UK - Nurse Lucy Letby, murder of babies, 7 Guilty of murder verdicts; 8 Guilty of attempted murder; 2 Not Guilty of attempted; 5 hung re attempted #37

[Seni]

Surely a successful TV doctor should be able to dance to the tune of the media, or am I wrong? (Not negatively at all). Dr. Ravi was a famous TV doctor. TV is nothing but media.

His TV role has nothing to do with this case.

I wonder why you mention it.

Also as a follower of this case since the beginning, I would like to remind posters of the meticulous notes Tortoise has made throughout, which you can consult.

 

[katydid23]

Honestly, I don't know. I don't think that they knowingly accused innocent person, but I can't put it behind overworked and underslept doctors that one of them became unduly suspicious and the rest...shared the flawed thinking, so to say?

No, that is not what happened.

Those unexpected collapses, which were happening at a shocking rate, had some things in common. The babies were not responding to resuscitation techniques in the usual way.

Instead of one shot of adrenaline, which was almost always effective, the doctors were using 3, 4 and even 5 shots of adrenaline to try and revive the babies.


Now if the explanations of these 'natural' causes are as varied as these 25 world experts claim, WHY is it that the babies did not respond in the usual way as others have when having pnuemonia or a common infection?

The doctors became suspicious that there might be malicious cause because of the unusual pattern of the deaths and collapses. The presenting symptoms were varied but the reactions to resuscitation techniques were all similar in their resistance. That made it seem like there could be someone intentionally or unintentionally causing the collapses.

Attention was not immediately focused upon Nurse Letby. That took a little time. But it was not flawed thinking in the end. Her deceitful actions designed to cover up her crimes came back to hurt her in the end. IMO

 

[katydid23]

<modsnip - quoted post was removed>

The mother of Baby E walked in and saw her baby screaming and bleeding from the mouth, which LL denied in court. It was her word against the parents. And the jury believed the parents over Nurse Letby.

And there was a nurse that testified against LL as well, saying she saw LL standing and doing nothing---and also that LL pointed out a baby that LL said 'looked' pale, but the other nurse said the room was dark and the baby was not visible to LL when she somehow knew the baby was ill.

 

[katydid23]

cought by who eactly how could he have caught her if wasnt there and she had to call him

That is exactly her pattern. She would do some intentional harm, wait awhile, and then 'call' for help.

At that point she would be on the resuscitation team and help save the child. Initially she was given credit and praise for sending the alarm, calling for help. By the time the consultants would come to check, the babies would suddenly go into sudden deep desaturations.

It happened like that over and over. Babies who seemed fine, had no recent issues, many who were close to being released, would quite suddenly collapse and never recover. 27 incidents like that.

She'd go on a 2 week vacation---no collapses. The day she'd return, sudden collapses begin again.

A baby is fine for 3 days. The designated nurse takes a dinner break after feeding and changing her patient, and she asks Nurse Letby to watch the baby. 45 minutes later the nurse comes back from break to see the child has coded and is brain dead. Nurse Lucy had sounded the alarm because the baby was pale and unresponsive...That same kind of scenario happened a few times. Eventually people became suspicious.

Her friends suggested she work with the less vulnerable babies so she could recover from the stress of losing so many babies. Lucy wouldn't hear of it. She only wanted to be with the most premature cases. Her superiors tried to convince her but she refused. And the collapse continued.

 

[katydid23]

What are you talking about? If the babies deteriorated because the unit was on its backside, it’s systemic failure, by everyone. The years of losing experience and institutional memory, until it gets to a point where consultants are rounding twice a week

NO, the consultants were constantly at the clinic, not just 2x a week. There was always at least one at all times.

and a nurse 3 years qualified is somehow considered senior.

<modsnip>

Yes, nurse shortages are a problem so they get promoted faster. It's a problem.

But it was not the cause of the 7 deaths. IMO

 

[katydid23]

Letby has always maintained she waited to see if the baby would self correct. She also said she would have called for help if Ravi hadn’t walked in. Just another desperate attempt to whip up media frenzy, with no substance.

Lucy Letby: Nurse may have been waiting for baby to ‘self-correct’

A NURSE accused of multiple attacks on babies told police she may have been waiting to see if an infant “self-corrected” before intervening, a…

www.chesterstandard.co.uk

There was expert testimony during the trial that preemies of that age/weight CANNOT SELF CORRECT and Nurse Letby would know that.

