Letby Case (part 2)

[OneFrenchEgg]

www.mumsnet.com/talk/_chat/4652340-lucy-letby-court-case?reply=121815754

follow up, remember rules around discussion of active cases

Perhaps she really isn’t as organised as she has initially came across. Maybe she is chaotic and forgetful hence the notes being at odds with various other accounts of what happened

I mean initially it seemed as though she was very competent in her role - There was various text messages from colleagues telling her how good she was and especially Dr A

Can she be a very competent nurse but be very disorganised or inadequate when writing up notes?

Foolish though going by what others have said on the importance of getting things accurate in case of later investigations

The ‘evidence’ is a supposition based on the fact the baby projectile vomited. It’s not that she vomited into a container which showed she’d vomited up far more than the amount administered. Dr Evans may be right but it’s not definitive.

Baby also had diaphragmatic splinting leading to oxygen deprivation which would fit with overfilling the stomach

I agree though a lot of the ‘causes’ of death seem to be retrospective rather than based on medical evidence at the time

Letby’s notes also state that she had withdrawn 45ml of milk, together with “air++”, from Child G’s stomach.

I guess it depends how much the baby was supposed to be fed

That's ridiculous and not what my comment meant at all.

In this case that is what it would take me to change my mind, as its based on a correlation between her presence and when the babies had complications. I think they have adequately put forward a case where what happened to these babies was malicious and intentionally (my opinion, I understand and respect that you do not agree).

I’d think the splintering of the diaphragm could have been caused by the violent vomit itself as well as an overfilled stomach.

The other issue is that it’s entirely speculative that LL “struck” the baby after another nurse it 45ml of milk. It may be that nurse gave her too much by mistake, or administered it clumsily with far too much ingress of air, and that was responsible for the later projective vomit. That would fit with LL later withdrawing air as per the notes. There’s no evidence LL went near the baby until that point.

So she did, fair point. But as I say it may be the nurse that administer the milk who made the mistake.

The baby had a feed, vomited such a large amount that it was believed that all or most of the feed had come up. However when the baby became ill soon after another professional aspirated another large quantity of milk from her.

This volume of milk should never have been in a baby that size. LL has admitted that today.

Yep. Agree it’s not clear who fed the baby.

FWIW I think there’s a typo in that news report. It should be splinting if the diaphragm (a medical term relating to a lack of diaphragmatic function causing respiratory distress and reduced oxygen) not splintering (which isn’t a recognised term.)

diaphragmatic rupture would be the term if caused by violent vomiting, and it’s very unlikely/impossible

Ah ok, as in ‘respiratory splinting’. ‘Splintering’ seemed a strange word to use of a muscle. I assumed it meant collapsed in some way.

The sewage thing is a bizarre one. I don't think it could ever have anything to do with any of these cases unless it was shown babies were dying of infection or pathogens? It is perhaps just her trying to add to her argument that the ward wasn't safe. Or perhaps just to throw a spanner in the works to confuse things generally.

I’m actually re-listening to the podcast as they’ve started the defence from baby A and I’ve got things muddled somewhat.

apparently infection couldn’t be ruled out as a COD for baby C and the discussion around the sinks was that a lack of hand washing could contribute to infections on the ward. Baby D was born with a suspected infection after antibiotics were not given.

he had pneumonia so not sure that’s likely but I guess all they have to show is reasonable doubt.

Wouldn’t you be more likely to get a cluster over a short time rather than spread out over a year? I’m trying to remember the case study from my aseptics training but it was ages ago and it’s slipped my mind.

Infection as CoD would likely be easy to spot. It can’t be ruled out but doesn’t necessarily explain their deaths either. Weren’t they both on antibiotics and improving at the time they died / needed resuscitating? Or am I misremembering.

Because the charges are individual the defence just has to create doubt (which could be a variety of different doubts) about the death of each case

I don’t think they’re suggesting that infection due to lack of hand washing was the COD for all

Listening back to the texts on the podcast, a few of her colleagues comment on her ‘run of bad luck’ and Lucy ‘having a bad time of it lately’ and each time she dismisses this saying ‘it could happen to anyone’ or similar.

it’s interesting. I know everyone reacts differently but I think I’d be saying ‘yes, it’s crap’ and acknowledging the bad luck. Her brushing it off feels like she’s trying to dismiss a pattern/association between herself and the babies quite early on.

Also going by what other nurses have said surely you’d start to question yourself if all these things were happening to your designated babies?

As in you’d be quite concerned that something was off? And try to protect yourself at least

I think baby D needed antibiotics for a potential strep B infection but did not get them.

That could equally be as much because she doesn’t want to be thought of as crap at her job and in some way responsible as because she’s murdering them all.

If anyone is involved in projects that fuck up at work you don’t want colleagues to thinking it’s your fault.

Exactly. I’d imagine if a regular nurse had a run of deaths of any patients in their care, they’d question themselves and they’d also question whether colleagues were questioning them.

But there’s nothing so far to suggest that LL was questioning her own competence whilst she was on the ward

There are messages showing she is worried that she is in trouble and communicating that with Dr A

Its only after she was removed that she was questioning herself (on her post it notes etc)

There wasn’t ever any insinuation of that at the time though - it was concerned colleagues who were worried she was having a hard time if it. And each time she brushes it off as ‘these things happen in our line of work’

they clearly don’t to that extent, as it’s remarked upon by her colleagues in the messages at the time.

I mean if she is normal and sane why on earth would she not be taking a closer look at these deaths and collapses that were happening on her watch……

I mean there’s a poster on this thread who has said you use your notes and records to protect yourself because things do and can go wrong.

However it is emerging that LL notes and records are at odds with parents/consultants/nurses recollections

It's all very...messy for want of a better descriptor. I am far from convinced that she is guilty but I am not confident saying she is innocent. I suppose a) I don't have to make that judgement and b) innocence doesn't matter in a trial as such, it's "guilty" and "not guilty"

I know they were concerned and there was no suspicion of negligence or worse at the time. But as I say in any line of work if things that you’re involved in go wrong, and people commiserate for having a hard time - I’d say it’s quite normal to wonder if they’re secretly questioning your competence, particularly if you’re questioning yourself and if you could have done things differently.

Perhaps. I don’t think there’s any evidence to support that though. No messages to her parents or friends outside of work where she expresses worry about being judged or about the surge in deaths on her watch.

it genuinely doesn’t read as if that’s the motivation for dismissing her colleagues’ concerns - there’s lots of kisses from them and genuine concerns for Lucy’s well-being.

hard to know the subtext though. It was just something that stood out to me on second listening