Babak Belurs

Kamis, 13 Oktober 2022

Lucy Letby trial: Nurse accused of murder 'cared deeply about babies' - BBC

A nurse accused of murdering babies on a neonatal ward "cared deeply" for those she had to look after, a court has heard.

Lucy Letby is charged with killing seven babies and attempting to murder 10 others at Countess of Chester Hospital in 2015 and 2016.

Outlining Ms Letby's defence, Ben Myers KC, said she was a "dedicated nurse" and in "no way did she want to harm them".

Ms Letby, 32, denies 22 charges.

Mr Myers told the court: "She trained hard to be a neonatal nurse and what she wanted was to care for babies she looked after.

"The defence say she is not guilty of causing intentional harm to any baby or to killing any baby.

"She loved her job. She cared deeply about the babies and also cared for their families.

"She had a fulfilling life, had friends, a life outside work."

Manchester Crown Court earlier heard how she had penned passages including "I am evil" and "I killed them on purpose because I'm not good enough to care for them".

The notes were among other papers and post-it notes which also contained "many protestations of innocence", the jury was told.

Note shown during the trial of Lucy Letby

But Mr Myers said "anyone with an ounce of human understanding" would see the notes as "the anguished outpouring of a young woman in fear and despair when she realises the enormity of what is being said about her".

He continued: "We recognise the sadness and the stress, and even the anger, that comes with allegations like these.

"I start on behalf of the defence by acknowledging how upsetting the allegations will be and acknowledging the very great loss and sadness of the families involved.

"Anything that I do, or say, during this trial is not intended to diminish that in any way."

But he told jurors it would be "staggeringly unfair" to convict a person without a word of evidence.

He said there was "a real danger" people will simply accept the prosecution theory of guilt "based firmly on coincidence".

Pointing to Ms Letby, of Hereford, sitting in the dock, he told jurors: "It is important to be careful that blame is not heaped on that woman when there may be others who have made mistakes or a system which has failed."

In some cases, he said, no-one could say why a particular child deteriorated or died.

Court drawing of Lucy Letby appearing at Manchester Crown Court

Mr Myers said the jury had been shown Ms Letby's text messages, her Facebook searches on the families of babies she was alleged to have harmed and "pieces of paper" and mentioned "amateur psychology".

But he said the "foundation" of the case was medical evidence.

Mr Myers said causes of a baby's deterioration or death were not always clear.

He added in this case the babies were "clinically fragile" and in conditions that could change "very swiftly and deteriorate very rapidly".

Mr Myers said: "Ms Letby is adamant she's done nothing intentionally to harm these babies."

With Child A, the first murder count, Ms Letby was said to have injected air into the child, but he said the defence does not accept an air embolus - or air bubble - was the cause of death.

Mr Myers said the "polite" way of describing the care of Child A on the unit was "sub-optimal".

With Child B, who was Child A's twin sister, who Ms Letby is accused of trying to kill, it was a "good example" of the "assumption of guilt" and experts had been "influenced by the theory of harm".

Mr Myers said Child C, who Ms Letby is also alleged to have murdered by injecting him with air, was a "very premature" baby, born at 30 weeks.

He said such babies were vulnerable, especially to infection, and Child C should have been at a specialist children's hospital.

Mr Myers said the hospital failed to provide adequate care for Child D, who Ms Letby was alleged to have murdered with air.

He said it was "beyond dispute" Child D should have been given antibiotics hours before she was treated with them, and there was more evidence infection played a part in her death.

He said the prosecution alleged Ms Letby injected Child E with a fatal amount of air and attacked him in front of his mother.

He said: "We say there is no clear explanation in his case for what happened.

"That being so, it is not right to rely on the assumption of guilt."

He next turned to allegations that Ms Letby attempted to murder Child F - the twin brother of Child E - and Child L by poisoning them with insulin.

The barrister said there was "nothing in fact" to establish this.

Child G, who Ms Letby is accused of attempting to murder on three occasions, was an "extremely premature" baby who was "high risk", he said.

The defence did not accept Ms Letby did anything to contribute to Child's G health problems in the neonatal unit.

Child H, who Ms Letby is alleged to have attacked twice, was another example of "sub-optimal care" by the hospital and "nothing to do with Lucy Letby", he said.

Mr Myers said the defence did not accept Ms Letby caused any harm to Child I, who she is said to have tried to kill on three occasions before succeeding on the fourth attempt.

He said: "We will say her collapses and ultimately death were part of a series of clinical problems which may well have been inevitable given her extreme prematurity."