That probably led the jury to disbelieve that excuse given by the defendant.

 

[Charlot123]

The MBP cases in this trial will not be revised. Nurse Letby purposely made those babies sick and injured, then she 'helped' save many of them, and soaked up the attention and credit for doing so.


The current medical term for Munchausen by proxy is Factitious Disorder Imposed on Another (FDIA). This term reflects the fact that the disorder involves a caregiver fabricating or inducing illness in another person, typically a child.

Learn more

She is the ultimate example of this horrible disorder, imo.

Yes, only Roy Meadow, the author of the diagnosis of MBP, who described it in the 70es, said that it was "clearly overused" by the 90es. You used this term. You probably know that in mid-2020es, it has been considered extremely rare and... well, people who throw it around so easily are considered old-school. And you said "Sociopathic Munchausen-by-proxy". This is strong. Did you meet with Lucy Letby? Does she meet the medical criteria for these conditions?

I am concerned about the level of hatred this case incites. We have people who work in NICU, who think they have a killer, and a group of international/British doctors who believe that the accused is not guilty and that in each case, there were other reasons for the sick babies to die, especially given that the consultants have poor level of knowledge. So, two opposing views. You can't throw the opinion of world-known specialists out of the window.

What the goal is, now, is to see that a grave judicial mistake hasn't been made. I am sure that the doctors meant no harm, just were not the most fit to care for young preemies, especially given that the units were so understaffed. But now someone may have to serve 15 lifespans for it.

It is my feeling that justice has to be impartial and maybe, less emotional. I understand the feelings because people believe in Lucy's guilt. But mistakes have been made before. Moms had to serve time for the poor luck of having babies with SIDS syndrome. And we now know it is hereditary. And one of the trial witnesses for that condition was also the proponent of MBP syndrome.

 

[Charlot123]

So is there anything in that email to say she didn't call him to the desaturation after he entered the room and saw her at the incubator doing nothing?

The irony is that desaturation could have nothing to do with dislodged tube. We don't know if the tube was dislodged. We know it was size 2 tube, instead of size 3 routinely used in preemies. The effect of a pencil in a mug. Lots of air flowed around it.

Now, the devices respond to the oxygen level. They don't tell you what happened. They say, dangerously low.

Per Dr. Shoo Lee, Dr. Jayaram didn't understand the physiology of ventilation. I wondered what was the issue with the neopuff. Surely it is easy to use? But I think Dr. Lee asked about the settings. He said that with collapsed lungs (that happened due to airleak), the pressure to expand the lungs has to be high, and this is not how the neopuff was set.

 

[Charlot123]

Clotted lines are clogged lines. You can't start an infusion if the line is clotted. You can't even flush it if it's a complete occlusion*. The treatment is a TPA dwell. This breaks up the clot and restores patency.

*a partially occluded line can infuse but not give back blood return. These are common. Same treatment- TPA dwell. I administer this treatment pretty often. Never seen a patient stroke out....

Sometimes a clot will form on the outside of the line. I've seen this happen exclusively with lines that had fluid infusing in them. The infusion does not disturb the clot. The treatment is Lovenox.

Regarding the antiphospholipid syndrome, the antibodies that passed from mom to baby were not the antibodies that would cause the baby to have increased risk of clotting. This was queried at the time of the baby's collapse. It was also discussed at trial.

When doctors speak of APS being passed on to the baby or not being passed on, they are speaking of the antibodies, not a genetic inheritance.

Respectfully, this article is at variance with your statement. IgG antibodies in antiphospholipid syndrome, the ones that cross the placenta, can also increase clotting. The authors said that measuring and quantifying the antibodies is important. But it was not done, so we have no material to discuss. What I can only say that the hematologist's answer "no" is not enough today.

Antiphospholipid syndrome - PMC

pmc.ncbi.nlm.nih.gov

 

[Charlot123]

His TV role has nothing to do with this case.

I wonder why you mention it.

Also as a follower of this case since the beginning, I would like to remind posters of the meticulous notes Tortoise has made throughout, which you can consult.

Oh, I was answering to the poster who said, "dr. Jayaram doesn't dance to the tune of the media." Knowing that he was a TV doctor i thought that was an imprecise, and somewhat ironic, statement.

