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

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He told the jury that the deaths of the brothers was a "tipping point for realising something very abnormal and wrong was happening on the neonatal unit".

He added: "This was happening again and again over that year. That cannot just be coincidence or bad luck, there had to be a cause."
 
Doctors resisted nurse's frontline return - trial - BBC News

Dr Gibbs said he had told hospital managers that Ms Letby could only return if CCTV was installed "in each room on the unit", a move he said was "very unusual" and "unheard of in my experience".

The medic said: "Over the next 11 months we had to resolutely resist attempts by management to have Staff Nurse Letby back on the unit."
 
This testimony from the consultants is really very compelling and mirrors a discussion we had on a previous thread about what should be done! CCTV!

Dr Gibbs said he had told hospital managers that Ms Letby could only return if CCTV was installed "in each room on the unit", a move he said was "very unusual" and "unheard of in my experience".

The medic said: "Over the next 11 months we had to resolutely resist attempts by management to have Staff Nurse Letby back on the unit."
 
The management were pushing to have LL brought back onto the unit?

I’m speechless. At the beginning of all this, I was questioning what kind of hospital would “move someone to day shifts” to see whether the deaths followed. I balked at it. But the reality is somehow turning out to be much worse, if that’s even possible.
 
At this time, Dr Gibbs said he had "become increasingly concerned at the accumulating number of unusual, unexpected and inexplicable collapses that had been happening on the neonatal unit and that Staff Nurse Letby had been involved in all of them".

He told the jury that the deaths of the brothers was a "tipping point for realising something very abnormal and wrong was happening on the neonatal unit".


He added: "This was happening again and again over that year. That cannot just be coincidence or bad luck, there had to be a cause."

I think that answers the question people were asking about whether there were any other unexpected collapses in that one year period, that we weren't aware of, that LL WASNT present at! According to Dr Gibbs she was involved in ALL of the unexpected collapses in that time period.

 
Dr Gibbs replied: “I was most heavily influenced by what was happening to babies on the unit… there was only one common factor.”

Mr Myers asked: “You didn’t contact the police, did you?”

Dr Gibbs said: “That was difficult. Nurse Letby seemed to be involved in all of the cases that involved me. Other consultants were involved with other babies.

“None of us regrettably realised two babies had been poisoned by insulin, so we didn’t have the full picture.

“After the deaths of the triplets – very regrettably too late for them – because the concerns had reached a tipping point, safety measures were introduced and one of the key safety measures which the consultants were insistent on was Lucy Letby be removed from the neonatal unit and that was not a simple, straightforward decision.”

 
Jurors were told Letby submitted a formal grievance to management after she was removed from the unit.

 
A tension pneumothorax can cause a collapse. This is when there is air in the chest that is outside of the lung, and it prevents the lung from inflating as well as pushes the heart to one side and interferes with circulation. It is only my opinion but I think it would be extremely uncommon (beggaring belief) for that to happen suddenly and spontaneously in an otherwise healthy 33 weeker who is not being mechanically ventilated. Pneumothorax can also occur during a resuscitation, as a side effect of efforts to ventilate the baby. (All just my opinion!)

I agree. Also, the symptoms such as increased O2 requirement tend to come on relatively slowly, so normally a quick check will arouse suspicions & transillumination plus a chest Xray confirms. Though as you say, a spontaneous pneumothorax in a well 33 weeker is pretty unusual, unless they're born with one, which evidently was not the case.
 
The management were pushing to have LL brought back onto the unit?

I’m speechless. At the beginning of all this, I was questioning what kind of hospital would “move someone to day shifts” to see whether the deaths followed. I balked at it. But the reality is somehow turning out to be much worse, if that’s even possible.

It's truly confounding. I wonder are we ever going to find out what drove the management's position on LL?
 

“senior management were extremely reluctant to involve the police to discuss what had happened because we had to keep insisting the police be involved.”

WHY. What is their reason for being so reluctant, if they want her back on the ward and see nothing suspicious surely you’d just want her cleared or for the police to say ‘yeah nothing to see here’ and lay it all to rest and get a highly qualified nurse back on the ward. The parents in this case need answers for why the actual F this happened.
 
