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

[Becci]

His texts seem to be based on how calm she was during resus, which, if guilty, is hardly surprising as she was the only one who knew the collapse was about to happen, whereas to everybody else it was unexpected.

if guilty, IMO

Baby q she weren't in the room?

 

[Becci]

& what exactly has she allegedly done to q or is it nxt wk we find out ty

 

[katydid23]

No idea if he's married, divorced, separated or never ever with the mother of his kids but as he was working the night shift, and his car would've otherwise been at the hospital all night,any hypothetical partner would've been none the wiser about where the car was all night. Unless they lived nearby and happened to see LL in it obviously.

But wouldn't his wife expect him to arrive home the next morning with his car?

 

[magikarpmagikarp]

Oh so it is something they take quite seriously, suggesting the sooner its checked out the better? I thought it'd just be routine blood tests to check for infections

I've had an accidental needlestick before, due to a faulty safety mechanism. It was a "dirty" needle that had been used to give an immunization to an infant. The risk for transmission of anything was extremely low. I washed my hands, called occupational health, filled out some incident paperwork, and made an appointment to be seen the next day for routine blood work. Did not require a trip to the ED. I had follow ups at intervals. Going to A&E sounds a little dramatic to me, unless you put it clear through your finger. That said, I am in the US and we do things kind of weird compared to the rest of the world so entirely possible it's my perspective that is skewed.

 

[katydid23]

He’s not leaving here alive, is he? Baby P —ep 25

In this episode Caroline and Liz examine what the prosecution say happened to Baby P, the second of two identical triplets allegedly murdered by Lucy Letby at the end of June 2016. The nurse is accused of killing him 23 hours after his brother, by injecting air into his feeding tube and tummy.

PART 3:
=======================


Soon afterwards the court heard the triplets parents went off to Liverpool Women’s Hospital with their remaining son

And Lucy Letby stayed late for the 2nd night running to write up her notes and around the same time she resumed her FaceBook convos with Dr A


Yes and before we outline these messages which were shown to the jury, we should explain that Lucy Letby pricked herself with the needle at some point during the failed resuscitation and in line with hospital protocol went to a ER to get checked out and to have some blood tests…


But while she was there, she fainted , the messages between her and Dr A begin at about 9:20 that evening while she’s still at the hospital.

DR: Have you been seen yet?

L: Yes, just got back. I made a fool of myself while there

DR: I asked them to be quick for you how did you make a fool of yourself?

L: Did you really? They said someone had asked for me to be seen ASAP and they knew what happened today
Everyone talking about it Whilst I was there I fainted

Dr: I asked them to see you quickly as a favour. I didn’t give any details about today
Maybe someone from the unit also called
Oh, are you ok now?

L; Bit shaky but okay. Writing my notes, they were reluctant to let me go as on my ow


Dr: You could have bleeped me. I am almost a responsible adult.

L: I did think about it but thought you would be in recess [?] [recess or resus?]
I’m okay anyway

Dr: Do you need a lift home?

L: No, I will be okay, thanks, not finished yet anyway

Dr: I can wait, it’s no problem

L: Can you give me 10 mins?

Dr: OK

L: I’m done

Dr: just outside the front door

L: two secs



So Dr A dropped Lucy home just after 10 pm but around an hour and 20 minutes later they resume their conversation via Facebook which continues until 1 in the morning:


L: thanks for the lift and for talking to A and E

Dr: I couldn’t have you walking back in the dark after a rubbish day, mini needle stick and an Annie faint

L: thank you, appreciated

DR: did you talk to Belinda about allocation for tomorrow ?