Is being a TV doctor a concern? In general, probably not. Personally, I do prefer doctors who practiced in India or China, countries with huge population, for myself or my family, because they are experienced. They saw many people. TV doesn't add unit experience. But tbh, people might be different. The fact that dr. Jay specifically is a poor NICU specialist i got from Dr. Shoo Lee's conclusion. He also explained why he arrived at it.

ETA: and Dr. Jayaram may still be a good pediatrician. We are discussing his experience as a neonatologist.

 

[Charlot123]

No, that is not what happened.

Those unexpected collapses, which were happening at a shocking rate, had some things in common. The babies were not responding to resuscitation techniques in the usual way.

Instead of one shot of adrenaline, which was almost always effective, the doctors were using 3, 4 and even 5 shots of adrenaline to try and revive the babies.


Now if the explanations of these 'natural' causes are as varied as these 25 world experts claim, WHY is it that the babies did not respond in the usual way as others have when having pnuemonia or a common infection?

The doctors became suspicious that there might be malicious cause because of the unusual pattern of the deaths and collapses. The presenting symptoms were varied but the reactions to resuscitation techniques were all similar in their resistance. That made it seem like there could be someone intentionally or unintentionally causing the collapses.

Attention was not immediately focused upon Nurse Letby. That took a little time. But it was not flawed thinking in the end. Her deceitful actions designed to cover up her crimes came back to hurt her in the end. IMO

OK you say the babies were not responding to resuscitation techniques the usual way.

How do we know if these were doctors who were resuscitating them, nurses or registrars? How do we know that the doctors knew what they were doing?

After all, Dr. Lee says that the reason baby K was not responding is because neopuff, delivering low-pressure airflow, would not be enough for the lungs that collapsed due to the airleak. Essentially, the consultant did not understand the mechanics of ventilation and how to use the neopuff.

Perhaps they started taking in more sick babies and didn't know enough to resuscitate them? Maybe there were different doctors working on the unit in 2012?

 

[JosieJo]

The picture of the COCH maternity services..understaffed, poor levels of cover for Dr's and Nurses, poor standards of documentation, errors is only on view because of the enquiry...this could be a picture of any of thousands of wards and depts across the UK in various specialities...we just don't see it.
It's shocking if read in detail by people who are not aware...( most of the public)

Yes it's horrendous...yes it needs sorting ASAP...and yes sadly may lead to a very slight spike in deaths ....but absolutely not such a huge spike of unexpected deaths and collapses on such a small unit. Certainly not cases that cannot be resuscitated as expected

 

[JosieJo]

OK you say the babies were not responding to resuscitation techniques the usual way.

How do we know if these were doctors who were resuscitating them, nurses or registrars? How do we know that the doctors knew what they were doing?

After all, Dr. Lee says that the reason baby K was not responding is because neopuff, delivering low-pressure airflow, would not be enough for the lungs that collapsed due to the airleak. Essentially, the consultant did not understand the mechanics of ventilation and how to use the neopuff.

Perhaps they started taking in more sick babies and didn't know enough to resuscitate them? Maybe there were different doctors working on the unit in 2012?

We know because the resus team for each baby was documented..many who gave evidence at trial.....senior nurses , registrar's and consultants

Many of the registrar's at the time are now Consultants themselves at specialist children's hospitals / departments

 

[Tortoise]

Dr. Evans is not a "career pediatrician". Simple Wikipedia contains enough information explaining why he had to leave pediatrics. Today, the reprimands for his statements would be way more serious. Let us not praise Dr. Evans.

That is your opinion.

He was in fact a career paediatrician.

I have seen nothing which leads me not to have a great deal of respect for his work, and I think he has come in for so much undeserved vitriolic criticism here and wider afield that I will counter that with praise where I think it is due. He is just a paediatrician with a qualified opinion based on decades of hands-on work with neonates, not a career spent in academia and trying to win awards and notoriety. He identified insulin poisoning, which was in turn verified by a highly qualified independent professor of paediatric endocrinology and diabetes. Opinions that some people don't like, and so they have turned to ad hominem attacks and a personal vendetta against him, because attacking the evidence obviously wasn't possible for the defence. The same thing with Dr Jayaram. So the conspiracists turn to innuendo, such as Dr Evans must have been given the heads up that Letby was the one nurse who looked after all these babies, he's untrustworthy because he determined within 10 minutes that the most egregious injury to a baby was unnatural, he really knew the consultants had queried the possibility of air embolism and he was a stooge brought in to complete the frame-up of an innocent nurse, he had some nefarious reason for getting involved in the case, etc etc etc, with ZERO evidence to back up the claims. Because it has to be personal when the evidence is overwhelming doesn't it. And of course the other independent experts all just abandoned their ethics, duties to the court, knowledge and professional specialist experience, and followed his lead. What is amusing, is that the people attacking him have no idea what the actual evidence was that convicted her. They just parrot untruths half the time.

