UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #10

[squish]

You would not have to. It’s the difference in light reflectivity between pink/red and white or close to white. Red/pink would actually blend in within a darker room.I might argue that there is more light Than moonlight bouncing around in that room especially with white walls and you can determine light colours in moonlight. I can understand judging by that picture how people think that but I’m not convinced. Difference being the canopy is in place to shield the child from any direct light. The baby being in the dark Wouldn’t negate light reflection from the skin in fact it would highlight it, an applicable phrase IMO is “ghostly white“ relative to the low oxygen in the blood which is what gives white skin it’s hue. Blood is red due to the iron content and oxygen is pink. if the babs skin colour matched the white sheets as well I think that would be concerning, again many shades of difference between red and white. Doesn’t make sense to have a treatment room without light for staff to see by.

On examination [Child I] centrally white, any ideas on what is meant by this? Centrally is the focused word.

i Would have thought any babe on the hdu would be hooked up to a heart monitor, the paleness suggests lack of blood flow I think? Presumably caused by a slow heartbeat but I have no med experience.

I think this makes sense and is my humble opinion. Full respect to others.

<modsnip - rude>

The other nurse did have to turn the light on, because she did actually turn the light on. The only reason for her to do that was because she couldn't see adequately in the dark.

The moon phase, the cloud cover at that moment, and the position of the moon relative to any windows in the room, have not been mentioned. But I would think it's distinctly unlikely that it would be the magic factor that enabled LL to determine Baby I's complexion in the dark.

 

[Supernovae]

There's white sheets or blankets on the mattress in the photo and you can't see it at the canopy end. That tells you that you wouldn't be able to see her skin tone, or a white object of any sort, IMO. Perhaps police dressed the bed in white blankets with padding inside it to raise its profile for that very purpose, as demonstrated in the earlier photo of the cot which just contained a bare mattress. It would be a simple matter of holding back the side flap of the canopy to allow the light from the corridor to shine on the baby briefly when doing an observation.

View attachment 398366

View attachment 398367
both photos from same link
Lucy Letby 'was in tears as she said 'it's always me when it happens'

I don't think you'd even have been able to tell if an adult sitting in that chair was notably pale, and that's without a canopy shading them from the light.

I think the greater problem is the one identified by the defence which is: exactly how literally can you interpret a picture reconstructed five years after the event? The danger is it creates an illusion of cctv like scientific precision to what is actually a visual rehashing of her impressionistic memory that you couldn't tell the baby's skin tone. You can tell that even with whatever's going on with the Chester Standard's website image quality for the same picture it becomes a lot less implausible.

 

[Tortoise]

"8.10am – LL made a nursing note: ' noted to be pale in cot by myself at 03:20hrs … apnoea alarm in situ and had not sounded. On examination centrally white, minimal shallow breaths followed by gasping observed.'"


This is a very interesting nursing note.

She's recorded the events as the designated nurse says they happened.

"and had not sounded", shows (without a shadow of a doubt IMO) that she knew that the apnoea/not breathing event happened before she noted the pallor from the doorway.

There's no reason to make a record of an alarm not sounding before the event that would make it sound. She wouldn't know that unless she already knew baby I stopped breathing before she noted she was pale.

This is the second time in 3 weeks (baby G, 21 Sep) that she discovered babies requiring resuscitation without alarms sounding, while not reporting it to managers, and not mentioning it to her friend when she texted her about baby G.

All MOO

 

[katydid23]

I think the greater problem is the one identified by the defence which is: exactly how literally can you interpret a picture reconstructed five years after the event? The danger is it creates an illusion of cctv like scientific precision to what is actually a visual rehashing of her impressionistic memory that you couldn't tell the baby's skin tone. You can tell that even with whatever's going on with the Chester Standard's website image quality for the same picture it becomes a lot less implausible.

I think a big problem for the defence, if we accept their assertion that LL was able to see that the baby was very pale and in need of help---WHY did LL just stand there doing nothing as opposed to stepping forward and checking on the baby?

It is a problem because others have said similar things, about finding LL standing doing nothing, alone in the room with babies on the verge of death. And in this case the defense seems to be pushing that narrative themselves.

 

[ColourPurple]

I think the greater problem is the one identified by the defence which is: exactly how literally can you interpret a picture reconstructed five years after the event? The danger is it creates an illusion of cctv like scientific precision to what is actually a visual rehashing of her impressionistic memory that you couldn't tell the baby's skin tone. You can tell that even with whatever's going on with the Chester Standard's website image quality for the same picture it becomes a lot less implausible.