L: yes , she’s going to try and give me a lighter workload but said we’ll have to see how it goes overnight with a 30 weaker and twins delivering overnight, only 5 of us on too

Dr: what are you doing? I can’t concentrate on anything [sad face emoji]

L: wanting to [cry emoji]

Dr: did in the car. Must have looked a right mess when I got in

L: I keep thinking of both of them in the cart together, so peaceful yet beyond words how awful it is

Dr: I know, Dad was pushing them back to you he stopped and thanked me [crying emoji]
I gave him a hug. It seemed the only thing to do [crying emoji]

L: so sad ,the family all thanked me when I took baby 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

Dr: I don’t know how it would be possible to get over losing a child. Let alone two


L: [crying emoji]. Think my head may explode


So Lucy Letby went to bed but the court heard that unbeknown to her, some of the consultants on the unit were so suspicious they decided she must be removed from work until a proper investigation could be carried out

We covered a lot of this in our bonus episode -episode 24 on Friday—but in a nutshell Baby P’s death prompted the head of the neonatal unit, Dr Steven Breary, to phone the hospital executive on duty and demand Lucy Letby be removed from work immediately


But his request was refused and Lucy returned to work the following day which is when she allegedly harmed the final baby in this case—Baby Q, who we’ll hear more about in a couple of weeks time

Lucy Letby denies murdering or harming any babies—so what did her KC , Ben Meyers, say about what happened to Baby P?


So like in the case of his brother, Mr Meyers said Baby P had suboptimal or poor care at the Countess.


He suggested his deterioration the night before he died was due to too much milk being given to him by nurse Alice, and that the air she removed from his tummy was due to some new problem going on in his gut. Nurse Alice admitted this was a possibility but she also said the air could have been there all along and only aspirated in the early hours because the tip of the feeding tube in his stomach had moved.


The court also heard that blood tests later showed no evidence that he had an infection.


Mr Meyers said Baby P’s death could have been complications related to his punctured lung

He suggested the puncture was caused by vigorous resuscitation attempts by the doctors,

Or because they set the air pressures too high when they attached him to the ventilator, helping him to breathe.


Dr Breary admitted that this was possible but said it was highly unlikely that the punctured lung cause by Baby P’s collapse because once it was spotted it was quickly resolved more than three and a half hours before his death.

Mr Meyers also pointed out to Dr Evans ,the prosecution’s expert witness, that his 1st report on Baby P actually blamed the punctured lung for his death. The barrister accused Dr Evans of inventing an extra dollop of air being administered to Baby P on the morning of June 24th, to take his theory over the line and support the allegation of murder against Lucy Letby.

Dr Evans denied this—but he admitted that after listening to the evidence from Doctors who treated Baby P that he’d changed his mind about what caused his collapse.


Mr Meyers also pointed out that there had been a mistake in the amount of adrenaline given to Baby P who was accidentally give double the intended dose in his drip, over the course of the afternoon. He suggested the drug could have made his condition worse.


But Dr Rackham told the jury that Baby P suffered no apparent side affects from the increased dosage, as did Dr Sandi Bowen, the other prosecution’s expert.



She said neither his blood pressure or heart rate went up dramatically, as would be expected if he had too much and both

Dr Bowen and Dr Evans agreed that air had been injected into Baby P’s tummy before his death.

They told jurors it squashed his lungs and splinted his diaphragm which compromised his breathing and caused his collapse.

So we have been talking about what we think the defense case is going to be, as it starts pretty soon. Here is what the podcast said about Meyer's cross examination action of the baby P death:


Lucy Letby denies murdering or harming any babies—so what did her KC , Ben Meyers, say about what happened to Baby P?

"So like in the case of his brother, Mr Meyers said Baby P had suboptimal or poor care at the Countess.


He suggested his deterioration the night before he died was due to too much milk being given to him by nurse Alice, and that the air she removed from his tummy was due to some new problem going on in his gut. Nurse Alice admitted this was a possibility but she also said the air could have been there all along and only aspirated in the early hours because the tip of the feeding tube in his stomach had moved."


[ is this^^^^ explanation, 'Nurse Alice over fed him', going to make sense for his sudden collapse and death? I am not sure that will move the jury that much. The 'new problem; in his gut seemed to have been ruled out afterwards.]


The court also heard that blood tests later showed no evidence that he had an infection.



Mr Meyers said Baby P’s death could have been complications related to his punctured lung
He suggested the puncture was caused by vigorous resuscitation attempts by the doctors,
Or because they set the air pressures too high when they attached him to the ventilator, helping him to breathe.

[Possibly, but that still does not explain the collapse in the 1st place. The resuscitation and the ventilator only happened because he had already collapsed.]

