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

[esther43]

Can completely understand the skepticism around the 'people at the top' they wernt wrong that there was something going on there.
Yes there are bidding wars between trusts that may exist outside of all this. I always thought it was pertinent that they were building that new baby unit and all the publicity that was due to bring.
I can't see though, why CoC would want to downgrade to a level 1 is usual circumstances. They would absolutely want to keep their level 2.
Ahead of the independent inquiry there was a peer review of the unit. Certain recommendations came out of that.
However a senior managers response to that scenario is not going to be ' ahh okay then, let's downgrade'
I think it's more likely that senior management tried to keep all this under the radar, to avoid getting downgraded. Then, when they had no choice because they were getting overturned by the consultant team and an investigation was getting launched, suddenly, they were all about 'well we must act immediately and downgrade'
They were knee deep in it, knowing they'd failed to act earlier. What would the public think, if they heard that a potential serial killer had been ignored for so long and the Trust did nothing except for 'get overturned'
They fell back on an old report and blamed it on poor staffing. The consultant were not sucking that up. jmo

Yeah I have not heard of anyone getting a pneumothorax from a high flow nasal cannula. I googled and I think that is what Optiflow is? I suppose maybe it's possible if grossly misused (flow turned up to 15L?) but can't imagine that happening accidentally. The pneumo was discovered shortly after a successful resuscitation, on x-ray. I can imagine a pneumothorax arising during the process of resuscitation or after being intubated and placed on a ventilator. As you said - from the high pressures needed to ventilate and oxygenate the baby.

Yeah, I think you're right optiflow is just a brand name for hight flow.
So if a result of resus, is it still the air pressure that causes it to occur?
I wonder also how AE through Ng tube or bloodstream might increase risk of pneumo. Apparently they are quite rare now, due to volume targeted ventilation. I still find it unusual that there would be two babies with this condition in a level 2 within 6 months. Maybe in a surgical unit dealing with the whole region but in one level 2 unit? Just another rarety I guess...jmo

 

[Marantz4250b]

They can and have provided evidence to suggest when LL is around but actually not much in the way of proving she was in a position to do as alleged and that’s a big part IMO. Yeh we have sound reason for the docs to allege AE only thing is those docs didn’t have the evidence to suggest someone had the opportunity to do it without detection. So the med notes say AE but witness statement, other med notes, etc say it’s not that so what do you do then?

I definitely agree with this. The most striking ones to me are the insulin cases; I think it's fair to say that there is little doubt that those bags were indeed adulterated with insulin but I can't recall them presenting any evidence at all demonstrating that she adulterated them, when she did it or how, specifically, she did it.

Same with so much of the other stuff; in some cases there were people very nearby or even in the same room with their backs turned, allegedly. Yet not once have the prosecution claimed that she was seen actually doing anything unlawful.

 

[Lincoln34]

Can completely understand the skepticism around the 'people at the top' they wernt wrong that there was something going on there.
Yes there are bidding wars between trusts that may exist outside of all this. I always thought it was pertinent that they were building that new baby unit and all the publicity that was due to bring.
I can't see though, why CoC would want to downgrade to a level 1 is usual circumstances. They would absolutely want to keep their level 2.
Ahead of the independent inquiry there was a peer review of the unit. Certain recommendations came out of that.
However a senior managers response to that scenario is not going to be ' ahh okay then, let's downgrade'
I think it's more likely that senior management tried to keep all this under the radar, to avoid getting downgraded. Then, when they had no choice because they were getting overturned by the consultant team and an investigation was getting launched, suddenly, they were all about 'well we must act immediately and downgrade'
They were knee deep in it, knowing they'd failed to act earlier. What would the public think, if they heard that a potential serial killer had been ignored for so long and the Trust did nothing except for 'get overturned'
They fell back on an old report and blamed it on poor staffing. The consultant were not sucking that up. jmo

I think all you say is correct. The rumours - and they were never more than that as far as I know -was for a large hospital centre to be built in Ellesmere Port and The Countess in general downgraded. The Countess of Chester site is large , well situated, and would have potential for house development . No source I’m afraid - only speculation at the time IMHO .

 

[Marantz4250b]

Yes, in cases such as Beverley Allitt, it was all about a craving for attention and sympathy and drama. They are incapable of any feeling for other people's suffering, but good at acting as if they care.

