UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #9

[Tortoise]

Dan O'Donoghue
https://twitter.com/MrDanDonoghue
@MrDanDonoghue
·
59s

We're now looking at Dr Ventress' notes from her next shift on 25 September (going into 26 September). She records at 23.50 that there had been 'several episodes of desaturation in the previous two hours'

This is the night shift where LL was designated nurse for H and is charged with (first) attempted murder. JFYI

yesterday's evidence - Recap: Lucy Letby trial, Wednesday, January 18

Letby recorded, for the Child H event at 3.22am, 'profound desaturation and colour loss to 30%, good chest movement and air entry, colour change on CO2 detector, neopuff commenced in 100% oxygen and help requested. Serous fluid +++ from all 3 drains, became bradycardic. Drs crash called and resus commenced as documented'.

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

The prosecution say Letby attempted to kill Child H on September 26 at 3.24am, and on September 27 at 12.55am.

 

[Dotta]

This is the night shift where LL was designated nurse for H and is charged with (first) attempted murder at 3.22am. JFYI

She was (allegedly) becoming careless IMO.

A designated nurse!

By the way, what is this JFYI??
EtA
I think I deciphered it
Just for your info?

 

[Tortoise]

Dan O'Donoghue

@MrDanDonoghue
·
1m

At around 1am on 26 September Child H's ventilation had to be increased, Dr Ventress again suspected a pneumothorax. She called a consultant for further advice

 

[Tortoise]

She was (allegedly) becoming careless IMO.

A designated nurse!

By the way, what is this JFYI??

Just for your information

 

[Dotta]

Just for your information

Txs!
I managed to decipher it
It all looks very mysterious, like cryptology haha

 

[Dotta]

Re Baby H

So it was reported that 1 lung collapsed.

But now she is "fine and healthy" thank goodness!

I wonder if damaged lung in infancy can be completely cured?

 

[Marantz4250b]

I thought she had been dismissed.

Quote from opening of trial - I suppose it doesn't say after dismissal, I'm making an assumption.

She was "going through a grievance procedure" with the NHS at the time

I don't think she was dismissed, although she may have been. If she was it was perhaps simply because she couldn't attend due to bail conditions. She can't have been dismissed for misconduct or negligence as they could not have a misconduct hearing while a police investigation was underway.

She's definitely had her nursing registration suspended pending investigation of the facts as that was reported on and took place a day or two after she was charged.

It would be interesting to know what the grievance procedure was about. Her texts given in evidence about people making comments about her may form the basis of that. Just my opinion, though.

 

[Sweeper2000]

Sorry but that BBC reporter uses the expression 'former colleague' all the time to refer to nurses who were LL's colleagues at the time of the messages.



I'll quote you an example -

https://twitter.com/MrDanDonoghue
Jury now being shown text messages sent between Ms Letby and colleagues on the morning after Child E's death. Ms Letby to a former colleague, who cannot be named for legal reasons, says she felt 'numb'

When her former colleague says 'you seem to be having some very bad luck' Ms Letby replies: 'Not a lot I can do really he had a massive haemorrhage, could have happened to any baby x'



Chester Standard report -
Recap: Lucy Letby trial, Tuesday, November 22

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"
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. Were 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"
Letby: "Not a lot I can do really. He had massive haemorrhage which could have happened to any baby x"
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 [sic] be ok. Chin up"
Letby: "I'm ok. Went to [colleague] for a chat earlier on [and with] nice people tonight."

“Jurors were also shown Facebook messages sent by Yvonne Griffiths, who was then the neonatal unit deputy manager, to Ms Letby on the morning after Child H's first collapse.
Ms Griffiths commended Ms Letby for "all your hard work these last few nights" and said it was "nice to see your confidence grow as you advance through your career".
Ms Letby thanked her, adding: "That's really nice to hear as I gather you are aware of some of the not so positive comments that have been made recently regarding my role which I have found quite upsetting.
"Our job is a pleasure to do and just hope I do the best for the babies and their family."
After Child H's second collapse on 27 September, Ms Letby exchanged messages with a former nursing colleague.
Ms Letby said: "It's all just so rubbish lately and always seems to happen at night when less people.
"Everyone is pretty burnt out and unit been awful."

