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

[Tortoise]

12:50pm

The intelligence analyst continues to talk through the sequence of events, with descriptions of the care being given to Child H throughout the day on September 25, 2015, which includes another desaturation in the afternoon.
The cardiac arrest team is beeped at 4.23pm to attend the neonatal unit.

12:58pm

The sequence goes to the night shift of September 25-26, in which Lucy Letby is listed as a designated nurse in nursery room 1 for Child H. No other babies are in nursery room 1, with four babies (including Child G) in room 2, four in room 3 and four in room 4.

LIVE: Lucy Letby trial, Wednesday, January 18

 

[Tortoise]

any Reasons why the shift leader or other nurse didn’t note the presence of air as unusual and or questionable? Isn’t it a recurring feature in the cases as well that the presence of air in the stomach is noted?

We had hardly any detail in the reporting when she gave evidence, Chester Standard reporter wasn't in court.

 

[Tortoise]

https://twitter.com/MrDanDonoghue
@MrDanDonoghue
·
43m

A statement from Child H's mother has been read to court. The mother explained that Child H was born six weeks premature. She was induced at the Countess of Chester in September 2015 after concerns over the mother's (who has diabetes) blood sugar levels

42m

The mother states that when Child H was born she and her husband were able to hold her and doctors said 'she was absolutely fine and may not even need to go to the neonatal unit'. But soon after, the mother said she 'began to look pale and began to make grunting noises'

41m

Child H was taken and given a more through examination, she was placed on the neonatal unit and needed oxygen. It was later necessary to put the infant on CPAP ventilation

38m

The mother says that the following morning she was not permitted to see her daughter by herself and had to wait for her husband's arrival. She said 'we both wen to NNU, we were stopped by staff and informed that overnight she’d been placed on a ventilator'.

39m

The mum said it was 'a shock to arrive and find (Child H) on a ventilator'. After several x-rays, it was established Child H had suffered a suspected lung puncture.

 

[LadyEdgeworth]

2:01pm

The trial is now resuming following the lunch break.

Recap: Lucy Letby trial, Wednesday, January 18

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]

2:08pm

The sequence of events continues, with clinical/routine records relayed to the court on September 25. A blood transfusion for Child H is begun at 11.05pm.
A desaturation for Child H is recorded at 11.30pm, with Letby writing the note up retrospectively at 4.14am the following day.
Observations are being taken more regularly due to the blood transfusion, the court hears.

Recap: Lucy Letby trial, Wednesday, January 18

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

 

[Tortoise]

If she had deliberately injected air knowing it would be difficult to measure and or ascertain it’s presence as normal why would she record in the notes the results of her own attempt to harm the baby? I would sooner think she would not record it. Isn’t that more fitting with someone trying to hide the harm they have caused?

Just to add, it would be interesting to do an in-depth dive into this issue of her note-making across all the cases, at some point. Trying to work out how intelligent she is, etc.

JMO

 

[Tortoise]

https://twitter.com/MrDanDonoghue

The following morning, the mother recalled that nursing staff woke her up and told her to come to the neonatal unit "right away" and inform the father to come too. When she arrived, Child H was being treated with "lots of medical" people surrounding her.

"It was obvious to me they were resuscitating her", the mother's statement said. "Staff managed to get (Child H) back and continued working on her, they were not able to explain why she suffered a cardiac collapse".

The court was told Child H made a good recovery, but later that day her parents were again roused and were told she was "not responding". The parents were met with an "almost identical scene" as Child H was being worked on by medical staff.

Following this second incident, Child H was transferred to Arrowe Park Hospital on 27 September where she "improved dramatically" and was eventually discharged on 9 October.

Text messages sent by Ms Letby in the days after Child G's collapse to a colleague noted how busy the unit was. She said: "It's completely unsafe"

Here's a wrap up of this morning's evidence, for the rest of the afternoon police intelligence analyst Kate Tyndall will be taking the court through hundreds of slides of sequencing evidence (basically a timeline of events)

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

 

[Tortoise]

From opening speech:

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

Letby was on duty for both those night shifts, and was the designated nurse for Child H.
That night [my note Sep 26th] , Child H was given a blood transfusion.
At 2.15am, medical notes by a doctor showed a re-accumulation of her left-sided pneumothorax. A further chest drain was inserted to relieve the pressure.
The ICU chart shows that Letby recorded having given Child H a dose of morphine at 1.25am and a dose of saline at 2.50am. The saline bolus was set to run for 20 minutes and would therefore have ended at 3.10am. Lucy Letby would have had the cover of legitimacy for accessing Child H's lines just before she collapsed again.
At 3.22am, Child H collapsed and required CPR. The attending doctor said the cause was unclear. He concluded the episode was 'hypoxia' (shortage of oxygen).

Letby made notes at 4.14am, recording a lowering of the heart rate at 11.30pm which required treatment.
She recorded the additional chest drain and a blood transfusion at 2am.
Of the collapse at 3.22am, she recorded: "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"
At 5.21am, Letby recorded a conversation between herself, the attending doctor, and Child H's parents.

