UK - Lucy Letby Trial - Media, Maps & Timeline *NO DISCUSSION*

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Court hears baby N suffered another collapse at around 14:50 on 15th June 2016. Lucy Letby writes in a nurses note that he had fresh blood around his mouth and blood aspirated from NG tube

Drs and anaesthetists struggled to intubate baby N, and couldn’t get an ET tube in. Jury is shown a Facebook message Letby sends at time to a dr colleague about Baby N collapse where she says “sat having a quiet moment and want to cry”

The doctor replied to Lucy Letby “have a cry, you’ll feel better. So sorry you’ve had a rubbish day”

Lucy Letby replies to doctor “don’t want to cry in front of people here, maybe when I’m home!”

Doctor replies to Letby “I’m sure he’s (Baby N) had the best care possible today and that you will have done everything you can for him”

Court hears baby N suffered another collapse at 19:40 that evening just as the nurses were doing a handover to the night shift

We are now hearing evidence from witness Jennifer Jones-Key, who was another nurse at the countess of Chester hospital on shift the night Baby N collapsed
 

The Trial of Lucy Letby, Episode 19: An Association, "The truth of it is we were thinking the unthinkable. We didn’t want to believe it.”​




In this bonus episode, Caroline and Liz discuss the change in focus the court took this week, as the jury heard more about how doctors were getting worried about a possible link between the babies who had been collapsing in the neonatal unit. It’s the first time the court has heard that there were some people who had started ‘to think the unthinkable”.

 
Manchester Crown Court heard that the registrar, who was working nights, messaged Letby: “Only a few hours to go and it’s holiday time – do you think you’ll manage to hand over quickly?

At about 5.25pm Letby replied: “I’ll still be here. He’s (Child N) poorly, bled again and became apnoeic.

“Sat having a quiet moment and want to cry. Just mad with so many people and lack of space etc.”

The doctor said: “Oh Lucy, poor little thing and you.

“Are you OK? Have a cry, you’ll feel better for it I’m sure. You’re welcome to take my car home if you’re too tired to walk. I sort out picking it up in the morning.

“So sorry you’ve had a rubbish day at the end of your long run – holiday well and truly deserved.”

Letby responded: “ I’m OK just feel like I’ve been running around all day and not really achieved anything positive for him.

“Don’t want to cry in front of people here, maybe when I’m home! That’s very kind re the (car) but should be OK. Have you managed to switch off at all and sleep?”

The doctor messaged: “No not really. Your day sounds as though as it’s been horrible. Poor you. Are you going to be OK?

“I’m sure he’s had the best care possible today and that you will have done everything you can for him.

“Are you doing anything nice before you go on holiday? You’re not having to do a long run of shifts to get the time off for that are you?”

Letby said: “No off for nearly 2 weeks!”

The doctor replied: “Oh what an end to a rubbish day. I haven’t been back to Torbay for a few years .. I’m always surprised how little it changes when I go back. Happy memories.

“I used to love Cockington in the summer – it always looked so pretty when the flowers were out. Have you handed over yet?” He added: “Look on the top shelf. Right hand side. For the walk home. Your still welcome to the car.”

Letby replied: “Cockington is gorgeous!! We always go there for afternoon tea. Dad was offered a job in Paignton many moons ago, could have been a very different childhood growing up by the sea. Looking forward to going back.

“Hope little man is OK and your night isn’t too stressful. On the home straight now at least.

“You are a sweetie (name of doctor), thank you.”

The doctor messaged: “Chocolate makes bad days a little better. Hope you liked it.”

Letby said: “That’s true. Just a shame I don’t usually eat chocolate … but on this occasion …”

The doctor replied: “It was well deserved today. Are you OK?

Letby said: “Yes thank you . Just glad he’s (Child N) OK.

“Hopefully I’ll sleep well tonight and can enjoy getting ready for hols. Are you OK?”

The doctor said: “He’s just left the building. I’d be surprised if you didnt sleep well after so many long days zzz.”

Letby said: “Glad he got off safely.”

The doctor replied: “My night is complete! Just been handed a 3-week-old for a cuddle, who am I to refuse!!”

Letby messaged: “Aww baby cuddles make everything seem better.”

Chester Standard Lucy Letby told colleague she ‘wanted to cry’ after baby collapsed

ITV https://www.itv.com/news/granada/2023-03-03/lucy-letby-told-colleague-she-wanted-to-cry-after-baby-collapsed-
trial-hears

Irish News - Lucy Letby told colleague she ‘wanted to cry' after baby collapsed, trial hears
 
Child N

1st allegation of attempted murder on night-shift of 2nd/3rd June 2016. At this time LL was supposed to be working day-shifts.

Draft Timeline





2 Jun 2016, Thursday



11.56am - a Facebook message from doc asks LL for an 'opinion on something'. LL replies: "Hope I can help!"

1.42pm - N was born at 34 weeks + 4 days, weighing 3lb 11oz. His clinical condition was excellent but he did have mild haemophilia, a blood disorder.

2pm - Nurse Caroline Oakley records N was admitted to the nnu at 2pm, and N had 'prematurity and clotting disorder'. (electronic evidence)

2.30pm - A blood sample was taken. (electronic evidence)

Time? - A clinical note by Dr Anthony Ukoh reports: '34+4 baby boy cried immediately, required no active resus'. 'Not for IM Vit K for now until haemophilia status known'. 'Observations: ...intermittently grunting++' (electronic evidence)

Afternoon - Dr Sudeshna Bhowmik’s statement - Dr SB says tests were carried out on N for haemophilia. It was discussed with the parents that N would be taken to the neonatal unit due to his prematurity, and would need an incubator for temperature control. N had intermittent grunting at one hour of age, which was not unusual for babies born via C-section as there would be increased fluid in the lungs. The usual practice was to observe for four hours to see if the baby would settle down. Vitamin K was withheld on the risk of increased bruising/bleeding for N, until test results came back. N was later screened for sepsis as he had continued grunting beyond the four-hour observation period. He was breathing without any support required.

3.10pm - A desaturation down to 67% oxygen saturation, lasting one minute, is recorded by nurse Caroline Oakley at 3.10pm. She noted: '[N] Allowed to rest. Sounds very mucousy. Grunting intermittently...dropped saturations to 67% when upset; temp being recorded and required 60% O2 to recover...awaiting blood results before being given Vit K.' The note adds: 'Decision made to screen and [nil by mouth], IV fluids/Vit K IV as prescribed as still grunting' (electronic evidence) X-exam of Dr Jennifer Loughnane: Mr Myers refers to notes made before the [evening] handover took place, in relation to N "intermittently grunting++" and an event of N desaturating to 67%. He asks if it is possible for a baby to desaturate because they are upset, via a 'false desaturation' from the Sats probe not picking up the trace. Dr JL says that can be the case, but it would usually be recorded as such in the medical notes. The number on the oxygen saturation reading could be lower, or not be displayed at all. A statement from Caroline Oakley describes N being born, transferred to the neonatal unit, and describes being aware the mother was a haemophilia carrier. N was dressed and placed in a 'hot cot'. He was 'grunting intermittently', which was not unusual. At 3pm, his temperature dropped to 36.4 degrees, and the temperature of the cot was increased to 39 degrees. N had a desaturation to 67% and was given 60% oxygen support, and was screened. N was presenting "quite typically" for a baby of his gestational age, and there were no overriding concerns at the time of the handover. A second statement by nurse Caroline Oakley said there was nothing to suggest the naso-gastric tube had been physically moved once inserted, nor any difficulties with the tube being initially inserted.