What was in fact found by the court of appeal, which unlike wiki is uneditable by conspiracy theorists and non-MSM podcasters who don't respect the juries' verdicts in this case, and therefore have an agenda to hound and trash Dr Evans, is as follows -

Court of Appeal https://www.judiciary.uk/wp-content/uploads/2024/07/R-v-Letby-Final-Judgment-20240702.pdf

Ground 1: the submissions to this court

104. The prosecution made some general points to rebut the allegations of bias and unreliability, including that almost every opinion given by Dr Evans was corroborated by another expert. In addition, it was pointed out that Dr Evans was the person who had identified that two of the babies had been poisoned by insulin (Baby F and Baby L). This was a matter which had eluded the treating medics and went to prove that someone was committing serious offences against babies in the unit; and it was particularly important independent evidence, bolstering Dr Evans’ credibility and reliability. Further, when Dr Evans reached his conclusions, he did so without knowing about other circumstantial evidence relied on by the prosecution in establishing guilt, including the applicant’s Facebook searches, the shift pattern evidence, and the “confession” in the note recovered from the applicant’s home on 3 July 2018.

[...]

110. When addressing the submission that Dr Evans lacked the requisite expertise for giving evidence in a case like this, Mr Johnson poses the rhetorical question - who would be better placed to advise on what may have been happening in a neonatal unit than someone who had been dealing with these facilities for 50 years? Dr Evans did have the requisite expertise. If he did step over the line in relation to one baby (Baby C – in which he gave his opinion on the cause of the baby’s collapse for the first time in his evidence to the jury), that did not invalidate his evidence generally. Dr Evans was in a position to give information outside of the knowledge of the court. He held concurrent registration with the General Medical Council and had the requisite experience. The reason Dr Evans did not classify himself as a neonatologist was because when he developed the speciality in South Wales, neonatology was a sub-speciality - so he didn’t train as a neonatologist. Each of these features was addressed by the judge, as was the question of reliability. Reliability can only be measured by reference to another admissible, credible opinion. Looking at each of the requirements of the law, the evidence of Dr Evans was admissible. In the oral submissions of Mr Myers, Mr Johnson said, the shortcomings of the evidence of Dr Evans were not explained. The cases relied upon by the defence in their written submissions were obviously distinguishable from the facts of this case.

Ground 1: discussion

111. As we point out below (in relation to grounds 2 and 3) there is a substantial degree of overlap between the grounds of appeal advanced by the applicant (save for ground 5, which raises a discrete jury management issue). This is because the first three grounds of appeal are essentially rooted in two (related) points: the bona fides of the prosecution experts (in particular, Dr Evans); and the quality of their evidence (in particular, about air embolus). No criticism is made of the summing-up in this case. It follows that (subject to the overarching contention by the defence that parts of the prosecution evidence should not have been left to the jury at all) the strengths or weakness of the prosecution evidence, as it is said to be, and more particularly, that of Dr Evans were fairly set out and left to the jury in appropriate terms.

112. With respect to Mr Myers, it is unarguably the case that Dr Evans was suitably qualified - or to put it another way, it is not arguable that he lacked the necessary expertise - to give evidence. That is the case whether one examines his professional qualifications and background, or the evidence he gave about this during the course of the trial.

113. A summary of the evidential position is as follows. Dr Evans qualified as a medical practitioner in 1971. He trained in paediatrics in Swansea, then in Cardiff and Liverpool. Each phase of that training involved specific training in neonatology and working in a neonatal unit. He was appointed a full-time clinical consultant paediatrician in Swansea in 1980, a position he held until 2009. During the 1980s he became involved in the development of the newborn services and intensive care services for babies. He was responsible for setting up, supervising and leading a neonatal intensive care service in Swansea from his appointment, developing intensive care services “from scratch.” His experience was, he said, “very much hands-on.” In 1990, in Swansea, the health board built a new children’s department, which included a new neonatal unit which he helped to design. His operational and managerial roles involved serving as clinical director of paediatrics and neonatology in Swansea between 1992 and 1997, and between 2004 to 2008. In his evidence he said that Swansea was one of the bigger units in South Wales and it covered the area of the whole of the southwest of Wales over time. He had training in neonatology. When he arrived, there was no specialist neonatology services at that hospital, and it was just a question of getting on with it. His team had to deal with all the babies in the catchment area. The only babies who were sent elsewhere, were those requiring surgery, who went to Cardiff, or those requiring cardiac care, who went to Bristol. So all of the “tiny babies who required intensive care were under my care and the care of my colleagues in Swansea from 1980 onwards.”

