I wanted to put all these tweets from yesterday afternoon together :
Dan O'Donoghue
When proceedings resume, at around 10.30am, we'll be hearing from more senior consultants - who worked with Ms Letby and a number of medical experts, who'll be giving their view on the cause of death of Child P
Dr Stephen Brearey is now giving evidence about the death of Child P.
Dr Brearey said he carried out a review of the case, that highlighted 'some minor deficiencies in care but none of which would have effected the outcome of (Child P)'
The medic said the events of 24 June were 'horrific' and that they would have 'traumatised' even the most experienced members of staff
He said he would expect 99% of babies born at 33week gestation on fourth day of life to survive
Dr Brearey starts to make a broader point about the times at which the deaths had occurred in 2015 and 2016. Mr Myers raises objections, judge says broader conclusions can be made elsewhere in other means
We're now back after a short break for lunch.
Dr Oliver Rackham is now in the witness box. He was part of the transport team from Arrowe Park Hospital (he was overseeing the transport of Child P to the hospital before his death)
Dr Rackham was on the neonatal transport team responsible (called Connect) in June 2016. He remembers being given a briefing on 24 June about Child P (he had suffered a number of desats that morning)
The medic tells the court that soon after he arrived at the Countess of Chester, at around 3pm, to transport Child P he collapsed and needed resuscitation. During the course of that resus he received seven doses of adrenaline - all to no effect
Dr Rackham said the medics 'had no explanation for why' Child P collapsed. Asked, with his experience, if he could give any reason for Child P's collapse, he said 'there was no obvious cause, it didn't fit with any obvious reason'
The medic said following Child P's death, there was a debrief on the unit. He said it was a chance for staff who work on resuscitation to 'make sure' that there was nothing missed. He said: 'We felt we had carried out resus well and in accordance with all appropriate guidelines'
Ben Myers KC has just invited Dr Rackham to give his view on adrenaline charts for Child P from that day. They show he received 16 bolus injections of adrenaline over the course of the day and was also given a slow infusion of the drug
From the numbers on the slow infusion chart, Mr Myers says this is 'significantly' higher than the dose that would be ideal - the doctor, with some caution, agrees
Mr Myers asks him to spell out what an excessive amount of adrenaline could do to a neonate - he says that it can cause increased heart rate, blood pressure and have an adverse effect on lactic acidosis
The judge seeks some clarification from the witness. He says that if Child P had been given excessive adrenaline, you would expect to see the effect within 10/15mins
M
edical expert Dr Dewi Evans is now in the witness box, he was asked to review the baby deaths by Cheshire Police in 2017
Dr Evans said he was 'at a loss to explain how this baby had collapsed'.
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'
Dr Evans will be cross examined tomorrow. Wrap up of today’s evidence
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