Bef. 6pm - An x-ray result before 6pm recorded that N likely had an infection. (electronic evidence)

6.47pm - Nurse Caroline Oakley recorded at 6.47pm that N's temperature, which had been low, was recovering. A family communication is recorded: 'Dad has visited baby on unit and updated by [Belinda] Simcock. Nurse CO has also visited mum... and updated...' A haemophilia diagnosis is confirmed for N. (electronic evidence)

7.30pm - LL is recorded as starting her night shift. Shift leader is Melanie Taylor and other designated nurses being Christopher Booth and Sophie Ellis. Booth has two babies in room 1, including Child N, Ellis had one in room 2 and two in room 3, and LL had two babies in room 4. Two babies were in transitional care, and another baby was 'rooming in with her parents' - that baby's designated nurse was LL.

A few minutes after 7.30pm –
A few minutes after entering the neonatal unit, LL Whatsapps a colleague and says she had a 'paper handover' as colleague Caroline had gone home.

8pm – Nurse Christopher Booth records 'care taken over approx 2000...oxygen saturations predominantly in mid 90s-100%'. He also records the usual handover checks.

Abt 8pm –
LL texted friends and sent a message to a colleague: “we’ve got a baby with haemophilia”.
Colleague: How many weeks?
LL: 34
Colleague: oh
LL: “everyone bit panicked by seems of things although baby appears fine”.
Colleague: male?

LL: Yeah.
8.04pm –
LL text to colleague: I’ll have to google it later, don’t know much about it
8.11pm –
LL texted her colleague: “complex condition, yeah 50:50 chance antenatally”.
Abt 8.30pm –
colleague: be careful with cannula and blood samples
LL: Oh and had weird FB message from [doctor] earlier
coll: 'Did u? Saying what?' 'Go commando? (cry laughing emoji)
LL: (4 x cry laughing emojis)
LL: 'Asking when I was working next week as wants to talk to me about something, has a favour to ask..?'
coll: 'Think he likes you too...'
coll: 'Hmm did u not ask what it was?'
LL: 'No just said when I was working and he said wants my opinion on something'
LL: Hmm... (puzzled emoji)
coll: 'Hmm'
LL: 'Do you think he's being odd?
coll: 'Thought as flirty as u'
LL: 'Shut up!'
coll: 'What?!'
LL: 'I don't flirt with him!'
coll: 'Ok'
LL: 'Certainly don't fancy him haha just nice guy'
coll: 'Ok'

LL/Coll: The conversation continues back on work, asking why there was a staff shortage on the unit. One of the staff members is speculated to be off with stress.

Night-shift - door swipe data and observation charts for Child N on June 2/3 2016 are entered into evidence.

10pm – The mother first visited the unit where N was. (mother’s statement)

After 10pm –
The conversation on Whatsapp, now continuing after 10pm, discusses another baby's condition.

10.55pm – Dr Jennifer Loughnane registrar’s evidence – Dr JL carried out a routine review, which included an examination of N. Dr JL has noted N's history up to that point in the first 12 hours of his life, and noting a concern of a growth restriction during pregnancy, and the weight of 1.67kg indicating N was "a small baby". No risk factors for sepsis were detected. N was 'screened [for infection] - due to grunting at four hours'. The grunting was, the court hears, due to N having extra fluid in the lungs. N was 'self-ventilating in air', 'respiratory rate 60', 'Sats 96% room air' Dr JL says there were no concerns re N other than the blood disorder he had.

Up to 1am - Further observations are recorded regularly for N up to 1am. (electronic evidence)

3 Jun 2016, Friday

1am - Nurse CB’s statement - He recalls N was stable, with oxygen saturations "almost 100%, and "no abnormalities" present. He says it was likely on the hour when he left for his one-hour meal break, saying he had "no concerns". He handed over care to a nurse, but does not recall who that was. When he returned from his break, he was "surprised" to learn N had become 'unsettled' and 'fractious' suffered a desaturation. He adds he had not been called back from his break.

[opening speech - 1.05am – [1st attempted murder allegation] - N suffered a sudden lowering of his oxygen levels from 99% to 40% - life-threatening levels. He was screaming and cried for 30 minutes. He recovered after emergency assistance.]

1.05am - electronic evidence: Child N then suffered a desaturation at 1.05am. Nurse CB noted: 'One episode whilst I was on my break, whereby infant was crying++ and not settling. He became dusky in colour, desaturating to 40s. Responded to facial oxygen within 1-2 minutes, crying [subsided] after 30 minutes. The note adds N's colour returned to pink perfusion. Nurses Taylor, Ellis, Booth and Thomas gave statements about not being present for the collapse.

[Opening Speeches - Prosecution: Independent experts say his sudden deterioration was consistent with inflicted injury which caused severe pain, or an injection of air. Dr Sandie Bohin said such a profound desaturation followed by a rapid recovery, in the absence of any painful or uncomfortable procedure, suggested an inflicted painful stimulus. She said – “this is life threatening. He was also noted to be … ‘screaming’ and apparently cried for 30 minutes. This is most unusual. I have never observed a premature neonate to scream. Professor Sally Kinsey describes the collapse on June 3 as dramatic with no recognised medical cause.” Defence: the defence say there are "many reasons" why a baby would shout or scream. "It was far more likely to be hunger" - "you certainly won't find evidence of anything else".]

1.10am - Dr JL’s evidence: At 1.10am Dr JL is informed about N having a desaturation. She does not recall who did so. The note at the time records: N 'got upset, looked mottled, dusky, sats 40%, O2 100%'. 'On my arrival, 40% O2, screaming, sternal recession, poor trace on Sats probe, pink'. Dr JL testifies on her arrival N’s oxygen level had dropped to 40% and he was screaming. She says 40% is a “quite significant desaturation”. She says “screaming” is unusual and “not a word I tend to write in notes very often.” Dr JL testified attempts were made to settle the baby, but she was crash bleeped away. On her return, N's saturation levels recovered to 100%, and he was asleep. The time of Dr JL’s return is not recorded. X-exam: Mr Myers asks about N 'screaming' and being 'pink', which he says if N had suffered a desaturation, he was "certainly recovering" from that. Dr JL agrees. Mr Myers asks about the relevance of the 'poor trace on Sats probe'. Dr JL says she had been told of the 40% sats reading, but on her arrival, she had seen N was pink. Mr Myers says there were no signs of N having any fresh blood anywhere. Dr JL agrees. Dr JL also agrees it is rare to be looking after a baby at the Countess of Chester Hospital - or any hospital - who has haemophilia. The prosecution re-examines Dr JL to clarify the '40% O2 (on my arrival)' note, and ask if that is a saturation reading or the oxygen support for N. Dr JL testifies she cannot be sure, but believes it would be the latter. Prosecution asks if the 40% oxygen saturation recorded by the nurse was inaccurate, it would have been noted as such in medical notes – Dr JL agrees that would be the case. Dr JL says she doesn’t recall if any movements of N associated with his screaming would have affected the security of the [blood oxygen] probe [giving an inaccurate reading].

Bef. 2am – Dr JL’s evidence: The plan was to continue to observe N and carry out the blood gas reading at 2am, indicating the note was made sometime before 2am.

2.04am – Dr JL’s evidence: A blood gas reading is carried out at 2.04am, and Dr JL says there is a raised lactate reading for N. Mr Myers says other than the raised lactate reading, the blood gas record at 2.04am was normal. Dr JL agrees.

2.04am - Nurse CB noted (up to 2.04am): 'No further episodes observed. Oxygen saturations have been consistently mid 90s-100%...in view of earlier episode, infant remains nil by mouth...' (electronic evidence)

8am – End of LL’s night shift

Nurse Ashleigh Hudson takes over care of N for the day shift on June 3. 'Tachypnoeic [my note – rapid shallow breathing] on handover, unsettled' (electronic evidence)

LL messages the same colleague (as at 8pm and 10pm): 'been busy” ...adding what had happened to a number of babies during the night shift, and what staff on duty had been doing. “Glad to be off, survived my nights tho :) (electronic evidence)

Dr Sudeshna Bhowmik records a list of 'problems' for N, including prematurity, jaundice and respiratory distress. A plan was to discuss with Alder Hey Children's Hospital haematology, and that discussion was carried out. (electronic evidence)

A dose of vitamin K is prescribed for N during the day shift.

