This is the transcript of Lucy Letby's police interviews as read in court between 17th & 27th April 2023. The part of the interviewing officer was read by the Prosecutor Philip Astbury. Lucy Letby's answers were read by DS Danielle Stonier, who was the main police interviewer from the 2nd arrest in 2019 onwards.
The interviews were not read in the order that they were conducted but were grouped by baby, each one including interviews across all 3 arrests. Some of the content was summarised by the prosecutor.
This transcript also includes additional content at the end of Day 4. The house search evidence at the beginning of Day 1 aren't included here. Interviews for Baby K were not included in the source transcript due to the pending retrial.
Source Transcript (PDF) - House searches and Police interviews Day 1
MR ASTBURY: My Lord, Danielle Stonier, please.
DS DANIELLE STONIER (sworn)
Examination-in-chief by MR ASTBURY
MR ASTBURY: Could you introduce yourself, please?
A. Yes, I'm Detective Sergeant Danielle Stonier from Cheshire Police.
Q. Thank you. Sergeant, you were one of the investigation team in the investigation in respect of
Lucy Letby?
A. Yes, that's correct.
Q. And one of your roles was to conduct interviews of Ms Letby?
A. Yes, that's right.
Q. The jury have heard this morning that Ms Letby was arrested on three separate occasions?
A. Yes, that's correct.
Q. 2018, 2019 and 2020?
A. Yes.
Q. Whilst in custody after those arrests she was interviewed by yourself and other officers
whilst in the police station; is that right?
A. Yes, she was.
Q. We'll come to the documents in a minute, but she had, am I correct, her solicitor with her at
each and every interview?
A. Yes, she did.
Q. As was her right?
A. Yes, that's right.
Q. And you are here to assist us with the interviews. We'll have a list of all of the interviews
in due course, but just to make clear that the exhibit I'm going to go through with you, you're
aware, aren't you, is a summary of the interview that took place. All interviews are recorded?
A. Yes, they are.
Q. They are transcribed in full?
A. Yes, that's right.
Q. And then a summary is prepared for a jury with the most relevant parts contained without
hopefully any repetition or irrelevant material therein?
A. Yes, that's right.
Q. So we're going to go together, if we may, through the summaries. We'll become familiar with
the format, but if we can look first, please, at our page [redacted]. You'll see they're all
paginated in the top right-hand corner.
A. Yes.
Q. These have been prepared, is this right, officer, in baby order?
A. Yes, that's right.
Q. Would this fairly reflect the process: questions were asked initially on 3 July and in the
days afterwards about each baby?
A. Yes, they were.
Q. So we have the first interview about [Baby A]. Then on the second occasion of arrest there
were more questions about [Baby A]. So they've been split into babies rather than dates; is that
right?
A. Yes, that's right.
Q. Thank you. So first of all we're going to begin with [Baby A] and the first interview about [Baby A]. If we look at the very first page of our exhibit --
MR JUSTICE GOSS: Well, the jury don't and can't because they haven't got it.
MR ASTBURY: I'm sorry, I thought -- they're all lined up ready, I do apologise.
(Handed)
There will be two of these folders, my Lord. We're hoping not to add too much paperwork to what's already been created. There will be another at some point.
(Pause)
MR JUSTICE GOSS: You'll see it's marked on the spine, "Interview bundle 1", because there's going to be a second bundle. I think if we go behind the first divider -- and don't, please, go beyond the first divider, don't start trying to read ahead into further interviews, just read the page that we're on during the course of the evidence.
MR ASTBURY: Yes.
Now we all have it, we'll become familiar with the form. This effectively contains the
information about the interview on the first page; is that right?
A. Yes, that's right.
Q. Headed "Record of interview". The name of the person interviewed: Lucy Letby. Place of
interview: the custody suite at Chester. Date of the interview: 4 July 2018. The time: 10.23 to
12.04. A reference number. The name of the two officers conducting the interview, not you on this
occasion. And also the fact that Ms Letby's solicitor was present.
A. Yes, that's correct.
Q. In presenting these, they're obviously in a question-and-answer format. I am going to, if I
may, play the role of the interviewing officer and deal with the summaries. If I can ask you to
assist with Ms Letby's replies, please.
A. Yes, no problem.
Q. Thank you.
The interview begins with introductions and caution. The caution is a formal set of words at the
outset of an interview; is that correct?
A. Yes, that's correct.
Q. Can you confirm for me that it is as follows:
"You don't have to say anything but it may harm your defence if you fail to mention when
questioned something that you later rely on in court, and anything you do say may be given in
evidence"?
A. Yes, that's correct.
Q. Thank you. The introductions consist of everybody stating their name who's present?
A. Yes.
Q. And an outline of what's about to take place?
A. Yes.
Q. Thank you.
Then the first question:
"Do you understand that Lucy"; yes?
A. Yes.
Q. Lucy Letby then confirmed that she'd received a copy of her notes relating to [Baby A].
Okay. In relation to [Baby A], other than the notes, do you remember [Baby A] and your care of
[Baby A], other than the notes you've just gone through?
A. Yes.
Q. You do. Would you like to tell me exactly, in your own words then, what your involvement was
with [Baby A] regarding around the time he collapsed?
A. So I remember I came on duty -- we start our night shift at 7.30 and we have a general handover
period which usually lasts until around 8 o'clock. And at that point I went to [Baby A]'s cot side
to receive individual handover with the nurse that had been looking after him in the day -- and I
believe this was around 8 o'clock and at this point the nurse looking after him was connecting or
drawing up some fluids to be connected via a long line that [Baby A] had inserted during the day.
So at this point, whilst we were getting -- sorry, so while at this point, whilst we were getting handover from each other, I checked the fluids with this other nurse and she connected them via the long line and shortly after that is when we noticed that [Baby A] had gone quite pale and mottled in his skin. Dave Harkness, the registrar, was in the nursery at the time and we called Dave over and began initiating airway support because [Baby A] was apnoeic and then we put a crash call out and Dr Jayaram came and then [Baby A] had full resuscitation.
Q. You came on duty at 7.30?
A. Yes.
Q. Okay. So what was your -- what were your actions when you came on duty on the ward?
A. So we have a generalised handover to start with all the nursing colleagues that hand over from
the day shift to the night shift.
Q. Okay.
A. And then, I'm not 100% sure of the timing, but I believe I got to [Baby A]'s cot side around 8
o'clock to have individual handover on [Baby A] from the nurse that was caring.
Q. Do you specifically remember this shift with [Baby A]?
A. Yes.
Q. Okay. What -- why do you remember that?
A. I remember [Baby A].
Q. So do you specifically recall going to [Baby A]'s cot side?
A. Yes.
Q. Okay. Tell us about your observations of [Baby A] at that time.
A. So I remember [Baby A] was on CPAP, which is respiratory support, and I didn't have a lot to do
with [Baby A] at that time because when I came to get handover the nurse caring for him was
already drawing up sterile fluids to go through the long line that had just been put in by the
doctors, so we went straight to checking the fluids.
Q. Okay. Tell me about what the support was, the breathing support?
A. [Baby A] was receiving CPAP.
Q. Okay. And at that point was there anything that alerted you to anything, even though you can't
remember which specifically [Baby A] had? Did you notice anything that concerned you with the way
he was receiving that treatment?
A. Not with that. The only thing I do remember is that he was a little bit jittery in appearance.
He was a bit jittery in his limbs and that can be a sign of low blood sugars, and he was due a
blood gas and a blood sugar shortly after I came on shift.
Q. Okay. So tell me what jittery is?
A. Jittery is sort of when the baby is making sort of involuntary jerking movements, their limbs.
Q. So it's not in reaction to pain?
A. No.
Q. No. So it --
A. Jittering is something you recognise as being -- it can be a sign of low blood sugar, it's
quite a different movement.
Q. Okay. Is that common?
A. It is common for preterm babies to be hypoglycaemic, yes.
Q. And was that --
A. And that's why we were keen to get the fluids connected because we were conscious that he
hadn't had fluids via his long line in the UVC at that point.
Q. Okay. Would the fluids have included something that would aid the jitteriness?
A. Yes.
Q. Okay. And what was that?
A. I'm not sure without looking which fluids we connected, whether it's 10% glucose or TPN.
Q. Okay. So tell me who the nurse was that you took over from.
A. Melanie Taylor.
Q. Okay. What was her hand over to you? This is from memory.
A. I can't remember specific details.
Q. Okay.
A. But I don't recall there being anything of any due concern.
Q. Okay.
Then the other officer asks:
"So when you came on duty how was [Baby A] presenting to you initially?"
A. From what I remember he -- I didn't have any concerns other than this jittery movement.
Q. Okay. Do you remember how long into your shift that he became jittery?
A. No.
Q. So you said you that checked the fluids with the other nurse. Is that again something that you
specifically remember with regards to [Baby A]?
A. I can't remember which fluids, but I know that Mel was there with the fluids when I came to get
handover and we made that a priority, to check the fluids and get those set up and running.
Q. Okay. Again, why was that -- why was that a priority?
A. Because he hadn't had his cannula, his peripheral cannula inserted in the day. He'd had a UVC
that they weren't happy to use and he'd had a long line inserted that the doctors had confirmed we
could use. So I think he'd gone a few hours without any fluids.
Q. Okay. Is that normal? Is that a cause for concern?
A. It's not ideal but when you have new babies and it's -- you have -- you can have problems
obtaining access to be able to give fluids, yeah.
Q. Right, okay. But there was nothing that gave you concern apart from the jitteriness --
A. No, not that I remember.
Q. -- at the point of handover?
A. No.
Q. Okay. So you said he became pale and mottled. Is that during the handover with Melanie?
A. I think it was after we connected the fluids.
Q. Okay.
A. He -- he was normal in appearance when we were having handover and once we connected the
fluids, it was noted that he -- his colour changed.
Q. Okay. So with regards, again from memory, yourself and Melanie, did you do that together?
A. I think Mel was drawing up the fluids and Mel was sterile because you have to do it
aseptically, connecting fluids, so I believe she was gowned up and setting the fluids up and I
checked the fluids with her because two people have to check any bags or any fluids that were
running.
Q. Okay.
A. And then I think, from memory, Mel connected the fluids to the long line.
Q. Okay. So what --
A. And then we set up the pump together, the infusion pump.
Q. Okay. So physical interaction at that stage with [Baby A], what exactly did you do --
A. I don't --
Q. -- in layman's terms?
A. I don't recall having any physical contact with [Baby A] at that point.
Q. Okay. So when did you have physical contact with [Baby A]; do you recall?
A. No. I think it was when he deteriorated.
Q. Okay.
And then the other officer:
"Do you remember what you were doing just prior to the deterioration, Lucy, what -- where you
were?"
A. I think I was at the bedside checking the equipment. So usually when we have received handover
we'll then go through and check all the emergency equipment.
Q. Right.
A. Check any infusion pumps, any ventilator support, you check all the equipment, check your
incubator, those sorts of things.
Q. And were there any issues with the equipment at that time?
A. No.
Q. Okay. And that's where you were just before he became unwell?
A. Yes, I think so.
Q. Was anyone else there with you at the time?
A. So Mel was still in the room and a registrar, Dave Harkness, was in the room with [Baby B].
Q. Okay. What was Mel doing, do you remember, at the time?
A. No.
Q. Okay. Were there any other babies?
A. I think she may have been writing her notes, but I -- I'm not 100% sure.
Q. Right. Were there any other babies in the room at that time?
A. I know [Baby B] was in the room. I'm not sure about any others.
Q. Right. Who was [Baby B]'s nurse at the time?
A. I think it was Caroline Bennion but again I'm not certain. I know Caroline Bennion was there
because she became involved once [Baby A] deteriorated. I'm not sure if she was on the day shift
or the night shift.
Q. And you say Dr Harkness was there?
A. Yes.
Q. What was he doing then?
A. He was doing something with [Baby B]. I'm not sure. But I just remember him being at her
incubator.
Q. Right. Okay.
Then the officer:
"Okay. So you've done those kind of connections. You didn't have any concerns at that stage. How
long between doing those and you noticing [Baby A] becoming pale and mottled?"
A. It was fairly soon. Within minutes, I think.
Q. 30 minutes, 2 minutes?
A. I don't know. Maybe 5 minutes.
Q. Okay.
A. Something like that.
Q. And Melanie had moved on to doing her notes?
A. I think so.
Q. And you were doing the check of the equipment?
A. Yes.
Q. Okay. So tell me how you interpret pale first of all in a neonatal baby?
A. It's a loss of colour. Babies are usually quite pink and he'd become more pale, as in almost
white.
Q. Okay. What does that mean to you as a nurse in that field?
A. That there's something wrong.
Q. Okay. Like what?
A. It could be an infection.
Q. Okay.
A. Could it be they are hypoglycaemic, that they've had a sudden collapse?
Q. Okay. And mottled, the same thing, how do you interpret the mottled appearance?
A. So mottled is a bit more of -- almost like a rash appearance, like blotchy red marks on the
skin.
Q. Okay. Is that a reflection of something in your experience?
A. Again, it can be a sign of infection, low blood sugars. If they're cold they can become
mottled. If they've got poor blood gases.
Q. Okay. And exactly what is mottled?
A. What is a mottled appearance?
Q. Yes.
A. So when the baby's quite pale and white and they can have sort of red areas on them.
Q. Red?
A. Yeah, like reddy-purple, yes.
Q. Okay. Was this specifically with regards to [Baby A], was it localised or was it spread out?
Where exactly did the mottling appear?
A. I think it was his hands and feet.
Q. Okay.
A. And he was centrally pale.
Q. Okay. So those two together, considering how he presented to you at that time, what were your
actions then?
A. So I think I went to him and checked him and found that he was apnoeic and not breathing.
Q. Okay. So how did you check him, what do you mean by check?
A. I looked to see if he was breathing and if the CPAP mask was in place still and the machine was
running.
Q. And was it?
A. Yes.
Q. Which machine was running?
A. The CPAP machine.
Q. Okay, yeah.
A. And then straightaway Dave was in the room, Dave Harkness, and I called him over from what I
recall.
Q. Okay. How did -- did you have to almost stimulate [Baby A] or physically check him?
A. I think so but I can't remember.
Q. And then Lucy Letby described the initial steps that would usually be taken to stimulate an
apnoeic baby. And the officer asked:
Okay, so you say that, you saw he wasn't breathing, that he was apnoeic.
A. Yes.
Q. So tell me how that presented in [Baby A].
A. How did I know that he was apnoeic?
Q. Yes.
A. I think I went over and assessed him. He wasn't breathing and I'm not sure what his
observations were doing. I can't recall his observations at the time.
Q. Okay. And then the other officer:
"At that time, was anyone else with you?"
A. Yes, Dave Harkness was on the cot side next to him. I'm sure Mel was in the room and Caroline
Bennion.
Q. So Dave Harkness would have witnessed the apnoea, the breathing had stopped, yeah?
A. I'm not sure that he was looking at [Baby A] at that time, but he was in the room.
Q. So how did he become aware that [Baby A] was apnoeic?
A. We called him over.
Q. Okay. Who's we?
A. I'm not sure whether it was myself or Mel or Caroline.
Q. Okay.
A. I'm not sure who. We were all in the room from what I remember, so I'm not sure which of us --
who I called for first -- or how it -- we were all in close proximity.
Q. Was he attached to any monitors?
A. Yes, he would have been attached to a Philips monitor.
Q. Okay. So in [Baby A]'s case in particular, was the monitor -- did the monitor go off?
A. I can't remember --
Q. Right.
A. -- specifically.
Q. Was it the monitors that attracted you to [Baby A] being apnoeic or was it your visual
observations?
A. I can't recall but I would assume it would be the monitor.
Q. Okay. So had you moved away from [Baby A] after you'd done the handover?
A. I can't specifically -- I don't know.
Q. Right. Because you said you were checking the --
A. If the equipment is adjacent to the cot side though --
Q. Yeah, so were you during that period of handover to you seeing/making these observations of the collapse?
Sorry. I'm not sure that makes sense.
Were you with [Baby A] throughout that period?
A. I believe I was checking the equipment, yes, at his cot side and his charts.
Q. When you talk about this mottled rash, can you give us any further description of how it
showed, its shape?
A. I think from memory it was more on the side that had his line in.
Q. Okay. Which side was that, do you remember?
A. I think it was his left.
Q. Okay. And you described it as a red/purple colour. Can you sort of help us with any
comparisons with anything colour-wise, the way it showed? Was there any -- was it bright red, was
it dark red?
A. I think it was more pale than the mottling, than the little areas of the mottling.
Q. Okay.
A. But predominantly it was paleness.
Q. Did anyone else see that mottling on [Baby A]?
A. Yes, I think it was still there when I called Dave and Caroline and the other nursing staff
came in.
Q. Did they say anything about it to you?
A. Yes, we were advised to stop the fluids on the long line straightaway.
Q. Did they say what they thought it was?
A. I think Dave mentioned that it could be potentially an issue with the line, so to stop the
fluids.
Q. Okay.
The other officer:
"How does a long line cause mottling?"
A. If a long line wasn't in the correct position you were running fluids and it was going outside
of the bloodstream into the tissues then it would cause circulatory problems to --
Q. Okay, right?
A. -- that limb or that area.
Q. Okay. Who had inserted the long line?
A. I think it was Dave Harkness. Doctors insert it, so it would have been a member of the medical
team.
Q. Okay. And that was prior to you coming on duty, I think you said, didn't you?
A. Yes.
Q. Because -- so that was already in situ?
A. Yes.
Q. And Lucy Letby was then asked to explain some of the entries from the notes which with she'd
been provided. The officer says:
Okay at 20.05 you put, "10% glucose commenced via long line with SN Taylor as agreed by Registrar
Harkness, who was present."
My Lord, that's a reference to tile 175 on the [Baby A] interview. I don't know whether it would help to have that up now so the jury know what's being discussed. 175.
The question is:
What was this for?
A. All the babies that aren't being fed need to have some fluids running to maintain the blood
sugars, so 10% glucose is the standard formula we would give for TPN. So [Baby A] was commenced
on, obviously, 10% glucose.
Q. Okay. And if we move along there I think we've covered -- you noted him to be jittery, that he
was due to have a blood gas and blood sugar taken. I think you mentioned that to us, didn't you?
And you went through the process of that. How was [Baby A] handling at that time?
A. I don't recall handling [Baby A].
Q. Right. At all that day?
A. No.
Q. Okay. Then I think you've put at 20.20, "[Baby A]'s hands and feet needed to be wiped. Centrally pale, poor perfusion, [Baby A] became apnoeic."
This is tile 179. Thank you.
So you put there that [Baby A] became apnoeic at the time, his hands and feet were noticeably
white. So is that -- was that the correct sort of way it sort of displayed: his hands and feet
were white, you saw them being white and then he became apnoeic at the same time or was that
afterwards?
A. I can't recall specifically.
Q. But was anyone else present when you saw those?
A. There were other staff present in the nursery, yes.
Q. Then she went on --
A. I remember raising about them being white. That's when I was advised to stop the fluids.
Q. At that time?
A. Yes, I believe when I was -- called for help, yes.
Q. Okay. So where you've put "centrally pale and perfusion", the poor perfusion refers to how you
described around the --
A. The limbs, yes.
Q. The extremities, okay?
A. Yes.
Q. Okay. And that could be caused [by a] problem with the long line?
A. Yes.
Q. So that's the same thing?
A. Yes.
Q. Okay.
Then the other officer:
"What do you mean by perfusion then? What's perfusion?"
A. The circulation.
Q. Okay. Was there a reason why it was particularly poor with [Baby A] --
A. No.
Q. -- in your opinion?
A. No.
Q. Okay. Then you've got Registrar Harkness in the nursery and assistance called for, so I take
it he was there pretty straightaway, was he?
A. Yes.
Q. And what was his initial advice to you?
A. To stop the fluids.
Q. And then shortly afterwards -- afterwards, "No heart rate was detected and full resuscitation commenced as per the medical notes". Do you want to just go through that process of the resuscitation for us then? Your, involvement?
And then:
"Specifically to [Baby A], to [Baby A]."
A. Okay. I can't remember specifically my role with [Baby A].
Q. Right. Is there anything at all that you do remember about the resuscitation?
A. No.
Q. Then sadly, [Baby A] passed away at 20.58 hours and was given to the parents to cuddle. How
were you feeling about that?
A. It was awful, really.
Q. Can you explain what was going through your mind?
A. Just how quickly it had all happened and I didn't have a relationship with the parents or
anything and obviously they came and [Baby B] was in the room at the time and we were conscious
that we were split between two babies and [Baby B] was present when this was all happening as
well.
Q. Do you know who gave -- gave him to the parents, who passed [Baby A]?
A. I think it was myself.
Q. You think or you remember?
A. No, I can't remember specifically for definite.
Q. What made you think it might have been you?
A. Usually it's the member of staff that has cared for the baby that's assigned to look after the
baby that would have that role.
Q. It must be a very difficult time for you.
A. Yes.
Q. How do you sort of deal with that? What's your sort of coping mechanism for that?
A. I think we just all as a team sort of supported one an other with it.
Q. Do you remember any sort of debriefs or chats with --
A. There was a debrief.
Q. Debrief?
A. A few days later, I think. I'm not sure of the exact date but there was one held formally.
Q. You remember that, do you?
A. Yes.
Q. Who was involved with that? Who was present?
A. I think it was led by Dr Jayaram. I can't remember any of the specific details about it.
Q. Was there any particular outcome from it at all?
A. No, I believe there was some mention that mum had various health issues that were looking into,
whether they could have affected [Baby A] and [Baby B], but I don't recall anything else.
Q. What about offloading to friends or family, you know, after your shift? Did you do any of
that?
A. I can't remember specifically but I would have told my parents and my friends, yes.
Q. But you don't know specifically?
A. No.
Q. Okay.
Then presumably this is to the other officer:
Is there anything you want to ask?
The officer says:
"Up to [Baby A] had you had experience of babies passing away professionally prior to his
death?"
A. Yes.
Q. Okay. What kind of occasions were they, in what circumstances?
A. I'd seen babies pass away at Liverpool Women's when I was doing my training there, very
pre-term babies.
Q. Okay.
A. And I -- we lost a 23-week baby on the unit when I first started, so I'd seen that baby.
Q. Okay. Is there sometimes an element of a death being expected within the neonatal unit?
A. Sometimes, yes --
Q. Okay.
A. -- depending on the baby's condition and gestation and things, yes.
Q. With regards to [Baby A], was his death anticipated or expected?
A. No. My concern at the time was whether there was -- had been any issue with the long line
because it was sort of in a few minutes after we connected the fluids that he seemed to
deteriorate, so I think my concern was that there was an issue either with the line or the fluids
that we'd connected.
Q. Okay. So you explained about how the long line can be in the wrong position and that can cause
problems. So that was your concern with the long line; is that correct?
A. Yes.
Q. Okay. What are the -- what were your concerns about the fluids that had been administered and
could cause a collapse?
A. So I didn't have a concern specifically about the fluid, but when thinking of what could have
caused it my concern was maybe the bag of fluid wasn't what we thought it was potentially.
Q. Okay.
And then the other officer:
"What did you think it was?"
A. 10% glucose.
Q. Did you say that Melanie attached it or you just don't recall who attached it?
A. I believe Mel was sterile so I think Mel would have attached it if she was sterile.
Q. Okay.
A. She would have been the one to have connected it. I can't remember for definite who connected
the bag, no.
Q. Where does the bag come from?
A. So the bags are all pre-sealed and they're in a cupboard in nursery 1.
Q. So who actually retrieves those out of the cupboard?
A. The nursing staff.
Q. Okay so did you retrieve that bag for [Baby A]?
A. No, not that I recall. I recall that Mel already had the bag out --
Q. Okay.
A. -- and was -- and already had the line ready to run through, so we checked the bag together.
Q. Okay. As part of your checks of the -- his equipment did you recheck his bag and the long line
after Mel had attached it?
A. I can't recall specifically.
Q. Would there be any record made of who attached this bag?
A. So usually when we sign the drug chart, the signature that signed for first is usually the
person that connected and the signature below is the co-signer.
Q. For the next part of the interview the officer returned to the notes and as a result of which
asked this:
"You then go on to say that:
"The hand and footprints were taken with consent along with a lock of hair. Hand and footprints of
sibling also obtained as per parents' wishes. Parents and maternal and paternal grandparents have
had time alone cuddling [Baby A]. [Baby A] has also spent time on CLS with parents on cold cot.
Photos taken with unit camera and parents' phones."
My Lord, I don't need to go to it now but the reference for that note is tile 222:
Do you remember who did those activities?
A. I believe I did. The footprints, I remember doing those for [Baby B].
Q. Can you go through the process of how you would do that then?
A. We have a set, a kit on the unit, that has a set of paper and wipes that we wipe the foot with
and then imprint that on to a piece of card and that's usually done with two people. We do it with
the hand and the feet.
Q. Okay. Obviously a very difficult -- [Baby A]'s passed away and you're doing that. How does it
make you feel doing that process?
A. I personally find that process quite -- it's quite nice to do something nice for the baby and
with the baby and I see it as a way of giving parents memories.
Q. Okay. Where did they take place? Where do you actually do this?
A. I can't remember specifically where we do it but you can either do it in the incubator or after
the baby's passed away and it's on the cold cot, we can do it in there. We can do it when they're
sat on the mum and dad. We can do it wherever, really. I don't recall specifically where I did
[Baby A]'s.
Q. And is -- who is present when this occurred?
A. Anybody can be present. So if -- the parents can be there. We usually do it with two members of
staff for the practicality of having somebody to assist you with the paper and the wipes, so it's
usually two members of staff do it.
Q. And what -- the documentation that you refer to in those notes -- what is that
documentation?
A. So we have a bereavement checklist that we have to go through when a baby dies. So we tick
things that we've done, such as hand and footprints, if photographs have been taken, is the baby
labelled, do parents -- aware of things like that, and that's passed over then to the staff taking
over and they continue that sheet.
Q. Okay.
Lucy Letby was then asked about a reference to [Baby A]'s parents in her notes.
The question was posed:
Is there a reason why you refer to them as mummy and daddy? Can you see that within those
notes?
A. Because they are their mum and dad.
Q. Obviously, some people call them by their names or parents of. But the reason why you --
A. No, usually we would refer to them as mum and dad or parents. We don't usually name them by
their Christian names.
Q. Okay. Then you put mementos gathered and placed in a memory box. Why was this done?
A. That's what we'd do for any baby that's passed away. We have a set bereavement box with various
mementos in it and that's when we would put things like the hand and footprints and items from
their cots, such as their cot card, their name bands.
Q. What about the family? Did you ever keep in touch with the family after [Baby A] died?
A. Only whilst [Baby B] was still a patient on the unit.
Q. Did you make any other notes through the course of caring for [Baby A], did you make any other
notes before you placed those on to the system?
A. I don't recall specifically with [Baby A], but quite often we have a handover sheet where we
write down information about the baby and if he was having a resus event or anything like that,
you might make notes on the back of your handover sheet to use at the end of the day to help with
writing your notes.
Q. Okay. You know the notes that you do make, handwritten notes that you make, like you say, for
the purpose of handover, what happens to those at the end of the shift?
A. They're usually disposed then in confidential waste.
Q. Right, okay. What do you do with yours? What did you do with [Baby A]'s in particular?
A. I don't recall.
Q. A discussion then took place regarding shift rotas at the time. A file, we are told, was kept
on the unit with shifts planned around a month in advance. Any swaps with other members of staff
or overtime would be handwritten on the paper forms. And there was no electronic system for
clocking on and off. Then Lucy Letby was asked:
How do you actually get on to the unit?
A. It's swipe access --
Q. Right.
A. -- to gain entry to the unit.
Q. Okay, and are there any particular times where you would work more overtime or times when you
wouldn't want to, you know, do you have set holidays throughout the year?
A. No.
Q. Okay. You don't get a call like last minute, 'We're short of staff'?
A. Yeah.
Q. You do?
A. Yes.
Q. How often was that?
A. Quite frequently on sort of a week-to-week basis, I would say.
Q. So what sort of notice would you be given for the overtime?
A. I mean, sometimes they would call you in the morning and say, "Could you work tonight?" or ring
you today and say, "Would you be able to work tomorrow?"
Q. Do you remember anybody else giving [Baby A] care in between the time that you had the
handover and the point of his collapse? I think you said about 8.20.
A. No.
Q. Okay. Obviously, having -- obviously, you've had his notes. Having read his notes, do you
think there was anything that you need to raise for us to have a look at during this interview now
with regards to [Baby A] that you feel we need to discuss?
A. No.
Q. Then Ms Letby's solicitor spoke:
The thing is in relation to [Baby A], I think you've only had less 20 minutes contact with him in
total, is that --
A. Yes.
Q. And then reverting to the officer:
Yeah, including his parents. Ever?
A. Yes, that was the first time.
Q. From the time of coming on duty to the time --
A. That was the first time I've met [Baby A], yes.
Q. So within the 20 minutes that you had, he's gone downhill, he became pale, you saw this
mottled effect on the feet, apnoeic, stopped breathing, collapsed, and then obviously a full
resuscitation attempt was made. Is that a fair sort of summary of what happened with [Baby A]?
A. Yes.
Q. Is there anything else you would like to tell us about [Baby A] and your care for [Baby A]
that can help us with this investigation?
A. No. So the only concern that I had was there was an issue potentially with the line or the
fluid that we'd attached.
Q. Okay. And again, we've spoken about the line: the potential problem there was that it was
wrongly located and that whatever was put through the line would seep out of the bloodstream?
A. Yes.
Q. Yeah, and the other potential problem there is the bag and whether it contained the correct
prescription?
A. Yes.
Q. And the interview in respect of [Baby A] was concluded at that point.
A. Yes, that's correct.
MR ASTBURY: Thank you. I'll just make this point, my Lord, if I may. Often, an interview would
carry on to another baby, it wouldn't necessarily stop and then start another interview.
A. Yes, that's right.
MR JUSTICE GOSS: Yes, but as has been done throughout this case, it's all been compartmentalised, so the interviews will be specific to the individual babies.
MR ASTBURY: Yes. Is that an appropriate point?
MR JUSTICE GOSS: Yes.
That gives you an idea of what's to come and another file of this. All right? These are your paper copies, your working documents for such use as you wish to put them during the course of the trial. We will now break off because there's no point in starting another interview and we will resume on Wednesday because tomorrow is a day off.
Friday is a day off. Monday the 24th is a day off and Wednesday the 26th is a day off so far as April is concerned. I will give you the full list on Wednesday in relation to it, but as far as this week is concerned, as you know, not sitting tomorrow, so it's Wednesday and Thursday of this week that you're required.
Next week, you're required Tuesday, Thursday and Friday. All right? You should have that in a sheet of paper that you had from earlier, before the Easter break. Thank you very much.
Please remember your solemn responsibilities as jurors in this case: no communication by any means with anyone, no research about anything to do with this case.
(In the absence of the jury)
MR JUSTICE GOSS: I'll give you each a copy of the non-sitting days as known at present, which does include one week before the bank holiday at the end of May, where the court will not be sitting 3 days and we're going to have to make a decision about that week. You'll see we've already got seven non-sitting days in May. So I'm not saying anything further at this stage, but we're just going to have to consider what's going to be done. That's why I didn't go beyond April with them.
Ms Letby is being brought tomorrow, is she?
MR MYERS: Yes, we understand she is, and we're grateful for that. We'd be grateful just for the opportunity for a brief visit at the end of today, at the conclusion today.
MR JUSTICE GOSS: I can see the officer is nodding. Thank you very much indeed. (4.12 pm)
(The court adjourned until 10.30 am Wednesday, 19 April 2023)
Source Transcript (PDF) - Police interviews Day 2
MR ASTBURY: My Lord, may I recall, please, Sergeant Stonier, and we'll return to the interviews.
MR JUSTICE GOSS: Certainly.
DC DANIELLE STONIER (continued) Examination-in-chief by MR ASTBURY (continued)
MR ASTBURY: Sergeant Stonier, we dealt with, on the last occasion, the first interview concerning
[Baby A], which took place on 4 July 2018; is that correct?
A. Yes, that's correct.
Q. Just by way of reminder, if it's necessary, more than one baby was discussed on that date and
the following day; is that right?
A. Yes, that's right.
Q. But for presentation purposes we are dealing with or compartmentalising, if I can use that
word, each baby in turn; is that right?
A. Yes, that's correct.
Q. So rather than the next baby being discussed on 4 July, we're going to go to the next
interview involving [Baby A]?
A. Yes.
Q. Thank you. That should be behind divider 2, please. Hopefully everyone has the frontispiece and a page [document redacted] on the top right-hand corner.
These have been paginated in such a way that it's the baby but consecutive page numbers, so clearly the last interview was 23 pages but we've carried on the pagination individually for [Baby A].
We can see from the date, this is now 11 June 2019; is that correct?
A. Yes, that's correct.
Q. So the next occasion upon which the defendant was interviewed about [Baby A]; is that
correct?
A. Yes, that's right.
Q. We heard some admissions on the last occasion to say that this was the next occasion upon
which Lucy Letby was arrested by the police.
A. Yes.
Q. Thank you. So if we can present them in the same fashion, please. I'll, as best I can, play
the part of the police officers if you can give the answers that Ms Letby provided.
A. Yes.
Q. Thank you.
We heard last time about the caution, so there was a series of introductions and caution; is that
correct?
A. That's correct.
Q. People state their name. There's a wording to introduce the interview and then the suspect is
reminded of the caution; is that correct?
A. Yes.
Q. Thank you.
The reply from Ms Letby.
A. Yes.
Q. Okay, Lucy [says the officer], the first baby I'm going to talk to you about is [Baby A].
He then continues:
Do you agree, Lucy, that it was actually you who noticed the colour changing to [Baby A]?
A. I noticed the colour change, yes.
Q. Okay. Again, was it you, Lucy, who connected the fluids to [Baby A]?
A. No, from my memory it -- it was Mel.
Q. And then in summary, Ms Letby was asked whether she was standing or stood by [Baby A]'s
incubator when he collapsed. She replied?
A. I was stood by the incubator carrying out my checks.
Q. Were you stood by his incubator when his monitor sounded?
A. I don't recall exactly when his monitor sounded. If I was stood at his cot side then, yes, I
would have heard the monitor. I agree I was stood at the incubator checking, carrying out my
checks as I said before.
Q. But you don't remember the alarm sounding?
A. I don't remember specifically, no. It was a long time ago. I don't remember what monitor went
off when.
Q. Okay. But do you remember you think that it was Nurse Taylor who connected the fluids
then?
A. Yes, but that is only from my memory.
Q. It's a long time ago.
A. Yeah. No, I agree, as in the fluids. She did sit at the computer writing her notes while I was
checking the fluids and everything else.
Q. Is it at that point, Lucy, that you have caused harm to [Baby A]?
A. No.
Q. Is it at that point, Lucy, that you have murdered [Baby A]?
A. No.
Q. Lucy Letby was informed of the experts' view concerning air embolus, and she replied.
A. Well, I don't know how he would have received a bolus of air. From which line? Does it say
which line?
Q. How would that be of significance, Lucy?
A. Um, because whoever did connect the fluids, either myself or Mel, they were connecting via a
long line.
Q. Mm-hm.
A. It'd be very hard to push air through a long line.
Q. See, you do know a little bit about it then, about air?
A. I know how we -- no, but I know how you flush fluids through a long line and that's a very --
it's a hard pressure to push through. I don't know how you'd push air through a long line.
Q. So are you saying that this was an accident then, Lucy?
A. No, I am saying I don't know how that occurred but I did not do anything deliberately and, yes,
they've quoted me being stood at the incubator, but that does that not mean I was doing anything
untoward to [Baby A].
Q. Was anyone else next to you by that incubator when the alarm sounded and stuff?
A. From memory, Reg Harkness was in the room at all times. He was with [Baby B] and Caroline
Bennion, another nurse, from memory, was in and out of the room.
Q. So you remember that?
A. From memory, yes.
Q. But you don't remember about the line? So you remember the line but you don't remember other
issues about that particular collapse, do you?
A. No.
Q. Did you deliberately inject air to [Baby A]?
A. No, I did not.
Q. Did you see anyone else cause harm to [Baby A]?
A. No.
Q. Do you have any explanation, Lucy, for [Baby A]'s collapse?
A. No. My concern at the time with [Baby A] was whether they -- there had potentially been an
issue with either the fluids or the line because it was so quickly after the fluids had been
connected that there was a problem. Um, I know I had asked for all fluids to be kept, for the bag
at the end to be checked. I don't know whether that was done or not. Do you know if --
Q. What can you tell me about air embolisms?
A. I don't know a lot air embolisms. I know when we're priming lines we're always taught to prime
the lines fully to make sure that the lines don't have any air in them because that would be
dangerous to the patient.
Q. Mm-hm. But when were you taught that, Lucy?
A. When I first very started doing fluids, when I started on the unit.
Q. Do you remember who told you that?
A. Not specifically, no.
Q. Right. But that's something you clearly knew, you were aware of?
A. Yes, it's something that all nursing staff -- we're very meticulous about checking the lines.
Q. And you'd be aware of the consequences of getting that wrong, would you?
A. Yeah, I think all nursing staff would be aware of that.
Q. And what are those dangers, Lucy?
A. Well, I don't know what it would cause, but you don't want air going into the bloodstream.
Q. Why?
A. Because that's just not where air would go -- it's not the natural pathological of where air
would be [as read].
Q. And what are the consequences then if air was in the bloodstream?
A. I'm not sure. Would it affect the baby's perfusion? I don't know exactly how it would affect a
baby.
Q. And Ms Letby maintained and continued to maintain she was not responsible for the death of [Baby A].
Again, officer, I know we covered this last time, but these are summaries of what are longer
interviews, simply reduced for the benefit of the jury; is that right?
A. Yes, that's correct.
MR JUSTICE GOSS: They're in part summary and in part verbatim. It's the relevant extracts. That was a 51-minute interview, as you'll have seen from the beginning, and that's just what are agreed to be the relevant parts of that interview. Otherwise you appreciate we would be here for an awful lot longer. I'm not going to point this out every time. You can see the record on the first page.
And we turn over, presumably now, Mr Astbury, to the next one, [document redacted]. You'll see the time of that one and, again, it has been significantly reduced.
MR ASTBURY: This is one of those occasions where other babies (sic) are interviewed in a longer
interview but again it's just distilled to [Baby A] for these purposes.
A. Yes, that's right.
Q. Thank you. So if we move on, we are now dated 10 November 2020; is that correct?
A. Yes, that's correct.
Q. The next is the third occasion upon which Ms Letby was arrested --
A. Yes, that's right.
Q. -- and a series of interviews took place. If we go in the same fashion again and we begin with a summary, which reads.
Following introductions and caution, officers recapped previous interviews concerning [Baby A].
The question is asked:
Did you ever try pushing air through long lines, Lucy?
A. No.
Q. Did you push air through [Baby A]'s peripheral line or his UVC?
A. No.
Q. Is there any way that air could accidentally be inserted through the UVC?
A. Not that I'm aware of, no.
Q. Would there be any visible changes to the skin, do you know?
A. I'm not sure.
Q. Can you explain to me what internal effects this process would cause?
A. If there was air down the line?
Q. Yes. And had been administered into a neonate.
A. Like an air embolism, an air embolism?
Q. Do you want to elaborate what that is for me then, Lucy?
A. I don't know exactly what it is, but when we were taught about lines and things, that's the
things we were taught of: that you clear the line and don't -- you know, make sure you haven't got
air -- any air in because that's what it could lead to.
Q. And you were fully aware of that throughout your time on the NNU and you were confident about
that process?
A. Yes.
Q. Lucy Letby was then informed of Professor Arthurs' opinion, he having viewed the radiographs
and was asked:
Is there anything you would like to say regarding that observation from Dr Arthurs, Lucy?
A. No, I can't explain how that air got there.
Q. Lucy Letby was then informed of the opinions expressed by Dr Evans and Dr Marnerides, and
asked:
Is there anything you wish to comment regarding this?
A. I did not deliberately give him any air.
Q. Okay, Lucy. So we're going to talk to you about some social media and Facebook accounts evidence, okay? DC Stephen Owens has reviewed the data retrieved from the download --
MR JUSTICE GOSS: It says "received"; is it meant to say "reviewed"?
