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

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I think we'll have to wait for the medical experts to confirm about when the attacks are purported to have taken place, but I think Letby is also accused of trying to kill the baby through giving too much milk as well as injecting air. Perhaps this is what she is supposed to be doing around 9pm? Collapse from air embolism seems to happen pretty quickly after injection so perhaps prosecution say this happened closer to 11pm?
I wonder what they will say caused the bleeding. We didn't see excessive bleeding in the other air embolus cases, so maybe this could be from giving excessive levels of milk?
 
I find this very confusing too. I find Child E an anomaly at this point. Why wpuld an air embolus cause a GI bleed?

But appreciate we haven't heard all of the medical experts yet. Dr Evans and Dr Bohin are good at setting the scene
 
I think we'll have to wait for the medical experts to confirm about when the attacks are purported to have taken place, but I think Letby is also accused of trying to kill the baby through giving too much milk as well as injecting air. Perhaps this is what she is supposed to be doing around 9pm? Collapse from air embolism seems to happen pretty quickly after injection so perhaps prosecution say this happened closer to 11pm?
I wonder what they will say caused the bleeding. We didn't see excessive bleeding in the other air embolus cases, so maybe this could be from giving excessive levels of milk?
Or perhaps it wasn't baby E that was given too much milk, and another baby. Might have gotten confused
 
I find this very confusing too. I find Child E an anomaly at this point. Why wpuld an air embolus cause a GI bleed?

But appreciate we haven't heard all of the medical experts yet. Dr Evans and Dr Bohin are good at setting the scene
I don't think they're related. This is what the prosecutor said in his opening statement -

Medical expert Dr Sandie Bohin agreed the cause of death was air embolus and acute bleeding.
She concluded that the cause of the bleeding was unknown but acknowledged “fleetingly rare” possible natural causes that could not be ruled out in the absence of a post-mortem.
Dr Bohin concentrated on the abdominal discolouration and concluded that air was deliberately introduced via an intravenous line.

Dr Dewi Evans said Child E's death "was the result of a combination of an air embolus and bleeding which was indicative of trauma".
The air embolus was "intentionally introduced" into Child E's bloodstream via an IV line "to cause significant harm".
 
I don't think they're related. This is what the prosecutor said in his opening statement -

Medical expert Dr Sandie Bohin agreed the cause of death was air embolus and acute bleeding.
She concluded that the cause of the bleeding was unknown but acknowledged “fleetingly rare” possible natural causes that could not be ruled out in the absence of a post-mortem.
Dr Bohin concentrated on the abdominal discolouration and concluded that air was deliberately introduced via an intravenous line.

Dr Dewi Evans said Child E's death "was the result of a combination of an air embolus and bleeding which was indicative of trauma".
The air embolus was "intentionally introduced" into Child E's bloodstream via an IV line "to cause significant harm".
Gosh, I totally missed that they had even commented yet! You are really on the ball Tortoise, thank you!
 
I think an arterial air embolism would take effect almost immediately, but there is a range in how long and in what volume it could to reach the heart causing the fatal blockage. I think one possible explanation for the series of collapses seen in some cases is that the air reached the heart at different times, which was enough to cause a collapse but not enough to cause death Nd then with every bit more air the problem would increase in severity leading to death. Gathered that from what people on here have said. I think just guessing you could expect the full effect within half n hour of administration. If blood circulates the entire system within a minute in an adult I would guess it would take that much time or less for all of it to get to the heart of a baby. It’s apparently a key feature of air embolism that sudden collapse is expected So presumably it’s effect is immediate upon administration.


3:30pm

Medical expert Dr Dewi Evans suggested Child A's collapse was "consistent with a deliberate injection of air or something else into [Child A]'s circulation a minute or two prior to deterioration," Mr Johnson told the court. Only Letby was present.
Another medical expert said the cause was "not some natural disease process, but a dose of air "deliberately administered".
An independent pathologist described the cause of death was 'unascertained', in that there was nothing in the autopsy that pointed to why Child A had died, but the cause was most likely 'exogenous air administration through the longline or UVC'.

But, by 8.26pm that same day he was "deteriorating rapidly".
He had been handed over to Letby's care less than half an hour earlier.
By 9pm, he had been pronounced dead -

Child C's death was a 'refinement of the theme' Letby had started with Children A & B​

Child C was pronounced dead just before 6am on the 14 June 2015.
At thge time, the consultant pathologist gave the cause of death as "widespread hypoxic/ischaemic damage to the heart/myocardium due to lung disease".
Child C's vocal cords were "swollen" - something the prosuection say is a reoccuring feature in this case.



in baby E case there is no allegation of inflicted trauma other than the alleged AE. I believe the blood is brought up by the prosecution because it fits with what they have suggested as a pattern in these cases, that swollen throats are a recurrent feature in them, Presumably linked to the method/s.
what I would like to know is how if it is a recurring feature it can fit within the alleged methods.
 
I’m also looking at the fact that if an AE is immediately of effect in baby A‘s case that it is really really suspicious. Looking at how many other staff did notice allot of deaths on the ward, the authorities knew these cases were unusual hence the investigation into baby A which LL attended, the suspicions by dr Ravi and unnamed others seemingly before Baby K, the investigation that happened early in the year of 2016. There does seem to be reason to think people would be asking questions and apparently they were yet no one saw anything and nobody suspected LL. I would be very interested to hear if LL was in direct proximity and close to the babies specifically immediately before the collapses or within half an hour of them. I could agree it might be easy to administer the method but I’m not convinced it would easy to avoid suspicion. If the collapses were that dramatic, pronounced, unexpected, close to the time of administration and talked about I can’t believe people wouldn’t be asking questions. It’s this bit that gets my attention. I could guess that air and milk pushed into the stomach would be much more immediately effective as well as there is no time for it to travel. However I don’t know if milk is drip fed but that just makes it more obvious as it’s visible to staff in the drip And would obviously be noted as n excessive amount of milk.

Medical expert Dr Dewi Evans suggested Child A's collapse was "consistent with a deliberate injection of air or something else into [Child A]'s circulation a minute or two prior to deterioration," Mr Johnson told the court. Only Letby was present.”

how is it that an individual could pretend she was doing something normal while delivering the AE, that baby then collapses within a minute or two of that person being in direct proximity and nobody notices anythin especially after so many cases of unexpected collapses and death. I could see someone o successfully concealing the method but I can’t see someone avoiding all suspicions after the fact Especially when in a few cases it supposedly involves multiple attacks.
it seems that all of these cases were held as unusual, the investigation into baby A which LL attended, other staff noticing that LL was having “bad luck”, one nurse noticed How the Deaths of A,C,D seemed unusual, the definite suspicions by dr Ravi and other staff around Baby k and last but not least the surprise investigation on the unit early in 2016. They are all significant red flags and could it be said that altogether would create an environment of suspicion or at least concern for practice and consequently a tightening up of observations on clinical practice?
 
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The nurse agrees with Ben Myers KC, defending, that neonates can sometimes deteriorate rapidly, and that sometimes they can deteriorate when they’d appeared quite stable. When asked if it follows that such babies can die she says “sometimes”.

Nurse agrees with Mr Myers that at the time some aspects of the neonatal unit at Chester were “quite old”. “Plumbing and drainage would not function as you would have expected.” The nurse says “correct”. Also agrees “at times” it was difficult to get hold of doctors when needed.
 
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