To get an accurate timeline you need to separate the bleeding, the feeding, the phone calls and the doctor arriving. There isn’t one statement that covers it all, they were all discussed at different points in the inquiry drilling into statements made in court. I initially posted about it due to the varying timelines that kept changing between articles about the trail and what the mum said at the inquiry- my point at the time being that the news articles from the trial aren’t accurate reflections of information as dependent on which paper you read they varied.
I did a detailed timeline during the trial, based on all the reports and testimony. None of those timings have changed.
Child E Timeline - Part 2 (from start of night shift of 3rd August 2015 to 11.30pm - links at end)
7.30pm to 8pm night shift – LL is designated nurse for twins E & F in room 1. Nurse Caroline Oakley was the shift-leader. There were 3 babies in room 2, one baby in room 3, and four babies in room 4. There is also a baby in the transitional care unit.
8pm - LL’s nursing note (written retrospectively at
4.51am): "
Mummy was present at start of shift attending to cares." Defence suggests to the mother that she went down to the neonatal unit at 8pm, at the time of the handover. The mother disagrees.
8.30-9pm – Dr Harkness “Dr H” (registrar) started his shift. The handover period lasts about 30 mins.
Just before 9pm – (Unrecorded) Bleeding. E had blood around his mouth and was “screaming” (mother’s evidence).
Mother’s testimony;
Mother took her expressed breast milk down to the neonatal unit, room 1;
Mother heard E “screaming more than crying” from the corridor before she entered the room;
LL was the only other adult in room 1;
LL was not near E’s incubator, she was standing between the two incubators busy at a work station;
There was blood on E’s face around his chin, above his lip and partly on his neck;
Mother was there for about 10 minutes and she tried to calm him by placing one hand on his head and the other on his stomach;
Mother asked LL why he was bleeding;
LL told Mother the NGT was rubbing the back of E’s throat;
LL told Mother to go back to her ward, the registrar was on his way and if there was a problem someone would ring up to the ward.
Mother went back to the ward.
LL did not record bleeding in the notes or report bleeding to doctors. Mother agrees with defence that no other staff came into the room when E was screaming. Defence says mother didn’t come down at 9pm, she came down at 10pm with the milk; Mother disagrees. Defence says the screaming was not as bad as the mother describes; Mother disagrees.
Prior to 9pm – LL records a discarded 16ml mucky slightly bile-stained aspirate -
LL's nursing note written retrospectively at 4.51am: "
prior to 21:00 feed, 16ml mucky slightly bile-stained aspirate obtained and discarded, abdo soft, not distended. SHO informed, to omit feed." (electronic evidence).
In police interview LL said she and another member of staff had disposed of the aspirate. (opening speech).
The SHO, Dr W, testified he had no recollection of receiving a report (a telephone call) of a bile-stained aspiration on the neonatal unit. He testified he would have recorded it in his notes and would have sought advice from the registrar (Dr Harkness). He testified he was in the paediatric unit and attended the neonatal unit (for the first time that night) at 11.40pm when a crash call was put out for E. He testified he was the only SHO covering paediatrics and neonatal unit that night, and Dr Harkness was the only registrar also covering those units that night.
9pm –
E’s milk feed due. Feeding chart: For the 9pm milk feed LL recorded
'omitted' and
‘discarded’ is recorded in a non-specific line. For aspirates the note
‘16ml mucky’ is made. (electronic evidence)
LL made no record of the mother visiting at 9pm with the milk, or of the bleed the mother has testified to.
After 9pm – In police interview LL said it was after 9pm that the SHO had reviewed E, but she couldn’t remember if it was face-to-face or over the phone. She said she had no independent memory of the conversation. (opening speech)
9.11pm to 9.15pm –
E’s mother phoned Father in a call lasting 4 mins 25 secs. She says she knew there was something very wrong. Father confirms that the mother was upset and very worried about bleeding from E’s mouth in this call. He said (at the time) he was sure the medical staff knew what they were doing and she was panicking over nothing.
