of insulin might have stayed in the tube.

Moo

 

[Kasmeer]

LL explicitly asked Police about 1 bag.

Besides, it was mentioned in this WS forum that residues of insulin might have stayed in the tube.

Moo

As I said in my post, if the second bag was clean, any residues would then be significantly diluted, and so improvement would be seen. From all that's posted here (and general common sense), insulin is something which has more effect if given in a higher dose - so it's clear logic to me that if there's only a trace residue remaining, it will have less effect.

I may be wrong, and it may work in a completely illogical manner, but the jury will have similar medical knowledge to me!

 

[Tortoise]

[...]

[Shelley Tomlins] was asked by prosecutor Philip Astbury if she had "at any point" administered insulin to Child F.
She replied "no".
[Sophie] Ellis, giving evidence from behind a screen, was asked the same question and replied "absolutely not".
Shift leader Ms [Belinda] Williamson was also asked if she had "at any stage" administered insulin to Child F and she also replied "no".

[...]

10%
Lucy Letby colleagues tell murder trial they did not give baby insulin

 

[crystalline]

Hello all,

I'm very sorry if I break any rules, my first time posting here however I have been reading this thread for a few weeks now, indeed it's quite a case to follow so apologies if I ask a question that may have already been answered.

I was wondering regarding the TPN bags - are they made up onsite or outsourced at that hospital does anyone know? I ask as I recall something back in 2014 regarding some TPN bags being accidently infected with some bacteria. Unsure if I can post a link but it was Bacillus cereus so easy enough to Google. I'm sure they would have done all the checks however, but just curious. I just feel there are so many routes yet to come up I'm this trial I feel the defence surely would be looking outside of the hospital setting. The Jury must be back and forth.

 

[Tortoise]

"Ms Tomlins, who worked on the day shifts of August 4 and 5, said stock nutrient bags would be kept in a padlocked fridge in the neo-natal unit.

The nursing shift leader would hold a bunch of keys for the fridge and for locked cupboards containing medication but they would be passed around the nurses with no log of access, she said."

10%
Accused´s nursing colleagues deny administering insulin to baby boy

 

[katydid23]

Lucy Letby colleagues tell murder trial they did not give baby insulin

Three nurses working on a neonatal ward where Lucy Letby allegedly poisoned a baby give evidence.

www.bbc.com

Jurors have heard how Child F's heart rate surged and his blood sugars dropped dangerously low after a feed was started shortly after midnight on 4 August.
The following day Ms Tomlins was on duty when a new intravenous line needed to be fitted.
she was asked by prosecutor Philip Astbury if she had "at any point" administered insulin to Child F.
She replied "no".
[the other two nurses relied "no" as well.]

 

[Tortoise]

Nurse Sophie Ellis, asked in court today if she added insulin to F's feed, was C's designated nurse the night C died.


SE was being supported by nurse MT that night and LL wasn't supposed to be in room 1. The shift-leader had to repeatedly tell her to go back to her baby. A look back at that evidence from 28th October -

"Today, Manchester Crown Court heard from Letby's colleague Sophie Ellis, who had been a newly-qualified nurse at the time and was caring for Baby C on the night shift, before the child died. [...]

Giving evidence from behind a screen, Ms Ellis said Baby C, who weighed 800 grams at birth, was fed for the first time at 11pm on June 13, and she left the room briefly to go to the nurse's station, but was then alerted by an alarm from the baby's monitor.

When asked what she saw when she returned to the room, she said: 'I'd seen Lucy standing by the incubator.'

She said Letby, 32, told her the baby's heart rate and oxygen levels had dropped [...]

Ms Ellis said Baby C's condition resolved by itself and she sat at the computer in the room, but the infant's heart rate and oxygen levels then dropped again.

The witness said: 'Lucy was stood at the incubator. I would have been looking from the computer, it was on the right-hand side.' [...]

Nurse tells court how she found Lucy Letby standing by incubator


"LL added, in the message to her mum: "He only weighed 800g. Sophie the new girl was looking after him, she was devastated."

"LL gives an update to a colleague and says, for Child C, "Doing well on Optiflow. Then collapsed. All happened very quickly. Sophie had him and is devastated."

 

[Tortoise]

Hello all,

I'm very sorry if I break any rules, my first time posting here however I have been reading this thread for a few weeks now, indeed it's quite a case to follow so apologies if I ask a question that may have already been answered.

I was wondering regarding the TPN bags - are they made up onsite or outsourced at that hospital does anyone know? I ask as I recall something back in 2014 regarding some TPN bags being accidently infected with some bacteria. Unsure if I can post a link but it was Bacillus cereus so easy enough to Google. I'm sure they would have done all the checks however, but just curious. I just feel there are so many routes yet to come up I'm this trial I feel the defence surely would be looking outside of the hospital setting. The Jury must be back and forth.

Hi crystalline, welcome to the thread/WS.

The TPN bags are made up by a pharmacy on site, according to opening speech.

 

[ColourPurple]

Nurse Sophie Ellis, asked in court today if she added insulin to F's feed, was C's designated nurse the night C died.