Dr Breary admitted that this was possible but said it was highly unlikely that the punctured lung cause by Baby P’s collapse because once it was spotted it was quickly resolved more than three and a half hours before his death.

Mr Meyers also pointed out to Dr Evans ,the prosecution’s expert witness, that his 1st report on Baby P actually blamed the punctured lung for his death. The barrister accused Dr Evans of inventing an extra dollop of air being administered to Baby P on the morning of June 24th, to take his theory over the line and support the allegation of murder against Lucy Letby.

Dr Evans denied this—but he admitted that after listening to the evidence from Doctors who treated Baby P that he’d changed his mind about what caused his collapse.



[It could add reasonable doubt that the initial report blamed the punctured lung. I'd like more clarification from Evans about WHY he changed his findings. I remember he said something about hearing more from the attending doctors ---but when and how? I think Meyers challenged him win that, IIRC]

"Mr Meyers also pointed out that there had been a mistake in the amount of adrenaline given to Baby P who was accidentally give double the intended dose in his drip, over the course of the afternoon. He suggested the drug could have made his condition worse."

But Dr Rackham told the jury that Baby P suffered no apparent side affects from the increased dosage, as did Dr Sandi Bowen, the other prosecution’s expert.
She said neither his blood pressure or heart rate went up dramatically, as would be expected if he had too much and both

[I guess Meyers could bring in some expert testimony that the double dosage would worsen his condition. But I think there was further testimony that the double dosage was on purpose because the doctor was concerned that Baby P was not responding well earlier]

Dr Bowen and Dr Evans agreed that air had been injected into Baby P’s tummy before his death.

They told jurors it squashed his lungs and splinted his diaphragm which compromised his breathing and caused his collapse.

 

[Observant-ADHD-ENFP-BSc]

I think that’s what it is for me; that so few others have chosen to do the same. Personally I feel I would if I was in their position. It’s interesting hearing everyone’s thoughts on this.
JMO

IMO
When I read that Dr. choc texted, "You are one of the few nurses across the region (I've worked pretty much everywhere) that I would trust with my own children". I automatically assumed he was a parent and then I assumed he was/is married and that is why he is behind the screen and anonymous.
That was my gut logic, I don't think exactly like that now, but I haven't dismissed that.
I guess what I am trying to say is I think they had a relationship, in a friends-with-benefits scenario and she used him one way or another.
JMO

 

[Observant-ADHD-ENFP-BSc]

Something that struck me was their conversations were on Facebook messenger..considering how much they messaged I'm suprised they didn't seem to have each others phone numbers ?

IMO
Maybe he was married and phone calls and texts would have been noticeable.
JMO

 

[katydid23]

& what exactly has she allegedly done to q or is it nxt wk we find out ty

These are notes from prosecution Opening Statements===they are not evidence because we don't know if they will successfully submit all of this as evidence yet

Chester Standard:

Child Q - attempted murder allegation
Child Q was born on June 22 - the day after Child O and P. He was premature but a good weight, and on CPAP for the first 20 hours.
He was admitted to the neonatal unit as he needed breathing support, but was initially stable.
He had a catheter in place via his umbilicus for nutrition, however he was well enough to commence feeding via his NGT. Initially he was put into room 1.



Nursing staff noted small amounts of bile when they checked his NGT on June 23-24. These were not of sufficient concern to stop him being fed milk.
A different nurse was Child Q's designated nurse on the night shift for June 24. She monitored him through the night, and fed him 0.5ml of milk every 2 hours at 3am, 5am and 7am.
The nurse was content with the condition, although the blood gases deteriorated slightly, so she referred the results to a doctor. The doctor reviewed them and was not concerned.
The day shift on June 25, Letby was on duty and was Child Q's designated nurse. Child Q had been moved into room 2.



Letby made notes on Child Q's fluid/feeding chart at 8am. Child Q was receiving nutrition Babiven via a UVC.
Just after 9am, Letby and the nurse were together in nursery 2, and it was feeding time. The other nurse attended to another child in the room.



According to the record, Child Q's heart and respiratory rates both increased for a short period of time.
But, the prosecution say, the feeding chart shows something 'unusual'.
That chart is shown to the court. The 9am fluid chart, in Letby's handwriting, appears unfinished, with numbers noted for fluids, but no record for the feed or Letby's signature initials at the bottom of the 9am column.
The prosecution suggests something caused Letby to leave halfway through doing this.