Abt. 6pm - Nurse Ashleigh Hudson records a 'slightly mucky aspirate' for N towards the end of the day shift, at about 6pm. The note of a summary of care between 8am-6pm records N was 'settled for the rest of the day', with 'minimal aspirates obtained. Aspirates clear with tiny old blood specks. 'Paeds have liaised with AHCH' (electronic evidence)

Dr Bhowmik’s statement - (re. desaturation event at 1.05am 3 June) - He had had 'an episode' where he desaturated to 40%, with colour change noted, but had "settled thereafter" and did not need "supplementary oxygen for very long". The rest of the examination by Dr Bhowmik on June 3 was "normal", and Child N was seen to be pink and well perfused, and doing "well from a respiratory point of view".

8pm nightshift - Nurse Christopher Booth, at the time of the night shift handover for June 3-4, records at 8pm N was settled. A family communication note by nurse Hudson: 'Both parents updated on current condition and plan of care. Mum very anxious, worried about baby being in the incubator. Explained need for it, to keep baby warm and make observation easier.' (electronic evidence)

4 Jun 2016, Saturday

3am - The sequence of events goes up to June 4 at 3am, where Nurse Christopher Booth records 'No significant desaturations, bradycardias or apnoeic episodes observed overnight...' (electronic evidence)

links in part 2 timeline
 
Child N

2nd and 3rd allegations of attempted murder on day-shift of 15th June 2016

Draft Timeline Part 2


14 Jun 2016, Tuesday

7.40am - N takes a feed of expressed breast milk. (electronic evidence)

8am – LL’s day-shift. LL records notes at the handover at 8am. She was N’s designated nurse.


LL messages a colleague to complain about having to finish up a previous shift' nurse's work, and had left a bottle 'dirty'. (electronic evidence)

Day-shift 8am to 8pm - LL records regular temperature readings for N which are all recorded in a 'normal range'. The court had previously been told readings in the 'yellow area' (too high, or too low) would be considered abnormal, but none of the temperature readings recorded as being too high or too low. LL notes: 'Demand feeding EBM via own bottle, completing more than required volumes. repeat SBR this morning on downward trend but not yet >50...otherwise ready for home'. In a family communication note: 'Mummy visiting this morning, carried out cares and feed. Put infant to breast. Discussed feeding at home' The notes show N was ready to go home, apart from further treatment required for jaundice, and was on phototherapy. Other family members visited N at the neonatal unit that day. (electronic evidence)


8pm – For the night shift of June 14, N was in nursery room 3. Nurse Jennifer Jones-Key, in a note written retrospectively, records N was 'nursed in incubator with eye protection in situ. Baby demand bottle feeding' at the start of the shift at 8pm. (electronic evidence). JJ-K’s evidence: She was on a night shift on 14 June 2016 and was N's designated nurse along with Neonatal assistant Lisa Walker. They took over N's care from LL, she tells the court there was no concerns on handover

After 8pm (assumed post-shift) –
LL is involved in a Whatsapp message conversation with a nurse, and a Facebook messenger conversation with a doctor at this time: -

The nurse colleague complains about work colleagues on that night shift.
LL says she has had a "lovely run of shifts in 3". "Nice babies and parents"

LL messages the doctor to say she was planning to go to Torquay with her parents in July 2016, and discusses about her having had hypothyroidism since she was 11, and had been giving her tremors/had 'blips over the past 12 months'
.
(electronic evidence)


15 Jun 2016, Wednesday

Just after 1am - A nursing note by JJ-K just after 1am on June 15 records N had become 'very unsettled' and 'looked very pale, mottled and veiny' with slight abdominal distension. A blood test was taken for analysis. Further observations are taken. (electronic evidence)

JJ-K evidence - She recalls that over that morning N 'started to have a few desaturations' and was placed on full monitoring.

5.10am – LL was awake according to the use of her phone -
LL to colleague at 5.10am: 'Awake already'
Colleague: "I wouldn't come in!"
LL: "Oh...why"
Colleague: "5 admissions, 1 vent"
LL: "OMG"
Colleague: "Baby [N] screened, looks like s**t"
(electronic evidence)

5.51am – JJ-K writes her retrospective nursing note for 1am.

Bef. 6am - JJ-K's note before 6am: 'baby looked worst this morning and cap refil after 3 secs. Reviewed again by paeds.'

From 7am – JJ-K’s evidence – JJ-K testifies that N 'settled down' but 'from 7am onwards he was having more desaturations'

Bef. 7.10am
LL messages doctor saying she might be back in '1' again for her next day shift (in nursery room 1).


7.10am – LL is recorded as entering the neonatal unit. She messages the doctor: "No repeat today. I've escaped being in 1, back in 3". (electronic evidence)

7.15am – [2nd alleged attempted murder] - The sequence of events shows N had a desaturation at 7.15am. Nurse JJ-K records: 'at 0715 baby crying and dropped saturations - as seen by NNU nurse Lucy [Letby].' The nurse adds N had to be given 100% oxygen support by a doctor. (electronic evidence)

JJ-K’s evidence – JJ-K testifies that shortly after 7am, LL came in to 'say hello'. At that point, she said 'I think the monitor went off, so Lucy went over to see. He went quite pale, I think he’d stopped breathing, I got the neopuff'. She's asked by the prosecutor where LL was in the room, she doesn't remember. She is asked again why LL was in the room - 'just to say hello, because we were friends', she says. She doesn't remember any conversation between them. She says the decision was taken to provide respiratory support to N. A nursing note from that morning states: 'noted to be mottled all over body and blue in colour and cold to touch'. X-exam: Mr Myers says essentially LL said hello to JJ-K then responded when N's monitor went off – JJ-K agrees.

[Opening speech: LL went into N’s room to say hello. When a 2nd nurse had her back turned LL told her N had lost oxygen and assisted with his breathing. There had been no alarm sounding and LL didn’t wait to see if he self-corrected. A doctor was unable to put a breathing tube into Child N because his throat was so swollen and he had fresh blood inside his mouth. He attempted 3 times.]

8am - N was transferred to nursery room 1 at 8am. A note (by JJ-K?) is made on the re-siting of the NG Tube: 'NG resited in right nostril with acid reaction. At handover baby dropped saturations and required Neopuff. Care handed over to NNU nurse Lucy Letby'. (electronic evidence)

LL is recorded as being the designated nurse for the day shift on June 15, and records, in a note written retrospectively: 'Infant transferred to nursery 1 on handover. Mottled, desaturating requiring Neopuff and oxygen...cold to touch.' (electronic evidence)

Time? Is this in 8am notes?? - LL's notes state that N's parents had been informed and that they were 'understandably upset' (electronic evidence)

Abt. 9am - LL records for 9am (in a note written at 1.53pm): 'Unable to intubate - fresh blood noted in mouth and yielded via suction ++.' (electronic evidence)

Bef. 10am
LL messages her colleague on Whatsapp before 10am: 'Thanks for staying to help. Much appreciated.'
(electronic evidence)

10am – LL records '1ml fresh blood aspirated' from N at 10am. (electronic evidence)

[opening speech: An intensive care chart is presented to the court, which records the amount of dextrose going into Child N. The bleeding record, of 10am '1ml fresh blood', recording aspirates from the NG tube. Said bleeding, the prosecution say, is not recorded anywhere in the medical notes. It was more than 2 hours after the attempts to intubate.]

