Lucy Letby Case #6

[Lexi]

this is the bit from the reporting but I’m a bit unclear about where the second bag came from.

i *think* this is saying that TPN bag 1 was taken off temporarily at 11am

but the next TPN bag wasn’t delivered until 4pm.

So between 11am-4pm it could only be TPN bag 1 or a stock bag. But Lucy wasn’t on shift at this point. If it was the stock bag then that could easily have been contaminated anyway as it was stored in the fridge with the insulin.

View attachment 1653617

This sounds confusing but my interpretation is (and I could be totally wrong):

*When they inserted the longline they took bloods and because they couldn’t stabilise baby’s glucose levels they requested a new TPN bag to be made up (hence why it took till 16:00hrs to get there)

*If they had put the new TPN bag up at 16:00 and rechecked bloods after an hour and baby’s glucose was still deranged they would have to stop the TpN and give IV fluids with added Dextrose. Glucose then stabilised.

*Was whatever was in the first bag still in baby’s bloodstream causing it to interact with the second TPN bag, hence baby’s sugars not stabilising. When the IV fluids with added dextrose was given baby’s glucose stabilised.

I’ve confused myself by what I’ve just wrote!

 

[Skellig]

I understand why you might bring it home accidentally, but I don't know why you'd hang on to it once you've realised? Unless she's just that disorganised.

Exactly yeah. Was the handover sheet her own patient ( who she killed?? ) or a patient she killed who wasn't her patient ?

It's all anyone is talking about now in work tonight. Might send them all. You're all seem very intelligent and make some great points

 

[Lht30]

I think if she is found guilty of even just one charge then people won’t think she is innocent for the others, they will just think there wasn’t enough evidence. Maybe it would be ‘bad luck’ if she was still thought of as guilty for some she didn’t actually do but if she’s killed even one baby then I don’t really care if she’s wrongly accused about others (i would only care about the parents who deserve the truth)

I think you're probably right. Mud sticks. If she's found not guilty then the terrible thing is the parents won't get the answers they need around why their children died.

 

[StatusWoe]

This sort of relates to the discussion about the note.

In an earlier thread I posted a link about Lucia de Berk, a paediatric nurse who was imprisoned for murder, only to be found innocent a few years later. I'm not saying that LL is comparable to her - these are obviously different circumstances - but the case was on my mind when people were discussing scapegoats and statistical errors. Anyway, here's a section from the wiki article. Got to admit these diary entries do sound incriminating. It really makes you think twice about writing things down! I think it shows how easy it is to misinterpret evidence when there's little context.

 

[bigbear22]

i just don’t know where I stand with this - I’m a nurse and we have so many viagrous checks and double signatures needed for sooooo many meds ESPECIALLY if IV or Parenteral…

I’ve been reading some of the evidence from press/twitter/here and onething I have noticed a lot of is ‘LL took over the care of’ or ‘ a 2nd bag was hung when LL wasn’t around’ I just don’t see why there couldn’t have been someone else tampering with bags - i think if your clever enough it*could* be fairly straight forward to contaminate a bag of fluids/feeds with insulin and leave in a prep space and an unwitting person could hang It… just my opinion!

hopefully more will come out

 

[Skellig]

Exactly yeah. Was the handover sheet her own patient ( who she killed?? ) or a patient she killed who wasn't her patient ?

It's all anyone is talking about now in work tonight. Might send them all. You're all seem very intelligent and make some great points

Lovely spelling and grammar mistakes can ye tell I'm on a long shift lol 6pm til 10 am

i just don’t know where I stand with this - I’m a nurse and we have so many viagrous checks and double signatures needed for sooooo many meds ESPECIALLY if IV or Parenteral…

I’ve been reading some of the evidence from press/twitter/here and onething I have noticed a lot of is ‘LL took over the care of’ or ‘ a 2nd bag was hung when LL wasn’t around’ I just don’t see why there couldn’t have been someone else tampering with bags - i think if your clever enough it*could* be fairly straight forward to contaminate a bag of fluids/feeds with insulin and leave in a prep space and an unwitting person could hang It… just my opinion!

hopefully more will come out

Exactly what I mean ! I'm in an adult hospital in ED and I triple check every single thing. So can't imagine how many times I'd check if it was in a NICU !!

Have you ever brought home a hand over sheet yourself ? I've never brought home a thing !