Letby signed for medication for another baby at 9.04am.
The other nurse agreed to keep an eye on Child Q at 9am.
A few minutes later, Child Q's monnitor alarms activated to alert staff to a deterioration in his condition.
Mr Johnson: "We say that Lucy Letby had sabotaged [Child Q] and had injected him with air and a clear fluid into his stomach via the NGT. She was trying to kill him."



The nurse called for help and was joined by another nurse. Child Q had been sick and nurses used a suction catheter while respiratory support was given. Lucy Letby appeared soon afterwards together with doctors who were responding to the call for help.
Medical notes indicates doctors were called to the unit at 9.17am as Child Q had "just vomited" and oxygen saturation levels were in the "low 60s".
The prosecution say medical staff gave him assistance with breathing using a Neopuff device and applied suction to clear his airways. The records indicate not only had his oxygen dropped but also his heart rate. He is described as “mottled” in appearance and, most significantly, a substantial amount of air was aspirated from his stomach via the NGT.
Mr Johnson tells the court the air had been put in there by Letby, as if the feeding chart had been followed correctly at 9am, the person feeding - Letby - would have aspirated Child Q's stomach to check there was nothing there before administering the 0.5ml milk feed.




Another nurse's medical note on an 'apnoea/brady/fit chart' notes: "09:10; brady 98; desat 68; fit ?; baby found to be very mucousy, clear mucous from nasopharynx oropharynx removed clear fluid +++.
"O2 via neopuff given post suctioning. Dr... emergency called to attend.
"NGT used to aspirate stomach by Nurse L Letby”
The prosecution say given that Letby was Child Q's designated nurse and she performed the aspiration of air, it might be thought surprising that she did not make the note – yet she did make notes in records of other babies’ notes at about the same time.
Mr Johnson: "We question whether this is an attempt by her to create a documentary alibi."



Computerised nursing notes made by Letby for that morning: "“09:10hrs [Child Q] attended to by SN... – he had vomited clear fluid nasally and from mouth, desaturation and bradycardia, mottled ++. Neopuff and suction applied. [Registrar] attended. Air ++ aspirated from NG tube”.
Following the collapse, blood was taken to test for infection and other parameters. A venous blood gas test showed results suggesting that he was unwell but this had resolved by 11.12am. He was started on a course of antibiotics as a precaution.
The doctor's view recorded at the time said Child Q's collapse was a result of “presumed sepsis with jaundice”.
At that stage a chest x ray was taken which showed nothing untoward. The more detailed blood tests were recorded at 1.50pm and showed slightly abnormal results which were treated.
Child Q had made a reasonable recovery through the day and at 7.20pm was "looking tired". Doctors took the decision to intubate him because his respiratory rate was down to 19 (low)and his heart rate was between 160-200 bpm (high). At that stage his blood gas readings were good.
The proseution say Lucy Letby was "worried" when she got home that night.
She texted a doctor at 10.46pm and asked "do I need to be worried about what Dr G was asking?"
The doctor sought to put her mind at rest and told her that Dr G was only asking to make sure that the normal procedures were carried out. She replied that after Child Q had collapsed she (LL) had walked into the equipment room and Dr G had been asking the other nurse who was present in the room (when Child Q had collapsed) and how quickly someone had gone to him because she (LL) had not been there.

She continued her texts to the doctor, telling him that she had needed to go to her designated baby in room 1.



The following day, Child Q's gases were unsatisfactory, but he had been extubated 4 hours earlier and was in air with high saturations.
Medical staff noted a 'mildly dilated loop of bowel' on Child Q's left side and raised the possibility of NEC and surgery.
Child Q was transferred to Alder Hey, where he quickly stabilised and no surgery was required.
The prosecution say this was "another child who had suffered life-threatening problems and...when out of the orbit of Lucy Letby, he made a rapid recovery."



Other than three days the following week, that was the last time Lucy Letby worked in the neonatal unit at the Countess of Chester Hospital, the court is told.



