Thirlwall Inquiry/Lucy Letby

[PrettyFlyforaMaiTai]

Is anyone following? There have been so astonishing revelations about how Letby was able to harm/murder babies for so long without being stopped.

Some interesting details so far:

• They have discovered through an audit that whilst on placements in Liverpool Women’s Hospital (Oct-Dec 12/Jan-Feb 15) dislodgement of endotracheal tubes occurred in 40% of shifts she worked. Usually it is found in less than 1% of shifts
• The Doctor she was allegedly involved with took her on supervised visits to Alder Hey Children’s Hospital during investigation
• She returned to the Unit at least once during the investigation (Feb 2017)
• Junior Doctors referred to her as Nurse Death at the time
• Letby sent an email to all staff on the neonatal unit saying she had been exonerated from accusations from medical staff. However, no one involved emailed to correct her that she hadn’t even been investigated yet, never mind exonerated
• Doctors who continued with their concerns were threatened with disciplinary action and were made to understand that mediation was compulsory. When one Doctor stated he felt uncomfortable the mediator stated that it was actually voluntary

Where are you following it please?

https://www.bbc.co.uk/news/live/c05j4dng9q0t

https://www.independent.co.uk/news/uk/crime/lucy-letby-inquiry-latest-innocent-appeal-thirlwall-babies-b2611411.html

The BBC have also had a live stream but they’ve not put it on today. I think it’s perhaps because some of those involved today’s evidence have anonymity.

Alison Kelley, the nursing manager at Countess of Chester Hospital; told the NMC (Nursing & Midwifery Council) that Letby was a witness, not a suspect. This was when the NMC had been informed of the police investigation via the press release at the same time as the media in 2017.

Yes, the inquiry can’t all be live-streamed because of the risk of accidentally identifying the families. I thought they’d initially said bout streaming any of it but I must have been wrong.

I’m finding it interesting just how quiet this thread has been so far. Especially as the other two in the past 2 weeks quickly filled up with those with questions about the case.
Hopefully those with questions will find the answers they were looking for; eg. how the many reviews were manipulated by senior management to ‘exonerate’ Letby, when in fact most were saying the exact opposite.
To be very generous, it looks like it was Harvey etc who couldn’t understand what the complex medical information contained in the reviews were telling them rather than the English Legal System and jury.

I’m just baffled at how many missed chances there were to contact the police. Even Letby’s own father asked why didn’t they contact the police if they thought his daughter was killing babies.

Even the consultants are coming under flack for it, and they were the ones who were trying to actively get her off the ward. The managers/directorates have a lot to answer for.

And some of the parents didn’t even find out about their babies non fatal collapses until the police came knocking after she was first arrested. Or in some cases, the first they found out about it was at the trial! They really tried to hush it up.

Another astonishing coincidence as I’m sure Letby supporters will be quick to dismiss this:

Barrister brings up incidents connected to Letby at a second hospital
Mr Baker sets out how unexpected collapses of children would usually be a rare occasion, but these incidents increased during Letby’s shifts.
Letby had training placements at Liverpool Women’s Hospital between October to December 2012 and January to February 2015.
“Given the prevalence of dislodgement of endotracheal tubes, in this case, my lady may perceive it as a common event, but the evidence suggests that it isn’t at all common. It is very uncommon, you will hear evidence that it generally occurs in less than 1 per cent of shifts,” he said.
“As a side note, you will hear that an audit carried out by Liverpool Women’s Hospital, whilst Letby was working there, dislodgement of endotracheal tubes occurred in 40 per cent of shifts that she worked.”

She does appear to be incredibly unlucky.

Yes, on top of all the other “unfortunate” events that apparently conspired against her, to have the rate at which breathing tubes get dislodged increase by 4000% on her shift at an earlier work placement…well with this latest revelation it’s almost as if someone up there has it in for the poor woman…

Operation Hummingbird is still running and looking into the babies that were at Liverpool Women’s aren’t they? So I’d imagine there will be more bad luck coming her way.

