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

Thanks guys it’s a very interesting article

Oxytocin is measured in units. It's used on labour ward to induce labour and strengthen contractions (the dreaded drip!) and to help the uterus contract down afterwards.So is heparin, it is used as a blood thinner for the treatment of clots and for cardiac surgery to ensure the blood will pass through the pumps without any problems.

🙄OMG as if I forgot oxytocin 😂 Christ. That’s worrying!

Mirabai at it again! Desperately on the hunt to find articles to prove that medication can be mistakenly administered. We KNOW that can very occasionally happen. But those are completely separate incidents to what happened here, as actual medical experts here have said there is no reason insulin would be directly administered, in that quantity into a TPN bag. Completely different scenario.

What happened after they got the results of F’s blood tests back? Someone earlier inthe week said they checked the records and ruled out accidental administration because no other babies were on insulin at the time. But they can’t have left it there surely. Presumably there was some sort of investigation.

Yes king of clay very good point - it seems like nothing happened though which is just very scary to think management must have known but done nothing about it

or maybe they did and ther suspicions began from there

it all seems odd though still - especially when a pp came on and said wards are so understaffed that mistakes are not as rare as the public would like to think

however in regards to the insulin they have stated that it’s in a very distinctive bottle etc and it would be v hard to not realise what you are doing

it seems like there was an addiction to getting in the crash team

id be interested to know crash team figures for the period after the accused was excused from the ward - surely the defence would be looking into all of that

What a surprise: so desperate to take a swipe, you didn’t read my post properly.

As it goes, the bag + insulin is only a hypothesis based on the glucose readings. We don’t actually know how it was administered, and LL wasn’t apparently on shift when the bag was changed.

Marabai

you can add stuff into the bag once it’s hooked up etc

yes she was on shift

Yes we’ve covered the ways in which it could have been done. We just don’t have any hard evidence.

Other posters have commented that she was not on shift when the TPN bag was changed for the stock bag (if it was), I don’t know who is correct.

Yes she or another person changed the bag at midnight and then there was a significant deterioration not long after

the records show both of them signed to say it had been done but the record didn’t say who had actually physically changed it

the other nurse was asked on the stand if it was her who put the insulin in and she said no

And yes you are correct no hard evidence of who actually administered the insulin

obviously they can see who was on the ward at that time due to records etc

there was a man giving evidence today talking about how they make up the bags etc and he was saying for that type of treatment bag insulin would not be put in there by the pharmacy team so no way could it have been a error from them

however that doesn’t mean it wasn’t done deliberately outwith the ward

so it does seem it was done maliciously for sure

I’ve said this before but the insulin issue is the first where I feel there is reasonable evidence of something untoward rather than opinion and interpretation.

But apparently that bag was changed at midday or so, when Letby was not on shift. And the problem continued. The expert's evidence was that both bags must have been contaminated.

I find that slightly bemusing, because as if anyone would say 'yes'.

The timeline is really confusing isn't it and the historical Chester Standard reporting doesn't always match up

From the RCPC report - it seems like there were various meetings and discussions at the hospital - not amounting to a formal internal investigation at the time of the deaths which didn't reach board level, communicate with one another or feed back to the NICU.

The unit was downgraded to level 1 by the board in July 2016 {?when concerns reached them} and they invited the RCPC to review the service wrt XS mortality

The RCPC report was published in November 2016 - one of it's 24 recommendations was to individually investigate each babies' death [?and look into the near misses too]

The up-shot of this investigation was the hospital reporting the deaths to the police in May 2017.

Chella 2 she was there when the original bag was given. The bags last for 48 hours. Despite child F being given extra sugar via this bag nothing improved for him so it was decided to give it externally - this caused the child to improve.

it was decided to change the bag at midnight. LL was there with a colleague - this proved to be fatal and within the hour the child crashed

the defence say that the bloods that were sent to the special lab were only done so after the second infusion bag and are arguing that no one knows if the first bag was contaminated so essentially he is saying no evidence that she was responsible for all the previous dips in his condition as his blood was not sent off to be tested

the prosecution say that all the indications are there that the child was also suffering insulin poisoning and that the previous bag must have been contaminated

as the bags last 48 hours yes LL will have gone home at some point after that bag was put into the child but still had the opportunity to inject something extra into the tube

still it seems very far fetched to think someone would harm a baby

Mind you I could be mistaken in my recollections but that’s my interpretation of the events from the live feed

I just can’t quite get my head around the idea that they had he evidence a baby had been given a massive dose of insulin a week after it happened and they didn’t investigate it fully so they had an answer to ‘how did it happen?’ and ‘who was responsible’.

Apparently it was late winter/early spring when they decided to remove her to the day shift the issues mentioned above happened 4/5 August and yes hopefully her team will ask what investigations were done on the ward when they realised that this had happened

I am wondering if they contacted the parents to tell them about the findings in the blood?!?! Hmmm

Quite like it

The reporting is quite confusing and difficult to follow, but our understanding has been that the original bag was hung at around midnight when LL was there, but there was a problem with the line (it "tissued", not sure what that means) the next day. I just checked - it was actually at 10 am. At that time the original bag was swapped for a stock bag from the fridge. LL wasn't there. From Hindmarsh evidence:

"Mr Johnson asks if the stock TPN bag was contaminated to the same degree as the bespoke bag.
Prof Hindmarsh says the glucose concentrations are not much different from 1.54am-10am, when the bag is changed, and after then.
"The contents [and contamination] are probably about the same."
Child F survived.

"Tissued" just means that instead of sitting in a vein as it's supposed to, the tip of the line inside the baby is leaking outside it. This means the fluid is running into the tissues instead of straight into the bloodstream. It characteristically leads to swelling round the site.

Just checking in on second thread had to drop this for a while.

Has there been any updates?

There is this from the BBC yesterday.

Lucy Letby Case

And this explains the Christmas break and further delays

Letby Case Delays