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

Status
Not open for further replies.
This struck me from the Daily Mail article:

'Dr Gibbs said the consultants had gradually come to realise that 'something very wrong was happening on our neonatal unit'.

As a group they had discussed every death and every collapse that occurred after June 2015. 'There was a common factor, and that became clear to all of us,' he said.'

So in other words LL was present for all of the deaths on the unit that year including the ones that don't form part of the charges. That's really interesting to me because one question was would the defence find instances of unexpected collapses or deaths where she wasn't present. It appears not
 
I've got this in a timeline for baby P based off opening speech and electronic evidence

23 June

6pm - Dr Gibbs reviewed P because O had died in unusual circumstances. The abdomen was full, mildly distended, no tenderness and active bowel sounds (good signs). He was screened for infection.

6pm - P was fed donor expressed milk signed only by LL

LL records, for the family communication: 'Parents kept updated on events throughout the afternoon - were present for some of the resuscitation and maternal grandmother present for support. '...Time alone [for parents and O] given. Photographs taken on mobile. Aware of need to keep lines/ET Tube in at present. 'O taken to family room to be with parents. Cooling cot arranged' (electronic evidence)

7.30/8pm – night-shift handover

8pm - P was fed donor expressed milk – there was a 14ml milk acidic aspirate. An x-ray taken at 8pm showed striking gaseous distension throughout the stomach and whole bowel.

8.24pm – LL made nursing notes for P.

On that night-shift milk feeds were stopped on the grounds that a further large part-digested aspirate was drawn up the NGT at feeding time.

8.35pm – LL made retrospective nursing notes for O for 1.15pm and 4.19pm (mix electronic evidence and opening speech)

8.51pm - A nursing note recorded at 20:51 by LL is being shown to court. It summarises O's deterioration and what happened with parents after (being taken to family room to be with him) (electronic evidence)

Shortly after 8.51pm –
Doc: Are you okay?
LL: 'think so, just finishing my notes, can't wait to get home. How are you?'
Doc: Had a moment in the car, bit better now.
doctor asks her if she is going to vote in the Brexit referendum
LL: 'no can't face that'
LL: Just walking home. Parents very grateful for everything. Nice to have some fresh air.
Doc: Your notes must have taken a long time. Had you documented anything from this morning?
LL: Can’t think straight, so took a while.
Doc: Phew, not the first day back you were expecting. I was glad you were there, everything felt safe. Thank you for looking out for me.
LL: No, but it happens. Don’t need to thank me, I’m pleased you were there, think we work well together. Sorry for my loss of composure moment
Doc: I was trying to say thanks for checking I was okay. We do work well together I’m glad you could talk to me and I hope I helped.
LL: That’s okay, good to talk it through otherwise carry it round.
Doc: There are very few things that a hug can’t help fix.
LL: One of those days
Doc: Thank you for keeping me company again. Sleep well.
LL: Don’t be daft, it’s a two-way thing and what friends are for. You had me blubbering, night.
Doc: Oh no, how guilty do I feel. Goodnight.
LL: Guilty? I mean you had to see me blubbering at work.
Doc: Oops my mistake. I thought it had tipped you over on the end of a bad day. Blubbering at work is normal for someone who cares about the families and babies that they look after.
LL: No, no I’m fully composed. Thank you a good cry is what’s needed sometimes. Hope you sleep.
Doc: Goodnight