I feel for anyone who had a baby in the neonatal unit at LWH during late 2012//early 2015. Imagine the fear and uncertainty that she might have targeted your baby?

I hope we'll get more detail on that Liverpool Women's Hospital statistic soon, because as it stands, it's meaningless.

Less than 1% of shifts "generally", but what percentage of shifts when Letby was working at LWH?

Because less than 1% per ventilation day is a target rate per infant, not per unit. And NICUs frequently have much higher rates per infant. And Liverpool as an intensive care unit for extremely premature babies would have more than one or two babies ventilated at any given time.

So until we know how often LWH saw umplanned extubations in total, not per infant, this information says nothing about how likely it is that any nurse would see such events on 40% of shifts.

I presume any parents concerned have been contacted already, since this hearing is so critical of Chester for not informing parents.

But if not I think dropping that 40% claim in with no context today was particularly irresponsible.

There is lots of criticism in the press and at the hearing of people who are concerned about the standard of evidence from Letby's conviction.

If Baker finds such concerns inappropriate, he should consider presenting his data much more rigorously. Not as a "sidenote" headline grabber with actual context to follow later.

I imagine anyone who had a baby in lwh already would be wondering whether their babies were targeted.

I imagine she murdered or attempted to murder a lot more babies than she was convicted of.

@Oftenaddled its an opening statement. You would not expect methodology to be released in an opening statement. The evidence is expected to take 5 months and the verdict released late next year. We’ll probably know more about how and why that figure was produced when it’s his turn to speak.

If a member of my team (I’m not healthcare) had a 40% failure rate when others had a 1% rate I would assume a skill issue and would get them to show me how they dealt with the task and I would ask them what they had been taught to make sure they understood the correct procedure. I would then watch to check failure rates improved and follow up for weeks until I was satisfied.

The fact that none of this ever happened just demonstrates that it’s complete bullshit.

It’s obviously not a skill issue though. It’s more like a power cut or water leak always happening on one nurse’s shift.

I think the 1% "generally" is so misleading though that it goes beyond not giving all data in an opening statement.

People are going away with the impression that Letby saw 40 times as many of these incidents as other nurses while this man compares apples with oranges. And by the time we see the full data, people will have absorbed the shock headline and moved on. It's irresponsible (or confused).

It would be largely a skill issue (though not all about nurses' skill). Fit of tube, handling the baby, manipulating the tube as part of processes can all dislodge it.

But the less than 1% per shift "generally" almost certainly refers to how likely this is for a single child on a ventilator, not a ward full of children. Otherwise Liverpool has stats amazingly out of sync with the rest of the world. So I don't expect that we'll see anything like the enormous discrepancy implied for Letby. We may find a smaller discrepancy and a skills issue. But we don't know yet - we haven't been given any useful context for that 40% of shifts.

Also worth pointing out that in Oct 22 (the placement at Liverpool) she was 22 years old and presumably very heavily supervised and being taught these skills.

Referring to her as “nurse death” Isn’t evidence against her, it’s evidence she was being bullied and that paranoia against her was growing. People can collectively believe all sorts of mad myths that grow and grow in the collective consciousness, it doesn’t make them true. They should have put CCTV on the wards to alleviate concerns that babies were being purposefully harmed.

Yes. If you're calling someone Nurse Death in the canteen but not reporting any concerns - you're just taking part in workplace bullying.

These were junior doctors as I understand it, and I don't know of any record that they raised concerns. If Letby was indeed a murderer, this sort of behaviour enabled her because it meant HR and external consultants could absolutely see a bullying problem and has to deal with that.

The answer to suspected murder is not to bully people.

On the face of it, but most are unlikely to think that a nurse was murdering babies, and more likely to have thought that it was bloody unlucky that babies died when she was on duty.
remember this enquiry isn’t a trial, it’s an enquiry to look at the failings that led to her being able to murder babies for so long. And thinking of her as nurse death rather than raising concerns is one of those.