Lucy Letby Case #18

[MmmB777]

[

I think you'd have to tell tho.. an unnamed, preverbal trauma can cause terrible harm.. no perfect solution for sure. Very upsetting.

Maybe you’re right, it just seemed so awful for her and she was clearly unable to think about it rationally. Urgh. I live nearby, it was very odd seeing it all in the doc. The old hospital is very eerie.

 

[docmum]

@docmum please help. I don’t think I can explain this anymore than I already have. Numerous experts and medically knowledgeable people have said it cannot be accidental for various reasons. One being it would never be given via tpn bag. I honestly don’t know how many times you want me to go over this, this convo has been on repeat most of the night. So I’ll just leave it here on the accidental administration of the insulin being impossible for tonight

I can’t change opinion where they don’t want to be changed. I’ve tried to get out as much as poss from my exploding brain and keep it objective where I could, before this afternoon that was a little easier. ‘Google searches’ are renowned as doctors worst nightmares. UK accredited journals or anything quoted in an NHS trust guideline (and is up to date) would be all I recommend re searching online.
I’m hoping that by keeping things clear and objective, that as the evidence adds up and the patterns are clearer, then my ramblings will become more relevant and the minor details will be less of a focus. Any doubt over insulin not being put in the bags really needs to be offset with why BM didn’t question Dr Gibbs today at all. But I’m sure he will have something re the insulin further down the line and I look forward to hearing what his analysts have found that could be relevant if so.

If I was an expert in medicine I would find it absolutely wild that some people will give more credit/weight to google than the skills and knowledge that took me years and years to achieve. I’ll believe Google but not the various medical experts all saying the same thing. Make it make sense

Used to it - as you can see

 

[MmmB777]

I am unsure.. there are some pieces of evidence which make her look guilty which is to be expected during a prosecution argument. There are also some pieces of evidence which I think aren't suspicious at all and those are the ones I sometimes offer a different view on... not because I think she's innocent but because there's a massive amount of people who think she's guilty and wheres the discussion if we're all repeating each other and saying the same thing? I've not tried to offer any scenario at all which makes her look innocent around the TPN and insulin.. it's good evidence and probably the backbone of the case.. I'd just like to hear the defence before I make up my mind on it. And no, Myers hasn't tried to defend it yet but this is the prosecution's case.

Ok maybe I misinterpret a lot of what you say! It seemed like you really were trying to offer multiple accidental or normal scenarios for the TPN bag stuff this evening, my mistake! I don’t have a problem with anybody being G/NG or unsure. I do remember absolutely everybody finding baby A extremely compelling, a lot of people that were “unsure” seemed to disappear then and then come back when they found something to cling on to, usually mistakes by the hospital which haven’t caused death. I think we all forget a little quickly what evidence we’ve already heard and how it also links to everything we’re yet to hear, personally.

 

[docmum]

I've just read a couple of the articles on Google and it seems pretty common for insulin to be added to TPN bags. These are all peer reviewed articles by experts in their field. Lots are more recent than these alleged attacks and from lots of different counties.
I think the difference in this case is probably that in the articles the trials were for treatment of chronic hypoglycaemia and diabetes, so it wouldn't matter necessarily if the insulin stuck to the bag, as you'd want a continuous administration anyway. In NICU you'd want to know exactly how much they were receiving and this doesn't seem to be the norm for administration.
This was interesting.. the use of TPN is itself a risk factor for the onset or aggravation of hyperglycemia.

Tpn has standard dextrose in it

 

[avabella]

the number of units aren’t relevant here ie not like saying she gave 10mg diamorphine.
insulin is either rapid acting or long acting in general. Diabetics get more specific. Neonatal units will only need to stock the rapid acting. This is the same type of insulin that diabetics tend to have with meals as it has a quick onset of action (and a quick clearance). Dose is very much trial and error for diabetics along with the specialist nurses. When it’s required in acute care such as here, you start with the lowest reasonable dose - neonates/children often calculate per kg for everything in medicine. The context around asking dr gibbs about the insulin that was given is clear - it was prescribed, jt was signed for, baby was given further doses of insulin and/or dextrose were given depending on the repeated feedback from testing their blood sugar at the bedside - because it is so rapid acting, you can stabilise things in only a few hours usually. This level of care for something such as insulin is why these patients have 1:1 nursing though. It’s constant monitoring. Insulin is incredibly dangerous.