Time? To a nursing colleague, LL: 'Lost a triplet today, been *advertiser censored* x'
colleague: *** hell, what happened?
LL: blew up abdomen, think it’s sepsis. Went very suddenly. IO access and abdominal drain
Colleague: how many weeks?
LL: 33
Colleague: assuming they all seemed stable if had all three?
LL: yeah, were all fine. This one still on Optiflow but weaning and all fully fed 2 x 12.
Colleague: Jesus
LL: had big tummy overnight but just ballooned after lunch and went from there.
Coll: big hugs. Be treating all of them with anti-b’s then, or think just that one?
LL: yeah, other two been re-screened and gases etc just in case, as not really sure what caused collapse. I want to be in Ibiza ☹
Coll: 'I bet you don't want to go back in tomorrow'
LL: 'I do and I don't' think good to go back in and talk about it'
Nurse: 'Poor parents'
LL said O had died on the student's first day of a four-week placement. She adds who was on duty that day.
Nurse: 'Lots of consultants then. bloody tragic news. We don't have any luck with 33-34wkrs. Never seem b able to tell do u
LL: 'Awful. No, not a good gestation. deteriorate so quick'.
nurse: hope other two have an easy ride now for the parents’ sake.
LL: worry as identical.
LL said one colleague was upset about what had happened.
LL adds: 'Yeah worried she's missed something'
Nurse: 'Wow identical triplets! Didn't know that even happened'


LL messaged a nursing colleague to suggest a cause of death as sepsis or NEC. She told police she thought that at the time because 'it was a discussion they had all had' on the unit."

LL’s mother messaged LL saying it was sad what had happened on the first day back after LL's holiday.
LL: 'Yep it's just as well I love my job!'

The doctor messages LL to say the debrief didn't find anything that was missed for the events of O.

LL messages the doctor to say 'apparently' she had sounded bossy around the time of the baptism call for O.
The doctor says he would interpret it as being proactive.
LL says she has 'broad shoulders' and had apologised, saying it could have been interpreted as being overly direct.
The two agree it had been a stressful situation.



24 Jun 2016, Fri – LL’s day-shift – murder charge child P

After midnight –

1.25am - The pair wish each other goodnight (electronic evidence)

6.39am – A nurse recorded P’s abdomen was soft and non-distended. 25ml of air had been aspirated by one of the nurses and the NGT had been placed on free-drainage. The problem P had when LL handed over to the night-shift had resolved. (opening speech)

Morning - doctor messages LL again that morning asking how she slept and letting her know that a medical director has been on ward (electronic evidence)

Ahead of the shift doctor messaged LL: "Are you OK? It's rubbish not to sleep well in the middle of 3 long days. Hope your day goes OK."
LL:
"Hmm maybe. I'll be watching them both (Child P and the surviving triplet) like a hawk.

7.30/8am – LL’s day-shift. P’s designated nurse (and the third triplet) in room 2.

LL to doctor: "I'm OK. Just don't want to be here really. Hoping I may get the new admissions."
LL to doctor: “I might see if she (a student nurse) can work with someone else as don’t feel I’m in frame of mind to support her properly and paperwork to finish off”

8.30am -
Text messages LL sent to a doctor at just after 8.30am suggest she had sent, or was sending, her student with a baby who needed an MRI scan.

Approx. 9.30am - LL's nursing notes from later that night (9.18pm-10pm) recorded: "Written in retrospect...NG tube on free drainage - trace amount in tube. Abdomen full – loops visible, soft to touch … Reg...arrived to carry out ward round – P had apnoea, brady, desat with mottled appearance requiring facial oxygen and neopuff for approx. 1 min. Abdomen becoming distended. Decision made to carry out bloods and gas (approx. 09:30)”

9.35am - A registrar noted P, at 9.35am, had “desat + bradys” and had a moderately distended / bloated abdomen and slightly mottled skin.

9.50am - P had an acute deterioration. A crash call went out. P was intubated and improved, and efforts were made to transfer him to Arrowe Park Hospital

11.30am - P desaturated again at 11.30am. He was given adrenaline.
His spontaneous circulation improved but he continued to deteriorate through the day.

11.57am - A punctured lung was identified from an x-ray taken at 11.57am, treatment started at 12.40pm.

12.40pm – treatment for punctured lung started.

3pm - The transport team arrived at 3pm. Just before they arrived, P's blood gases were taken and were satisfactory. A doctor was hopeful of P's prospects. The court hears LL said to her something like "he’s not leaving here alive is he?"

3.14pm - P's final collapse came at 3.14pm and, despite resuscitative efforts, he died at 4pm.