@StatusWoe your name

 

[Haveyouanywool]

i just don’t know where I stand with this - I’m a nurse and we have so many viagrous checks and double signatures needed for sooooo many meds ESPECIALLY if IV or Parenteral…

I’ve been reading some of the evidence from press/twitter/here and onething I have noticed a lot of is ‘LL took over the care of’ or ‘ a 2nd bag was hung when LL wasn’t around’ I just don’t see why there couldn’t have been someone else tampering with bags - i think if your clever enough it*could* be fairly straight forward to contaminate a bag of fluids/feeds with insulin and leave in a prep space and an unwitting person could hang It… just my opinion!

hopefully more will come out

Was this second person with murderous intent on the same shift as LL? Would they only be targeting her or would it be random?
Seems a bit far fetched to me.

 

[bigbear22]

Was this second person with murderous intent on the same shift as LL? Would they only be targeting her or would it be random?
Seems a bit far fetched to me.

Ohh potentially I mean I obvs don’t know the ins and outs but I’ve had patients transferred to me from other departments with IVs to be started and I usually chuck them and start fresh making my own - I’m not gonna hang something someone else made!!!

I have no idea if LL is guilty - although it isn’t looking good - I was just giving an example of how Iwas reading some things

 

[Haveyouanywool]

Ohh potentially I mean I obvs don’t know the ins and outs but I’ve had patients transferred to me from other departments with IVs to be started and I usually chuck them and start fresh making my own - I’m not gonna hang something someone else made!!!

I have no idea if LL is guilty - although it isn’t looking good - I was just giving an example of how Iwas reading some things

I mean you’re right that someone could fairly easily tamper with bags etc, but the air embolisms and over inflating of the stomach?
Statistically one homicidal maniac at a hospital would be very rare but two at the same time? And in the same department?

 

[michmrob]

I think she kept the handover sheets so that she could get her timelines straight if she were ever questioned….

 

[bigbear22]

I mean you’re right that someone could fairly easily tamper with bags etc, but the air embolisms and over inflating of the stomach?
Statistically one homicidal maniac at a hospital would be very rare but two at the same time? And in the same department?

Yes agreed, just trying to make sense of it

 

[Laura8868]

I think she kept the handover sheets so that she could get her timelines straight if she were ever questioned….

Handover sheet wouldn't really help her with those sort of information.
She could request access to notes from so and so shift for this and that patients. She will be granted access in advance so she could prepare herself for court case/internal investigation.
That's why notes always should be well organised and everything documented'- so, as a nurse we could have a proof what really happened.

Was this second person with murderous intent on the same shift as LL? Would they only be targeting her or would it be random?
Seems a bit far fetched to me.

The odds of having not one but two potential killers on the unit are close to 0% I think?
I heard of killer doctors/nurses before but not two in same hospital on the same time

 

[bluefish40]

The people that think she’s guilty what do you think about the insulin contaminated IV bag never being in her presence at any time? This makes me think is it easy for IV bags to be contaminated accidentally??

I have been thinking about this also.
Where I worked they were stored in a room with a fridge for expressed breast milk etc. the bags aren’t locked away or anything as essentially it’s sterile water with a little bit of sugar in some cases (explaining as easy as I can)
It’s much quieter on nights.
Say she knew a baby could be started on an infusion of water soon (the water bag connected to the patient) she could enter the room with the milk and water bags ‘as she was going to get some milk for her patient’ or ‘oh your busy, I will go and start running a bag of Iv fluid for you and I’ll bring it in to check with you’ This shouldn’t happen, but in a failing hospital with low regular staff it’s feasible.
I’m trying to understand how she could end up in the room on her own, she would then have time to put some insulin in a syringe (or potentially have already don’t this at a different time previously)
As mentioned the IV bags have little tubes at the bottom, one where you connect a giving set to run it through, and a second tube to add any medications you might need. They do have plastic tags that you snap off before you can access the spongy part. But in my experience it wasn’t always the case. (10+years ago)
She could have done it under the guise of being helpful, and been on her own.
Or she could have done it once it was set up, quickly injected the bag in the second tube or via the giving set. The saline bags come in a clear plastic bag, it’s far fetched but could she have opened the bag and the plastic clip just enough to inject the bag with insulin, and then still have it believable for the packaging around the bag to make noise when she opened it, and she took off the plastic clip to look like it was being removed for the first time?