SE was being supported by nurse MT that night and LL wasn't supposed to be in room 1. The shift-leader had to repeatedly tell her to go back to her baby. A look back at that evidence from 28th October -

"Today, Manchester Crown Court heard from Letby's colleague Sophie Ellis, who had been a newly-qualified nurse at the time and was caring for Baby C on the night shift, before the child died. [...]

Giving evidence from behind a screen, Ms Ellis said Baby C, who weighed 800 grams at birth, was fed for the first time at 11pm on June 13, and she left the room briefly to go to the nurse's station, but was then alerted by an alarm from the baby's monitor.

When asked what she saw when she returned to the room, she said: 'I'd seen Lucy standing by the incubator.'

She said Letby, 32, told her the baby's heart rate and oxygen levels had dropped [...]

Ms Ellis said Baby C's condition resolved by itself and she sat at the computer in the room, but the infant's heart rate and oxygen levels then dropped again.

The witness said: 'Lucy was stood at the incubator. I would have been looking from the computer, it was on the right-hand side.' [...]

Nurse tells court how she found Lucy Letby standing by incubator


"LL added, in the message to her mum: "He only weighed 800g. Sophie the new girl was looking after him, she was devastated."

"LL gives an update to a colleague and says, for Child C, "Doing well on Optiflow. Then collapsed. All happened very quickly. Sophie had him and is devastated."

So according to that article Sophie was Baby C's designated nurse. LL was supposed to be in another room looking after another baby but the two times that Baby C's alarm went off because of breathing problems, LL was standing by his cot. Then, after he died, she told her mother and colleague that Sophie had been looking after him. And Sophie was also Baby |F's designated nurse when "somebody" put insulin in the TPN bag?

There definitely seems to be an element of trying to set others up (Sophie on two occasions so far) ... if LL is guilty of course.


ETA After Baby C's death: "Letby later sent a message to Ellis and told her: “We are a good team and we’ll get through. You did so, so well.”

www. thetimes.co.uk/article/lucy-letby-told-fellow-nurse-heatbreak-trial-hrcq2kq7r

 

[Anxala]

I'm just pondering and wondering out loud here so bear with me:

LL has, according to the prosecution, following presumably intense scrutiny and a very careful process of elimination, been deemed the one crucial common factor in all of the babies' deaths. They say she was allegedly present on all the shifts and involved in some way or another with all the babies who died and/or presented with sudden/unexplained downturns in their wellbeing.

I wonder if there are other staff in the unit who also fitted the 'present' criteria but just not quite as significantly and critically as LL allegedly does?

Just pondering in the absence of not knowing what the defence might have up its sleeve.

 

[Dcflag]

(Italics by me to show the part I'm responding to)

It doesn't really need to "explain" it though, just provide reasonable doubt. I'm relying on some assumptions which may be proved wrong by those more knowledgeable (but unless they're explained in court, the jury will be laypersons with similar knowledge to myself):

- a "stock bag" sounds like one of several? So to poison it in advance requires luck to get the correct one.
- The reporting said that the original bag was prescribed for 48 hours, so it wouldn't be expected to be changed in that time?
- A "stock bag" is not a bespoke one, so could be used on any baby in need of it?

Based on those, poisoning a second bag would be probably unnecessary, could take some luck to hit the right bag, and would be more likely to poison random other babies than the intended target. Now so far we've been presented with what appear to be highly targetted attacks; pre-poisoning a bag that could hit any random baby does not at all fit with the MO shown thus far.

So, to my logic, if a stock bag was poisoned, that would indicate someone present at the time it was fitted doing the poisoning, to maintain the targetted attack (I don't buy the contaminated hardware theory; it's not an allergy where trace amounts can cause immense harm, the dilution that a clean bag of liquid would surely produce would be bound to show improvements - from a lay person's opinion, of course!). And that to me, if I were on the jury, would result in me voting "not guilty", probably on all the cases, given it's all about the weight of evidence adding up to prove it was LL - a clearly deliberate attack which is equally clearly NOT her would be a strong indicator that they have the wrong person in the dock.


Of course all of the above is IF there was a second bag at noon; I'm in agreement that there probably wasn't one, and as such, Baby F is much more clear evidence against her... but IF there was it really doesn't matter how the first one caused problems, it still creates all the reasonable doubt the defence need. If there's reference numbers to prove it either way those should be produced to confirm this (perhaps the court has been told but we haven't?)


(All my opinion only, and most of the above is opinion only in the case that the second bag exists!)

A random bag could be the intention I suppose? That way the baby that receives it could be on any shift at any time to any baby. Perhaps the tainted tpn bag was only ever to remove suspicion from her specifically (allegedly speaking of course).

 

[katydid23]

So according to that article Sophie was Baby C's designated nurse. LL was supposed to be in another room looking after another baby but the two times that Baby C's alarm went off because of breathing problems, LL was standing by his cot. Then, after he died, she told her mother and colleague that Sophie had been looking after him. And Sophie was also Baby |F's designated nurse when "somebody" put insulin in the TPN bag?