9.11pm to 10.52pm – mother was waiting to hear about E, panicking and talking to the midwife. Mother had not seen this midwife before. She confirms the first name of the midwife was Susan. She was later told by a midwife to call her husband.
9.13pm – LL made a note in twin F’s records. (opening statement)
9.40pm –
Sudden large vomit of fresh blood and 14ml aspirate.
Registrar Dr David Harkness attended at LL’s request re. a ‘gastric bleed’. LL told him there had also been a large, very slightly bile-stained aspirate at approx. 9.10pm.
Dr H attended and wrote clinical note for 9.40pm at 10.10pm: “
asked to see patient re: gastric bleed. Large, very slightly bile-stained aspirate 30 mins ago. Sudden large vomit of fresh blood and 14ml aspirate”. E was: “alert, pink, well perfused”, with an abdomen which was “soft, not distended” and no bowel sounds. The note adds “G I bleed? Cause”. (electronic evidence) See 10pm for Dr H’s testimony.
10pm – (see 9.40pm, for Dr H’s clinical note of the examination that finished around 10pm)
Dr H testimony - he was called to E (bleeped by LL) ‘at around 10pm’ because he had blood in his vomit. He recalls ‘small amounts of blood’, miniscule blood flecks were spotted when the NG tube was brought out of E. Dr H testifies it isn’t clear from his note how much of the 14ml aspirate contained fresh blood. He testifies the fresh blood was what he witnessed, having been called over to see it. He did not see E vomit, but saw the fresh blood as a product of it. He noted E's blood pressure was 'very good', a CRT reading was good, the heart rate was 'normal' and saturation rates were good, with minimal oxygen support. He testifies ‘at that point in time, everything is fine, except for the blood in the aspirate’. E was 'pink, well perfused', the lungs were 'clear', the abdomen was 'soft, not distended'. Dr H notes: 'GI bleed ? Cause', and tells the court that is a possible diagnosis for the bleeding, and
a plan of action with administration of antibiotics is made. The note “close observation” is made, emphasising the designated nurse - LL - was to monitor E closely in room 1. Dr H says, from his recollection, he does not believe he left the unit as the bleed was 'something unusual' so he does not believe he went very far. Defence asks about the sequence of events, referring to a police statement Dr H made - "I was asked to review [E] by Letby. 'Looking at the notes it was 10pm-10.30pm...I only came on at 9pm'. He described, in the statement, the aspirate was largely mucusy. He said he could not be sure if there was a fleck of blood around E's face. '
[E] looked relatively settled and there was nothing to suggest that was going to change'.
10pm - LL’s nursing notes: "
At 10pm large vomit of fresh blood. 14ml fresh blood aspirate obtained from NG tube. Reg Harkness attended. Blood gas satisfactory..." Child E was 'handling well'. (electronic evidence)
10pm – LL made a further nursing note at 4.51am saying E’s mother had visited the neonatal unit at 10pm.
LL’s further note: “
[Mother] visited again approx. 22:00. Aware that we had obtained blood from his NG tube and were starting some different medications to treat this. She was updated by Reg Harkness and contained [E]. Informed her that we would contact her if any changes. Once [E] began to deteriorate midwifery staff were contacted. Both parents present during resus.” (note shown during opening speech and first part reported in electronic evidence).
In police interview LL said she could remember the mother leaving after the ‘10pm visit’. (opening speech).
Mother’s testimony - Defence puts to the mother that she went to the neonatal unit with her breast milk; the mother “absolutely” disagrees. Defence suggests LL never mentioned the feeding tube irritating E; mother disagrees. Defence asks if there was a conversation between LL, a doctor, and her, regarding medication; Mother disagrees and says she was told (at 9pm visit) a doctor would be down to see [E].