MR ASTBURY: That's my error, sorry, I was looking at "retrieved" instead of "received":
DC Stephen Owens has received the data retrieved from the download and has provided analysis of
searches made through your Facebook account. Can you describe your relationship with the parents
of [Baby A]?
A. There is no relationship with the parents.
Q. You have no relationship, there is no -- did you have any -- did you talk to them, did
you?
A. A professional relationship.
Q. Professional?
A. But nothing outside of the unit, no.
Q. Was that the case with all the parents?
A. Of the babies in the inquiry?
Q. Yes, yes.
A. Yes.
Q. Did you have any contact with them outside of work, Lucy?
A. No.
Q. How did you communicate with them if you needed to speak to them?
A. It would either be in person on the unit or telephone calls.
Q. Any other means?
A. No.
Q. And who instigated the contact? Who would instigate the communication?
A. Well, it'd be either way. It would be if the parent phoned the unit or came to the unit and
asked a question or if I had something that I needed to talk to the parents about.
Q. Did you use social media to research the parents, Lucy?
A. I don't recall.
Q. You don't recall?
A. No.
Q. I take it you remember having a Facebook account?
A. Yes.
Q. Do you still have a Facebook account now, Lucy?
A. No.
Q. Did you ever use Facebook to communicate with your friends and family?
A. Yes.
Q. Did you use it to search for individuals?
A. Yes, at times, yes.
Q. But you don't remember researching the parents and any of the babies?
A. Not specifically, no.
Q. What device did you generally use when you were communicating with friends and family?
A. Which device?
Q. With your Facebook account on.
A. Usually a phone or a tablet.
Q. And where would these searches take place, generally?
A. Searches?
Q. When you were searching for friends or family?
A. Oh, I don't know. Anywhere. At home or out.
Q. Did you friend request any of the parents of these babies at all, Lucy?
A. Not that I remember, no.
Q. Did they contact you at all through Facebook?
A. I can't remember.
Q. So from our records, Lucy, [Baby A], who was born on 7 June 2015, and died on 8 June 2015, on
four attempts, 9 June, 10 June, 25 June and 2 September 2015, you searched on your account for the
name of [Mother of Babies A & B], which we know is the mother. Can you give any explanation for
that?
A. No.
Q. Do you agree you made those searches on Facebook then now I've told you this?
A. Yes. Yeah, if they're there, but I don't recall why or that I've pursued it any further in
terms of asking them to be friends or messaging or anything like that.
Q. There was obviously three searches, Lucy, in June, pretty much after the birth and, obviously,
the death of [Baby A] as well. When were you searching? What were you looking for?
A. I'm not sure. I don't know that I was looking for anything.
Q. Okay. Then you -- the next search you did, the final search, was in September, the same year,
2015. Again, when you searched for [Mother of Babies A & B], what were you looking for on that
occasion?
A. To see if they -- to see how maybe [Baby B] was doing.
Q. Okay. And why did you do that?
A. Because we think about the babies on the unit at times and we talk about then and wonder where
they are now and what they are doing.
Q. Okay. What did you find when you did that search for [Baby B]?
A. I don't remember.
Q. Okay. Do you recall what you saw?
A. No.
Q. Did anybody else know you did that search for [Baby B]?
A. No.
Q. Okay. So you said on that one for September you think potentially you were looking for [Baby
B]. What about the ones you did in June then?
A. I don't know.
Q. Okay. Did the mum know that you were looking for updates on [Baby B]?
A. No.
Q. Okay.
And then she was asked:
So it was nearly 6 weeks after [Baby B] had been discharged from the hospital and you were still
looking to see how she was getting on, is that correct, 2 September 2015?
A. Yes, if that's the date, yeah.
Q. Thank you.
That concludes this summary and indeed the three summaries for [Baby A].
A. Yes, that's correct.
Q. My Lord, we'll move on to [Baby B], please, if we may. The same approach, officer, the three
interviews for [Baby B] together rather than in chronological order --
A. Yes.
Q. -- together with other babies. We have Lucy Letby and the date on this interview is 4 July
2018. We can see the total duration. If we turn the page for the summary, please. The jury will
see this is obviously the continuation of an interview that's already started, I think in
relation, on this occasion, to [Baby A].
A. Yes.
Q. So it carries on but we put it separately for [Baby B]:
So we're going to move on to [Baby B] now. I think you've had a copy of the notes. I take it prior
to the interview you've had a chance to discuss that with your solicitor?
A. Yes.
Q. Do you remember [Baby B]?
A. Yes.
Q. Do you remember obviously [Baby B] in relation to [Baby A] and the relationship there?
A. Yes.
Q. Okay. Other than the notes that you've looked through, do you remember your involvement with
the care of [Baby B]?
A. No.
Q. Okay. So what we're going to do then, we'll just go through those particular notes that you've
had a chance to look at and (inaudible: coughing) 9 June 2015, I think that says "nutrition
prescription".
A. Yeah.
Q. Okay.
My Lord, it might be one of those occasions when we could have the tile up so the jury know what's being discussed. If I can ask Mr Murphy to go to tile 213, please.
The question was asked:
Perhaps you could just describe to us what that is and sort of who signed what?
A. Yes, this is a prescription for TPN, which is parenteral nutrition that we give to babies and
that consists of Babiven and lipids, which is two separate infusions. So this here is what has
been prescribed at the rate here.
Q. And Lucy Letby explained the various information contained within the prescription, confirmed her signature and that of [Nurse A]. If we can scroll down, please.
So this is the document that's been discussed in this phase of the interview?
A. Yes, it is.
Q. Okay:
Can you just tell us the date and time that you commenced them?
A. I believe that's 10 June 2015 at 00.05.
Q. Lucy Letby was then asked about the relevant fluid chart. She confirmed that it recorded a morphine infusion of 40 micrograms from a premade syringe, the volume was 4ml and was administered via a bolus, administered with a push, not via a pump.
Then it says:
What time was that on there?
If we go to tile 241, please, Mr Murphy. The question was asked:
Okay, so what time is that one on their (sic) page?
A. 10 June 2015 at 01.08.
Q. Are we right in saying then, Lucy, that in respect of the first two entries you're involved
with the care of [Baby B]?
A. Yes, from a perspective, yes.
Q. Ms Letby was then shown the record of the infusion beginning, which is this document at 1.10
am, which followed the bolus.
A. And that's myself and another nurse that has given that.
Q. Okay. Again, you signed it first there?
A. Yes.
Q. Does that --
A. So presumably, yes, I --
Q. Do you remember that?
A. I don't remember, but usually whoever signs --
Q. Okay.
A. The top is the person that has given it.
Q. Okay.
Then the interview moved on to the parenteral nutrition form and Lucy Letby described the various
entries and how it would be checked.
A. Then when we've done that, we sign with the lipid batch number and document that here and write
the time that we've commenced it.
Q. Okay. When you say "we", is that somebody else's signature there?
A. That's my signature.
Q. Yeah?
A. But ideally it should have been co-signed by somebody.
Q. Okay.
I think this is going back to the prescription form, which had the reference to lipid. If we go
back to that, Mr Murphy. The last tile was 213, please. Scroll down a little bit, please. Thank
you:
Okay, when you say "we", is that somebody else's signature there?
A. Yes, that's my signature.
Q. Yeah?
A. But ideally it should have been co-signed by somebody.
Q. Okay. At 00.05, that's your signature?
A. Yes.
Q. So essentially your signature on there means what with regards to this, that it's you that's
check it or you that's administered it?
A. That I've checked it.
Q. The officers then asked Lucy Letby about the blood gas chart, which is at 232, please, Mr
Murphy:
Okay, so that's really just a record, isn't it, signed by you and dated?
A. It's just -- yes.
Q. So what's that, that date there -- sorry, that time, is that a time or a date?
A. 00.51.
Q. Time, okay. And again?
A. So that I've written there, so this gas was taken during Neopuffing.
Q. Right.
A. So the baby was being Neopuffed with a pressure of 30 over 6 in 100% oxygen.
Q. Okay. Is that an event there? Is that something happening that she's being Neopuffed?
A. Yes.
Q. Lucy Letby was then shown the relevant observations chart, which is at 237, please, Mr
Murphy:
What does that say to you?
A. So this is an observation chart.
Q. Yes.
A. So we usually do hourly observations on the babies, so I've carried out observations at 01.00
hours.
Q. Okay.
A. So I've documented her heart rate, her respiratory rate, and when it's a cross it means that
it's a ventilator rate.
Q. Lucy Letby then explained the various other entries on the form. The officer said:
Okay.
A. I haven't done a temperature at that time because we don't always do temperatures hourly.
Q. Okay. Is there a reason [this is where we should perhaps focus on the form] there's nothing in
the column before apart from the top, that part there, there's no signatures? Are you aware of any
reason why that would be?
A. No.
Q. Okay.
A. In this column here --
Q. Yes.
A. -- where it's not signed? No.
Q. And there's no values in it there -- well, there's a couple but some are missed off.
A. No.
Q. Okay is there a reason why there you've only got one signature on that form, Lucy?
A. I can't recall specifically, but sometimes you would do separate observations -- if the nurse
caring for a baby was on a break you might cover for them or if they were busy doing something
with the baby. Sometimes another member of staff would record the observations for them.
Q. Okay. Do you remember who the designated nurse was for [Baby B] on this --
A. [Nurse A].
Q. How do you remember that clearly?
A. I don't remember, I can just see from these signatures.
Q. From the notes?
A. Yes.
Q. Okay, and who were you designated nurse for?
A. I don't recall.
Q. Okay. Well, thank you for that. So on that particular shift then on 9 June into the 10th, do
you -- do you remember the shift at all?
A. Not with any clarity, no.
Q. Or any observations that you had with [Baby B] that caused you concern at all on that
shift?
A. I do remember that she had some mottling that looked a little bit similar to [Baby A]'s
appearance the day before.
Q. Okay, and how did you become aware of that?
A. One of the staff nurses had raised concerns and got the doctors to review her.
Q. Do you remember who that was?
A. Who reviewed her medically?
Q. Who the staff nurse was.
A. I think it was [Nurse A].
Q. Okay, and that mottling as you've described it, is it something you witnessed in [Baby B]
yourself?
A. Yes.
Q. You did? When was that?
A. I don't recall at what point.
Q. And the circumstances around you seeing this mottling, who was there with you at the time?
A. I think it was [Nurse A].
Q. Okay. Can you describe that mottling? Is it similar to that with [Baby A] or different?
A. I remember -- I think she was more mottled as opposed to [Baby A] was paler -- [Baby A] was
more pale centrally and --
Q. Okay.
A. -- mottled peripherally and I think from what I recall [Baby B] was more mottled and that
extended over more of her body rather than just her limbs.
Q. So was it a different colour?
A. From what I remember it was just darker than [Baby A]. So [Baby A] was pale, whereas [Baby B]
was more mottled, which is this sort of purply red --
Q. Right, okay.
A. -- rash appearance.
Q. And any particular shapes to that?
A. Well, usually mottling is sort of a patchy round appearance.
Q. So as the experienced nurse you are, what was that saying to you differently to [Baby A]? You
-- what was going through your mind at the time when you saw this?
A. I don't recall.
Q. Okay. When you saw that, did you take any action in the treatment of [Baby B]?
A. Not that I remember, no.
Q. Do you recall whether [Baby B] was attached to a monitor at all?
A. I don't recall specifically, but the majority of babies on the unit are attached to a monitor,
so I'd assume that [Baby B] had been.
Q. Do you remember any alarm activation at all from a monitor?
A. No.
Q. So you remember seeing this mottled effect on [Baby B], do you? Do you remember the event that
took place just after midnight? Do you remember what happened to [Baby B] then?
A. No.
Q. No? Were you aware later that something had happened to [Baby B]?
A. Yes, I know something happened to [Baby B] but I'm not -- I don't remember specifically at what
time or how that event happened.
Q. Okay. I'm just thinking in -- when you witnessed this mottling effect on [Baby B] whether or
not it was shortly afterwards or before.
A. It was -- it was before any resuscitation was being performed, I think.
Q. Right. Do you remember how long before?
A. No.
Q. Okay. I take it when a baby is struggling, you know, the designated nurse would call out for
help and assistance. Am I right in saying that?
A. Yes.
Q. So in this particular instance, with [Baby B], do you remember any -- any calls at all from
any of the nurses asking for help or assistance?
A. No, I think from memory [Nurse A] alerted me to the rash -- well, to the mottling appearance. I
don't recall after that how -- who came after that or who asked for further support.
Q. When she alerted you, what were you doing, what had you been doing just before that?
A. I don't recall.
Q. Do you remember which baby you were caring for at that time?
A. No.
Q. No? Do you remember if you were working in the same nursery at that time?
A. No.
Q. Okay. But [Nurse A] (sic) called out to you to see this particular rash on the baby so --
A. I believe so, yes.
Q. Okay. So would it be fair to say that you were in the vicinity of [Nurse A] (sic) or would
have -- is it possible that she could have come to you in another room and asked?
A. It's possible I was either in the room or maybe at the nurses' station. If somebody shouted
from nursery 1 you would hear them from the nurses' station.
Q. Were you involved at all with [Baby B]'s parents? I know obviously when [Baby A] sadly passed
away you were, but when [Baby B] was struggling, were you involved with the parents then at
all?
A. I believe I had conversations with them, but I don't recall specifics but I do remember seeing
the parents.
Q. Okay. So it's fair to say then in regards to this particular episode for [Baby B] that you
don't particularly remember the shift, you remember being called by [Nurse A] (sic) to have a look
at this mottling on the abdomen of [Baby B], yeah?
A. Yes.
Q. Do you remember any collapse event?
A. I remember her requiring resuscitation, but I don't recall how -- how that transpired, how it
got to that point --
Q. Right.
A. -- or when that happened.
Q. But you became aware of that post-event? You weren't involved with the resuscitation
yourself?
A. I don't remember my role in the resuscitation, if I did play a role.
Q. Okay.
Then one officer asked the other:
Anything you want to ask?
So the things that we've referred to here, do they constitute you giving [Baby B], in some
capacity, care?
A. Yes, if I delivered a medication.
Q. Okay and in -- under what circumstances would that be? I know you referred to one that may be,
maybe it was a break. Would that apply to all of them?
A. Possibly, or if the nurse caring for that baby is doing something else with the baby then other
members of staff may do their drugs for them or if they are preparing drugs --
Q. Right.
A. -- for another baby anyway. Sometimes that person will carry on and do the drugs for --
Q. Okay.
A. -- that baby.
Q. For those ones that we've talked about, do you recall when you had that contact with [Baby B],
if you had any concerns for her?
A. I don't recall having any concerns, no.
Q. Okay.
A. I don't remember specifically the contact but I don't remember there being any concerns. But
I'm not sure at what point.
Q. If you had have had concerns, what would you have done?
A. Raised it to the nurse looking after her or the doctors.
Q. Okay. And from what you just said, it was [Nurse A] (sic) potentially that raised the issue
with you about the mottling, it wasn't you that raised it, or you don't recall?
A. I don't recall. I think it was [Nurse A] that alerted me to it.
Q. Okay. What was your understanding of the clinical position of [Baby B]?
A. Prior to this event?
Q. Yeah.
A. That there hadn't been any undue concerns expressed.
Q. And do you remember where [Baby B] was, which nursery [Baby B] was in?
A. Nursery 1.
Q. Okay. And you don't remember whether you were working in there or not?
A. No.
Q. Right. Did you have cause to handle [Baby B] at all?
A. I would have handled her to an extent to give the medications and to attach those lines.
Q. And then we've summarised that Lucy Letby explained that she would not have needed to handle
[Baby B] when attaching the bag to the long line. She would have gone to the baby, together with
her colleague who connected it to the patient. Lucy Letby was then asked about the entry detailing
the morphine bolus, which I think we've already looked at, at tile 241.
A. Okay, so that's the morphine bolus, so that would seem that I would have given that to [Baby
B].
Q. And physically, what do you do?
A. Attach the morphine syringe to [Baby B] and give the volume. It says IV. I'm not sure which
type of access [Baby B] had, whether it's a peripheral cannula, a long line or a UVC.
Q. So that's a physical pressing of a syringe into the baby via something?
A. Yes.
Q. But you can't be sure what that was, what the apparatus was?
A. I'm not sure which line it was delivered through, no.
Q. Okay. So that would be physical contact?
A. Yes, to attach to the line, yes.
Q. And who's that there, sorry?
A. Mary Griffiths (sic).
Q. So would Mary be with you on the signing out and the administration?
A. Yes.
Q. Okay.
Then Lucy Letby explained that blood would have been taken by a heel prick from [Baby B], that a
doctor would have been required for any other method:
At that time then do you remember how [Baby B] -- how she was presenting?
A. I don't recall at that time, but looking at this it was happening during Neopuff, so she was
obviously being Neopuffed by somebody whilst I was taking the blood gas.
Q. Right.
A. And the blood gases aren't great, so --
Q. So does that say to you that's post-collapse?
A. Or during, yes.
Q. How did that sort of make you feel? You'd been involved with [Baby A]'s care the day
before.
A. The only concern primarily were the parents and how they were coping with that. Obviously
they'd already lost [Baby A] and then to have to see [Baby B] go through resuscitation...
Q. You said you had a bit of contact with the parents following [Baby B]'s collapse. What was
that, can you remember?
A. No, I don't recall specific things, what was said or anything, no.
Q. So were you present at all when [Baby B]'s parents were asking questions, making requests
following [Baby B]'s collapse?
A. Yes, I was there in the nursery with them, yes.
Q. Was anyone else there with you?
A. I don't recall ever being on my own with them.
Q. How come you recall that specifically, being with them after that in the nursery?
A. Because I just remember how upset they were.
Q. Right. There's nothing else that sticks in your mind as a reminder?
A. No, I think it's just that they were there again and saying they didn't want this to happen to
[Baby B], what had happened to [Baby A].
Q. You must build up quite a rapport with the parents through the care of their babies, am I
right in saying that?
A. Yes, we get to know some of the parents quite well, yes.
Q. Is there anything particular about [Baby A] and [Baby B]'s parents that warmed you to
them?
A. Just I know they'd waited a long time for [Baby A] and [Baby B] and that they were much-wanted
babies.
Q. Who told you that?
A. It was known through the handover that we have. So when we have nursing handover you have a
little bit of background as to the parents and the pregnancy and things.
Q. Does that sort of change the way you deal with them at all or affect the way you deal with
them?
A. No, I'd like to think that you treat all parents the same but obviously you just bear in mind
what they've gone through to get to that -- to get to this point, but I think that the care you
would give them and their babies would be the same as -- as any other parents.
Q. And following [Baby B]'s collapse have you kept in touch with them at all?
A. No.
Q. Is that something you have done with other babies?
A. No -- that have died?
Q. Any of them, you know, treated, cared for. Is that a process that you know you would do or
not?
A. No. I have done with -- there was one or two families from Liverpool Women's when I did my
placement there.
Q. Okay. I've got -- when you gave your first account to us you said you think it was [Nurse A]
that called for the doctors. What doctors attended, can you recall?
A. No.
Q. Okay. So I presume you don't know where they were, if you don't know who it was that was
called?
A. No.
Q. Okay, thank you. Is there anything else that you would like to tell us about your care with
[Baby B] and that particular day, that particular episode, anything that stands out you think,
might think would be helpful for us?
A. No, as I say I don't remember specifics with [Baby B].
Q. So it's fair to say you were on the periphery of the care for [Baby B] by the charts that you
have signed and --
A. Yes.
Q. -- some of the processes that you have undertaken?
A. Yes.
Q. And it's fair to say you have seen this mottled effect on the baby but it was highlighted to
you by the designated nurse, [Nuse A] (sic)?
A. I believe so, yes.
Q. But -- yeah, but you don't specifically remember any, any collapse event on that particular
shift?
A. No.
Q. Okay, no. We'll end this interview. If we close, it's 3 minutes past midday.
So as we did with [Baby A], moving on to the second occasion when [Baby B] was discussed, this is
11 June 2019. We can see part of an interview that lasted 51 minutes.
A. Yes, that's correct.
Q. Thank you:
We're going to talk to you about [Baby B] now.
And then they continued:
In your previous interview you remembered that [Baby B] needed resuscitation but you could not
recall how that transpired. Do you remember that in your previous interview?
A. Yes.
Q. Lucy Letby then confirmed her signature alongside the TPN bag and lipid syringe at 00.05 hours
and that her signature at 00.15 hours on the blood gas record suggests that she was involved in
[Baby B]'s care over that period:
That was prior to her collapse at 00.30 hours, [Baby B]'s collapse some minutes later. Do you
understand what we're saying here?
A. Yes.
Q. Lucy Letby couldn't remember if she was allocated another baby in nursery 1:
Okay, so we've got the situation here that [Baby B] collapses and you're there shortly before with
the blood gas record.
We just looked at it so I'm not going to go back to it.
A. Can [Nurse A] remember who took the gas?
Q. Well, I'm saying to you it is possible that it could have been you.
A. It's possible, but have you asked her who took the gas?
Q. Well, I'm asking you if that is you taking the gas.
A. I can't guarantee by what's written on there who took -- I've run that gas on the machine and
written it down, I don't know whether I was the one that obtained the blood or with whether I just
ran the gas for her.
Q. Lucy Letby was informed of the opinion of the experts as to [Baby B]'s collapse and was
asked:
Do you have any explanation, Lucy, for the dislodgement of [Baby B]'s nasal prongs?
A. No, I don't, no, and if we look here she's actually been weaning off CPAP so I'd be concerned,
if she had managed 2.5 hours off CPAP, why dislodged prongs would cause such a deterioration.
Q. So you're saying that's a mistake then?
A. What's a mistake?
Q. That the nasal prongs were dislodged for that length of time.
A. No, I'm not saying that they weren't, I'm just saying that she had previously managed 2.5 hours
off CPAP, so I would be concerned, if they were dislodged for few minutes, why she would suddenly
deteriorate.
Q. Did you inject into [Baby B]'s long line at the time the TPN bag was being connected?
A. No.
Q. Is there anything you want to say regarding [Baby B]?
A. Yeah, I didn't -- I didn't do anything deliberately to [Baby B] to harm her.
Q. Okay. Are you responsible for attempted murder, Lucy?
A. No.
Q. Then the interview was stopped.
The third and final interview in respect of [Baby B] took place on 10 November 2020.
A. Yes, that's correct.
Q. It begins:
Okay, so we'll move on to talk about [Baby B], Lucy.
They summarise the previous interviews concerning [Baby B] and ask:
[Baby B] collapsed. Do you have any explanation for that?
A. No, there's no explanation.
Q. Okay. Is there anything else you wish to add?
A. No.
Q. Okay. When I did the introduction to the interview, Lucy, I said to you that we would be speaking to you about messages recovered from your mobile phone that was taken from you when you were last arrested.
Just pausing there, we've touched on the phones already, but on the first occasion of arrest in
July 2018, that's the phone that was seized by the police; is that right?
A. Yes, that's right.
Q. That's the phone that's given rise to the analysis and the contents that we have seen in a
number of sequence of events charts?
A. Yes.
Q. Thank you:
So on 30 June 2015, at 21.49, [Nurse A] sent you a message that said:
"Yeah, there's something odd about that night and the other three that went so suddenly."
You immediately replied saying:
"What do you mean?"
You then said:
"Odd that we lost three in different circumstances?"
Do you recall that conversation?
A. No, not really, no.
Q. Okay, well, we'll just move on. Okay. [Nurse A] replied saying:
"I don't know. Were they different?"
And she says:
"Ignore me, I'm speculating."
You then respond to [Nurse A], saying:
"Well, [Baby C] was tiny, obviously compromised in the utero. [Baby D] septic. It's [Baby A] I
can't get my head around."
So my colleague's just asked you, do you recall having that conversation?
A. No.
Q. Why did you respond asking her what did she mean?
A. I don't recall this conversation other than obviously reading it there now. I think I'm asking
what does she mean that there is something odd.
Q. Okay. She said that it was odd that you lost three different babies in different circumstances
and you questioned whether they were different. What did you mean by that?
A. I'm not sure.
Q. Okay. She said to you that she was speculating. Do you know what the speculation was
about?
A. No.
Q. So in response to her message, you responded that:
"Obviously [Baby C] was tiny, compromised in the utero (sic)."
As way of an explanation. Tell me what you meant by that?
A. That I said that [Baby C] was tiny?
Q. Yes. "Compromised in the utero" (sic), what did you mean by that?
A. That he was a baby that was born prematurely and unwell at the time.
Q. Okay. So "compromised in the utero" (sic) is that your explanation for that terminology
given?
A. Yeah, so he'd had all nutrients and hadn't grown as well as what we'd expect.
Q. And you said that you "couldn't get your head around [Baby A]". What was it that you couldn't
get your head around?
A. I don't recall saying that. I -- I can't comment.
Q. That concludes those interviews in respect of [Baby B]?
A. Yes, that's right.
Q. Moving on then, please, to [Baby C], who we have just touched upon in that last interview. The
first interview in respect of [Baby C], 4 July again, 2018.
A. Yes, that's correct.
Q. We can see the interview began with introductions and caution.
A. Yes.
Q. Ms Letby replied "yes":
We're going to talk about [Baby C]. At 15.31 hours on 10 June 2015, [Baby C] was born to [Parents
of Baby C] at 800 grams, and [Baby C] was transferred to the neonatal ward. [Baby C] died at 05.58
hours on 14 June 2015. Do you remember [Baby C]?
A. Yes.
Q. Did you have an involvement with the care of [Baby C]?
A. Just with his resuscitation from what I remember.
Q. Okay. Can you explain to us what your involvement was then, please?
A. I'm not sure what my exact role was but I remember him requiring resuscitation.
Q. Okay.
A. I remember that he'd not long had his first feed by one of the nurses and it wasn't long after
that that he deteriorated, so I'm not sure what my role was with him in that resuscitation. I
think I did chest compressions. I remember we waited for the vicar to call and we carried on
resuscitation efforts until the vicar arrived. And then we withdrew care and [Baby C] lived for
several hours after that, around in the parents' accommodation.
Q. Okay. Are you aware of why he required resuscitation?
A. No, I don't recall the events leading up to that I just know that he had resuscitation.
Q. So you're not aware of what the circumstances of his collapse were?
A. No.
Q. Had you had contact with him up to that point?
A. Not that I recall, no.
Q. So in terms of that day in particular, do you know who his designated nurse was?
A. Sophie Ellis.
Q. What kind of time of day was this?
A. Nights. It was on nights.
Q. Your nights?
A. Yeah.
Q. And who were you designated nurse for?
A. I don't remember.
Q. So when did you first become aware of this requirement to resuscitate [Baby C]?
A. I don't remember.
Q. Was it something that you discovered, for example, or was it something you were alerted to and
you reacted to?
A. I don't think I discovered it. I think I became a part of it afterwards.
Q. Okay.
A. I think I'd been asked to help.
Q. You say you don't think, is that because you don't remember?
A. I don't remember.
Q. Okay. So you said that whatever the event was, you said that it happened shortly after his
first feed. Was that his first feed ever or his first feed on that shift?
A. No, I think from memory it was his first feed ever.
Q. Okay, so tell me about what happens with a baby's first feed.
A. So the doctors will tell you that they're happy for a baby to commence feeds and they will be
fed via the nasogastric tube.
Q. Can you remember the feeding method specifically with regards to [Baby C]?
A. I don't know what he was fed. I believe it was nasogastric, but we wouldn't feed him any other
way.
Q. Right, okay. But do you remember that specifically, when you were in resus with him?
A. No, not giving the feed, no.
Q. Okay. Were you involved with that first feed at all?
A. Not that I remember.
Q. Okay. Any care of him at all other than resus?
A. Not that I remember.
Q. So in terms of your role within the resus of him, tell us exactly what you did.
A. I think I did chest compressions but I don't know for certain.
Q. What makes you say that you think you did chest compressions?
A. Because I don't recall doing any drugs for him. I wouldn't have the airway because the doctors
usually have the airway, so I think if I was involved then I would -- the other role would have
been chest compressions.
Q. How do you remember that you took part in his resuscitation?
A. Because I can remember the family and the staff being there around [Baby C].
Q. Okay, so tell us about that then.
A. I believe it was -- Dr Gibbs, the consultant, was there and mum came and I think dad was at
home and he had to come into the hospital and, as I say, they requested for [Baby C] to be
baptised and there was a little bit of a delay in getting the vicar, so we carried on with the
resuscitation efforts until the vicar could come to baptise him.
Q. But what else? Is there anything else that makes you remember him specifically in the
circumstances?
A. I just remember him because he was a small baby.
Q. Do you remember which nursery he was in?
A. Nursery 1.
Q. So tell us about the other members of staff that were treating him during the resus during
your contact with him?
A. I think Sophie Ellis was there.
Q. Yes?
A. I think Dr Gibbs was the consultant and I think it was Melanie Taylor and [Nurse B] that were
the band 6s. And I don't think I remember anyone else.
Q. Lucy Letby then described the different roles undertaken during the course of a resuscitation
and was asked:
What would happen with the resus notes?
A. So they're usually just written down in rough and then --
Q. Yes?
A. -- they're transferred into the medical notes.
Q. What happens to the rough notes?
A. They will be disposed of.
Q. Just prior to the collapse, Lucy, had you any cause to go into nursery 1 at all?
A. I don't remember.
Q. Were you working in nursery 1?
A. I don't think I was, but I don't recall which baby I was looking after.
Q. Okay. And you don't remember the process of how you ended up in nursery 1 with the resus?
A. No.
Q. You've then said that [Baby C], you understood, after the first feed, had suffered a
deterioration. Do you remember what that deterioration was?
A. I think he dropped his oxygen levels.
Q. Right, okay. So you think or you know that he dropped his respiratory --
A. I think.
Q. Is that from memory?
A. Yes.
Q. How would you become aware of that then, Lucy?
A. Either somebody alerted me or his monitor would alarm.
Q. Right. Do you remember somebody alerting you about that?
A. I don't remember.
Q. Lucy Letby then explained that during resuscitation there had been a delay while the vicar
attended to baptise [Baby C]:
Right, you mean you mentioned about the parents being there. Were they there when you first
arrived or did they come --
A. No, I think mum came after and then dad was a little while after that.
Q. Okay.
A. Because I think mum was resident upstairs on the ward so she came quite quickly but I think dad
was at home.
Q. And you don't remember if anyone else was giving resuscitation to him?
A. Not that I remember, no.
Q. Lucy Letby was asked about the decision to cease resuscitation:
Right, and who has the -- well, makes the final decision?
A. The consultant.
Q. And that was Dr Gibbs, was it?
A. Yes.
Q. Okay. You say that then you withdrew care and [Baby C] was with his parents for several hours.
Did you have -- apart from the resus did you have any interaction with them following that?
A. Yes, I think I checked a dose of morphine because he was having morphine around the parents'
accommodation.
Q. So the care essentially carries on, does it?
A. He wasn't receiving active treatment, he was just having morphine for pain relief.
Q. Yes.
A. He wasn't having any other, you know, respiratory support or anything like that --
Q. Okay.
A. -- but he was having the morphine.
Q. And what was your knowledge of [Baby C]'s clinical position, obviously prior to the
deterioration?
A. I don't really recall.
Q. Okay. Just a couple of questions. Did you have cause to alter or deal with [Baby C]'s
equipment that was attached to him at all?
A. No.
Q. Or handle [Baby C] in any way? Did you have a need to handle him?
A. I don't recall handling [Baby C]. I would have done to assist with the resuscitation. I don't
recall handling him beforehand.
Q. When you came on duty, Lucy, you have told us that Sophie was the designated nurse for [Baby
C]. Do you recall who you were working with on that day?
A. No.
Q. Do you know if you were asked to look after any baby whilst a nurse was on her break at all,
in particular [Baby C]?
A. Not that I recall.
Q. Do you remember whereabouts in nursery 1 [Baby C] was?
A. Yes.
Q. Then Lucy Letby was able to mark on a plan where [Baby C] had been situated:
In relation to [Baby C]'s parents, did you have any contact with them at all? I know they were
there when [Baby C] collapsed. Any other sort of contact with them at all?
A. Obviously I know I went to [Baby C] when he was around in the family room with mum and dad.
Q. Right, okay.
A. So I would have had some interaction with them then.
Q. Any prior to the collapse?
A. Not that I remember.
Q. Okay. Again, I know it's another difficult time for you, Lucy, but how did you deal with that?
How did you feel after looking after [Baby C]?
A. I found [Baby C]'s quite hard because of the fact that he did live for several hours
afterwards, which I hadn't seen before. A baby sort of gasping in the parents' room like that, and
then Sophie was particularly upset. I think it had been her first death as well and she was quite
upset about it.
Q. And following [Baby C]'s death, do you -- were you involved with moving (sic) any of the
equipment from him at all?
A. Not that I remember.
Q. Was there any particular task that you were involved with after [Baby C]'s death?
A. As I say, I think I checked some morphine, but I don't recall anything, any other role.
Q. Okay. You talked about the memory box previously on the babies. Were you involved with that at
all?
A. I don't remember. I think I may have done hand and footprints, but I can't remember
specifically.
Q. Would there be a reason why you've done that? You weren't the designated nurse, were you, for
[Baby C]?
A. No, I don't know whether I helped Sophie with them.
Q. Okay.
A. I can't remember for definite. I have a vague recollection of doing them whilst he was sat with
mum and dad, but I can't remember for certain.
Q. What about giving [Baby C] a bath? Did you do anything like that?
A. I don't remember.
Q. No? Were you involved at all with the post-mortem arrangements for [Baby C]?
A. No.
Q. And I take it you didn't have any contact with the family afterwards following that?
A. No.
Q. What about a debrief? Were you involved in a debrief? Do you recall a debrief for [Baby
C]?
A. I don't recall a debrief, no.
Q. Again, you know, we talked about how you were dealing with these situations. Do you remember
specifically with [Baby C] how you -- I don't know whether you spoke to any of your friends or
family to try and ease your mind.
A. I know Sophie and I had quite a long conversation. Sophie and I were both living in the same
area at the time, in nursing accommodation, and we had quite a lengthy conversation about it. And
the girls that were on shift that night, we spoke about it. I don't recall who else I told
specifically.
Q. Okay. Is there anything else you can help us with regarding [Baby C]?
A. No, I don't think so.
Q. At that stage the interview regarding [Baby C] came to an end.
A. Yes, that's correct.
Q. Thank you. Moving on, please, to the next interview. The second interview.
MR JUSTICE GOSS: We'll just do this one and then we'll have the break. I know there is a third one, but the print is smaller on this one, it'll take a bit longer.
MR ASTBURY: Very good.
We move on to 11 July 2019 [sic] and we can see this is part of a longer interview:
Lucy [it begins] I now want to talk to you about [Baby C]. Are you okay to carry on?
A. Yes.
Q. Then the officers interviewing summarised the previous interview concerning [Baby C] and Lucy
Letby was asked:
Okay, Nurse Sophie Ellis has been spoken to, Lucy. She was out of the room at the nurses' station
when [Baby C]'s alarm sounded. She says that you had your own designated baby who was in nursery
3. Do you agree with that?
A. No, as I've said before I don't remember who I was looking after on that shift. I would have to
look and check.
Q. She goes on to say that when she was -- went into nursery 1 in response to the alarms, she
says that you were standing next to [Baby C]'s cot as she entered. Do you agree with that?
A. I don't remember specifically when I entered the room or why I entered the room.
Q. Nurse Sophie Ellis says that you said, "He's just dropped his HR in saturations" (sic), or
something similar. Do you recall saying that to Sophie Ellis?
A. No.
Q. You were placed into nursery 3 during this shift and had your own designated baby to look
after; do you agree with this?
A. Not from memory. I'd have to check. If that's documented as being right then yes, it would of
(sic). I don't remember.
Q. Okay, Lucy, have you got any explanation as to why you were already in nursery 1 when [Baby
C]'s alarms were sounding?
A. I don't recall from memory. I may have been in there doing the checks that we do in the ITU
room, I may have been getting a drug out of the cupboard, might have been using the computer. I
might have heard his alarms, I don't -- I don't recall.
Q. Okay. What checks are they, Lucy?
A. There's the resus trolley that's in the room and the ITU spaces were all checked each evening.
Q. Would you do all that whilst caring for other babies then?
A. Yes.
Q. Had you been treating [Baby C] at this time, Lucy?
A. Not that I remember.
Q. Have you got any explanation as to why you were stood at [Baby C]'s cot side as Sophie Ellis
has told us?
A. No. As I say, not from memory. I don't recall why specifically I was there.
Q. The comments that you've made to her, "He's just dropped his HR and saturations", or something
similar to that. Have you got any explanation as to why you made that comment to Sophie?
A. That's what I must have witnessed alarming on the alarm and that's when she come in -- sorry,
that's when she's come.
Q. You have got no explanation as to why you're in nursery 1?
A. No. As I said, I don't recall.
Q. And then the next part of the interview is summarised. The views expressed by Dr Evans and
other clinicians concerning [Baby C]'s collapse were summarised. Lucy Letby agreed that [Baby C]
was stable prior to his collapse. Lucy Letby was asked about messaging, downloaded from her mobile
telephone. If I can ask, please, Mr Murphy to go to tile 147 to begin with. Lucy Letby was
asked:
So this is a conversation between you and Jen. Who would Jen be?
A. Jen is a nursery nurse on the unit, used to be.
Q. What's Jenny's surname, Lucy?
A. Jones.
Q. Okay. So you said there:
"I just keep thinking about Mon."
I presume there you're saying Monday. I feel I need to be in 1.
I think this is the next message, please, Mr Murphy.
If I simply read the messages.
MR JUSTICE GOSS: I think read the messages and just let Mr Murphy go along as best he can.
Otherwise -- you interrupted that message. Go back to it:
"'I just keep thinking about Mon.' I presume you're saying Monday."
Then carry on from there.
MR ASTBURY: The jury will see that the tile numbers are there if they want to cross-reference.
MR JUSTICE GOSS: Exactly.
MR ASTBURY: "I feel I need to be in 1 to overcome it but [Nurse B] said no."
Jen's then responded minutes later:
"I agree with her. Don't think it will help. You need a break from full-on IT. U you have to let
it go or it will eat you up. I know not easy and will take time."
Do you recall that conversation, Lucy, that you had with Jen?
A. No.
Q. Can you tell me where you were when it took place?
A. No, I don't remember the conversation.
Q. What do the messages relate to?
A. I don't remember.
Q. What is it that you felt like you needed to overcome, Lucy?
A. I'm assuming it's this, I'd had a previous bad experience in 1, I don't know what date.
Q. Okay. So this is 13 June, right?
Then Lucy Letby confirmed that with that date in mind, [Baby A] had died on 8 June 2015 and was
asked:
Is that what you could have been referring to, Lucy?
A. Possibly, yes.
Q. You then went on to say to Jen:
"Not the vented baby necessarily, I just feel I need to be in 1 to get the image out of my head.
Mel said the same and [Nurse B] let her go. Being in 3 is eating me up. All I can see is him in
1."
You've then gone on to say:
"It probably sounds odd but it's how I feel."
Jen replied:
"Well it's up to you but don't think it's going to help. It sounds very odd and I would be
complete opposite. I can understand [Nurse B]. She's trying to look after you all."
Lucy Letby was then asked:
Describe the image that you're referring to there, Lucy.
A. I think it's the image of [Baby A].
Q. Okay. What do you mean by "eating you up"?
A. It's very difficult. Whenever you see a dead baby, it's very hard to get that image out of your
head.
Q. And explain to me why being in nursery 1 is going to help you deal with that image?
A. Because I would see different babies in there, it'd be a different scenario to the scenario
that I had that time when he died.
Q. How do you know it's going to be a different scenario?
A. Well, if it's a different baby, it's different staff, it's a different night.
Q. You then went on to say:
"Well that's how I feel and when I've experienced it at the Women's, I have needed to go straight
back and have a sick baby, otherwise the image of the one you lost never goes. Why send Mel if
she's trying to look after us? She was in bits over it. Don't expect people to understand but I
know how I feel and how I've dealt with it before. I've voiced that so I can't do any more. People
should respect that."