The level in the blood is not something that has a meaning to me, sorry. What was overwhelming was the ratio of insulin and cpeptide. When the baby wasn’t responding to treatment with the incident once the tpn was started, the bloods sent to the specialist hospital showed that the baby had been exposed to so much insulin that their body had stopped producing insulin entirely in order to try to stay alive as part of the feedback from recognising their own sugars were low. Keep in mind that by this time, baby had repeated infusions of glucose and dextrose at this point - and they had basically no trace of their own insulin that was detectable. No one can ever say how much was in there. It’s the gravity of how that babies body was trying to survive at that time of the blood test; and then the (thankfully) rapid improvement again afterwards. The NICU team saved this babies life from one of their own. It’s unbelievable.

Thank you for this - read over it again and think I may need to save it just to refresh my mind every so often. I guess this type of practice is second nature when you work in this industry but for the layperson it is really tricky to get the head around.

 

[OldBlondie]

[
Maybe you’re right, it just seemed so awful for her and she was clearly unable to think about it rationally. Urgh. I live nearby, it was very odd seeing it all in the doc. The old hospital is very eerie.

Just out of interest in any of the documentaries on BA, do they say what her defence was? Did she have a good defence? I can only just remember BA, and it was everywhere as others have said people running and throwing stuff at the van coming in and out of court, but I can’t actually remember many of the details. Just wondering how her defence was in comparison to LL’s?

I can’t change opinion where they don’t want to be changed. I’ve tried to get out as much as poss from my exploding brain and keep it objective where I could, before this afternoon that was a little easier. ‘Google searches’ are renowned as doctors worst nightmares. UK accredited journals or anything quoted in an NHS trust guideline (and is up to date) would be all I recommend re searching online.
I’m hoping that by keeping things clear and objective, that as the evidence adds up and the patterns are clearer, then my ramblings will become more relevant and the minor details will be less of a focus. Any doubt over insulin not being put in the bags really needs to be offset with why BM didn’t question Dr Gibbs today at all. But I’m sure he will have something re the insulin further down the line and I look forward to hearing what his analysts have found that could be relevant if so.



Used to it - as you can see

Please don’t ever leave this thread. It needs you. We need you. In all seriousness though it’s really much appreciated that you always take the time to explain things, (sometimes more than once) and answer any questions that we have, or clarify bits when needed

 

[Daisydunn15]

Ok maybe I misinterpret a lot of what you say! It seemed like you really were trying to offer multiple accidental or normal scenarios for the TPN bag stuff this evening, my mistake! I don’t have a problem with anybody being G/NG or unsure. I do remember absolutely everybody finding baby A extremely compelling, a lot of people that were “unsure” seemed to disappear then and then come back when they found something to cling on to, usually mistakes by the hospital which haven’t caused death. I think we all forget a little quickly what evidence we’ve already heard and how it also links to everything we’re yet to hear, personally.

No, thats not what I was saying. Someone said they'd found on Google that insulin can be added to TPNs, from what we've heard so far I assumed this never ever happened because it sticks to the bag, so I was interested surprised to find that it sometimes does happen I was just responding to someone else who'd read it and if anything pointing out differences with this case but I don't think you can disregard information purely because it's on Google, I disregarded it because the studies were on diabetic patients and because nhs England has different standards for this country..
The evidence for A was compelling, I said so myself at the time. I'm also interested to see what the defence have to say about it, I don't think I've gone away and come back when there's something to cling to I just post more frequently when my baby decides to nap.

 

[docmum]

Thank you for this - read over it again and think I may need to save it just to refresh my mind every so often. I guess this type of practice is second nature when you work in this industry but for the layperson it is really tricky to get the head around.

Completely understand, and it’s no trouble at all. I have to refresh certain things before updating here myself.. Happy to objectively explain details any time or repeat it if it isn’t saved, please just ask.

 

[Daisydunn15]

Tpn has standard dextrose in it

Is that the same for the bespoke bags or would it depend entirely on the prescription? Not something I've used.

 

[Mollie&Cookie]

I've voted unsure a few times as although the prosecution evidence is pretty damming so far I need to hear what the defence say.
Just to throw it out there, is it possible these fluid bags/tpn bags were somehow contaminated in the pharmacy at preparation even before they arrived as stock on the unit. I'm guessing probably not as these sorts of events would have been happening all over the hospital.