Lucy Letby: Parents saw baby resuscitated twice, murder trial told

Nurse Lucy Letby is accused of attempting to murder the premature baby girl on two occasions.

www.bbc.co.uk

I don’t understand why if both were current colleagues at the time the messages were sent he would use current tense in one reference and past tense in another just a few sentences later. I did spot the similarity in wording though And have tweeted him in hope of a clarification. I also don’t think LL would mention the unit if the recipient of that text was a current member of it at the time. Her wording suggests the recipient isn’t a current colleague of hers.

I would think the phrase “luck of the draw“ is a potentially stronger example of an attempt to deflect possible negative attention. As it achieves two things at once, absolvement of personal responsibility and assigning the blame to random chance.

just looking at the two sentences I think you could perceive a difference in feel to them. Her first sentence “it’s all so rubbish“ is actually a personal and informal statement noting her use of the word “rubbish“ which is personal to her. That initial and personal sentence is actually the one that points the blame including potential blame at herself whereas her second sentence which is colder and more professional noting her use of the word “unit” is a better opportunity to blame the event under discussion on the state of the unit Which she doesn’t. The two sentences are very different in feel and I don’t believe that she would include potential negative attention in a personal statement if she was trying to manipulate When there is a better opportunity to blame it on the unit Present in her second sentence. Her first sentence is personally orientated whereas her second is outward towards the unit and a better opportunity to deflect Blame.

there is the possibility that the second sentence is used to deflect negative attention upon a later Realisation that her first sentence points the finger at herself although this is a weaker proposition. would also depend on if the two sentences are part of the same text in which case it Suggests she isn’t trying to manipulate. Those quotation marks leave questions.

im really not getting the impression just by looking at the evidence that she is a skilled manipulator. It takes a Machiavellian understanding of others perspective and emotion to successfully manipulate and I’m not seeing that.

jmo

 

[ColourPurple]

Dan O'Donoghue
@MrDanDonoghue
·
1m

At around 1am on 26 September Child H's ventilation had to be increased, Dr Ventress again suspected a pneumothorax. She called a consultant for further advice

I'm still getting really confused with the timeline for Baby H.

Are they saying LL allegedly caused the pneumthorax / punctured/collapsed lung? Or did Baby H have one anyway shortyl after birth and they then suspected another one on the 26th? Or is the pneumthorax completely unrelated to the charges?

 

[Tortoise]

I'm still getting really confused with the timeline for Baby H.

Are they saying LL allegedly caused the pneumthorax / punctured/collapsed lung? Or did Baby H have one anyway shortyl after birth and they then suspected another one on the 26th? Or is the pneumthorax completely unrelated to the charges?

I have a timeline underway, but in the meantime this is from opening speech -


Child H was born in September 2015 and had breathing difficulties shortly after birth.
She was transferred to neonatal unit nursery room 1.

Independent experts say there was an "unacceptable delay" in tubating her and administering a protein which helps the lungs, which the prosecution say means the case is complicated by "sub-optimal treatment" at the hospital.
Additionally, Child H "was put on a ventilator she was not paralysed; she was also left with butterfly needles in her chest for prolonged periods which may have punctured her lung tissues and contributed to further punctured lungs."

The prosecution say Letby attempted to kill Child H on September 26 at 3.24am, and on September 27 at 12.55am.
Mr Johnson said Child H had previously deteriorated on the night of September 23 and required ventilator support and intubation, followed later by oxygen support.
The court hears Child H responded to intervening treatment, but desaturations were "frequent" and "significant".
Mr Johnson said all but two events could be explained medically and responded to with routine resuscitative measures.
The two events - in the early hours of September 26 and 27, were "uncharacteristic" and required CPR.

 

[Tortoise]

“Jurors were also shown Facebook messages sent by Yvonne Griffiths, who was then the neonatal unit deputy manager, to Ms Letby on the morning after Child H's first collapse.
Ms Griffiths commended Ms Letby for "all your hard work these last few nights" and said it was "nice to see your confidence grow as you advance through your career".
Ms Letby thanked her, adding: "That's really nice to hear as I gather you are aware of some of the not so positive comments that have been made recently regarding my role which I have found quite upsetting.
"Our job is a pleasure to do and just hope I do the best for the babies and their family."
After Child H's second collapse on 27 September, Ms Letby exchanged messages with a former nursing colleague.
Ms Letby said: "It's all just so rubbish lately and always seems to happen at night when less people.
"Everyone is pretty burnt out and unit been awful."

