UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #27

[Tortoise]

10:26am

The trial is now resuming.
The judge, Mr Justice James Goss, is beginning his summing up.
He says the prosecution case is there was deliberate harm at the Countess of Chester Hospital neonatal unit, sometimes repeated attempts on the same infants, and some of those babies died.
He says after Child O and Child P died, and Child Q collapsed on successive days in June 2016, Lucy Letby was confined to clerical duties.

10:29am

He reminds the jury of the background to the offences alleged on the indictment.
He says the Countess of Chester Hospital is, and was, busy.
He says the jury are now familiar with the tertiary system of hospitals, with the Countess a level 2 unit, routinely providing care to babies of 27+ weeks gestation. The jury have been provided with a guide, and walkthrough recordings, of the unit.
One room, 'room one', the ICU room, had four incubators and two computers plus other pieces of equipment. Room two was the HDU, rooms three and four were special care babies rooms.

10:31am

He says the last evidence heard was from Lorenzo Mansutti, an experienced plumber at the Countess of Chester Hospital.
The Women's and Children's building was built in the 1960s and there were issues with the plumbing, and there was an incident between 2015-2016 where the hand basin backed up with foul water. There was another incident where room 4's floor flooded after a back-up sink overflowed. None of the incidents reported happened on the days when the alleged offences took place.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

10:34am

Consultant Dr John Gibbs had said in evidence it would have been better if there were more consultants, but refused to say the staffing level at the time compromised the care of neonatal infants.
He says every year, up to 2015, the number of deaths at the neonatal unit was within the number to be expected, and less than the national average.
Between 2015-2016, the number of deaths "increased significantly", including the number of "unusual" events. The defence said this was a consquence of higher admissions and a higher number of infants with more complex needs.

10:37am

In evidence, Letby was asked about her relationship with other staff. She said she had "no problem or issue" with any of the doctors and had a "normal working relationship" with them "at the time", except for one female doctor she did not get on that well with.
She said she "loved one [male] doctor as a friend", but there was no loving relationship between the the two.
She later said four doctors had "conspired against her falsely" - Dr Stephen Breary, Dr Ravi Jayaram, Dr John Gibbs and one other.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Lincoln34]

10:26am

The trial is now resuming.
The judge, Mr Justice James Goss, is beginning his summing up.
He says the prosecution case is there was deliberate harm at the Countess of Chester Hospital neonatal unit, sometimes repeated attempts on the same infants, and some of those babies died.
He says after Child O and Child P died, and Child Q collapsed on successive days in June 2016, Lucy Letby was confined to clerical duties.

10:29am

He reminds the jury of the background to the offences alleged on the indictment.
He says the Countess of Chester Hospital is, and was, busy.
He says the jury are now familiar with the tertiary system of hospitals, with the Countess a level 2 unit, routinely providing care to babies of 27+ weeks gestation. The jury have been provided with a guide, and walkthrough recordings, of the unit.
One room, 'room one', the ICU room, had four incubators and two computers plus other pieces of equipment. Room two was the HDU, rooms three and four were special care babies rooms.

10:31am

He says the last evidence heard was from Lorenzo Mansutti, an experienced plumber at the Countess of Chester Hospital.
The Women's and Children's building was built in the 1960s and there were issues with the plumbing, and there was an incident between 2015-2016 where the hand basin backed up with foul water. There was another incident where room 4's floor flooded after a back-up sink overflowed. None of the incidents reported happened on the days when the alleged offences took place.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

I’m surprised the plumber has a staring role so early in the summing up. Is there something I’m missing about Mr Plumber?

 

[Tortoise]

10:40am

The judge says the evidence given by witnesses behind screens, or from remote locations on videolinks, should not be diminished in any way. He adds their evidence should be judged in the same way as any other witness in the case.
He says established guidelines had one designated nurse to one ICU baby, one nurse to two HDU babies, and one nurse to four special care babies.
He says nursing notes would be written retrospectively on computers. They had an accurate electonic timing of the start and completion of the note.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

10:44am

He says nurses were asked about staffing levels.
The court had heard from one nurse: "Sometimes there were more babies [on the unit] than there were meant to be". 2015-2016 "was a busy period" with more babies with higher acuity.
Staff "were giving up breaks" to provide care.
"It was always quite busy," said another nurse.
Dr Stephen Breary accepted nursing levels were lower than the gold standard guidelines. He added their levels were similar to other neonatal units, and staffing levels were better than those around Cheshire units. The court heard the other units did not have the mortality levels.