Asked:
When you say the image, how did it help it disappear?
A. How did what help?
Q. The image. You've said:
"I needed to go straight back and have a sick baby otherwise the image of the one you lost never
goes."
A. Because I think when you go to the same incubator space and there's a different baby in there
you sort of kind of let that other baby go. Until you go into the space you just always see that
baby until there's another baby there.
Q. So is it the same space or the same nursery?
A. Um, both, really.
Q. And you've said that -- you've voiced it:
"I've voiced it so I can't do any more. People should respect that."
Who did you voice it to, Lucy?
A. I don't remember from memory. I'm assuming from reading that it was [Nurse B].
Q. Okay. At 23.01, you then went on to send a further text to Jen:
"Women's can be awful but I learnt the hard way you have to speak up to get support. I lost a baby
one day and a few hours later was given another dying baby just born in the same cot space. The
girls there said it was important to overcome the image. It was awful. By the end of the day I
realised -- I realised they were right."
Which baby were you referring to there, Lucy?
A. I don't remember.
Q. You then went on to say to Jen:
"Anyway, forget it. I can only talk about it properly with those who knew him and Mel not
interested so I'll overcome it myself. You get some sleep."
Jen's then responded to you, Lucy, saying:
"That's a bit mean, isn't it? Don't have to know him to understand. We have all been there."
You have then gone on:
"I don't mean it like that. Just that only those who saw him know what image I have in my head.
Forget it. I'm obviously making more of it than I should."
How did you feel at the time, Lucy, when (sic) Jen's response to what you were trying to tell
her?
A. Frustrated.
Q. Mm-hm. Is it fair to say that it appears that Jen didn't understand how you were feeling at
this time?
A. Yeah.
Q. And from looking at those messages and reading them, it appears that towards the end of the
communication you're upset by the tone of Jen's messages. Is that how you were feeling?
A. Yeah -- well, I -- I can't remember specifically, but I think I just felt that we weren't
really getting anywhere with the conversation.
Q. Okay. Is it not the compassionate response that you were maybe expecting from her?
A. Yeah.
Q. Okay. At 23.09, Lucy, is when you sent the final message, that final message, to Jen on that
shift, on that day, 13 June, 23.09. And it was a night shift as you've already confirmed in your
previous interview. Where were you when you sent that message to her?
A. I don't remember.
Q. Do you agree that you were at work?
A. I don't -- was I on shift that day?
Q. Sorry [says the officer] and also in those text messages, Lucy, at 21.55, you've actually
said, "Being in 3 is eating me up". So would that suggest that you were on the unit at that time
at 21.55?
A. I'm at work, yes.
Q. Yes.
A. Yeah.
Q. And "being in 3" would suggest that you're working in nursery 3?
A. Yes.
Q. Okay. Sorry. No, so where would you be then, using your mobile phone on the unit when you were
working, Lucy?
A. I don't recall specifically on that occasion. On nights we quite often have our phones out at
the nurses' station.
Q. Okay. I'll just tell you something, Lucy, that might help you. So you sent that final text to
Jen at 23.09 and [Baby C] collapsed at 23.15.
A. Right.
Q. So 6 minutes after you sent that message, [Baby C] has collapsed.
A. Right.
Q. What are your thoughts on that?
A. I don't have any thoughts on that.
Q. So you sent a text to Jen at 23.09, [Baby C]'s alarm has then sounded, Sophie Ellis has seen
you at his cot side, and he collapsed at 23.15 hours.
A. Right.
Q. What are your thoughts on that?
A. I don't recall where I was at that time that I sent that text. I might have been at the nurses'
station and then I've gone into nursery 1 to do something else.
Q. Mm-hm. The text messages suggest that you were frustrated, Lucy, that you weren't working in
nursery 1. Do you agree? I'll just remind you what you said there --
A. Yes. I think I felt that it would help if I could have been in nursery 1.
Q. "I just feel I need to be in 1 to get the image out of my head. Being in 3 is eating me up. All I can see is him in 1."
Yeah?
A. Yes.
Q. And within 6 minutes, as my colleague said, you were in nursery 1?
A. Yeah.
Q. Do you agree with that, Lucy?
A. Yes.
Q. And within them 6 minutes, [Baby C]'s collapsed?
A. Yes.
Q. Did you cause [Baby C] to collapse, Lucy, when you went into him 6 minutes after that
conversation?
A. No.
Q. You were the only staff member in the nursery at the time [Baby C] collapsed as well, weren't
you?
A. Yes.
Q. Yeah. And you were seen at his cot side when his alarm sounded, weren't you?
A. Yeah.
Q. And at that time you were feeling frustrated and upset, which we've gone through, by the tone
of your messages; do you agree with that?
A. Yes.
Q. You've then gone on to attack [Baby C]?
A. No, I haven't, no.
Q. Lucy, did you murder [Baby C]?
A. No.
Q. Can you give us any explanation, Lucy, as to how [Baby C] died?
A. No.
Q. I think we'll bring the interview to a close at that point. It is 18.35 and the interview is now stopped.
MR JUSTICE GOSS: Mr Myers?
MR MYERS: May I make one amendment to something that I said earlier while it's fresh, just for the purposes of clarification. When Professor Arthurs was giving evidence, I referred to the timing of the radiographs, the 05.05 and 11.58, and said it was with Dr Gibbs possibly that we'd established the timing. In fact, I'm grateful for the assistance I've received, it was with [Dr A] that we saw the timing and it was confirmed with him, in fact in re-examination, that in all probability it appears that 5.05 is the pm and 11.58 is am. So they were that way round.
I can give your Lordship the reference to that if it assists, but just to be clear it was [Dr A] that was dealt with, not Dr Gibbs.
MR JUSTICE GOSS: Thank you very much. I have a vague recollection of a doctor dealing with it, but I couldn't remember the identity of the doctor. It's a long time ago.
MR MYERS: I was grateful to be reminded as well, thank you.
MR JUSTICE GOSS: All right. We'll have a ten-minute break then, please, members of the jury, as usual, and then continue with the interviews. You'll appreciate this is going to take well beyond today going through these interviews. We'll have another break this afternoon as well. (12.02 pm)
(A short break) (12.12 pm)
MR ASTBURY: Officer, if we can move on to the third occasion, please, upon which Lucy Letby was interviewed about [Baby C]. If we're all in the right place, it should be [document redacted] in the top right-hand corner, please, behind divider 3.
We can see the date again, 10 November 2020. The names of those present. This section of the
interview begins:
Okay, Lucy, we're going to move on to [Baby C].
The officers summarised previous interviews regarding [Baby C]. Lucy Letby was asked:
Is there anything you want to add regarding [Baby C] before we move on, Lucy?
A. No.
Q. Okay. Dr Katherine Davis states that she tried to intubate [Baby C] on three occasions, which
were unsuccessful, and she noted that [Baby C]'s vocal cords were swollen and blocking the route
and was therefore unable to complete the procedure. Have you got any explanation for the trauma to
[Baby C]'s airway?
A. No.
Q. Did you cause that injury, Lucy?
A. No.
Q. [Father of Baby C] is the father of [Baby C] and he states that whilst [Baby C] was dying in
one of the nurseries, the nurses said to him words similar to:
"You have said your goodbyes now. Do you want to put him in here?"
Referring to a basket. He described how the comments shook him and upset his wife [Mother of Baby
C] as [Baby C] hadn't died yet. Do you remember making that comment, Lucy?
A. No. Was it myself that said it? I... I...
Q. So if it wasn't you, do you remember who it might have been?
A. No, I don't recall that conversation.
Q. "Do you want to put him in here?", referring to a basket?
A. It was -- it was a basket that they -- sorry, it was a basket that they go in, that they go and
take round into the family room, so that they can have time with the baby, but we weren't taking
[Baby C] away or anything in the basket.
Q. The parents obviously found the comment very upsetting at that time.
A. Yeah, yeah, that's very sad.
Q. You don't recall saying it?
A. No.
Q. [Nurse B], she said she was the nurse in charge at the time [Baby C] passed away and she gave
the aftercare duties with the parents to Melanie Taylor. Do you know Melanie Taylor?
A. Yes.
Q. She said she tried to send you back to JE [we've changed that to the initials, the baby is
named in the interview].
A. Yes.
Q. But for these purposes:
She said she tried to send you back to JE, who you were responsible for in nursery 3. However, you
kept trying to help Melanie. Is this true? Do you remember that?
A. No, I can't remember.
Q. Why would you want to help Melanie when you had your own baby to care for, Lucy, if what
[Nurse B] is saying is correct?
A. Because as a unit we usually pull together and try and support each other on something like
that.
Q. When the nurse in charge asks you to do something, wouldn't you do it?
A. Yeah. I don't recall that I didn't.
Q. Okay.
A. But I, you know, didn't care for my patient [as read].
Q. So in relation to social media, Lucy, as I've just informed you, [Baby C] was born on 10 June
2015 and he died on 14 June 2015. On 14 June, at 15.52 hours, you searched for both [Father of
Baby C] and for [Mother of Baby C]. Do you remember making those searches on Facebook?
A. No.
Q. Why would you have done these searches, Lucy?
A. I'm not sure.
Q. Is there anything you wish to add regarding this?
A. No.
Q. So as we said, [Baby C] was born on 10 June, died on 14 June, Lucy. I want to talk to you about the messages on your phone again.
That's the exhibit reference for the download for the phone, JD-13.
A. Yes.
Q. What nursery was [Baby C] in on the night of the 13th, do you remember?
A. Nursery 1.
Q. Prior to [Baby C] collapsing at 23.15 on the 13th, you were messaging Jen on WhatsApp, which
started around 21.30 hours. There were 21 messages, messages between you, which both stopped at
23.09 hours. 21 messages in total. And you said [at tile 149] you needed to be in nursery 1 to get
the image of the baby on Monday out of your head. You said that Mel had asked to move into nursery
1 and [Nurse B] had allowed her. Had you asked to move too into that nursery to care for --
A. I don't remember.
Q. Did Mel not allow you to move?
A. I don't remember.
Q. You said in one of the messages:
"From when (sic) I've experienced it at Women's I've needed to go straight back and have a sick
baby, otherwise the image of the one you've lost never goes."
I question the fact Mel would not let you go into number 1. Do you remember saying that,
Lucy?
A. I can remember that. I don't remember the whole thing about where I was and what I'd asked Mel
to do, but I do remember the -- above the -- that I mentioned the baby and needing to be in ITU,
yeah.
Q. So if you wanted to get into nursery 1, how did you feel about not being allowed into nursery
1?
A. I don't remember specifically. It's just something that when you experience being with a sick
baby, me personally, to then go into another nursery and have special care babies, it makes it
very hard again to go back into an ITU environment, so I prefer to sort of go straight back into
it.
Q. And that really concludes what was said in that third interview in respect of [Baby C]?
A. Yes.
Q. Thank you.
Moving on next, please, to [Baby D]. The first interview concerning [Baby D], as we can see on
the next page, divider [redacted], took place on 4 July 2018; is that right?
A. Yes.
Q. We can see the times of the interview and the persons present again. If we go to the text, the
interview had commenced with [Baby C], so it's a follow-on from that first interview concerning
[Baby C]?
A. Yes, that's right.
Q. Okay [said the officer], I shall move on. We're going to talk about [Baby D]. At 16.01 hours on 20 June 2015...
And the officers then summarised what happened to [Baby D] on the NNU and the suggestion of skin
discolouration leading to her death on 22 June 2015:
Do you remember [Baby D] at all?
A. No.
Q. Lucy Letby confirmed that she received a copy of the relevant notes. She was shown the neonatal infusion chart and the entry at 02.40 hours on 22 June. The reference there, my Lord, is to tile 227 if anyone wants to look. She confirmed the signatures were hers and Caroline Oakley's.
Lucy Letby was also shown the neonatal prescription chart, which appears at tile 237, and
confirmed the same signatures, hers and Caroline Oakley's, appeared at 01.25 and 03.40 hours:
Right, okay. You're the first signature on those. From that do you presume then that you
administered?
A. Yes.
Q. Lucy Letby confirmed she'd also been involved in the administration of medication to [Baby D]
at 02.39 hours that morning:
Is there anything you can tell us about what happened to [Baby D]?
A. I don't really remember [Baby D].
Q. Okay. At half past 1, we're talking about the half past 1 incident, which occurred on 22 June
2015, do you recall where you were working at that time?
A. No.
Q. Did you have any observations of [Baby D] at all? Did you -- did you go into the ward where
[Baby D] was, into the nursery that (sic) [Baby D] was?
A. I don't remember.
Q. Do you remember that shift at all?
A. No.
Q. Do you remember who the designated nurse was for instance?
A. No.
Q. Or which nursery she was in, no?
A. I believe she was in nursery 1, yes.
Q. What makes you think that?
A. Because I remember drawing up the medications in there and I think I did draw up some
medications in there.
Q. Right. Why would you be involved with the care of [Baby D] if you weren't the designated
nurse?
A. Because two people are needed to administer drugs.
Q. You were involved with the care somewhat but you can't remember being asked to help or --
A. No.
Q. -- being approached by another nurse?
A. No.
Q. Do you remember helping out with a break at all when a nurse went on a break?
A. No, I really can't remember.
Q. Okay. In terms of these here that we've just spoken about, again when you say -- you talked
about a flush?
A. So a flush is where we give sort of millilitres of normal saline after giving the medication so
that it's flushed through and not sitting in the end of the line.
Q. So is that a needle in like you were describing?
A. It's a syringe attached to the end of the IV port, yes.
Q. So that's a physical act?
A. Yes.
Q. Okay. And would that take two of you to do that or is it just the drawing of the
medication?
A. It wouldn't take two people to give it, no, unless it was given sterilely, but usually if you
draw it up it would just takes one person to actually give it.
Q. So [Baby D] suffered three episodes before she sadly died and you can't remember any collapse
of [Baby D], any involvement in the care for [Baby D] at that time?
A. No.
Q. You can't remember being called to help or to -- either seeing [Baby D] struggling at all or
any change of colour to her? You don't remember at all?
A. I don't recall [Baby D], no.
Q. No. And that was the same at 3 o'clock: she started crying, she desaturated again, something
you don't remember?
A. No.
Q. And this discolouration to the skin, to the trunk, legs and arms and chin, you don't remember
that on any of the babies on that particular day?
A. Not enough to comment on, no.
Q. And obviously, sadly, [Baby D] passed away. Do you recall getting involved with the
resuscitation at all of [Baby D]?
A. Not that I remember. I think I drew drugs that day -- well, I did draw drugs that day.
Q. Okay, and again with the family, do you remember [Baby D]'s family?
A. No.
Q. So other than the notes you signed, is there anything else that you can remember about that
particular shift?
A. No.
Q. So taking those notes away, you wouldn't have remembered [Baby D] at all?
A. No, not enough to confidently say what happened, no.
Q. Pausing there, that's a reference to the notes that Ms Letby's been provided with to refresh
her memory during the interview.
A. Yes.
Q. Thank you:
So which one of those procedures there would involve sort of handling [Baby D]?
A. Well, all of them to attach the medication to the port.
Q. Okay.
A. I don't touch the baby, you just have to connect the end of the fluid to the cannula or the
line that they've got in place.
Q. Right, so you don't have to move the baby?
A. I don't physically pick up the baby or move the baby, no, it's just connecting.
Q. Does that cause them to wake up or can they feel that?
A. Sometimes they can feel the flush going through, yes.
Q. Right, but you don't recall any reaction to that?
A. No.
Q. Is there anything else that you want to say about [Baby D] that you can recall or help us out
with?
A. No.
Q. Okay. So I think we might as well go to a break then. It's quarter past 2 and the interview is at an end.
We move to the second interview, please, in respect of [Baby D], which takes place on 11 June 2019 and is at [document redacted] in the top right-hand corner.
It begins with introductions and caution; is that right?
A. Yes, that's correct.
Q. Then:
Okay, Lucy, we're going to talk to you now about [Baby D]. Okay?
A. Yes.
Q. The officers summarise the previous interview regarding [Baby D]:
You were working in nursery 1 together with Caroline Oakley on that particular shift and you were
caring for another baby; is that correct?
A. I don't remember who I was caring for on that shift.
Q. Do you remember calling Caroline Oakley back after [Baby D] collapsed, Lucy?
A. No.
Q. Is it possible that you did?
A. It's possible. I don't remember [Baby D]. I don't remember the exact events.
Q. Do you now recall being in nursery 1, Lucy, with what I've just said to you?
A. No.
Q. In respect of the baby, if a baby is ill would a nurse go on her break if a baby was ill?
A. It would depend how ill the baby was. If they were acutely unwell, then no. All staff would be
needed on the unit.
Q. So in respect of [Baby D], do you think Caroline would have gone on a break if she thought
that [Baby D] needed care or treatment?
A. Not unless that had been handed over to someone to do in her absence.
Q. Is there any reason why you remember the administering of the medication and not the
collapses, Lucy?
A. No, I've only remembered the medication from looking through the notes and seeing that I
obviously did sign for medications.
Q. Is it because you remember the administration of medication because that's when you took the
opportunity to attack [Baby D], Lucy --
A. No.
Q. -- and administer air?
A. No.
Q. And the view of the experts concerning air embolus was put to Lucy Letby and she said...
A. I did not deliberately do anything to [Baby D], no.
Q. Is there anything you wish to say about [Baby D]?
A. No.
Q. We move to the third interview for [Baby D], which is [document redacted]. It took place on 10
November 2020; is that correct?
A. Yes, that's correct.
Q. Usual set-up on the frontispiece. The previous interviews concerning [Baby D] were summarised
by the officers. Lucy Letby confirmed that she still had no recollection of [Baby D]:
As I said to you before, Lucy, [Baby D] was born on 20 June 2015 and died on 22 June, so 2 days
later. On 25 June you did a Facebook search for [Father of Baby D] and on 25 June, again, you then
searched for [Mother of Baby D]. Do you agree that you made those searches on Facebook, Lucy?
A. I don't now recall doing it, but yes, I must have if they're there, yes.
Q. Explain why you made those searches.
A. I can't explain. I don't remember doing it.
Q. Can you tell me what you were looking for, Lucy?
A. No.
Q. Were you looking for photographs of the babies, Lucy?
A. No.
Q. Are you saying that you definitely wouldn't be looking for photographs, you'd be looking for
something else then?
A. I don't know what I was looking for, but I wouldn't be looking for photos of a dead baby on
their social media.
Q. Perhaps the baby when it was alive?
A. No -- I don't know.
Q. You don't know what you were looking for?
A. No.
Q. Okay. Regarding your mobile phone, Lucy, and the examination of messages that's been
completed, at 8.41 on 22 June 2015 you messaged [Nurse A] about [Baby D]'s death and said:
"Messed about a couple of times and came out in this weird rash. Looking like overwhelming sepsis.
Liz came in, re-screened, et cetera, and reviewing what ABX she was on, et cetera, in case it was
sepsis."
Who said it was looking like overwhelming sepsis, Lucy?
A. I don't recall. From that it looks as though they re-screened her, which is something that we
do to indicate that there is an infection and so we would change her antibiotics to reflect that.
Q. Was it your opinion that it was looking like sepsis for [Baby D]?
A. I don't recall.
Q. At 9 o'clock on 22 June 2015 you said:
"I think there is an element of fate involved. There is a reason for everything."
Tell me what you meant by that.
A. Was it said in relation to [Baby D]?
Q. So that is -- obviously you send that first message at 8.41 to [Nurse A] and then 20 minutes
later you then said to her again:
"I think there's an element of fate involved, there's a reason for everything."
So following on from that conversation.
A. Well, I'm not sure in what respect that was said. You know, I don't know what I've been asked
or what [Nurse A] has said to initiate that. But the opinion would be in that, you know, it's fate
that the babies get unwell sometimes, that's -- but I would have to know the context in which I
said it.
Q. Okay. So you say there:
"There's a reason for everything."
What did you mean by that?
A. Again I'm not sure specifically without knowing what I was talking to [Nurse A] about.
Q. Well, you're talking to her, obviously, bout [Baby D]'s death there and you said there:
"I think there's an element of fate."
Why would you think that?
A. Because sometimes things can't be changed or, you know, fully explained sometimes. That is
fate, like, why is a baby born prematurely or, you know, born with something wrong with it. It's
not always something that's within control, it's fate.
Q. Okay. So later the same day at 20.34, so 34 minutes past 8 in the evening, you messaged [Nurse
A] that Yvonne Farmer said Liz Newby was suggesting it may have been meningitis. Do you recall if
Yvonne said that to you directly, Lucy?
A. No, I don't recall that at all.
Q. Had that ever been suggested before?
A. I don't remember.
Q. Was it a case then that it was just your suggestion that it may have been meningitis for [Baby
D]?
A. I don't remember, so I can't comment.
Q. Okay. At 21.59 hours on 30 June you messaged [Nurse A] and said that [Baby D] was septic and
she asked if it was definitely septic and did the PM confirm it. You replied that the full PM
wasn't back yet. Do you recall where you got the information from that [Baby D] was septic?
A. No. Having looked at that, I wonder if it was after some sort of debrief, but I -- I don't know
for definite, no.
Q. Okay. And how would you have known if the full report wasn't back yet?
A. Well, if I'd been told that by someone medical. We don't have access to records.
Q. Okay. On 26 June, again, the same year, 2015, you have a message conversation with Minna, so a
colleague. Do you recall Minna?
A. Yes, yes.
Q. Who suggested that you should have counselling, but you said that you couldn't do it, you said
that you couldn't talk about it and you can't stop crying. Why could you not do the counselling,
Lucy?
A. I don't recall the conversation.
Q. Have you got anything else you wish to add in relation to those messages or anything else in
relation to [Baby D]?
A. No.
Q. The officer asks the other:
Do you have anything you want to say? Do you remember at the time, around 26 June 2015, after
[Baby D]'s death, were you particularly upset and disturbed by what had happened?
A. I honestly can't remember.
Q. That concluded the interview concerning [Baby D].
A. Yes.
Q. We move on to [Baby E]. We see, hopefully in the top right-hand corner, [redacted]. We can
see, as far as [Baby E] was concerned, that the first interview took place on 4 July 2018.
A. Yes. That's correct.
Q. The interview began, as we can see from the summary, with introductions and caution?
A. Yes.
Q. So we're going to continue [says the officer], the same format as previously, Lucy, and we're
going to go on to [Baby E].
A. Okay.
Q. Okay. At 17.53 hours on 29 July 2015, [Baby E] was born to [Parents of Babies E & F]. At 23.40
hours on 3 August 2015, he suddenly deteriorated and at 01.40 hours on 4 August 2015 [Baby E] was
pronounced deceased. I believe you've had the chance to go through the notes.
A. Yes.
Q. Other than those notes, do you remember your involvement with the care of [Baby E]?
A. Yes.
Q. Okay. Do you want to just tell us then in your own words what you do remember, please?
A. So I remember the care of [Baby E], from memory. I believe he'd been started on insulin earlier
in the day. He was on an insulin infusion, but otherwise doing well and was starting to have
enteral feeds. I remember after some of his feeds for me I was getting large aspirates back from
his NG tube and when I consulted the doctor we omitted, I think, a feed and then his abdomen
became distended and he was reviewed by the doctors and some medications were started and his
abdomen continued to distend and become discoloured and ended up needing respiratory support and
began bleeding and then he needed resuscitation.
Q. Is there anything else from your memory?
A. And I remember caring for [Baby E] once he had passed away.
Q. Okay. So in terms of care given, when was the care given to [Baby E] by you?
A. So I took over on a night shift and so it would have been from around 8 o'clock in the evening.
Q. Is that the 3rd into the 4th? So he died at 01.40 on the 4th, the morning of the 4th?
A. So this was the 3rd, yeah.
Q. The 3rd into the 4th?
A. Yes.
Q. Sorry, go on. In terms of sort of handover what did you understand to be his clinical
position?
A. From memory that he was stable and there was nothing sort of untoward other than the fact he
was on insulin.
Q. Okay. In terms of caregiving, did anybody else have care for [Baby E] overnight on that
shift?
A. Not that I recall, no.
Q. Okay.
A. It was just myself.
Q. In respect of the care, Lucy, where was [Baby E]?
A. He was in nursery 1.
Q. Okay. Do you recall any other babies in nursery 1 at that time on that shift?
A. Yes, I think his brother was in there as well, [Baby F].
Q. Were there any other members of staff there?
A. When? At any point?
Q. On that shift on the night you were caring for [Baby E].
A. I know another nurse was there, I don't know at what point she was in the room, Belinda
Simcock.
Q. Okay. Was she caring for [Baby E]'s brother?
A. I don't remember.
Q. So at what point do you remember Belinda being in there then?
A. I think it was Belinda that was there when he -- when I asked for the help because he had blood
back from his NG tube. I think it was Belinda that I showed it to.
Q. Is that something you think or that you remember?
A. I think.
Q. Right. You've obviously mentioned her name and you obviously think that's the time. What makes
you think it was her at the relevant time when the blood was there?
A. Because I remember showing the blood to somebody and I think it was Belinda.
Q. Okay and what did Belinda say to that?
A. That we discard that and not feed him and then get the doctors to review him.
Q. Okay. So you were his designated nurse, just to make that clear?
A. Yes.
Q. Okay. So you then went on to say that he was doing well, having feeds, and you said something
feeds and I didn't quite catch it. The name of the type of feeds?
A. I think he was starting feeds, I think so.
Q. Okay. And how was he during the feeds on that evening?
A. I think from memory he had one feed that I gave him that was okay and then on the next feed I
was getting a large aspirate back from his NG tube.
Q. Okay. What about the sort of interventions, did he have the up-the-nose tubes?
A. No.
Q. Lucy Letby explained that [Baby E] was attached to a Philips monitor, he had a nasogastric
tube in place and was self-ventilating in air:
Okay, so who puts the tube down?
A. Nursing staff.
Q. Did you do that with [Baby E]?
A. Not that I recall, no.
Q. The feeding charts might show us that, mightn't they?
A. Yes, I don't remember putting the tube in on [Baby E], so I think he would have had it already
in.
Q. So in terms of him doing well, what do you consider as doing well?
A. That his observations were stable, that he was handling appropriately. I think from memory that
his blood sugar levels were stable.
Q. Any concerns at all for [Baby E] at this point?
A. No, not prior to that large aspirate, no.
Q. What about his colour?
A. I don't recall there being a problem with his colour at that point.
Q. Okay. Anything before the aspirate? So you then said there was a large aspirate.
A. I think it was a bile aspirate.
Q. I don't know what that is.
A. Bile is a product that's produced by the liver that we get from the bowel.
Q. Okay.
A. And usually it's a sign they're not digesting their feeds or there's potentially an infection.
Bile isn't something we want to be getting back from the stomach.
Q. What is that suggesting to you then, Lucy?
A. Then there's some sort of abdominal issue.
Q. Is it something you would escalate to a doctor, for example?
A. So usually from my perspective as a band 5, you would ask a senior member of nursing staff, so
a band 6 or the nurse in charge, and they would advise.
Q. Right. Is that what she is?
A. Yes.
Q. And what was the advice?
A. To discard that and omit the feed --
Q. Okay.
A. -- I think from memory.
Q. Okay. Are there any circumstances where you would need to keep the aspirate, the bile-type
substances?
A. You could keep it to show the doctors, and that's what we usually do.
Q. Right.
A. So we discard it from the baby in that we don't return it.
Q. Oh.
A. But we usually keep the syringe to show a member of staff.
Q. Did you do that in this case?
A. I don't remember.
Q. You then said that his abdomen was distended. How -- what kind of time difference is there
here?
A. I'm not sure from memory but I think maybe an hour, something like that. I don't think it was
long.
Q. Okay. Had you gone away from [Baby E] and come back in the hour or were you caring for him
throughout that period?
A. I don't recall if I had another baby that I was caring for at that point, but I don't remember
being with [Baby E] the whole time. Usually for a baby that's self-ventilating, we wouldn't need
to be --
Q. Okay.
A. -- at the cot side the whole time.
Q. Okay. So in terms of the -- his abdomen being distended, can you describe that further for
me?
A. So I noticed that his abdomen became fuller and rounder and then later on in the evening there
was a discolouration area to part of his abdomen, like a purple discolouration.
Q. Okay. So this initial distended abdomen, what does that -- what do you -- what does that
trigger within a neonatal nurse?
A. So you'd be wanting to know why the abdomen's become distended, so usually we would get the
senior nurse to -- or the medical team to come and review.
Q. Okay. So what did you do in this case?
A. I believe I got the doctors to come and review him.
Q. Okay. Do you know who that was?
A. I think it was Dave Harkness.
Q. So this distended abdomen was about an hour after the aspirate. And when did you request
--
A. You'd have to check. I -- I can't remember specific times because I know I got blood back from
his NG tube at some point as well.
Q. Is that before or after Dr Harkness attended and reviewed him?
A. I'm not sure from memory.
Q. Okay. And you said that he was then reviewed. What was the outcome of the review?
A. So we started some -- I think he was reviewed twice but after we started some medications on
[Baby E] because I believe he had antibiotics specifically for the abdomen and also a drug called
ranitidine --
Q. Okay.
A. -- that can help with bleeding.
Q. And was there any other issues causing any concerns with [Baby E]?
A. Not that I recall from memory at that time, no.
Q. Sorry, you then went on to say that -- about the discoloured area. You've touched on that a
little bit. Tell me a little more about the discolouration?
A. I noticed that there was becoming a discolouration to his abdomen, but I can't say exactly
where but there was becoming a patch of sort of purpleness on his abdomen.
Q. And what did that indicate to you? What -- did that cause you concern with regards to [Baby
E]?
A. It caused concern, yes.
Q. Why? Why is that a concern?
A. Because that's not something that is normal for a baby to have.
Q. So in terms of how big the patch was and its location and you know how long it was there for,
what can you tell me about that?
A. I think from memory it was towards the right-hand side, by his umbilicus, but I can't remember
the extent or the size at the moment. We don't see many babies that have abdominal problems and
things like that.
Q. What, the distension or the discolouration?
A. The discolouration.
Q. Okay. What was that a sign of to you?
A. There's an ongoing abdomen problem.
Q. Okay. Did anyone else witness that discolouration?
A. I believe he was reviewed again by the doctors, yes.
Q. How long after the distension did the discolouration appear?
A. Again, I can't be specific on times.
Q. Okay. If you just talk generally, whether it was a few minutes or a few hours, can you clarify
more than that?
A. I would say minutes rather than hours.
Q. Okay. Were you still with [Baby E] throughout these changes?
A. I don't recall if I was there consistently or if I'd left at any point. I don't recall. I think
he -- from memory he deteriorated and was desaturating and having apnoeas and needed some support
with the Neopuff.
Q. Okay. How long after that, how long after the discolouration was that requirement?
A. Again, I'm not sure.
Q. Can you say minutes as opposed to hours?
A. I would say minutes, yes.
Q. Okay. So what action did you take at that point?
A. I think we got the doctors to review him again.
Q. Okay, think or you know?
A. Think.
Q. You think. So when you say we, who's we?
A. I think Belinda Simcock was with me.
Q. Was anyone with you at the point of you realising that he required respiratory support?
A. Not that I recall, no.
Q. Okay. How were you alerted to it?
A. I don't remember.
Q. Lucy Letby, in summary, could not remember how she became aware that [Baby E] required
respiratory support. She confirmed that he was connected to a monitor at the time:
Okay, but you don't recall whether the monitor alerted you to the --
A. No.
Q. -- to the desaturation? Okay. So at that point you think that you obviously responded but
Belinda was there and you that you did -- sorry, did you say you alerted the doctors?
A. I think so, yes.
Q. And who responded to that?
A. Dave Harkness.
Q. Do you know where he was when he was requested?
A. I'm not sure where but he wasn't on the unit.
Q. He was or he wasn't on the unit?
A. Wasn't.
Q. Okay. What's the process that you go through to alert him?
A. I'm not sure because I'm not sure if I was the one who called him or if it was somebody else.
Q. Right, and how long after you realised that this deterioration was going on did he arrive?
A. I can't be specific. I don't know.
Q. Okay. Then you stated there was bleeding. Tell me about that.
A. So I was getting blood back from the NG tube and from memory I'm not sure at what point that
came, that I first noticed that there was some blood coming from the NG tube.
Q. Okay. In how long after you recognising his deterioration did you see the bleeding?
A. I'm not sure if the bleeding came before that or after.
Q. While we're talking about bleeding then, can you describe the, you know what, what colour,
what the colour of that was? I know it's a strange question to ask, but --
A. It was fresh blood.
Q. Okay. What was that suggesting to you then?
A. That it's a fresh bleed, it's an active bleed, it's not old blood, it's new blood.
Q. So what could be going on with [Baby E] for this to happen?
A. That he's bleeding in his abdomen.
Q. Okay.
Lucy Letby was then asked some questions about her notes, notes that she had in front of her
presumably.
A. Yes.
Q. In quotes, and it's at tile 126 if anyone wants to refer to it:
"At 22.00 a large vomit of fresh blood, 14ml of fresh blood. Aspirate obtained with NG tube. Reg
Harkness attended."
Yes?
A. Okay.
Q. Was that the first time that you'd seen blood?
A. I think so, yes. I'd have to check the actual feeding chart because that's where I would
document the aspirates.
Q. The officers then read the relevant note in full or that nursing note in full:
Okay, had you seen any blood on [Baby E] prior to that large vomit of fresh blood?
A. No, not from my notes and my charts, no.
Q. But if -- if you had would you have put it in the notes?
A. Yes.
Q. Okay. When you saw that blood, was anyone there at that time with you?
A. I think I showed it to Belinda. I'm not sure if she was there when I actually obtained it.
Q. Lucy Letby couldn't remember whether Belinda Simcock was in the room with her when she first
saw blood:
What about any of the family?
A. I don't recall. I -- I know mum visited at some point but I'm not sure at which point the mum
was there. I know she was sat with him for a period of time.
Q. Okay. I presume that if she have been there she would have seen the blood herself then, would
she?
A. Yes.
Q. Okay. Do you remember whether or not the family saw blood?
A. I don't remember that, no.
Q. Do you remember any conversation that you had with the family regarding the blood at all?
A. Not from memory, no. I'd have to check my notes.
Q. What about updating the family regarding the blood?
A. I believe mum was updated, yes.
Q. Who updated the family?
A. I think myself and Reg Harkness.
Q. Do you remember when that happened then?
A. I think it was after he'd been reviewed and we had started the medications.
Q. Okay. So Reg Harkness attended. What was his view of the blood? What was his feeling that was
going on?
A. I think he wanted us to start with the metronidazole and ranitidine, which is used to treat
bowel conditions.
Q. Did he have a view of what the condition was for [Baby E]?
A. I think there was mention of it being necrotising enterocolitis and I think he ordered an
abdominal X-ray as well.
Q. Was there any issues with the NG tube at all? Was it correctly fitted?
A. I don't recall there being any issues with it.
Q. In the correct position, was it?
A. Without an X-ray the only way I would know is checking that -- when we document here the length
that it's been inserted, that's what you would check --
Q. Okay.
A. -- prior to aspirate and if the aspirate is an acidic aspirate then it indicates that it's in
the stomach.
Q. So in relation to 14ml of fresh blood, which you put, is that a large quantity?
A. Yes.
Q. Okay. But that was the first quantity that you measured with your treatment of [Baby E] that
evening?
A. Of blood. I'd had the bile aspirate prior to that.
Q. Yes, but that was not blood?
A. No.
Q. You describe that bile aspirate as "mucky"; what did you mean by that?
A. It's mucky, it's sort of dark, it's not pure bile -- so bile is bright green where mucky is
sort of a bit darker.
Q. And that was prior to the 9 o'clock feed that you put in your notes, prior to the 21.00 feed,
yeah?
A. Yes, and that's the feed that I omitted.
Q. Then, in summary, Lucy Letby was able to confirm that she had not fitted [Baby E]'s feeding
tube, he had been due a feed at 21.00 hours, but she had found the mucky aspirate before that and
it had been omitted as a result. She took her times from the clock on the nursery wall:
Would there be any -- at any time if you'd found blood on [Baby E] that you wouldn't have told a
doctor?
A. No.
Q. No, I take it you know the sign of fresh blood being vomited -- was that a sign there was
something serious going on?
A. Yes, I have not seen a baby vomit like that. I have not seen a baby have blood coming back like
that before.
Q. Okay. Would that be something that you would tell the family or is it something that you, you
know, you've dismissed, were you overly concerned at that point?
A. I was concerned in that it was something that I hadn't seen before, but I don't recall the
registrar being overly concerned.
Q. Right, okay. So it's not something that you would concern the parents with necessarily?
A. I think it's something we would tell the parents, probably. I'm not sure without looking at my
notes, notes in terms of them, what they were told.
Q. Okay. If you had told the parents about that would that have been in your notes, would you
have put that in your notes?
A. Yes, yes.
Q. You then go on to say:
"The abdomen was soft and non-distended, the SHO informed, and to omit feed."
Who checked the abdomen?
A. Myself.
Q. Right. So you were happy at that point and you were not overly concerned?
A. No, so I'm happy the abdomen was soft and non-distended and then got the SHO to review him.
Q. Okay. And this would have been after 9 o'clock, am I right in saying that?
A. Yes.
Q. Okay. And the SHO, who was the SHO?
A. I don't remember.
Q. Right. Did they actually attend or did they just give you advice regarding that? You've
obviously got "SHO informed, to omit feed".
A. I don't remember. I don't remember if they physically came or whether that was a telephone
conversation.
Q. Right, but that doesn't remind you at all of who actually saw him or reviewed him over the
phone?
A. No.
Q. Okay. So after whoever it was that came, if they did come, and prescribed this to help [Baby
E]'s tummy settle because of the mucky --
A. Yes.
Q. Is that right?
A. Yes.
Q. And then you've then co-signed it. Did you administer that as his designated nurse?
A. I don't recall.
Q. So was [Baby E] showing any sort of signs or symptoms after the bile that was aspirated?
A. Not that I remember, no.
Q. No, so there was no real change in his handling or anything?
A. No.
Q. And Lucy Letby was then asked about the distinction between the vomit and the aspirate.
A. So a large vomit is -- is a large amount that's come out of the mouth.
Q. In addition to the 14ml of fresh blood aspirate?
A. Yes.
Q. Did he vomit prior to the aspirate?
A. I'm not sure.
Q. If -- you know, how you've written it here, one and then the other?
A. Oh sorry, yes, he's vomited, and then I've got blood back from his tube.
Q. Okay. But are we clear that it didn't occur before 10 o'clock though? You've got at 22.00
hours "large vomit". There is no blood loss --
A. No.
Q. -- prior to that?
A. No.
Q. That was the first time?
A. Yes.
Q. Then the officer returned to the notes:
Okay, and then a further 13ml of blood obtained by 11, 23.00 hours. Where was this obtained
from?
A. The NG tube.
Q. So at this point there's a total of 27ml of fresh blood in the period of an hour, is that
right, together with the vomit of blood? Right, okay. So what was going through your mind at that
time when another 13ml of blood were taken?
A. I was quite concerned.
Q. Lucy Letby could not remember how soon after this further quantity of blood that [Baby E] deteriorated again. She thought Dr Harkness was there at the time.
She was asked:
Around this time just prior to obviously his desaturation, what were your activities?
A. What, for [Baby E]?
Q. Generally.
A. I don't remember.
Q. Okay, because of the previous blood were you around [Baby E] all the time?
A. I don't remember.
Q. Okay. You then go on to say:
"Oxygen given by a Neopuff, toes becoming white and [Baby E] cool to touch."
Like you say, Reg Harkness is present throughout. And then continues with the note.
"[Baby E] began to decline. At 23.40 hours he came bradycardic. A purple band of discolouration over the abdomen. Perfusion poor and a CRT in 3 seconds."
This purple band, can you describe that to us?
A. As I said before, I don't remember it specifically, but I think it was a purplish area around
his umbilical area.