Mr Myers said the hospital was "well out of its depth" with Child J, who Ms Letby is said to have tried to murder, and knowing how to treat her.

He said an assumption of deliberate harm had been made rather than an alternative explanation of a baby receiving inadequate care.

Child K, who is subject of another count of attempted murder, was said to have been harmed with the deliberate dislodging of a breathing tube.

But Mr Myers said the probable cause was the child inadvertently moving the tube herself.

Her case was another example of "sub-optimal care" in that she should have been treated at a more specialist unit.

Mr Myers said the defense did not accept that Child M, who is the twin brother of Child L, was harmed by an injection of excessive air or airway obstruction.

The defence's insisted there was no obvious cause of his collapse.

Mr Myers said: "We are back in the territory of blame being put on Lucy Letby because there is no obvious alternative."

Addressing the allegation that Child N was deliberately harmed by a nasogastric tube being pushed into his throat which caused him to scream, Mr Myers said: "The defence observe there are many reasons why a baby will shout or scream.

"We say it is more far more likely to be hunger. That may sound banal but sometimes it can be true."

Mr Myers said Child N was another baby who received "sub-optimal care" - not from Ms Letby - and should have been treated elsewhere.

The barrister said there was no evidence that Ms Letby inflicted harm to either Child O or Child P - two of three triplets - who she is said to have murdered, or to Child Q, who she allegedly attempted to murder.

Finally, Mr Myers said there were problems with the way the neonatal unit was run, suggesting it was overstretched and understaffed.

He added: "This whole case is complicated.

"Sat in that dock is a young woman who says this is not her fault, so we need to look at the evidence."

The trial was adjourned until Friday morning.

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Rabu, 12 Oktober 2022

PMQs: Liz Truss pledges no public spending cuts as she defends mini-budget - BBC

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By Chris Mason & Sam Francis

BBC Politics

Liz Truss has said she is "absolutely" not planning public spending cuts.

Markets are waiting to find out how the government proposes to bring down debt, following the chancellor's tax cutting mini-budget last month.

Ms Truss told MPs the government would focus on reducing debt "not by cutting public spending but by making sure we spend public money well".

Sir Keir Starmer said the government's "borrowing spree" had left homeowners worried about their mortgages.

Speaking during Prime Minister's Questions, the Labour leader called for a reversal of the mini-budget, which set out plans for £43bn borrowing to fund tax cuts intended to stimulate economic growth.

Government borrowing costs have increased following market turmoil over the last month, and the Bank of England has warned interest rates could rise again.

Meanwhile, the Institute for Fiscal Studies think tank has warned that the chancellor will need to make spending cuts to put the country's finances on a sustainable path, saying the government would have to spend £60bn a year less by 2026-27.

The chancellor has promised the government's economic plan will be outlined on 31 October, accompanied by an assessment by the independent Office for Budget Responsibility.

During PMQs, Sir Keir asked Ms Truss if she stood by her pledge, made during her leadership election, that "I'm not planning public spending reductions".

The prime minister replied: "Absolutely. What we will make sure is that over the medium term the debt is falling. But we will do that not by cutting public spending but by making sure we spend public money well."

Following PMQs, the prime minister's spokesman said there will be "difficult decisions" for the government regarding public spending, and that the chancellor would announce measures "in due course".

The government has previously said it was committed to spending settlements, set out in the 2021 Comprehensive Spending Review.

Chancellor Kwasi Kwarteng said earlier this month: "I think it's a matter of good practice and really important that we stick within the envelope of the CSR."

The review set out plans for increases to public spending above inflation, but with prices now rising, with inflation at 9.9% in August, government department budgets will come under pressure.

The prime minister's official spokesman has so far refused to confirm whether departmental budgets would stick to the below inflation increases set out in the CSR.

Privately several senior government figures have acknowledged there will "belt tightening" in departmental budgets coming.

Reporters repeatedly asked if public money being spent on the energy price cap freeze explains how the government can say that there won't be spending cuts, when belts are expected to be tightened.

Given the size of the intervention in the energy markets, there would still be capacity for significant cuts in some budgets, while allowing the PM to accurately say that government spending overall has increased.

At PMQs, Sir Keir said the prime minister needs to "stop ducking responsibility".

He told her: "Does she think the public will ever forgive the Conservative Party if they keep on defending this madness and go ahead with their kamikaze budget?"

Ms Truss hit back, asking whether Labour would reverse the government's support for energy bills.

The PM said: "We are seeing interest rates rising globally in the face of Putin's appalling war in Ukraine.