Morning - mother’s statement – parents were informed N had had a bleed and to attend hospital as soon as possible. On arrival N was in intensive care and LL was there with other people. They were told they had tried to intubate N between 4am and 8am.

Morning - father’s statement - On the day Child N was due to come home, on June 15, the father was at work. He received a call from Lucy Letby saying Child N was 'a bit unwell' during the night, but was fine now. He did not get the impression that Child N was still unwell. He then received a call from child N's mother to come to the hospital as soon as possible. When he arrived, Lucy Letby was in the room with Child N, giving cares. There was "no urgency". Lucy said: "Hi. He's been a bit unwell during the night." He said he was "shocked" when he saw Child N, as he had dried reddy-brown blood around the mouth and his skin was 'blueish in colour'. "He had dried blood around his lips. His lips weren't fully covered in blood, there was loads spattered over him like he'd coughed. "I remember being confused and thinking, 'what's wrong with him?'" "No-one told us what happened, or why."

Bef. 11am –
The doctor (who had done the earlier intubation) messages LL before 11am to ask: "Is he ok?"

11am - LL notes (retrospectively) for 11am: 'Small amount of fresh blood orally and 1ml from NG tube' (mix Dan Donoghue tweets and Chester Standard update)

11.29am –
LL messages the doctor in response: 'Small amounts of blood from mouth & 1ml from NG. Looks like pulmonary bleed on xray. [Given factor 8 – wait and see - opening speech] apnoeas have improved. Sorry if I was off during intubation (then refers to how another nurse was faffing) I like things to be tidy & calm (Well, as much as possible!)"
Doctor: "No, you were perfectly fine with me...I thought you were wanting to just get on with in case there was another desat."
LL: 'Well I have got my hair in a bun today, it's only fitting that I was 'serious Lucy' !!' LL adds: 'no more bleeding thankfully'
, in relation to N. [opening speech - Other than that phone message at 11.29am, there is no evidence that LL brought the bleeding to the attention of any of the medical staff.]


Time? Abt 2pm? – father’s statement - after staying on the neonatal unit for a few hours, the parents went out for "20 to 25 minutes" to buy some food, as they had not eaten that day. When they returned to the neonatal unit, they found the blinds were down and a staff member on reception told them Child N was "really unwell". The father said he was "scared" as medics soon after needed to give Child N resuscitation." (BBC)

After going outside for a bite to eat, they returned to the neonatal unit and found the blinds were down. A staff member on reception said Child N was "really unwell" and if they would like a priest. (Chester Standard) In written statements read to the court, the parents expressed surprise that the neonatal unit had no Factor 8 for their baby, even though they were aware he had haemophilia. At one point a specialist haemophilia nurse had been sent from Alder Hey Children's Hospital to bring some factor in a taxi. Lucy Letby 'hugged mother after trying to kill her baby three times'

The father said the baby’s condition deteriorated twice more, once when he and his partner left to get food and again when they left to seek medical advice for his partner, who was feeling unwell. Lucy Letby hugged mother after alleged attempt to murder baby, court hears

[opening speech - 1.53pm - In an update recorded on the computer by LL at 1.53pm she wrote that Child N was “stiff” on handling and extending upper limbs, back arching … settled in between episodes.]

1.53pm - LL recorded a retrospective note for 9am (see above). (electronic evidence)

Time? Abt 2.45pm?? – mother’s statement - The parents were told to go out and get some fresh air. While they were out N had his second collapse.

2.50pm – [3rd alleged attempted murder] - At 14:50 N had a profound desaturation. LL’s notes written retrospectively at 6.30pm: 'Infant became apnoeic with desat to 44%. heart rate 90bpm. Fresh blood noted from mouth and 3mls blood aspirated from NG tube. Drs crash called'. Nursing notes record that there was difficulty trying to insert an ET tube. With two doctors failing to 'obtain a secure airway'. Two consultants from the anaesthetic team were called to help, but they also had difficulty fitting an ET tube, the nursing notes show. (electronic evidence and opening speech)

[opening speech - 2.59pm – A consultant was called at 2.59pm. While awaiting a consultant, a junior doctor looked into the airway of Child N and saw a “large swelling at the end of his epiglottis” he could only just see the bottom of the vocal cords. He had never seen anything like this before in a newborn baby. A further attempt to insert a breathing tube again found blood in his throat. The junior doctor's notes made at 4.30pm recorded: "desaturated this afternoon at 2:50pm with blood in the oropharynx + blood in the NG tube. Improved with bagging. Elective intubation planned following ??? unsuccessful attempts with 2 registrars and 2 consultants cords difficult to visualise” The prosecution said Child N had been "so unwell" that attempts were made to reintubate him, but the doctor could not see down Child N's throat as the view was obscured by fresh blood. A more specialist team was called to carry out the intubation.]

[opening speech - At 3pm there is a further entry in LL's writing of '3ml blood', initialled not by LL.]


Time? – mother’s statement – A spur of the moment baptism took place. In a statement, the baby’s mother said: “Lucy was our main point of contact through the day because she was tending to (Child N) in between consultants being with him. “We had (Child N) baptised during the day and that was recommended to us by Lucy.” (Evening Standard)

Bef. 5.25pm
Doc to LL: 'Only a few hours to go and it's holiday time - do you think you'll manage to hand over quickly?'
5.25pm -
LL: 'I'll still be here. He's (Child N) poorly, bled again and became apnoeic. Two anaesthetic consultants failed to intubate.

[opening speech - 6.30pm – LL recorded at 6.30pm her notes for 2.50pm.]


7.40pm - Notes from 19:40 on June 15 show that there was a further 'profound desaturation'. Child N had 'colour loss' and required neopuff breathing support (electronic evidence)

7.48pm - At 19:48 baby N required resuscitation and a number of doses of adrenaline.
He eventually stabilised. LL said in a message to a colleague, who can't be named for legal reasons, that Child N's parents were present and had had the boy christened. (electronic evidence)

Time? 7.40pm collapse? – father’s statement - Someone came into the maternity room, where Child N's mother was staying with the father. The staff member said: "You'd better come - he's really ill this time." Upon their arrival to the intensive treatment unit, resuscitation efforts were being administered to Child N. The father said he could not watch what was going on. Staff from Alder Hey Children's Hospital were among the staff members in the room. After a breathing tube was fitted, Child N stabilised and 'calmed down'.

After 7.40pm - father’s statement - The parents spoke to a haemophiliac specialist nurse who had come from Alder Hey via taxi. Child N was taken to the transport team, in a process "which seemed like forever", by 11pm.

Unnamed female doctor’s evidence - The doctor has told the court she remembers the events of that evening and Ms Letby. She said LL 'seemed quite agitated' when a team of specialists arrived from Alder Hey to help with Child N's treatment. 'She approached me a few times and said who are these people, who are these people....from working alongside the nurses and doctors at Chester, I felt that it was out of character from what I’d experienced previously in a medical emergency', she said.

Around 8pm or later?? -
At the end of her shift, Ms Letby sent a WhatsApp message to a nursing colleague, who also cannot be named, saying: 'Losing the will' (electronic evidence)


Prob. Around 8pm? –
LL: 'Sat having a quiet moment and want to cry. Just mad with so many people and lack of space etc.'
Doc: 'Oh Lucy, poor little thing and you.
Doc: 'Are you OK? Have a cry, you'll feel better for it I'm sure. You're welcome to take my car home if you're too tired to walk. I sort out picking it up in the morning.
Doc: 'So sorry you've had a rubbish day at the end of your long run - holiday well and truly deserved.'
LL: 'I'm OK just feel like I've been running around all day and not really achieved anything positive for him.
LL: 'Don't want to cry in front of people here, maybe when I'm home! That's very kind re the (car) but should be OK. Have you managed to switch off at all and sleep?'
Doc: 'No not really. Your day sounds as though as it's been horrible. Poor you. Are you going to be OK?
Doc: 'I'm sure he's had the best care possible today and that you will have done everything you can for him.
Doc: 'Are you doing anything nice before you go on holiday? You're not having to do a long run of shifts to get the time off for that are you?'
LL: 'No off for nearly 2 weeks!'
Doc: 'Oh what an end to a rubbish day. I haven't been back to Torbay for a few years .. I'm always surprised how little it changes when I go back. Happy memories.

