Nurse Lucy Letby goes on trial for baby murders
Warnings that Lucy Letby might be responsible for several deaths in a hospital’s neonatal unit were allegedly ignored by a senior executive, a jury has heard. Karen Rees, a duty executive in urgent care in June 2016, reportedly said there was no evidence that the nurse had anything to do with what had happened.
One of her colleagues said she refused to stop the nurse from working until the sudden and unexplained death of a triplet was investigated properly.
Stephen Brearey, a consultant paediatrician at the Countess of Chester Hospital, told the jury at Manchester Crown Court he called Ms Rees because he could not find a natural cause for the death of Baby O.
He also recalled that Letby declined his suggestion that she take the weekend off “to recover” and said during the medical debrief into the failed resuscitation she had not seemed “overly upset”.
Dr Brearey told the court he had found the deaths of Baby O and his fellow twin, Baby P, particularly upsetting because both seemed to be improving and would have eventually been able to go home.
Letby, 33, originally from Hereford, is on trial accused of murdering seven babies and the attempted murder of 10 others between June 2015 and June 2016.
Dr Brearey told the court that even before the twins’ died, he and some of his colleagues had spoken to management about the association between Letby being present on the unit and the deaths that had occurred.
He said: “I phoned Karen Rees, the duty executive in urgent care, who was familiar with the concerns already.
“I explained what had happened and said I didn’t want Nurse Letby to come back to work the following day or until this was investigated properly.
“Karen said no to that, and (that) there was no evidence.
“The crux of the conversation was that I then put to her ‘Was she happy to take responsibility for this decision in view of the fact that myself and consultant colleagues would not be happy with Nurse Letby going to work the following day?’
“She responded ‘Yes, she would be happy’. I said ‘Would you be happy if something happened to any of the babies the following day?’ She said ‘Yes’.”
Dr Brearey told prosecutor Philip Astbury: “All the events in the trial are distressing, but O and P’s deaths were particularly distressing for those involved, and deeply so with me, really.
“But there were clearly some elements of the case that I was concerned about.
“All three triplets were born in such good condition and were following a healthy path towards growing and developing and hopefully going home.
“The deterioration of O really came out of the blue as far as that was concerned: the fact that we had to intervene initially felt like a surprise, the fact that each time we tried to stabilise and resuscitate him he’d get to a point and deteriorate (again) soon afterwards.
“The fact that he had two bradycardias and desaturations was exceptionally unusual. The rash was unusual and like nothing I’d seen before or since.
“We’d excluded many if not all natural causes for him collapsing like this, and I couldn’t then, or now, think of a natural cause.
“I intended to escalate it the following day, but P had already started deteriorating and I was helping with some of his care the following day.”
Mail Online reports that after Baby P’s death he had attended a debrief with Dr Oliver Rackham, a colleague from Arrowe Park Hospital who had arrived at the Countess as part of a transport team.
Dr Brearey told the court: “Nurse Letby was present in that debrief. I asked her how she was feeling, and I can remember suggesting to her that she would need the weekend off to recover from this.
“She didn’t seem overly upset in the debrief, or at all, and told me at the time that she was on shift the next day, a Saturday.
“I was concerned that this was because we’d already expressed our concerns to senior management about the association between Nurse Letby and the deaths we’d seen on the unit’.
It was at this point that he rang Ms Rees.
Dr Brearey said that when Letby was first linked to deaths on the unit colleagues reacted by saying: “No, it can’t be Lucy. Not nice Lucy.”
And he said that over the course of the year, all the consultants became aware of the association between the nurse and some of the collapses of babies on the unit.
Ben Myers, defending, asserted that the link to his client amounted to confirmation bias, but this was rejected by Dr Brearey.
He replied: “We try to be as objective as possible”, he said.
Asked if there was “naturally a bias” against Letby once the link had been made, he replied: “I disagree.”
The neonatal unit’s nursing manager, Eirian Powell, first spotted a connection while carrying out a review into three events in June 2015.
Dr Brearey said she had looked at staffing but also other things like incubator space and microbiology.
In late June or early July that year he and Ms Powell met with Alison Kelly, the hospital’s director of nursing, and the head of risk, because they were concerned about why there had been three deaths in a short period of time.
He told the court that medical staff had learned useful things from every case they reviewed, but nothing to explain the actual reason why the babies had collapsed.
And he said that “more suspicion arose” as more and more unexplained events happened on the unit.
But when Letby’s defence asked him why he had not gone to police, he said: “You’re making this a little more simplistic than it actually was.
“It’s not something anyone wished to consider: considering that a member of your staff is harming babies.
“Actually, the senior nursing staff on the unit didn’t believe this could be Lucy until the point – and beyond – when O and P died. None of us (the paediatricians) wanted to believe it either.”
Consultants on the unit were concerned about what was happening but no obvious “red flags” were being raised either outside the trust or within it.
In February 2016 a colleague from the Liverpool Women’s Hospital was brought in to carry out a review.
Once their report was completed the consultants and Ms Powell sought a meeting with senior executives, including the director of safety and quality and the director of nursing.
Dr Brearey said that in the February review, there wasn’t a single case that had highlighted a lack of staff.
And when asked again about why they didn’t call the police earlier, the registrar replied: “The reason we didn’t go to the police was we wanted to escalate it within the structure of the hospital.
“We wanted the support of the medical director and the executives of the hospital. We were acting on facts, not beliefs.
“We were trying to escalate appropriately with the facts we had at the time’.
“I’ve not been to the police over neonatal deaths and I don’t think any other neonatal lead has. I needed executive support. I was doing as much as I could.”
The trial continues today.
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