10:48am

The judge says the jury should consider if sub-optimal care was a factor in the collapses of the babies. He says in a few cases, it is accepted there was sub-optimal care.
He said Letby accepted herself that sub-optimal care played little or no part in most of the babies' cases.
He says [defence barrister] Benjamin Myers KC repeatedly suggested that doctors "had gone out of their way" to "damage" the defendant by blaming her for sub-optimal failures in care. He says she "did nothing to harm any baby".
He says it is up to the jury to find who is telling the truth and who is "reliable".
He adds he is not going to put a single document up for the jury to look at, as they have all the documents.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Dotta]

If he's going to get this done in four days I think he must have a different plan, which doesn't involve any speeding!

Phew!
what a relief!

I was worried about Mr Dan.

He was always in Court for so many months doing his duty and I wouldn't like him to collapse typing furiously trying to catch what the Judge is saying!

What a job!

 

[Tortoise]

10:51am

He says in two cases, two babies received insulin when it was "wholly inappropriate" to do so. Each of them - Child F, Child L - was a twin. He says the prosecution say there is "no doubt" it was added intentionally.
He says the prosecution say the chances of more than one person acting in that way [administering insulin] is not realistic.
He adds the defence invite the jury to question the samples, and the "lack of harm" caused by the infants if they had been poisoned by insulin.
He says the prosecution say the intention was "endangering the lives" of the two babies.

10:55am

The judge says the prosecution referred to a list of reoccurring factors for babies in the case.
He says for the defence, they say Letby was a committed, hard-working nurse, and if there was someone intent on harming children, it was not her.
The judge now gives the background to Letby, starting as a nurse at the Countess of Chester Hospital in 2012 as a band 5 nurse.
The court had heard Letby "always strived to go on every course she could".
In March/April 2015, Letby had completed a six-month course - including a placement at Liverpool Women's Hospital - she qualified in the speciality of caring for intensive care babies. She was the only band 5 nurse [along with colleague Bernadette Butterworth] to have that qualification.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Observe_dont_Absorb]

I’m surprised the plumber has a staring role so early in the summing up. Is there something I’m missing about Mr Plumber?

Sounds like the judge has just swiped that one off the table, possibly never to be mentioned again, an early 'exclusion' as it were.

 

[Tortoise]

11:02am

The judge says Letby has no previous convictions. He says it is entirely for the jury to attach the weight of the defendant's previous character.
Letby had said she had cared for hundreds of babies, and that hurting a baby was completely against everything a nurse is.
Colleague Christopher Booth "confirmed" she was "conscientious, hard-working, and willing to help", and another colleague said Letby would "remain friends" with the parents of babies on Facebook.
Eirian Powell said Letby was "an exceptionally good nurse".
Letby had a "passion" for working in the intensive care side, and "staff knew" she enjoyed that side of care.
The judge says Letby's health was good, and she did not take time off work in 2015-2016. She was "flexible", living at Ash House [accommodation at the Countess], then at a flat between 2014-2015, then back to Ash House until April 6, 2016, to Westbourne Road, Chester.
Letby was "often asked to do more" than the required number of shifts per month.
She was "devastated" when taken off clinical duties in 2016. She had "prided herself" on being very competent.
Letby registered a grievance in September 2016. It was at that time she learned she was being blamed for the deaths, and that that was "sickening", and her mental health "deteriorated".
She was arrested at her home in July 2018. She was interviewed, then moved to Hereford to be with her parents. A search was conducted of her Chester home.

11:06am

The arrest "traumatised" Letby, she said.
A defence statement was confirmed by her on February 11, 2022. The judge says some of it differs from the police interviews.
He refers to his next legal direction, on the defence statement.
He says if the jury find "a material difference" between the two statements, the jury are entitled to ask themselves why.
He says the defence say the task was made more difficult by the delays in bringing the case, and the volume of evidence served.
He says if the jury are sure there is a 'material difference', and they do not believe the defandant is telling the truth on the reason for those differences, then that should be in support of the prosecution case.
He says the jury must not convict on the basis of those changes alone.

11:08am

The judge refers to delays in the case.
He says the jury should take into account the passage of time since the events, and the impact that might have on the witnesses and the defendant in recalling them.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

11:15am

The judge refers to expert witnesses who have given evidence in the case.
He says the jury would expect to hear evidence from experts with relevant expertise. Their role is to be a witness, not an advocate.
He says the defence have criticised that evidence, and will come to that when going through the relevant cases.
He says the jury are entitled to consider their opinions when coming to conclusions on the case. It is up to them to consider some or all of their evidence.
He says their evidence is part of the case, and the jury should not consider it in isolation, and should be considered in the context of expert, clinical and relevant circumstantial evidence.
The experts did exclude some reasons for collapses based on their own knowledge and expertise.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Enquirer-2019]

The problem is, you can find ‘evidence’ for almost anything if you look for it, you can find research papers for anything and everything. It’s whether or not they stand up to scrutiny in the context of these babies is what’s important, and we don’t know if they do. In fact when he put his theories to the experts on the stand during cross-examination, they were often able to give reasons why what he was saying wasn’t applicable, or very unlikely etc. JMO.