Ohhh so LL crying was at Baby O's death and the being excited and animated offering the memory box was the next day at Baby P's death?
 
I've got this in a timeline for baby P based off opening speech and electronic evidence

23 June

6pm - Dr Gibbs reviewed P because O had died in unusual circumstances. The abdomen was full, mildly distended, no tenderness and active bowel sounds (good signs). He was screened for infection.

6pm - P was fed donor expressed milk signed only by LL

LL records, for the family communication: 'Parents kept updated on events throughout the afternoon - were present for some of the resuscitation and maternal grandmother present for support. '...Time alone [for parents and O] given. Photographs taken on mobile. Aware of need to keep lines/ET Tube in at present. 'O taken to family room to be with parents. Cooling cot arranged' (electronic evidence)

7.30/8pm – night-shift handover

8pm - P was fed donor expressed milk – there was a 14ml milk acidic aspirate. An x-ray taken at 8pm showed striking gaseous distension throughout the stomach and whole bowel.

8.24pm – LL made nursing notes for P.

On that night-shift milk feeds were stopped on the grounds that a further large part-digested aspirate was drawn up the NGT at feeding time.

8.35pm – LL made retrospective nursing notes for O for 1.15pm and 4.19pm (mix electronic evidence and opening speech)

8.51pm - A nursing note recorded at 20:51 by LL is being shown to court. It summarises O's deterioration and what happened with parents after (being taken to family room to be with him) (electronic evidence)

Shortly after 8.51pm –
Doc: Are you okay?
LL: 'think so, just finishing my notes, can't wait to get home. How are you?'
Doc: Had a moment in the car, bit better now.
doctor asks her if she is going to vote in the Brexit referendum
LL: 'no can't face that'
LL: Just walking home. Parents very grateful for everything. Nice to have some fresh air.
Doc: Your notes must have taken a long time. Had you documented anything from this morning?
LL: Can’t think straight, so took a while.
Doc: Phew, not the first day back you were expecting. I was glad you were there, everything felt safe. Thank you for looking out for me.
LL: No, but it happens. Don’t need to thank me, I’m pleased you were there, think we work well together. Sorry for my loss of composure moment
Doc: I was trying to say thanks for checking I was okay. We do work well together I’m glad you could talk to me and I hope I helped.
LL: That’s okay, good to talk it through otherwise carry it round.
Doc: There are very few things that a hug can’t help fix.
LL: One of those days
Doc: Thank you for keeping me company again. Sleep well.
LL: Don’t be daft, it’s a two-way thing and what friends are for. You had me blubbering, night.
Doc: Oh no, how guilty do I feel. Goodnight.
LL: Guilty? I mean you had to see me blubbering at work.
Doc: Oops my mistake. I thought it had tipped you over on the end of a bad day. Blubbering at work is normal for someone who cares about the families and babies that they look after.
LL: No, no I’m fully composed. Thank you a good cry is what’s needed sometimes. Hope you sleep.
Doc: Goodnight


Time? To a nursing colleague, LL: 'Lost a triplet today, been *advertiser censored* x'
colleague: *** hell, what happened?
LL: blew up abdomen, think it’s sepsis. Went very suddenly. IO access and abdominal drain
Colleague: how many weeks?
LL: 33
Colleague: assuming they all seemed stable if had all three?
LL: yeah, were all fine. This one still on Optiflow but weaning and all fully fed 2 x 12.
Colleague: Jesus
LL: had big tummy overnight but just ballooned after lunch and went from there.
Coll: big hugs. Be treating all of them with anti-b’s then, or think just that one?
LL: yeah, other two been re-screened and gases etc just in case, as not really sure what caused collapse. I want to be in Ibiza ☹
Coll: 'I bet you don't want to go back in tomorrow'
LL: 'I do and I don't' think good to go back in and talk about it'
Nurse: 'Poor parents'
LL said O had died on the student's first day of a four-week placement. She adds who was on duty that day.
Nurse: 'Lots of consultants then. bloody tragic news. We don't have any luck with 33-34wkrs. Never seem b able to tell do u
LL: 'Awful. No, not a good gestation. deteriorate so quick'.
nurse: hope other two have an easy ride now for the parents’ sake.
LL: worry as identical.
LL said one colleague was upset about what had happened.
LL adds: 'Yeah worried she's missed something'
Nurse: 'Wow identical triplets! Didn't know that even happened'


LL messaged a nursing colleague to suggest a cause of death as sepsis or NEC. She told police she thought that at the time because 'it was a discussion they had all had' on the unit."