Registrar Dr H is asked about LL’s [later] nursing note. Dr H testified he does not know what 'contained' meant in the context. He says he does not remember if the mother was present at that time. Defence says a 'containment technique' was a technique used to calm a baby. Defence says “all of what had happened in the 10.10pm note, had happened by 10.10pm.” Dr H testified this was a 40-minute period of several year ago, this was potentially a period of 9.30-10.10pm. In his police statement, Dr H said he would have been 'bleeped' by LL. He said he had seen 'a dirty aspirate which may have contained blood flecks and bile'. Defence says his police statement said “[E] had 'nothing dramatic' around the baby's face, and could not be sure if there were any blood flecks. [E] was 'not in distress' and 'appeared fine'.” Dr H says he does not know if he saw [E]'s mother, and does not have a clear recollection. He says it could be the case, looking at the notes provided. Defence asks if Dr H had 'any particular concerns' from the first reading. Dr H says there wasn't. Prosecution then ask about the timing of Dr H 'meeting the mother of Child E'. Dr H said that would have been the case, based on the nursing note. The prosecution ask if that was from looking at LL’s note. Dr H agrees. The prosecution say
Dr H's clinical note does not refer to meeting the family. Dr H said it could be documented, but would depend on the level of detail of the discussion.
Bef.10.52pm – neonatal unit contacted the midwife and told of E’s deterioration.
10.52pm – Mother’s phone called the father’s phone. (electronic evidence) Mother doesn’t remember details of the call. Midwife spoke to the father telling him to come to the hospital, after the neonatal unit rang the ward. Defence suggests this is the call where mother told the father about [E] bleeding, and the mother was not as worried at the 9.11pm call as she was at 10.52pm; Mother disagrees with all of that. Father says this call was split between the midwife and the mother and he was told not to panic but to get over here now. He testifies bleeding was not referred to in this call.
By 11pm – LL called registrar back to see E - 13ml blood from NGT on free-drainage, E crying and beginning to decline.
A neonatal fluid balance chart has no name or notes for the 11pm column. LL’s retrospective nursing notes said: '
NG tube on free drainage. Further 13mls blood obtained by 11pm. Beginning to desaturate and perfusion poor. Oxygen given via Neopuff'. E was said by LL to be 'cold to the touch' and was beginning to 'decline'. (electronic evidence)
11pm – Registrar Dr H noted: '
13ml blood-stained fluid from NGT on free drainage.' E's blood pressure was 'stable' and saturates' remained 60-70%', and 'making good respiratory effort', and was 'crying'.
A plan of action, including x-rays and medication, was made. (electronic evidence).
Consultant’s testimony – she was on call in hospital accommodation and had phone contact with the registrar. “This [sats 60-70% despite being on 100% oxygen] suggests something dramatic has changed in his clinical condition. It suggests there’s not a problem with his breathing effort that is making his oxygen saturation low.” [she would arrive at the unit at 12.25am].
Dr H’s testimony -
LL called him into room 1, where 'Further ‘GI’ blood loss and desaturation to 70%' is noted. A '13ml blood-stained fluid from NGT on free drainage' is noted. He says he remembers seeing 'fresh, red blood in the tube', with the contents of the stomach. He says the free drainage setup would have allowed the vomit to come out rather than go into the baby's lungs. He testifies the origin of the blood must have come from somewhere in the oesophageal tract, down to the stomach. It rules out blood coming from the lungs. The saturates 'remained 60-70% in 100% O2', Dr H said 'because of E's condition', the oxygen requirement had gone up from 'minimal support'. He says E was still trying to breathe at this time. The comment 'crying' is added in the note. Dr H testified E is still well enough to be awake and conscious to cry. He said just the note 'crying' would suggest it was a 'typical cry'. Dr H says the fact E was crying would mean he would have had to have been taking deep breaths to do so.
