Lucy Letby Court Case

[Pebble21uk]

Today has been the first day of the trial, which is expected to last for six months. One thread has already been pulled on the subject. Upon deletion MNHQ said that a thread about the case is fine but please read the rules around contempt of court before posting... these are copied and pasted here:
Publicly commenting on a court case:

You might be in contempt of court if you speak publicly or post on social media.
For example, you should not:
say whether you think a person is guilty or innocent
refer to someone’s previous convictions
name someone the judge has allowed to be anonymous, even if you did not know this
name victims, witnesses and offenders under 18
name sex crime victims
share any evidence or facts about a case that the judge has said cannot be made public

If any of the above take place then new threads will also be pulled. Let's please try and keep it going!

Currently, the markers of how poorly Baby C was (air in the stomach, restless, loss of weight, signs of infection, bile and black aspirate) all occurred prior to LL coming onto the ward.

It's possible that the prosecution will, in time, go on to reveal more, indicating foul play, but currently, the Defence is able to demonstrate that this is a very weak little baby, with issues that could be significant to its survival.

I just want to point out that weight loss is normal in ALL newborns, & even more so in preterm infants for whom nutrition can be difficult. Air in the stomach is routine if a baby is on CPAP. Neither are signs the infant is ill in any way. Bilestained aspirate is always a worry as it can indicate a serious gut problem, but would be monitored extremely carefully.

Im confused as to the gestation of these babies, has it ever been said? What level is the unit? If its a two then sure this little one shouldve been shipped out to a level three unit like Manchester with all tese signs of NEC? Should this hospital have kept hold of any of these babies?

My understanding is that NICU is from birth to actual due date (if born before due date) then PICU is from actual due date onwards - but I'm only recollecting what a PICU nurse friend told me a good few years back.

AFAIK Chester is a level 2 unit, which is why some babies were shipped out when poorly. Not sure what the rationale was for those who weren't.

This isn't always the case, in my experience babies can be kept on NICU until well after due date, especially if they are progressing well in terms of breathing, eating etc, and until discharge.

When babies have more complex health issues, and discharge is not close, it is more likely that they will be transferred to the children's wards/hospital.

Lots of clinical information missing .
Babies A and Bs mother had a blood disorder it would be useful to know what that was.
The gestation of all the babies has not been reported (I’m using live feed on Chester newspaper).
Have these facts been reported elsewhere?

I imagine there’s a reporting restriction on the mothers blood condition for her confidentiality. It wouldn’t be hard for people who know her to identify her from the reports of what happened to the twins.

No baby is ever transferred to a PICU because of gestation. It's extremely rare for a child to be in hospital after their due date these days, in fact most go home after 34 weeks' gestation, but if it looks to be long-term they would go to a paediatric ward.

Also, they go to postnatal at birth if born at 34 weeks & are well - or at least ghey do where I worked!

It look as though the Chester Standard Live feed isn't running again today? Does anyone know of any others?

www.leaderlive.co.uk/news/23084146.live-lucy-letby-trial-friday-october-28/

www.leaderlive.co.uk/news/23084146.live-lucy-letby-trial-friday-october-28/

@BernadetteRostankowskiWolowitz @NNUJan Thank you both!

Nurse Ellis seems unsure of her testimony. Keeps saying she can remember Letby being in the room but not who else was or whether her own mentor was. Often can't say what Letby was doing. Says Child C may quite possibly have had two episodes of bradycardia. Then next says Letby wasn't there for the first one but was for the second, but she wasn't certain a minute ago that there were two bradycardic episodes. With a such a vague memory (it was 2015 to be fair) does it sound like some unconscious bias is there? Has she convinced herself she saw Letby hence her certainty in saying that but her vagueness about the rest (e.g. who else was present)?

I'm a new mum and I'm reading the transcripts of the court case and I hope nobody minds me saying but I'm finding it very worrying that the most junior of doctors were putting in the lines into the premature babies and that a junior nurse was left looking after a premature baby.
Isn't it dangerous to the baby if these lines are put in the wrong way?
I'm worried that one of the other doctors took 5 attempts to put one in and doctor yesterday said she wrote on her notes that she got the line on on the third attempt....