LL’s mother messaged LL saying it was sad what had happened on the first day back after LL's holiday.
LL: 'Yep it's just as well I love my job!'

The doctor messages LL to say the debrief didn't find anything that was missed for the events of O.

LL messages the doctor to say 'apparently' she had sounded bossy around the time of the baptism call for O.
The doctor says he would interpret it as being proactive.
LL says she has 'broad shoulders' and had apologised, saying it could have been interpreted as being overly direct.
The two agree it had been a stressful situation.



24 Jun 2016, Fri – LL’s day-shift – murder charge child P

After midnight –

1.25am - The pair wish each other goodnight (electronic evidence)

6.39am – A nurse recorded P’s abdomen was soft and non-distended. 25ml of air had been aspirated by one of the nurses and the NGT had been placed on free-drainage. The problem P had when LL handed over to the night-shift had resolved. (opening speech)

Morning - doctor messages LL again that morning asking how she slept and letting her know that a medical director has been on ward (electronic evidence)

Ahead of the shift doctor messaged LL: "Are you OK? It's rubbish not to sleep well in the middle of 3 long days. Hope your day goes OK."
LL:
"Hmm maybe. I'll be watching them both (Child P and the surviving triplet) like a hawk.

7.30/8am – LL’s day-shift. P’s designated nurse (and the third triplet) in room 2.

LL to doctor: "I'm OK. Just don't want to be here really. Hoping I may get the new admissions."
LL to doctor: “I might see if she (a student nurse) can work with someone else as don’t feel I’m in frame of mind to support her properly and paperwork to finish off”

8.30am -
Text messages LL sent to a doctor at just after 8.30am suggest she had sent, or was sending, her student with a baby who needed an MRI scan.

Approx. 9.30am - LL's nursing notes from later that night (9.18pm-10pm) recorded: "Written in retrospect...NG tube on free drainage - trace amount in tube. Abdomen full – loops visible, soft to touch … Reg...arrived to carry out ward round – P had apnoea, brady, desat with mottled appearance requiring facial oxygen and neopuff for approx. 1 min. Abdomen becoming distended. Decision made to carry out bloods and gas (approx. 09:30)”

9.35am - A registrar noted P, at 9.35am, had “desat + bradys” and had a moderately distended / bloated abdomen and slightly mottled skin.

9.50am - P had an acute deterioration. A crash call went out. P was intubated and improved, and efforts were made to transfer him to Arrowe Park Hospital

11.30am - P desaturated again at 11.30am. He was given adrenaline.
His spontaneous circulation improved but he continued to deteriorate through the day.

11.57am - A punctured lung was identified from an x-ray taken at 11.57am, treatment started at 12.40pm.

12.40pm – treatment for punctured lung started.

3pm - The transport team arrived at 3pm. Just before they arrived, P's blood gases were taken and were satisfactory. A doctor was hopeful of P's prospects. The court hears LL said to her something like "he’s not leaving here alive is he?"

3.14pm - P's final collapse came at 3.14pm and, despite resuscitative efforts, he died at 4pm.

Thank you as always, Tortoise, for putting that all together. I have a lot of questions that I hope will be answered with the testimony tomorrow. This poor baby.
 