Medical expert Dr Dewi Evans said Child Q's collapse was due to 'inappropriate care', and he had been injected with air via the NGT.
The significant amount of air aspirated from his stomach 'could not have arisen in any other way'.

Dr Sandie Bohin noted Child Q was well up until June 25 and believed something happened between 9am and his collapse.
He was only being fed what Dr Bohin describes as “tiny” amounts of milk yet he had taken in “copious amounts of air” from the NGT. This was abnormal.
The effect of a large volume of air in the stomach would “squash” the lungs leading to desaturation and instability. Although a baby may recover quickly after such an event, he may remain unstable for some time thereafter.
She agreed with Dr Evans’ conclusion that events were consistent with the introduction of a large amount of air via the NGT.

A professor reviewed brain imaging of Child Q taken in November 2019 - more than three years later. He found evidence of abnormalities which whilst they were not diagnostic of him having suffered a brain injury as a result of being given excessive air and liquid via his NGT, they could be explained.



In Letby's home search, officers recovered the handover sheet from the morning of June 25 which included Child Q's name. This was a document which should not have left the hospital.
When interviewed by police, Letby agreed Child Q had been well enough for her to leave him on the morning of June 25.
When asked about the excess air aspirated from his stomach, she suggested babies sometimes gulp air when they vomit. She denied putting excess air down the NGT.

Lucy Letby trial recap: Prosecution finishes outlining case, defence gives statement

 

[Sweeper2000]

& what exactly has she allegedly done to q or is it nxt wk we find out ty

Baby q is the last of the prosecution’s evidence and I think we will hear it this coming week. the alleged act is one of having injected air and a clear fluid into his ng tube.

im very curious to see if the prosecution expands on its suggestion that something made her leave halfway through writing a note. Struggling to envisage exactly what that could be.

 

[Sweeper2000]

Just thought of a question that should have been asked by now maybe. I can remember trying to figure out exactly how much air would have to be used in a AE to be lethal and the answer was “not much” but I’m wondering now about how much air or milk or other thing would have to be used in a ngt for it to be lethal? It’s relevant to the question of what equipment would be used and how difficult it would be to hide it. I can see A small syringe in intravenous AE but wouldn’t any matter into the ng tube be a different question? Think I read somewhere the babies should be able to deal with about 40 mls without a problem?, 40 mls or more is a big syringe I think so I’m wondering how easily you could hide that. Curious how often a big syringe is used on a NNU as well.

 

[esther43]

I think that you’re meant to hold the affected part below the level of the heart, go to the appropriate sink, encourage it to bleed under running water.

One should take note of where the needle stick came from (some patients may be statistically at higher risk of harbouring blood borne infections). The ward manager and patient’s consultant may therefore get involved, so that the injured gets any necessary preventative treatment, while respecting patient confidentiality.

Then off to A & E, later (once open) to Occupational Health (eg regarding hepatitis B immunisations and titre).

Some confidential record is usually needed such as an accident form.

I’m shocked that staff are not seen quickly at A & E (unless there is a terrible emergency).

I've had an accidental needlestick before, due to a faulty safety mechanism. It was a "dirty" needle that had been used to give an immunization to an infant. The risk for transmission of anything was extremely low. I washed my hands, called occupational health, filled out some incident paperwork, and made an appointment to be seen the next day for routine blood work. Did not require a trip to the ED. I had follow ups at intervals. Going to A&E sounds a little dramatic to me, unless you put it clear through your finger. That said, I am in the US and we do things kind of weird compared to the rest of the world so entirely possible it's my perspective that is skewed.

Tbh it seems a bit over the top to me too. I can not see the NHS telling staff they must come to A&E with that, not with 4 hour waits and ambulances stacked up in the car park.
I think it's very telling that with so much going on at the unit, that they thought it best to send LL to A&E for a scratch on her pinky or whatever..
What can they do for her that she's not able to do for herself?

 

[e145]

Just thought of a question that should have been asked by now maybe. I can remember trying to figure out exactly how much air would have to be used in a AE to be lethal and the answer was “not much” but I’m wondering now about how much air or milk or other thing would have to be used in a ngt for it to be lethal? It’s relevant to the question of what equipment would be used and how difficult it would be to hide it. I can see A small syringe in intravenous AE but wouldn’t any matter into the ng tube be a different question? Think I read somewhere the babies should be able to deal with about 40 mls without a problem?, 40 mls or more is a big syringe I think so I’m wondering how easily you could hide that. Curious how often a big syringe is used on a NNU as well.