Q. Okay. Was that the same one that you'd previously described?
A. Yes.
Q. Okay. Because you obviously describe it as a band. Why? What do you mean by a band?
A. A band -- it was in sort of a line.
Q. Horizontal or vertical?
A. I would read "band" as horizontal, from memory.
Q. And do you remember the width of that at all?
A. No.
Q. And had you seen anything like that before?
A. No, I don't think so.
Q. The officers read the notes of [Baby E]'s unsuccessful resuscitation and she was asked:
Do you remember what your role was in the resuscitation?
A. I think I carried out chest compressions at one point because I remember I was pressing down
more, more blood came out of his mouth.
Q. So how were you feeling, Lucy, at that time?
A. It wasn't nice to see.
Q. Do you remember what time the mother was present?
A. Only from what I've written there, that was present at the start of the shift and then visiting
again at 10 o'clock.
Q. Okay. Do you remember when she left then?
A. After the 10 o'clock visit when --
Q. This is the note:
"Mummy was present at start of shift attending to cares. Visited again approximately 10 o'clock.
So she's obviously there."
What time would you have come on shift in the morning -- sorry, in the evening?
A. 8 o'clock.
Q. 8 o'clock. Do you remember what time she left before she returned?
A. No.
Q. No, okay. Well, she did leave and she came back, you've put at 10 o'clock.
A. Yes.
Q. Did anything happen to [Baby E] before she returned at 10 o'clock? I think in your notes that
you got --
A. When I look back --
Q. Yeah, you've got this.
A. He had the mucky aspirate at 9 o'clock.
Q. Yeah, but no bleed at all before she returned at 10 o'clock?
A. I think -- well, there was at 10 o'clock, so --
Q. Okay, not before 10 o'clock. We've got she returned at 22.00 hours and I think it was 22.00
hours when we had the large vomit. A large vomit of fresh blood, yeah. So prior to mum coming at
10 o'clock --
A. No.
Q. No. Do you remember how that conversation with mum went regarding that bleed?
A. I remember her being concerned.
Q. Okay. Do you remember what she said to you?
A. Just that she would like us to contact her if there was any further decline or any update for
her. She was resting upstairs at the time.
Q. Okay. Did she see the vomit as well because obviously the first one is at 22.00, "large vomit
of fresh blood", and obviously aspirate obtained from the NG tube.
A. I would assume that she was there then.
Q. During the vomit and the aspirate because it just -- on this communication, excuse me, it just
says that she was aware that we'd obtained blood from his NG tube, not with reference to the
vomit?
A. No, so I'm not sure when he vomited then. I don't think he vomited prior her coming.
Q. So you think he vomited after her coming?
A. Because I think I probably would have written -- explained that we'd had a vomit and blood from
his NG tube if he'd vomited.
Q. Okay, so what does that make you think about the first lot of notes then where it's at 22,
large vomit of fresh blood, and then the 14ml fresh blood aspirate obtained, and that's on the
first page, though, you know at 22.00?
A. That he's had a large vomit at 22.00.
Q. Yes, but obviously you're saying that she, mum, returned at 22.00.
A. I've said approximately, so I don't --
Q. Right.
A. I've written approximately 22.00.
Q. Okay.
A. So I'm not sure.
Q. But obviously this must be post-vomit because that's when you got the blood from the NG tube
because that's what you told her?
A. Yes.
Q. I'm right in saying this -- and then I'm a bit confused, yeah.
Then there's some talking between the officers:
I suppose the question is: how did she become aware? Is it something that you've told her or
something she's witnessed?
A. About the blood from his NG tube?
Q. Mm-hm.
A. I would read from this that I've told her because I've told her that we're starting medications
to treat it.
Q. Okay, okay.
A. So she visually saw it.
Q. So he must -- he must have vomited before then, mustn't he?
A. I would assume so, yes.
Q. So would there be any reason why you wouldn't tell mum over the vomit of blood?
A. No, not that I remember.
Q. What's the conversation that you had with her, can you recall?
A. I'm not sure if it was myself that told her or somebody else and I'm writing that she's been
told because I was there when somebody else told her. I'm not sure.
Q. Right, okay.
A. And then just reading this, I've put that mum was updated by Reg Harkness.
Q. Yeah, okay.
A. So I -- I think it was a joint discussion between myself and Reg Harkness to update mum.
Q. How were you feeling after [Baby E]'s death?
A. It was upsetting, [Baby E]'s.
Q. Whose decision was it for you to bathe [Baby E]?
A. The parents asked me to.
Q. Did you create a memory box for [Baby E] at all?
A. Yes.
Q. On the instigation of who?
A. What do you mean, who told me to?
Q. Yeah, yeah. Did you -- was that something you --
A. It's just something that we do for babies. I don't think anybody told me to do it.
Q. Right. So is it something you would always do? Is it something the family would say, yeah, can
you do that for me?
A. No, we'd do it.
Q. Okay. As a matter of course?
A. Yes.
Q. And again, did you stay in touch with the family at all following [Baby E]'s death?
A. Only for the time that [Baby F] remained on the unit. Not afterwards, no.
Q. Okay. And obviously another stressful day for you. How did you deal with it personally?
A. I don't recall specifically. I know I found it very helpful to -- to have bathed him and had
some time with him and dressing him. I found that quite a privilege that mum and dad wanted me to
do that for them.
Q. Do you have any opinion as an experienced neonatal nurse as to what happened to [Baby E]?
A. No, I'm not medically trained and I don't know exactly what happened to him, but I feel there
was obviously some sort of bleed from his abdomen.
Q. Right, okay.
A. And obviously I did feel that the registrar wasn't overly concerned and, I don't know, I was a
little bit concerned but I felt reassured that he wasn't.
Q. Okay. And following deterioration, did you raise that -- your concerns with anybody?
A. I think I discussed it with Belinda.
Q. Oh right. And what was the outcome of that?
A. I'm not sure.
Q. Okay. And what were the concerns that you expressed at that time to Belinda?
A. I think I spoke to her about that, that I'd not seen a baby bleed in that way before, and her
being more experienced, had she seen it and what would potentially cause that, and was it
something that maybe the registrar could have acted on differently or something that we could have
done differently.
Q. Right. And do you know what her answer was?
A. No, I don't remember.
MR ASTBURY: Right. We'll take a bit of a break, shall we, just 5 minutes? It's 6 minutes past 8.
MR JUSTICE GOSS: Right. That's a convenient point for us to have a break. Just slightly over the hour. It's just after 1 o'clock now, according to that clock. Can I say 2.05, please, to continue? Thank you very much.
(In the absence of the jury)
MR JUSTICE GOSS: I gather everyone's got the updated list and I'm told the jury have got it as well. I'll mention it at the end of today as well, the non-sitting days. Thank you very much. (1.03 pm)
(The short adjournment) (2.05 pm)
MR JUSTICE GOSS: Yes.
MR ASTBURY: Officer, we had reached the second interview for [Baby E], which begins at [redacted] on our pagination. It's an interview which took place on 11 June 2019. Again we have the full interview times set out, but dealing solely with [Baby E], could we pick up, please, with the introductions and caution.
The officers recapped on the previous interview concerning [Baby E]. Followed with this
question:
In your notes you stated that:
"Prior to the 9 o'clock feed, 60ml of mucky slightly bile-stained aspirate was obtained and
discarded, abdomen soft and non-distended. SHO informed to omit feed."
Do you recall, Lucy, which SHO you informed?
A. No, I don't.
Q. Okay. Tell me what was discussed during that conversation.
A. I can't remember whether it was a face-to-face conversation or a telephone conversation.
Q. Okay.
A. I don't recall it specifically, I can't remember who it was with.
Q. Okay. Do you recall the content of that conversation?
A. No, because I can't remember who it was with.
Q. Dr Chris Wood was the duty SHO on this day from 8.30 in the evening. He does not recall
speaking to yourself as indicated in your notes. Do you recall if it was Chris Wood, Lucy?
A. I don't recall who it was, no.
Q. If he was the duty SHO on from half 8 in the evening is it likely it would have been him who
you spoke to?
A. Yeah, him or his registrar, yeah.
Q. Mm-hm. And doesn't have any contact until this is via the crash call system --
A. Right.
Q. -- and says he arrives at around 00.37 hours.
A. Reg Harkness that reviewed the baby?
Q. Say again, sorry?
A. Reg Harkness reviewed the baby at some point.
Q. Okay, but in your notes it says "SHO informed".
A. Right.
Q. That's what I'm --
A. Okay, I don't recall specifically speaking to an SHO so I can't confirm that it was him or not
him.
Q. He would have been the only one, there's only one SHO on duty.
A. Yeah.
Q. If it was the registrar that you informed, Lucy, would you have written registrar in your
notes and not SHO?
A. Yes, unless I have just done it as an oversight.
Q. Because obviously using the word "informed" would suggest that you wrote this after you had
spoken to them?
A. Yes.
Q. Do you agree with that?
A. Yes.
Q. Okay. A statement's been obtained, Lucy, from [Mother of Babies E & F], the mother of [Baby
E]. She's given us an account of this night, 3 August 2015 going into the 4th. She says:
"I expressed some milk and took it to the neonatal ward at around 9 pm."
Tell me what you remember about [Mother of Babies E & F] arriving on the ward at around 9
o'clock, Lucy.
A. I can't remember. I'd have to look at what I've documented.
Q. So Lucy Letby was provided with her note and asked:
Okay, so do you recall her arriving on the ward at 9 o'clock?
A. No, not that specific time, no.
Q. Okay. Do you recall [Mother of Babies E & F] --
A. Yes.
Q. -- the mother of [Baby E]? Do you recall if she was expressing milk?
A. I don't remember.
Q. Is it common for mothers to express milk and bring --
A. Yes.
Q. She goes on to say:
"When I arrived [Baby E] was crying and really upset. He had blood coming out of his mouth."
Do you recall that, Lucy?
A. No.
Q. Tell me about the blood around [Baby E]'s mouth at this time.
A. I can't remember specifically what time I saw the blood or didn't see blood. I don't remember
it.
Q. Okay, so from your notes in your previous interview you commented that [Baby E] had a large
vomit of fresh blood at 10 o'clock on 3 August. I'll give you a copy. If you just have a look at
your notes there, Lucy.
A. Yes.
Q. Can you see there the 10 o'clock that you discussed in your first interview?
A. That the mum is visiting again at 10 o'clock?
Q. Yes.
A. Yeah.
Q. Yes, can you see where you've documented that in your notes?
A. Yes, yeah.
Q. Do you recall [Mother of Babies E & F] visiting now you have had a chance to look at your
notes?
A. Yes, I remember she came down.
Q. Okay, so --
A. I don't remember details of the visit.
Q. But when you say she came down, where did she come from, Lucy?
A. Post-natal ward.
Q. Tell me what you remember of her coming to the neonatal ward then?
A. I know she came down. I think she sat with [Baby E] for a bit and I think at some point she was
updated by a registrar, maybe about [Baby E], I don't remember.
Q. Okay. Just confirm the time that you put down there, Lucy, for us, that that's happened?
A. 22.00 hours.
Q. Okay. Do you recall, Lucy, when [Mother of Babies E & F] attended the ward that [Baby E] had
blood on him?
A. No, I don't remember.
Q. Do you have any recollection of [Mother of Babies E & F] arriving and seeing [Baby E], her
son, crying and being really upset?
A. I can't remember what [Baby E] was like when she visited.
Q. Do you recall any conversations with [Mother of Babies E & F] about the blood around [Baby
E]'s mouth, Lucy?
A. Not from my memory now, no.
Q. Okay. She goes on to say:
"I tried to use the containment technique but it did not work. I was really alarmed and
instinctively knew there was a problem. Lucy, the nurse on duty, told me not to worry."
Do you recall that?
A. No.
Q. She said that you said to her it would just be his feed, his feeding tube, irritating his
throat, and the registrar would be along to see him soon. Do you agree you said that to her,
Lucy?
A. I don't remember saying that, no.
Q. She says you told her to go back upstairs. Do you recall that?
A. No.
Q. She says there that you told her it would just be his feeding tube irritating his throat.
Explain to me what made you believe it was his feeding tube?
A. I don't know, I don't know why I would say it was the feeding tube irritating his throat.
That's not a normal reason for a baby to have blood in its mouth. I don't know why I would have
said that.
Q. Okay. Had you contacted the registrar at this point, Lucy?
A. I don't remember.
Q. Is it in your notes, Lucy?
A. I've documented she was updated by Reg Harkness and contained [Baby E] so I'm assuming that's
around the time at 10 o'clock when she visited. She was referring to offering containment holding.
Q. You're clear with the time there, Lucy, aren't you?
A. I've documented 22.00 hours, 10 o'clock, yeah.
Q. Is there anything there in your notes about [Baby E]'s feeding tube irritating him?
A. No.
Q. Is there anything there, Lucy, in your note about [Mother of Babies E & F] arriving and [Baby
E] crying and being really upset?
A. No.
Q. Okay. [Mother of Babies E & F] says that you told her it was the feeding tube irritating his
throat. Why did you tell her to go back upstairs if it was just an irritation?
A. I don't think I told her definitively she needed to go and leave the unit, we just often advise
parents at night to go and get some rest.
Q. Okay.
A. So I think it was said in that intent rather than saying she had to leave.
Q. Okay. At 9 o'clock?
A. No, I've documented it at 10 o'clock.
Q. It was explained to Lucy Letby that [Mother of Babies E & F] had obtained her mobile telephone
records and insisted that her visit was 9 pm:
What time have you got that [Mother of Babies E & F] had attended?
A. Approximately 8 o'clock, 10 o'clock.
Q. In fact it's in 24-hour, so it says 20.00 and then 22.00.
A. Yes.
Q. Okay.
A. And that she was here, present at the start of the shift, attending to cares.
Q. Okay.
A. And I'm not sure how long she stayed for after attending to the cares.
Q. Is there any reason, Lucy, that what you've documented in your notes could be incorrect?
A. No. So did mum come down again at 10 o'clock? I put that she visited at the start of the shift
attending to cares. I haven't put when she left.
Q. Okay. Is that something you would document in your notes if a baby has blood round its
mouth?
A. It would be documented somewhere, either on the fluid chart or in the notes.
Q. Lucy Letby was shown the telephone records and reminded of the reasons that [Mother of Babies
E & F] said this took place at 9 pm. She was asked:
Do you agree, Lucy, that that paints a different picture to what's recorded in your notes?
A. On the notes, yeah. Can I just have a look at the fluid chart?
Q. Yeah, of course you can.
A. Okay.
Q. Okay.
Can I pause there: was the fluid chart shown to Lucy Letby at that point?
A. Yes, I believe so.
Q. Okay, I'll ask the question again: does that account differ from what is documented in your
notes?
A. Yeah, so I haven't written about any blood coming from [Baby E]'s mouth in the notes.
Q. Okay.
A. I haven't documented on his chart either until 21.00 hours.
Q. Can you explain that to me?
A. I've made an error. I've put "approximately 10 o'clock" and it must have been before that.
Q. Then one officer asks the other:
Do you want to ask anything?
If you have witnessed blood as [Mother of Babies E & F] describes, what would your action be?
A. To give suction to suck the blood out of the mouth.
Q. Who would you inform?
A. Another member of staff or doctors.
Q. Would you look at that as a serious situation?
A. It depends how much has come out. I don't know if this is a mucousy amount of blood that would
look a lot that isn't a large amount. I don't recall.
Q. It upset [Mother of Babies E & F], didn't it, because she then goes and calls her husband?
A. Yes. I can understand any -- any amount of blood would be upsetting to a parent, yeah. I'm
really sorry that she feels that way.
Q. But if you saw lots of blood coming out of a baby's mouth, what would you do? What would be
your --
A. To suction that blood to clear the airway and then escalate it.
Q. Escalate it. So when you talk about escalation what is that then Lucy?
A. To the -- a band 6 or the nurse in charge.
Q. Okay, and ultimately the doctor?
A. Yes.
Q. Okay. From the evidence that we have read out to you, Lucy, you were at [Baby E]'s cot side
when his mum, [Mother of Babies E & F], walked in when he had blood around his mouth. Do you agree
with that?
A. From [Mother of Babies E & F]’s recollection, yes.
Q. Do you agree, having spent time looking at them, that the time on your notes is incorrect?
A. Yes, I've written an approximation of 22.
Q. Mm-hm.
A. And that it seems the event was before that, yes:
"Aware that we've had blood and was starting different medications."
She was updated by Reg Harkness so to me that reads that by the time he had been on to the unit.
Q. By what time, sorry?
A. Approximately 22.00. Do we have the time that Reg Harkness came?
Q. Lucy Letby was informed that Dr Harkness' note recorded 10 pm. And she was asked:
Did you make any attempts to clean up the blood?
A. I don't remember, but I don't think I would have left him with blood in his mouth.
Q. Why didn't you escalate it then, Lucy, like you've just said that you would have done?
A. I don't remember that. I don't know whether I did escalate it or not. I thought Belinda Simcock
was involved at some point but I don't know at what point I escalated or what I was escalating.
I'm not sure when I called the reg though. Does it say I called him before that? Do we have a
bleep time? It may have been that he attended, couldn't come straightaway.
Q. Your notes have given the time on them, Lucy.
A. Yes, the time that he attended the unit and reviewed him.
Q. Mm-hm.
A. It may have been that I contacted him prior to that. I've put that:
"[She] came down again at approximately 22.00 hours, aware that we've obtained blood from his NG
tube and was starting different medications. She was updated by Reg Harkness."
So at that point the registrar had been and started new medication.
Q. Mm-hm.
A. I'm not sure at what time he was called.
Q. Why haven't you noted the bleeding in the notes then?
A. I'm not sure.
Q. But there's nothing to support what [Mother of Babies E & F] is saying about the event at 9
o'clock?
A. No, at 9 o'clock I've documented that there was 16ml mucky aspirate, not blood.
Q. There's a bit of a difference though, isn't there, Lucy, between a mucky aspirate and blood
around the mouth?
A. Yes, yes.
Q. And that's the mucky aspirate, Lucy, that you have documented in your notes that "SHO
informed", yeah?
A. Mm, you see I don't remember contacting, whether it was done by a telephone call, in which case
it wouldn't have been documented --
Q. Mm-hm.
A. -- that he told me over the phone to omit the feed.
Q. But he says he doesn't recall speaking to yourself.
A. No.
Q. Can you explain to me, Lucy, why the bleed which [Mother of Babies E & F], [Baby E]'s mum,
witnessed was ignored?
A. As I say, I don't specifically remember that bleed and I think if it had been anything of the
volume she is stating then it would have been escalated. I wouldn't have just left him bleeding. I
can imagine that any amount of blood, however small, would be very concerning to a parent --
Q. Yeah.
A. -- whether that a tiny amount or what they view to be a lot.
Q. Is this because you intentionally caused harm to [Baby E], Lucy?
A. No -- have I caused this bleed?
Q. Yes.
A. No, no.
Q. Is it that [Mother of Babies E & F] has walked in whilst you're attacking him?
A. No.
Q. Is that why you told [Mother of Babies E & F] to go back upstairs, Lucy?
A. I don't recall definitively telling her to go upstairs. I believe my advice was to go upstairs
and get some rest and we will contact you if there are any changes.
Q. Lucy Letby was informed that Dr Marnerides view was that the cause of death was unascertained
and she replied...
A. No, I believe at the time with -- he was -- the consultant felt it was necrotising
enterocolitis that he had died from.
Q. What are your thoughts on that?
A. Well, that's what the consultant and doctors at the time felt that it was. Babies with
necrotising enterocolitis do get discolouration of the bowel.
Q. Mm-hm.
A. They can bleed as a result.
Q. Is there any explanation you can give, Lucy, as to why the bleed witnessed by [Mother of
Babies E & F] was never recorded and why you didn't take any immediate action to seek help from
anyone?
A. No.
Q. That part of the interview then concluded.
A. Yes.
Q. We can move on to page 40 of [Baby E]'s interview summaries. It's the third interview in time and it takes place on 10 November 2020.
It begins with the officers summarising events surrounding [Baby E] and what Lucy Letby had said
on the last occasion she was interviewed. Then the question is asked:
Is there a reason why [Mother of Babies E & F] couldn't visit [Baby E] when she was -- when he was
being cleaned, Lucy?
A. No. We might advise the parent not to be there but would never ask, you know, shut the door and
say they can't come through, no.
Q. So if a parent wanted to be there at that time you would allow that?
A. I would personally, yeah. I don't see why the others wouldn't either.
Q. Dr Harkness, he's provided a statement. He states that at 22.00 hours he was asked by you to
review [Baby E]. Do you remember showing an aspirate to Dr Harkness around that time?
A. I remember the aspirate, yes, yeah.
Q. Was that aspirate that you showed to Dr Harkness from [Baby E], Lucy?
A. Yes.
Q. Tell me about the photograph you took of [Baby F] once [Baby E] had passed away. Do you
remember?
A. If I took any photographs of [Baby F]?
Q. Yes.
A. I don't recall. I think -- I think I did separate photos, but they didn't want photos of them
both together.
Q. So do you remember taking a photograph of [Baby F] with a teddy bear?
A. I don't remember specific photographs, no. I know that I did -- I think I did take some
photographs of [Baby E].
Q. The officers then turn to telecommunications:
At 9.06 hours on the 4th, you've messaged [Nurse A] and said:
"He was IUGR and REDF plus prem and query Down's, so guess he was very high risk. It was just
awful because he was bleeding from everywhere during resus. Got him back but gas incompatible.
Parents completely distraught. I feel numb."
Do you remember that conversation?
A. Yeah.
Q. Was that accurate, what I've just gone through there, Lucy, from what you recall?
A. Yes.
Q. Was he bleeding from everywhere?
A. Yeah.
Q. Where exactly was he bleeding from, can you remember?
A. His nasogastric tube, his mouth and I think he passed some rectally as well.
Q. Is that description that you've said in your message reflected anywhere in the clinical or
nursing notes that you can recall?
A. I'm not sure.
Q. But why was he high risk, Lucy?
A. Because he was a premature twin with other risk factors.
Q. What does "gas incompatible" mean?
A. That he has had a blood gas but it -- it's not really compatible, there's not a lot we can do
to reverse it, which means ultimately he will pass away.
Q. At 20.09 hours on the 4th you've had a message conversation with Jen and said:
"He had massive haemorrhage. Could have happened to any baby."
Do you recall that message?
A. No.
Q. Was that right, that it could have happened to any baby?
A. Yeah, I think any baby could have a haemorrhage, yeah.
Q. A massive haemorrhage in the way you've described it in that previous text?
A. I would think so. You know, I'm not a doctor, but --
Q. You went on to say that it was an abdominal bleed. How did you know that Lucy?
A. Because we were getting blood back from his NG tube and I think he passed blood rectally, which
would indicate that it was an abdominal issue.
Q. Okay.
And that was the conclusion of that part of that interview.
If we move on to the next interviews, please, in respect of [Baby F], [Baby E]'s brother. We see
the first interview beginning [redacted], which in fact took place on 10 June 2019, so the second
occasion upon which Lucy Letby was arrested.
A. Yes, that's correct.
Q. Again, is it right this is part of a longer interview that this has been distilled from?
A. Yes.
Q. It begins insofar as this document is concerned:
So we're going to move on to [Baby F] and we're going to talk to you about him now. He was a baby
boy, it's the second of identical twins born at 17.54 hours on 29 July 2015. His sibling, [Baby
E], died the following day and is also part of this inquiry.
That's in fact an error it wasn't the following day:
[Baby F] was on parenteral nutrition which was administered intravenously and at 00.25 hours on 5
August the bag was changed. Immediately afterwards [Baby F] experienced a sudden rise in heart
rate, became tachycardic, and the results of blood glucose tests suggest he suffered an unexpected
hypoglycaemic episode.
[Baby F]'s blood glucose levels rapidly improved when the parenteral nutrition was stopped and he left the Countess of Chester Hospital on 13 August 2015.
Lucy, did you inflict an injury to [Baby F]?
A. No.
Q. Do you remember [Baby F], Lucy?
A. Yes.
Q. What do you remember about him?
A. I just remember him more as being the surviving twin of [Baby E].
Q. Is there anything you can tell me about your involvement with [Baby F]?
A. No, I don't recall the incident other than looking at the notes there.
Q. Okay, right. Are you aware of any other person inflicting injury to [Baby F], Lucy?
A. No.
Q. Lucy Letby confirmed that she had the relevant notes. She was asked:
Okay, what we talk about now, is that going to be from your memory or is that from the notes
you've been provided?
A. Notes provided. I don't recall this, this day at all.
Q. Okay. Were you the designated nurse for [Baby F] on this day, Lucy?
A. No.
Q. Could you describe what that form is to me, please?
A. So this is a TPN chart for his fluids and myself and another nurse have signed for that bag.
Q. I wonder if Mr Murphy could put tile 147 up:
Could you describe what that form is to me, please?
A. So this is a TPN chart for his fluids and myself and another nurse have signed for that bag.
Q. I wonder if perhaps Mr Murphy could just scroll down. I'm not going to refer specifically to
it but if everybody refreshes their memory from the form:
If you go down to the ingredients, what's in there?
A. Well, this is a standard bag, so we would check it against the label that's on. There's a label
on the actual bag that would reflect this. So we'd check the values against what was actually in
on the bag.
Q. Okay. Then moving down to the next session, where it starts "feed log", what does that
say?
A. That's what they've worked out as being within the bag, so the log that's done by the pharmacy.
Q. Okay.
A. And again we would check that against the label that was on the bag.
Q. Okay. So this parenteral nutrition, where would it be kept?
A. In -- in the locked fridge.
Q. So this is the locked fridge that you were describing to us in the previous interview?
A. Yes.
Q. Next to the nurse's station in the equipment room?
A. Yes.
Q. Sorry that was her answer, I'm jumping ahead:
Yes, okay. So this is the same key that's passed around with the nurses to gain access to that
fridge?
A. Yes.
Q. Okay. Is there a particular shelf this would be kept on?
A. Yeah, the TPN is usually all kept together near the bottom of the fridge, I think.
Q. Okay. You said this is prescribed, so would it have had the name of the baby on it?
A. Yeah, it would have had "Twin 2 [Surname of Babies E & F]" on it.
Q. What other information would be on that label, the bag?
A. All the information that's here, so the baby's date of birth, the ward, the CC number, and all
these figures that we see here.
Q. Okay. And that TPN bag or the TPN bags where would they be kept in comparison to the insulin
that we discussed before?
A. To insulin?
Q. Yes. Would that be in the same fridge?
A. Lower down in the fridge.
Q. Lower down in the fridge?
A. The bags are lower down, yeah.
Q. Okay so the insulin's at the top of the fridge, is it?
A. Yes.
Q. Okay and who would have access to that fridge other than the nurses? Anyone else at all?
You're saying the key is being moved around between the nurses.
A. Mm-hm. Sometimes the nursery nurses might go into the fridge. The pharmacist would have access.
Doctors would occasionally go in if we gave them the keys.
Q. Right, but it would all come through the same key, would it?
A. Yes.
Q. There isn't another set of keys that someone else has?
A. Not that I'm aware of, no.
Q. Okay. And this TPN bag, what -- could you describe to me what it looks like?
A. So it -- it's a bag of fluid and it's yellow in colour and then it's got a red bag over the top
of it with another label on with this information.
Q. Okay. Is there a reason why there's another bag over it at all?
A. It's to protect it from the light.
Q. So it's light-sensitive?
A. Yeah.
Q. What effect does light have on it if it is to get in?
A. I'm not sure what effect it would have. We're just told that we always need to keep it covered.
Q. Okay. You say it's yellow in colour. Is there any port to this particular bag to add things to
it?
A. No, there's the end valve that you'd break off to attach a syringe. I don't think there's
anything else.
Q. Right. And is it something that you can add things to if needs be?
A. No, we don't add to TPN.
Q. No?
A. That's -- it's made by the pharmacy and it's a secure bag. We don't.
Q. Right. Is there any reason at all at any time you would add anything to the TPN bag?
A. No, not that I'm aware of no.
Q. No. But is it designed, if someone wanted to add something to it, would it be -- is it
designed for that purpose, is there an access port?
A. Not sure. I can't remember if that one has got a port or not.
Q. Okay. Is there a -- can you explain to me the process of actually obtaining and administering
this nutrition?
A. So it's -- the specific bags for the patients are prescribed on a set TPN form, so that gets
sent over to the CIVAS unit in pharmacy and then they make up the bag according to what's written
on that form.
Q. Okay. That bag then is obviously taken to the fridge somehow. Who does that?
A. It's brought up by the pharmacy technicians in the day. Sometimes either they put it in the
fridge or a member of staff will take it from them and they put it into the fridge.
Q. Okay. Do you remember who actually obtained this nutrition from the fridge for [Baby F]?
A. No, I don't, no.
Q. No, but you signed and dated that, yeah?
A. Yes.
Q. What does that actually mean then, the fact that your name's against that particular form?
A. That I've checked that bag with that person.
Q. Right. So are we saying that you've administered this particular bag or not?
A. I don't recall from memory. I don't know.
Q. All right. Who else has signed that prescription, Lucy?
A. [Nurse A].
Q. Okay. And you described before to my colleague about the nutrition being kept in these bags,
you told me. Tell us about it coming in a red bag as well. That red bag, is it sealed?
A. No.
Q. Is it delivered in those red bags to the unit?
A. Yeah.
Q. And then is the TPN stored in the fridge with those red bags?
A. Yes, and then we take it off to check the bag underneath matches the details on the label.
Q. Okay. And?
A. So it should be a three-way check, so you're checking the chart, the bag, and the red bag.
Q. Okay. And tell me where those checks take place?
A. Usually at the bedside -- well, in the nursery of the baby, either at the bedside or wherever
you're drawing up the fluid.
Q. So it comes with a red bag on top of it. Does that man that there's a label or a prescription
label on that red bag as well as the TPN bag itself?
A. So there's -- yeah, there's a label like this, of this half up on the red bag [as read]. It's
specific to that patient, yes.
Q. Right okay. Can you just go through the process, Lucy, of how you would connect this bag to a
baby?
A. So it depends if you -- if you're starting it fresh you would have to get a new giving set and
insert a giving set into the bag, run the fluid through, and then connect it to the baby. Or
sometimes we just do a fluid bag change so the bag would literally just be unscrewed from the
existing line and the new one put on.
Q. Okay. Is that done with someone or?
A. Yes.
Q. It is all the time?
A. Well, we try to, yeah.
Q. Does it automatically start then? Is there a process you have to do for it to start?
A. No. If we were starting it from scratch, we would have to put up the giving set through the
pump and set the pump.
Q. Right.
A. Or if it was just a bag change then the pump would already be programmed and you'd just change
the bag.
Q. Right, okay. You discussed before about protecting from infection and stuff. Is that a similar
sort of process where one -- there will be a --
A. It's sterile, yes.
Q. Sterile, okay.
A. Yeah.
Q. Then you talk about the pump. How's that sort of controlled?
A. So the pump -- if I'm setting it up or if I'm doing a bag?
Q. If you're setting it up.
A. So if I was setting it up then you'd have two people there, you'd run the giving set through
the pump, and you'd both check the volume that was being infused, set a volume, an hourly rate,
and a volume to be infused, and then you'll both connect that to the baby and start it.
Q. Okay. And if it was being simply replaced with or for another one?
A. You wouldn't need to touch the pump other than to pause it just whilst you're changing the bag.
Q. And how is that done, how's it paused?
A. There's a button on it.
Q. Right. This particular bag that you've -- there's a signature for a time, 00.25. Do you
remember any involvement with connecting that bag at all to [Baby F]?
A. No, I don't sorry.
Q. Right. Is there no sort of system that would suggest whether you connected that or you
wouldn't have to physically put in the notes to say that "I've connected this bag"?
A. No. So say it's usually -- it's the first signature usually is the person that's giving it, but
not -- it's not a set policy, that's just how other people tend to do it.
Q. Right. In relation to that prescription, Lucy, do you specifically recall your
involvement?
A. No.
Q. Lucy, is there a policy in respect of these bags and reconnecting old bags at all, if need be?
Are you allowed to do that if --
A. Reconnect an old bag?
Q. Yeah.
A. No, you shouldn't do because you've broken the line. So once that bag's disconnected it's
potentially open to the air, so it's --
Q. Right.
A. It's not a sterile unit then.
Q. Are there any circumstances where you'd connect the same bag?
A. Take the bag off and reconnect it?
Q. Yes.
A. No.
Q. What would happen to that bag?
A. It just gets disposed of.
Q. Okay. Is that in the room or --
A. Yeah.
Q. Okay.
A. Well, some people do it in the room. You're supposed to go to the sluice and do it and put it
in the dirty sink in the sluice.
Q. Lucy Letby confirmed that her signature appeared on [Baby F]'s observations chart at 5 am. She explained she may have been helping out a nurse who'd gone on their break.
Can we move to page 2:
Lucy, explain to me what that page refers to.
If we can put up tile 152, please.
A. So this is the intensive care chart, so we've got as part of those observations I've read --
done a drip reading at 5 am and a blood sugar and I've also documented his respiratory support as
well.
Q. Okay. And are any of those readings of concern to you at all?
A. Well, those are -- his respiratory settings have remained the same. Looking here, his blood
sugar's 2.9 I'm not sure what it had been prior to that. That's potentially a little bit low.
Q. Is that something you would expect in a baby?
A. It's unusual for a baby that's on full fluids.
Q. Okay. So this is -- what's this a sign of to you then?
A. That I'm not sure what his sugars were prior to that. Potentially something's changed.
Q. Okay, so if you have a look at the 11 o'clock. I know your signature is not next to it, but
it's got the word "off".
A. Yeah.
Q. What would that mean to you?
A. That somebody's turned the fluids off.
Q. Okay. And why would that --
A. To fill that hour, the pump hasn't been running.
Q. Why would that happen? Why would that be done, do we know?
A. I'm guessing it's because there's been an access issue. Sometimes if they haven't got a cannula
to run it through, if that's tissued or leaking, then he would have been without fluids.
Q. And obviously that sugar level at 2.9 there, have you done anything or given anything to [Baby
F] to try and increase that sugar level?
A. No.
Q. And can you explain what updates you would have given the designated nurse on return from her
break?
A. So I would have informed her what the blood sugar was.
Q. Okay.
A. And informed her of these observations and that I have decreased the incubator temperature in
response.
Q. Why -- explain why you would have updated her about those.
A. Because I've made a change to her baby while she's not been there.
Q. Can you just move to page 3 for me, please, Lucy. What is that chart?
If we pause there and go to tile 191, please.
A. So this is a fluid chart.
Q. Okay. If you look at the three highlighted sections, I take it that would have been on her
copy that she was given?
A. Yes, it was, yes.
Q. Can you confirm that's your signature there for me?
A. Yes.
Q. And the times for those, please?
A. 03.50, 04.10, 04.20.
Q. All for 5/8, am I right in saying, 2015?
A. Yes.
Q. Okay. What are you actually giving at that point?
A. So a glucose bolus, a saline bolus and then 10% dextrose commenced.
Q. Okay. And is there a reason for this -- for these medications?
A. Because he's got low blood sugar I've given a bolus.
Q. Okay. So this is all to try and bring that blood sugar up to now, yeah?
A. Yes.
Q. Okay and your signature appears at the top of the first one and at the bottom of the next two;
is that correct?
A. Yes.
Q. As you explained before, it does not mean that any of those were administered by yourself or
by --
A. No, I can't conclusively say who -- who gave those.
Q. Do you recognise the other signature for those three?
A. I think it's [Nurse A].
Q. So the readings that you had taken there, the low blood sugar and then administration of
dextrose on a couple of occasions, it's a sign that [Baby F]'s not doing so well? Am I right in
saying that?
A. Yeah. I would say something's changing.
Q. Okay.
Lucy Letby was then shown the blood gas record chart, which is tile 181, please:
Okay. Can you explain to me off that chart there the rapid decrease in glucose from the reading
obtained at 01.54 on the 5th? Do you see how we've got the glucose referrals of 3.8, 5.5, and then
on 5 August there's a space and it drops to 0.8?
A. No.
Q. What is that a sign to you -- what do you think is happening there with [Baby F]?
A. Something's happening for him to drop his blood sugars.
Q. That's extremely low, isn't it, 0.8?
A. Yes.
Q. Is that dangerously low?
A. Yes.
Q. Okay, but you don't know what has happened to [Baby F] to cause those blood sugars and what's
going on inside him to cause those --
A. No.
Q. -- blood sugars to drop like that?
A. No.
Q. In your experience have you ever seen a baby with such low blood sugars?
A. Yes.
Q. You have and what was the cause of that?
A. We've had a few babies on the unit that have had a hyperinsulinaemia, which is what I spoke
about before at the end, a crying condition (sic) that they're born with.
Q. Right, okay.
A. And they've had very low blood sugars and we've had to use a lot of dextrose and they've ended
up being taken to Alder Hey.
Q. Okay. There's just one more, sorry. If you can go to page 5 of the chart, that's another
prescription chart, isn't it?
A. Yes.
Q. That's tile 146, please, Mr Murphy.
My Lord, if we can just pause there. If we go back up, and we'll check, but the second reply down, the "crying condition", we're wondering if that should say "endocrine", which of course is to do with the insulin and the hormonal system. We'll double-check that. It doesn't seem to be a crying condition.
MR JUSTICE GOSS: This will have been an audio typist listening to the recording of this and typing what they thought they could hear.
MR ASTBURY: And I'm afraid I missed it up until now. We'll double-check that.
MR JUSTICE GOSS: I will just make a note of that.
Thank you.
MR ASTBURY: Thank you.
So if we scroll up a little bit, please, Mr Murphy. Th officer says again:
So that's another prescription chart, isn't it?
A. Yes.
Q. Do you recognise that signature?
A. Yeah, that's mine.
Q. And what's that prescription for?
A. So I've signed for a lipid syringe. The syringe number's there, and I've signed for that.
Q. Can you tell me what lipid -- what's the purpose of that?
A. Lipid accompanies the TPN as part of their nutrition, so it -- it's fats, basically, lipid.
Q. Right. So?
A. And that's run as a separate syringe to the TPN.
Q. Okay. Is that kept in the fridge?
A. Yeah, it's kept in the same bag usually as the TPN. It's a white syringe.
Q. Right. So it's kept with the TPN, yeah --
A. Yes.
Q. -- in the same fridge?
Okay. Do you remember that particular drug when you signed for it? Is that something you remember
going to the fridge for at all?
A. No I don't, no.
Q. Again so would this suggest that you might have or you might not have administered that
particular lipid --
A. Yes.
Q. -- to [Baby F]; is that right?
A. Yes.
Q. But you -- it's clear that you're involved in his care at that particular time?
A. Yes.
Q. Okay. And there's no other signature there, is there?
A. No.
Q. Is there a reason for that?
A. It might just be an oversight. Ideally, you would have it signed -- when you checked the TPN
bag, you would do -- sign both syringes, you'd sign up here for the TPN and the lipid.
Q. Lucy, you said before that it's kept in the same bag. Explain what you mean by that.
A. So it's prescribed for a baby which this is -- it comes up in a pack with the red bag, the TPN,
and then a syringe comes up as well with a giving set on it, the lipid syringe.
Q. So that's tucked inside the red bag or?
A. No, it's not in the red bag, it's in -- in a clear bag with --
Q. Right.
A. So the TPN is with the red bag and there's a lipid syringe and that's within a bag.
Q. Right. And inside there is the syringe and the red bag?
A. Yes.
Q. Tell me how long the lipid would last for?
A. 24 hours I think it is --
Q. Okay.
A. -- normally.
Q. And how long would the TPN last for?
A. The TPN is 36.
Q. Okay.
A. It's different, I think, from memory.
Q. Were you aware, Lucy, of the concerns for [Baby F] regarding his blood sugar levels at the
time?
A. No.
Q. It's not something that sticks in your mind or was discussed amongst staff members or with
doctors?
A. Not that I recall, no.
Q. No?
A. I don't know. I don't remember this day. I don't remember a doctor being there.
Q. Do you remember any involvement with [Baby F] after 5 August?
A. No, I know I've -- I've looked after [Baby F] before he went home. I don't -- I don't recall
the specific dates.