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

 

[Dotta]

https://twitter.com/MrDanDonoghue

The following morning, the mother recalled that nursing staff woke her up and told her to come to the neonatal unit "right away" and inform the father to come too. When she arrived, Child H was being treated with "lots of medical" people surrounding her.

"It was obvious to me they were resuscitating her", the mother's statement said. "Staff managed to get (Child H) back and continued working on her, they were not able to explain why she suffered a cardiac collapse".

The court was told Child H made a good recovery, but later that day her parents were again roused and were told she was "not responding". The parents were met with an "almost identical scene" as Child H was being worked on by medical staff.

Following this second incident, Child H was transferred to Arrowe Park Hospital on 27 September where she "improved dramatically" and was eventually discharged on 9 October.

Text messages sent by Ms Letby in the days after Child G's collapse to a colleague noted how busy the unit was. She said: "It's completely unsafe"

Here's a wrap up of this morning's evidence, for the rest of the afternoon police intelligence analyst Kate Tyndall will be taking the court through hundreds of slides of sequencing evidence (basically a timeline of events)

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

This Arrowe Park Hospital seems excellent.
Weren't they surprised that babies from CC were in such a sad state on arrival but recuperated quickly in their hospital?
I wonder how many babies were sent to Arrowe Park?

 

[LadyEdgeworth]

2:19pm

A morphine bolus is administered to Child H at 1.30am on September 26, and the blood transfusion is recorded by Letby as being completed at 2am.
However, a separate, handwritten paper record shows the blood transfusion having been completed at 3.05am. This separate record is not signed by anyone.
Letby records 'poor blood gas and 100% oxygen requirement' and a third chest drain was inserted around this time, the court hears.
Dr John Gibbs records this as being about 2.15am, as the chest x-ray showed a re-accumulation of Child H's left-sided pneumothorax (ie a collapsed lung). A further, third chest drain was inserted to relieve the pressure.

2:24pm

At 3.22am, Child H suffered a 'profound desaturation and colour loss to 30%'.
Letby records: 'Good chest movement and air entry, colur change on CO2 detector. Neopuff commenced in 100% oxygen and help requested.'
An intensive care chart for Child H on September 26 records 'blood complete 0324 - RESUS'. The record is initialled by Lucy Letby.
Dr Alison Ventress confirms in a clinical record she was crash called at 3.24am as Child H "had desat requiring bagging...Sats 60s then heart rate down to less than 100 so nurses crash called, wasn't being handled at all, no trigger identified.'
Upon her arrival, Child H was 'being bagged via ETT, good chest movement, capnograph positive, sats 60%, heart rate 70 down to 50'.
A test for a collapsed lung was carried out and air was removed.

2:31pm

Dr John Gibbs, consultant paediatrician, records he was called from home at 3.30am and arrived at the neonatal unit at 3.36am. He saw 'CPR in progress', and Child H had no pulse when chest compressions stopped.
The sequence of events details the series of medications administered to Child H.
Lucy Letby's note records, for 3.46am, 'x3 doses adrenaline and x1 dose atropine given...chest compressions stopped at 0346, heart rate 180, saturations >90, placed back on to a ventilator, 30% oxygen'.

Recap: Lucy Letby trial, Wednesday, January 18

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

 

[Tortoise]

Another reporter

https://twitter.com/JudithMoritz

The prosecution team have now moved on to the case of the next baby - known as baby H. Lucy Letby is accused of attempting to murder the baby girl on two occasions in September 2015.

Jury told that baby H was born prematurely at 34 weeks gestation. Initially had no issues, but was struggling to breathe, and taken to the @TheCountessNHS neonatal unit.

Court hears that there were two occasions on consecutive nights (26 & 27 Sept 2015) when baby H suffered a cardiac collapse, and that her parents were called suddenly to the unit both times, to find staff resuscitating her.

Jury hears statements read on behalf of baby H's parents. Her mum describes dashing to her daughter after the 1st collapse. Says staff "were actually running along the corridors. We took a short cut to the unit. I was trying to ask questions but they just said I had to come now".

After the two collapses, baby H was transferred to a different hospital (Arrowe Park, Wirral). She was only there for 2 days, and made a quick recovery. Jury told "She improved dramatically as soon as she got there.. She was off the ventilator...Was like a totally different baby"

Baby H's dad says that at @TheCountessNHS "they seemed to be happy to make slow progress, in Arrowe Park they were more proactive, it was a completely different set up".

Baby H returned to the neonatal unit at Chester two days later, once she'd recovered at Arrowe Park. She was discharged aged 18 days, and the jury is told that she has been fine and healthy ever since.

 

[Dotta]

Another reporter

https://twitter.com/JudithMoritz

The prosecution team have now moved on to the case of the next baby - known as baby H. Lucy Letby is accused of attempting to murder the baby girl on two occasions in September 2015.

Jury told that baby H was born prematurely at 34 weeks gestation. Initially had no issues, but was struggling to breathe, and taken to the @TheCountessNHS neonatal unit.

Court hears that there were two occasions on consecutive nights (26 & 27 Sept 2015) when baby H suffered a cardiac collapse, and that her parents were called suddenly to the unit both times, to find staff resuscitating her.