 

[Treesy19]

Bloody hell this thread moves faster than the Frankie and Savannah one did. I was disappearing into the toilets at work fairly regularly with that one. I’ll roundup my thoughts then after a hop around reading most posts.

I’m not surprised after today though given the sure conclusion that F has been given synthetic insulin when absolutely wasn’t prescribed it. Poor old Letby in the wrong vicinity at the wrong time yet again. All a big misunderstanding, mere loose suspicions have resulted in a multi-million pound trial pinning it on Lucy - rather than going after the real killer. Sounds like I’ll not bother having a look at the Facebook group posts I wonder how many of those people would be happy to leave their newborn in a room with Lucy Letby.

A hospital serial killer has to be devious by nature. Otherwise they’re not even going to tick off one victim, let alone multiple. A non-devious person just wouldn’t amass these numbers of course. She was hardly ever going to say to the rest of the staff, “hey, can you look that way I’m just going to do something I don’t want you to see”, or, “sorry, can you go out the room a minute”.

Really feel for parents of E and F this week, after last week too. I bet that little boy who is now 7 is cherished like nobody’s business.

We’ve heard about the Facebook searches, I’m just really curious whether her Google searches came a cropper. Did she search Beverly Allitt ever. I certainly have, but then I’m not a nurse in the same field who happened to be present around the events of 22 serious allegations and then be accused of them all.

So there are 9 people voting that they think she’s innocent anyone willing to say who they think is responsible if it not her?

I mean, I’m hoping a couple of these NG could be accidental voting - you know, like when you’re scrolling Mail Online comments sections and accidentally vote someone down when you mean up.

 

[Wellthisisinteresting]

Yeah If you are fond of your brain cells I would avoid the FB groups

 

[OldBlondie]

I've voted unsure a few times as although the prosecution evidence is pretty damming so far I need to hear what the defence say.
Just to throw it out there, is it possible these fluid bags/tpn bags were somehow contaminated in the pharmacy at preparation even before they arrived as stock on the unit. I'm guessing probably not as these sorts of events would have been happening all over the hospital.

I think it’s more the fact that they can’t be contaminated by accident or mistake. So if they were contaminated at pharmacy, then it would still have been a deliberate act. I’m not medical, but there was a poster a few pages back that explained why it would nearly be impossible for it to have been done in pharmacy. I did think BM would have at least had some questions today for consultant, so will definitely be interesting tomorrow to see where BM is going and what he has to say. Luckily Mark is deffo there so we’ll have live reporting all day

 

[docmum]

What a day. My head is spinning. I’ve found the evidence incredibly difficult to process today. Yes it’s the prosecution evidence only and I actually hope there’s excellent evidence to counteract what has been left ‘hanging’ so to speak. I can’t get my head around *someone* - not necessarily the defendant, knowingly poisoning a bag with a lethal dose of a drug, with knowledge of how to override machines so that the nurse looking after the baby 1:1 was totally unaware the baby was being poisoned directly in front of them. I have been in the nhs nearly 20 years and I have been tearful more than once today trying to comprehend *someone* could do this. Because it was done somehow. My heart aches for the babies, the parents and for those staff who were actually being humiliated by one of their own. The unit has failings for sure, but please objectively look at those insulin levels, and then look at a miracle survivor baby

The point I wanted to make was that I know the nhs fairly bloody well. I can’t explain further, maybe that’s a good thing! But I hate this trial. For those who feel she is not guilty or feel unsure, I can appreciate and understand why based on lack of beyond reasonable doubt evidence etc, but tonight I can understand indecision based on just how the actual feck anyone can be capable of deliberate actions such as these. I think a lot of the conflict today has been based around disbelief and I’m right there with it. Again, I can’t imagine the disbelief within those staff members giving evidence, and the police who waded through literally tons of notes to get here.

Am bowing out for tonight. Will no doubt be back in the morning but I got dockid in for bedtime snuggles earlier and decided to keep them here for the night to recharge my belief in the world. Sending love to all as I know everyone is finding this tough for various reasons, but I am captivated by the thread and the insights, and we have a hell of a rollercoaster ahead of us

 

[candyland_]

Dont think ove seen that one? Can you remember where you saw it/what it's called?