Ohhh so LL crying was at Baby O's death and the being excited and animated offering the memory box was the next day at Baby P's death?
I haven't got in that timeline the messaging after baby P's death. Parents said she was crying when she brought both boys to them, and then she had the faint at A&E and doctor took her home, and at some point (not sure time) Dr Brearey said they had a meeting and he suggested she take the next day off and she didn't appear upset at all.


some testimony about post P's death -

The doctor, who cannot be identified for legal reasons, asked Letby: “Have you been seen yet?”
Letby replied: “Yes just got back. I made a fool of myself whilst there.”
The doctor, who was also involved in the resuscitation efforts, said: “I asked them to be quick for you. How did you make a fool of yourself?”
Letby responded: “They said someone had asked for me to been seen asap and they knew what had happened today.
“Everyone talking about it whilst I was there. I fainted.”
The doctor asked: “Oh are you OK now?”
Letby replied: “Bit shaky but OK. Writing my notes. They were reluctant to let me go as on my own.”
The doctor said: “You could have bleeped me. I’m almost a responsible adult!
“Do you need a lift home?”
After she was dropped off by the doctor at her home address, Letby messaged him: “Thank you for the lift and for talking to A&E.”
The doctor said: “I can’t have you walking back in the dark after a rubbish day, mini needlestick and an A&E faint.”

He later asked: “What are u doing? I can’t concentrate on anything.”
Letby said: “Wanting to (cry emoji).”
The doctor said: “Did in car. Must have looked a right mess when I got in.”
Letby replied: “I keep thinking of them (Child O and Child P) both in the cot together. So peaceful yet beyond words how awful it is.
“So sad. The family thanked me when I took (Child P) in dressed. And I know age doesn’t make it any easier/harder but such a lot to go through at a young age.”
The doctor said: “I don’t know how it would be possible to get over losing a child, let alone 2.”
Letby responded with a crying emoji and wrote: “Think my head may explode…”

 
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."

I had to read that back to myself several times... :eek:
 
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.'
I think we're all feeling it too. Well I certainly am, I feel the heaviness of the devastation and the grief, the shock awakening hitting like a bolt of lightening, leading to a flurry of meetings and heated discussions, people talking, LL fainting, as if a whirlwind had passed through.

One doctor who was seemingly oblivious.

And it's not even over yet, with baby Q ahead.

JMO
 
Yes, that's right. In that she was his nurse the previous evening & he was restless at the start of the night shift.
I think that might have been baby N?

The night before the day of baby O's death LL had just flown back from holiday.

But she is accused of putting air down his NG tube and air embolus -

"The witness told Mr Myers he believed there were three separate events – the final collapse and two earlier incidents which “compromised” Child O.

Dr Evans said that inflicted trauma to the liver took place at some point and an amount of air was put down the infant’s nasogastric tube which caused vomiting and swelling to his stomach.

Mr Myers said: “I suggest that vigorous chest compressions can cause or are capable of causing internal injuries to the liver.”

Dr Evans replied: “I have never seen it.”

Fellow expert witness, neonatologist Dr Sandie Bohin, said she too had never seen liver damage from CPR.

She told the court she concluded that injections of air “with no innocent cause” were responsible for Child O’s “unexpected” deterioration."

 
I think that might have been baby N?

The night before the day of baby O's death LL had just flown back from holiday.

But she is accused of putting air down his NG tube and air embolus -

"The witness told Mr Myers he believed there were three separate events – the final collapse and two earlier incidents which “compromised” Child O.

Dr Evans said that inflicted trauma to the liver took place at some point and an amount of air was put down the infant’s nasogastric tube which caused vomiting and swelling to his stomach.

Mr Myers said: “I suggest that vigorous chest compressions can cause or are capable of causing internal injuries to the liver.”

Dr Evans replied: “I have never seen it.”

Fellow expert witness, neonatologist Dr Sandie Bohin, said she too had never seen liver damage from CPR.

She told the court she concluded that injections of air “with no innocent cause” were responsible for Child O’s “unexpected” deterioration."

You're correct, apologies.
 
I think the hospital admins were responding to the pressure from the Union reps, which would probably be threatening that if their employee was not returned to her prior job, there could be court action.