There was more to it with BA. It's convenient for the press to print the line that she was doing it for the attention but her motives were more detailed than that. Basically, she liked hurting people. She was known to be someone who was violent and had been violent towards partners. When she had left nursing in the period before her trial she was known to have poisoned the family she was staying with including the dog!

 

[Tortoise]

I definitely agree with this. The most striking ones to me are the insulin cases; I think it's fair to say that there is little doubt that those bags were indeed adulterated with insulin but I can't recall them presenting any evidence at all demonstrating that she adulterated them, when she did it or how, specifically, she did it.

Same with so much of the other stuff; in some cases there were people very nearby or even in the same room with their backs turned, allegedly. Yet not once have the prosecution claimed that she was seen actually doing anything unlawful.

Are you saying someone needs to have seen her engaged in the various acts for the prosecution to prove it? What happened to reasonable deduction from the evidence presented?

Is it realistic to propose that someone engaged in these acts would do them when others were watching what they were doing?

 

[Marantz4250b]

Are you saying someone needs to have seen her engaged in the various acts for the prosecution to prove it? What happened to reasonable deduction from the evidence presented?

Is it realistic to propose that someone engaged in these acts would do them when others were watching what they were doing?

I'm not saying that, no. I'm saying that they haven't presented any evidence which directly links her to what she's accused of, which they haven't, unless I've missed it.

Somebody put insulin in those bags - the prosecution have only demonstrated the she hung them up and signed or them, thugh, not that she actually adulterated them. Now, perhaps, a jury will infer that she did it based on the evidence but there is no evidence as yet presented to demonstrate when, where and how she allegedly did it.

The problem I have with the notion that she did these things when no one was watching is that there are a huge number of charges. If guilty then she's had an immense run of good luck never to have been caught as some of the alleged acts are brazen and would have taken some time. Yes, if guilty, then she may just either be very skilled at this or just very lucky that no one in the vicinity turned round, or suchlike, at the wrong time.

Many years ago the IRA said to Margaret Thatcher - "We only need to by lucky once, you need to be lucky every time", or words to that effect. Same applies here, I think.

 

[Tortoise]

I'm not saying that, no. I'm saying that they haven't presented any evidence which directly links her to what she's accused of, which they haven't, unless I've missed it.

Somebody put insulin in those bags - the prosecution have only demonstrated the she hung them up and signed or them, thugh, not that she actually adulterated them. Now, perhaps, a jury will infer that she did it based on the evidence but there is no evidence as yet presented to demonstrate when, where and how she allegedly did it.

The problem I have with the notion that she did these things when no one was watching is that there are a huge number of charges. If guilty then she's had an immense run of good luck never to have been caught as some of the alleged acts are brazen and would have taken some time. Yes, if guilty, then she may just either be very skilled at this or just very lucky that no one in the vicinity turned round, or suchlike, at the wrong time.

Many years ago the IRA said to Margaret Thatcher - "We only need to by lucky once, you need to be lucky every time", or words to that effect. Same applies here, I think.

It's extremely rare to have surreptitious murders witnessed by anybody.

In this type of environment, there would be no point in collecting DNA because everyone's DNA is either expected to be there because they work there, or they are wearing sterile gloves. And everything would have been disposed of long ago in any case.

Most of these events, if they happened at the times alleged, happened when others had left the room. The few that are alleged to have happened with other nurses or doctors in the vicinity, there is evidence that they were engaged in other tasks.

The alleged perpetrator is fully in control of when they strike in every alleged instance and other people are not alert to the possibility of what even to be watching for because it wouldn't occur to them that a nurse is doing anything they shouldn't be doing. The alleged perpetrator can stop at any moment, and have their hands out of view in any case, and none of the acts involve weapons which no one would expect to see in the room. A syringe is needed to inject fluids, a bubble of air is not going to be visible across a nursery.

It's not necessary for the defence to prove innocence, but in this case it is very apparent that the defence has not once been able to demonstrate that she could not have done what is alleged because there is evidence of her being elsewhere or doing something else, like administering to another baby, or texting at the time, for instance.

