Lucy Letby Case #9

[crumpets2]

But imagine the paleness had presented itself in such a way that you’d never seen before. Would you make it clear that this is something you’d never seen before?

Yes, it’s appearance and who I escalated it too.
Edit - just going back to something I’ve never seen before, I probably wouldn’t say that word for word as in nursing you’re going to see something you haven’t seen before every shift near enough, but detailed appearance and who I escalated it too for sure, if I got any of my colleagues to look. And if I recommended anything such as medical photography for example.

Yes and I would have also documented any discussion with staff. I know in critical events our fight/flight kicks in but this in my experience has caused me all the more to over document if you know what I mean. Often staying late or revisiting the record. Being understaffed increases risk too so I would also document this. Even now I will write regularly “sudden change, discussed with (name colleagues” and informed consultant of same.

Yep agree, then reading it over and over! I think I’d rather leave late than have to come back the next day to document something, but everyone has different circumstances at home I guess

 

[Weeder]

Question for nurses about notes

would you expect to see the word unusual?
Say if somebody in your care was unusually pale for a person who had a problem that you wouldn’t expect paleness to be a symptom would you write pale or unusually pale in your notes?

I like to think I would have tried to describe it.
In latter years writing pale wouldn't have cut it. You write where at least, size, appearance, feel, type.

I feel like some people refuse to see any point that disrupts the evidence. I thought the point of a trial discussion thread was to do that, so that's what I will be doing.
For me the mottling doesn't indicate embolism as such. It's indicative of all sorts of conditions. The female doctor seems to describe flitting patches, which again I'd question in terms of being indicative of embolism or even mottling, if I were the defence.
I think it happened I just think it's not something that currently has any veracity for baby A
So for me, we still can't even pin the embolism diagnosis.

 

[Tofino]

Seeing as there’s 40%+ that have voted they think she’s guilty I’d say it’s surprisingly one sided, especially at the moment. You might be the best person to ask but I promise to look through the wiki too - somebody notes ?? and I think that is about the mottling? Maybe it’s the time they try to photograph it. X

oh it was child B, it was in the mother’s witness statement. Not in prosecution opening statement. Mum took a photo and the jury will have seen it.

 

[Milktray]

.

It’s interesting isn’t it because at what stage does it become ‘unusual’? And I’d certainly think if something was outside the frame of normal reference then it would be notable and highlighted in notes/discussions.

A question for medics if I may jump on? Would there be case study discussions/monthly meetings etc re: cases? Surely these would have come up?

Well exactly. What did they think it was if it wasn't normal? Surely anything so 'unusual' would be not just documented but investigated?

 

[Windowtothewall]

So it seems like nothing was documented for child A on the rash. But it was noted for Child B in the notes and they have a record of a camera being requested (which would only happen if it was unusual) and the mother's statement that the consultant said it was unusual.

Child A is the weakest link here then with the rashes not being recorded. However, we know from child B onwards the rash was recorded for other victims in medical notes. So for the jury it will be a case of whether they believe the nurse/doctor's claim child A had a rash because all the others did and it's proven, or don't believe it as it wasn't recorded.

 

[Lackofimagination]

So it seems like nothing was documented for child A on the rash. But it was noted for Child B in the notes and they have a record of a camera being requested (which would only happen if it was unusual) and the mother's statement that the consultant said it was unusual.

Child A is the weakest link here then with the rashes not being recorded. However, we know from child B onwards the rash was recorded for other victims in medical notes. So for the jury it will be a case of whether they believe the nurse/doctor's claim child A had a rash because all the others did and it's proven, or don't believe it as it wasn't recorded.

I hate talking about the babies this way, just as numbers it feels awful. However with the evidence not being the best with child A does anyone think that’s why they started with that child? So the closer it gets to verdict day the evidence will be solid?

 

[avabella]

I hate talking about the babies this way, just as numbers it feels awful. However with the evidence not being the best with child A does anyone think that’s why they started with that child? So the closer it gets to verdict day the evidence will be solid?

It's chronological I'm sure? So they started with A because that baby was the first?

So it seems like nothing was documented for child A on the rash. But it was noted for Child B in the notes and they have a record of a camera being requested (which would only happen if it was unusual) and the mother's statement that the consultant said it was unusual.

Child A is the weakest link here then with the rashes not being recorded. However, we know from child B onwards the rash was recorded for other victims in medical notes. So for the jury it will be a case of whether they believe the nurse/doctor's claim child A had a rash because all the others did and it's proven, or don't believe it as it wasn't recorded.

That's a good point because if I'm understanding correctly baby A was the first so perhaps was put down to an anomaly. It's unacceptable it wasn't recorded at the time and my heart breaks for that poor family, but hopefully other incidences were recorded properly thereafter.

 

[MmmB777]

I like to think I would have tried to describe it.
In latter years writing pale wouldn't have cut it. You write where at least, size, appearance, feel, type.

I feel like some people refuse to see any point that disrupts the evidence. I thought the point of a trial discussion thread was to do that, so that's what I will be doing.
For me the mottling doesn't indicate embolism as such. It's indicative of all sorts of conditions. The female doctor seems to describe flitting patches, which again I'd question in terms of being indicative of embolism or even mottling, if I were the defence.
I think it happened I just think it's not something that currently has any veracity for baby A
So for me, we still can't even pin the embolism diagnosis.