Doc: 'I used to love Cockington in the summer - it always looked so pretty when the flowers were out. Have you handed over yet?'

Guess later than 8pm -
Doc: 'Look on the top shelf. Right hand side. For the walk home. Your [sic] still welcome to the car.'
LL: 'Cockington is gorgeous!! We always go there for afternoon tea. Dad was offered a job in Paignton many moons ago, could have been a very different childhood growing up by the sea. Looking forward to going back.
LL: 'Hope little man is OK and your night isn't too stressful. On the home straight now at least.
LL: 'You are a sweetie (name of doctor), thank you.'
Doc: 'Chocolate makes bad days a little better. Hope you liked it.'
LL: 'That's true. Just a shame I don't usually eat chocolate ... but on this occasion ...'
Doc: 'It was well deserved today. Are you OK?
LL: 'Yes thank you. Just glad he's (Child N) OK.
LL: 'Hopefully I'll sleep well tonight and can enjoy getting ready for hols. Are you OK?'


After 8pm - Father’s statement - He said Letby approached them as they were waiting for the baby to be transferred to Merseyside’s Alder Hey Children’s Hospital, where he made a full recovery. He said: “Lucy then came up to us. “She told us she’d stayed on late past the end of her shift and she said to (my partner), ‘I hope he’s OK’ and gave my partner a hug. “She might have given (my partner) a kiss, I’m not sure.” Lucy Letby hugged mother after alleged attempt to murder baby, court hears

Time? 10pm guess –
LL: 'What do you think caused his (Child N's) bleed?'
Doc: 'I think there will be a haemangioma or collection. If it was epiglottitis his crp should have been higher because he was starting to become unwell'. Doctor says he's 'optimistic he'll be okay'
LL: 'That's brilliant news, thanks for letting me know'

Abt 11pm
Doc to LL: 'He's just left the building. I'd be surprised if you didnt sleep well after so many long days zzz.'
LL: 'Glad he got off safely.'
Doc: 'My night is complete! Just been handed a 3-week-old for a cuddle, who am I to refuse!!'

LL: 'Aww baby cuddles make everything seem better.'


[opening speeches – Prosecution: Experts suggested blood in Child N’s throat was a result of the thrusting of a tube into the back of his throat to inflict injury. Dr Bohin’s view was that the likely cause of the bleeding was trauma to the mouth, to the throat or to the oropharynx, most likely from a NGT or suction catheter. Prof Sally Kinsey excluded the possibility of a pulmonary haemorrhage - in other words, bleeding in the lungs, causing the collapse on June 15. In her opinion such bleeding would not have occurred spontaneously in a child with Child N's degree of haemophilia. It follows, the prosecution say, the bleeding was caused by trauma. Professor Kinsey also ruled out heavy-handed intubation as a cause. Defence: Regarding the allegation Letby did something to cause Child N to bleed, the prosecution say the intubating doctor already saw blood, because Letby harmed him. The defence disagree and say blood was "not identified until intubation had already happened, or was in the process of happening". There were three attempts to intubate him. The defence say, again, there was "sub-optimal care" for Child N.]

[opening speech - In police interview, Letby had difficulty remembering Child N.
She did recall an occasion when doctors had difficulty intubating him. She agreed that she had seen blood but denied being responsible for causing him harm.
She could not explain the entry in her notes timed at 10am on June 15 in which she recorded aspirating more fresh blood which she had not apparently brought to the attention of anyone else.]




Links

Evening Standard - Lucy Letby hugged mother after alleged attempt to murder baby, court hears
Chester Standard 2 Mar Recap: Lucy Letby trial, Thursday, March 2
Tweets
https://twitter.com/MerseyHack
https://twitter.com/MrDanDonoghue
https://twitter.com/MelBarhamITV
 
Prosecution evidence, March 6th 2023, Day 67 - Tweets https://twitter.com/MrDanDonoghue


Child N


Registrar Dr Huw Mayberry, Re. 3pm 15th June 2016

I'll be bringing live updates from Manchester Crown Court this morning where the murder trial of nurse Lucy Letby continues. We'll be hearing evidence in relation to Child N, who the Crown say Ms Letby tried to kill on 3 occasions in June 2016. She denies all charges.

Dr Huw Mayberry is first to give evidence today - via live link from Australia. Dr Mayberry currently works as a registrar in Melbourne, back in 2016 he was at the Countess of Chester Hospital

Dr Mayberry is being asked about the events of June 15, 2016. Child N crashed several times throughout that day - at one point requiring full resuscitation and six doses of adrenaline

Dr Mayberry was crash bleeped to attend the neonatal unit at around 15:00 due to a 'sudden desaturation following 3ml aspirate of blood from NG (tube)'

The doctor tells the court he tried to intubate Child N, but he 'was unable to get a very clear view because there was substantial swelling within the airway'. He said that this swelling was 'unlike anything I had encountered previously'

He said the infant's epiglottis (flap of tissue at the back of the throat) was 'quite swollen, it looked quite large and reddy pink in colour'. He adds 'I had not seen this in my practice before, only in textbooks'

He tells the court that his initial thought was that this could be epiglottitis - this often caused by an infection, but can also sometimes happen as a result of a throat injury

Dr Mayberry tells the court that he does not recall seeing any blood in Child N's throat. Asked if he could he could give a cause for the swelling, he says 'no it’s not something I've had much experience of'

Cross-Examination

Ben Myers KC, defending, is now questioning Dr Mayberry. He asks in his professional opinion what can be the cause of blood - he says he told Cheshire Police it could have been a result of gastric irritation or Necrotising enterocolitis (NEC)

He says it could also have been a result of Child N's blood disorder, which resulted in a deficiency of an essential blood-clotting protein
 
Prosecution evidence, March 6th 2023, Day 67 - Tweets https://twitter.com/MrDanDonoghue


Child N

Unnamed Registrar, Re. night-shift 1am to approx 9am 15th June 2016


We're now hearing from another doctor, who cannot be named for legal reasons, about the events of June 15.

The medic tells the court that he recalls Child N as he had trouble trying to intubate him, he says 'which for me is not a frequent occurrence'

Notes from the early hours of June 15 show that the doctor ordered a blood test as Child N was mottled in appearance and he wasn't sure why

The mottling eventually resolved, but over the next few hours Child N suffered five desaturations. The doctor said this made him think the baby boy had an infection. A septic screen of his bloods was then ordered


He tells the court that results ruled out infection as a cause. He said there was some concern about blood 'not being delivered to the skin in way that is normal'. By 8am on 15 June, Child N's mottling had returned. The doctor took the decision to move him to Nursery 1

Nursery 1 allows for more intensive care and treatment

The doctor tells the court that on that morning he took the decision to intubate Child N and put him onto a ventilator. He recalls seeing 'unusual' swelling and blood in the back of the baby boy's throat

After three unsuccessful attempts to intubate, the doctor abandoned the procedure. His note from that morning states: 'intubation abandoned due to blood present at oropharynx and likelihood of trauma due to repeated attempts'

Child N was then placed on non-invasive respiratory support

Cross-Examination

Ms Letby's defence lawyer Ben Myers KC is now questioning the doctor.