I think it was on ITV Hub. You might have to search Trevor McDonald for it to come up.

Dont think ove seen that one? Can you remember where you saw it/what it's called?

It’s always the same poster

 

[PeninsulaAndOriental]

I’m married to a Pharmacist, who also works in a hospital aseptic unit which makes TPN both for babies and adults.

Insulin is NEVER added to TPN.

 

[avabella]

What a day. My head is spinning. I’ve found the evidence incredibly difficult to process today. Yes it’s the prosecution evidence only and I actually hope there’s excellent evidence to counteract what has been left ‘hanging’ so to speak. I can’t get my head around *someone* - not necessarily the defendant, knowingly poisoning a bag with a lethal dose of a drug, with knowledge of how to override machines so that the nurse looking after the baby 1:1 was totally unaware the baby was being poisoned directly in front of them. I have been in the nhs nearly 20 years and I have been tearful more than once today trying to comprehend *someone* could do this. Because it was done somehow. My heart aches for the babies, the parents and for those staff who were actually being humiliated by one of their own. The unit has failings for sure, but please objectively look at those insulin levels, and then look at a miracle survivor baby

The point I wanted to make was that I know the nhs fairly bloody well. I can’t explain further, maybe that’s a good thing! But I hate this trial. For those who feel she is not guilty or feel unsure, I can appreciate and understand why based on lack of beyond reasonable doubt evidence etc, but tonight I can understand indecision based on just how the actual feck anyone can be capable of deliberate actions such as these. I think a lot of the conflict today has been based around disbelief and I’m right there with it. Again, I can’t imagine the disbelief within those staff members giving evidence, and the police who waded through literally tons of notes to get here.

Am bowing out for tonight. Will no doubt be back in the morning but I got dockid in for bedtime snuggles earlier and decided to keep them here for the night to recharge my belief in the world. Sending love to all as I know everyone is finding this tough for various reasons, but I am captivated by the thread and the insights, and we have a hell of a rollercoaster ahead of us

Despite the awful circumstances we are all discussing and the topic of your post, this is one of the most compassionate and well explained posts I've read throughout any thread of LL's

 

[dottynotty]

Sorry, is there an issue with me posting in the thread?

Seems that way. I stopped contributing as there is no point.

 

[onthefence1]

Been following the trial and threads but lurking and never commenting. As the name suggests, im absolutely on the fence. Agreed, lots of information we read looks dodgy, but playing devils advocate, here are sone thoughts. (Random thoughts as im late to the commenting party may i add).

I think the NICU sounded particularly unsafe, re:staffing and decision making (taking a baby weighing 800g which would have certainly been safer in a level 3 unit), not checking critically low blood sugars for hours.

The maternity services.. The lady who had a terrible birth, 60 hours after waters went and no antibiotics, poor care!

The "watching for babys to self correct when desatting) this is common in any aspect of nursing, not too concerning for me, its common practice, you might adjust settings and appear to be watching, knowing with experience levels will go up.

The taking a baby off cpap who had obviously deteriorating gases, strange decision.

The air in vessels, 2 babies (i think) had new long lines put in (1 had it removed during resus) can we be sure these lines were primed?
Air via NG tubes. Other nurses handled these tubes, new nurses who may have been less experienced, is it beyond reasonable doubt that they couldnt have caused it?
Insulin... could this have been a complete incompetent medication error? Short staffed, over run, tired, no breaks, you arent focusing the same. Having reviewed many incidents as part of my work, they are very common! I.e patients given completely wrong medication for reasons unknown.
Theres so much dodgey ground for me, at this point if i was a juror, i could not say guilty beyond reasonable doubt... not saying shes innocent, just interested to hear the defence. Hey what if the doctors not primed the long lines, causing embulous, the nurses have been pushing air accidently down ng tubes, not knowing the harm it could cause, then theres been 2 huge meds errors (ive known of similar ) she could be a scapegoat... could be a calculated killer, theres no winners here.

 

[MmmB777]

Seems that way. I stopped contributing as there is no point.

The person you’ve quoted continuously jibes at me for how often I post and makes personal insults. It’s a little hypocritical to question if I’m allowing her to post. I bit tonight, I’ll go back to reporting instead as that was getting the comments removed. Post away. And please I beg of you both - mute me. It’s that easy x