Q. Are you responsible for the attempted murder, Lucy, of [Baby F] on the 5th?
A. No, no.
Q. Did you cause him any significant harm on 5 August?
A. No.
Q. Are you aware of anybody else causing him significant harm?
A. No.
Q. Did you unintentionally cause him harm on 5 August?
A. Not that I know of, no.
Q. We talked about insulin and the effects of insulin, didn't we, on blood sugar levels? Did you
inject insulin into [Baby F]?
A. No. Can I just ask a question about this, in terms of the bags and everything?
Q. Yeah.
A. I'm assuming they were -- they haven't been kept or checked, you know, post-events?
Q. Would they be? Would they be kept somewhere? You said that they might be.
A. No, it would be disposed of. That's what I'm saying, we've got no bags.
Q. Well, if you -- the date of it is 2015.
A. Yeah.
Q. Is it likely that the bags would be kept --
A. No.
Q. -- for that long?
A. No.
Q. You've asked the question. So are there occasions when they might be?
A. I -- if there's a baby that there's been a concern about we would keep the bag usually and ask
somebody to check that bag or check the pump.
Q. Okay.
A. If there's an unexplained...
Q. Are you aware if that was the case with [Baby F]?
A. No, no, that's what I'm asking, if anything was kept.
Q. Right. Would you know where they would keep that?
A. If there's a concern it would usually be kept in the sluice.
Q. Right. Okay, is that on the neonatal unit?
A. Yes.
Q. Would that have been recorded anywhere if there was a reason to keep any equipment?
A. Mm, no, it was just -- they'd usually just write on the bag, you know, can we have this bag
checked, and the shift leader would pass it on to the next member of staff.
Q. Okay. Is there a reason why you've asked that question? What's going through your mind?
A. When something's happened in that time you're asking me if I have given him insulin. I'm
wondering if there's an issue with something else.
Q. Right, okay. Obviously we'll look into that but I doubt 4 years down the line --
A. No.
Q. And that concluded the interview so far as [Baby F] was concerned on that date.
A. Yes.
Q. Thank you. A second interview for [Baby F] took place on 12 June 2019.
A. Yes, that's correct.
Q. Again we can see the time set out on the form and the persons present. The officers summarised
the earlier interview regarding [Baby F]. Then began with the question:
At 00.10 hours on 3 August, Lucy, a TPN bag has been changed and there was only one signature on
the prescription, which you stated was an oversight; do you agree?
A. I think that was on the lipid chart, was it?
Q. There's a copy there. I think it was. Just have a little look. Yeah, it was one signature;
yes?
A. Yes, for the lipid yes.
Q. In fact that first question should read 4 August, shouldn't it?
A. Yes.
Q. Thank you -- in fact, no, that's the first bag, isn't it?
A. Yes.
Q. So that is right, the 3rd.
A. And then --
Q. At 00.25 on 5 August, two signatures were on the prescription and you confirmed that the order
of prescriptions did not reflect who connected the bag; do you agree?
A. Yes.
Q. Okay. Did you attack [Baby F], Lucy?
A. No.
Q. Did you intentionally administer insulin into [Baby F] --
A. No.
Q. -- knowing that it would cause his collapse --
A. No.
Q. -- and potentially cause him to die?
A. No.
Q. Did you attempt to murder [Baby F]?
A. No.
Q. Did you administer --
A. No.
Q. -- insulin into the bags of TPN, Lucy?
A. No.
Q. Then she carried on.
A. Was his TPN bag checked?
Q. When?
A. After the event. You're saying that the insulin was put in there. How do we know that insulin
was put in there when we've checked the bag?
Q. It's some time since the event, isn't it?
A. Yes.
Q. And I ask the question again to you: did you administer insulin?
A. No.
Q. The police continue to suggest someone had administered insulin to [Baby F] and Lucy Letby
replied...
A. I didn't.
Q. You did?
A. No.
Q. Did you attempt to murder [Baby F]?
A. No.
Q. That interview then concluded.
Moving to the third interview in respect of [Baby F], beginning at [redacted], we can see that
that began at 16.58, or this portion of it did, the interview began earlier, on 10 November
2020.
A. Yes.
Q. And it began:
Okay. We'll move on to [Baby F], [Baby E]'s twin Lucy. [Baby F] was the second of the identical
twins and was admitted to the NNU after birth.
It was recorded that [Baby F] had an abnormally high level of insulin, 4,657 picomoles per litre.
The insulin C-peptide level was very low, less than 169. Do you want to say anything about that
summary of him, Lucy?
A. No, I don't know what those figures mean or anything.
Q. The statement of Shelley Tomlins states that at 7 pm she connected a 15% dextrose infusion along with [Nurse C] and [Baby F]'s blood sugars normalised rapidly.
I don't think, in fact, there was an answer to that question --
A. No.
Q. -- if it was in fact a question:
So would you say that that's expected, that you'd expect that to happen, or do you say that's
inconsistent?
A. No, I'd expect them to rise because we've given a bolus of sugar, so he should respond to that.
Q. Okay, so looking at your social media, Lucy, for [Baby F] and [Baby E], you've completed searches for their mother, [Mother of Babies E & F], on 6 August 2015 -- these are all in the same year -- 23 August, 14 September, 5 October, 5 November, 14 November, 7 December, then Christmas Day, 25 December, and then again on 4 January 2016, and then on 10 January 2016.
As I say, they are searches that you've done on Facebook for [Mother of Babies E & F] and his --
and [Father of Babies E & F] as well. Do you remember making those searches?
A. No.
Q. There's ten searches altogether -- nine for [Mother of Babies E & F], one for [Father of
Babies E & F] -- going from August through to December and then, like I say, two in January. Have
you got any explanation for why that number of searches were made for those parents?
A. Only if it was to see if there was anything to see how [Baby F] was doing.
Q. Why would you want to know how [Baby F] was doing?
A. Because as a member of staff you care about what happens to the babies and obviously they've
been through a really difficult time.
Q. And do you recall if you found anything, Lucy?
A. I can't remember.
Q. Was anybody else aware that you were making these searches for the parents?
A. No, I don't think so.
Q. Okay. So if you were looking to see how a baby was doing, would you be looking for a specific
part of that account, comments that were being made or how would you --
A. Well, like, their profile photos of them, you know, with the baby.
Q. Right. I think I asked the question before about looking for a photograph of the baby, so is
that a possibility then?
A. Yes.
Q. I take it you had success in accessing [Mother of Babies E & F]'s account for you to --
A. I don't recall.
Q. -- search on all these other dates? If it was blank on the first one, then you wouldn't be
going back looking on the additional ones, would you?
A. No.
Q. Do you know the point I'm trying to make?
A. Yeah, but if it was just the profile picture that was -- that you could see --
Q. Right.
A. -- maybe I was looking to see if those had changed each time.
Q. Okay.
A. I don't remember.
Q. So are we saying that [Mother of Babies E & F]'s profile picture would possibly be with her
son?
A. Yes.
Q. And that's what you would be looking for when you said to see how he was getting on? So you're
saying by looking at the photograph you would know how her son was doing?
A. Well, only visually just so to see that they were -- I don't know.
Q. Is there -- were you obsessed with this particular family, Lucy?
A. No.
Q. [Baby F] was discharged on 13 August 2015 and [Baby E] died on 4 August 2015. Five months
later you are still searching the family. Is there anything you want to comment on that?
A. No.
Q. Looking at your mobile phone, Lucy, and messages exchanged in relation to [Baby E] and [Baby
F], on 5 August 2015 at 8.53 in the morning you messaged [Nurse A] who had looked at [Baby F] and
night and you told her that his sugar reading was 1.8 at 8 o'clock in the morning. Is that low, a
low reading?
A. Yes.
Q. Do you recall how you found that out?
A. I don't recall off the top of my head, no. I'm assuming it's from looking at his charts.
Q. And do you know why you -- why did you find out what his sugar reading was?
A. No, I don't know.
Q. Why did you do that? Why did you then send her the message?
A. I don't remember. I don't think it was to report and blame. It was just to keep her updated.
Q. And that was where that particular interview concluded.
A. Yes.
MR JUSTICE GOSS: That's probably as good a point as anyway because the next interview is more substantial, and we're moving on to another baby.
MR ASTBURY: Yes.
MR JUSTICE GOSS: So a bit early, but we'll have the ten-minute break now, otherwise we're going on until quite late.
(In the absence of the jury)
MR JUSTICE GOSS: Is this the point at which some sheets have to be changed?
MR ASTBURY: Yes.
MR JUSTICE GOSS: I thought it was. It was another reason for breaking off then?
(Handed)
MR JUSTICE GOSS: I'll leave you just to explain this to the jury when we come to it.
MR ASTBURY: Thank you.
MR JUSTICE GOSS: I don't know whether you want to do it before we start or --
MR ASTBURY: I will. It's easier that way.
MR JUSTICE GOSS: Thank you very much. Ten minutes, please.
Mr Murphy, juror number 9's iPad, please. (2.55 pm)
(A short break) (3.07 pm)
MR ASTBURY: Hopefully everyone has the first interview of [Baby G] open in their ring binder file with the page reference [redacted]. Before we begin that particular interview, my Lord, there is a formatting error on two pages.
MR JUSTICE GOSS: Right.
MR ASTBURY: So I'm going to ask, please, if everybody wouldn't mind turning to page 11, [redacted], and to remove pages 11 and 12, please.
MR JUSTICE GOSS: So [redacted], [redacted] to be removed?
MR ASTBURY: Yes, please. If we get those out of the way to avoid any confusion.
MR JUSTICE GOSS: Could you pass them up to the end, please? Two pages, each of you, [redacted] and [redacted].
(Pause)
You're going to get substitutes now.
(Handed)
Because they're also [redacted] and [redacted], you'll see the reason you got rid of those ones first, so you couldn't muddle them up.
MR ASTBURY: Can I ask everyone to go back to [redacted], please, and we'll start the interview,
officer, the first interview in which the case regarding [Baby G] was discussed with Lucy Letby.
This took place on 5 July 2018?
A. Yes, that's correct.
Q. We can see the times that this particular tape was running and that the interview began with
the usual introductions and a caution; is that right?
A. Yes.
Q. If we turn the page, please. The question begins:
So in June 2015 there were three deaths and one serious collapse. [Baby E] was in August of the
same year and then obviously (inaudible: coughing) about [Baby I]...
That's a reference to [Baby I], who had already been discussed, I think, in the interviews at
this stage but we haven't reached her because we're dealing with the babies as they appear on the
indictment?
A. Yes.
Q. Okay:
... who had a multiple collapse [it should say "multiple collapses"] and passed away in September.
So that's all those cases bar [Baby B], who survived. All in that really short period of time.
What were you thinking during that period?
A. That it was a shock to have that many deaths.
Q. Even just those first four collapses and three deaths, all within, I mean, a couple of weeks
in June, all in one month.
A. Yes.
Q. It must -- it must have been devastating.
A. Yes.
Q. And Lucy Letby was then asked to describe how she coped with deaths on the unit in June
2015.
A. You just have to find a way to deal with it and carry on to provide the job and care that we do
give.
Q. Okay. Did any -- at any stage you think, what on earth is going on here?
A. Yes, in terms of what we'd suddenly had a spike like that. Not in terms of why they had died,
just that we were getting that number of babies in a short space of time.
Q. Did any of the staff sort of almost question with the hospital or with colleagues where the
spike was coming from, maybe what could resolve it, what investigations needed to be made?
A. Not that I'm aware of, no.
Q. Did you yourself?
A. No.
Q. Okay. Why didn't you question the spike, this one that we've -- the babies that we've spoken
about up to now?
A. In a formal way?
Q. Yeah.
A. Because I didn't feel that anything -- there was anything that needed to be -- maybe looked
into. It was just a shock for everybody.
Q. Okay. Lucy, you dealt with all of these as well, didn't you?
A. Yes.
Q. What do you put that down to, bad luck?
A. Yes.
Q. And then Lucy Letby was asked questions about what happened to [Baby G] in the early hours of
the morning and 7 September 2015:
Okay. Do you remember who the designated nurse was for [Baby G]?
A. [Nurse E].
Q. Okay. How do you remember that?
A. Because I remember that I -- that [Nurse E] was on her break when this happened with [Baby G].
Q. Do you remember where [Baby G] was in the unit?
A. Yes, in nursery 2.
Q. Do you remember what the clinical position was for [Baby G] at this point when you came on
duty?
A. I don't remember there being any concerns.
Q. Okay. And whether or not [Baby G] was attached to any monitors at all?
A. I don't remember.
Q. You don't recall? Okay. Do you remember who you were the designated nurse for on this
particular day?
A. No, I don't remember.
Q. Okay, were you working in the same nursery?
A. I don't remember.
Q. Okay. If you carry on through the notes there, Lucy, it says that:
"[Baby G] had a large projectile milky vomit at 2.15. Continued to vomit ++. 45ml of milk obtained
from NG tube with air ++."
What can you tell us about that?
A. So I found that [Baby G] was vomiting.
Q. Okay. Can you tell us any more about that particular episode?
A. I just remember that there was a lot of vomit and that she was projectile vomiting.
Q. Okay. At this point in time who was responsible for [Baby G]'s care?
A. I believe [Nurse E] was the nurse looking after [Baby G] for that shift.
Q. Okay. Just going back to that first line, we've got:
"Care given from 02.00 to present."
Is there a reason why it's 02.00?
A. I must have taken over the care at that time.
Q. Okay. But you don't remember that?
A. I don't remember it, the exact time that I took over, no.
Q. What was your involvement with [Baby G] --
A. Okay.
Q. -- in that quarter of an hour period when you took over?
A. I don't remember.
Q. Sorry, do you remember how [Baby G] presented when you took over then at 2 o'clock? Were there
any issues or concerns with [Baby G] at that time?
A. Not that I remember, no.
Q. Okay, do you physically remember that or has that just come from your notes?
A. No, I do remember her vomiting.
Q. So can you describe -- when you've called it a large vomit, can you describe that to us? Where
did it go? What colour was it?
A. From what I remember it was a milky coloured vomit and it was a large volume that was going
into the bed and down [Baby G]'s clothes.
Q. What was that saying to you in your profession?
A. I'm not sure. Sometimes babies do vomit.
Q. Okay.
A. But it's in -- it's not very often that it's projectile.
Q. So is that what you're saying it was? If we call it projectile, what do you mean by that?
A. A forceful vomit.
Q. Okay. Right. Can you give an explanation of why that might have occurred in [Baby G]'s
case?
A. I'm not sure. Had she just been fed prior to that?
Q. Were you involved with the feeding of [Baby G] at all?
A. Not that I remember.
Q. Okay. You put there as well:
"... obtained from the NG tube with air ++."
What's the significance of that, Lucy?
A. So there's air in her abdomen that -- sometimes when babies vomit they can take on air as well
if they're gasping with the vomiting.
Q. So you got ++, what's that suggesting?
A. It was a larger volume of air than just the general amount that we would usually obtain.
Q. Okay. And your thought was that was because of the vomit?
A. Yes.
Q. Is there any explanation of why [Baby G] might have this large amount of air?
MR JUSTICE GOSS: "Any other explanation."
MR ASTBURY: Sorry.
A. I'm not sure. Sometimes air can just accumulate in the abdomen.
Q. For what reason?
A. If there's some sort of bowel issue or infection.
Q. Okay. But at the beginning of shift, everything was okay, yeah? And then within quarter of an
hour she deteriorated somewhat. When [Baby G] was sick, was anyone else present at the time?
A. Not that I remember, no.
Q. Did you highlight this to anyone?
A. I believe I asked for the doctors to review her, yes.
Q. Was that the first sign to you that something was wrong with [Baby G]?
A. I think so, yes. Although she'd been a baby that had been backwards and forwards to different
units at other times.
Q. And you know when you said "air ++ from the NG tube", how did you measure that amount of air?
How did you come to that conclusion?
A. So when I've withdrawn the 45ml of milk, air came out with it.
Q. But what determined in your mind to put ++ in your notes?
A. That it was a large amount. I haven't measured the volume.
Q. You described the sick -- the vomit as forceful. Exactly how forceful was it?
A. From memory, I think it went into the cot and [Baby G], down [Baby G]'s clothing.
Q. What was her position in the cot at that stage?
A. I think she was on her back.
Q. You think or you know?
A. I think.
Q. Okay. So immediately prior to this vomit, where had you done and what were you -- where had
you been and what were you doing?
A. I don't remember.
Q. So at the point of the vomit what exactly were you doing?
A. I don't remember.
Q. Okay. But you were present at [Baby G]'s cot?
A. I think I went into her into because she was vomiting. I heard her vomiting.
Q. So did you see the vomit or did you not see the vomit?
A. I did see her vomiting.
Q. So why did you go in to her?
A. I don't remember. I don't know if I went in because I heard her vomiting and then when I
arrived she was still vomiting, I don't remember.
Q. So just to be clear, you believe that you may or may not have been present when she was
vomiting and it may be that you were -- you went into her because you heard her vomiting?
A. Yes.
Q. But you don't know where you were?
A. No.
Q. Okay. At the point you took over at 2, were there any concerns for [Baby G]?
A. No, as I say I don't remember why I took over. I thought I took over her care because she
needed further intervention and moving to another nursery, which the other nurse couldn't care for
her.
Q. At the start of the interview you said that you remember that her designated nurse was on a
break.
A. Yes, I think so.
Q. Is that why you took over her care at 2?
A. Usually if we take over care for somebody on a break we don't document it anywhere, we would
just carry out any task that needed to be done whilst that person wasn't on the unit. We don't
usually write that we've taken over care.
Q. Okay. Were you the first person to treat [Baby G] following the vomit, tend to her?
A. Yes, I think so yes.
Q. Okay. Moving on in the notes, I think you've got them there in front of you:
"Abdomen noticed to be distended and discoloured. Colour improved. Colour improved a few minutes
after aspirating tube. Remained distended but soft."
Who noted this, do you remember?
A. Myself.
Q. You physically remember that, do you?
A. From my notes I remember.
Q. Okay. This discolouration, can you describe that any further to us and from the notes?
A. No, I don't remember clearly the discolouration.
Q. Okay.
Lucy Letby confirmed that Dr Ventress attended, but then was called away to the labour ward and
the plan was to start fluids:
Okay. You then go on to say:
"At approximately 03.15 [Baby G] had a profound deterioration to 20%, marked colour loss with
apnoea, bradycardic to the 50s, Neopuffed in 100% oxygen."
How soon after did that occur from when the doctor left to go to the theatre?
A. I don't remember.
Q. You said you remember her going off to the theatre. Can you give us any sort of idea? Was it
shortly afterwards, some time afterwards?
A. I really don't remember.
Q. Okay. So who was present when this profound desaturation occurred?
A. I don't remember.
Q. Do you remember where you were when this occurred?
A. No.
Q. Where were you prior to when it happened? What were you doing?
A. So I'm not sure whether I was going to get fluids ready. I don't know if I was in the nursery
or whether I was out of the nursery to go and get the fluids ready. I really -- I don't remember
specifically.
Q. Okay. Do you remember the colour loss? This colour loss, can you describe it in any further to
us [as read]?
A. No.
Q. Lucy Letby then confirmed she took over [Baby I]’s care after she'd fallen ill and that a nurse would not ordinarily endorse the notes if they were just covering whilst the designated nurse...
(Pause)
That should be [Baby G], not [Baby I]. Thank you.
Would not ordinarily endorse the notes. Can I just ask everyone perhaps to change that before we move on?
(Pause)
A nurse would not ordinarily endorse the notes if they were just covering while the designated
nurse went on his or her break:
And following [Baby G]'s collapse did you have any involvement with the family at all?
A. I think the parents attended the unit, yes, but I can't remember specifically if they did or if
I spoke to them.
Q. Okay. We're going to move on to 21 September 2015 and the second episode that [Baby G] suffered. There's a few pages of notes that we're going to show to you, similar to the last time.
Lucy Letby was then provided with the relevant notes.
A. So this is a feed chart. I fed [Baby G] at 9.15 on 21 September and I fed her breast milk of
40ml via an NG tube.
Q. Could we put tile 47 up, please, Mr Murphy? Just while we're talking about the documents.
A. So this is a feed chart, I fed [Baby G] at 9.15 on 21 September and I fed her breast milk of
40ml via an NG tube. And I've written:
"30ml discarded and two milky projectile vomits."
She's had her blood sugars taken at that time, which was 9.2, and I've written that she had a large bowel movement that was loose and watery and green and I have written in the comments box that she was reviewed by the doctors.
Q. Yes. So this obviously is 21 September, some 2 weeks after the first episode, which we've just
discussed. Do you remember this particular shift, Lucy?
A. Yes, vaguely.
Q. Can you remember your involvement with the care of [Baby G] on this day?
A. I think from memory [Baby G] was down in nursery 4 and I looked after her for a period of time
in the morning and then someone else took over later on in the morning.
Q. Right. Is there anything else you can remember about that?
A. I remember it was a busy day and I think I had several other babies as well as [Baby G].
Q. Who was the designated nurse for [Baby G] on this shift?
A. Myself.
Q. Okay. You've already said that you were caring for other babies.
A. I think I may have been split between nursery 3 and nursery 4 but I don't remember
specifically.
Q. Okay. And in relation to the unit, what is nursery 3 and 4 compared to the other two?
A. So they're special care nurseries with just babies that require special care.
Q. So as far as their general sort of well-being, are they in a better place than babies that
would be cared for in the other nurseries?
A. Yes.
Q. Would [Baby G] have been attached to any equipment at that time?
A. Yes, I think she was still on a Masimo monitor.
Q. What was the care plan in place for [Baby G] at this time?
A. I don't remember.
Q. Okay. Do you remember how [Baby G] was handling?
A. No, I don't remember.
Q. Were there any concerns for [Baby G] from you at this time in the health of [Baby G]?
A. I think from memory mum had maybe said that she was quieter than usual.
Q. Do you remember when she said that to you?
A. I don't remember an exact time, no.
Q. Okay. What did you do about that?
A. I don't remember without looking at my notes.
Q. If you follow the notes with me, Lucy [and this is tile 65, I don't think we need to go to it,
my Lord]:
"[Baby G] nursed in her cot. [Baby G] appears pale. Temperature 36.4. Hat in situ and well
wrapped. NG tube feed. Expressed breast milk given. AWT at 09.00 as [Baby G] asleep and due
immunisations."
Why have you noted that she appeared pale? What was your view of that?
A. I don't remember from memory.
Q. Okay. Did anyone else comment on that at all?
A. I think her mum may have.
Q. Do you remember this particular feed for [Baby G]?
A. No, not clearly.
Q. Lucy Letby explained how [Baby G] would have been fed by gravity via her NG tube when she was
asleep:
Okay, and on this particular occasion at 09.00 did everything go swimmingly, according to
plan?
A. I don't remember without reading my notes.
Q. That's fine.
A. So from reading my notes there it would appear there wasn't an issue with that 9 o'clock feed.
Q. Okay. At 10.15:
"x2 large projectile milky vomits. Brief self-resolving apnoea and desaturation to 35% with colour
loss."
What can you tell me about that?
A. I don't remember it clearly.
Q. Do you remember being present when this occurred?
A. I don't remember.
Q. There's nothing you remember about that event? Did the monitor activate?
A. I don't remember.
Q. Can you remember if anyone else was present at the time?
A. No, I don't remember.
Q. Or what you did?
A. I don't know if mum was there. I don't remember.
Q. What did you think was going on with [Baby G] at this time?
A. I don't remember my thoughts on that day.
Q. There are 30ml of undigested milk discarded. What's that saying to you, that it's
undigested?
A. That he hasn't digested the milk that was given to her at 9 o'clock.
Q. And in your opinion is there a reason for that?
A. She'd only been fed an hour prior to that so it's not unusual that she would still have
undigested milk in abdomen, her stomach.
Q. And you then go on to say:
"Temperature remains low, tachycardic, greater than 100 beats a minute since vomit [180]. Mum
states that [Baby G] does not appear as well as she did yesterday."
Do you remember at what stage she actually said that to you?
A. No, I don't remember.
Q. The way your notes read would suggest that's post, post-vomit. Is that the way you look at
it?
A. Yes.
Q. And then the next activity date:
"12.52. Mummy telephoned this morning. Arrived shortly after 10 [10 o'clock]."
Do you remember who telephoned her?
A. It says there that mum telephoned the unit.
Q. Okay. Do you remember who spoke to her?
A. No. Usually the designated nurse would try to speak to the parent if they've phoned. I don't
remember.
Q. Did you have any dealings with the family after [Baby G] had left?
A. Discharged [Baby G]?
Q. Mm-hm?
A. No.
Q. That interview then concluded; is that right?
A. Yes.
Q. Thank you.
We then go on to the second interview centring on [Baby G]. It took place on 11 June 2019.
A. Yes.
Q. Following introductions, Lucy Letby confirmed that she was okay to continue; is that
right?
A. Yes, that's correct.
Q. Okay, Lucy, I want to talk to you about [Baby G]. When you were interviewed about [Baby G],
Lucy, in relation to the collapse on 7 September, you stated that you remembered her because
[Nurse E], who was [Baby G]'s designated nurse, was on a break when this happened with [Baby
G].
A. Yes.
Q. Do you recall that?
A. Yes.
Q. You also confirmed that you (inaudible: coughing) [Baby G] when she projectile vomited; can
you remember that?
A. Yes.
Q. Do you agree, Lucy, that [Baby G] was stable at this time that [Nurse E] had gone on her
break?
A. Yes, I don't remember there being anything concerning with her.
Q. Okay. Do you also agree that [Nurse E] wouldn't have gone on her break if there were issues
with [Baby G]?
A. No, [Nurse E] wouldn't have left her, no.
Q. Lucy Letby was then informed of Dr Evans' opinion:
Would you agree, Lucy, that [Baby G] must have received more than the required 45ml of feed if
this amount was aspirated following a collapse given that her vomiting was described as
projectile?
A. Yes, either that or she's not digested the milk from the previous feed.
Q. It's just -- sorry, is there a test that you do to see if that's the case before you do a
feed, Lucy?
A. Yes, so usually the tube is tested between -- after -- before each feed to see how much is in.
Q. So you would aspirate to see what's --
A. We always test the tube. We don't always pull back to see the full volume, but you'd always
take a little bit to test the pH of the --
Q. Right. And if that test would indicate that the feed hadn't been digested, would you still
continue to feed the baby the full amount of the following feed?
A. Um, it would depend on the baby's circumstances but no, not necessarily, no.
Q. So under what circumstances, if the milk hasn't been digested, would you still give a full
feed?
A. I'd ask for advice from somebody else.
Q. Okay. So in your experience, Lucy, would you give a baby a full feed if the milk from the
previous feed hadn't been digested?
A. No.
Q. At any point while [Nurse E] was on her break have you overfed [Baby G], causing her to
vomit?
A. No.
Q. Did you administer air to [Baby G] at this time, causing her to collapse?
A. No.
Q. In your previous interview, Lucy, you said that you obtained a larger volume of air from the
NG tube than just the general amount you would usually obtain.
A. Yeah, I'm not sure at what point I did aspirate the tube and find that air. Was it when she
vomited?
Q. Yeah, you said after a vomit you took over her care as a designated nurse and you obtained a
larger volume of air from the NG tube than just the general amount you'd obtained.
A. Yeah.
Q. Would you agree that she must have received a bolus of air from the feeding syringe?
A. Air has got there somehow, yes.
Q. Do you have an explanation, Lucy, as to how the air could have got there?
A. No.
Q. Are you responsible for the attempted murder of [Baby G] on this day, 7 September, Lucy?
A. No.
Q. Okay.
Looking at the 21 September, Lucy, [Baby G] was stable. You stated that you carried out
observations on [Baby G] at 9 am and at 11 am and that you fed her at 09.15 hours, 40ml via her NG
tube. I'll just show you the feeding chart for that day.
A. Yes.
Q. That verifies what I have just said to you; do you agree with that?
A. Yes.
Q. You were then asked, Lucy, about [Baby G] suffering two milky vomits at 10.15. However, you
couldn't recall if you were present for those. You confirmed that you aspirated 30ml, which is
shown in the feeding charts following the two vomits. Looking at those feeding charts, Lucy, can
you tell me if there was any undigested milk in [Baby G]'s stomach prior to giving her that 9
o'clock feed?
A. There, 30ml of milk that was discarded.
Q. Okay. So that's in line with that entry there at the top. What can you tell me about that?
A. That 30ml of milk was found --
Q. Mm-hm.
A. -- on aspiration --
Q. Mm-hm?
A. -- and it was discarded.
Q. Okay. And have you still -- have you then still gone on to feed [Baby G] 40ml at 9 am?
A. Yes. It would look like that, yes.
Q. So prior to that feed, can you confirm that [Baby G]'s stomach would have been empty, having
discarded that 30ml?
A. Yes.
Q. Okay. And you've then emptied her stomach of the 30ml, you've fed her the 40ml, and then she's
suffered the two projectile milky vomits?
A. Yes.
Q. Do you agree, Lucy, that [Baby G] was fed far more than 40ml for her then to suffer two large
milky projectile vomits?
A. No. I think she could have projectile vomited on 40ml.
Q. Lucy Letby was then informed of Dr Evans' opinion that [Baby G] had received excessive volumes
of both milk and air.
A. I didn't overfeed her.
Q. Did you administer air to [Baby G] via her NG tube, Lucy?
A. No.
Q. Lucy Letby indicated she could not say where any air came from. And she was asked:
Are you responsible for the attempted murder of [Baby G], Lucy?
A. No.
Q. Have you got any further explanation as to how this could have happened to [Baby G]?
A. No.
Q. Moving on to the third interview in respect of [Baby G]. We can see, officer, that took place
on 10 November 2020.
A. Yes.
Q. And the portion that we're about to read or the summary was part of a longer interview, the
times of which are set out below the date?
A. Yes.
Q. Thank you. So looking at this summary:
The next baby I want to talk to you about, Lucy, is [Baby G]. On your previous interviews
regarding [Baby G], Lucy, you denied being responsible for the attempted murder of [Baby G] on the
7th and then on 21 September 2015. Is there anything you wish to say, Lucy?
A. No.
Q. Okay. We've got a statement from Dr Ventress. She stated that at 3.30 hours, while she tried
to ventilate [Baby G], she noted bloodstained fluid coming up from the trachea and through the
vocal cords at the back of her throat. Dr Ventress reconnected [Baby G] to the ventilator and
things then improved. Do you recall that?
A. No.
Q. Do you know the cause of [Baby G]'s injury to her throat?
A. No.
Q. At 06.05 hours [Baby G] had another episode. She said that she changed her breathing tube.
When this was removed she noted there were thick secretions in [Baby G]'s mouth and a blood clot
at the end. Can you explain the thick secretions and the blood clot?
A. No.
Q. Do you know or can you give any explanation, Lucy, as to how this would have happened?
A. No, unless it was -- the clot might have come through intubation maybe. I don't know. Trauma in
the tube. I don't know what makes secretions thick.
MR JUSTICE GOSS: It actually says "this would have been caused", not "how this had happened". I'm only correcting you because people who don't have access to the records may be making notes of it.
MR ASTBURY: Sorry. Nearly done.
MR JUSTICE GOSS: I know, you've had a long day.
MR ASTBURY: Have you ever seen thick secretions within a baby before?
A. Yes.
Q. And what was the cause for those?
A. I think sometimes it's an infection, but sometimes babies just have thick secretions.
Q. So how can trauma be caused by putting the tube in then?
A. I'm not sure, but it's -- it's a doctor's role, but they quite often say sometimes that, you
know, it was a difficult -- it was a tight airway or they've, you know, it's been difficult to
pass the tube. So if that can cause a little bit of abrasion or something, and sometimes we do get
bloodstained secretions back from the tube and with the suction and the doctors will say, oh,
that's because it was traumatic to get it in.
Q. Okay. We've got a statement from [Nurse B], Lucy. Do you remember [Nurse B]?
A. Yes.
Q. Okay. She's provided evidence as to doctors attending to [Baby G] on 21 September and placing
screens around her so they could fit a cannula and describes [Baby G] as being on the procedure
trolley with her Masimo monitor switched on. She states that at some point she left [Baby G] with
the doctors so she could attend elsewhere on the unit and a short time later she heard you
shouting for assistance. She says you were providing ventilation breaths and she noted that [Baby
G]'s Masimo monitor was switched off. Do you recall that event that [Nurse B]'s describing?
A. Parts of it. Yeah, I recall going to [Baby G] and finding her behind the screen --
Q. Okay.
A. -- on the procedure trolley, which we wouldn't -- we'd never leave a baby unattended on the
procedure trolley.
Q. And in relation to the Masimo monitor being switched off, do you recall that?
A. No.
Q. Is it bad practice to switch the monitor off during a situation as described by [Nurse B]
there?
A. Yes. But I am not sure when I came in to her whether she had the monitor on or not.
Q. And then colleague:
You said, Lucy, then in your first response that with regards to being left on the procedure
trolley, you'd never do that.
A. No, we'd never routinely leave a baby alone on a procedure trolley.
Q. So has someone made a mistake there, do you think?
A. Yes.
Q. Okay. So?
A. And we also wouldn't leave a baby behind the screens either. It should be --
Q. Right?
A. -- in view of whoever attended.
Q. So looking at social media, Lucy, and Facebook, just as a reminder so you can correlate the
dates, [Baby G] was born on 31 May 2015 and you completed numerous searches for [Baby G]'s mother
[Mother of Baby G]. You searched for her on 21 September 2015, 5 November 2015, 14 November 2015,
23 January 2016, 12 February 2016, and then 1 September 2016. Do you agree that you made those
searches on Facebook?
A. Yes.
Q. Do you remember making them?
A. No.
Q. Have you got any comments you wish to make about those searches, Lucy?
A. No.
Q. Okay. In relation to your mobile phone and text messages, in relation to the event to [Baby G]
that happened on 21 September, at 9.20 in the evening of that date you messaged [Nurse A] and
said:
"Looked rubbish when I took over this morning. Then she vomited at 9 and I got her screened."
Why did you make that comment and send that message to [Nurse A]?
A. I'm not sure.
Q. Do you recall sending it, Lucy?
A. No.
Q. When you said "looked rubbish", can you explain what you meant by that?
A. I don't remember.
Q. Okay. The time by my watch is 5.38 and the interview is suspended.
So that was the conclusion of that third interview with [Baby G] --
A. Yes.
Q. -- concerning [Baby G]. Thank you.
So we move on to [Baby H].
MR JUSTICE GOSS: This will be the last baby for today. It's just so that people know where we go to. It's only 13 pages in total. It'll only be 15 or 20 minutes, then we'll finish for the day. Otherwise everything amalgamates into one, so to speak, and it becomes difficult. So this will be the last baby and it's relatively short in terms of interviews, just so that people know.
MR ASTBURY: [Document redacted], all being well, being the page that's now open. We can see the
date of interview, the first interview involving [Baby H], 5 July 2018.
A. Yes.
Q. It began with introductions and caution?
A. Yes.
Q. Okay, as I said, this is a continuation of interviews and the baby that we are going to speak
about now is [Baby H]. Are you happy that you've had chance to read the notes prior to the
interview?
A. Yes.
Q. Okay. Any notes as before are here and available for you to look at if that helps your memory,
okay, and you can do that.
A. Yes.
Q. Then in fact, Ms Letby's solicitor asked:
"Do you want to have the notes in front of you?"
And she replied?
A. Yes, please.
Q. Okay. Just to summarise, [Baby H] was born at 18.22 on 22/9/15. At 03.22 hours on 26/9/2015,
[Baby H] collapsed. She also collapsed a second time on 27/9/2015. Okay?
A. Yes.
Q. Okay. Generally, with regard to [Baby H], and specifically the collapses that I have just
mentioned, do you have memories aside from the notes?
A. Yes.
Q. Okay. So tell me what memory you have.
A. I remember caring for [Baby H]. She had chest drains in and chest drains aren't something that
I've looked after a lot or see a lot of on the unit.
Q. Okay.
A. So I remember her predominantly in that aspect of having chest drains.
Q. So specifically what about the collapses?
A. I remember on one of the collapses we needed to insert another chest drain and there was some
delay in obtaining the equipment because it wasn't something that we use a lot on the unit and I
think she had two different types of chest drain and so they're cared for in different ways.
Q. The officers confirmed that Lucy Letby had read her notes and then took her...
Let's go to your entry. If you look at 3.22:
"Profound desaturation and colour loss to 30%."
A. Yes.
Q. Okay. Tell us about that.
A. I only remember via my notes that she had a desaturation and colour loss. Um, Neopuff was
commenced. I assume that was by myself and I would have summoned help at that point. I think I do
remember that there was a lot of fluid coming out of her drains at the time.
Q. Okay. So up to this point of the desaturation, how was [Baby H] handling?
A. I don't remember.
Q. Okay. So how were you alerted to this particular desaturation?
A. I would assume from her monitors alarming.
Q. Do you remember?
A. No.
Q. What monitors was she on?
A. All ventilated babies would be on a Philips monitor, which is a full monitoring system.
Q. Okay. So you don't recall where you were at the time that this desaturation occurred. You
don't know whether you were present --
A. No.
Q. -- or whether it was the monitor that alerted you?
A. No, I don't remember.
Q. Okay. Was anybody else given (sic) her care at this time?
A. Not that I remember. If we're giving medication, somebody else would have checked those with
me. I don't recall any other care.
Q. Okay. But from your notes you were designated nurse?
A. Yes.
Q. Okay. So with regards to the colour loss to 30%, explain that to me.
A. I don't remember it specifically for [Baby H], but profound desaturation, colour loss to 30 --
colour loss would be sort of a -- would be sort of a blue pale appearance.
Q. Okay. All over or in certain areas?
A. It would usually be all over. I don't remember specifically for [Baby H].
Q. Where you said, "Good chest movement and air entry" --
A. Yeah.
Q. -- "colour change on CO2 detector", what does that mean?
A. The CO2 detector would be something that we put on to the end of the ET tube and when that
changes colour it shows that there's -- that the tube is retaining CO2, which shows the tube is in
position.
Q. Okay. Then you put:
"Serous fluid ++."
Can you see that entry?
A. Yes.
Q. Okay, "From all three drains".
So you mentioned previously there was a lot of fluids coming from the chest drains.
A. Yes.
Q. So tell me about that, your observations.
A. The drains were connected and some of them were going into additional sort of tube inputs and I
remember a lot of secresive (sic) looking fluid coming out of these drains.
Q. What's serous-looking fluid?
A. Serous fluid is sort of like a yellowy milky colour. It's serous fluid from inside the body.
Q. And then obviously she's become:
"Bradycardic. Doctors crash called and resus."
Who did that, who did the crash call?
A. I don't remember.
Q. Okay. So from 03.22 when you've noted the profound desaturation to the crash call, do you
recall how long that was, what time period?
A. No.
Q. On the 26th do you recall the resus of [Baby H] on this occasion?
A. No.
Q. Can you recall what role you played?
A. No, not without looking.
Q. Then can I just ask one question, so from your notes there:
"[Baby H] desaturating ++ on handling."
Is that to say that [Baby H] started to go downhill when you were with her?
A. So that means [Baby H]'s desaturating when she's being handled, yes.
Q. So prior to that were there any concerns for [Baby H]?
A. Prior to the desaturation?
Q. Yes.
A. And the handling?
Q. Yes.
A. The desaturation?
Q. Yes. The point I'm trying to get across is, did [Baby H] start to desaturate when she was in
your possession?
A. Yes, I've written that she's desaturating on handling, so minimum handling was observed when
possible.
Q. Okay, but you -- it was you that was handling [Baby H] at the time?
A. Yes.
Q. Can you remember what you were doing?
A. No.
Q. Okay. So next there's an addendum, 05.21.
A. Yeah.
Q. "Conversation with myself, Dr Gibbs and the parents, explaining [Baby H]'s deterioration. Parents concerned re brain damage. Support and information given. Aware that [Baby H] is poorly and may deteriorate again. Blessing offered by Dr Gibbs. Parents keen for this to happen tonight. Extended family members contacted and coming to the unit. Catholic priest asked to attend."
Okay. What was the explanation given as to [Baby H]'s deterioration?
A. I don't recall specifically.
Q. Okay. And why was it likely that she would deteriorate again?
A. I don't think it was likely, I think it was just a potential that as she was a sick baby she
could deteriorate again.