"What we are making sure is that we protect our economy at this very difficult time internationally.

"As a result of our action - and this has been independently corroborated - we will see higher growth and lower inflation."

In the House of Commons later, answering questions from MPs on the economic situation, Chief Secretary to the Treasury Chris Philp said there would be "no real term cuts" to public spending.

"We do plan iron discipline when it comes to spending restraint," he added.

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Treasury Select Committee chair Mel Stride called on the Treasury to "come forward with a further rowing back" on the tax announcements in the mini-budget.

Mr Stride, who is Conservative MP for Central Devon, said the Chancellor has "a huge challenge" reassuring the markets ahead of his 31 October announcement.

"He has to get the fiscal rules right, he has to come forward with spending restraint and revenue raisers that are politically deliverable," Mr Stride said.

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2022-10-12 16:21:31Z
1591825534

Lucy Letby trial: Nurse killed baby and sent parents card, trial told - BBC

A nurse accused of murdering babies on a neonatal ward killed a premature baby girl on the fourth attempt before sending her parents a sympathy card, a court has heard.

Lucy Letby is charged with murdering seven babies and attempting to murder 10 others at Countess of Chester Hospital in 2015 and 2016.

Manchester Crown Court was told Ms Letby allegedly tried to kill the girl by injecting her with air.

Ms Letby, 32, denies 22 charges.

Continuing the prosecution's opening statement for a third day, Nick Johnson KC said the circumstances of the girl's death were "an extreme example even by the standards of this case".

"There were four separate occasions on which we allege Lucy Letby tried to kill her," he said.

The child, referred to for legal reasons as Child I, was "resilient," he said, "but ultimately at the fourth attempt, Lucy Letby succeeded in killing her".

He said on the first occasion Ms Letby, of Hereford, had injected Child I with air.

On her second attempt, he said she had stood in the doorway of the girl's darkened room and commented she looked pale.

The girl's designated nurse then turned on the light and saw Child I was not breathing.

Following a third alleged attempt to kill her, Child I was again found to have excess air in her stomach, which had affected her breathing.

She was transferred to Arrowe Park Hospital where she stabilised, before being taken back to Chester, the court heard.

When Child I's medical alarm went off following a fourth attempt, another nurse found Ms Letby next to the incubator, the jury was told.

The baby died that morning.

Mr Johnson said: "[Child I] was born very early and very small.

"But she survived the first two months of her life and was doing well by the time Lucy Letby got her hands on her.

"It was persistent, it was calculated and it was cold-blooded."

The court heard how in the immediate aftermath of Child I's death her parents were taken to a private room and asked if the baby's mother wanted to bathe her daughter.

As the mother bathed her child, Ms Letby came into the room and, in the words of the mother, she "was smiling and kept going on about how she was present at the baby's first bath and how much the baby had loved it".

The jury was told Ms Letby later sent a sympathy card to the child's parents and kept an image of the card on her phone.

During a police interview she agreed this was unusual but said it was not often nurses got to know a family as well as they had got to know Child I's, the court heard.

The court was also told how a suspicious doctor walked in on Ms Letby as she allegedly attempted to kill another baby.

Dr Ravi Jayaram, a paediatric consultant, had helped deliver Child K, who was born at 25 weeks, and later became aware Ms Letby was alone with the baby.

Mr Johnson told the jury: "Feeling uncomfortable with this because he had started to notice the coincidence between the unexplained deaths, serious collapses and the presence of Lucy Letby, Dr Jayaram decided to check on where [Ms Letby] was and how Child K was.

"As he walked in he saw Ms Letby standing over Child K's incubator.

"Dr Jayaram could see from the monitor on the wall that Child K's oxygen saturation level was falling dangerously low, to somewhere in the 80s."

He said an alarm should have been sounding as Child K's oxygen levels were falling.

"We allege she was trying to kill Child K when Dr Jayaram walked in," Mr Johnson said.

Dr Jayaram found Child K's chest was not moving and asked Ms Letby if anything had happened, to which she replied: "She's just started deteriorating now."

Mr Johnson said Dr Jayaram found Child K's breathing tube had been dislodged.

The prosecutor said it was possible for this to happen in an active baby, but Child K was very premature and had been sedated.

'Remarkable recovery'

The jury heard the alarm should have sounded but could be overridden for one minute.

Despite his concerns at the time, Dr Jayaram did not make a note of his suspicions, the court heard.

Later the same morning Ms Letby was again at Child K's cot calling for help.