The plan of action was 'replace losses' - getting fluid back in. 'Strict fluid balance'. Dr H says he is planning to intubate E and do an x-ray to check Child E's lungs and abdomen to try and explain why the baby was deteriorating. The type of intubation was 'elective', which was not on the level of 'an emergency situation', Dr H testified. Dr H testified he planned to discuss the result of the x-ray with surgeons at Alder Hey and seek advice from them. Dr H testified he would then have been preparing to intubate and get the equipment ready. X-exam – His police statement says: “However, around half an hour to an hour later [after the 10pm examination] there was a large amount of fluid which came up the tube. From memory it was 12-14ml of blood which for a baby was a substantial amount'. Dr H says ‘[E] brought up further 'fresh blood' in quantities which he had 'not seen [in sudden cases] since'. Dr H agrees the second note, with blood vomit, was 'more concerning' and suggested a gastrointestinal bleed. Defence asks if such a bleed was serious; Dr H: "Potentially". Defence suggests that a GI bleed should have led to a blood transfusion. Dr H says if there were other observations which collated that, he would have done so, but at this point, he would not have done so, as the blood vomit could have had other causes. He said a blood transfusion 'may have come up in a conversation' with a fellow doctor. Defence asks why that wasn't documented. Dr H says he cannot answer that. The '13ml blood-stained fluid' is a 'significant quantity' Dr H confirms. Defence said this follows other blood which came out earlier, and a typical baby would have had something 'in the region of 120ml' in him at that time. Dr H agrees. Defence said there had been 27mls of blood and aspirate taken from him in that time, which was 'up to a quarter' of E's blood; Dr H agrees. Defence says the heart rate is 'normal', but the saturation rate is 'low', the heart rate 'should be higher'; Dr H says "Not necessarily - there are multiple factors to that. It's part of a separate conversation with expert witnesses, it is not as simple as saying one reading should go up in line with others.” He says blood pressure was normal, and there were other factors to consider. Defence says the pairing of heart rate and saturations is 'not normal'. Dr H says it is abnormal in the sense that the heart rate is normal and the saturations rate is abnormal.
SHO Dr W is questioned by the defence about a clinical note: ‘plan - discuss with surgeons, with x-rays’ – he is asked if he was aware surgeons at the CoCH were capable of performing gastric surgery on a neonate the size of [E]. SHO says he is not aware of that, and most likely this would be done at Alder Hey Hospital.
c.11.10pm to 11.40pm – preparations were made for the elective intubation
11.28pm-11.30pm – Dr H testifies prescriptions were made from 11.28pm-11.30pm for a number of drugs for E.
11.30pm - observation chart has blood pressure and respiratory rate recorded, no record of heart rate made, and blank readings for cot temperature, and no initials recorded.
Midwife Susan Brookes says she had a call from the neonatal unit to ask the mother to go down in 30 minutes as E had a bleed and required intubating, “very poorly”. The mother was upset and asked to go sooner. (midwife’s testimony)
Child E Timeline - Part 3 (from 11.40pm 3rd August 2015 to end of night shift 4th August 2015 - links at end)
11.40pm –
Baby E’s 1st collapse (of 3) - with purple-blue blotching over abdomen.
