Professor Hindmarsh said the following possibilities happened.
That the same bag was transferred over the line, that the replacement stock bag was contaminated, or that some part of the 'giving set' was contaminated by insulin fron the first TPN bag which had bound to the plastic, and therefore continued to flow through the hardware even after a non-contaminated bag was attached.
"There can be no doubt that somebody contaminated that original bag with insulin.
"Because of that...the problem continued through the day."
I think they are suggesting the other bags may have been contaminated. However, from reading the evidence, I don’t think the TPN was replaced at noon that day. I think it was the same bag that was transferred over. I think I missed a day of evidence though, when it stated the nurse said she changed the bag? Can someone clarify this for me please
The only time a new bag was 100 percent given was here!
Child F's blood glucose increased, before falling back.
A new bespoke TPN was made for Child F, delivered at 4pm. - which shortly after child Fs blood sugar started to return to normal.
The prosecution say this could not have been the same one fitted to Child F at noon that day which would have been either a bespoke bag which Lucy Letby co-signed for, or a stock bag from the fridge. I think the evidence is getting confused. This comment is referring to the bag change at 4pm or shortly after (4 pm states when it was ordered so I so don’t think the timing is exact here), and highlighting how the noon bag was a ‘letby bag’.
Child F's blood sample at
5.56pm had a glucose level was very low, and after
he was taken off the TPN and replaced with dextrose, his blood glucose levels returned to normal by 7.30pm. He had no further episodes of hypoglycaemia.
Blood sugar readings for that period:
1.9 (4pm)
1.9 (6pm)
2.5 (7pm)
4.1 (9.17pm)
From the above it suggests that there is only a 1 hour and 56 minutes window that baby F had the actual NEW TPN bag (probably less) and then his blood sugar started to return to normal
.
Is this Because he was taken off from a 4pm NEW contaminated bag (through the lines etc) and given dextrose ? Or because the bag before 4pm was the **original bag*** ? My thoughts are the high readings are In reference to the previous bag, perhaps there was a much higher amount of insulin in the original set then they realise. His blood sugar started to return to normal once they intervened but perhaps it was just the normal process of things. What I mean is insulin has a four to 6 hour window to be broken down and be undetectable. His readings were high yes at 5.56 pm (after a new bag), but let’s say perhaps they were even higher at 3.30 or 4pm (they didn’t check these). What I’m suggesting is could baby Fs insulin levels have been double this previously and basically by 4 pm onwards it was correcting its self naturally and with the help of dextrose and had nothing to do with being taken off that particular TPN bag?
I hope people understand what I’m saying, it’s so confusing I know and I’m not sure I’m explain my self very well. I think she 100 percent contaminated the original bag and that that bag was never changed. I’m just confused over the last bag, doesn’t change her guilt but wondering if it is being interpreted wrong not by the experts but by us and the defence.