The thing is the jury haven't just got the reconstructed pic to go on, they've got an eye witness account from the nurse who was actually there, saying that the room was too dark for anybody to be able to make out that the baby was pale. So though the pic may or may not be helpful, I think it'll come down to whether the jury believe the nurse or whether they believe LL's explanation to the police that she may have been able to spot something the other nurse wasn't able to, because she was more experienced.

 

[Dotta]

I think a big problem for the defence

And in this case the defense seems to be pushing that narrative themselves.

Well, what else can the Defence do?
It is, sometimes, a thankless job.

Only LL knows the truth.
JMO

 

[Supernovae]

"8.10am – LL made a nursing note: ' noted to be pale in cot by myself at 03:20hrs … apnoea alarm in situ and had not sounded. On examination centrally white, minimal shallow breaths followed by gasping observed.'"


This is a very interesting nursing note.

She's recorded the events as the designated nurse says they happened.

"and had not sounded", shows (without a shadow of a doubt IMO) that she knew that the apnoea/not breathing event happened before she noted the pallor from the doorway.

There's no reason to make a record of an alarm not sounding before the event that would make it sound. She wouldn't know that unless she already knew baby I stopped breathing before she noted she was pale.

Surely that would be obvious from how poor the babies condition was?

 

[Tortoise]

I think the greater problem is the one identified by the defence which is: exactly how literally can you interpret a picture reconstructed five years after the event? The danger is it creates an illusion of cctv like scientific precision to what is actually a visual rehashing of her impressionistic memory that you couldn't tell the baby's skin tone. You can tell that even with whatever's going on with the Chester Standard's website image quality for the same picture it becomes a lot less implausible.

How can you claim to know it's the same picture, or that the difference between the two is an image quality issue?

As I said, I doubt Myers would have challenged the nurse's memory of the lighting, if it wasn't problematic for LL.

IMO

 

[ColourPurple]

"8.10am – LL made a nursing note: ' noted to be pale in cot by myself at 03:20hrs … apnoea alarm in situ and had not sounded. On examination centrally white, minimal shallow breaths followed by gasping observed.'"


This is a very interesting nursing note.

She's recorded the events as the designated nurse says they happened.

"and had not sounded", shows (without a shadow of a doubt IMO) that she knew that the apnoea/not breathing event happened before she noted the pallor from the doorway.

There's no reason to make a record of an alarm not sounding before the event that would make it sound. She wouldn't know that unless she already knew baby I stopped breathing before she noted she was pale.

This is the second time in 3 weeks (baby G, 21 Sep) that she discovered babies requiring resuscitation without alarms sounding, while not reporting it to managers, and not mentioning it to her friend when she texted her about baby G.

All MOO

Ah so LL herself has cleared up the question of whether the alarm was on. It was in situ but hadn't gone off.

 

[Tortoise]

Surely that would be obvious from how poor the babies condition was?

So she guessed that baby I stopped breathing before they actually noted it?

What makes you think that it's obvious how long a baby has not been breathing? By being pale?

 

[Sweeper2000]

<modsnip - rude>

The other nurse did have to turn the light on, because she did actually turn the light on. The only reason for her to do that was because she couldn't see adequately in the dark.

The moon phase, the cloud cover at that moment, and the position of the moon relative to any windows in the room, have not been mentioned. But I would think it's distinctly unlikely that it would be the magic factor that enabled LL to determine Baby I's complexion in the dark.

Light bounces off of lighter colours, it’s a fact. If the baby was actually darker than white or pale it would blend in more as less reflective of light. This is fact. I was actually referring to the level of light being more than moonlight due to the lights in the hallway Not actually being lit by moonlight. Not sure how you got there. I would like to think if I saw a baby the same colour as the white sheets around them I would pick up on it. Deathly pale is a well known phrase.

"8.10am – LL made a nursing note: ' noted to be pale in cot by myself at 03:20hrs … apnoea alarm in situ and had not sounded. On examination centrally white, minimal shallow breaths followed by gasping observed.'"


This is a very interesting nursing note.

She's recorded the events as the designated nurse says they happened.

"and had not sounded", shows (without a shadow of a doubt IMO) that she knew that the apnoea/not breathing event happened before she noted the pallor from the doorway.

There's no reason to make a record of an alarm not sounding before the event that would make it sound. She wouldn't know that unless she already knew baby I stopped breathing before she noted she was pale.