I can’t believe we’re nearly at the end. Finally.

IMOO - The defences strategy appeared to be consistent with your initial point i.e., proving that theories (e.g., by the prosecution) do not stand up to scrutiny’.

Whereas, your claim that the defences scrutiny held no water with the expert witness, is inaccurate, since on numerous occasions during questioning, and restated during closing - the defence highlighted e.,g, issues, gaps, holes, contradictions, and apparent biases, with many of their (I.e., expert witnesses) findings. Their main argument many had in response, was to state that e.g., in their opinion X or Y was more likely’

Furthermore, a member asked me yesterday why Myers has not brought his own expert witnesses; I did not know the answer - I had queried the same fact of late, and believed he absolutely should have.

But, upon reflection I think he is intentionally avoiding introducing new material that would likely generate long drawn out arguments, and instead chose to focus on weaknesses in the defensives theories; which he supported with scientific references, and evidence he/ his team have previously submitted (e.g., he referred on numerous occasions to an evidential document available to the jury). JMOO

 

[Tortoise]

11:17am

He says he will turn to the relevant cases. He says the material is dense, and is conscious of the circumstances in which they happened, and does not intend to be insensitive. He reminds the jury of his initial direction for the jury to treat the case on the evidence, not on emotion.
He adds he is conscious the jury has already heard nine days of closing speeches.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

11:22am

He refers to the case of Child A - the twin of Child B.
He recalls the events of their birth and the collapse.
Child A's cause of death was "unascertained". The prosecution case is Child A did not die of any natural cause, but instead had air deliberately injected intravenously system with the intention to kill.
The defence say Letby did nothing to harm Child A, and raised issues with the long line.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[DianaWW]

IMOO - The defences strategy appear to be constant with your initial point i.e., proving that theories (e.g., by the prosecution) do not stand up to scrutiny’. Whereas, your claim that the defences scrutiny held no water with the expert witness, is not accurate, since on numerous occasions during questioning, and restated during closing, the defence highlighted e.,g, issues, gaps, holes, contradictions, and apparent biases, with many of their (I.e., expert witnesses) findings. The main argument many had in response, was to state that, in their opinion only ‘X or Y’ was more likely.

Furthermore, a member asked me yesterday why Myers has not brought his own expert witnesses; I did not know the answer - I had queried the same fact of late, and believed he absolutely should have. But, upon reflection I think he is intentionally avoiding introducing new material that would likely generate long drawn out arguments, and instead focusing on weaknesses in the defensives theory, supported by scientific reference, and evidence he/ his team have previously submitted (e.g., he referred on numerous occasions to an evidential document available to the jury). JMOO

I disagree. I believe for the most part, the medical experts theories did hold up to the scrutiny of cross-examination. The defence may have created some doubt in one or two cases, but the fact that several experts with different areas of expertise agreed in most cases holds weight in my mind.

As to whether the defence claims hold up to scrutiny, we don't know. I think it was a mistake not to bring in their own experts if indeed they were able to find any. But that's just my opinion. I'm also conscious that we're hearing just a small percentage of what the jury hear, so will fully respect whatever verdict they come back with.

 

[Tortoise]

11:35am

The judge details what neonatal unit staff were recorded, and recalled, doing for Child A before the collapse. He says there were issues siting a cannula "as can happen".
A long line was later inserted by registrar Dr David Harkness.
Nurse Melanie Taylor came on duty. Child A was "stable and satisfactory", and the nurse "had no concerns". She ended her shift at 8pm, and handed over to the defendant, who had come in at 7.27pm. She confirmed a 10% dextrose bag had been prescribed, to be given via the long line.
All three babies that night in room 1 required long lines - Child A, Child B and one other.
Dr Harkness was unsure if the long line was in the perfect position. He believed it was "imperfect", but good enough to be used.
Dr Dewi Evans said the position was not a problem, and there was no evidence of the end of the line puncturing the heart lining. He said if there was, it would show up on a post-mortem examination. Dr Sandie Bohin said it was "not in an optimal position" but "safe to use".
Melanie Taylor said she was sitting at the computer in room 1 when Child A started to deteriorate.
The alarms sounded, and Melanie Taylor went over, thinking the baby was going to recover. She said Letby was administering Neopuff. She says it "was a bit of a blur".
Letby said she was not initially intending to work that night shift, but was "happy to help" after being asked to work. "There was a lot going on", and she said Melanie Taylor, "being the sterile nurse", was administering fluids.
Child A's hands and feet were "white" at the time of the desaturation - 'centrally pale and poor perfusion'.
An emergency crash call was put out.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