114. In cross-examination, as in his submissions to us, Mr Myers did not dispute that Dr Evans had extensive experience. But Mr Myers put to Dr Evans that his expertise or experience in the field of neonatology was less than that of a consultant neonatologist. Dr Evans did not accept this. He said in the 1980s, when he started out, neonatology was a relatively new discipline, and there were relatively few neonatologists; as a paediatrician in Swansea, he served a large population and was one of only a few consultants, hence, his hands-on experience was extensive, and “full on” and he had greater contact with a greater number of babies. His generation was responsible for the development and evolution of neonatal care in the United Kingdom and the local health board deferred to him in developing the service, and in appointing and training the relevant staff. He had retired from practice in 2009, having been a consultant paediatrician therefore for 30 years. Since then he had worked as an expert witness, having attended a number of courses to equip to perform that role, and dealt with a large number of cases where there were allegations of clinical negligence involving small babies. He said he saw his role as providing assistance to the court in sorting out some extremely challenging issues. He did not call himself an expert, but an independent medical witness whose opinion was based, not on being an expert, but on being a doctor.

115. Though the defence draws particular attention to the fact that Dr Evans is not a consultant neonatologist, one of the principal experts instructed by the defence, albeit he did not give evidence at trial, is a paediatric consultant not a neonatologist. Returning to Dr Evans’ position however, he was a highly experienced paediatric consultant with decades of clinical hands-on experience with neonates. He certainly had sufficient knowledge to render his opinion of value; he had expertise that was capable of assisting the jury and was unarguably able to provide evidence with regard to neonates on matters within his expertise, but outwith the experience of the jury.

116. As to his impartiality, the focus here is on Dr Evans’ role in the investigation. It is important to put this into context however, a matter emphasised both by the judge and the single judge. As the single judge said, there was a vast quantity of technical medical material which could not possibly be understood or evaluated without the assistance and appropriate direction of a properly qualified expert with forensic and clinical experience of such cases. Within the space of a month in 2017, Dr Evans provided initial “sift” reports on some 30 babies who had died or suffered life threatening events at the hospital. He then provided follow up reports in respect of babies where there appeared to be no natural explanation for the death or adverse event. He added to or if necessary, revised his reports in the light of further information which became available. He produced some 114 witness statements plus a joint expert report dated 4 September 2022. He identified air embolus as a potential cause of death or collapse in several of the “sift” report statements. The single judge said, and we agree, that the judge was fully entitled to conclude that the approach of Dr Evans to his task was reasonable and did not amount to partiality or lack of independence, nor was it unreasonable for Dr Evans thereafter to provide some direction and structure in relation to identified cases. To the extent that he was acting as an investigator or director of the investigation, he was not doing so in a way that precluded him from being an expert witness in the case.

117. It is obvious that wherever possible, objections to admissibility, particularly to expert evidence, should be dealt with before the evidence is given, rather than afterwards. The risk otherwise is that the trial process will be derailed. The procedural rules contained in what is now para 7 of the Criminal Practice Direction 2023 are indeed designed to streamline the process for the admission of expert evidence, and to minimise the areas of contention at the trial itself. It is to be noted in this case however that the application to exclude Dr Evans’ evidence on the grounds it was inadmissible was not made until part way through the trial. This tends to suggest that the real bone of contention was not Dr Evans’ qualifications or competence per se (matters that otherwise could and should been addressed pre-trial) but concerned the way in which he gave his evidence.