Lucy Letby: Parents saw baby resuscitated twice, murder trial told

Nurse Lucy Letby is accused of attempting to murder the premature baby girl on two occasions.

www.bbc.co.uk

I don’t understand why if both were current colleagues at the time the messages were sent he would use current tense in one reference and past tense in another just a few sentences later.

Just to respond to this part, I haven't read the rest yet,

was then the deputy manager...she is now the manager.

Tweet from November 30th -

Yvonne Griffiths, who is a neonatal unit manager at the Countess of Chester, is first in the witness box today.

 

[Marantz4250b]

im really not getting the impression just by looking at the evidence that she is a skilled manipulator. It takes a Machiavellian understanding of others perspective and emotion to successfully manipulate and I’m not seeing that.

jmo

I entirely agree! Just my opinion and feeling on this but she comes over as a person who is a very long way from being any sort of manipulator. That's the exact feeling I got right from the start when the media published her pics and statements from people who knew her. The texts and suchlike support that, in my my opinion.

Now, that's not say say that she isn't trying to manipulate but if she is she's not very good at it.

All of that makes it so unbelievable if she actually is guilty of all this. I mean, how on earth does someone get away with offences of such gravity for so long if they're a pretty crap liar?

Obviously, all my own opinion.

 

[ColourPurple]

I have a timeline underway, but in the meantime this is from opening speech -


Child H was born in September 2015 and had breathing difficulties shortly after birth.
She was transferred to neonatal unit nursery room 1.

Independent experts say there was an "unacceptable delay" in tubating her and administering a protein which helps the lungs, which the prosecution say means the case is complicated by "sub-optimal treatment" at the hospital.
Additionally, Child H "was put on a ventilator she was not paralysed; she was also left with butterfly needles in her chest for prolonged periods which may have punctured her lung tissues and contributed to further punctured lungs."

The prosecution say Letby attempted to kill Child H on September 26 at 3.24am, and on September 27 at 12.55am.
Mr Johnson said Child H had previously deteriorated on the night of September 23 and required ventilator support and intubation, followed later by oxygen support.
The court hears Child H responded to intervening treatment, but desaturations were "frequent" and "significant".
Mr Johnson said all but two events could be explained medically and responded to with routine resuscitative measures.
The two events - in the early hours of September 26 and 27, were "uncharacteristic" and required CPR.

That's helpful, thanks. So there was more than one incident of punctured lung/s and they may (or may not ) have been caused by butterfly needles in her chest.

 

[ColourPurple]

I entirely agree! Just my opinion and feeling on this but she comes over as a person who is a very long way from being any sort of manipulator. That's the exact feeling I got right from the start when the media published her pics and statements from people who knew her. The texts and suchlike support that, in my my opinion.

Now, that's not say say that she isn't trying to manipulate but if she is she's not very good at it.

All of that makes it so unbelievable if she actually is guilty of all this. I mean, how on earth does someone get away with offences of such gravity for so long if they're a pretty crap liar?

Obviously, all my own opinion.

I think (whether guilty or innocent) her texts showed a manipulative side when she'd been trying to get back into Room 1 after Baby A's death.

The other examples of possible manipulation depend on whether or not she's guilty so it's hard to say for sure. For example her talk of fate, and her throwing in the longwinded explanation about how one little thing could tip a baby over the edge - both are manipulative if she was responsible for the deaths and collapses, but obviously aren't if she isn't. If she's guilty then I think she is incredibly manipulative. "Trust me I'm a nurse".

 

[Dotta]

I think (whether guilty or innocent) her texts showed a manipulaitve side when she'd been trying to get back into Room 1 after Baby A's death.

The other examples of possible maniuplation depend on whether or not she's guilty so it's hard to say for sure. For example her talk of fate, and her throwing in the longwinded explanation about how one little thing could tip a baby over the edge - both are manipulaitve if she was responsible for the deaths and collapses but obviosuly aren't if she isn't. If she's guilty then I think she is incredibly manipulative. "Trust me I'm a nurse".

If guilty...

"Trust me, I'm a nurse"

might become the creepiest leitmotiv of this case.