Q. How did you feel about, what were your concerns about, the collapse of [Baby H]?
A. I think it was quite a new thing for me. As I said previously, I've not cared for many babies
with chest drains before because obviously I came on shift to [Baby H], who was stable but was
already ventilated with drains in situ, which --
Q. Okay.
A. -- is something I hadn't seen a lot of on the unit.
Q. Okay. And what challenges did that bring?
A. So it's a different level of care to have to give to a baby with -- with those drains.
Q. Right.
A. And as I say, it's not something we see a lot of on the unit. Quite often, babies like that
would be transferred out and cared for at a level 3 hospital.
Q. The contact with [Baby H]'s parents with that collapse, do you remember any of the contact
between them?
A. I remember them coming to the units and having a blessing for [Baby H], yes.
Q. Okay. Any particular conversations you had with them other than you've noted in your note?
A. Not that I recall.
Q. Then questions turn to the second event on 27 September 2015. Lucy Letby confirmed that she'd
been through the notes, but said that she did not recall in great detail from memory. The officers
recapped those entries on the night shift of the 26th into the 27th, which bore Lucy Letby's
name:
Okay. Do they remind you of this second collapse of [Baby H]?
A. Not in any clear detail, no.
Q. Would you agree by those notes you are at the periphery of the care for [Baby H] on that
occasion?
A. Yes.
Q. Okay. And again, what about contact with parents?
A. I don't recall specifically speaking to the parents.
Q. Okay.
A. I'm assuming if they were there I would have spoken to them at some point.
Q. Anything else you want to add that we've not specifically asked you about, about the care of
[Baby H]?
A. No. As I say, for me, I just remember [Baby H] because of chest drains being an unusual thing
and the difficulty we had at times with obtaining the equipment for her.
Q. Thank you. That concluded that particular interview.
We move on to the second interview at [redacted], please. We can see this took place on 11 June
2019.
A. Yes.
Q. Okay, we'll move on to [Baby H] now, Lucy. You remembered [Baby H] from her chest drains and,
following one of her collapses, having to insert another chest drain, and I think you remember it
because you didn't use them a lot on the unit. Do you remember that?
A. Yes.
Q. You were designated nurse for [Baby H] on 26 September and involved with her care on 27
September 2015 from the notes again. Do you remember that?
A. Yes.
Q. Lucy Letby was then shown the prescription chart at tile 235 and the entry dated 26 September 2015. Can I just ask Mr Murphy to put that up, please. That will be the third entry up from the bottom.
Can you just confirm to me that's your signature there, Lucy, on that?
A. That's my signature, yes.
Q. Okay. Can you just confirm what your signature was against?
A. Um, it was a saline bolus.
Q. And is that the administration of a saline bolus?
A. I'm not sure who administered it.
Q. Can you just tell me the other signature next to your name? Do you recognise it at all or is
it unreadable?
A. No, I wouldn't confidently say. [Nurse A]?
Q. You were the designated nurse for this day, Lucy?
A. Mm-hm.
Q. Does that make it more likely that you'd have administered this?
A. No, it depends who was drawing up the drugs at the time, if any other drugs were being drawn up
at the same time.
Q. Okay.
Lucy Letby then denied being responsible for the profound desaturation, which required
resuscitation at 03.22:
Did you intentionally cause her harm?
A. No.
Q. Dr Ventress says that she was crash called to the neonatal unit at 03.24 hours on 26 September
and she documents that no trigger to the collapse had been identified. Is there anything you did,
in your opinion, Lucy, that caused her to collapse?
A. No.
Q. Do you have an opinion on why she collapsed?
A. No. She was a sick baby at the time.
Q. Did you attack her at this time?
A. No, I did not.
Q. What did you do, Lucy, that caused [Baby H] to collapse?
A. I didn't do anything.
Q. That interview concluded at 9.37 on that particular day.
Then interviewed in part on the third occasion on 10 November 2020.
A. Yes.
Q. The usual information on our frontispiece. Following introductions, Lucy Letby confirmed that
she was okay to continue answering questions:
Lucy, I'm going to talk to you now about [Baby H]. In your previous interviews, Lucy, you
remembered [Baby H] from her chest drains. You denied being responsible for her collapses on both
of those days. Is there anything else you'd like to add regarding those interviews?
A. No.
Q. So we have a statement from Shelley Tomlins at 21.45 hours on 26 September. [Baby H]
desaturated and she -- and she suctioned thick bloodstained secretions from her ET tube. Do you
know the cause for the thick bloodstained secretions?
A. No.
Q. Lucy Letby was asked about the valve which Dr Jayaram recalled he had found closed. She said
she was unfamiliar with chest drains and denied closing it, and was asked:
Right, okay, what would the consequences be to [Baby H] with the valve being closed?
A. The drain wouldn't be doing its job.
Q. In regards to social media, Lucy, [Baby H], as we told you, was born on 22 September and
discharged on 9 October 2015. On 5 October 2015, at 01.18 hours in the morning, you searched on
social media for [Mother of Baby H; do you agree?
A. Yeah. I don't remember doing it, but yeah.
Q. Okay. In regards to your mobile phone, this is a text message from you to [Nurse A] on 26
September 2015 at 21.32 hours. It says this:
"[Baby H] had had good day, one drain removed, but just blocked tube and tonnes of secretions.
Shelley has her."
Then it says:
"[Nurse B] in 4 and seemed a bit off when she came in, saying she'd have liked to have had her but
now keeps saying she doesn't feel well."
"I have..."
And then we have edited that to "E and N". The full names are there, they're not indictment
babies:
"Hope you're okay."
Do you remember that text message?
A. No.
Q. Is it a common occurrence to have tonnes of secretions, Lucy?
A. No.
Q. Right, okay. Was this to pass the blame to Shelley with regard to the secretions?
A. No, there's no blame, I'm just stating the fact that Shelley looked after her. Maybe [Nurse A]
asked me who had her. I don't know.
Q. And that was the extent of the interview on that day.
A. Yes.
MR JUSTICE GOSS: The remaining interviews in this file are all relating to [Baby I] and they're much more substantial. We won't start them now. I know it's a bit earlier, but it's been a long day, and it's a long weekend as far as you're concerned, a long break, 4 days.
I gather you've been given the sheet of the non-sitting days. You probably noticed that there was an additional day that I've added to it, which is Wednesday, 3 May. The Monday is a public holiday, but the Wednesday is a non-sitting day as well. You may take this, as it says, that as at today these are the non-sitting days for this month and next month. All right?
So this is an appropriate point to remind you of your obligations, as it's a four-day break from this trial, not to communicate by any means with anyone about anything to do with this case and not to conduct research about anyone or anything to do with this case. You've known that now for over 6 months. So please, you'll appreciate I said at the outset how important that is, but of course it's important that it runs right through to the very end of the case. Thank you very much. I'll see you on Tuesday of next week.
(In the absence of the jury)
MR JUSTICE GOSS: I don't think there's anything else?
MR ASTBURY: No, thank you.
MR MYERS: We'd be grateful if Ms Letby could remain for a little while for us to speak to her, my Lord.
MR JUSTICE GOSS: Yes. Mr Myers and others -- will you be going down, Mr Myers?
MR MYERS: I will be.
MR JUSTICE GOSS: And others will be coming down very shortly, so please don't remove her from the building until they've been down. Thank you very much. (3.58 pm)
(The court adjourned until 10.30 am on Tuesday, 25 April 2023)
Source Transcript (PDF) - Police interviews Day 3
MR JUSTICE GOSS: Mr Astbury.
MR ASTBURY: My Lord, we had reached on the last occasion the final four dividers in bundle 1, which are the interviews concerning [Baby I].
Before we read those interviews, there was an issue that arose in the interview on [Baby F] and the precise wording used on the tape. It has been checked and we can confirm, so I was going to ask if we can perhaps go back to that page now and everybody make the same amendment.
MR JUSTICE GOSS: Certainly.
MR ASTBURY: It is page [redacted] and it's behind the divider marked [redacted]. Everyone has
page [redacted]?
(Pause)
It's the second reply down the page, my Lord. It begins:
"We've had a few babies on the unit who have had hyperinsulinaemia, which is what I spoke about
before the end."
And then it should say "endocrine condition" as opposed to "a crying condition".
MR JUSTICE GOSS: Yes.
MR ASTBURY: I'm told it sounds very similar on the tape, so simply misheard by the typist.
MR JUSTICE GOSS: Thank you very much.
DS DANIELLE STONIER (continued) Examination-in-chief by MR ASTBURY (continued)
MR ASTBURY: If everyone's made that amendment can we go back, please, to the divider marked [redacted], [Baby I].
Four interviews, officer, as far as [Baby I] is concerned?
A. Yes, that's correct.
Q. The first one taking place on 4 July 2018. We can see the times set out. We can see in the
body of the interview:
Okay. This is a continuation of the interview. I'm going to move on now to [Baby I]. There's a few
episode for [Baby I], so just bear with me because some I'm going to read out to you.
A. Okay.
Q. The officer then summarised [Baby I]'s birth and the incidents alleged to be suspicious. Then
Ms Letby's solicitor said:
I think in relation to this baby because there's more than one incident, and to avoid any
confusion between incidents...
And then one officer interjects:
We're just going to stick to the note for this one.
And then the other officer says:
On 23 August 2015, were you working on this date or did you have cause to go to the NNU, the
neonatal unit, on that day?
A. I'm not sure without looking at the off-duty notes.
Q. Was there any way you could jog your memory at all? Is there anything --
A. My own personal diary.
Q. Right. So your personal diary. Did you -- every time you worked would you put something on
your diary?
A. Yes.
Q. Without fail?
A. Yes.
Q. Okay. So if we go to the notes then, this is for 30 September 2015.
A. Yes.
Q. So who was the designated nurse for [Baby I] at this time?
A. Well, from reading that, myself.
Q. Okay. Do you recall if you were caring for any other babies at this time?
A. I don't remember.
Q. In which unit she was being cared for, which nursery was she was being cared for?
A. I think it was nursery 3.
Q. Okay, you think or you remember?
A. No, I'm fairly certain it was nursery 3 but I'm not 100% sure.
Q. Okay. Do you recall on this particular day what the clinical position was for [Baby I]?
A. From -- not from memory, I need to --
Q. Okay.
A. -- refer to my notes as well. Just that she was nursed on a hot cot but was still having a low
temperature so that hot cot needed to be increased during the day that I was looking after her.
Q. Who fed [Baby I] this time?
A. I don't recall from memory. I'd have to check the feeding chart but I think mum was present for
some of the feeds.
Q. How do you remember that?
A. I don't remember from that specific day but I know mum was very present with [Baby I] a lot of
the time. She came in for a lot of her feeds?
Q. Do you recall if you had any concerns for her at this time at all?
A. Not at this moment, no.
Q. No? Do you recall how she was handling?
A. No.
Q. You then go on to say:
"The abdomen appears full and slightly distended, soft to touch. [Baby I] straining ++. Bowels
have been opened."
Do you remember -- do you remember that event?
And my Lord, that tile number is for reference if anyone wants to see the note.
A. Not in great detail, no.
Q. No? You don't remember who discovered it? Did you discover it, do you remember?
A. I remember having a conversation with mum about it, I'm not sure if it was myself that noticed
or whether mum highlighted it to me.
Q. Had there been any change to [Baby I]'s care prior to this happening?
A. Not that I'm aware of, no.
Q. Okay. You put:
"Mum feels it's more distended to yesterday and that [Baby I]'s quiet."
Do you remember that conversation with mum?
A. Yes, I remember talking to mum about [Baby I], yes.
Q. And that particular conversation about the abdomen more distended?
A. As prompted by my notes, yes.
Q. I don't suppose you remember when mum arrived?
A. No.
Q. You said that mum was present for the feeds or some of the feeds?
A. I think, yes. I'd have to check the charts. It would be written. Can I have a look at them?
Q. Yes. So mum was present for the 10 o'clock feed and carried out the feeds...
Sorry, this is a continuation not a different line, my mistake.
A. Yes. So mum was present for the 10 o'clock feed and carried out the feed and cares. And then
the next feed was the tube feeds. I'm not sure if mum was present or not but I know she was there
for the 10 o'clock feed because she gave her a bottle.
Q. Okay. And then what? What about the feeds after that?
A. So they're tube feeds. So I've given the tube feeds, but I'm not sure if mum was present or
not.
Q. Okay. What times were they?
A. At 1 o'clock and 4 o'clock.
Q. Okay. So it was mum at --
A. Mum at 10.
Q. Yes.
A. And myself at 1 o'clock and 4 o'clock.
Q. Via tube?
A. Yes.
Q. You've noted that, "Appears generally pale". Were you concerned at that point at all?
A. No. From memory [Baby I] was often paler in colour.
Q. Was often paler in colour?
A. Yes.
Q. So who asked for the review?
A. Myself from reading the notes.
Q. Was there a reason why that was?
A. I think it -- I think it was because I was discussing with mum that -- that we, that she
noticed a change in [Baby I], so I asked the doctors to review her with that in mind.
Q. Okay. Do you know which doctors they were?
A. No. And I think they were asked to review in lieu of the hot cot needing to be increased as
well.
Q. And how were you feeling about [Baby I] at that point then? How was she presenting?
A. I don't remember being unduly concerned about her.
Q. Lucy Letby, it was summarised, wrote up the relevant observations at 13.36 hours. She believed
they occurred some time after [Baby I] opened her bowel at 10 am and before 13.30. The question
was asked:
Okay. Another activity on the notes that you put in on page 2. The date is 30 September at 19.31.
Have you got that one?
A. Yes.
Q. And it's got:
"Reviewed by doctors at 15.00 as [Baby I] appeared mottled in colour with distended abdomen and
more prominent veins."
Do you remember who those doctors were?
A. No.
Q. Okay.
A. I think it might have been [Dr A], the registrar.
Q. Okay. Is this in relation to the review that you asked for in your previous notes, you know
when --
A. No, this is an additional review.
Q. Okay, right. And why was -- so why was that review asked for?
A. Because [Baby I] had become more mottled in colour and more distended abdomen.
Q. Right, okay. And who discovered this mottled colour?
A. I'm not sure if it was myself or not.
Q. Right. And when you put previously that you realised that she was pale, "appears generally
pale", how soon after can you remember when she became mottled?
A. The following notes here would read that she became mottled at around 15.00.
Q. So I'm just asking if you remember when she was pale and how soon after was the mottled
highlighted to you [as read]?
A. No I don't remember.
Q. You don't? Okay.
A. But I -- I think mum was there when the doctors were reviewing her because I think mum saw the
mottling as well.
Q. Can you describe the mottled colour to us?
A. I can't remember [Baby I]'s appearance exactly, no.
Q. Okay. What was the relevance of the prominent veins?
A. So when babies' abdomens distend their veins become more prominent because of this distension.
Q. Okay. And whereabouts were those veins sort of more prominent?
A. I don't remember exactly. Just on her abdomen. I don't remember where.
Q. Okay. But you said about mum might have been there and noticed the mottle [as read]?
A. Yes.
Q. It's purely for the timings, that's all.
A. I think -- was it when I've written the next account at 19.32?
Q. Yes?
A. I have written that mum was present when reviewed by doctors.
Q. Yes?
A. And then had left the unit when [Baby I] had a large vomit.
Q. Okay. So that's --
A. So I think the 13.48 entry is referring to:
"Mummy is to carry out feeds and cares of the morning feeds."
Q. So where you've put, "Reviewed by doctors at 15.00", is that when the doctors came to review
or do you think that's when she appeared mottled from the way it's written?
A. I -- I would read that she became mottled around that time and that's when she was reviewed by
the doctors due to that.
Q. Right. Okay:
"At 16.30 [Baby I] had a large vomit from the mouth and nose++, suction given. Became apnoeic with
bradycardia, desaturation (30s). Help summoned and IPPV (ventilation) given for approximate 3
minutes and 100% oxygen to recover. Doctors were crash called."
How did you become aware of this large vomit, can you remember, at 16.30?
A. I'm not sure, no.
Q. Do you remember who was present?
A. No.
Q. Do you remember just prior to that what you were doing at all?
A. No.
Q. Do you remember who actually put the crash call out at this time on this day?
A. No, I'm not sure who put the call out.
Q. No? Okay.
A. And do you remember how soon the doctors arrived?
Q. I don't remember exact timings, no?
MR JUSTICE GOSS: That's the wrong way round. It should be:
"Question: And do you remember how soon the doctors arrived?"
A. I don't remember exact timings, no.
MR ASTBURY: No? Okay.
MR JUSTICE GOSS: That's wrong again.
MR ASTBURY: Do you recall who the doctors were?
A. I think it was [Dr A].
Q. Then in summary, Lucy Letby confirmed [Baby I] was moved into nursery 1 for closer
observations and because she needed an incubator. She was placed nil by mouth and she, Lucy Letby,
continued as her designated nurse:
So do you recall when mum left the unit?
A. No.
Q. Did she leave prior to or after the vomit?
A. I've written -- I don't remember from memory but I've written that she had left the unit when
[Baby I] had the vomit, that she was there where the doctors reviewed her at 15.00.
Q. Who discovered the vomit?
A. I don't remember.
Q. If we go to the activity date, timed at 20.26, it starts off with, "Peripheral line sited".
Have you got that?
A. Yes.
Q. My Lord, I don't think we need to put the tile up for this. It's there if anybody needs
it:
"... and 10ml per kilogram saline bolus given. 10% glucose commenced. At 19.30 [Baby I] became
apnoeic, abdomen distended ++, confirmed bradycardias, desaturation followed."
Clearly, this is the note being read, officer, isn't it?
A. Yes, it is.
Q. "SHO in attendance and registrar crash called."
Do you recall who the SHO was at that time?
A. No.
Q. Or who the registrar was who you refer to there?
A. I'm not sure if the registrar would have still been [Dr A], who was on a day shift.
Q. Do you remember who discovered this event? I mean do you actually remember this event
occurring, Lucy?
A. No.
Q. You don't? Okay.
A. Only through prompt of my notes.
Q. So if we move on to the 12th into 13 October, and Lucy Letby confirmed that she had the
relevant notes before her:
Do you recall this event of 12/13th at all compared to the last event? Is there anything specific
about that that day? I'll just lead you through your notes.
A. Oh yes, sorry. So this is when she was found apnoeic in the cot at night.
Q. "[Baby I] noted to be pale in the cot by myself at 03.20. SN Hudson present."
So who had you taken care from at that time, do you remember?
A. From Staff Nurse Hudson.
Q. Lucy Letby confirmed that she'd taken over as [Baby I]'s designated nurse that night after the
relevant incident:
So do you want to tell us what the clinical position was for [Baby I] at that time?
A. When I took over her care?
Q. Yes.
A. Well, she'd been found in the cot apnoeic -- well, sort of gasping and required Neopuffing and
then intubating.
Q. Okay. And is -- why was that care passed to you then?
A. Because Staff Nurse Hudson was a junior band 5 nurse that couldn't care for intensive care
patients, which [Baby I] had then become.
Q. In your notes you put, "Noted to be pale". Can you elaborate at all on that? Can you expand
any observations at all?
A. Some of it. When we went into the nursery, put the light on -- the lights aren't on in the
nursery at night and we had put the lights on for something and I noticed -- I looked over at
[Baby I] and I noticed she was pale in colour in the cot.
Q. Okay.
A. So her face was pale.
Q. Do you remember what your observations were in relation to handling [Baby I] at that time?
A. I think we went over to her and pulled the covers off her and undid her babygro a little bit so
we could see her colour centrally.
Q. You then put in your notes:
"Apnoea alarm in situ and had not sounded."
Can you give an explanation for that at all?
A. So the apnoea alarm's are programmed to alarm if a baby hasn't breathed for 20 seconds.
Q. Right.
A. When we found [Baby I], [Baby I] was shallow breathing and gasping, so potentially if she had
gasped once every 20 seconds or more then the alarm would not have gone off.
Q. Right.
Then colleague:
When you say "when we discovered her", who were you with?
A. Ashleigh Hudson, who was caring for [Baby I].
Q. Okay. And what cause did you have to go to the nursery?
A. I don't remember. We both went in together for something but I don't remember why we were going
into the nursery.
Q. Okay. And what treatment had you given to [Baby I] up to that point; can you recall?
A. On that night?
Q. Yes.
A. Nothing that I'm aware of.
Q. You then go on to say that:
"On examination [Baby I] was centrally white."
What do you mean by that?
A. So when we pulled her babygro away and looked to her body she was white.
Q. Okay. What was your thoughts of what was going on then?
A. That she was collapsing in some way.
Q. Okay:
"Minimal shallow breaths followed by gasping observed."
What does this sort of mean to you?
A. So she was breathing but very shallowly and not very often and then was gasping.
Q. What action did you take at that point?
A. Well, we started to give Neopuff ventilation and called for help.
Q. Okay. Do you remember actually who called for assistance at that time?
A. I think I started ventilation breaths and Ashleigh called for help but that's just from memory.
Q. Okay. Do you remember who actually came to assist, how long it took for them to arrive?
A. No, I don't recall exact timings, no.
Q. Okay, was there full resus efforts at this time.
A. No. I think they were just obtaining an airway.
Q. Lucy Letby was then asked about her subsequent notes with the question:
What do you mean by stiff in posture?
A. So she's holding her limbs stiffly. So they have a rigid posture.
Q. Is that a sign of anything to you?
A. It can be that they're in pain.
Q. And then the question is:
Is that a suitable time for us to stop, yeah, or do you wish to...
And then Ms Letby's solicitor said:
We could do one more thing. I am just thinking, if you're okay to do one more, but there's so much
to do tomorrow and I think we said we'd do it now, so we've got about 25 minutes.
A. Is this the last one for [Baby I]?
Q. There's two left.
A. Can we leave it then, please?
Q. The solicitor then said:
Yeah, okay.
And then the officers:
Okay, that's fine. Is there -- just explain to us the reason why you want to leave it at this
moment in time?
A. I just feel that I'm tired and I've gone through a lot at the moment and I want to be clear
with the information that I am giving to you and I think that would be better tomorrow.
Q. Okay, yeah.
Then the second officer:
Okay, the time is 2 minutes to 9.
And that was the conclusion of that first interview in respect of [Baby I].
A. Yes.
Q. Moving to the second interview, we can see, as has been suggested previously, that this is the
next day, 5 July 2018. It begins at 9.43 in the morning. It begins with the officer saying:
Okay, we were in the middle of dealing with [Baby I], [Baby I]. So I would like now to concentrate
on the event that occurred at around 7 o'clock and 7.45 in the morning of 14 October 2015. This is
when [Baby I] became bradycardic, requiring intubation and resuscitation.
Lucy Letby confirmed that she'd been provided with notes:
It is -- before we go through these notes, do you remember that particular shift?
A. No.
Q. Okay. Do you remember the clinical position for [Baby I] at that time?
A. No.
Q. Lucy Letby couldn't recall [Baby I]'s handover, which nursery she was in or which staff were
on duty in each nursery. She was asked:
Okay, if we just move on with these notes, there is a -- you've noted some bruising,
discolouration evident on sternum and right side of chest from chest compressions. How were you
aware of this, Lucy? Have you got to that point --
A. Yes.
Q. -- in the notes? You have? Yes. Do you remember that, those bruising (sic)?
A. From reading my notes, yes.
Q. Only from reading your notes. Do you remember how you became aware they were from the chest
compressions?
A. Because of where they were on her chest.
Q. Lucy Letby confirmed the remainder of the note and explained what was meant by containment
holding:
"At 05.00 [again from the notes] the abdomen noticed to be more distended and firmer in appearance
with area of discolouration spreading on right-hand side. Veins more prominent. Oxygen began to
increase, colour became pale."
Have you -- can you see that in the notes?
A. Yes.
Q. Do you remember who was present when this occurred?
A. No.
Q. Do you remember what you were doing when this occurred?
A. No.
Q. Okay. Now this particular discolouration, can you remember that on [Baby I] at this time?
A. Not specifically, no.
Q. Do you remember -- you say it was spreading on her right-hand side. Do you remember where it
was spreading from?
A. I think it was spreading from the centre of her abdomen across to the right-hand side.
Q. Who alerted the doctor?
A. I don't remember.
Q. No? Do you remember who was involved in the resuscitation?
A. I remember Dr Jayaram being the consultant and I think it was Chris Booth, the nurse.
Q. Okay. What was your --
A. That was just from my memory.
Q. Do you remember what your role was?
A. I think from memory it was giving the resuscitation drugs.
Q. The officers then confirmed the remainder of Lucy Letby's notes from 14 October 2015 but she
said she could remember little of it:
Moving on to 15 October 2015, do you remember that particular shift of 15 October 2015?
A. Not -- not without knowing what happened, no.
Q. Okay. This is where she continued to have further problems, centring on desaturations at 4
o'clock in the morning, desaturations, bradycardia and chest compressions for 3 minutes. Okay? So
you don't -- you don't particularly remember that shift or any involvement with [Baby I] on that
day?
A. Is this the day that [Baby I] died?
Q. No, it isn't, no.
A. No, I don't recall it specifically no.
Q. If we move on then to the 22nd to 23 October 2015, and this is the occasion when [Baby I], sadly, did pass away.
The officers took Lucy Letby through the list of resuscitation drugs and she was able to confirm
her participation post-collapse together with Chris Booth:
Okay, all right then. So prior to you doing the resuscitation drugs, can you recall that
evening?
A. No.
Q. Okay. Do you recall attending to [Baby I] at all on that shift?
A. Not from memory, no.
Q. So prior to the collapse of [Baby I], you don't recall that shift?
A. No.
Q. At all? You don't recall either doing or where you were?
A. No.
Q. Do you recall how you became aware of the collapse of [Baby I] that led to the
resuscitation?
A. No.
Q. Okay. Do you recall whether or an alarm was activated or --
A. I don't remember.
Q. Okay. Sadly, following the collapse, [Baby I] passed away. Do you remember your involvement
with the parents at all?
A. Not specific details, no. I remember -- I remember they were coming to the unit and they came
with siblings.
Q. Is there anything else you remember about the parents and your involvement?
A. No.
Q. What do -- what is your memory of [Baby I]'s death?
A. I don't remember specific details, I just remember her dying. And the parents having time with
her and then the siblings came and they had time with her as well.
Q. Do you remember -- obviously [Baby I] had been in and out of the Countess of Chester Hospital
from her very early stages of life through to October. Do you remember that she was in and out of
the hospital and one minute she was on the unit and the next minute she wasn't?
A. Yes.
Q. Did you have a feeling of what was happening to [Baby I] through that time?
A. No. I think there was a feeling maybe amongst the nursing staff that she was going to other
hospitals a lot and then coming back and then needing to go again and I think there was a little
bit of a conversation of were they were sending her back too quickly to us.
Q. Okay. Whose feeling was that? Do you remember who actually said that?
A. No.
Q. Was that you, your view of it?
A. Yes.
Q. What do you think was wrong with [Baby I]?
A. I don't know.
Q. Do you think that [Baby I] was being allowed to leave other hospitals when she wasn't
well?
A. No, because I don't think she was unwell on her arrival back to us, but sometimes the transfers
-- I think she only went for 2 days at one point and came back, it's just -- it's just a quick
turnaround for a baby and it's a lot for a baby to undergo a transfer and I think it was just felt
that some of the time things were quite short for a baby to go through transfer.
Q. And how do you think that affects the health of a baby?
A. It's just no -- it's quite a stressful thing to have a baby going into the back of an ambulance
and different incubators being moved, undergoing the journey, different members of staff involved.
Q. Did you stay in contact with the family at all after [Baby I] passed away?
A. No.
Q. Okay. Is there anything else you would like to tell us about [Baby I]?
A. No.
Q. How did you cope with [Baby I]'s death?
A. It affected everybody on the unit because we all knew [Baby I] quite well and we'd got to know
the family. And then I wanted to go to [Baby I]'s funeral, I was unfortunately working at the time
so I didn't go.
Q. That interview was then concluded so far as [Baby I] was concerned.
A. Yes.
Q. Moving on to the third interview, which of course the second occasion by way of arrest when
interviews took place. This is now 11 June 2019?
A. Yes.
Q. And we have the time set out and the persons present in the usual way:
I'm going to talk to you now, Lucy, about [Baby I]. First of all, Lucy, I would like to talk to
you about this exhibit.
And then there's an exhibit reference given:
Let me show you a picture of that. Can you explain what that is, Lucy, for me?
Perhaps if we do put this up, my Lord. It's [redacted], tile 296, please.
Lucy Letby was asked:
Can you explain what that is, Lucy, for me?
A. Yeah, I sent a sympathy card to the parents because I wasn't able to attend the funeral.
Q. Okay. Is this normal practice, Lucy?
A. No. Well, it's not very often that we would get to know a family as well as we did with [Baby
I].
Q. Okay. Is there a reason why you didn't go to the funeral?
A. I was working. I wasn't able to change my shift. It was suggested that I could send a card via
one of the other nurses who was going.
Q. Pausing there, officer, this isn't the original card, of course, this is the image that was
found on the telephone --
A. On the phone, yes.
Q. Have you sent cards to other patients before, Lucy?
A. No.
Q. This is the only one you've ever sent?
A. Yes.
Q. We've got images of this recovered from your phone. Why did you take photographs of it on your
phone?
A. To remember what I'd sent to them.
Q. Why did you do that?
A. I often take pictures of -- of any cards that I've sent, even birthday cards. Anything like
that, I often take pictures of them.
Q. Did you forward these photographs on to anyone?
A. Not that I remember, no.
Q. Why did you want to remember what you'd wrote to them, Lucy?
A. It was upsetting losing [Baby I] and I think it was nice to remember the -- the kind words that
I'd hoped I'd shared with that family and, as I say, I usually photograph any birthday cards that
I send. Anything like that, that's what I'd usually do.
Q. In relation to 30 September 2015, Lucy, in your interview you stated that you were the
designated nurse on this particular date for [Baby I].
A. Yes.
Q. Okay. From your notes at 16.30 hours, [Baby I] had a large vomit, bradycardia and desaturation
and suffered a collapse and, as a result, [Baby I] was transferred to nursery 1. Do you remember
that?
A. Yes.
Q. You confirmed that:
"At 19.30 hours [Baby I] became apnoeic, her abdomen distended and air ++ was aspirated from her
NG tube."
Do you remember that?
A. Yes.
Q. The officer then summarised Dr Evans' opinion that air had been introduced to [Baby I]'s
stomach and asked the question:
You were caring for [Baby I] on this particular shift, you were with her in nursery 3 and you went
with her to nursery 1?
A. Yeah.
Q. Did you cause her collapse?
A. No. In my documentation I've aspirated air, not put air down.
Q. Did you inject air into [Baby I]'s stomach, Lucy?
A. No. The air's got in through some other aspect.
Q. So your --
A. If a baby's crying or -- there are other reasons why a baby can -- babies can have air in their
stomach.
Q. Okay. Moving on to 13 October Lucy, and your interview, you said you found [Baby I] apnoeic in
her cot, gasping for breath, which resulted in her needing Neopuff and intubating. Staff Nurse
Ashleigh Hudson was the designated nurse at this time and you took over the care for [Baby I]
after her collapse in nursery 1. Do you remember that?
A. Yes.
Q. With reference to you commenting that [Baby I] was pale, you said:
"When we went into the nursery, put the lights on -- the lights aren't on in the nursery at night
and we put the lights on for something and I noticed -- I looked over at [Baby I] and I noticed
she looked pale in colour in the cot."
Do you remember saying that to us?
A. Yes.
Q. Was this the first time that you'd noticed [Baby I] was pale, Lucy, within that paragraph, as
I've said? I'll just go through it again:
"When we went into the nursery, put the lights on -- the lights aren't on in the nursery at night
and we put the lights on for something and I noticed -- I looked over at [Baby I] and I noticed
that she looked pale in colour in the cot."
Was that accurate? Was that the first time you saw her pale?
A. From my memory, yes.
Q. Okay. So, "When went into the nursery", would that be you and who?
A. Ashleigh.
Q. When you say you put the lights on for something, what was that for, do you know, "And we put
the lights on for something"?
A. I can't remember whether we were both entering the nursery for some reason. I don't remember
what the reason was for.
Q. Am I right in saying that you wouldn't have seen her pale without the lights on? You put the
lights on.
A. It would be harder to tell if she was pale with the lights off, yeah.
Q. Okay, so were you -- so you were with Ashleigh at this time?
A. I think so, yeah. I'm not sure at what point we put the lights on, whether that was before or
after we saw [Baby I].
Q. You said there Lucy, "We put the lights on for something".
A. Yes.
Q. "And I noticed -- I looked over at [Baby I]..."
A. Yes.
Q. "... and I noticed that she looked pale in colour."
A. Yes.
Q. That would suggest that you've noticed having put the lights on.
A. Having put the lights on, yeah.
Q. Do you remember where you would have been stood then over the incubator to see her pale? Would
that have been directly over her, towards the end?
A. Yeah, I don't -- I think she was in the cot at that point.
Q. Okay.
A. It would have been -- she was in the cot space near to the nursery entrance, so it would have
been -- once you put the light on it would have been quite easy to see into the cot.
Q. Okay. Is the reason why you went over with Ashleigh at that time [as read]?
A. No, I don't remember why.
Q. Do you remember or did you examine [Baby I] prior to switching the light on at all?
A. I can't remember.
Q. Ashleigh Hudson states that [Baby I] was doing well, she'd gone out of nursery 2 for about 15
minutes, and when she returned you were stood in the doorway, that you looked towards [Baby I],
and said that she looked a little pale, a little bit pale. Do you remember that?
A. No. I remember us being in the nursery together and putting the lights on.
Q. Do you remember telling Ashleigh that [Baby I] looked a little bit pale at the doorway?
A. Yes.
Q. You do?
A. I think, yeah, but I think it's when we put the lights on.
Q. Do you remember exactly the order of events, Lucy, how you knew that she was pale?
A. No. From my memory, we were both in the nursery -- we were both at the nursery...
Sorry:
We were both inside the nursery. I think I looked over at [Baby I], I don't know. I -- I thought
that we put the lights on as we went into the room.
Q. She says the first time she saw [Baby I] pale -- how could you see from the doorway that [Baby
I] was pale without having the light on, Lucy? How did you know she was pale?
A. Maybe I spotted something that Ashleigh wasn't able to spot. The rooms are never that dark that
you would not be able to see the baby at all. There's always a level of light for that reason.
Q. What is it, Lucy, that you could have spotted that Ashleigh didn't?
A. Her colouring.
Q. How would you able to spot the colouring then and Ashleigh couldn't if you were both stood at
the same place?
A. I'm more experienced than Ashleigh.
Q. Okay, but colourings are visual thing; do you agree?
A. Yes.
Q. So a change in colour?
A. Yes, yeah, there's varying degrees of -- of paleness and [Baby I] was often a pale baby anyway.
Q. Okay. Then you see on top of that, Lucy:
"[Baby I] was also lying in -- in the cot and positioned over the cot was what we call a cot
cover."
You know what a cot cover is, don't you?
A. Mm, yes.
Q. So again how did you know that she was pale before you approached the designated nurse,
Ashleigh?
A. Because from where her cot side is -- if the canopy is over that way, the light can get in from
that way for her -- she's still facing outwards towards the door.
Q. But the light's not on, Lucy.
A. No, but there's still light coming in from the main corridor, which is where we were stood, by
the doorway.
Q. So you're saying that you didn't go to [Baby I] prior to --
A. I'm saying I don't remember.
Q. What would your action be if you realised she wasn't well?
A. Let somebody know.
Q. Did you?
A. I believe from that comment I've told Ashleigh that she looked pale.
Q. Why didn't you do something prior to her arriving back?
A. Well, I don't know at what point I found [Baby I]. I thought we were both together when we
found her, but --
Q. So t the time she arrives back, you've looked over towards [Baby I], is that what you're
saying?
A. Possibly, yeah.
Q. So you're saying from that position you could notice, you would notice that she was pale and
she wasn't well with the poor light and the tent structure?
A. I think, yeah, you could have an idea, yeah.
Q. Is the tent structure over the head, Lucy?
A. The tent structure covers sort of the upper part of the cot, yes.
Q. Okay.
A. It has two peaks so that light comes through the top and not -- through the bottom end of the
cot and not through the top.
Q. When the light was switched on, she describes her as being white, looked in shock, and could
tell something was completely wrong with her. This is a reference to Ashleigh Hudson:
"She [Baby I] wasn't breathing properly and gasping for air. She looked dead when I first looked
at her."
That's what Ashleigh's saying.
A. She did look dead.
Q. Do you have a good memory of [Baby I] at this time that we're talking about?
A. Yeah.
Q. Okay. What was [Baby I] wearing?
A. I don't know. A babygro?
Q. A babygro?
A. No, I don't remember. A babygro. I don't know if she -- I assume she had a babygro on, I don't
remember.
Q. Okay. If she's -- if it's a night shift, babies are in a cot in the evening and, as I say,
[Baby I]'s in a cot as opposed to an incubator, what would she have been wearing?
A. A babygro and possibly a cardigan.
Q. Mm-hm, okay. And when my colleague asked you to describe the canopy, you explained that
there's two -- well, it was described as a tent-like structure and you described two pieces coming
over her, each side with the light shining up from the bottom.
A. There isn't a light shining up, but the lights --
Q. The light would shine up from the bottom?
A. Yeah, yes, yes.
Q. So just explain to me then, if the light is shining up from the bottom, you're stood in the
doorway, and [Baby I]'s got a babygro and a cardigan on, how would you be able to tell she was
pale?
A. Because we could see her face.
Q. [Baby I]'s upper body and face would have been even more shaded from the light with this tent
structure; do you agree with that?
A. Because there's always a gap in the tent structure, it's never fully encased around the baby.
There's always a degree of light, natural light, that would be on the cot.
Q. But it is, yeah -- okay, I appreciate it may have been on the cot, but I'm trying to
understand how you could tell that [Baby I] was pale when the only part of her body on show would
have been her face, which would have been under the tent structure. So how could you see that she
was pale from the doorway, Lucy?
A. Because it wasn't completely covering it.
Q. Wasn't covering what?
A. The canopy wasn't completely covering all of [Baby I] so that she was completely out of view.
Q. Okay, I appreciate that, but she's got a babygro on which you've described as well. So do you
agree that the only thing on show at this time would have been her face?
A. Yes.
Q. And you were stood at --
A. Or hands if she had her hands out, I don't know.
Q. And you were stood in the doorway and the light in the nursery was off; do you agree with
that?
A. Yeah, yeah.
Q. And there was this tent structure over [Baby I] as well?
A. Yeah.
Q. Do you therefore agree then that it wouldn't be possible to see if [Baby I] was pale as I've
highlighted all those things to you?
A. No, because there's still an element of light in the room coming from the doorway and [Baby
I]'s cot was positioned by a window where light would have been coming through from the lighting
on the unit.
Q. Okay. But as I said to you, she's got this tent structure over her, Lucy, and you're stood in
the doorway and she's only got her head on show, her face.
A. There's little distance from the doorway in the cot and usually cots are tilted upwards so the
head would be facing.
Q. Do you agree, Lucy, that it would have been difficult to see a change in discolouration to
[Baby I]'s face from the doorway?
A. Yes, it would have been more difficult than if a light had been on, yes.
Q. Okay. Is it a fact, Lucy, that you knew that she'd be looking pale because you'd just attacked
her?
A. No.
Q. You'd attacked her within minutes of Ashleigh returning so you knew that when she would go to
her cot side and turn the light on, she would look pale?
A. No.
Q. Lucy Letby was then informed of Dr Evans' opinion, that an X-ray timed at 4.21 showed large
amounts of air in [Baby I]'s stomach and intestines:
"He says, Lucy, that air was injected into [Baby I]'s stomach."
A. Okay. Well, I haven't injected air into [Baby I].
Q. Are you responsible for [Baby I]'s attempted murder, Lucy?
A. No.
Q. Moving to 14 October, Lucy, you confirm that you were the designated nurse. Can you remember
or tell me anything about [Baby I]'s collapse on 14 October, Lucy?
A. No.
Q. Were you present when she collapsed?
A. I don't remember.
Q. You've already confirmed that you were on duty and that you were her designated nurse. Did you
intentionally harm [Baby I] at this time, Lucy?