11.40pm - LL retrospective nursing notes: "
11.40pm became Bradycardiac, purple band of discolouration over abdomen, perfusion poor, CRT 3secs. "Emergency intubation successful and placed on ventilator." LL’s further notes at 4.51am: 'Required 100% oxygen, saturations 80%, SIMV 22/5 rate 60. Further saline bolus and morphine bolus given. 2nd peripheral line sited. Once [E] began to deteriorate, midwifery staff were contacted." (electronic evidence). Although LL was participating in the resuscitation, she co-signed for medication given to a baby in room 4. (opening speech)
11.40pm - Dr H’s clinical notes, written retrospectively: '
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)
11.40pm - Dr H testifies that
prior to 11.40pm, E was still to be 'under close observation' by LL. Dr H testifies he was in the room when the 'sudden deterioration' happened, and was there with LL and another nurse. Those nurses “would have been gathering the drugs to be administered”. Dr H testified: "This was a strange pattern over the tummy and abdomen, which didn't fit with the poor perfusion - the rest was still pink, but there were these strange purple patches." “Some of the patches were still pink, but others were purple-blue, and were unusual. Dr H likens the purple-blue colour to “what you would see after going for a swim in cold water and coming out, with 'purple-blue' colour on the lips.” “The rest of the skin was 'normal colour'. The abdomen had 'purple patches', which didn't fit with an anatomical part of the body, it is difficult to describe in any detail, without a photo.” Dr H testified he has seen this in Child A before and had not seen it on any other baby, outside of the babies in the case. “The patches were 'different sizes' and in the region of 1-2cm big - 'not dots'. The areas were 'on the abdomen - not above the chest or below the groin - in the middle section'. The patches 'did not fit with the perfusion' seen. If the abdomen was dusky or white, then the whole of the body would gradually take that colour too. In the case of an affected blood supply, the blood would be lost from the legs first and the body would pull the blood 'into the middle of the body'”. X-exam - A nursing colleague had referred to 'discoloured abdomen' in a retrospectively written note at 1.30am. Defence says Dr H had referred to the discolouration being 'strange' and 'unusual', and 'appearing and disappearing' - that does not appear in the medical note. Dr H says that observation had "stayed with him" and the clinical note he made at the time was not 'forensic'. Defence reads out part of Dr H's police statement, referring to the discolouration being on the abdomen. Dr H says he does not recall the part of the statement of the discolourations' 'path to the body', and said he would not agree with the wording of that. Dr H testified he has not been in discussions with anyone in relation to these observations. Defence says by October 2018 (the time of his police statement), there had been discussions in the hospital about the skin discolourations. Dr H testified there were discussions to say it was unusual, but refutes any of the details of the discolourations had been discussed. Defence says Dr H is 'putting details together' from various observations. Dr H: "No." Defence says
Child A's skin discolouration, as referred to by Dr H in court earlier in the trial, were not mentioned in the clinical note at the time, or the note to the coroner [for Child A]. Defence says 'red patches' found on Child A were not mentioned for Child E. Dr H testified the overall discolouration observations were 'similar enough'. Prosecution re-direct - Dr H's interview with police Sept 2018 is relayed to the court. Dr H is asked about the skin discolouration, and says it is 'similar [between Child A and Child E]' and is not a rash. The interview transcript says E's discolouration was 'around the abdomen and chest', with 'purple patches' that 'suddenly come on'. "It came so quickly - not affected by the monitors or anything". "It was just these purple and pale patches". He was asked in the police interview if that was symptomatic of other cases, and Dr H said it was not.
11.40pm - Dr Wood SHO working in the paediatric unit immediately attended upon a crash call for E. He doesn’t recall being in the neonatal unit that night before 11.40pm. He signed a prescription for morphine for E. The accompanying medical note by Dr W says:
Sats 60-70%, morphine bolus – sats improved to 80%. He says resuscitation had already begun upon his arrival. He recorded notes. He recorded staff present – a team of 6 – including himself, Dr H, another doctor, and three senior nurses including LL.
11.45am – E was intubated as an emergency and put on a ventilator. Morphine administered – purple discolouration remained – bleeding settled
Dr H’s testimony - Dr H's notes record '
intubated as an emergency at 11.45pm'. He says although there were risks associated with this, the 'safer option' for E was to do things as an emergency.
An ET tube was inserted, with 'good air and chest movement' recorded, and the tube was recorded to be in the correct place. E was also 'put on ventilator', with 100% oxygen. The saturation readings were '60-70%', and after a morphine bolus was administered, those improved to 80%. The 'purple discolouration of abdomen remained', it is noted. E's blood pressure had dropped but was still in the normal range.