JMO

 

[magikarpmagikarp]

Yeah, I think you're right optiflow is just a brand name for hight flow.
So if a result of resus, is it still the air pressure that causes it to occur?
I wonder also how AE through Ng tube or bloodstream might increase risk of pneumo. Apparently they are quite rare now, due to volume targeted ventilation. I still find it unusual that there would be two babies with this condition in a level 2 within 6 months. Maybe in a surgical unit dealing with the whole region but in one level 2 unit? Just another rarety I guess...jmo

The T-piece resuscitator(NeoPuff) is set by pressure - it lets you set a PIP and PEEP. I don't think physical trauma has been suggested, nor has deliberate misuse of the Optiflow been proposed.

I am just speculating, but from the testimony it sounded like they were having to use higher pressure at some point, due to the baby's oxygen levels. It's not specified whether the high pressures were PIP or PEEP. Volume control still uses a set PEEP, and that is what you would increase if you were struggling to oxygenate (along with the FiO2). So perhaps they used a higher PEEP to try and improve oxygenation once on the ventilator? PEEP that is "too high" could lead to pneumothorax. Why would someone use a high PEEP? Perhaps if they were unable to oxygenate the baby...? Unfortunately this level of detail from the testimony is not available. Just thinking out loud here and really not sure at all.

I agree this seems like it should be rare for a level 2. Spontaneous pneumothorax can happen at delivery, but you know... that's at delivery, not 3 days later.

 

[magikarpmagikarp]

Yes, if guilty, then she may just either be very skilled at this or just very lucky that no one in the vicinity turned round, or suchlike, at the wrong time.

Some of the things she has been accused of doing could have a benign appearance when you are not considering one of your coworkers to be a murderer. I would think nothing of turning around to see my coworker flushing an IV after giving a med and I wouldn't be scrutinizing the syringe to see if it was air or fluid, nor am I confident I could tell that from across the room.

 

[katydid23]

I'm not saying that, no. I'm saying that they haven't presented any evidence which directly links her to what she's accused of, which they haven't, unless I've missed it.

I think they have successfully shown that she could have done these things AND she was often the only person who could have. Also she is allegedly the only one who could have been the perp, in ALL of the unexplained cases.That is an important pattern.

Somebody put insulin in those bags - the prosecution have only demonstrated the she hung them up and signed or them, thugh, not that she actually adulterated them. Now, perhaps, a jury will infer that she did it based on the evidence but there is no evidence as yet presented to demonstrate when, where and how she allegedly did it.

If she signed for them and hung them, then it follows that she also prepared them. Otherwise, how did she get them? And why would she sign for them?

If someone else prepared them and handed them to her, wouldn't she have testified to that?

The problem I have with the notion that she did these things when no one was watching is that there are a huge number of charges. If guilty then she's had an immense run of good luck never to have been caught as some of the alleged acts are brazen and would have taken some time.

I am not sure which ones were brazen? It seems like they were all done in secret, undercover, and not in front of others.

However the timing was brazen in some cases---especially the last 3---- O,P and Q.

Yes, if guilty, then she may just either be very skilled at this or just very lucky that no one in the vicinity turned round, or suchlike, at the wrong time.

Many years ago the IRA said to Margaret Thatcher - "We only need to by lucky once, you need to be lucky every time", or words to that effect. Same applies here, I think.

I don't think it was luck. I think she was very strategic, the way she changed up her methods, from air, to internal injuries, to overfeeding, to insulin poisoning, back to A/E, then combinations of them.
It made it hard for consultants to figure out what was happening. They obviously didn't immediately think it was a serial killer masquerading as a nurse.

 

[JosieJo]

I definitely agree with this. The most striking ones to me are the insulin cases; I think it's fair to say that there is little doubt that those bags were indeed adulterated with insulin but I can't recall them presenting any evidence at all demonstrating that she adulterated them, when she did it or how, specifically, she did it.

Same with so much of the other stuff; in some cases there were people very nearby or even in the same room with their backs turned, allegedly. Yet not once have the prosecution claimed that she was seen actually doing anything unlawful.

How many murder trials have ever had a witness to the act?
This case also has a defendant with a legitimate reason to be there handling the alleged "murder weapons"

 

[JosieJo]

I do wonder how far back into the cases Dr Choc goes

 

[Kemug]

Yeah appeared to have dislodged his breathing tube whilst sedated/paralysed. And Dr NiceGuy had been called back to him (sedated) after he'd left to go to the tea room to get a drink with a female doctor. He was called back before the kettle even had chance to boil.