118. In general terms, the quality of a witness’s evidence in that respect is quintessentially a matter for the jury to assess. The judge referred in his ruling both to the nature of the cross-examination, and Dr Evans’ response to it (“I accept that at times Dr Evans, particularly when asked repeated questions on a topic to which he believed he had given an answer engaged in a form of argument and, on occasions, he appeared to be frustrated by the persistence of the questioning and/or was dismissive of suggestions. He was often prolix and would answer a question by an explanation rather than directly”). The particular trial dynamic which arose between counsel and the witness was also apparent to us from the transcripts of Dr Evans’ cross-examination. The judge’s interventions as to the questions asked or the responses to them, were rare. Wisely, in our judgement, he let these matters play out in front of the jury. As it was, by the time of the judge’s ruling, Dr Evans had given evidence on seven separate days in respect of seven of the babies. The judge was therefore particularly well-placed, as the single judge put it, to make a carefully considered assessment of Dr Evans’qualifications and competence to give the expert evidence in question.

119. Further, when considering whether Dr Evans’ evidence was sufficiently reliable to be admitted (one of the criteria for admissibility identified in what is now para 7.1.1 of the Criminal Procedure Rules 2023) it was material, as the judge pointed out, that Dr Evans’ expert opinion was given in ignorance of other potentially incriminating material relied on at the trial. It was also material that there was other expert evidence which supported Dr Evans’ conclusions (indeed as the prosecution asserted, almost all of Dr Evans’ opinions were corroborated by another expert). We should add that the suggestion made in this context that Dr Bohin was simply basing her opinions on those of Dr Evans, rather than reaching her own conclusions, is not supported by evidence. And it would be wrong to imply that her bona fides, or that of the other prosecution experts for that matter, should be doubted simply because she or they agreed with Dr Evans’ conclusions in certain respects.

120. Though none were highlighted in submissions to us, we have carefully considered the particular examples of Dr Evans’ conduct relied on in the Perfected Grounds of Appeal, and the prosecution’s answer to them. We have done so by reference to the extracts from the transcripts to which we were specifically directed, but in the context of the vast volume of other material (including the transcripts of the evidence) we have read for the purposes of this application more generally. In the event, we have no doubt that all of the criticisms of Dr Evans, including those made by reference to the observations of Jackson LJ in a different case, were capable of being dealt with within the trial process, or that the judge was fully entitled to conclude that ultimately, as with any other witness, it was for the jury to assess Dr Evans’ reliability having regard to all the evidence in the case, with the assistance of comment and submissions from counsel on each side. By the same token, there is no arguable basis for interfering with the judge’s exercise of his discretion not to exclude the evidence of Dr Evans under section 78 of PACE.

121. It follows that we do not consider this ground of appeal to be arguable.

122. We should note finally, that after the judge’s ruling of 10 January 2023, Dr Evans was asked about the observations of Jackson LJ in cross-examination. The effect of Dr Evans’s evidence, and we summarise, was that the criticisms made in the decision were based on a false premise. The report was not an expert report prepared for the court or a witness statement; rather, it was a letter to the solicitors in the care case, and had been used by the solicitors (for the purposes of the application for permission to appeal) without his knowledge or consent. Further, he had not known of the decision before it was brought to his attention by the prosecution. Everyone in this trial (i.e. that of the applicant) had seen the decision before he did.

 

[Tortoise]

Well, I looked into it. Antiphospholipid syndrome may be genetic or accompany autoimmune conditions such as lupus, but it seldom manifests at birth. However, the antibodies that are elevated in it are:

Anticardiolipin (aCL) antibodies (IgG, IgM) and Anti–beta-2 glycoprotein I antibodies (IgG, IgM).

One type of antibodies is enough to promote clotting.

IgM antibodies do not cross the placenta. IgG antibodies do.

So one day after birth, the baby born from a mother with antiphospholipid syndrome can have antiphospholipid antibodies of IgG type that he received from the mother via placenta and that are circulating in his blood . His risk of clotting can be higher.

The question asked by judge Johnson at trial was not well-formulated. "Did the baby get the condition from the mother?" Or rather, "did the mother "pass it on to a baby?" My question was, "pass on what?"

The answer of the hematologist was "no" but it is not that simple.

"Pass on" the APL syndrome "genetically"? - the answer is "no", or maybe, "not yet". Can the mother pass on antibodies that cause clotting? Of IgM type - no, but of IgG type - yes. It can never be a sharp "no" in such cases. The best answer is, "here are the tests we did, the antibodies we checked, here are the odds." But this is not what I heard.

But the main issue was that if a baby is not receiving fluid for 4 hours, that by itself could have caused thrombosis.