The plan was to administer further medication, but there was a concern that administering a drug to make the heart beat faster would lead to 'worse bleeding'. Dr H says 'from his recollection' the blood had settled and there was no further substantial amount of blood recorded. The court hears the preparations are made for the intubation during that half hour (prior). Dr H disagrees with the defence that it was a "delay" and was using his time "appropriately". "You make more mistakes when you are not taking your time." Defence says the blood transfusion is mentioned for the first time at a later note, after 11.40pm. Dr H says it would not have been appropriate to give more saline boluses without administrating fresh blood. He disagrees a blood transfusion was not considered earlier. He says his documentation is not as thorough as it would be now, and agrees in hindsight, it should have been documented more clearly. Defence says the intubation should have happened earlier. Dr H says there are benefits to an elective intubation compared to an emergency intubation, as the latter could cause stress and complications to the baby. He said that 'now' this would still have been the course to take in that situation.
Consultant’s testimony – she disagrees they were too slow to intubate E.
12 midnight - Mother (and father) with midwife returned to the neonatal unit and sat in the corridor while E was being worked on by medics. Midwife left after 10 minutes and mum was eventually allowed in once E had been stabilised.
4 Aug 2015, Tuesday
12.15am – LL’s notes:
heart rate 'down from where it had been earlier', and a drop in temperature, recording he was on 100% oxygen. (electronic evidence)
12.25am - Consultant paediatrician arrived at the neonatal unit. (electronic evidence) When she got there
E’s blood oxygen level was 80% in 100% oxygen. “they’ve improved since ventilation but they’re still not as good as we would like them to be”. (consultant’s testimony)
12.27am –
Chest and abdomen x-rayed - An x-ray is taken at 12.27am, relating to the chest and abdomen. (electronic evidence)
Consultant’s testimony –
x-ray showed E’s heart size was normal and his lungs were clear. “there’s no indication from the x-ray why E’s saturation was low” she says.
Dr H’ testimony – Defence asks why a consultation with surgeons was required following x-rays; Dr H says advice would have been taken from them once the extra results would have been acquired from the x-rays. Defence says he could have been dealing with a 'very serious situation indeed'; Dr H: "Potentially." Dr H says things were "changing" but E was still "stable". Defence: "Are you suggesting that a baby who has lost a quarter of its blood is not an emergency situation?"; Dr H: "What I'm suggesting is there are things to do and there is time to do it." Defence says transfusion was not being considered at this point, and one of the 'obvious things' to consider - "It is something you had failed to consider, isn't it?"; Dr H says it was likely considered, but accepts it was not documented at the 11pm note. Defence suggests it was a "serious mistake" not to consider blood transfusion; Dr H: "I disagree." Defence: "I would suggest you were out of your depth at this point"; Dr H: "I disagree, that is wrong and disrespectful to my ability." Defence says blood transfusion is not considered; Dr H: "we do have a plan, and we do have a discussion with a consultant."
Shortly after 12.30am – LL’s notes:
Shortly after 12.30am Child E was placed on breathing support and given medication after resuscitation. (electronic evidence)
12.36am –
Baby E’s 2nd collapse (of 3).
LL’s note: '
Resus commenced as documented'. (electronic evidence)
The consultant noted:
CPR commenced, along with ventilations, and medications. (electronic evidence)
Consultant’s testimony – her notes say E’s:
blood oxygen had fallen to 50-60% in 100% oxygen and he had no detectable heart rate. CPR was started. She was the team leader for the resuscitation efforts – she wouldn’t get involved in the physical tasks because “you lose awareness of the overall situation”. She says they did discuss blood transfusion but it’s not in the notes made. She agrees she should have gone to the unit sooner but doesn’t think she would have made any different decisions (from the doctors who were there).
Dr H testimony - Dr H said he and a colleague were stood at the end of the incubator, discussing what medication and plans were being put in place for E, when E collapsed. Dr H recalls the
resuscitation efforts began. Defence refers to E's collapse 'in front of the medical staff'. He says by this point, "there had still been no transfusion"; Dr H said there was no further evidence of bleeding after the second bleed. Defence: "The reaction to the second haemorrhage was far too slow wasn't it?"; Dr H disagrees.
12.37am – SHO Dr Wood recorded
efforts to resuscitate E from 12.37am. 5 doses of adrenaline were administered.
