Lucy Letby Case #42

[Futtrit]

2:38pm

Mr Myers said no cause was identified for the collapse of Child H.
He says there were "very serious failings in care".


2:44pm

Mr Myers refers to the case of Child I, which he says has a lot of detail to it.

He says Child I was very small and "fragile" and "capable of deteriorating from almost nothing".

He says this was evidence heard from her time in Liverpool.

He says nurses would talk of Child I 'having a big tummy', and Dr Bohin agreed there were multiple occasions noted of a distended abdomen.

He says Child I regularly presented as "mottled".

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2:49pm

Mr Myers refers to an event of 'abdominal distention' on August 23, which experts had agreed was 'consistent of harm', but is not on the sequence of events and Letby was not on duty.

He says there is an 18-hour period from September 5-6 where Child I deteriorated from being a well baby, to the point she was transferred to Arrowe Park Hospital.

Mr Myers says it shows how quick Child I could deteriorate, and "she was not doing well".

 

[Futtrit]

2:19pm

Mr Myers says both experts put "poor opinions" forward.

He refers to the first event of June 15, 2016, in the morning, at 7.15am.

He says there is no evidence of anyone seeing Letby coming in and causing harm to Child N.

He says the prosecution created the narrative Child N was sabotaged in advance the previous night by Letby before she left at the end of her shift.

He refers to nurse Jennifer Jones-Key's note for the June 14-15 shift.

He says in evidence, Jennifer Jones-Key said Child N first deteriorated at 1am, and remained at that condition through the rest of the night.

Mr Myers says that "is an end to the sabotage theory", as Child N became unwell several hours into that night shift.

 

[Futtrit]

12:47pm

Mr Myers refers to the case of Child M, and outlines the events that took place.

He says it was established he was in a corner of room 1 on April 9, which "wasn't ideal" as the unit was busy.

He says Letby was "doing nothing" to harm Child M, and had participated in giving antibiotics 15 minutes prior.

He says Dr Evans and Dr Sandie Bohin had worked in a theory of how slowly air embolus could take effect.

He says that theory is "unbelievable".

 

[Futtrit]

12:31pm

Mr Myers refers to the second event for Child G on September 21, 'At 1015 x2 large projectile milky vomits....desaturation to 35% with colour loss. NG Tube aspirated - 30mls undigested milk discarded.'

He says if Letby is alleged to have attempted to kill Child G, 'what a thing to put it in a nursing note'.

He asks where the 'document fraud', or 'cooking the notes' is.

He says it is "an incredibly weak basis" that the only two events of milky vomits on September 7 and September 21 are suspcious

 

[amsmall]

View attachment 2274990View attachment 2274992View attachment 2274995

Thank you I was thinking there's no crack today

 

[Futtrit]

2:04pm

The trial is now resuming following its lunch break.

 

[Futtrit]

3:43pm

He says for the final event, there are two signficant desaturations, one just before midnight, seen by Ashleigh Hudson, who is not sure why.

He says there is a similar event at 1.06am the following morning, on October 23, when Child I does not recover and dies at 2.30am.

He says the difference with the latter is Lucy Letby is there.

He asks what the difference is between the two events.


He says Child I was a very poorly baby before this night, and Child I "would have been under terrible stress".

 

[LurkerLouiseLoves]

CRP rises very quickly in response to any tissue inflammation and is not a marker of infection

very very HIGH CRP results can indicate infection but rapidly high CRP results only indicicate that there is INFLAMMATION which can result from infection/damage/medication heck even sleep can effect CRP

but in this case, sudden inflammation due to tiussue damage like an injury would cause a massive spike in CRP in a neonate



in regards to the insulin, if the cannula tissued and, I have not been following this case well at all... but a high blood insulin indicates it is in the blood not the tissues, insluin is a protien and does not normally get into the tissues, it sits on receptors in on cells to allow glucose to move in to cells so its only high if you have a huge abount of glucose and the pancreas needs to releas insulin to get the glucose into cells or it is injected into you

I’m aware the CRP rise is not because of the presence of infection directly but as a result of inflammation which can be caused by infection or any of the other examples we both gave.
I stated it is used as a marker/indicator/adjunct for assessment that infection could be present (a inflammation response has happened, such as from a infection/sepsis)
Or do you disagree? If you were only shown a elevated CRP and there was no history of trauma/post op/autoimmune issues it would be sensible to assume infection wouldn’t it? Or would you assume something different first line? I’m genuinely curious and not disagreeing with you.
I don’t think my comment was stating it was definitely the result of infection but that I could see how it wasn’t used as a valid marker in surgical patients the previous poster was taking about as those patients would have a raised CRP because they were post op regardless of infection presence. But in other patients it can be a more useful.
Is this the baby with physical force liver damage? I get the letters confused but I don’t think it is.
If not then trauma wouldn’t be the most obvious reason for CRP presence in this baby. So it could be reasonable to assume it was because of infection. A CRP of > 200 is pretty high or do you not feel it is? I’ve only really seen CRP closer to 400/500 a much smaller number of times. I don’t really have a comment in regards to the insulin absorption, I don’t know enough to comment.