This is the second time in 3 weeks (baby G, 21 Sep) that she discovered babies requiring resuscitation without alarms sounding, while not reporting it to managers, and not mentioning it to her friend when she texted her about baby G.

All MOO

not quite certain about that. That could be a reference to the moment in which the baby was discovered to be pale and the monitor should have sounded before. Doesn’t state exactly when this deterioration happened or started.

I think a big problem for the defence, if we accept their assertion that LL was able to see that the baby was very pale and in need of help---WHY did LL just stand there doing nothing as opposed to stepping forward and checking on the baby?

It is a problem because others have said similar things, about finding LL standing doing nothing, alone in the room with babies on the verge of death. And in this case the defense seems to be pushing that narrative themselves.

not her baby to treat Whilst the DN is there.

im not sure about the other cases of alarms not sounding but if they were not hers to treat I would assume it would be the DN’s job to report. As is the case with baby I.

is there a difference in monitors between apnoea and breathing monitors? or all in one.

 

[Supernovae]

How can you claim to know it's the same picture, or that the difference between the two is an image quality issue?

As I said, I doubt Myers would have challenged the nurse's memory of the lighting, if it wasn't problematic for LL.

IMO

I can't imagine why the Chester Standard would publish a completely different image to illustrate their article. You can also see the difference in the famous picture of Lucy Letby holding the baby grow in the different articles. I'm not an expert in photography so I don't know if this is the correct terminology but it looks more unnatural and more saturated on the Chester Standard than the Mail and the BBC.

 

[esther43]

Hi. Baby I's stay in hospital spanned across a lengthy period. Just when baby I should have been going home, a life that was hers for the taking came to a tragic end. The prosecution say she was 'very premature' and that this was what led to her untimely death. I put together this timeline, for people like me (ex neonatal parents) who think in 'gestations'!! Let me know if anyone finds this format helpful and I may add to it. I've tried to focus on the medical trajectory rather than other evidence presented as I know are other threads looking at this.

27 WEEKS (+3)
7th Aug -
Baby I was born at Liverpool womens hospital born @ 27+3. A statement from a consultant neonatalogist at LW hospital said she was born in 'very good condition'.and 'stabilised very quickly' with no concerns, before being admitted to the neonatal unit after being allowed to be shown to her mother.
She had 'very good gases' after being put on breathing support device CPAP.
There were readings consistent with an infection, but Child I was on antibiotics. A lumbar puncture and phototherapy were commenced.

8th Aug -
Feeds were started, using expressed breast milk and baby I continued to be 'very stable, in spite of having an infection'.She later had desats and brady's, so a second line of antibiotics was begun- to last for 5 days. The CRP infection marker was low, but the white blood cell count was elevated. After a short gap in feeds, Baby I continued to be fed. She was stable when taken off CPAP for short periods of time.


9th Aug -
10th Aug -

11th Aug
At five days old baby I graduates from ITU and moves into the high dependency room at Liverpool Women's hospital whilst the staff start to arrange for a transfer to CoC

12th Aug -

13th Aug -

28 WEEKS (+3)
14th Aug -
15th Aug -
16th Aug -
17th Aug -
18th Aug -
It''s transfer day. Baby I was stable on CPAP, having four hours off it. By this time she was tolerating feeds "very well". She had "normal tone, posture and movement".She weighed 90g more than her birth weight, (around 3lb 3oz) which "was good", as it was expected that babies would drop in weight in the days after birth.She was moved to room 2 at the CoC neonatal unit.

19th Aug-
20th Aug-

29 WEEKS GEST (+3)
21st Aug -
22nd Aug -
23rd Aug -
24th Aug -
25th Aug -
26th Aug -
28th Aug -

30 WEEKS GEST (+3)
28th Aug -
29th Aug-
30th Aug-
31st Aug-
1st Sept-
2nd Sept-
3rd Sept-

31 WEEKS GEST (+3)
4th Sept
5th Sept
6th Sept
Staff at the Countess suspected Baby I had NEC as her stomach had swelled. She was transferred to Liverpool Women's so she would be close to Alder Hey, if surgery was required.When the parents arrived, they were informed Baby I did not have NEC, and she improved.
Upon Baby I's return to Liverpool Women's Hospital, her blood gases and heart rate were "normal".It was thought that baby I had suspected sepsis rather than NEC, and a course of antibiotics began to cover for both possibilities.She was kept nil by mouth but was "stable" on the night of 6th September.