Jury hears statements read on behalf of baby H's parents. Her mum describes dashing to her daughter after the 1st collapse. Says staff "were actually running along the corridors. We took a short cut to the unit. I was trying to ask questions but they just said I had to come now".

After the two collapses, baby H was transferred to a different hospital (Arrowe Park, Wirral). She was only there for 2 days, and made a quick recovery. Jury told "She improved dramatically as soon as she got there.. She was off the ventilator...Was like a totally different baby"

Baby H's dad says that at @TheCountessNHS "they seemed to be happy to make slow progress, in Arrowe Park they were more proactive, it was a completely different set up".

Baby H returned to the neonatal unit at Chester two days later, once she'd recovered at Arrowe Park. She was discharged aged 18 days, and the jury is told that she has been fine and healthy ever since.

"Fine and healthy ever since"

 

[LadyEdgeworth]

2:34pm

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'.

2:37pm

Letby records a Child H family communication at 4.28am: 'Parents visiting at start of shift. Updated on condition and advised to try and rest overnight. Midwife contacted during resus to [help take mum to the unit].'
A follow-up note said parents were concerned about the possibility of brain damage, and Child H remained poorly and could relapse. Dr John Gibbs offered a blessing to be administered and the parents accepted the offer.
Child H was then blessed with parents and family members present.

2:39pm

Letby recorded 'good blood gas at 0700 - ventilation reduced to 22/4, and rate reduced...in 26% oxygen. [Child H] appears settled...noted to have white blanching on left wrist'.

Recap: Lucy Letby trial, Wednesday, January 18

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

 

[Tortoise]

https://twitter.com/MrDanDonoghue

Court now being shown medical notes from Child H's first collapse on the morning of 26 September 2015. Notes show she suffered a 'profound desaturation and colour loss to 30%'. Child H required resuscitation and adrenaline was given to her at around 3:30am

Notes recorded at the time state 'no trigger identified' for the collapse

Court now being shown text messages sent on the morning after Child H's first collapse. Yvonne Griffiths, who was the Countess of Chester Hospital neonatal unit deputy manager, praises Ms Letby for 'all your hard work these last few nights'

She said to Ms Letby that is is 'nice to see your confidence grow as you advance through your career' Ms Letby thanked her and said 'I just hope I do the best for baby and family'

 

[LadyEdgeworth]

2:54pm

A series of messages recovered from Letby's phone, of messages sent to and from her phone at around 9am on September 26, are shown to the court. They include Letby's colleague Yvonne Griffiths commending Letby for "all your hard work these last few nights". She says Letby "composed" herself "very well during a stressful situation" and it was "nice to see" her "confidence grow" as she advanced throughout her career.
Letby shows this message to a colleague and asks her how she should reply. Her colleague expresses surprise. A series of messages are exchanged between Letby and the colleague acknowledging there had previously been "bitchiness" among staff and there had been "comments" about Letby regarding her role which Letby had found "upsetting".

2:56pm

Medical notes record Child H's parents were present as treatment continued for the baby girl, with further medication administered during the day of September 26.

Recap: Lucy Letby trial, Wednesday, January 18

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]

Would love to know that those "comments" regarding her role were..

 

[Tortoise]

BBC reporter decides we don't need to know about the discussions over the text.

 

[mart321]

This Arrowe Park Hospital seems excellent.
Weren't they surprised that babies from CC were in such a sad state on arrival but recuperated quickly in their hospital?
I wonder how many babies were sent to Arrowe Park?

Arrowe park is a higher level unit, I would expect it to have a different set-up. They deal with more high dependency babies.

 

[Tortoise]

Would love to know that those "comments" regarding her role were..

I think the weekly Mail Podcast is usually quite good for text information. They usually have two people reading the back and forth texts.

 

[Sweeper2000]

Just to add, it would be interesting to do an in-depth dive into this issue of her note-making across all the cases, at some point. Trying to work out how intelligent she is, etc.

JMO

agreed, I’m not currently expecting particularly high intelligence from LL atm at least not in the way that would allow her to meticulously see potential problems further down the line. Just judging from scant knowledge atm I would say the post it note offered as evidence by the prosecution is evidence of her being at least slightly lacking awareness for want of better words. I’m also looking at this mistake about babies gulping air when vomiting, it sounds like the kind of thing you read on the web and there is a huge amount of false or inaccurate information on the web. I Think the post it note really was a stupid thing to write either way but especially if she is guilty as charged. Stupid thing to write when she knew she was under suspicion and even more stupid to keep it around rather than dispose of, the same as the other medical documents found by the police. I kind of think it’s presence is more indicative of someone who was just distraught and in turmoil and perhaps prone to making mistakes as any normal person would be in that situation. Nothing quite like pressure and feeling to make a person slip up.

might be difficult to get a proper gauge of her smarts though, if she was the designated nurse for only three of the babies in the cases we might not be able to get much depth on her. Lady edgeworth would probably have that capacity having peer reviewed studies before. I think LL police interviews and personal texts would give a greater insight As well.

JMO