The union reps would probably be asserting that there was no proof of any wrong doing on her part, and she is demanding her job back and possibly some kind of compensation? She had filed a grievance and that has some teeth to it.
But she wasn’t suspended or dismissed, or disciplined, and presumably her salary remained the same. So what pressure could the union realistically be applying that would cause management to make continued attempts to reinstate her into that particular role. Surely it’s up to NHS what roles they place their staff into.

Although I’ve never worked for the NHS so I’m not sure, just speculating.

Edit: furthermore I could submit a grievance against my employer tomorrow without even mentioning it to my union rep. The existence of a grievance doesn’t mean the complaint had any merit.
 
I thought he was saying that he could only look at the cases where he was on duty---thus involved.

But later on, after conferring with other doctors, they also looked at who was caring for the babies that collapsed under their care---and LL allegedly came to their minds as well.JMO
Interesting point, yes that too I guess.
 
One thing that has occurred to me. The doctors seem to have been so caught up in the environment of their workplace, that they seem to have forgotten that they didn’t need management’s permission to go to the police. Just like any other human being who sees or suspects a crime, any one of them at any point could have gone to police and said they think they were witness to a murder/assault, or that they have reason to believe such crimes have occurred.

All this time after they started suspecting, they were waiting for management’s support, and what for? Yes it would made things easier for the police investigation if everyone was cooperating, but hospital management rules are not the law.
 
One thing that has occurred to me. The doctors seem to have been so caught up in the environment of their workplace, that they seem to have forgotten that they didn’t need management’s permission to go to the police. Just like any other human being who sees or suspects a crime, any one of them at any point could have gone to police and said they think they were witness to a murder/assault, or that they have reason to believe such crimes have occurred.

All this time after they started suspecting, they were waiting for management’s support, and what for? Yes it would made things easier for the police investigation if everyone was cooperating, but hospital management rules are not the law.
I think if they'd been aware of the insulin poisonings things would have gone very differently. JMO
 
Ohhh so LL crying was at Baby O's death and the being excited and animated offering the memory box was the next day at Baby P's death?
I noticed too where doctor choc appears to mention something about crying at work- Or crying from his lead in the car (mirroring)? and then we hear the consultant saying when they had the debrief, she appeared absolutely fine and ready for work the next day.

The whole thing is just really weird imo. I’m not surprised consultants were concerned.
JMO
 
One thing that has occurred to me. The doctors seem to have been so caught up in the environment of their workplace, that they seem to have forgotten that they didn’t need management’s permission to go to the police. Just like any other human being who sees or suspects a crime, any one of them at any point could have gone to police and said they think they were witness to a murder/assault, or that they have reason to believe such crimes have occurred.

All this time after they started suspecting, they were waiting for management’s support, and what for? Yes it would made things easier for the police investigation if everyone was cooperating, but hospital management rules are not the law.
It’s not just that, there seems to have been a widespread reluctance to put anything down in writing. I said it at the time and I stand by it, I do not think Dr J simply forgot to write down about that suspicious rash, I think he was conditioned not to write it down specifically due to the suspicious nature of it. And I believe him when he says he regrets it now.

Everything seems to have been “I spoke to X, they spoke to X, everyone was talking in the canteen, consultants held a secret meeting” but there’s so little actual evidence of any of it.

In fact, it’s quite interesting that LL’s note questioned what “written evidence” they had of the allegations.

Clearly a cultural issue within the organisation, which absolutely needs to change.

JMO.
 
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.
I'm just catching up with things here but the evidence today is just unbelievable, quite honestly! Whether she ends up being found guilty or not, this hospital is going to get absolutely shafted over the coming months and years!!!
 
Jurors were told Letby submitted a formal grievance to management after she was removed from the unit.

This is what many people here speculated her grievance was about. I think this also is what she refers to in the part of the note where she says ...they have no evidence....

MOO.
 
Status
Not open for further replies.

Members online

Online statistics

Members online
79
Guests online
891
Total visitors
970

Forum statistics

Threads
589,925
Messages
17,927,731
Members
228,002
Latest member
zipperoni
Back
Top