7th Sept
There was a "mechnical obstruction" in the ET tube and Child I was re-intubated. After this she "had normal gases and improved very well".Feeds were gradually increased and the course of antibiotics ended after five days.

8th Sept-
9th Sept-
10th Sept-


32 WEEKS GEST (+3)
11th Sept
Baby I continued to tolerate and build up feeds, which was a sign the baby girl did not have NEC.
The expectations of staff at LW hospital were that she would return to the Countess of Chester Hospital and continue to improve.

12th Sept
Antibiotics end.

13th Sept
12.15pm -Baby I transferred back to CoC
1.36pm - Letby records Baby I's temperature in the hotcot. She adds a note "'Abdomen appears full and slightly distended. Soft to touch, straining++. Bowels have been opened. Mum feels it is more distended to yesterday and that baby I is quiet. Appears generally pale. Not on monitor...[will continue to monitor situation]"
LL notes that mum has visited and provided cares.
14th Sept
15th Sept
16th Sept
17th Sept
18th Sept

33 WEEKS GEST (+3)
19th Sept-
20th Sept-
21st Sept-
Letby was working a long day shift. During that day, 'baby G' (not baby I!) suffered a significant deterioration at 10.15am.

22nd Sept-

23rd Sept - LL on nightshift
24th Sept -LL on nightshift
25th Sept- LL on nightshift

34 WEEKS GEST (+3)
26th Sept-
27th Sept- LL not working
28th Sept- LL not working

29th Sept-
LL not working. Note recorded by nurse Shelley Tomlins ' Baby I 'remains pale but managing to complete bottles (slow to feed as windy).' The overnight shift nurse, Jennifer Jones-Key, said Baby I continued to be fed regularly, with her tummy 'full but soft'.

30th Sept-
(Incident 1?) Letby was looking after three babies in room three that day, including Baby I. Feeds are continued for baby I. (35mls expressed breast milk and fortifier.

10am: feed is by bottle

1pm: NG feed (baby is asleep) Note recorded by LL 'EBM+fortifier, NGT, vomit aspirated 5ml, ph5'.

3am: Letby records, 'Reviewed by Drs, appeared mottled in colour with distended abdomen and more prominent veins. Advised to continue. Temperature within normal range with hot cot at 38 degrees. Full monitoring recommenced. within normal range.'

4pm: NG feed ohas an aspirate of 3ml, with Baby I 'asleep'. It is signed by Letby's initials.

4.30pm: Feed chart for Baby I records
'large vomit and apnoea - nil by mouth'. It is not signed by anyone.

4.30pm: LL notes baby I had a large vomit from mouth and nose++ suction given. Became apnoeic with bradycardia and desatuartion (30s). Help summoned and IPPV given for approx 3min in 100% oxygen to recover. Drs were crash called.
'Transferred to nursery 1...'
A doctor records he is crash called. He notes 'Chest clear... Abdomen distended, active bowel sounds all zones'

5.23pm: LL receives text from a colleague thanking LL for a birthday message.

5.45: Medication of glucose and sodium chloride is co-signed by Letby (and for 6pm)

5.39pm: An x-ray is taken of baby I with the radiologist recording: 'There is splinting of the diaphragm due to bowel distension...there is moderately severe bowel distention which is thought to involve both large and small bowel.

'The appearances are suspicious of NEC...'

6.00pm: Medication of glucose and sodium chloride is co-signed by Letby (same as above)
A CRP blood reading for baby I is 'less than 1'.

7.30pm Baby B suffered another deterioration. LL notes she became apnoeic - abdomen distended++ and firm. Bradycardia and desaturation followed, SHO in attendance and registrar called...

'Nil by mouth. NG tube on free drainage. Cannula inserted but tissued during saline bolus (5mls given).

'Colour appears pale but improved from earlier in shift. Abdomen appears full and distended. Veins more prominent. Not further vomits. Responsive but quiet on handling.'

For the family communications: 'Mummy present when reviewed by Drs. Had left unit when baby I had large vomit and transferred to nursery 1. [Mother] up to date with current plan...'

8pm:The doctor records 'ticks' for temperature instability and apnoea for Child I.
8.26pm: Letby's final note from 8.26pm: 'Baby I is now very pale and quiet.'