Also the nurses keep saying in the trial that doctors were aware of issues they saw with the babies.....

"The three attempts to insert a long line, from a clinical note, are shown to the court again.

Mr Myers asks if there is a guide to the number of attempts, or who should administer them.

Dr Beech said it would be a procedure by a doctor, not a nurse, and would be done by the most junior doctor present, to get them experience, subject to availability and the complexity of the procedure.

Dr Beech said there was "an unwritten rule" a registrar would have two or three attempts before escalating the procedure to someone more senior."

This makes me very worried I don't know how everyone else feels?

Junior Doctors have still done many years of "doctoring" so that they do the procedure seems fine to me, and I've heard the lines are like 2mil wide so must be a very fiddly job.

3 attempts sounds bad, five much worse though. I suppose inserting these lines is essential to the baby's recovery.

It's hard to know without context of other hospitals with great reputations discussing how they do this/how many takes they do.

It was incredibly vague. So she can't recall where she was as it was so long ago, they should use her police testimony. Yet nothing on the testimony mentions LL, but she now says she knows LL was there?

@Newmum2123 do you have a medical background? 'Junior doctor' does not mean what you may think it does.

No I don't but I suppose it means a doctor who finished university a few yeah before...
It's worrying because Dr Beech said it's a procedure given to the most junior doctor to give them experience...
A premature baby would be the most difficult case I think to put a line in due to their tiny size ...it's worrying I have to be honest but if my baby had been premature and sick with dark bile I would prefer the Consultant to do it ..
Not sure what anyone else feels ?

I think the title junior doctor is misleading to people outside the medical field as they could have up to eight years working in a hospital as a doctor.

Below is an official description and while I understand what you're saying, it's worth bearing in mind that all junior doctors will need to gain hands on experience in order to become senior doctor themselves. And that if they don't get the chance, we would have no senior doctors or ones with no hands on experience which also wouldn't be a workable solution.

I appreciate though that on an individual basis, everyone would in an ideal world want their little one to only have procedures by a consultant with lots of experience, but it's not possible.

Junior doctors are qualified doctors in clinical training.
They have completed a medical degree and foundation training, and have anywhere up to eight years' experience working as a hospital doctor, depending on their specialty, or up to three years in general practice.
All junior doctors work under the supervisor of a senior doctor.

Again, Im just trying to visualise the size of them because its not mentioned their gestations at all. A junior doctor would do it but nine times out of ten there will be someone either a fellow doctor or nurse close by to support them and call for a registrar. Ive never heard of more than three attempts at a long line I have to say. Like I said i cant visualise the ward, how many beds, the layout, the staffing, why they had such sick babies there if they were only level 2. I mean I havent followed it so closely as its too distressing, Im only going by the comments on here.

A junior doctor working in such a specialised area will be likely to be someone much further along in their training than "the most junior of doctors". They might be the most junior of the doctors present, but they will probably be several years into their specialist training (I am not a paediatrician but am in another very specialised area of medicine, and that is certainly the case there).

Junior doctor just means anyone below consultant, so is a bit misleading. The most junior doctors on neonatal units are SHOs, so not newly-qualified. It's standard practice for them to perform procedures under supervision - how else could they gain expertise? If they find it too hard the more senior doctor, usually a registrar or senior registrar, would step in. Babies are at no risk because of this.

I would think that today was another good day for the defence. Mr Myers questioning of nurse Melanie Taylor showed her recollections o be very sketchy about who was where and when.
She didn't mention where LL was during the crisis with Child C in her police statement, but said it was because the police didn't ask her. Surely where LL was when the alleged crime was committed is completely fundamental.

And please don't flame me - but as a non-medical person, I completely understand what @Newmum2123 is saying. I was in hospital in August and needed frequent cannula changes and bloods taken. None of the Junior doctors could find a vein - seriously. They either had to use ultrasound in the end or defer to a phlebotomist or consultant's assistant. They kept trying though - up to five times as they didn't want to be defeated. I had to plead with one to stop - I was black and blue.

It would be recorded in the clinical records I would imagine what senior doctor was present.

The public online GMC (General Medical Council) Register will also show the date a doctor graduated from university and what date they registered with the GMC. This can assist a patient wanting to have an idea what experience a doctor posseses post university.