Well she might have just used a small (5ml) syringe multiple times. Not hard to draw up air, could be done in her pocket. Come on it's not that hard if you think about it.

 

[esther43]

Absolutely not! I once waited in uniform for 1.5 hours in the waiting room with mild concussion.

Yep, I've seen nurses in a&e. They have to wait, the same as everyone else.

Because he finds out new information, for example.

People can trust others and then think they were wrong to trust them.

Where does honesty, niceness or bias come into it?

His txts to ll

I think he cared about her at the time but had no idea what he was involving himself in.
It seems to be like he changed his mind at some point after LL was moved to admin and all the deaths stopped.
Which would suggest 'renewed thinking' to me rather than confirmation bias. JMO

 

[katydid23]

Tbh it seems a bit over the top to me too. I can not see the NHS telling staff they must come to A&E with that, not with 4 hour waits and ambulances stacked up in the car park.
I think it's very telling that with so much going on at the unit, that they thought it best to send LL to A&E for a scratch on her pinky or whatever..
What can they do for her that she's not able to do for herself?

The only way it would make more sense would be if one had given a shot to an adult, and then jabbed oneself. Then one could be concerned about hepatitis, aids, or any number of infections.

But a newborn? Are there as many deadly afflictions to be concerned with in a newborn? IDK, I am not a doctor, so I may be ignorant of those possibilities.

 

[esther43]

Well she might have just used a small (5ml) syringe multiple times. Not hard to draw up air, could be done in her pocket. Come on it's not that hard if you think about it.

The only way it would make more sense would be if one had given a shot to an adult, and then jabbed oneself. Then one could be concerned about hepatitis, aids, or any number of infections.

But a newborn? Are there as many deadly afflictions to be concerned with in a newborn? IDK, I am not a doctor, so I may be ignorant of those possibilities.

I could only think that if it was a drug withdrawal baby she was treating there could be a risk of hep C or hiv there I suppose. I'll pop that one in the 'slim chance bank' with the 2000 other entries associated with LL!

 

[esther43]

Just thought of a question that should have been asked by now maybe. I can remember trying to figure out exactly how much air would have to be used in a AE to be lethal and the answer was “not much” but I’m wondering now about how much air or milk or other thing would have to be used in a ngt for it to be lethal? It’s relevant to the question of what equipment would be used and how difficult it would be to hide it. I can see A small syringe in intravenous AE but wouldn’t any matter into the ng tube be a different question? Think I read somewhere the babies should be able to deal with about 40 mls without a problem?, 40 mls or more is a big syringe I think so I’m wondering how easily you could hide that. Curious how often a big syringe is used on a NNU as well.

I think we have heard that amount of air is one factor, the pace at which it enters the system has a baring. But not sure if this info was relevent only to AE into bloodstream or air into Ng too.

 

[marynnu]

Just thought of a question that should have been asked by now maybe. I can remember trying to figure out exactly how much air would have to be used in a AE to be lethal and the answer was “not much” but I’m wondering now about how much air or milk or other thing would have to be used in a ngt for it to be lethal? It’s relevant to the question of what equipment would be used and how difficult it would be to hide it. I can see A small syringe in intravenous AE but wouldn’t any matter into the ng tube be a different question? Think I read somewhere the babies should be able to deal with about 40 mls without a problem?, 40 mls or more is a big syringe I think so I’m wondering how easily you could hide that. Curious how often a big syringe is used on a NNU as well.

If someone wanted to push in 40mls of air, they wouldn't need a big syringe. They could just push in 10mls 4 times! You only use a 10 or 20ml syringe when gravity feeding in the normal way, no matter how big the feed.

 

[Sweeper2000]

I think we have heard that amount of air is one factor, the pace at which it enters the system has a baring. But not sure if this info was relevent only to AE into bloodstream or air into Ng too.

Yeh it’s only relevant to arterial AE but the ng tube is different. Has to be enough to splint the diaphragm which I would assume is a significant amount.