8.30pm: Nurse (BB) who took over care of Child I for the night shift, records: 'During handover that baby I's abdo became more distended and hard she had become apnoeic nad bradycardiac and sats had dropped. IPPV given and despite a good seal with Neopuff there was still no chest movement...'
Multiple texts exchanged between LL and colleagues that evening.

1st Oct -
8.30am:Nurse (AH) was the designated nurse this day)
8.30am: Nurse (BB) inputs an Incident for 8.30pm the previous night, about administering an antibiotic infusion over 10 minutes instead of 30 minutes. 'Although correct dose was given it was delivered at a faster rate.

'When aware of mistake, infusion was adjusted. Reg and shift leader informed'.

8.44am: note by Nurse (BB) 'handling much better without desats/Bradys'.Was initially very pale colour has improved, abdo remains distended and firm but less distended than at beginning of shift'.

A doctor, during the ward round, said it was considered to restart feeds for baby I. The parents were concerned that baby I may be lactose intolerant, and that had possibly led to abdominal distention.

1.36pm: Nurse (AH) notes baby I appears pale but pink and well perfused...' followed by a number of medical notes

7.48pm: Review by Paeds SHO...abdomen is softer and less distended, ? start cautiously feeding...'

2nd Oct-

35 WEEKS GEST (+3)
3rd Oct-
4th Oct-
5th Oct-
6th Oct-
7th Oct
8th Oct-
9th Oct-

36 WEEKS GEST (+3)
10th Oct-
11th Oct-

12th Oct-
(Incident 2?)

13th Oct-

14th Oct-
(Incident 3?)

15th Oct-
16th Oct-

36 WEEKS GEST (+3)
17th Oct-
18th Oct-
19th Oct-
20th Oct-
21st Oct-
22nd Oct-

 

[Sweeper2000]

So she guessed that baby I stopped breathing before they actually noted it?

What makes you think that it's obvious how long a baby has not been breathing? By being pale?

The baby was breathing once every twenty seconds or 4 to 5 times a minute according to testimony.

Pallor is a pale color of the skin that can be caused by illness, emotional shock or stress, stimulant use, or anemia, and is the result of a reduced amount of oxyhaemoglobin and may also be visible as pallor of the conjunctivae of the eyes on physical examination.

Pallor is more evident on the face and palms. It can develop suddenly or gradually, depending on the cause. It is not usually clinically significant unless it is accompanied by a general pallor (pale lips, tongue, palms, mouth and other regions with mucous membranes). It is distinguished from similar presentations such as hypopigmentation (lack or loss of skin pigment) or simply a fair complexion.

Pallor - Wikipedia

en.wikipedia.org

 

[Becci]

Candida auris: Symptoms, spread, and outbreak risk

Candida auris is a type of fungus that can cause infections in people who are already ill and usually in a healthcare setting, such as a hospital. Learn more.

www.medicalnewstoday.com

 

[Dotta]

Candida auris: Symptoms, spread, and outbreak risk

Candida auris is a type of fungus that can cause infections in people who are already ill and usually in a healthcare setting, such as a hospital. Learn more.

www.medicalnewstoday.com

Umm...
Could this Candida only attack the infants who were in LL's orbit?
What about other wards?

And it is a candid question.

JMO

 

[Becci]

Umm...
Could this Candida only attack the infants who were in LL's orbit?
What about other wards?

And it is a candid question.

JMO

Sounds possible. Someone infected can carry it for months or something on them lines.
No idea just thought after reading it it was quite interesting.

 

[Sweeper2000]

Just reading through the thread, I thought it might be a good idea to see if there are any points in the cases that can be mutually agreed upon. Put ourselves in the juries shoes so to speak. So far anyway.

maybe as a starting point and we have already covered it was which cases so far were the strongest that something had actually happened. We all agreed was the insulin.

 

[Dotta]

Sounds possible. Someone infected can carry it for months or something on them lines.
No idea just thought after reading it it was quite interesting.

Hmmm
Didn't Mum of Baby "I" say that some nurses never cared about washing (never mind disinfecting) hands?
Yuck!

But you reminded me of an article I read years ago about an old hospital that had to be torn down b/c its walls were sooo infected with germs that it was a health hazard.

But it was a veeery old building.

JMO

 

[JosieJo]

I think concentrating on photos and lighting is barking up the wrong tree.

The nurse who was actually there at the time thought it strange that LL could see the baby was pale.

She has stood on oath and said the colour of the baby could not be seen.

Why would anyone disbelieve this nurses testimony?

It's obviously damaging to LL and the defence could not defend it