11:42am

Dr Rachel Lambie had said Child A 'looked like Child B', pale and blotchy all over. The defence said her original police statement referred to Child A being pale, with white hands.
She thought there was a "lot of discussion" over the rashes. She said no-one had told her what to say on them.
The defence "draw your attention" to the difference, the judge says.

11:42am

The judge's next legal direction is on differences in evidential statements.
He says what a witness says in the witness box is all evidence for consideration. He says where there are, or appear to be, differences in accounts, it is for the jury to decide how different those accounts are, and how important they are.
He says if there are important differences, they should consider them, and the explanations given. He says if the jury do not accept their explanations, they should treat the witness' evidence with caution. If the explanations are accepted, then the evidence can be treated as such.
He says it is "really no more than a common-sense approach" "to see where the truth lies".

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Tortoise]

11:48am

Dr Harkness had given a description of the 'blotchy' rash, saying it was only seen again by him in the case of Child E. The defence criticised him for not including the description in medical notes at the time or in notes to the coroner.
Dr Ravi Jayaram had said it was "highly unusual" in the way that Child A was deteriorating and his heart rate fell even after intubation. At the time, he noted Child A's pale skin.
His explanation for not including the 'pink patches' skin discolouration to the coroner - mentioning it to the police later - was "he had not considered it clinically relevant" at the time. He said it was "a matter of regret" he had not mentioned them.
He says he could not explain how Child A collapsed.
He said he read a document in a medical paper about skin discolouration in a case of air embolus. He said he had not been influenced by that paper when it came to that explanation.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk

 

[Enquirer-2019]

I disagree. I believe for the most part, the medical experts theories did hold up to the scrutiny of cross-examination. The defence may have created some doubt in one or two cases, but the fact that several experts with different areas of expertise agreed in most cases holds weight in my mind.

As to whether the defence claims hold up to scrutiny, we don't know. I think it was a mistake not to bring in their own experts if indeed they were able to find any. But that's just my opinion. I'm also conscious that we're hearing just a small percentage of what the jury hear, so will fully respect whatever verdict they come back with.

It appears that we respectfully disagree on both the overall independent validity, and reliability of the prosecutions expert witnesses.

I have never followed such a challenging, and complex case - d/t the amount of horrific charges predominantly based on individuals opinions from respected doctors; exacerbated by the apparent atypical behaviour of a defendant (e.g., diary notes). I think the answer to behavioural complexities in this case IMO lay within the science of the mind - E.g., individual differences; social-group norms; cognitive biases; mental health. JMOO

 

[SleepyJoe]

He said Letby accepted herself that sub-optimal care played little or no part in most of the babies' cases.
He says [defence barrister] Benjamin Myers KC repeatedly suggested that doctors "had gone out of their way" to "damage" the defendant by blaming her for sub-optimal failures in care. He says she "did nothing to harm any baby".

Wow! These are both powerful statements!

 

[Tortoise]

12:14pm

The trial is resuming after a short break.
The judge is continuing the summing up, in the case of Child A.
He recalls what Letby had said in police interview, and recalled 'red, purple blotchy markings' on Child A, which she thought were signs of an infection.
She believed there was an issue with the long line, and Melanie Taylor had connected the fluids to Child A.
Child A's death was not expected or anticipated. She said she thought the bag of fluid was 'not what they thought it was', but they had checked it afterwards.
She said she did not keep in touch with the parents, and did not recall what she did with the handover notes.
She said she did not know much about air embolisms, and all staff were "meticulous" about precautionary checks to prevent that happening. She denied pushing air through the line.
She could not recall using social media to search for the mother of Child A, and when asked to explain searches for the mother on Facebook, said she could not do so.
Letby said the fluid bag should be contained and put in the sluice room for checking.
She said staffing levels contributed to the death of Child A, citing difficulties with the long line and Child A's lack of fluids for several hours.
She said if air embolus was the cause, Melanie Taylor was responsible. She disagreed with the descriptions of skin discolouration given by a nursing colleague and Dr Harkness.
She said searching for the parents was a "common pattern of behaviour" for her.

Recap: Lucy Letby trial, July 3 - judge's summing up

The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more, is…

www.chesterstandard.co.uk