I never said it was difficult to do as alleged but I do think it’s difficult to do without being seen. I also think it’s very blatantly an abnormal thing for a nurse to repetitively pump a syringe. Easy enough to blend in ie priming a line but using a big syringe? Pumping a small syringe multiple of times?

 

[Sweeper2000]

If someone wanted to push in 40mls of air, they wouldn't need a big syringe. They could just push in 10mls 4 times! You only use a 10 or 20ml syringe when gravity feeding in the normal way, no matter how big the feed.

Any estimates on the ml of air necessary to over inflate a stomach like that Mary pls? In this context would you think it more reasonable for an alleged murderer to use a big syringe or to pump a smaller one many times? Difficult question to me, I would assume anyone doing it would spend the least amount of time on it as possible which pushes me towards the larger syringe. also wondering when larger syringes are used? I’m also wondering exactly how one would determine that any air aspirated from a stomach should or shouldn’t be there? Empty spaces are normally full of gas so how is it that this air is thought to be present through deliberate actions.

 

[Tortoise]

So we have been talking about what we think the defense case is going to be, as it starts pretty soon. Here is what the podcast said about Meyer's cross examination action of the baby P death:


Lucy Letby denies murdering or harming any babies—so what did her KC , Ben Meyers, say about what happened to Baby P?

"So like in the case of his brother, Mr Meyers said Baby P had suboptimal or poor care at the Countess.


He suggested his deterioration the night before he died was due to too much milk being given to him by nurse Alice, and that the air she removed from his tummy was due to some new problem going on in his gut. Nurse Alice admitted this was a possibility but she also said the air could have been there all along and only aspirated in the early hours because the tip of the feeding tube in his stomach had moved."


[ is this^^^^ explanation, 'Nurse Alice over fed him', going to make sense for his sudden collapse and death? I am not sure that will move the jury that much. The 'new problem; in his gut seemed to have been ruled out afterwards.]


The court also heard that blood tests later showed no evidence that he had an infection.



Mr Meyers said Baby P’s death could have been complications related to his punctured lung
He suggested the puncture was caused by vigorous resuscitation attempts by the doctors,
Or because they set the air pressures too high when they attached him to the ventilator, helping him to breathe.

[Possibly, but that still does not explain the collapse in the 1st place. The resuscitation and the ventilator only happened because he had already collapsed.]

Dr Breary admitted that this was possible but said it was highly unlikely that the punctured lung cause by Baby P’s collapse because once it was spotted it was quickly resolved more than three and a half hours before his death.

Mr Meyers also pointed out to Dr Evans ,the prosecution’s expert witness, that his 1st report on Baby P actually blamed the punctured lung for his death. The barrister accused Dr Evans of inventing an extra dollop of air being administered to Baby P on the morning of June 24th, to take his theory over the line and support the allegation of murder against Lucy Letby.

Dr Evans denied this—but he admitted that after listening to the evidence from Doctors who treated Baby P that he’d changed his mind about what caused his collapse.



[It could add reasonable doubt that the initial report blamed the punctured lung. I'd like more clarification from Evans about WHY he changed his findings. I remember he said something about hearing more from the attending doctors ---but when and how? I think Meyers challenged him win that, IIRC]

"Mr Meyers also pointed out that there had been a mistake in the amount of adrenaline given to Baby P who was accidentally give double the intended dose in his drip, over the course of the afternoon. He suggested the drug could have made his condition worse."

But Dr Rackham told the jury that Baby P suffered no apparent side affects from the increased dosage, as did Dr Sandi Bowen, the other prosecution’s expert.
She said neither his blood pressure or heart rate went up dramatically, as would be expected if he had too much and both

[I guess Meyers could bring in some expert testimony that the double dosage would worsen his condition. But I think there was further testimony that the double dosage was on purpose because the doctor was concerned that Baby P was not responding well earlier]

Dr Bowen and Dr Evans agreed that air had been injected into Baby P’s tummy before his death.

They told jurors it squashed his lungs and splinted his diaphragm which compromised his breathing and caused his collapse.

Thanks katydid. I think nurse Alice should be nurse Ellis. Sophie Ellis.