Myers is asking the doctor when he saw the blood in Child N's throat. He said 'I believe blood was there at insertion attempt number one' Myers puts it to him that 'if you can't see, you wouldn't attempt it?' He replies:'You can do, if quite certain of position'

Mr Myers has just quoted the doctor's police statement from 2018. In this he says he was 'not sure' if the bleeding was his 'fault' due to his attempts to move the tongue with a medical implement to intubate
 
Prosecution evidence, March 6th 2023, Day 67 - Tweets https://twitter.com/MrDanDonoghue


Child N

Consultant Dr John Gibbs, re 4pm 15th June 2016


We're back after a short break. Retired consultant paediatrician Dr John Gibbs is now in the witness box. He was called to attend Child N at around 16:00 on June 15

Citing his notes, Dr Gibbs recalls that a specialist team had been called to help doctors with Child N's breathing (due to various problems with trying to intubate)

The team from Alder Hey Children's Hospital arrived in Chester at 19:20. They were made up of experienced intensive care consultants and an ear, nose and throat surgeon. Plan was to take Child N try to intubate, if that failed an emergency tracheostomy would take place

Dr Gibbs tells the court that Child N suffered a 'sudden deterioration' before the team could carry out the procedure however. Heart rate dropped to 60bpm, oxygen dropped to 40% - 'clear he was not being ventilated properly', Dr Gibbs said

At this point, Dr Gibbs said chest compressions were started and six doses of adrenaline were given over 30mins. A specialist doctor from Alder Hey also finally managed to intubate the baby, which allowed him to be placed on a ventilator

Asked for his conclusions about the events of June 15, Dr Gibbs says the blood could have been a result of a bleed on the lung - but adds 'why (Child N) had that swelling documented by colleagues, I really don’t know'

Dr Gibbs says that 'in the end I don’t think infection was the cause' of Child N's collapse
 
Prosecution evidence, March 6th 2023, Day 67 - Tweets https://twitter.com/MrDanDonoghue


Child N

Consultant Dr Stephen Brearey re. afternoon 15th June 2016


Dr Stephen Brearey is now in the witness box. He was on duty on the afternoon of June 15. He was called to help with Child N by a colleague as doctors were having difficulty intubating the infant

Dr Brearey made an unsuccessful attempt to intubate the baby boy. He tells the court from reviewing his notes it wasn't successful due to blood and swelling at the back of Child N's throat, which blocked vision of his airway

Cross-Examination

Mr Myers is now questioning Dr Brearey, he's asking him about Child N's blood disorder, which increases the risk of bleeding

Mr Myers is taking the court back over notes of that day, they show that there was seven attempts to intubate Child N (before Alder Hey team succeeded). Mr Myers asks if this is something that should have been possible to do, he replies 'in normal circumstances yes'

The medic tells the court that he 'can think of no natural, normal cause for why (Child N) deteriorated multiple times' and then improved afterwards at Alder Hey
 
Prosecution evidence, March 6th 2023, Day 67 - Tweets https://twitter.com/MrDanDonoghue


Child N

Dr Francis Potter, Alder Hey team, re 7.20pm onwards, 15th June 2016


Dr Francis Potter is now in the witness box. He was part of the Alder Hey team that assisted on June 15 - he said he remembers the case as it was 'quite unusual' for his team to get a call to go out and assist

He says when he arrived Child N was 'mottled and grey' in appearance - he recalls starting use of a bag and mask to ventilate the baby boy. When this didn't work, chest compressions were commenced

Dr Potter says after Child N stabilised and was transported to Alder Hey he recovered 'fairly rapidly' - within 48hrs he had left intensive care

Cross-Examination

Mr Myers is now questioning the medic. He asks whether repeated attempts to intubate could cause stress to the baby, he says it would cause stress to the person trying to intubate

He said 'failure makes the second attempt more difficult and third more difficult'...he adds that rather than making repeated attempts, they should be limited and someone with more experience should be called to help quickly
 
various media write-ups - 6th March 2023 Day 67 prosecution case -



"Asked about his recollection of that morning, he said: "I saw blood at the back of the throat, blood that prevented me seeing where the entry to his airway was.
"I also recall that the back of the throat looked unusual, there was a degree of swelling."

10% BBC
Doctors saw blood in baby's throat, nurse trial told

[...]

Prosecutor Simon Driver asked: “ What did you notice first?”

The doctor replied: “I think I will have seen the blood first because that is such an unusual thing to see at the time of intubation.”

He said he could not see where the blood was coming from or what had caused the swelling.

The doctor told Ben Myers KC, defending, that he had told police in 2018 that he was not sure if he had “inadvertently” caused the bleed during the procedure.

He agreed that because of Child N's haemophilia – an inherited blood clotting disorder – there was a concern he would bleed.

[...]

He [Dr Gibbs] told the court he “couldn’t understand” why two consultants, two registrars and two anaesthetists had failed previously to intubate Child N throughout the day, but said the adrenaline may have helped reduce the swelling.

[...]

Dr Potter agreed with Mr Myers that Child N was readmitted on July 3 with further episodes of apnoea, but no explanation was found and the situation settled after he was given breathing support.


Irish News ‘Unusual' presence of blood in throat of baby ‘attacked by nurse', court told

stv - ‘Unusual’ presence of blood in throat of baby ‘attacked by nurse’

chester standard - Lucy Letby: ‘Unusual’ presence of blood in throat of baby
 
Prosecution evidence, March 7th 2023, Day 68 - Tweets https://twitter.com/MrDanDonoghue


Child N

Doctors and nurses agreed evidence statements re. 15th June 2016


Nurse Lucy Letby's murder trial continues at Manchester Crown Court this morning. We'll be hearing evidence in relation to a baby boy, Child N, who Ms Letby is accused of trying to kill on three occasions in June 2016. She denies all charges

The prosecution allege Ms Letby made her first attempt on Child N's life on 3 June, before carrying out two more attacks on 15 June. The Crown say Child N's deteriorations were consistent with some kind of "inflicted injury" or him having received an injection of air.

Jury are currently being read statements of agreed evidence from doctors and nurses who worked 15 June. They're in relation to the treatment of Child N, who crashed several times that day

A nurse, who cannot be named for legal reasons, said in her statement that she remembers being 'shocked' at Child N's deterioration that day. She said that he was previously stable and ready to go home that day

Independent Nursing Healthcare Advisor Elizabeth Morgan re.15th June 2016

Court being read a statement from Independent Nursing Healthcare Advisor Elizabeth Morgan, who was asked by Cheshire Police whether Ms Letby's 'failure' to alert other medics that fresh blood had been aspirated from Child N's mouth that day fits with 'good practice'

Ms Morgan said in her professional opinion, it would be 'standard good practice' to escalate anything unusual - first verbally and then later recoded
 
Prosecution evidence, March 7th 2023, Day 68 - Tweets https://twitter.com/MrDanDonoghue


Child N

Professor Sally Kinsey, Prosecution Medical Expert


Blood expert Prof Sally Kinsey is now in the witness box. She was approached to review Child N's case

Child N has a rare blood disease, Prof Kinsey is explains to the jury that this can cause 'catastrophic' bleeding following minor injury. Child N had a 'moderate' variant of the condition, she tells the court

Prof Kinsey is asked whether the blood seen in Child N's throat that day could have been caused as a result of self injury or a spontaneous bleed due to his blood condition - she says no

Cross-Examination

Ben Myers KC, defending, is now questioning the witness. He says his questioning will focus on whether a physical act can be established for causing the bleed

Prof Kinsey tells the court that Child N's blood disorder did make him "more likely to bleed", but said: "He won’t just bleed for no reason."
 
Prosecution evidence, March 7th 2023, Day 68 - Tweets https://twitter.com/MrDanDonoghue


Child N

Dr Dewi Evans, Prosecution Medical Expert


12.35pm
Medical expert Dr Dewi Evans is now in the witness box, he was asked to review the case by Cheshire Police.