A. No.
Q. Did you cause her collapse intentionally?
A. No.
Q. Did you attempt to murder [Baby I] in the early hours of 14 October?
A. No.
Q. Moving to the 22nd into 23 October, Lucy, in your interview you confirmed that you couldn't
remember specific details but you remembered [Baby I] dying and her parents having time with her
and her siblings coming and having time with her also. Do you remember being involved in the
resuscitation of [Baby I], Lucy?
A. I remember from my notes that I was part of the drug administration/drawing up, yes.
Q. Nurse Ashleigh Hudson says that just prior to the final collapse, she responded and went in
and saw that you were already by her incubator. She states there was no other member of staff in
the room. Do you remember that?
A. No.
Q. Were you the person to find [Baby I] collapsed?
A. I can't remember from memory.
Q. Were you there before the alarm sounded, Lucy?
A. I don't remember.
Q. Were you on your own?
A. I don't remember.
Q. What were you doing to [Baby I] at that time, Lucy?
A. I don't remember.
Q. Ashleigh says that when she walked in [Baby I] was crying, it seemed different than normal.
Why was [Baby I] crying, Lucy?
A. I don't know. Maybe that's why I've gone to her if she's crying.
Q. What have you done to cause her to cry in this manner, Lucy?
A. I haven't done anything to her.
Q. Ashleigh said it seemed like she was in pain and very distressed. Why was she in pain?
A. I don't know.
Q. What had you done to her, Lucy, to cause this pain?
A. I hadn't done anything to her.
Q. Why was she so distressed? Why was [Baby I] so distressed on this occasion, Lucy?
A. I'm not sure. Is this when her abdomen was distended? It could have been causing her pain
maybe.
Q. Lucy Letby was informed of Dr Evans' opinion that events were consistent with an air
embolus:
Did you do that, Lucy?
A. No.
Q. Did you cause the death of [Baby I]?
A. No.
Q. Have you repeatedly attacked [Baby I], Lucy?
A. No.
Q. That interview then concluded; is that right?
A. Yes.
Q. Thank you. Then the final interview, insofar as [Baby I] is concerned, took place 10 November
2020.
A. Yes.
Q. Again, we have the times and list of people present and it begins thus:
So Lucy, we're going to move on to [Baby I]. She died at 02.30 hours on 23 October 2015 whilst at
the Countess of Chester Hospital. [Baby I] was only 11 weeks old when she died. You denied being
responsible for her death. Is there anything you wish to add, Lucy, with regards to [Baby I]?
A. No.
Q. Bernie Butterworth has said during the handover on 30 September, [Baby I] suffered a
desaturation and her tummy was getting bigger. She advised you to aspirate [Baby I]'s tummy, which
was done, and reported a lot of air coming out of the NG tube. Do you know why there was so much
air inside her stomach, Lucy?
A. No.
Q. Had you administered air to [Baby I] prior to this handover.
A. No.
Q. Do you remember exchanging messages with [Nurse A] regarding [Baby I] at all?
A. Not in details, no.
Q. The messages are regarding the care of [Baby I]. And you informed her that [Baby I] was "not
good" during your night shift on the 13th into 14 October. And on 14 October you asked to care for
[Baby I] again on the following shift. Why did you particularly want to look after [Baby I] again
the following shift, Lucy?
A. It's quite common that if you're on a shift you would, for the continuity of the care, keep the
same baby and obviously I'd had [Baby I] the day before and knew her and probably wanted to
continue with that.
Q. The messages go on to say that someone else had been allocated [Baby I] and you asked if
something had happened; what did you mean by this?
A. I don't recall that.
Q. What did you think could have happened to mean that you couldn't care for her any longer?
A. I don't remember that being the case so I don't know.
Q. [Nurse A] informed you that someone else had been allocated [Baby I]. How did that make you
feel or how would that make you feel?
A. I don't remember.
Q. If you had her on one particular night and you came on the following night and you didn't have
her, would that make you -- would you be disappointed about that if you particularly wanted to
care for her? Would you be angered?
A. I wouldn't be angered, I might be a little bit disappointed that we haven't got that
continuity, but it does happen, so you don't always -- you can't always have the same patients.
Q. Is there a reason why you specifically would ask for it then with a text message to [Nurse
A]?
A. Just for continuity.
Q. So when looking on social media, Lucy, as we said [Baby I] was born on 7 August 2015 and died
on 23 October 2015. On 5 October at 01.16, you searched for [Mother of Baby I], and again on 5
November 2015 at 23.44 hours. And for a third time on 29 May 2016, 7 months after [Baby I] had
passed away. Do you agree that you must have made these searches, Lucy, for us to talk to you
about them now?
A. Yes.
Q. Again, why have you done these searches?
A. I don't know. I don't recall doing them.
Q. And the interview then concluded in respect of [Baby I].
A. Yes.
Q. We have bundle 2 of further interviews for the remaining babies. If I could ask for those to be distributed.
(Pause)
Just for clarity, the same approach with this bundle of interviews. Rather than producing
interviews as a whole with more than one subject area, they've been broken down into individual
babies across the entire time span.
A. Yes, that's right.
Q. On this occasion, we begin with [Baby J]. This is an interview on 4 July 2018?
A. Yes.
Q. So the first time Ms Letby was arrested?
A. Yes.
Q. We can see the times and dates and people present again. It begins thus:
Okay, what we'll do now is go on to [Baby J]. Do you recall [Baby J]?
A. I remember [Baby J] as a baby that was transferred to us with stomas and I believe a Broviac
line as well.
Q. Sorry, say again?
A. So [Baby J] was transferred to us with stomas in situ and a Broviac line.
Q. Okay.
A. And I remember that because, again, that's not something that we have on the unit very often,
babies with either stomas or a Broviac line. And I just remember her mum and dad because they'd
already lost [Baby J]'s twin in utero earlier on in the pregnancy.
Q. Right. Okay. Did you have contact with the parents?
A. Yes, during [Baby J]'s stay, yes.
Q. Because you have told us before that sometimes you get to know about the parents' situation
through a briefing. So you actually had contact with them --
A. Yes.
Q. -- rather than just that knowledge through the --
A. Yes.
Q. Okay. So during the early hours of 27 November 2015, [Baby J] had several episodes. Do you
recall those episodes?
A. I'd have to check the notes to confirm my memories, all right?
Q. Lucy Letby was referred to the relevant notes -- it's a little bit faint this one -- and
confirmed the administration of medication to [Baby J] at 00.02 hours, which is shown on tile 149,
and her signature on the infusion prescription chart at 07.20 hours, along with another nurse, and
again we've included the tile reference there:
Okay. So with regard to these episodes that [Baby J] had during the early hours of the 27th, do
you recall anything about those episodes, those collapses?
A. Not clearly, no.
Q. So you weren't her designated nurse. Were you required to treat her other than obviously from
the two pages --
A. From my memory there was an occasion when [Baby J] was transferred into my nursery.
Q. Right. So tell us about that.
A. I'm not sure specifically on the date, which date that was, but there was a date she was down
in nursery 4 and she was moved up into nursery 2.
Q. Okay.
A. And I believe that was when myself and Mary were working in that nursery.
Q. Okay. So if that was this occasion, do you remember the collapse prior to her being moved
nurseries?
A. I remember what I was told about it, yes.
Q. What was that?
A. I think that she'd been found apnoeic in the cot, sort of having desaturations in the cot.
Q. Okay. So you think you only treated her after that episode and then she moved into the --
A. I think so.
Q. Is there anything else that you want to say about [Baby J]?
A. No. Again, she's just a baby I remember because it was unusual to have a baby with her level of
care on the unit.
Q. Okay.
That's the conclusion of the interview and the time is 1.45, so no great depth with [Baby J] on
that occasion.
A. No.
Q. Interviewed again on 12 June 2019 and following introductions and caution:
Okay, Lucy, we're going to talk to you now about [Baby J], okay? [Baby J] was born on 31 October
2015 and during the early hours of 27 November 2015, [Baby J] had two episodes. In your last
interview, Lucy, you remembered [Baby J] and that she was transferred to the Countess of Chester
with stomas and a Broviac line. On 27 November, you were working with Mary Griffiths (sic) and you
recall that [Baby J] was found apnoeic in her cot and when we've shown you observation charts,
you've confirmed that you were involved in her care. Do you remember that?
A. Vaguely, yes.
Q. Okay. From your previous interview you signed charts and notes confirming that you were around
[Baby J] when she suffered desaturations; do you agree?
A. From the notes, yes.
Q. Yes, okay. So in relation to 27 November, Nicola Dennison was her designated nurse. The
nursing records show that whilst in nursery 4 under the care of Nicola, [Baby J] suffered two
collapses, 4 am and 5 am. Were you present in nursery 4 around either of those two times, Lucy,
when she collapsed?
A. I don't remember. I think I was called to help. I don't remember specifically.
Q. Right. Do you remember who called you?
A. I think it was Nicky.
Q. So you weren't there at the time of the collapse, you were called there post-collapse? Is that
what you're saying?
A. I think so, from memory, yes.
Q. Okay. Did you cause [Baby J] to become unwell, Lucy, knowing she would be moved into nursery 2
with you?
A. No.
Q. There are entries in the prescription records that show you being involved in the
administration of medication to [Baby J].
A. Yes.
Q. Lucy Letby was then shown those records again, the one timed at 00.02, just after
midnight:
Do you agree this shows that you were working in nursery 4 and involved in [Baby J]'s care?
A. Yeah, I don't remember if [Baby J] was in nursery 4 at this point, I don't remember. I don't
recall this. Obviously I have signed for something, I don't recall that medication.
Q. Thank you for that, Lucy. The nursing records show that [Baby J] was moved into nursery 2 with you after her collapse at 5 am.
At 07.11 hours on 27 November an entry was made on the nursing notes made by Mary Griffith. She
states:
"[Baby J]'s monitor went off at 6.56, myself and L Letby attended."
A. Yes.
Q. Okay. Lucy, were you responsible for [Baby J]'s collapse?
A. No.
Q. Did you do something to make her become unwell?
A. No.
Q. Did you attempt to kill her?
A. No.
Q. Lucy Letby denied smothering [Baby J] or obstructing her airway:
Lucy, are you responsible for the collapse of [Baby J]?
A. No.
Q. Moving on to the third interview which took place on 10 November 2020:
Okay, Lucy, we'll move on to [Baby J]. With regard to your Facebook account you made two searches
on 17 December, you made them at 10 o'clock in the evening. On one of the searches you searched
for [Mother of Baby J] and in the other one you searched for [Father of Baby J], the parents. Do
you agree you made those searches?
A. I don't remember doing that.
Q. Okay. In regards to your phone and text messages, Lucy, on 23 November at 9.46 am, you
messaged [Nurse A] saying:
"She's good, I think. In 4, doing well with feeds. Hoping to get her home soon."
On 27 November at 7.40 [Baby J] suffered an event, you messaged Jen after and said:
"[Baby J] fitting, I'm thinking maybe sepsis."
That description there where you said "[Baby J] fitting, I'm thinking maybe sepsis", would that
be reflected anywhere in the clinical or nursing notes?
A. Yeah, it would have been documented if she was having a seizure and if they'd screened her for
sepsis.
Q. Who said to you that they thought [Baby J] had sepsis?
A. I don't remember.
Q. Do you know if she did have sepsis?
A. I don't know. I think she had. Didn't she come back with positive cultures from her Broviac
line?
Q. Would you message colleagues about updates with babies?
A. Yes.
Q. And would you be the first one to prompt the conversation or would you only give the
information if you were asked for it?
A. It worked both ways. Sometimes I'd be asked, sometimes I would give that information.
Q. And on those occasions why would you give it?
A. Usually in relation to if somebody would have asked how my day was or if there was something I
just -- that I wanted to offload a little bit to somebody that was also a nurse.
Q. Just before we move on, the social media side of things, Lucy, where we obviously have
evidence of searches being made for the individuals, does anyone else have access to that account
who could have done that instead of you, colleagues at work?
A. Not that I know of, no.
Q. Have you ever passed your phone to anyone for them to search for family members? I think the
question I am asking is --
A. Well --
Q. -- could anyone else have done those searches or --
A. Potentially if my phone was left somewhere or somebody knew my password, but I don't know if
that's the case.
Q. Right, okay. If you left your phone somewhere, it would be locked, would it?
A. Yes.
Q. That was the conclusion of [Baby J]'s interview.
A. Yes.
Q. Thank you. [Redacted]
MR JUSTICE GOSS: That's a convenient point to have a ten-minute break. We'll have 10 minutes, please, members of the jury.
It occurs to me, Mr Astbury, it would be quite helpful if there was a sequential list -- I know one can cross-reference the indictment, but a sequential list of which interviews, the order in which they come, because it's sometimes quite difficult to read the initials on the tabs. I'm not being critical, I'm just thinking of the jury when they're deliberating on this and they say for example they want to look at the [Baby K] interviews they will be able to locate it pretty quickly by just looking at the index at the front.
MR ASTBURY: That's easily done, my Lord.
MR JUSTICE GOSS: I'm just trying to make life easier. So in respect of each bundle, there will be an index with a list of the interviews in the order in which they appear and then you'll be able to locate them more quickly.
Thank you very much, 10 minutes.
(In the absence of the jury)
MR JUSTICE GOSS: I'm not seeking to be prescriptive, but I think a front sheet of the babies, the dates of the interviews and matters such as that. Because generally they're nearly a year apart, 18, 19, 20, but there are some where there are two interviews sequentially.
MR ASTBURY: They span 2 or 3 days in time.
MR JUSTICE GOSS: Thank you very much. Ten minutes, please. (11.46 am)
(A short break) (11.58 am)
(In the presence of the jury)
MR ASTBURY: Officer, [Baby L]. The first questions asked about [Baby L] were on 10 June 2019.
A. Yes.
Q. Usual headings. The interview began:
Right, okay, Lucy, we're going to talk to you now about [Baby L]. [Baby L], a baby boy, is twin
number 1, born via a semi-elective caesarean section at 33 plus 2 weeks' gestation. He was born on
8 April 2016 at the Countess of Chester Hospital. [Baby L] was admitted to the NNU at 10.30 on 8
April and due to prematurity and the need to stabilise his blood sugars he was under the constant
care of Dr Gibbs. There was a constant issue with controlling [Baby L]'s blood sugar levels whilst
on the NNU. Lucy, did you inflict any injury on [Baby L]?
A. No.
Q. Are you aware of anyone else inflicting any injury on him, Lucy?
A. No.
Q. Tell me about your involvement with [Baby L], Lucy.
A. I'd have to make reference to the notes, if that's okay.
Q. Lucy Letby was then given the opportunity to refer to the notes and was asked:
Okay. Do you specifically recall your involvement with him whilst he was on the neonatal unit?
A. Some, yes.
Q. Why is that? What is it that you recall?
A. I remember going to the delivery with the twins.
Q. Okay. What about after when he was admitted to the ward?
A. I don't remember a great deal about that.
Q. The delivery of the twins that you've just told me about, is that from your own recollection
or is that having reviewed the notes in front of you?
A. No, I can remember going to their delivery.
Q. Okay. Is there anything else you remember about [Baby L] in particular?
A. No.
Q. Lucy Letby was directed to the pain management chart and observations chart -- charts, I
should say, pleural -- where she identified her signatures:
Okay, if you turn over the page, Lucy, the next one is a blood gas record form. Again, can you
confirm that's your signature there on the first couple of entries?
A. Yes, the first four are mine, yes.
Q. I'm going to ask Mr Murphy, please, to go to tile 5 of [Baby L]'s sequence of events. There are a few questions about this document. If we scroll down a little, please, thank you.
The question was asked:
Can you confirm that's your signature there on the first couple of entries?
A. Yes, the first four are mine, yes.
Q. We can see those first four entries on the document:
You would agree? Okay. And can you just give me a brief explanation of this form?
A. So this is a blood gas form. When we take bloods from a baby we run it through a blood gas
machine and it tells us their oxygen levels, how they're managing, basically, within their blood,
and that's done when they are born, usually when they first arrive on the unit. So like at 10.58,
there's a venous sample, which has been done by a doctor.
Q. Okay.
A. And us nursing staff don't take venous samples and I have documented that he's got a low blood
sugar, which is then repeated and that's a capillary sample which I probably would have taken
myself.
Q. Okay.
A. And again he's got a low blood sugar and I've then repeated blood sugars at 16.00 and 18.00 --
Q. Yeah.
A. -- and documented them.
Q. Okay. Looking at that chart, Lucy, and having a look at the glucose, is there anything
significant you can tell me?
A. He's got a low blood sugar --
Q. Okay.
A. -- on both entries.
Q. What do you class as low?
A. Um, less than 3, I think it is.
Q. What's the reasons for that?
A. It could be that he's -- well, he's not had any feeds yet, he's not had any fluids running.
Q. Okay, in your experience working on the NNU, is that a sort of figure that you would
expect?
A. Um, I wouldn't necessarily expect it, but it's not a huge surprise. Sometimes babies get cold
or stressed at delivery and it can drop their blood sugar.
Q. Okay. If you turn the page, Lucy, this is a fluid balance chart. Again, there's a number of
entries there. Can you confirm they're your signatures at the bottom?
A. Yes, they are, yes.
Q. Just go to tile 11, please, Mr Murphy, while we're in the sequence of events. Signatures at
the bottom confirmed. Question:
In the green? Okay. Can you tell me...
Pausing there, were some of these entries highlighted in advance of being provided to Lucy
Letby?
A. Yes, they were.
Q. So that would be the reference to "in the green"?
A. Yes.
Q. Can you tell me what you signed for there?
A. Okay. So this here is the fluid chart. So I've documented here that he's on 10% glucose and
I've documented the rate and how much has gone through each hour and how the line is. That's the
score to say whether -- the pressure that's going through the line to check that the cannula's
working.
Q. Lucy Letby confirmed that [Baby L] had received intravenous fluids and milk via his NGT and
was asked:
Okay, is there anything that would give you cause for concern on that chart from what you can
see?
A. No, no.
Q. Take that down, please, Mr Murphy.
Lucy Letby was then shown the records of her having administered medication to [Baby L] with both
Mary Griffith and Amy Davies as co-signers:
Yeah. Would you say it's fair to say that you've had quite significant involvement with [Baby L]
by looking at the notes so far with his care?
A. Yes.
Q. The officer then asked about the first blood sugar reading of 1.9 that was taken shortly after
birth:
Would that give you any cause for concern if you saw that reading?
A. Yes, because it's a low reading, so you would -- you would escalate that to the doctors and be
guided by them and then you would give a feed.
Q. Okay. And how would that affect the baby's health?
A. Um, well, if they've got low blood sugars, they're going to be cold, they're going to be
compromised, they're not going to be able to main their temperature. It can also be a sign of
infection.
Q. Okay. Long term, Lucy, what would be -- what would that mean, low sugar? If they had low
sugars for a long period of time, what are the consequences?
A. If it's very prolonged I think it can cause brain damage and even death.
Q. What would you -- what changes would you expect to see in a baby once they've been given that
glucose?
A. Well, the blood sugar would start to increase. He's a small baby, isn't he? He's an IUGR baby
so sometimes they are -- they do have a low sugar.
Q. Is the low blood sugar common in neonate babies?
A. Yes.
Q. And --
A. It's not an unusual thing to see.
Q. And if it was reversed, if the sugar was high?
A. So if the sugar was high then there's a protocol that we follow. It has to have two regions --
I think it's a 14, so many hours apart, and then you would look at commencing insulin --
Q. Okay.
A. -- and reducing, looking at what is their TPN fluids, whether there's anything in that that can
be reduced.
Q. Okay. What are the different types of insulin that they'd use on neonates?
A. There's only one type on the unit.
Q. Okay.
A. I'm not sure exactly what it is, but there's only one type that I think was on the unit.
Q. And is that used often on the unit to regulate babies' blood sugar levels?
A. Um, no. I would say it's a common thing to have a baby on insulin [as read].
Q. "Wouldn't say."
A. Sorry:
I wouldn't say it's a common thing to have a baby on insulin.
Q. Okay. And from recollection, and you having looked through the notes before, was insulin part
of [Baby L]'s care treatment plan?
A. Not at birth.
Q. Okay. May it have come into place later down the line with his care on the unit?
A. I'd have to look. He went on to develop raised blood sugars and I know he's insulin, yes.
Q. Okay. Was it regularly used?
A. On babies in general?
Q. Yes.
A. Um, so I wouldn't say it was regularly used but it's not an uncommon thing to use. There are
babies that do have insulin but not -- not a lot of babies.
Q. Okay. And you specifically, Lucy, what training inputs have you had around controlling blood
sugar levels for babies?
A. What training have I had myself?
Q. Yes.
A. Um --
Q. To enable you to obviously manage it and perform your role?
A. Yeah, so just we've a competency framework that's completed when we first start on the unit and
then we have a hypoglycaemia pathway policy on the unit to follow in response to whatever readings
you are getting from the baby and how to manage it.
Q. Okay. And --
A. So not sort of specific nurse training as such, but there's a guideline on the system.
Q. Okay. And do you have any kind of duty to maintain that training?
A. No, it's just something that you self-certify when you're happy. There's no formal --
Q. Do you remember when your last training was in respect of that since you've been working on
the unit?
A. Well, I'd -- it's not something that we have regular training on. It's one of those things
that's sort of done.
Q. Right.
A. And then once you're competent, you're competent, if it -- it's not one that's reflected on.
Q. Would you say you were competent in this process?
A. Um, guided by doctors, yes. I mean, it wouldn't be me managing -- I wouldn't decide when to
start insulin or anything like that, but in line with knowing when to take readings, then yeah.
Q. So the use of insulin was started by a doctor?
A. Yes.
Q. So a doctor would determine when it would be introduced?
A. Yeah, so we might raise with them, in line with policy, that the baby has met the criteria but
then would have to prescribe either the dextrose or anything to do -- to treat a high or low
sugar. Low blood sugar would come from them.
Q. And can all nurses on the unit administer insulin?
A. As far as I'm aware, yeah, I think so.
Q. Okay.
A. Well, just -- actually, no, because if you give insulin it usually goes through a central line,
so only certain nurses on the unit can use a central line.
Q. And can you explain the process in administering the insulin via the line? How would you do
that?
A. Insulin specifically or just...
Q. Well, any, any medication then that you'd use to use that line.
Lucy Letby then explained the procedure: when any medication was administered via a long line, one nurse would be sterile while the other was "dirty", opening things, passing items, accessing the incubator, et cetera.
Then the questions continued:
Okay, and specifically insulin, Lucy, on the unit, where was that kept --
A. It was kept in the fridge in the equipment room.
Q. Okay. And who would have access to that fridge?
A. Um, it's locked, so any member of nursing staff can access the keys, they get passed around,
whoever's -- one member of staff would just have them and pass them on to whoever.
Q. Right.
A. There's no allocated person to hold the keys, so --
Q. Okay.
A. -- it would be nursing staff. Sometimes the nursery nurses go into the fridge as well.
Q. And how many sets of keys were there on the unit?
A. Keys? Just the one that I'm aware of and then there were spare sets --
Q. Right?
A. -- in the office for emergencies.
Q. So when you say passed around, would it just be one?
A. There's one set of keys and then they are just sort of passed to whoever needs them. There's
not one person that's in charge of the keys.
Q. Okay. So you said this fridge is in the equipment room?
A. Yes, yes. Yeah, so there's a large where they store all the premade drugs such as the TPN and
anything made-up --
Q. Okay.
A. -- by CIVAS and there's a small fridge on top of our own that's got other drugs in, such as eye
drops, the insulin, and all things like that in it. I can't remember exactly now whether it's all
in one fridge or whether it is two separate fridges.
Q. And you said there was one set of keys that you were aware of. Just remind me where they were
again if you needed them?
A. So they're passed around between members of staff. There's nobody allocated to have the keys,
they're just passed around as and when somebody might need them.
Q. Okay. So there's no hook for them or no cabinet where they're kept?
A. No, they're always kept on a member of staff.
Q. So if you were -- if you needed access to the fridge, what would you do, have to go on all the
members of staff that are on and say, "Have you go the keys"? Is that what you'd do?
A. Yeah. So yeah, it's very much you ask who's got the keys and then they would either come to you
or you would take the keys -- and yeah.
Q. Okay. Now you just you did mention something else in the fridge. What else was in the fridge,
did you say, with the insulin. There was other --
A. So there's other drugs in there. There's, um, our emergency resuscitation drugs and there's
also drugs like eye drops and things and anything that might have come up from pharmacy that a
baby's on that needs to be kept refrigerated.
Q. Such as?
A. Antibiotics mainly.
Q. Okay. In the fridge, Lucy, do you record or document when you've accessed the fridge?
A. No, no.
Q. Okay. And how would you know the amount of insulin to use on a baby that requires it?
A. It would be prescribed, you'd have to take it out of the vial, it comes in a -- and you'd have
to make up an infusion of that amount.
Q. Okay. So you say it's prescribed. So actually it would have the baby's name on then, would
it?
A. The insulin wouldn't, no, because it's a stock drug.
Q. Right, okay.
A. But for the prescription we would take the vial out and make up an insulin infusion and then
the insulin would go back in then as being opened and you can only keep it for --
Q. Right.
A. There's a certain amount of time -- I can't remember how many days you can keep the insulin
open and then it has to be disregarded.
Q. So if it was on a certain measurement, would there be two of you that do that?
A. Yes, yeah.
Q. Okay, and would that be done by the fridge, would it?
A. No, it wouldn't be done by the fridge because it's not a clinical area. So we'd take it through
to the nursery and make it up there.
Q. Just going back to this room, Lucy, that it's kept in. It's labelled on the diagram as
"sterile store". How would you get access to that room?
A. This room is just propped open all the time.
Q. Right, okay.
A. It's just open and it's where we get -- all the equipment is kept and people have their tea and
coffee and it's just used for everything, that room, and it's just open all the time.
Q. Lucy Letby was asked about the hypoglycaemic pathway in [Baby L]'s case. She explained that if
tolerating feeds, he would have received milk to start with before introducing fluids if his sugar
did not then improve. She was asked:
And from looking at the entry would you have had any concerns about how [Baby L] was doing?
A. Um, no.
Q. And would you say that hypoglycaemia was a danger to [Baby L] at this time when you have made
that entry?
A. No, not at this time -- and he's got two good readings of 2.5 and 5.8.
Q. Uh-uh.
A. He's tolerating his feeds, he's not vomiting, no.
Q. Lucy Letby explained that the readings that followed showed that [Baby L] was becoming more
stable. She could not remember whether the policy was below 2 or 3 that the readings would become
a concern. Tests could be carried out in the nursery using a machine specifically for blood sugar
called a Hemicube or using the blood gas machine if other reading were being taken with that:
Do you specifically recall the parents, Lucy?
A. I can remember the parents, yes.
Q. Okay. And again with that entry is there anything else that you can tell us about the visit to
the parents that you haven't documented there?
A. No. I just remember them being really happy.
Q. The interviewing officers then moved on to events on 9 April 2016 for which Lucy Letby also
had the relevant notes. She confirmed where her signature appeared and she was asked:
Again, can you confirm by those entries that you've been involved in [Baby L]'s care on the
9th?
A. Yes.
Q. There's an infusion therapy chart. Can you confirm your signatures on that chart, Lucy?
A. Yes. They're my signatures, yes.
Q. Go to tile 115, please, Mr Murphy:
If you can confirm the date on that is 9/4?
A. Yes.
Q. Can you tell me what the infusions are?
A. So we started a bag of 10% glucose at 3ml per kilo per hour.
Q. Okay.
A. And that was started at 12 o'clock.
Q. Okay.
A. Then baby's had a bolus, so a set amount of dextrose given --
Q. Okay.
A. -- at 15.40.
Q. Okay. So you say the first entry is in relation to a bag?
A. Um -- it's a bag.
Q. Yes.
A. So it's a 500ml bag that we checked out.
Q. Okay.
A. But it's running at 3ml per kilo per hour --
Q. Okay.
A. -- which is the hypoglycaemia treatment.
Q. Do you recall if you connected that bag?
A. I don't remember.
Q. Well, your signature's at the top of that under the column "nurse setting up infusion". Would
that help you to recall if you set it up?
A. I can't recall from memory, no.
Q. In relation to those bags then, Lucy, where were the medicines kept stored?
A. The dextrose bags are kept in nursery 1 in a cupboard.
Q. Right, okay.
A. It's not a locked cupboard, it was just in the bottom corner.
Q. So they're premade up, are they?
A. Yes.
Q. Right.
A. You would add to the bag if needed, but the bags just come as standard.
Q. When you say you add to the bag, how would you do that?
A. Um, well, you'd have to draw up whatever you were putting into it and then break off the seal
and -- because the bags are all sealed --
Q. Okay.
A. -- you'd have to open that bag, then open up a seal, and then put whatever you were putting
into the bag.
Q. When you say a seal, has the bag got entry points on it?
A. What do you mean, sorry?
Q. If you were going to add something to the bag --
A. So the bag is in a cellophane bag, so you'd have to rip the cellophane bag, open the bag, and
you've got your bag of fluid.
Q. Right, okay.
A. And to open the bag of fluid there's a twist break in the valve that you'd have to pull off.
Q. Right.
A. And then you would attach it to a line or syringe, whatever you're attaching it to.
Q. Okay.
A. And then there's a port on the other side that's like just a one-way port that you can put a
needle into if you were putting another medication into that.
Q. What sort of things would you add to it?
A. So it's very rarely, really, that I've done it. Sometimes we'd add -- like, if babies are on
sort of like a sodium chloride infusion or potassium or something, but I don't think -- they go
into separate syringes usually. Sometimes you put antibiotics into it but it's not -- I can't
recall -- I can't really say how -- if I've ever done that, if ever.
Q. And where would you -- where would add into the back take place? Where would you do that [as
read]?
A. In the nursery.
Q. Which one?
A. Whichever nursery that baby was in usually.
Q. Okay. To add something to the bag could would you need authority to do that from a doctor?
A. Yes, it would need prescribing.
Q. Okay. Underneath the 10%, is that a bolus that's being given on 9/4?
A. Yes. So it's 4.3ml, yeah.
Q. Okay. So you talked before about adding it to a bag. How would that have been given to [Baby
L]?
A. That wouldn't have been added, that would have been just drawn up.
Q. Yes?
A. Then you'd flush afterwards. That's just a one-off amount that was given directly.
Q. Okay. Again, do you remember if you were the one to administer that to [Baby L]?
A. I don't recall that, no. If this is the day that I'm thinking of, the unit was very busy --
Q. Right, okay.
A. -- and it was myself and Mary in the nursery with, I think, six babies and I think they were
just all...
Sorry:
And I think they were just doing all of the drugs for all of the --
Q. Right.
A. -- babies if that's the day, if I'm remembering correctly. Obviously I -- I can't see off-duty
or I don't know if -- what that day was like.
Q. Okay.
A. But from memory there was a day when we were both in nursery 1 with the twins and it was really
busy.
Q. When you say six babies, you were looking after six babies?
A. No, between myself and Mary.
Q. Right.
A. There were six babies in the nursery. We should only have five but we had six and one of them
was the second twin and he was sort of in not a proper space, so not what we would call a proper
space but the room was full so.
Q. Okay. Whether there any nurses working in that room with you at that time do you remember;
no?
A. Not from memory. I know I was working with Mary, I do remember myself and Mary.
Q. Okay. So going back to the administration of those drugs again, and you've got your name above
another signature -- is that Mary's signature, is it, and do you recall on the 9th what nursery
you were working in?
A. Nursery 1, if that's the day I'm thinking of.
Q. Okay. I mean, was -- I mean, [Baby L], he remained in nursery 1 from when he was born the day
before?
A. Yeah.
Q. He wasn't moved?
A. Not that I am aware of. So if I'm remembering it from the day correctly, twin 1 was in a space
and then [Baby M] the other twin, was in a non-space against the wall and I think Mary had those
two babies. I had a baby that was in the other ITU space and the other two babies that were in the
room.
Q. You were saying there were six in nursery 1 at this time. So is that normally on a one-to-one
basis?
A. Yes, so ideally a baby in nursery 1 -- if they're classed as ITU care, they should be
one-to-one.
Q. Right, okay.
A. Not all of these babies were ITU care, but the nurseries outside were full.
Q. Okay.
A. So if I remember correctly there was just a bit of a backlog and the unit was full --
Q. Right.
A. -- and we had these babies all in nursery 1.
Q. Right. Would [Baby L] be classed as an ITU baby then or not?
A. No, I don't see that he would be, no.
Q. Do you recall much about [Baby L]'s blood sugar levels the following day, so on the 9th,
Lucy?
A. No. I remember from memory there was a problem with him when I was helping Mary because Mary
wasn't overly --
Q. Okay.
A. -- familiar with the protocol.
Q. Tell me about that problem.
A. I think his sugars had become low, which would make sense here, and if we had to give a bolus
-- I don't remember specifically and then I think from memory -- I wondered if were -- I think we
checked to see that his line was running and that his fluids weren't leaking or anything like
that, which could have caused a low blood sugar.
Q. Okay.
A. But I don't remember any more details.
Q. Is there anything else that could cause a low blood sugar reading?
A. So it could be if his IV wasn't going into the right place or if it had become detached and was
leaking, so he wouldn't be getting the fluids -- he hadn't been fed --
Q. Mm-hm.
A. -- or not enough feed. Sometimes they drop their blood sugars if they're unwell, so they've got
an infection, if they're cold.
Q. And you say that you've -- you remember Mary having an issue with it the following day. Is
that from reading your notes?
A. If it's the day I remember. I remember it was really busy. I remember that from memory.
Q. And do you remember if there were any concerns for [Baby L] that day?
A. No, I remember us thinking it was strange that he'd dropped his sugars, I think, and then I
think we were looking at the line to see if there was an issue and things like that, but I don't
remember.
Q. Because a lot of the reasons you've just mentioned are manageable, aren't they, if they're --
the fluids or the feed, for instance?
A. Yeah.
Q. So it would all help with those sugar levels, wouldn't they?
A. Yes, unless the baby has an underlying -- an underlying, like, anaemia (sic) or something.
Q. What's that then?
A. That's a condition where the baby has got low blood sugars and that's a sort of endocrine
problem and that's managed by Alder Hey and they do need --
Q. Right.
A. -- supplements and things. That's something that's --
Q. Do you know if that was the case for [Baby L] then?
A. No, I don't remember it being the case for [Baby L], no.
Q. Now I appreciate that it's obviously some time ago, Lucy, but do you remember a specific care
plan in place to manage [Baby L]'s blood sugar levels?
A. No, not from memory, no.
Q. Okay. And from what you've been looking at there on the 9th can you confirm if he was
continuing to receive treatment for his blood sugars?
A. He is on those two entries. I don't know if we've got a fluid chart or not. That would confirm
what feed he was having.
Q. Did you have any further involvement in managing his blood sugars other than what we've
discussed?
A. No, not that I am aware of, no.
Q. Other than directed by the doctor, did you administer any other medication to [Baby L], Lucy,
on either the 8th or the 9th, Lucy?
A. Not that isn't documented, no.
Q. Okay. And if you had have done, you would have documented it?
A. It would have been prescribed, so I'd have to sign the prescription chart, yeah.
Q. Okay. Specifically in relation to insulin, Lucy, do you remember administering it to [Baby L]
when it wasn't prescribed?
A. No.
Q. Did you intentionally attempt to murder [Baby L], Lucy, by injecting him with insulin?
A. No.
Q. Did you intentionally cause him any harm?
A. No.
Q. Is there any way, Lucy, that it might have been a mistake, that you might have unintentionally
administered insulin; is that possible?
A. I don't really see how. If we picked up a wrong drug it would have been two of us that had
checked it. It's unlikely that we have at any point picked up an insulin rather than something
else.
Q. Is insulin clearly marked, the bags?
A. It's not in a bag, it's in a vial.
Q. Yeah, the vial, is it clearly marked insulin?
A. Yeah, it's in a box, it's in the --
Q. So there's no way the mistake could be made in that respect, could it?
A. No, not with two people.
Q. And it would never be done with one person, would it?
A. No.
Q. Are you aware of anyone else causing [Baby L] harm, Lucy, on 9 April 2016?
A. No.
Q. It's 21 minutes to 2 and the interview is now stopped.
A second interview in respect of [Baby L] took place on 12 June 2019?
A. Yes.
Q. So 2 days after the one we've just read together, this, of course, being the second occasion
that Lucy Letby was under arrest.
A. Yes.
Q. All right.
At the outset of this passage, the officers began by summarising that which Lucy Letby had said previously about [Baby L] and the documents within the notes bearing her signature.
They then explained that [Baby L] had been found to have had a very high level of insulin in
association with a low/normal value of C-peptide:
Have you got anything you wish to say about that?
A. I don't know what that means.
Q. The officers then explained the experts' view that this would have been administered during
the hours leading up to 09.59 on 9 April 2016 and that it was impossible for [Baby L] to have
received that mistakenly:
Do you agree with that, Lucy?
A. Yeah, I would. Yeah, I don't know how it would accidentally get given.
Q. If it was used inappropriately, insulin, it will cause hypoglycaemia?
A. Yes.
Q. Lucy Letby was then asked about Dr Evans' report:
And he says that if lasting for a sufficient amount of time it can lead to irreversible
neurological damage.
A. Yes.
Q. Are you responsible for that, Lucy?
A. That wasn't done by me.
Q. Lucy, did you administer insulin to [Baby L]?
A. No.
Q. Are you responsible for the attempted murder of [Baby L], Lucy?
A. No.
Q. Is there any explanation, Lucy -- you've already confirmed that you've been involved with the
care of [Baby L]. Is there any explanation whatsoever how insulin has ended up in [Baby L]'s
circulation?
A. No. Not unless it was already in one of the bags that we were -- or some of his fluids that he
was already receiving --
Q. Did you put insulin?
A. -- no.
Q. In one of those bags?
A. No.
Q. Okay.
That concluded that section of the interview.
A. Yes.
Q. Then questions were asked about [Baby L] on a third occasion, that being 10 November 2020.
A. Yes.
Q. And this part of the interview begins:
Okay, so we'll move on to [Baby L] then. You agreed that insulin could not have been administered
to a neonate mistakenly and that it can only be used -- it can cause hypoglycaemia and damage to
the brain. You've denied administering insulin to [Baby L] and causing him harm. Is there anything
else you'd like to add, Lucy?
A. No.
Q. Then the officers informed Lucy Letby of the results of [Baby L]'s blood test with an insulin
level of 1,099 picomoles per litre and an insulin C-peptide level of 264 and that this was
considered by clinicians as abnormal.
A. Yeah.
Q. Are you aware of C-peptide, Lucy, and what it means when I said that?
A. Yeah.
Q. Is that something you're aware of?
A. Yeah.
Q. Okay. Did you target [Baby L] with insulin because he had a low glucose at birth, Lucy?
A. No.
Q. Did you target [Baby L] because he was a twin like [Babies A & B] and [Babies E & F]?
A. No.
Q. That concludes the interviews in respect of [Baby L]?
A. Yes, that's right.
Q. We then move on to his twin brother, [Baby M]. Back in time to 5 July 2018 --
A. Yes, that's correct.
Q. -- when Lucy Letby was first questioned about [Baby M]:
So we'll go on to [Baby M]. I'll just remind you who [Baby M] is. He was born at 10.14 hours on 8
April 2016. He was one of a twin. He was transferred to the neonatal unit at 10.30 on 8 April. At
16.00 hours on 9 April [Baby M] collapsed and required resuscitation. So what can you tell us
about your care and memories of [Baby M]?
A. So I remember [Baby M] on this particular day. I was working in nursery 1 with another member
of staff and the nursery was very busy and [Baby M] wasn't in. We usually have four babies in a
nursery and [Baby M] was the fifth baby and he was not in a usual space. He was sort of in a
corner space and therefore he wasn't on a full Philips monitor, he was on a small Masimo monitor,
and I just remember the unit being very busy and myself and this other nurse were preparing drugs
on the other side of nursery 1 and we heard [Baby M]'s monitor going off and I attended to his
monitor. I don't remember exactly what was on the monitor, but I think he was having a
desaturation and I started some airway intervention and Mary got some help.
