Just to backtrack a bit. With Baby F and the insulin test that was sent to Liverpool and came back sky high.
Was there a reason given, why this wasnt further investigated at the time, as this seems like it could have been a missed opportunity.
the doctor's testimony -
10:34am
The first witness is a doctor who has previously given evidence in the trial, but cannot be named due to reporting restrictions.
She says she didn't have any direct treating care role for Child F.
10:42am
The doctor says the cortisol reading was 'normal', the insulin at a reading of 4,657 was "too high for a baby who has a low blood sugar".
The doctor says it would be expected, with a baby in low blood sugar, for insulin to stop being produced, so that would also be low.
The insulin c-peptide reading of 'less than 169' does not correlate with the insulin reading. The insulin and insulin-cpep readings would be 'proportionate' with each other.
The doctor says it was likely insulin was given as a drug or medicine, rather than being produced by Child F, to account for this insulin reading.
"This is something we found very confusing at the time," the doctor says, and said there weren't any other babies in the unit being prescribed insulin at that time, which would rule out "accidental administration".
10:43am
The doctor says there are "some medical conditions" where a low blood sugar reading would also see a high insulin reading, but the low insulin c-peptide reading meant those conditions would be ruled out.
The insulin reading was "physiologically inappropriate", the court hears.
10:45am
The doctor said those readings would be repeated, but as Child F's blood sugar levels had returned to normal by the time the test results came back several days later, there would be "no way" to repeat the test and expect similar results.
10:46am
The doctor tells the court that Child F had received 'rapid acting insulin' on July 31, but the effect of that insulin would have "long gone" by the time the hypoglycaemia episode was recorded on August 5.
10:47am
The clinical note added 'as now well and sugars stable, for no further [investigations].
"If hypoglycaemia again at any point for repeat screen."
The doctor says if Child F had any further episodes of low blood sugar, then the blood test would be carried out again.
10:50am
The prosecution ask if anything was done with this data.
The doctor says it was looked to see if anyone else at the time was prescribed insulin in the whole neonatal unit, for a possible 'accidental administration', but there were no other babies at that time. No further action was taken.
Cross-Examination
Ben Myers KC, for Letby's defence, asks to clarify that Child F's blood sugar had stabilised at that time. The doctor agrees.
Judge's Question
The doctor clarifies, on a question from the judge Mr Justice James Goss, that the scope of the 'insulin prescription' checks were made for August 4 and August 5.
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