12.37pm
Dr Evans’ opinion is that the bleeding in Child N's throat was not caused by the attempts to intubate, but instead some preceding trauma

12.41pm
Dr Evans says Child N's 'progress was pretty uneventful' and was 'making satisfactory progress for a baby that was premature but otherwise well' in the weeks from birth to 15 June

12.49pm
Court being taken back over timeline of Child N's crashes on 15 June - which culminated in CPR and him having six doses of adrenaline, before he was eventually transferred to Alder Hey Hospital

12.56pm
Dr Evans is giving his analysis on Child N's first collapse on June 3. The baby suffered a profound and sudden collapse in the early hours of that day. This was preceded by, what one doctor recalled, as 'screaming' - Dr Evans said that is 'very unusual' for a child of this age

12.57pm
Dr Evans says he went and reviewed scientific research papers on air embolus (injection of air) - these found that in some cases where babies had been injected accidentally with air, there was a period of screaming before desaturation an death

12.58pm
He said what happened with Child N was 'repeated' in what we have seen in previous cases

1.07pm
On the 15 June incident, Dr Evans said in his opinion the bleeding 'was a result of trauma to his upper airway'

Cross-Examination

2.06pm
We're back after a short break. Ms Letby's defence lawyer Ben Myers KC is now questioning Dr Evans

2.11pm
Mr Myers points out that Dr Evans wrote several reports on the collapse of Child N. In his first report written in 2018, the medic didn't mention the incident on 3 June. He tells Mr Myers he 'overlooked' it and later included in subsequent reports

2.12pm
Mr Myers says 'if you considered it significant you would have said so in your first report'

2.17pm
Mr Myers puts it to Dr Evans that there is 'nothing' in the medical notes for Child N 'to support a suggestion that there was an inflicted injury'. Dr Evans disagrees, he says that was his opinion when he authored his report in 2019 and says 'that is my opinion now'

2.36pm
On whether Child N had received an injection of air on 3 June, Mr Myers put it to Dr Evans that there was no evidence of an injection of air and that the medic was attempting "to work a piece of evidence in to support" his theory on air embolus.

2.36pm
He disagreed and said he was "applying standard clinical practice" in his review and said it was written with knowledge of previous babies in this case. "I think that we have to seriously consider that this baby was a victim of air embolus on 3 June", he said.

2.59pm
Mr Myers has just been questioning Dr Evans about how he was approached to review these cases. He says he was approached. Mr Myers pulls up an email from 2017 that Dr Evans sent to the National Crime Agency telling them the death's at Chester 'sound like my kind of case'

3pm
He accuses Dr Evans of 'touting for work' and says he was using his review to 'fit the allegation not the facts'. He puts it to him that air embolus was mentioned to him by Cheshire Police before the review, he denies accusations - accuses Myers of 'going on a wild goose chase'
 
Prosecution evidence, March 7th 2023, Day 68 - Tweets https://twitter.com/MrDanDonoghue


Child N

Dr Sandie Bohin, Prosecution Medical Expert


3.34pm
Dr Sarah Bohin, who also reviewed the case, is now in the witness box. She said the bleeding suffered by Child N on 15 June could have been caused by 'local trauma to the mouth'

3.45pm
On the incident on 3 June, Dr Bohin says she has 'never experienced' a neonatal baby crying for 30mins. She says it is an 'extraordinarily long' time and puts it down to an 'inflicted painful stimulus'
 
Prosecution evidence, March 8th 2023, Day 69 - Tweets https://twitter.com/MrDanDonoghue


Triplets O and P


I'm back at Manchester Crown Court for the trial of nurse Lucy Letby. Today we'll be moving onto the case of Child O - who Ms Letby is accused of murdering in June 2016. She denies all charges

Manchester Crown Court has previously heard that Child O was in good condition and stable up until the afternoon of 23 June when he suffered a "remarkable deterioration" and died.

The court has heard that Child O was one of three triplet brothers born at the Countess of Chester Hospital on 21 June. The prosecution say Ms Letby murdered Child O and his brother Child P on 23 June and 24 June respectively.

Mother's Statement

A statement from the mother of the triplets has just been read. She recalls on 23 June that she was told by doctors Child O's "needed a little help to breathe, so a tube had been put down his throat". She went down to the unit thereafter

She said 'By the time I got there, it was a scene of chaos. The staff appeared to be in a state of panic, and it didn't seem controlled at all'

The mother said her son was 'swollen all over his body' and that doctors were 'struggling to get injections into his veins, so eventually injected directly into the bone'

The mother said a senior doctor eventually told her 'things weren’t looking good' and if 'he did manage to survive he would have brain damage, so it might be best he didn’t survive' Child O passed away 5pm. The mother said it came 'like a bolt of the blue'

The mother said in her statement that she was 'devastated' and didn't sleep that night. She said the following day, a midwife came to get her as Child O's brother, Child P was 'really poorly'

The mother said when she got down to the unit it was 'it was like déjà vu', she said 'everyone was running around again, it looked chaotic'

Due to having a c-section, the mum was in a wheelchair so she sat outside the nursery room. She said she noticed one of the doctors outside the room 'sitting at a computer desk googling how to do what looked like a relatively simple medical procedure' on Child P

She said 'naturally this alarmed me'. She said Child P 'looked very similar' to how Child O had looked the previous day

Eventually a consultant arrived from Arrowe Park Hospital to help with Child P's treatment, the mother said she 'felt reassured' by his presence as he was 'calm whereas everyone else was in a panic'

Eventually it was decided resuscitation of Child P should be stopped and he was pronounced dead that afternoon.

The third brother was transferred, at the parents request, to another hospital that day

Father's Evidence by Video

The court is now being played a video interview with the father of the triplets on the events of June 2016

In the video the father recalled that there was 'definitely swelling' on Child O, and compared his stomach to 'ET'. He could not recall why. He also pointed to his hands, he says there were 'bright blue' veins. He said he could 'see bright blue all over'

He recalled the scene for Child P was 'worse than the day before' and said it was 'pandemonium'

Electronic Evidence

Cheshire Police intelligence analyst Kate Tyndall is no in the witness box. She'll take the court through sequencing evidence, first for Child O and then Child P - essentially the chronology of what happened

We've just been shown messages between Ms Letby and a colleague, who cannot be named for legal reasons, sent on June 21 2016. Ms Letby was in Ibiza at the time - the pair are discussing her holiday and what was happening at Chester

Ms Letby is back in work after her holiday to Ibiza on 23 June. In a message to a colleague, sent on the 22 June, Ms Letby says she will 'probably be back in with a bang lol'
 
Prosecution evidence, March 8th 2023, Day 69 - Chester Standard Updates LIVE: Lucy Letby trial, Wednesday, March 8


Triplets O and P


9:22am

Previously, the prosecution said in the opening that Child O was one of three triplet brothers born at the Countess of Chester Hospital on June 21, 2016.
The prosecution say Lucy Letby murdered Child O, and brother Child P, on June 23 and June 24 respectively.

10:39am

The prosecution is now beginning its evidence for Child O and Child P, two boys who were triplets born on June 21, 2016 at the Countess of Chester Hospital.
Simon Driver, prosecuting, tells the jury the case of Child O will be heard first, over the next few days, before the case of Child P begins.

Mother's Statement

10:42am

A statement from the mother of Child O, Child P and the other triplet is read out to the court.
She says she had a 12-week scan at the Countess of Chester Hospital 'which seemed to take a bit longer than normal', where her partner realised there was more than one baby. It was confirmed she had triplets.
The triplets would be identical, she was informed, and she was referred to Liverpool Women's Hospital to see a specialist. She was informed there was an 80% chance one of the triplets would be smaller than the other two.