Hope it’s ok to ask, I’m not a medic but even if you don’t agree that the air had been administered, why would there be an unusual amount and placement of air in baby a? Near the baby’s spine which the radiographer hadn’t seen before except another baby in this case). I don’t think the defence question that’s there just how it got there. The prosecution expert witness radiographer said it was likened to a car crash. So presumably if there is air is it not air embolism? Genuine questions, feel free to ignore if you’d rather, thank you!

 

[Lackofimagination]

It's chronological I'm sure? So they started with A because that baby was the first?

I hadn’t even thought of it that way. I didn’t know if they were going to do it on what they thought they would get a guilty for.

 

[friedeggontoast]

Dr. Ravi Jayaram is giving his evidence now. He’s the one that said he had suspicions about LL, will be interesting to hear his statement.

 

[Tofino]

I like to think I would have tried to describe it.
In latter years writing pale wouldn't have cut it. You write where at least, size, appearance, feel, type.

I feel like some people refuse to see any point that disrupts the evidence. I thought the point of a trial discussion thread was to do that, so that's what I will be doing.
For me the mottling doesn't indicate embolism as such. It's indicative of all sorts of conditions. The female doctor seems to describe flitting patches, which again I'd question in terms of being indicative of embolism or even mottling, if I were the defence.
I think it happened I just think it's not something that currently has any veracity for baby A
So for me, we still can't even pin the embolism diagnosis.

With respect, the prosecution have indicated they have 5 medical experts all saying the most likely cause of death is air embolism (I know we have only had one testify so far). I don’t think at this stage some variances from the witnesses in the description of the skin discolouration (especially appreciating the scant reporting) is enough to say it disrupts the evidence. You could also say those that think she is not guilty are looking for any inconsistency to prove her innocence. The legal standard is beyond reasonable doubt. A few variances in description doesn’t make me doubt the witnesses so far.

 

[MmmB777]

Dr. Ravi Jayaram is giving his evidence now. He’s the one that said he had suspicions about LL, will be interesting to hear his statement.

View attachment 1674547

I’m dreading it to be honest. I think people already have his cards marked

 

[Windowtothewall]

Oh they had another person give evidence after Nurse A and before Dr Jayaram. From Dan D's Twitter.

Dr Lambie who was also called to resuscitate Child B She recalls 'patches of purple and red flitting around her body, they lasted 10s, disappeared and moved. As we treated her, they subsided and went away.'

Interesting that defence did not ask this doctor any questions at all? Why question Nurse A's recollection but not Dr Lambie's account of the blotches?

 

[MrsDimSum]

 

[Hannah_204]

I’m dreading it to be honest. I think people already have his cards marked

What do you mean? Sorry if I’ve missed something

 

[crumpets2]

Oh they had another person give evidence after Nurse A and before Dr Jayaram. From Dan D's Twitter.

Dr Lambie who was also called to resuscitate Child B She recalls 'patches of purple and red flitting around her body, they lasted 10s, disappeared and moved. As we treated her, they subsided and went away.'

Interesting that defence did not ask this doctor any questions at all? Why question Nurse A's recollection but not Dr Lambie's account of the blotches?

I thought this but the reporting today isn’t as thorough as previous days so maybe not been reported?

 

[oldflames]

I think it’s concerning they didn’t note down the unusual mottling on baby A, however they did note it down for baby B which must mean something?

Perhaps they were surprised by Baby A’s deterioration because they were meant to be stable that things just got lost in the stress of the situation combined with low staffing. Or maybe they put down not seeing this type of mottling as lack of experience, but when it happened twice to the same set of twins they thought ‘this must be wrong’. I’m unsure

 

[Windowtothewall]

I thought this but the reporting today isn’t as thorough as previous days so maybe not been reported?

True this. Will have to wait to see the newspaper write up of the day to know for sure. Though Dan is reporting on big developments today so you'd hope he didn't miss something as big as a defence line of questioning. But who knows!

 

[Milktray]

Oh they had another person give evidence after Nurse A and before Dr Jayaram. From Dan D's Twitter.

Dr Lambie who was also called to resuscitate Child B She recalls 'patches of purple and red flitting around her body, they lasted 10s, disappeared and moved. As we treated her, they subsided and went away.'

Interesting that defence did not ask this doctor any questions at all? Why question Nurse A's recollection but not Dr Lambie's account of the blotches?

They might have questioned her. Reporting is awful today.

 

[veevee04]

The idea that LL is being used as a scapegoat to put all the blame on her for a failing hospital has been put forward a lot over the threads.

It's not as simple as you go ohh I made a mistake and just quit Healthcare is very dog eat dog, some staff do throw others under the bus. I've had that but there was CCTV to prove I didn't do anything wrong. An accusation means you can end up suspended under investigation by the GMC and NMC. Stuck in limbo as these cases can take years. You can be struck off and face criminal charges there are reasons why staff would want to cover up their mistakes.

I dont know about the scapegoat theory I'm not sure I buy it. LL does fit the profile though odd ball with no life outside of work