12.50am -
A blood transfusion is started for E at 12.50am, and several adrenaline doses are administered. (electronic evidence)
Dr H’s testimony - Defence says a blood transfusion, for O-negative blood, is noted at 12.50am on the medical notes. Dr H says the O-negative blood [a type which can be suitable for all blood transfusions] would be used in this instance as seeking a specifically matched blood type at this stage would take too long in acquiring it from the donor fridge.
Consultant testimony - says she does not think a late blood transfusion led to E’s collapse and death.
1.01am - LL's nursing note, for 1.01am, reads: '
chest compressions no longer required'. (electronic evidence)
The SHO recorded:
chest compressions stop at 1.01am, with ventilations continuing.
Dr H’s testimony:
[E]'s heart rate recovered at 1.01am, and the parents had arrived by that time.
1.15am –
Baby E’s 3rd and final (fatal) collapse –
LL notes: '
further decline, resus recommenced'. (electronic evidence)
SHO Dr W recorded:
E’s heart rate fell again and CPR recommenced.
Dr H’s testimony - He tells the court the blood supply was 'very poor'. He says during CPR, blood was coming out of Child E's nose and mouth, suggesting the blood pressure was low. He says the sight was "not very nice, particularly". Dr H is asked about the bleeding seen on E. He says: "I have never seen it in a baby, to this extent." He says he had seen the level of blood in a teenager, but not, relatively, in a baby as small as E. Defence says, in 'distressing detail' relayed by Dr H earlier in court, it had been discussed about blood coming from E's mouth and nose during CPR. Dr H said blood would 'keep coming out' until the cause of it is found. Defence says the cause of death would be 'acute blood loss'; Dr H said that cannot be known without a post-mortem examination. He says the blood loss could be a factor, but it is not 'black and white'. He said it was 'not his place' to call for a post-mortem examination. Defence says the blood loss seen would normally be 'fatal'; Dr H said it could be 'linked'. Defence asks if the actions taken were 'far too slow'; Dr H: "No." "Would you have admitted it if it was?"; "Yes."
Time? - Dr H’s testimony –
A pathology report for [E] is shown, with 'PT and APTT' readings. Those are two tests for blood clotting measurements. They were 'high, but not enough to be shocked by'. The readings were 19.5 and 53.6, compared to the normal ranges of '12.5-15' and '26-35' respectively.
1.23am - CPR was discontinued at 1.23am –
LL notes: '
resus discontinued when [E] was given to parents. [E] was actively bleeding.' (electronic evidence)
SHO Dr W notes:
CPR stopped and E was cleaned.
1.24am – SHO Dr W notes:
ventilation efforts stopped and E was given to his parents.
Shortly before 1.30am – LL’s notes:
resus was needed again, but was sadly unsuccessful (electronic evidence)
1.40am –
The time of death was recorded as 1.40am on August 4. No post-mortem was conducted.
Murder charge Child E – air (allegedly) injected into bloodstream and bleeding indicative of trauma.
Links:
Opening speech – Chester Standard
Recap: Prosecution opens trial of Lucy Letby accused of Countess of Chester Hospital baby murders
Opening speech – ITV
Who are the children alleged to have been murdered by Lucy Letby? | ITV News
Mother’s and father’s testimony –
Recap: Lucy Letby trial, Monday, November 14
Unnamed nurse’s testimony (day shift) –
Recap: Lucy Letby trial, Tuesday, November 15
Electronic evidence –
Recap: Lucy Letby trial, Monday, November 14
Dr Wood (SHO)’s testimony –
Recap: Lucy Letby trial, Tuesday, November 15
Dr Harkness’s testimony –
Recap: Lucy Letby trial, Thursday, November 17
Consultant’s testimony –
UK - Lucy Letby Trial - Media, Maps & Timeline *NO DISCUSSION*
Midwife’s witness statement -
Recap: Lucy Letby trial, Tuesday, November 15
Supplementary text details Daily Mail
Colleagues of Lucy Letby told her she was 'terrible run of bad luck'
