Lucy Letby: have you changed your mind - thread 3

[Typicalwave]

New thread for those following or wishing to comment - originally started by @kittybythelighthouse.

They went through more insulin in 2015 than 2014, altogether. This doesn't tell us much, because most of it would be thrown out unused once open in the fridge for a while. So we know they needed new insulin bottles at least five times in 2015, and I think it was two or three times in 2014.

This tells us nothing about overall use of insulin. It was on standby in the fridge.

But what we don't have is an order for extra insulin for Lucy Letby to use in poisoning children around the time she would have needed it. So if they would normally have one bottle in the fridge, and she would have needed more than one bottle as Chase suggests, she would have made herself look very conspicuous by ordering an extra supply!

Were there other babies also on generic TPN at the same time as baby F?

Thank you.

As I thought.

None

I don't think we have that information, but the TPN bags were expected to be used quite frequently - hence having them to hand. So if not simultaneously, the remaining bags in the batch would likely be used shortly afterwards: on baby F if nobody else, I suppose.

Gosh, how fortunate for Lucy (who lived to target multiples) that the nurse on duty chose the correct bag after choosing the first (again, correct) bag so she could act out her narcissistic jealousy fuelled rage (from the comfort of her own home) for baby F daring to be a (surviving) twin.

Generic or bespoke, PN or any other IV, once a bag has been hung for one patient it would never be moved to another. Infection control aside, once it has been spiked with a giving set (tubing that goes between bag and patient’s IV access) it will leak if everywhere if detached.

Thank you. That’s the rest of the puzzle piece for me.

Another question re TPN bags - what was their shelf life, once mixed?

48 hours

Thanks. Sorry, one last question. Do we know how frequently generic TPN bags stored on the ward expired before use?

Do you know that for certain? I’d be very surprised if it was that short.

I guess maybe not that hard for Letby to judge, if there were no other babies at that time on TPN (and I acknowledge that we don’t actually know this) and if you assume that whoever takes the next bag will just reach for the nearest to them?

So how did Letby’s know that the 1st bag hind for baby F would need to be swapped due to failure of the line? i Don’t think we can make assumptions on how the bags were stored in the fridge.

The whole point of having stock bags present is so that PN can be started as soon as needed and if the pharmacy is closed. So a new baby could have been started at any time, even if none were on it while LL was on duty.

According to news reports, Myers said so in court about this batch, in his closing speech. Could it be that this batch was 48 hours from expiry at some relevant point maybe?

Yes.

Unless Letby could also predict new babies being admitted.

Plainly so - TO ME. I’d appreciate it if you didn’t try to police how I express myself, but that to one side it is an objective fact that it is considered “plainly implausible” by many people, including leading experts.

Your point about the jury is foolish but I’ll humour you. Sure, one of these random members of the public may by sheer chance happened to have been an expert in insulin and neonates but that is plainly (yes, I said plainly and I meant it) vanishingly unlikely let alone the idea that they all were.

Mm I’ll need to see those reports later when I have time. Batches are usually made with enough shelf life to at least last over a long bank holiday, often a week or so.

Yes, which is one reason why I think a hybrid model might work better. Facts can be established in advance of the trial to the best possible scientific standard by consulting the best possible experts.

Currently the legal system doesn’t concern itself with scientific standards, as long as legal procedure is adhered to, and it badly misuses terms like ‘peer review’. Juries would have to make do with a non black and white answer if that is the actual science. It is what it is. If that means reasonable doubt, then that’s what that means. It’s certainly not better than simply picking something and arguing as if it is scientific fact, when it is actually contended. Science cannot bend to procedure. It’s nonsense to try and make it so for bureaucratic convenience.

The aftermath of this trial - which makes the trials and investigation look extraordinarily wasteful in terms of time and money, not to mention much more traumatic for everyone involved (including the public actually) than it needed to be - is what should have happened in a calm and measured way beforehand.

I’m not saying a hybrid model would be perfect either of course, but it’s likely that nothing would be absolutely perfect.

Good point - Letby couldng possibly predict if a new baby would be admitted needing TPN whilst she was off duty.

I am fairly sure that there was an article in a newspaper that claimed that insulin went missing from a cabinet in the unit.
But this was in the early days of the trial, and I only mention this because it was one of the first posts that I made about this, as I couldn't understand how a drug that was restricted and had to be signed out could go missing.
It was pointed out that it didn't go missing but more used etc.

Sorry, I did understand your point, I was addressing Liz Hull’s habit of pretending that “insulin poisoning” isn’t essentially hypoglycaemia, which is admittedly a side note.

Was it Hull who first released that info about Baby F? Perhaps she had permission to do that. I can’t see her jeopardising access to whichever of the parents she has access to, but who knows.

Actually, I wonder if I misread what he was saying, and he meant the bag could potentially hang for 48 hours? Earlier, cross examining Ian Allen the pharmacist, he refers to one month, which makes more sense.

Reports at https://lucyletbyinnocence.com/Lucy-Letby-Case-6.html

@Typicalwave sorry if I misled you on this.

I agree, but maybe that was a risk she thought worth taking and/or perhaps she wasn’t being quite as targeted with her attacks as the prosecution case made out.

If she is guilty of what she has been convicted of, and given the evidential difficulties that are so apparent from these threads in relation to deliberate harm in healthcare, I’m afraid I find it hard to believe there weren’t attempts to harm other babies that either flew completely under the radar or for which there was not enough evidence to charge her.

Sorry, yes I missed this. They’re doing something with the electricity on my street and my blimmin’ internet keeps going off. No insulin was missing on the unit. Saying that they went through “more than expected” is not quite right. IIRC they went through more than the previous year, but this follows since they were taking in babies that were more premature and hence more likely to need it.