There definitely seems to be an element of trying to set others up (Sophie on two occasions so far) ... if LL is guilty of course.


ETA After Baby C's death: "Letby later sent a message to Ellis and told her: “We are a good team and we’ll get through. You did so, so well.”

www. thetimes.co.uk/article/lucy-letby-told-fellow-nurse-heatbreak-trial-hrcq2kq7r

I wonder if she allegedly 'set up' SE because she was a brand new nurse. It would be easier to do so, imo.

 

[katydid23]

I'm just pondering and wondering out loud here so bear with me:

LL has, according to the prosecution, following presumably intense scrutiny and a very careful process of elimination, been deemed the one crucial common factor in all of the babies' deaths. They say she was allegedly present on all the shifts and involved in some way or another with all the babies who died and/or presented with sudden/unexplained downturns in their wellbeing.

I wonder if there are other staff in the unit who also fitted the 'present' criteria but just not quite as significantly and critically as LL allegedly does?

Just pondering in the absence of not knowing what the defence might have up its sleeve.

If the others fit in the 'present ' criteria, but not asa significantly or as critically, then they would likely be dismissed by the jury as being the guilty party. It is only going to be relevant if there is one party that was there at each death and attack, and consistently and significantly so. JMO

 

[ColourPurple]

I wonder if she 'set up' SE because she was a brand new nurse. It would be easier to do so, imo.

I wonder who Baby K's designated nurse was when thishappned? As it sounds similar to what happened with Baby C


"Although he did not have a view into Nursery 1 - where the most vulnerable babies are treated - Dr Jayaram was aware the designated nurse was not there, a fact backed up by door swipe data. Lucy Letby was the only nurse in room 1, alone with Child K. Mr Johnson said: "Feeling uncomfortable with this because he was beginning to notice the coincidence between the unexplained deaths and serious collapses and the presence of Lucy Letby, Dr Jayaram decided to check on where Lucy Letby was and where [Child K] was.

"As he walked in, he could see Letby standing over Child K's incubator. He could see Child K's oxygen levels were falling. However, the alarm was not sounding and Lucy Letby was making no effort to help."Dr Jayaram went straight to treat Child K and found her chest was not moving, he asked Letby if anything had happened to which she replied, 'she’s just started deteriorating now'." Dr Jayaram found Child K's breathing tube had been dislodged.

Child K was very premature, and had been sedated and inactive. The tube had been secured by tape and attached to Child K's headgear. Mr Johnson: "It's well recognised if you handle a child you can dislodge the tube accidentally, but any experienced staff member would recognise that."Dr Jayaram was troubled as the levels were falling and Nurse Letby had been the only person in the room."

'TV doctor Ravi walked in on Lucy Letby 'attacking 98-minute-old baby''

A CONSULTANT paediatrician at the Countess of Chester Hospital walked in on neonatal nurse Lucy Letby 'trying to kill' a 1lb 8oz baby that had been…

www.northwaleschronicle.co.uk

ETA same with child I

"Mr Johnson said for Child I, born in Liverpool Women's Hospital in August 2015, Letby made four attempts to kill her, succeeding on the fourth attempt.On the final occasion, Mr Johnson said it was at 1.06am when a nurse, having left the nursery temporarily, responded to Child I's alarm and saw Lucy Letby at the incubator. Child I was very distressed and wanted to intervene, but Letby assured her that they would be able to settle the baby. Child I then collapsed."

 

[Tortoise]

"A chart is displayed to the jury about the presence of staff on duty at the time the babies were "attacked", with Letby present for all 24 incidents listed between 2015 and 2016.

The majority of incidents are at night-time. No other member of registered nurse and/or nursery nurse staff is present for more than a total of seven incidents."

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

 

[Dotta]

"Medical staff on the unit managed to revive Baby F and he was later transferred to another hospital."

Lucy Letby's colleagues say they didn't give insulin to alleged victim

Three former colleagues of Lucy Letby (pictured) told Manchester Crown Court today that they had never given insulin to a baby that was allegedly poisoned by the nurse at the Countess of Chester Hospital.

www.dailymail.co.uk

 

[Tortoise]

"Medical staff on the unit managed to revive Baby F and he was later transferred to another hospital."

Lucy Letby's colleagues say they didn't give insulin to alleged victim

Three former colleagues of Lucy Letby (pictured) told Manchester Crown Court today that they had never given insulin to a baby that was allegedly poisoned by the nurse at the Countess of Chester Hospital.

www.dailymail.co.uk

From that article

"Miss Tomlins told the court she recalled a new TPN intravenous feed bag being set up for Baby E after a longline tube needed to be replaced because it had 'tissued'.

This would have come from the padlocked fridge on the unit. Nurses had access to bespoke TPN bags for individual babies and stock bags for more general use or where there was no time to wait for a bespoke bag. [...]

Asked what type of feed bag would have been used on August 4, Miss Tomlins replied: 'It would depend on whether there were any more bags made up for him.

'If we had run out I assume we would have just attached to one of our stock bags and ordered more for him. It took a few hours for them to come from the pharmacy'."