JMO

 

[mart321]

Can't see the charges for baby H sticking at at the moment

Dr Ventress has agreed that

"the cumulative impact of those procedures could have resulted in a collapse like the one observed on 26 September" she agrees

Mr Myers sets out that Child H had had three chest drains inserted and numerous desaturations in the run up to 26 September, Dr Ventress agrees. He asks whether those medical procedures are 'likely to put strain on a little body like hers', she agrees

 

[Tortoise]

We're now looking at Dr Ventress notes from 03:22 when Child H suffered a profound collapse which needed a full resuscitation. CPR was commenced at 03.26 and three doses of adrenaline were administered between 03.30 and 03.39

At 03.46 chest compressions were stopped as Child H's heart rate had improved and her colour started improving - treatment was successful

Ben Myers KC, defending, is now questioning Dr Ventress. The medic agrees that desaturations in babies like Child H are not 'uncommon'. She agrees that Child H was 'clearly unwell'

Mr Myers sets out that Child H had had three chest drains inserted and numerous desaturations in the run up to 26 September, Dr Ventress agrees. He asks whether those medical procedures are 'likely to put strain on a little body like hers', she agrees

Mr Myers asks if it is possible the cumulative impact of those procedures could have resulted in a collapse like the one observed on 26 September, she agrees

A former nursing colleague of Ms Letby, who cannot be named for legal reasons, is now in the witness box. She is taking the court through her notes on Child H from 25 September 2015

https://twitter.com/MrDanDonoghue

 

[Tortoise]

Can't see the charges for baby H sticking at at the moment

Dr Ventress has agreed that

"the cumulative impact of those procedures could have resulted in a collapse like the one observed on 26 September" she agrees

Mr Myers sets out that Child H had had three chest drains inserted and numerous desaturations in the run up to 26 September, Dr Ventress agrees. He asks whether those medical procedures are 'likely to put strain on a little body like hers', she agrees

She's not the expert here though. On the night in question the doctor and the consultant couldn't explain why her heart stopped. It was written in her notes that there was "no trigger". She was sent to Arrowe Park and they did extensive testing there and also could not explain it from her medical history.

 

[ColourPurple]

Can't see the charges for baby H sticking at at the moment

Dr Ventress has agreed that

"the cumulative impact of those procedures could have resulted in a collapse like the one observed on 26 September" she agrees

Mr Myers sets out that Child H had had three chest drains inserted and numerous desaturations in the run up to 26 September, Dr Ventress agrees. He asks whether those medical procedures are 'likely to put strain on a little body like hers', she agrees

I agree (if guilty) that it's going to be harder to prove whether LL was responsible for any desats as Baby H was already having desats . However, from the opening speech, apparently the desats when LL was on shift differed from the others:

The court hears Child H responded to intervening treatment, but desaturations were "frequent" and "significant".
Mr Johnson said all but two events could be explained medically and responded to with routine resuscitative measures.
The two events - in the early hours of September 26 and 27, were "uncharacteristic" and required CPR.

all IMO

 

[ColourPurple]

She's not the expert here though. On the night in question the doctor and the consultant couldn't explain why her heart stopped. It was written in her notes that there was "no trigger". She was sent to Arrowe Park and they did extensive testing there and also could not explain it from her medical history.

I see she also noted that on 25th September, the 70ml of air she aspirated via needle aspiration in the chest after the desat at 1.25am was "quite a lot for a baby that size". And she then went on to aspirate another 60ml after the desat at 1.45 and then another 85ml after the desat at 3am. Are they suggesting LL was injecting the air into Baby H?


"Her notes show that at 1.25am Child H had another profound desaturation. Oxygen levels down to 30s. Dr Ventress performed an emergency pneumothorax aspiration, 70ml of air was aspirated which was 'quite a lot for a baby that size' she tells the court

Child H's sats improved after the procedure, but there was a further desaturation at 1.45am. Second aspiration was then needed and another butterfly needle inserted into lower chest, this again worked and drained a further 60mls of air - again sats improved

The baby girl's sats remained in the stable range until 3am when she had another profound desaturation, her blood oxygen fell to 26%. 85mls of air aspirated and her sats again improved. A plan was drawn up to insert a further chest drain"
·

https://twitter.com/MrDanDonoghue