And remember that there was no venous access, that the picc line was inserted around 5 pm when Lucy wasn't even at work and only at 8 pm when X-ray was done was the fluid started.

And before anyone says I am not a neonatal hematologist: the 14-expert panel refuted the opinion of the court-appointed hematologist. But mostly, the issue is complicated, and there is a jury, and all these issues had to be explained to the ordinary folks weighing on the fate of a nurse and a very complicated medical issue.

Who is Judge Johnson?

Please provide a link to the evidence that the line was inserted around 5pm.

 

[Tortoise]

Baby A evidence

At 4pm, a cannula is tissued and Child A begins to be fed expressed breast milk for the first time.



The next witness to give evidence is Dr David Harkness.

A note by Dr Harkness at 7pm: "Long line inserted at 1st attempt."
A sticker confirming the insertion of the long line is placed.
An x-ray review sticker is also placed, timed 7.09pm.
Dr Harkness said he was junior at the time, so would have recommended the long line be moved back slightly, as outlined in his recorded note, but now he would say the long line was in the right position.

Dr Harkness's x-ray review said at the time the x-ray was available to review, he was "scrubbed inserting a line into another patient", which meant he had to adhere to sterilised conditions, he explains.
The doctor's opinion at the time was the position of the long line was "less than perfect", the prosecution said.
Dr Harkness said that following consultation and in accordance with guidelines, the position of the longline was "actually correct".

He said he was "just about finished with [another baby]" when he was called to Child A at 8.26pm.


Letby's notes, written retrospectively at 7.56am on June 9, are shown to the court. They begin: "Glucose commenced via long line...UVC remained in situ from day shift, instructed line not to be used by registrar.


The prosecution point out the '10% glucose commenced at 8.05pm', signed by Lucy Letby, as a 'major event' on the chart for the 8pm timeslot.

Miss Taylor is asked about the retrospectively written note at 9.28pm on June 8, which begins.
"Observations stable, pink, well perfused. UVC still insitu, but in wrong position, to be used if no other access available.
"Long line inserted by reg Dr Harkness, secured, x-rayed. 10% dextrose run through and connected to long line."

Recap: Lucy Letby trial, Thursday, October 20

 

[Marantz4250b]

so why would 25 of the world experts say there was poor when there wasnt there not being paid for any of this

How do you know this? Do you have a link demonstrating that each one is acting fo free?

As to your first point; not a single one these 25 "world experts" had anything to say on this case from 2018 when she was first arrested until well after the conclusion of all her trials and multiple appeals over five years later!

In addition, not a single one of them (as far as we can tell) ever attended a single day of either of her trials and I'm betting that none of them followed to case when it was progressing. Dr Lee certainly did not as one of the central planks of his argument is something which was examined at trial and comprehensively dismissed, even the defence accepted it!

That, of itself, is an absolutely massive failure on his part to get even basic facts straight. If you don't even know what issues were brought up - and dismissed - at trial then you are certainly no "world expert" in medico-legal matters!

 

[Marantz4250b]

What have supposed staff shortages got to do with Letby's killing spree?

Hospitals up and down the country suffer from staff shortages.

Unless you're saying if more staff were on the ward, Letby's opportunities to attack babies would have been limited.

In fact, had there been more staff it would have been even more difficult to spot a murderer. More staff, more business and more people floating about the place. IMO.

 

[Marantz4250b]

and sewage on the ward

Which was rare and proven to have nothing to do with any of the deaths or collapses.

Sorry, but you're just trolling now because 90% of what you post has been dealt with multiple times on here and comprehensively at both trials.

On ignore you go!

 

[magikarpmagikarp]

Respectfully, this article is at variance with your statement. IgG antibodies in antiphospholipid syndrome, the ones that cross the placenta, can also increase clotting. The authors said that measuring and quantifying the antibodies is important. But it was not done, so we have no material to discuss. What I can only say that the hematologist's answer "no" is not enough today.

Antiphospholipid syndrome - PMC

pmc.ncbi.nlm.nih.gov

We have been over this already.

In the context of the neonatal unit, the passage of antibodies is what the doctors are discussing. The expert hematologist at trial said that the antibodies passed on for Baby A were not the ones that increased clotting. There had been preliminary blood work done that allowed her to state this. Her position was the same as that of the resource hospital at the time of the collapses. Dead horse.