10:46am

Two weeks later she went for a follow-up scan, and everything was 'fine', as were further fortnightly scans.
She was informed the triplets were 'unlikely' to stay at the Countess of Chester Hospital neonatal unit, as there would not be the space for three nursery beds, and they may have to be treated at Birmingham.
On June 21, the mother was admitted to the Countess of Chester Hospital, was assessed, and advised to go for a C-section.
She went to theatre at 2pm, and the triplet boys were born shortly afterwards. They had been named in advance, and the babies were named in the order they came out.
In recovery, she was brought pictures with the boys and their birth weights recorded.

10:47am

The mother was taken to see all the baby boys, and handled all of them.
On the neonatal unit, there "didn't seem to be any routine for washing hands".
All the triplets were in nursery room 1, and they were all brain scanned, with no concerns.

10:49am

The following day, the mother was taken to see the triplets, and was informed all were doing well.
She said she asked on numerous occasions, about expressing milk, but no-one came to help until after Child O passed away, when a nurse called Lucy handed her an information leaflet.

10:52am

On June 23, the mother was in the ward and still struggling to walk. About 10-15 minutes after the father had been to the unit, he came back with a consultant doctor, who informed her Child O's stomach had swollen and 'needed a little help to breathe, so a tube had been put down his throat'. He was calm and said this was normal.
The mother was put into a wheelchair, and upon arrival at the nursery, she said: "By the time I got there, it was a scene of chaos". A lot of doctors and staff surrounded Child O.
"I remember nurse Lucy was there, all the time."
"The staff appeared to be in a state of panic, and it didn't seem controlled at all."
The mother said she sat outside, and could not bring herself to be too close, as Child O kept arresting and changing colour. "He was swollen all over his body".

10:55am

At some point, another doctor arrived and told the mother "things weren't looking good" for Child O, and said if he did survive, he would likely have brain damage.
Child O passed away at 5pm.
Child P and the other boy were in nursery room 2.
The mother said: "This whole episode had come like a bolt out of the blue. On the face of it, everything seemed to be going well with the triplets.
"As a family, we were naturally devastated.
"With hindsight, there were a number of things we found unusual."
The mother said she didn't expect a student nurse to be looking after one of the babies.
She said they kept seeking reassurance that the other two boys were fine.

10:57am

A doctor, who was "quite upset", said she was very sorry for what had happened to Child O, and photos were taken of the baby boy.
The mother said she didn't sleep at all that night. She, at one point, asked the midwife to check if the other two boys were ok. She was reassured they were fine.
The following day, they went to the neonatal unit and were informed by a nurse the two boys had "been like angels", behaving all night and feeding regularly.

10:59am

The mother recalled having breakfast and freshening up.
She then heard voices and saw a midwife was present and advised to go to the neonatal unit, as Child P was unwell.
"I was devastated. A couple of hours earlier he had been fine.
"I called my mum to tell her it was happening again."
When she arrived, she said it was "like deja vu" and the situation was "chaotic" with people "running around" in nursery room 2, where both boys were.

11:03am

The mother said she sat outside "for long periods of time".
At one point, a young doctor looked to be Googling 'how to insert a line'.
They needed to do this process as Child P's lungs had collapsed during CPR.
"This alarmed me".
The mother was informed they were looking to transfer Child P to Liverpool, but they needed to stabilise the baby first as he kept collapsing.
She was told things were "looking a lot more hopeful" for Child P - he looked veiny, but his stomach was not distended like Child O's was.
At some point, the transport team arrived. The reaction from the transport team was "incredible to watch" as "they just took over".
'Even the consultant took a back seat'. "We were reassured, he seemed calm."
Child P passed away.
The mother said she and her partner "begged" the transport team to take the surviving boy with him to Liverpool Women's Hospital.

11:07am

The mother said she had to discharge herself from the Countess of Chester Hospital, and asked for her care to be transferred to Liverpool. "They refused, which was the last thing I needed."
The mother travelled to Liverpool, having stopped to pick up some clothes along the way, and were .
"We were just made to feel at ease - the two hospitals felt like night and day."
The staff said the surviving baby boy could be treated there for as long as there was a bed available, but did not need intensive treatment.
The surviving baby stayed at the hospital for three and a half weeks.
The mother said she was "surprised" there was not 1:1 nursing care for the triplets, and a student nurse was looking after them, with Lucy Letby 'popping in'.
Lucy Letby was "extremely emotional" and "in pieces" after Child P passed away. She was "in floods of tears", the mother said. A doctor also arrived and "was also upset".

Grandmother's Statement

11:18am

A statement from the grandmother of the triplets is now being read out.
She said she was aware the triplets were identical and couldn't be told apart, apart from their identity tags, and were in differently coloured blankets, and were all of good weight.
"All was well, up until June 23."
She was informed "something was wrong" with Child O.
She left work and travelled to the hospital, and upon arrival, Child O was being baptised, and the parents were "hysterical" and "at a loss".
The grandmother recalls Lucy Letby was there, and was "softly spoken".
Child O continued to deteriorate, and a Dr John Gibbs was called to the unit, who asked Lucy Letby how many shots of adrenaline had been administered, and Lucy said she was not sure, three or four. Dr Gibbs replied: "Well, what was it, Three or four?" Lucy Letby appeared to be referring to a scrap of paper for records which had yet to be updated.
Lucy Letby was in the unit, and the grandmother said: "I remember thanking her for her assistance during the ordeal."
The grandmother said she could not recall what happened with Child O, as she was too busy consoling the parents.
When she received the "awful call" about Child P being unwell, the grandmother was at home.
She arrived at the hospital and saw a number of doctors surrounding Child P. There had been "a signficiant improvement" in Child P's condition. His condition 'seemed fine' for an hour or two, but then took a dramatic turn for the worse.
Outside the nursery room, a nurse researched a procedure on a desktop computer.
"I was a little surprised at this, as I assumed the staff knew what they were doing. I thought they were possibly just confirming the procedure."
Child P continued deteriorating and the call was made to transfer him to Liverpool, but Child P sadly passed away.
It was decided that as the transport team were already present, they would take the surviving boy to Liverpool Women's Hospital, as they were not sure if there was a congenital condition.
A doctor informed the family there would be post-mortems for Child O and Child P to establish the causes of death.

Father's (Video) Statement

11:26am

A 15-minute video interview is now being played, as agreed evidence, with the father of the triplets. The video interview was recorded in December 2019.
He says, for June 23, the scene was "a mess".
He recalls being taken to the unit by a nurse 'asap', "there's something going on".
He said he and the mother both "panicked".
He recalls there was "definitely swelling" on Child O, but could not recall why, and, getting upset and pointing to his hands, he says there were 'bright blue' veins.

11:30am

He said medical staff were doing 'not a lot', and seemed to be concentrating on Child O's temperature.
He said there were "lots of people, rushing in and out".
He recalls seeing a 'pot belly' appearance for Child O, which then had 'gone down'.
The ordeal lasted "ages" for Child O. It "seemed like hours".
The doctor could offer 'no explanation' for what had happened to Child O which has resulted in him dying, the father recalls.

11:38am

The interview talks about the events of June 24.
The father recalls having spent time with the two boys.
He recalls the scene for Child P was "worse than the day before", and was "pandemonium".
He said there was nothing of the sign for Child P of a swollen belly.
He said the medical staff did not have any explanation for why Child P was unwell.
The transport team arrived, but Child P passed away within 10-15 minutes.
He recalls he and the mother asked the transport team to take the surviving baby boy to Liverpool Women's Hospital.
The father adds: "I am sure it was Lucy Letby who wheeled the two boys to us. She said how sorry she was.
"I'm pretty certain she dressed them up."
He said it was Lucy Letby's job to do up the memory box, which included an SD card containing memories of Child O and Child P.
The surviving baby stayed in Liverpool for 'about 11 days' and there were 'no complications at all' apart from a 'small hole in his heart', and remained stable.
 

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