She was assisting the baby with her breathing and it was found Child K's breathing tube had this time slipped too far into her throat, the court heard.

Child K was transferred to another hospital later that day but remained unwell and died two days later. Ms Letby is not accused of her murder.

Earlier, Mr Johnson told the court about attempts made on the life of another premature girl, Child H, on two consecutive night shifts.

He said that girl had a series of known medical problems but had suffered two inexplicable collapses.

He said on the first night, Ms Letby was the girl's designated nurse and, after she collapsed, she was transferred to Arrowe Park Hospital and underwent a "dramatic improvement".

He said Ms Letby had not been Child H's designated nurse the following night, after she was returned to Chester.

Mr Johnson said: "It is a notable fact in the case of [Child H] and others that as soon as children were removed from the Countess of Chester and the sphere of influence of Lucy Letby, it was often followed by their sudden and remarkable recovery."

He said a week after the baby's collapses, Ms Letby searched Facebook for the girl's parents and for the families of two other children she is accused of attacking.

The court also heard about Child J, who Ms Letby is accused of trying to murder.

She was a premature baby girl who was "doing well and healthy" after a bowel operation.

But she suffered two serious problems with her breathing overnight in November 2015 when Ms Letby was one of the six nurses working, the jury was told.

She was moved to a high-dependency room and had a seizure at 06:56 GMT. At 07:20 Ms Letby gave the baby a glucose infusion.

Minutes later Child J collapsed again with a seizure and had to be resuscitated, with the help of a doctor, but he could not explain why it had happened again, the jury heard.

An independent medical expert who reviewed Child J's case said it was "of concern and consistent with some form of obstruction of her airways, such as smothering".

Again, Ms Letby, made searches on Facebook for the child's parents.

The jury was told of twin baby brothers, Child L and M, who the nurse is charged with attempting to murder in April 2016.

By this time, Ms Letby was supposed only to be working day shifts because consultants were concerned about the correlation between her presence and unexpected deaths and life-threatening episodes on the night-shifts.

Mr Johnson said the defendant had volunteered to work an extra shift after she noted Child L's low glucose levels shortly after his birth the previous day.

"We say that in effect she saw the opportunity to complete what she had attempted [with Child F]," he said.

The prosecution said Ms Letby attacked Child L first by adding insulin to his nutrient feed and then, while that attack was under way, administering air into Child M's circulation.

Child M suffered an unexpected life-threatening event "without warning" and came close to death and his twin's blood sugar was left dangerously due to the insulin poisoning, the court heard.

When Ms Letby's home in Chester was searched two years later, medical notes were found detailing how many doses of adrenaline were given to Child M during his collapse and a note of his collapse was in her diary.

"She denied the notes were a souvenir and she denied deliberately trying to harm [Child M]," Mr Johnson said.

The nurse allegedly tried to kill another premature baby, referred to as Child N, who had a blood disorder, on three occasions.

Mr Johnson said this meant Ms Letby believed, wrongly, his disorder gave her "cover" to attack him because if he bled it would be put down to the condition.

He suffered a sudden life-threatening lowering of his blood oxygen levels but recovered after emergency assistance, the court heard.

Independent medical experts said the baby's sudden deterioration was consistent with some kind of "inflicted injury" or him having received an injection of air.

Twelve days later, in June 2016, Ms Letby is alleged to have made two more attempts to murder Child N.

Court sketch of Prosecutor Nick Johnson KC

The court also heard about Child O and Child P, two boys from a set of triplets. Ms Letby is charged with murdering them both on successive days.

Within a few minutes of the nurse coming into the neonatal unit, Child O suffered his first collapse described as a "remarkable deterioration", the jury was told.

A breathing tube was inserted by medical staff and the baby was resuscitated but he suffered another episode later and this time doctors were not able to resuscitate him.

A post-mortem examination found unclotted blood in Child O's body from a liver injury and a coroner certified death on the basis of natural causes and intra-abdominal bleeding.

Mr Johnson said: "It would not occur to [the coroner] a nurse would have assaulted a child in the neonatal unit."

He said an independent pathologist had since reviewed the case and was of the opinion the liver injury was not the result of chest compressions in resuscitation.

Mr Johnson said the most likely cause was an impact-type trauma, adding: "In brutal terms, an assault."

The expert also concluded Child O had fatefully received excessive amounts of air into the bloodstream and through a nasogastric tube.

A year later, on the anniversary of Child O's death, Ms Letby carried out a Facebook search for his family's surname, the court was told.

The trial continues.