I don't think the reporting towards the end of trial really painted a coherent picture of the end of her time on the unit, in the press. It is my personal opinion that the media struggled with not having attended consistently.
I've pieced together from different reports some of the evidence of Letby's 'record-keeping' in her final week as a nurse on the NNU.
23rd June 2016 - date of baby O's murder. She was accused of pumping his stomach with air, crushing his liver, and later injecting air into his IV line:
Letby is accused of falsifying a medical note, saying Child O was on CPAP when he was not.
"The level of gas in the bowel is more than would have been expected in a normal baby," one doctor's note said.
"Why did you write CPAP in the gas chart?" Mr Johnson asks.
"I can't answer that now," Letby says.
NJ KC: "You were covering for air you’d given him weren’t you?"
Lucy Letby: "No"
Mr Johnson says Letby made a false reading for Child O at 1.20pm on the blood gas chart. "Even by the standards of misrecording information, this is right up there."
He says the note Child O was put on to CPAP from Optiflow was "a lie", and it had been spotted by Dr Sandie Bohin.
Mr Johnson says someone looking at the paperwork, retrospectively, might conclude this note could form an innocent explanation as to why Child O had died.
--
A Datix form is shown to the court, recorded by Letby, which Mr Johnson says was inaccurate in the 'peripheral access lost' note. Dr Brearey said "it's not correct".
Mr Johnson says "it's a lie".
He says Letby is trying to invent evidence that peripheral access was lost. If it was, Mr Johnson say, then air could not be injected into the infant. He says if that note was accepted, it would support her case that this was not air embolus.
The form adds: 'SB [Dr Brearey] wishes amendment to incident form - Patient did not lose peripheral access, intraosseous access required for blood samples only.'
Letby says she does not believe her Datix report was untrue at the time.
NJ: "You were very worried that they were on to you, weren't you?"
LL: "No."
--
26th June 2016 - Letby has meltdown after being asked not to come in the next day
Asked about the timing of the call, she said she was worried about receiving the call "so late in the day" [after 5pm] in advance of working a night shift.
She agrees she was worried it was something serious.
Letby had messaged a doctor about it: "I can't talk about this now."
She writes, 12 minutes later: "Sorry, that was rude.
Felt completely overwhelmed & panicked for a minute.
"We all worked tirelessly & did everything possible, i don't see how anyone can question that.
"Im having a meltdown++ but think that's what I need to do"
--
30th June 2016 - Letby's last ever shift:
A Datix form for the clinical incident is shown to the court - June 30, 2016, 3pm, with the port on one of the lumens noted to not have a bung on the end and was therefore 'open'. Registrar informed. Letby is the reporter of the incident.
Letby submitted a clinical incident report stating that on June 30, 2016 she noticed a bung had been left off the port of an intravenous line, which could accidentally let air in.
In his closing speech ... Nick Johnson KC said: “It is Lucy Letby, we say, getting her defence in first. She knew the net was closing. ... “Text messages showed she knew there was going to be an investigation.
“She put in a form that contained a lie and the purpose of putting this in is to create the impression that air embolism could have arisen on the unit as a result of poor practice. ... “It is a calculated attempt by a devious woman to deflect suspicion.”
Mr Johnson told jurors they could be sure the report timed at 3pm was false because Letby would have started her shift at 8am and any nurse doing their job properly would not take that long to spot the issue.
When giving evidence, Letby denied the prosecutor’s claim the report was effectively an “insurance policy to cover yourself for accidental air embolism”.
Letby texted a colleague -
"Yes because Thought it's a massive infection risk and risk of air embolism, don't know how long it had been like that."
(All links in media thread.)
I've pieced together from different reports some of the evidence of Letby's 'record-keeping' in her final week as a nurse on the NNU.
23rd June 2016 - date of baby O's murder. She was accused of pumping his stomach with air, crushing his liver, and later injecting air into his IV line:
Letby is accused of falsifying a medical note, saying Child O was on CPAP when he was not.
"The level of gas in the bowel is more than would have been expected in a normal baby," one doctor's note said.
"Why did you write CPAP in the gas chart?" Mr Johnson asks.
"I can't answer that now," Letby says.
NJ KC: "You were covering for air you’d given him weren’t you?"
Lucy Letby: "No"
Mr Johnson says Letby made a false reading for Child O at 1.20pm on the blood gas chart. "Even by the standards of misrecording information, this is right up there."
He says the note Child O was put on to CPAP from Optiflow was "a lie", and it had been spotted by Dr Sandie Bohin.
Mr Johnson says someone looking at the paperwork, retrospectively, might conclude this note could form an innocent explanation as to why Child O had died.
--
A Datix form is shown to the court, recorded by Letby, which Mr Johnson says was inaccurate in the 'peripheral access lost' note. Dr Brearey said "it's not correct".
Mr Johnson says "it's a lie".
He says Letby is trying to invent evidence that peripheral access was lost. If it was, Mr Johnson say, then air could not be injected into the infant. He says if that note was accepted, it would support her case that this was not air embolus.
The form adds: 'SB [Dr Brearey] wishes amendment to incident form - Patient did not lose peripheral access, intraosseous access required for blood samples only.'
Letby says she does not believe her Datix report was untrue at the time.
NJ: "You were very worried that they were on to you, weren't you?"
LL: "No."
--
26th June 2016 - Letby has meltdown after being asked not to come in the next day
Asked about the timing of the call, she said she was worried about receiving the call "so late in the day" [after 5pm] in advance of working a night shift.
She agrees she was worried it was something serious.
Letby had messaged a doctor about it: "I can't talk about this now."
She writes, 12 minutes later: "Sorry, that was rude.
Felt completely overwhelmed & panicked for a minute.
"We all worked tirelessly & did everything possible, i don't see how anyone can question that.
"Im having a meltdown++ but think that's what I need to do"
--
30th June 2016 - Letby's last ever shift:
A Datix form for the clinical incident is shown to the court - June 30, 2016, 3pm, with the port on one of the lumens noted to not have a bung on the end and was therefore 'open'. Registrar informed. Letby is the reporter of the incident.
Letby submitted a clinical incident report stating that on June 30, 2016 she noticed a bung had been left off the port of an intravenous line, which could accidentally let air in.
In his closing speech ... Nick Johnson KC said: “It is Lucy Letby, we say, getting her defence in first. She knew the net was closing. ... “Text messages showed she knew there was going to be an investigation.
“She put in a form that contained a lie and the purpose of putting this in is to create the impression that air embolism could have arisen on the unit as a result of poor practice. ... “It is a calculated attempt by a devious woman to deflect suspicion.”
Mr Johnson told jurors they could be sure the report timed at 3pm was false because Letby would have started her shift at 8am and any nurse doing their job properly would not take that long to spot the issue.
When giving evidence, Letby denied the prosecutor’s claim the report was effectively an “insurance policy to cover yourself for accidental air embolism”.
Letby texted a colleague -
"Yes because Thought it's a massive infection risk and risk of air embolism, don't know how long it had been like that."
(All links in media thread.)
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