And the reason Dr NIceGuy was there in the first place was because when a different doctor responded to LL's first crash call for Baby P, one of the nurses (the Dr couldn't remember which) asked whether Dr NiceGuy was in and asked if he could attend as "The nurse wanted him in particular" to attend. Which he did after being bleeped.

Why did LL want Dr NiceGuy in particular? Were his attentions bearing fruit, and she was becoming interested in him? Or did she perhaps see him as an easy mark for deception, him being sympathetic to her? Or both?

 

[LadyEdgeworth]

Why did LL want Dr NiceGuy in particular? Were his attentions bearing fruit, and she was becoming interested in him? Or did she perhaps see him as an easy mark for deception, him being sympathetic to her? Or both?

He was already all over her really I think she just saw an easy way to get attention. Every time he felt bad for poor Lucy she got treats, attention, chocolate, lifts home, texts all night etc.

 

[Kemug]

It’s a small world and I’m surprised that she took the admin role and didn’t try for constructive dismissal . CD is not easy to establish but she might have manufactured a case of CD here to try for a settlement and avoid the awkwardness. The Countess is a hospital where a lot of folks know each other.

I'm surprised that she didn't just quietly resign and find a new position elsewhere. I'm sure hospital management would have been only too thankful to take the opportunity to let her go without any fuss.

 

[ColourPurple]

Many years ago the IRA said to Margaret Thatcher - "We only need to by lucky once, you need to be lucky every time", or words to that effect. Same applies here, I think.

Can't really compare the two situations at all. Maggie & co were well aware that the IRA wanted to kill them and had things in place to protect them from that danger, eg security and the police. So yes the IRA would have to be "lucky" to get past those defences.

Whereas nobody suspected a nurse was allegedly trying to kill defenceless little babies. Therefore, other than the inbuilt safety features designed to stop air embolism, there were no defences in place. LL didn't have to try to enter places that she wasn't allowed to be in, or carry weapons/tools that she wouldn't usually be using and a lot of the time it was just her and a baby in the room . She could attack these babies easily whilst going about her normal day to day work activities. They were basically sitting ducks, no luck was required to attack them or to avoid being seen attacking them.

 

[ColourPurple]

Why did LL want Dr NiceGuy in particular? Were his attentions bearing fruit, and she was becoming interested in him? Or did she perhaps see him as an easy mark for deception, him being sympathetic to her? Or both?

We have to say that although LL sent out the crash call, the other doctor couldn't remember which nurse wanted Dr NiceGuy in particular, so he didn't say for sure it was LL who requested him, though it seems likely it would be.

If it was LL and if she is guilty then it looks like she may have wanted his attention, admiration, presence, company and/or just wanted him to be a part of the whole resus and bereavment process, which would mean they could then talk about and relive it later.

Whether that means she was interested in him romantically too or just interested in all of those things, who knows. All IMO, if guilty, etc.

 

[katydid23]

We have to say that although LL sent out the crash call, the other doctor couldn't remember which nurse wanted Dr NiceGuy in particular, so he didn't say for sure it was LL who requested him, though it seems likely it would be.

If it was LL and if she is guilty then it looks like she may have wanted his attention, admiration, presence, company and/or just wanted him to be a part of the whole resus and bereavment process, which would mean they could then talk about and relive it later.

Whether that means she was interested in him romantically too or just interested in all of those things, who knows. All IMO, if guilty, etc.

I think she liked all those things mentioned above---attention, admiration, presence, and the shared experience w/him to relive later.

But I think she also liked that he had her back because he thought she was a totally organised and competent nurse. So he was a kind of insurance for her in case things went sideways. JMO

 

[katydid23]

Dan O'Donoghue

@MrDanDonoghue
·
2m

Lucy Letby's murder trial is not sitting today due to a juror illness, due back tomorrow

 

[LadyEdgeworth]

Dan O'Donoghue
@MrDanDonoghue
·
2m

Lucy Letby's murder trial is not sitting today due to a juror illness, due back tomorrow

These jurors have the worst immune systems in the universe