"He told Ben Myers KC, defending, the collapses were unique events 'that I'd never seen before in my career'.

Dr Gibbs continued: 'Medicine could never be an exact science and there were occasions when doctors were unable to find an explanation for a patient's demise.

'But this was happening again and again on our unit and that can't just be coincidence or bad luck. There had to be a cause.

[...]

Dr Brearey told the jury: 'What struck me was the horrific nature of the whole day…I could see the trauma on the faces of the staff involved. The events of that day struck me as being very exceptional.'

[...]

Dr Brearey had 'clearly' been aware of the association with Letby, and he recalled how Baby P's collapse had occurred near the start of a day shift. This had also been the case in the death of Baby O.

Questioned by Philip Astbury, prosecuting, he went on to point out that the collapses of Baby N and of a set of twins in the case, Baby L and Baby M also happened during day shifts.

At this point Mr Myers rose to say he had 'identified the fact that this going on to what Dr Brearey wants to say rather than simply answering the question'.

He was not lodging a formal objection, but suggested the paediatrician's evidence was following a pattern in which medical witnesses were 'expanding well beyond the question to say what they wish'."

[...]

 
Dan O'Donoghue

@MrDanDonoghue
·
2h

Dr Evans said he was 'at a loss to explain how this baby had collapsed'.

Dan O'Donoghue

@MrDanDonoghue
·
2h

He noted 'a lot of gas' in Child P's bowel from the evening before his death, he said it 'begs the question whether excess gas in the abdomen 8pm on night before, was the result of air being injected down his NG tube'

Dan O'Donoghue

@MrDanDonoghue
·
2h

Dr Evans will be cross examined tomorrow. Wrap up of today’s evidence

 
Reading the testimony from the consultants is absolutely chilling. I don't get the "LL is a scapegoat for hospital failings" narrative at all.
Yeh I agree. Although I’m not sure the typical scapegoat label applies here. I think it’s used to mean there are known instances of mistakes that are blamed on innocent parties. This case I think that word is used to mean there are events that don’t have explanations and they have to have a reason for them, ll became the only running theme throughout. More confirmation bias than scapegoat. Things are going wrong so someone must be to blame, rather than if innocent these events have no known medical cause and would be viewed very suspiciously but maybe without cause. So everyone is concerned and right to be so but without cause if innocent. I certainly haven’t read much that makes me think this hosp was not operating at the level that would cause errors like this. There’s a few instances of sub clinical treatment but far from blanket failings.

im finding managements position difficult to fathom. I can only assume they were thinking of LL and maybe the reaction to police involvement. If LL had a proper heart to heart with management and they believed her and still had the belief there was no evidence I think they are bound by law to protect her interests. They have to side with her regardless of what other staff were saying. Fair treatment etc. I think we will have to wait and see exac what their angle was but can only guess it revolves around the no evidence part. Remember no one saw her do anything and the post mortem came back without red flags but not sure about that. Natural causes etc.

I am surprised at ll reaction as well, 11 months of trying to Get back on the unit.
 
Dan O'Donoghue
@MrDanDonoghue
·
2h

Dr Evans said he was 'at a loss to explain how this baby had collapsed'.

Dan O'Donoghue
@MrDanDonoghue
·
2h

He noted 'a lot of gas' in Child P's bowel from the evening before his death, he said it 'begs the question whether excess gas in the abdomen 8pm on night before, was the result of air being injected down his NG tube'

Dan O'Donoghue
@MrDanDonoghue
·
2h

Dr Evans will be cross examined tomorrow. Wrap up of today’s evidence



Is he suggesting that the day before P died, LL allegedly injected air into his NG tube/stomach before she finished her day shift... after allegedly killing Baby O?

Do we know what time she finished her shift on the day O died?


IMO
 
"But he [Dr Gibbs] went on to say that he and his colleagues did not have "the full picture" and that they knew only that babies had been dying and Ms Letby's presence was a "common factor"."


I think the way this is worded might mean that all the near-fatal collapses hadn't been linked with LL at that time.

JMO
 
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