I can’t articulate myself very well but I think especially on nights she will have had a lot more opportunity than you would think.

ETA - she was a busy body so being over helpful setting up Iv bags for nurses who were busy could be feasible, trying to remember this was a ward that was severely understaffed, so best practices would have possible slipped.

 

[Stiltoncheese]

Maybe the house was emptied for the sale pics, but it is very minimalistic. Especially considering the defence said she scribbles a lot of things down and keeps them. I wonder whereabouts the things were found because I imagine a table piled high with junk. I forgot about the colleagues names, my first thoughts was she was trying to get her story straight and work out who knows what etc.

What does everyone think of the statement bellow from the defence made about other bits of notes found in the house. I am not sure what to make of this.

"On some of the notes were phrases such as “Why/how has this happened – what process has led to this current situation. What allegations have been made and by who? Do they have written evidence to support their comments?"

I wondered about this (sorry if someone already covered this, just catching up).
Could this have been a phone conversation with her union as she was in disciplinary proceedings. It may be they have said these phrases to her as something to consider and she has written them doen as a prompt.

They sound like the classic things you would ask or consider if you were being investigated about something (thinking work rather than police here) and we're trying to get some clarity about your rile in everything and what case they were bringing against you

 

[yellowboat]

As someone else said, she hung the first bag and assembled the IV line. Insulin reacts with plastic causing administration to be erratic. The plastic of the IV line could still be contaminated with insulin when the second bag was given.
Insulin is never given by IV for this reason. There is no way this contamination could have happened accidentally.

We give insulin via sliding scale in paediatrics. It’s diluted in a 50ml syringe and we adjust the mls/hr based on bm. It’s a more controlled way of administering especially in tiny babies.

 

[MmmB777]

When I predicted somebody saying she could have been writing about her houseplants.. I didn’t actually think anyone would ‍ mind blown!
Something sticking with me..Letby describing what was happening to the babies as fate? It was an odd turn of phrase (in the context of all the other information) I thought. It’s not a term I’d expect anyone with a medical type profession/brain to use even outside of the hospital environment. I do know doctors and nurses that have faith but I don’t think they’d think of things in terms of fate. It feels different to it being a religious slant on things.

 

[stardust1]

I wondered about this (sorry if someone already covered this, just catching up).
Could this have been a phone conversation with her union as she was in disciplinary proceedings. It may be they have said these phrases to her as something to consider and she has written them doen as a prompt.

They sound like the classic things you would ask or consider if you were being investigated about something (thinking work rather than police here) and we're trying to get some clarity about your rile in everything and what case they were bringing against you

Yes they sound very formal considering how all over the other note is. I think it is now a case of was she writing it because she was innocent and wanted to sort it out or was she guilty and needed her story straight

 

[Stiltoncheese]

@crumpets2 @Tofino what type of things could she be going through a grievance for if you take away the accusations?

Could this have been her challenging why she had been moved onto admin duties. There are texts that show she was clearly unhappy with when she had to do feeding duties on less sick babies which prosecution implied she may have seen as beneath her skill set. Therefore a move to admin duties must have felt like the ultimate insult to her?

 

[stardust1]

Could this have been her challenging why she had been moved onto admin duties. There are texts that show she was clearly unhappy with when she had to do feeding duties on less sick babies which prosecution implied she may have seen as beneath her skill set. Therefore a move to admin duties must have felt like the ultimate insult to her?

But do you not think it is almost narcissistic to kick up a fuss about that knowing you were guilty? I’d have thought you’d shut your self people are onto you and try and run. Although it does seem near the end she started to get clever with time stamps etc.

 

[Stiltoncheese]

I've just realised my last 2 posts have been covered extensively over the previous 4 pages sorry. I quote posted them before I had caught up, so sorry for repeating what had already been discussed and adding to an already long thread!!

But do you not think it is almost narcissistic to kick up a fuss about that knowing you were guilty? I’d have thought you’d shut your self people are onto you and try and run. Although it does seem near the end she started to get clever with time stamps etc.

Hard to say. Maybe she thought if she kicked up a fuss then it would show she must therefore be innocent because guilty people try to hide things and not put themselves under the spotlight? If she is guilty, she may have felt the police wouldn't have any physical evidence so she could bring the grievance thinking she would not be under police suspicion at that stage?