 

[Futtrit]

10:56am

He turns to the case of Child K. He outlines the events and allegation.

He says the allegation "illustrates a good deal wrong with this case".

He says Child K "should not have been at the Countess of Chester Hospital", but should have been treated at a tertiary unit.

He says arrangements were being made post-birth.

He says a review carried out at Arrowe Park Hospital said care at the Countess was "sub-optimal".

He says the defence acknowledge there is a question whether transporting the mother before birth was possible.

He says Child K should have received surfactant.

 

[Futtrit]

11:24am

Mr Myers refers to the case of Child G, for which there are three allegations. He recalls the key events during her care at the Countess of Chester Hospital's neonatal unit in September 2015.

 

[Futtrit]

2:07pm

Mr Myers says it occurs to him they are halfway through the material, and appreciates it is very detailed.

He says it is important and necessary to go through the detail.

He continues with the case of Child H. He says the defence suggests a 'build-up' of what had gone on, and a poorly positioned chest drain, caused the collapse at 3.15am, after a third chest drain was put in.

He said it must have been "a huge stress on a baby".

 

[Futtrit]

10:37am

He says Child J's mother is "a fairly neutral witness on this topic".

He says she said she drew comparisons betwen the care at Alder Hey Children's Hospital and the Countess of Chester Hospital, and the latter was 'not favourable'.

She says the staff at the Countess relied on them to sort stoma care.

She says they were left to "feel unwelcome", and asked about that, she said she felt their concerns "were not treated seriously".

She says the staff there "did not have the same confidence and ability" in dealing with stoma bags.

Mr Myers says this statement is used as the basis for their argument that the Countess was receiving too many babies with complex needs.

 

[Bobbiewilson]

I thought she was being held near Wilmslow

 

[Futtrit]

11:30am

Mr Myers says nurse Joanne Williams recalled Dr Jayaram had asked her what had happened, and who was in the room when the alarms went off.

He asks why Dr Jayaram would ask her that if he had been in the room at the time, seeing Letby in there.

He refers to a note on the transport team: "Call received from Dr Jayaram baby dislodged the tube and had to be re-intubated".

 

[AllieBee]

Whilst the judge directed the jury that they can consider all the cases together, I’m sure that when it comes to the actual verdict that each case will be announced individually.

I don't know the legal world at all but surely they would need to come up with G/NG for each individual charge?

 

[abelleza]

Out of everything for me. I think it’s the handover notes. They were not insignificant to her. They meant something. You don’t keep something in pristine condition in a rose embossed keep sake box, that isn’t significant. Even on their own, they speak so loudly to foul play. The fact that she kept them under her bed and they moved house with her multiple time. I also am still really curious about the medical equipment and walking stick in her bedroom!

It was in her garage, not her bedroom.

 

[Futtrit]

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1:00pm

He says by 3pm, Child M was made nil by mouth, and says it can be argued that was 'not a great direction of travel for him'.

He says if it is accepted that the 4pm event is a signficant escalation, it does not show Letby caused harm at that time.

 

[Futtrit]

2:18pm

Mr Myers says the second chest drain "may be another aspect of poor care".

He says it was put in the 'wrong position' for Child H by Dr Jayaram.

Two x-rays are shown.

He says Dr Bohin accepted, in cross-examination, that the position of the chest drain was not in accordance with guidelines.

She said the position of the tip was sub-optimal.

Mr Myers says the tip also moved around.

A number of x-ray images for Child H are shown for the positions of the chest drain tip.

He says it is shown to have moved, and says the tips of the other ones had not.

 

[November2019]

Has BM said anything about the handover sheets yet?

 

[Futtrit]

2:37pm

He says Child H had a 'profound desat' at 2030 and a further 45% desaturation at 2145.

He says the 'profound desaturation to 40%' at 0055 is the one Letby is blamed for, "randomly".

There is also a desaturation at 0330, which Letby is not linked with.

Mr Myers says the desaturation at 12.55am is part of a series Child H had been going
through that night.