Q. Okay. Was it Mary that you were preparing the drugs with?
A. Yes.
Q. Okay. So tell us your observations at the point where you tended at the desaturation.
A. So I don't remember specific values or anything, but I think I went to [Baby M] and he was
having a desaturation and dropped his heart rate, I think, or some -- I can't remember if he was
apnoeic or whether he was just intermittently breathing.
Q. Okay. Can you tell me what other babies were in the room and what other nurses were in the
room or family members?
A. I'm not sure about family hence, I believe Mary and myself were doing drugs over the other side
of the nursery, so Mary was there, and then we had -- I had a baby in nursery 1 in the top end and
there was a baby next to [Baby M] and then there were two babies at the other end of nursery 1.
Q. Okay. So prior to this collapse -- I know you said that you were preparing drugs with Mary. So
if we include that in the time of the event, just prior to what you were doing what were your
activities?
A. Checking the drugs with Mary.
Q. Okay. And prior to that?
A. Prior to the drugs? I don't recall.
Q. Did you have babies in the same nursery as [Baby M]?
A. Yes.
Q. Can you remember which babies they were?
A. I can't recall their names but I know they were in the nursery.
Q. Lucy Letby sketched a plan of the nursery at the time with the positions of other babies and
she was then asked about some of the notes. If we can go to tile 127, please, Mr Murphy.
A. So it's 9 April 2016.
Q. And the time?
A. 15.30.
Q. Okay:
What's that activity, just generally?
A. So this is the commencement of a 10% dextrose bag.
Q. So would that have been you physically having contact with [Baby M]?
A. Yes.
Q. Yeah, and that's at --
A. To connect the bag, yes.
Q. -- 15.30?
A. Yes.
Q. Okay. Sorry, can you remember who -- I don't know if I asked you, did you say who his
designated nurse was?
A. Mary Griffith.
Q. Okay.
Lucy Letby was then shown the two prescriptions suggesting that she was involved in the
administration of medication to [Baby M] at 15.45:
So -- okay, do those entries signify to you that you were having contact with [Baby M] in the
run-up to the event at 4 or 16.00 hours?
A. Yes, I'm not sure if I was the one who actually administered the medications, but yes, I was
involved --
Q. Yeah.
A. -- with the medications, yes.
Q. Okay. Is that something that you would ordinarily do with another nurse who had babies in the
same nursery as the babies that you were looking after?
A. Yes.
Q. Would you do treatments together, essentially, or certainly concerning the drugs?
A. Yes, or at least check each other's drugs, yes.
Q. Okay. But do you remember having specific contact with [Baby M] during those times?
A. No.
Q. Lucy Letby explained that she took over as [Baby M]'s designated nurse at resuscitation as his
designated nurse was not ITU-trained. Lucy Letby thought [Baby M] had been reallocated to her by
[Nurse B]. She was asked:
Right, okay, were you involved in the resuscitation at all?
A. I think I gave drugs from memory.
Q. Okay. And are you aware of who else was involved in the resuscitation?
A. I remember Dr Jayaram was the consultant. I'm not sure which other members of staff. I know
Mary was in the room and I think [Nurse B] was in the room as well.
Q. Okay. Go down then to family communication.
A. Yes.
Q. And then the officer quotes:
"Parents and family members present for resuscitation and fully updated by medical and nursing
staff. Parents have remained with the twins."
And then she was asked the question:
Who informed the parents?
A. I don't remember.
Q. Do you recall if you had contact with them at that stage?
A. I remember them coming to visit [Baby M]. I don't remember if I was the nurse that -- that
asked them to come to the unit but I do remember speaking to them once I'd taken over the care
because we moved [Baby M] to another space in the nursery.
Q. In the same nursery?
A. Yes, but to a designated space whereas before he had just been on a side wall in.
Q. Right. And what time would you -- should you have finished?
A. 8 o'clock.
Q. So what was the purpose of still being there at 21.22?
A. I think there was a lot to hand over, a lot of things. I had other babies that needed to be
handed over and then obviously [Baby M] was quite a complex case to hand over, so I envisage
that's why I was there later.
Q. Is that quite a common thing?
A. Yes.
Q. Okay.
A. And obviously any patient care handing over would take priority over the notes. The notes are
the last thing that we would do.
Q. Okay. So with regards to the event itself, once you were alerted with [Baby M]'s monitor going
off what -- tell me again what your observations of [Baby M] were.
A. When his monitor went off?
Q. Yeah.
A. Just from memory I remember that he -- it was alarming because he was desaturating and I think
he was bradycardic as well.
Q. Okay.
A. And I don't remember whether he was apnoeic or whether he was just shallow breathing.
Q. Do you know why he desaturated?
A. No.
Q. So when you attended to him, there was -- was there nothing obvious that had caused the
desaturation?
A. Not that I can remember.
Q. Then a colleague asked:
Any more questions?
A. But I do remember that his -- his colour was a little bit harder to access (sic) with him being
an Asian baby and also he was in a corner space where there's poorer lighting.
Q. I think that should probably read "assess" rather than "access".
A. Yes.
Q. Okay. And then she was asked:
Is there anything else that you recall about [Baby M]?
A. No, I just remember it being a particularly busy shift.
Q. Why do you remember that?
A. Because it's not very often that we have that many babies in nursery 1 and I just remember it
being --
Q. Right.
A. -- Mary and myself. Mary's quite a junior member of staff, so --
Q. Right, okay.
A. I just remember supporting her and doing a lot with her and us both commenting on how busy it
was and things.
Q. And then the question is:
Does anybody want to add anything else?
The answer is no and the interview concluded at 2.50 pm.
If we move on, please, to 12 June 2019 and the second occasion upon which [Baby M] was discussed
with Lucy Letby:
Okay, Lucy, we're going to now talk to you about [Baby M].
And the officers summarised [Baby M]'s case and the last interview:
Do you remember that, Lucy?
A. Yes.
Q. Then Dr Ukoh says:
"On examination at 10.25 hours on 9 April there appeared nothing untoward. He was breathing on his
own with no support and was fully feeding. He looked well and settled."
It appears, Lucy, that [Baby M] was okay in the morning at this time; do you agree with that?
A. Yes.
Q. At 4 pm she, meaning Mary Griffith, was preparing medication within the nursery and states you
were the check nurse for it; do you recall that, Lucy?
A. Yes.
Q. Do you remember exactly where you were when [Baby M]'s alarm sounded?
A. On the workbench with Mary drawing up medications.
Q. Do you agree you were the first one at the cot side when the alarm sounded?
A. I think I was, yes.
Q. Lucy, did you do something to [Baby M] to cause him to collapse?
A. No.
Q. Were you aware of any issues with [Baby M]?
A. No.
Q. [Baby M] required resuscitation at this point. You became the designated nurse for [Baby M].
Do you remember this?
A. Yes.
Q. Did you cause [Baby M] to collapse so you could care for him in nursery 1, Lucy?
A. No.
Q. Did you attempt to kill [Baby M]?
A. No.
Q. The officers then summarised the opinion expressed by Dr Bohin:
Is there anything you wish to say about that, Lucy?
A. I didn't cause that and I don't know who would have. Mary and I were doing drugs at the time.
Q. Did you obstruct [Baby M]'s airway?
A. No.
Q. Did you intentionally administer air into [Baby M]?
A. No.
Q. You have admitted having contact with [Baby M] up to his collapse, haven't you?
A. Yes.
Q. Mary says that her back was to the incubator when the collapse --
A. We were drawing up the medications together.
Q. Lucy, on 4 July a search took place at your home address and I'm going to show you police exhibit PMB8 somewhere.
Then we've noted PMB8 is the paper towel with the resuscitation drugs and timed annotated on it
in relation to [Baby M]:
It's a list of drugs during [Baby M]'s resuscitation and the times they were administered.
A. Okay.
Q. Okay. Can you give me an explanation why they were recovered from your bedroom, Lucy?
A. They've inadvertently come home with me on the night shift.
Q. Do you remember taking them home?
A. No.
Q. Have you obtained a copy of those from the NNU?
A. This was written on a paper towel.
Q. Did you write it?
A. No, that doesn't look like my writing, no.
Q. So how has it come into your possession?
A. I imagine that I have had to backdate it with somebody, the drug administration times, or
notes.
Q. Okay. Where would you put it on you to take home?
A. In my pocket.
Q. Why weren't they placed in the confidential waste, Lucy?
A. It's an error on my part that I've not emptied my pockets before leaving.
Q. So when you've arrived home and you've emptied your pockets and seen that, why have you not
destroyed it?
A. I don't know.
Q. Why have you kept it, Lucy?
A. Well, there's no reason why I've kept it.
Q. Was this to remind you of when you attacked [Baby M]?
A. No.
Q. Lucy, these relate to April 2016; do you agree?
A. Yes.
Q. And they were found -- then found in your home address in 2018, a significant time later.
Explain why they remained at your home address for that amount of time.
A. It's just got put to one side and then forgotten about.
Q. Whose handwriting is this?
A. I think some of this here is mine. This one here, it looks like [Nurse B]. I'm not sure about
all of it.
Q. And you've previously confirmed that you were not the designated nurse for [Baby M].
A. I was post-collapse, from when this started.
Q. But prior to collapse?
A. No.
Q. Okay. Can I just show you a section of police reference NAC9, Lucy. We did discuss your diary
on previous interviews. Just, do you recognise that as --
A. Yes.
Q. -- as a copy in your interview and the second page if you can just have a look at that for me.
Okay. The entry for 8 April, can you see it?
A. Yes.
Q. Do you see "LD twins"?
A. Yes.
Q. Can you explain what that is?
A. No.
Q. What would LD mean?
A. Long day.
Q. What would twins mean?
A. They were twins on the unit at that time.
Q. And that was 8 April 2016. The time we're talking about [Baby M]. Does that relate to [Babies
L & M], Lucy?
A. Is that the day they were born?
Q. Was it 8 April? Yeah, I think it was. Yes, it is.
A. Yeah.
Q. Is there a reason why you've put that in your diary?
A. Because I've attended their delivery.
Q. Okay. If you look at 9 April, Lucy --
A. Yeah.
Q. -- what does it say there?
A. "Long day extra twin resussed."
Q. Right. Can you explain those entries to me, Lucy?
A. So I'm working a long day and I've done that as an extra shift and on that day the twins needed
resus.
Q. And why have you put that in your diary?
A. Because I've done an extra shift and I've documented what happened on that day.
Q. Okay. So for what purpose, though, have you put "resus -- "twins resussed", then? For you to
reflect on?
A. Because that was a significant event on that day.
Q. Okay, so that's for you to look back on and remind you of that particular event. Is that why
you've put it in the diary?
A. Yeah, and it was an extra shift, so it was an extra, it was my fourth long day in a row.
Q. Okay. Let's take LD and extra to one side. The twins resus is there to remind you that [Babies
L & M] had a resuscitation occurred on that day?
A. Yes.
Q. To remind you, yes?
A. The same as the day before. I've written that I went to the delivery, yes.
Q. Okay. Lucy, are you responsible for the attempted murder of [Baby M]?
A. No.
Q. Okay.
Then the interview concluded at that time at 10.15 am.
A. Yes, that's correct.
Q. Moving on to the third interview concerning [Baby M], which took place on 10 November
2020.
A. Yes, that's right.
Q. It begins or this section of the interview begins:
Okay, Lucy, we're going to move on to [Baby M]. You denied administering air to [Baby M], causing
him harm. Do you recall [Baby M]?
A. Yeah.
Q. Is there anything you wish to add?
A. No.
Q. The officers turn to telecommunications and question Lucy Letby about some of her messages.
Perhaps if we put tile 384 up, please, Mr Murphy, because this message isn't reproduced in the
interview:
So that first one I read to you, Lucy, that you sent to Mary, why did you message her?
A. Because I knew she'd be thinking about the twins and we'd had a really busy day that day and
she wasn't used to that sort of thing happening and I just wanted to let her know that obviously
I'd phoned and that was how the twins were.
Q. Would you ordinarily message her? Is she someone who is a regular contact for you?
A. Not a regular contact but she -- I would have had her number because we were in, like, a lunch
group so she would have my number.
Q. Okay. What's the lunch group?
A. It's a few girls from the unit that used to meet for lunch sometimes.
Q. Okay. Is that like a group chat?
A. Yes.
Q. Did she ask for an update to be sent to her, Lucy?
A. I'm not sure.
Q. And why did you thank her for her help, her support?
A. Well, we worked really closely that day together and had a lot to do and I think she did really
well in -- in supporting me and carrying on with her role.
Q. Okay. Then the messages to [Nurse E]. Why did you send those, talking about obviously the unit
and the staff and what was happening?
A. I'm not sure. I don't know whether she'd asked how my day was or how I was and that was my
reply. I'm not sure.
Q. Explain why you called the unit in a "dire way with staff"? What did you mean by that?
A. There's not enough staff and poor skill mix for the babies on the unit.
Q. So have you ever highlighted that to supervision, your concerns about the staffing? Obviously
you've called it "in a dire way". Have you told anyone?
A. Yeah, and it was well-known on the unit, we all agreed that at the moment, at that time, that
was how the unit was and that's how the staffing was.
Q. Management?
A. Not management, no.
Q. Have you ever voiced your concern, this opinion, to anyone else before?
A. Yes, I would say it was readily discussed amongst the nursing staff and shift leaders.
Q. Why did you feel the need to talk to [Nurse E] about [Baby M] when [Nurse E] wasn't managing
[Baby M] at the time, it was Mary's baby, [Baby M] was being looked after by Mary?
A. What did I say about [Baby M]?
Q. In the --
A. That he had one collapse before resus.
Q. Yes.
A. But I've told her about the other babies on the unit as well. I've stated we've got five babies
and he was the one that collapsed. We also had one on an exchange line and one hypoglycaemic baby.
Q. The interview concerning [Baby M] concluded at that point.
A. Yes.
Q. Thank you.
Moving on to [Baby N]. The first interview about [Baby N] took place on 10 June 2019.
A. Yes.
Q. And began with the officers summarising the events on the two dates upon which [Baby N] is
said to have been attacked. Lucy Letby was asked:
Do you remember [Baby N], Lucy?
A. Yes, but only from -- reading my notes triggered my memory to who he was. I don't think he had
a name when I cared for him, he was "male infant".
Q. Okay. In relation to 3 June, did you inflict injury on [Baby N]?
A. No.
Q. Are you aware of anybody else inflicting an injury on him?
A. No.
Q. Do you specifically recall your involvement with him on that day?
A. Not specifically what I did with him. I just remember that he -- he had an airway issue that
was very unusual and we had to get an anaesthetics over and get a team from Alder Hey to come
over. It was something all quite new and something that we don't usually see on the unit. He had a
different airway in that we don't usually use.
Q. Tell me about that.
A. So they -- they came to intubate him with a normal ET tube and they couldn't pass the tube, the
doctors.
Q. Is this on the 3rd now, Lucy, or is this --
A. I'm not sure which date.
Q. This is just after he was born. This is the day after he was born.
A. This is the day that he went to Alder Hey.
Q. Okay. Tell me about your involvement with his care on 3 June.
A. I'd have to look at the notes.
Q. Okay.
A. I don't recall that day.
Q. Lucy, do you have any recollection of [Baby N] during the first couple of days of his
life?
A. No.
Q. At any point were you made aware of any concerns with [Baby N] during the first couple of days
he was on the neonatal unit?
A. Not that I can remember, no.
Q. Okay.
A. He's sticking in my head because of the airway issue rather than anything prior to that, so...
Q. Okay. I want to move on to 15 June, which -- you've got some notes there in front of you. Did
you inflict injury to [Baby N] on 15 June, Lucy?
A. No, no.
Q. Are you aware of any other person inflicting injury to [Baby N]?
A. No, no.
Q. Okay. In relation to those notes in front of you, have you had time to look over those
notes?
A. Yes.
Q. Okay, for 15 June. Do you recall your involvement with [Baby N]?
A. Not specifically in terms of actual care. As I say, it's more the airway issue and everything
that happened surrounding that.
Q. Okay. Tell me about what led to the airway issue.
A. I don't remember. I can read my notes and say obviously he's declined.
Q. Okay.
A. I don't remember his decline myself.
Q. Tell me about what recollections you have of [Baby N] then from memory.
A. That he was a really difficult baby to intubate and he was having a blood -- bloodied
secretions and things. He was a baby that -- that we had to use a specific airway on, that I've
never used before, we don't use it very often.
Q. Okay. You said that there to me about bloodied secretions. Tell me about that in more
detail.
A. When they were trying to intubate him, I remember he was having blood in his mouth and I think
we got some back from the tube as well and they were querying it was because they were traumatic
intubation in trying to get the tube down.
Q. Is that common in neonate babies?
A. To bleed?
Q. Yes.
A. If it's traumatic intubation, yes.
Q. Okay, and why do you specifically remember that, Lucy?
A. Because it's not something you see a lot of, although it happens, and I remember so many
different people coming in and trying to tube him and he was bleeding and they were sort of
arguing, well, should we be trying to carry on this if we're causing him trauma. But obviously
they needed an airway and that's when we went for the I-gel airway, which is less traumatic.
Q. Okay, and can you describe to me what led to this intubation?
A. Not from memory, no.
Q. Lucy Letby recalled that these events took place in nursery 1.
A. But I remember when we had the team and everything coming in, that's when -- that's where he
was.
Q. Okay. So your very first memory of [Baby N] is these attempts to intubate?
A. From memory, yes.
Q. Who was the very first doctor you remember trying to intubate him?
A. I don't recall.
Q. You don't recall?
A. No.
Q. And were you in charge of [Baby N] at that time?
A. Yes.
Q. So he -- you were his designated nurse?
A. Yes.
Q. Okay. Do you remember if this was an early part of the shift or --
A. No, it was later on in the day.
Q. Okay.
A. Because I know there was an issue about handover and people changing over at 4 o'clock and then
they were getting anaesthetics over and --
Q. Right.
A. -- Alder Hey having to come over. I remember it was later on in the day.
Q. Right, okay. So that was towards the end of 15 June, I think, 2016. But he suffered an episode
earlier on in that day. Do you remember that at all?
A. No.
Q. Lucy Letby was shown the intensive care chart, which is at tile 239, please, Mr Murphy:
Can you explain the entries to me?
A. So this is an observation chart. The baby's on hourly observations. So each time we've
documented heart rate, respiratory rate, temperature, blood pressure (sic). And looking at this,
his respiratory rate has deteriorated throughout each hour.
Q. I'm going to ask you to pause there because that's clearly not the right chart.
MR JUSTICE GOSS: It's a fluid balance chart.
MR ASTBURY: It is, but I think it might be the wrong SoE. We need the second SoE, please. My mistake.
(Pause)
So right tile number, wrong sequence, apologies.
Can you explain the entries to me?
A. So this is an observation chart. The baby's on hourly observations. So each time we've
documented heart rate, respiratory rate, temperature, blood sugar. And looking at this, his
respiratory rate has deteriorated throughout each hour.
Q. Okay. From looking at those entries you've made there, did you have -- did you -- well,
looking at them, did you have any concerns for how [Baby N] was at this time?
A. I don't remember it from the time, but --
Q. Uh-huh.
A. I'm not sure what his respiratory rate was before, but that's concerning.
Q. Okay. Have you got any explanation as to why there aren't any for 15.00 hours?
A. I'm not sure if that's when we were doing something with him, when he first required an airway,
and that's why it's not recorded on that hour.
Q. Okay.
A. Because the following hour he's been ventilated, so --
Q. Uh-huh.
A. -- so I'd assume at 3 o'clock it was when he was unwell.
Q. Okay.
A. And therefore a set of observations weren't carried out.
Q. Is that normal practice, if a baby's unwell, not to complete a set of observations?
A. If there's not time, yes, if the baby's acutely unwell and we're all with the baby.
Q. Do you recognise the signatures before you've signed, the initials?
A. Yes, I think that's Jenny Jones.
Q. Okay, and am I right in saying then you've taken the care over from Jenny Jones, have you?
A. Yes, it looks that way, yeah.
Q. Okay. What time would you come on shift?
A. Half past 7.
Q. Half past 7. Would that be your first observation then at 9 o'clock if you've come on at half
past 7? What the point I'm trying to say is --
A. Oh, did I have the baby from half past 7?
Q. Yes. Do you recall?
A. I don't recall.
Q. Okay. So you've taken over from Jenny there. So are you saying at this particular point there
are no major concerns for [Baby N] at that time?
A. Yes.
Q. Okay. So something's happened?
A. Well, something's --
Q. For him to be moved?
A. Something's changed here because he's gone from just temperature obs to full observations.
Q. Right, okay.
A. So I'm not sure.
Q. But he's remained with the nursery nurse until your --
A. Yes.
Q. You've taken over his care, I think the first observation at 9 o'clock?
A. Yes.
Q. Do you remember when the first attempts to intubate were?
A. No.
Q. If you move on to this next chart, this is an intensive care chart and there's a number of signatures on there.
If we go to tile 238, please:
Can you explain that to me?
A. Okay, so this is -- we've documented the baby's on 10% dextrose, so I've read the drip each
hour, which is those readings there, and this is an aspirate from the NG tube. Took 1ml -- sorry,
took 1ml, fresh blood, not passed urine, said green stool, and his blood sugar was 11.3.
Q. Okay.
A. And when I've taken over at 9 o'clock, the line was occluding so I've put midazolam, so he's on
midazolam -- oh no, it's the line that's occluding.
Q. Which line, sorry?
A. So he's 10 -- he's 10% dextrose, line occluding. So I've read it, there's no pressure going
through, it's occluding.
Q. Okay. So looking particularly at the entry at 10 o'clock, which is the first one you've made
on that chart.
A. I've got the millilitres an hour that's running through the pump, so it's set to give 10.6ml an
hour.
Q. Yeah?
A. Total that's gone through and I've read it's 23ml.
Q. Yeah.
A. The VIP score is zero.
Q. Mm-hm.
A. And then I've also aspirated his NG tube and there's 1ml of fresh blood.
Q. Okay.
A. And I've done a set of cares, so I've looked at the nappy, he's not passed any urine and I've
got a green stool.
Q. Okay, so that 1ml of fresh blood. Can you explain that to me?
A. I don't remember it from memory.
Q. Okay.
A. But I've obviously checked his tube and 1ml has come out.
Q. Would that be concerning to you?
A. Fresh blood, yeah.
Q. You explain to me what you did about that, Lucy.
A. I don't remember.
Q. Okay. And in the next column?
A. I don't know if I've written it on the --
Q. And then afterwards you've put there, green.
A. Yeah.
Q. Is that in relation to [Baby N]'s stool?
A. Yes.
Q. Again, can you explain what that would show? What would it mean if it was green?
A. That it's containing bile.
Q. Okay. So there's the fresh blood and the green. Would that give you any cause for concern?
A. Yeah, and that he's not passed urine.
Q. Okay. Just in your experience, Lucy, the fresh blood, you know, what can cause that?
A. Is this when he was first born?
Q. No, this is on the 15th.
A. No. So any sort of trauma to the airway, if he's having sort of abdominal issue, an abdominal
bleed --
Q. Okay.
A. -- something like that. If the tube's been, the NG tube's been inserted forcefully it can cause
a bit of a trauma going down.
Q. Is that something that's quite common, a tube being forced down?
A. No, it's -- I wouldn't say that's common but it can happen.
Q. Right. What sort of circumstances would cause that then? I mean, is it a difficult
process?
A. Passing the tube?
Q. Mm-hm.
A. The nasogastric tube, no.
Q. So sometimes it would be if there's some sort of a structure issue struggling to pass the tube?
MR JUSTICE GOSS: Go back. The officer repeats the answer, "No, no".
A. So sometimes it would be if there's some sort of a structure issue struggling to pass the tube.
MR ASTBURY: But in your experience that's caused, in the past, bleeding has it?
A. Yeah, it can do, yeah.
Q. Is that bad bleeding or just a small amount of blood?
A. No, just a small amount.
Q. Such as 1ml?
A. Yeah, I wouldn't expect any more than that.
Q. So here we're recording if the baby's receiving any respiratory support.
A. Sorry, that's me:
So here we're recording if the baby's receiving any respiratory support, which [Baby N] is --
Q. Mm-hm.
A. -- recording the ratios of that each hour. Also we document his oxygen levels and whether he's
receiving any oxygen and then we've got a comments part here.
Q. Can you confirm to me, Lucy, that those are your signatures at the bottom?
A. Yes.
Q. Lucy Letby was then taken to the environmental checks, which are at tile 239, which I think indicates we've made an error earlier but we'll put it right over lunch. The next form is definitely 239.
MR JUSTICE GOSS: Yes.
MR ASTBURY: Or if that's an appropriate moment.
MR JUSTICE GOSS: I think so. I was concerned because I think the chart we were looking at before was the wrong chart. It wasn't an observation chart, it was a different chart. We'll revisit that after lunch. We'll break off there. This goes on for some time, this part of the interview. Let's look at the right documents when we're going to them.
Thank you. 2 o'clock then, please, members of the jury.
(In the absence of the jury)
MR JUSTICE GOSS: I tried to look at my iPad, but that's not -- I hadn't been using it this morning, but I couldn't log in. It's just gone into a loop.
MR ASTBURY: We're confident the tile number is wrong, the first time not the second time, but it's in the jury's bundle so I'll take them back to it and we'll correct it and then we'll move on to the right --
MR JUSTICE GOSS: If we could, we could just go back over it because it's not easy to follow when you're not looking at the right document.
All right, thank you very much.
Just estimating, I don't think we're going to complete this this afternoon? It's quite dense.
MR ASTBURY: Yes. I'd been optimistic at 12 o'clock but not so now.
MR JUSTICE GOSS: And also --
MR ASTBURY: There may be an issue that needs to be addressed as well.
MR JUSTICE GOSS: That's why I'm mentioning it at this stage. There is this other issue, for which I thank you for the documents. Do you want me to address that this afternoon or do we want to sit tomorrow? The jury won't be here tomorrow and we could deal with it tomorrow because, Mr Myers, I've already said the defendant should be here tomorrow.
MR MYERS: Yes, we're grateful for that, my Lord.
MR JUSTICE GOSS: I think the best thing is rather than dealing with it at the end of the day, we'll deal with it at 10.30 tomorrow morning if that's convenient to you, Mr Johnson.
MR JOHNSON: I've got a dental issue and I've been putting it off and putting it off, and I got tomorrow.
MR JUSTICE GOSS: Right, so you can't do tomorrow then. Right, we'll do it this afternoon. We'll just break off earlier with the interviews.
MR MYERS: It won't take very long, I suspect, because what we have to say on both sides has been reduced to writing.
MR JUSTICE GOSS: I've seen it, I haven't read it in detail. I see some of it is agreed but some of it is still controversial. We'll finish with the jury earlier this afternoon. It'll be no bad thing because this is dense. So Mr Astbury, just at a convenient point in the second session --
MR ASTBURY: Yes.
MR JUSTICE GOSS: -- to give us time, but I want to finish by 4.15 completely. I want to rise at 4.15 this afternoon in any event.
MR ASTBURY: We'll agree a time between us.
MR JUSTICE GOSS: If you would. Thank you very much. 2 o'clock, please. (1.01 pm)
(The short adjournment) (2.00 pm)
(In the presence of the jury)
MR ASTBURY: My Lord, there was some confusion over which tile we should have been looking at with the observations chart, so could I just go back and correct the error I'm afraid I've set in train. If I could ask everybody, please, to go back to [redacted]. Thank you.
The tile number attributed in the summary at the top of [redacted] is tile 239. I'm just confirming now, but can we amend that number, please, to tile 172? That's on the [Baby N] sequence of events chart at 2 and it should read 172. Apologies for that.
If there's any further confusion, there's a hard copy of it within the separate jury bundle because it's one of the observation charts. So if anyone wants the J reference, it's J19314.
Officer, we'd reached [redacted] in the interviews and we'd reached tile 239 on that same
sequence of events chart, please, Mr Murphy. We'd got, I think, officer to the first question:
Can you read to me what you've wrote there?
A. I've put "blood in mouth".
Q. Yes.
A. "10ml per kilo saline bolus."
Q. So before that, other side of the chart, you've got you aspirated the blood.
A. Yeah, at 10 o'clock.
Q. At 10 o'clock. And that was from the tube?
A. Yeah.
Q. Then it says "blood in mouth"?
A. Yes.
Q. Can you explain to me the differences in them two?
A. So the blood in the mouth -- it's orally in the baby's mouth, on its lips.
Q. Okay.
A. In its mouth, whereas the nasogastric tube, the tube sits in their tummy, so if we've got blood
out of them it comes from the tummy rather than -- that blood was fresh, like orally in its mouth.
Q. Right. Can you explain to me what that looked like on [Baby N]?
A. I don't remember it specifically.
Q. Okay. Have you put "blood ++" there?
"That's another entry, I think", says the -- in fact that was you, officer.
A. Yes.
Q. Is that your writing?
A. It is, yeah.
Q. Is that suggesting there's a lot of blood?
A. Yes.
Q. And that's under the time of 8 o'clock, isn't it?
A. Yes.
Q. Are we suggesting that there's blood before -- quite a lot of blood before attempts to
intubate?
A. Yes.
Q. Can you remember that, Lucy?
A. Not really, no.
Q. I'm just trying to --
A. Reading this, I remember seeing that we gave factor VIII. It's coming back to me that he was a
baby that had a bleeding issue.
Q. So what would factor VIII be used for?
A. Clotting.
Q. Okay.
A. It's not something you give routinely. I don't recall ever giving him that before.
Q. Right. But I'm right in saying that's at 8 o'clock in the morning; yes?
A. Yes.
Q. Is it a lot of blood?
A. Yes, on oral suction.
Q. Do you have any recollection of that, Lucy?
A. Not specifically, no.
Q. Okay. At 4 o'clock there you also made another entry. Can you read that out to me?
A. "Small blood orally."
Q. Can you explain that to me?
A. I don't remember it but from my notes I found a small amount of blood again in the oral cavity.
Q. Okay. And do you have any recollection of that?
A. No. I think this was during the time -- I do remember him bleeding when we were having
difficulties with the airway, but I'm not sure when we started -- oh yeah, so the airway issue was
from 3 o'clock.
Q. Does it help with your memory in relation to the blood? Was it there before attempts to
intubate? Can you remember?
A. Not from memory. Obviously reading this, yes, he did have blood before intubation.
Q. Okay. Before intubation or before attempts to intubate?
A. I'm not sure when the attempts were.
Q. Right.
A. I'm guessing that as he was on BiPAP here we're not attempting there. I assume it's been
attempted from 15.00.
Q. Tell me why he was transferred to nursery 1?
A. I don't remember but from reading here when we came in at 7.30 and he deteriorated, he was
mottled, he was desaturating, requiring intervention, and so he's been moved.
Q. You start work on a day shift, is it -- 7.30, is it?
A. Yes.
Q. Okay, so you come on at 7.30 and straight into work or do you --
A. No, we have a handover period during that time.
Q. Right, okay. So if --
A. So from 7.30 I might have been receiving handover on this baby and another baby that I was
caring for.
Q. So, "Transfer to nursery 1 at handover". So are we saying this -- whatever has gone on has and
caused him to be moved into nursery 1 has occurred right at the time that you started that
shift?
A. Well, prior to. He's transferred to nursery 1 at -- on the handover.
Q. So just as the night shift are going off, just as you, as the day shift, are coming in?
A. Yes.
Q. This is when this event occurred?
A. Yes.
Q. Yeah?
A. It's when both teams are still there so the night staff and the day staff.
Q. Yes, okay, right. Do you recall him being transferred to nursery 1, Lucy?
A. No, no.
Q. Okay. The handover you talked about, who conducted it?
A. I can't remember receiving handover.
Q. Okay. Am I right in saying though for the notes before that it was Jennifer Jones that was the
signature?
A. Yes, yes.
Q. Is that the likelihood designated nurse [as read]?
A. Yes, it was likely, yes, and that would make sense that he was out in one of the nurseries
being looked after by a nursery nurse and has then required a nurse to take over.
Q. Okay, right, okay. You've then got:
"Mottled, desaturating and requiring Neopuff and oxygen. Capillary refill 3 to 4 seconds, cold to
touch."
Just that particular entry there, Lucy, explain it to me?
A. So he's mottled in colour. When he's been transferred, he's desaturating so he's needing
respiratory intervention to maintain his breathing and oxygen levels. His capillary refill is slow
at 3 to 4 seconds and he's cold to the touch, which would reflect that.
Q. So you've said to me then that when he was transferred he was mottled. Given that you made
this entry on these nursing records did you witness, see [Baby N] to put those comments on the
nursing records at that time?
A. Yes, I would have seen him. I don't remember it but I would have. I've written that I've
checked the equipment and that's how he looked on the handover, so yeah.
Q. Okay so would you have been present at [Baby N]'s cot side at that time then?
A. Yeah, I was in the room, yeah.
Q. Okay. The mottling, explain that to me. Visually what would it look like?
A. It's like a very -- it's like a pale skin and then like a blotchy appearance of darker, either
like reddy/bluey blotches, mottling. Sometimes white spots, like white patches.
Q. Okay. You've got there that Neopuff and oxygen was required. Who administered that?
A. I don't remember.
Q. Okay. Do you recall why that was needed?
A. No.
Q. Who else was present at this time, Lucy?
A. I don't remember from memory. I don't remember this.
Q. And how often has that happened to you previously, that babies collapse during handover?
A. Yeah, it's happened before.
Q. Has it happened to you when the baby's in a less -- one of the other nurseries?
A. Yes.
Q. You know, we've just agreed that, that a nursery nurse was looking after [Baby N].
A. Yes.
Q. So am I right in saying that the baby would have been nursery 3 or 4; is that right?
A. Presumably, yes, yeah.
Q. So that's happened to you before, that a baby's gone from a special care baby --
A. Yes, from -- yes, from one of the lower down nurseries who needed to come back up, yeah.
Q. Okay. Am I right in saying that the fact that [Baby N] was in one of the other nurseries would
be that they weren't overly concerned for him at that time he was there?
A. And being looked after by a nursery nurse. He's classed as a special care.
Q. If they were concerned before the handover he would have been moved, I'm right in saying, if
he --
A. If he'd acutely unwell, yes, they would have moved him.
Q. Okay. So if he became acutely unwell during the handover period between when the night shift and the day shift were on duty together.
Ms Letby nodded. It's obviously not recorded on here:
Okay. Other than those descriptions that you have put there of [Baby N], Lucy -- mottled,
desaturation, cold to touch -- was there anything else from memory you remember about him?
A. No.
Q. Okay. The next bit says:
"Decision made to intubate, drugs given as prescribed. Unable to intubate. Fresh blood noted in
mouth. Yielded by suc [suction] ++."
Explain that to me.
A. So the doctors made a decision to intubate the baby and we've given routine drugs. We have a
set of intubation drugs that we give routinely when we are going to intubate.
Q. Okay.
A. The doctor's been able to intubate and there's fresh blood in the mouth and it's been obtained
via suction as well so we -- we always suction the oral cavity (inaudible: coughing) tube down and
blood has come back --
Q. Okay.
A. -- when doing that suctioning.
Q. And you're interrupted there:
Sorry, Dan, can I ask a question there: so is this saying that they've been unable to intubate
because of the fresh blood there? Is that what they're saying?
A. No. They're just -- they've been unable to intubate and we've also noticed there's fresh blood.
I'm not sure.
Q. Right, okay.
A. I'm not sure whether they haven't been able to because there's blood or it's another issue. I
don't know.
Q. Right, okay.
A. That would be in the medical notes.
Q. Just breaking the entry down there, it says, "Decision made to intubate". So whose decision
was it, Lucy?
A. I don't remember specifically but it would be a doctor's decision.
Q. Okay. And, "Drugs given as prescribed". Who gave them drugs to [Baby N]?
A. I'm not sure without looking.
Q. Okay and, "Unable to intubate". Obviously I've just asked that question. Do you have any
recollection as to who that was that was unable to intubate?
A. No.
Q. Okay. Can you explain why this was?
A. That they couldn't tube him?
Q. Mm-hm.
A. No.
Q. Do you have any recollection at all of this process as it's been documented here?
A. No.
Q. Okay. When did you first see the blood, Lucy, on [Baby N]?
A. I'm not sure from memory.
Q. Okay. And on seeing blood on a neonate there was -- sorry?
A. There was blood before we started --
Q. Mm-hm.
A. -- to tube him.
Q. Okay. How do you remember that?
A. Because I've remembered it from reading in the notes.
Q. Okay. Does that concern you, that there was blood?
A. Yes.
Q. Why did you think he was bleeding?
A. I'm not sure.
Q. Okay. Again, I appreciate I've already asked this question, but do you have any recollection
of what you could visually see in terms of the blood?
A. Not this early on, no.
Q. Okay. As we've previously looked at in them notes, you've documented that it was on the tubing
and around the mouth. Before that we've looked on those notes. Do you recall that?
A. Not from memory as such.
Q. Okay. Do you recall if there was blood anywhere else on [Baby N] at this time, Lucy?
A. No.
Q. Okay. So from what just said, Lucy, you're happy in your memory that there was blood present
before the attempts to intubate him? Is that what you just said, without the tube, before you
tried to put the tube?
A. Yes.
Q. And that's from your memory because it's not clear in the notes there, is it?
A. No, but the chart is because I've documented it on here, haven't I, at 9 o'clock, when I've
done his cares, that there is fresh blood on the -- when I've checked the tube.
Q. Okay. So that's why you've come to that decision?
A. Yeah, from my notes.
Q. Not that you actually physically remember?
A. No. My physical memory of blood comes later when he was being intubated.
Q. Okay. I'm just going to move on and read out the next couple of entries to you, Lucy. It
says:
"Remained cool through the day. Incubator temperature increased. Documented a respiratory low,
varying oxygen requirements."
Then it says:
"Perfusion and colour initially poor."
Can you explain what that means to me?
A. So that would reflect the source of mottling and the coolness. And perfusion is the capillary
refill time I have documented earlier of 3 to 4 seconds.
Q. Okay.
A. And colour is poor. So poor colouring would be mottling and just sort of a paler/bluier colour.
Q. Mm-hm. Okay. And it says:
"Saline bolus as prescribed and cool."
Who prescribed that?
A. No.
Q. Okay. Would that have been something that you instigated, that [Baby N] needed that bolus?
A. Yes, it might have been something that I have escalated that to a doctor and said that his
observations are this, he's looking like this.
Q. Okay. And how would you have gone about that?
A. As I say, I don't remember specifically, so I don't know if the doctor was in the room or
whether I would have called the doctor --
Q. Okay.
A. -- whether I've escalated it to the nurse in charge, I don't remember.
Q. The officers continued to read Lucy Letby's nursing note:
Okay. The next bit says:
"Remains pale/mottled, but improved from earlier in shift. Nil by mouth. IV fluid 10% glucose via
peripheral line."
Then it says:
"Small amount of fresh blood orally. 1ml obtained from NG tube. Nil further bleeding."
Again, this further mottling that you've documented there, can you explain that to me?
A. Again, as before, mottling.
Q. Mm.
A. I'm assuming his colour's still -- he's still looking mottled.
Q. It says there you put that it was fresh. How do you know it was fresh?
A. It would have been by the colour. So it was obviously bright red blood which indicates it was
fresh.
Q. And "1ml obtained from NG tube". Tell me how that's measured?
A. So it would have been -- we aspirate the tube with a 10ml syringe, so when I have drawn back,
1ml's come out into that syringe.
Q. And what would have happened to that blood?
A. You either show it to somebody and then it would be discarded.
Q. Do you recall showing it to anybody?
A. No.
Q. Okay. Do you have any explanation as to why there was fresh blood to [Baby N] orally?
A. No.
Q. Do you recall telling anyone else about it?
A. No I don't remember who was there, staff, I don't remember.
Q. Okay. Did it give you any cause for concern?
A. I don't remember from memory. I mean, reading this now, it would be a cause for concern. I
imagine that's why then he's gone on to need factor VIII and had bloods taken.
Q. Okay. In relation to securing an airway and then "ENT doctors attended to assess [Baby N]"; is
that correct [as read]?
A. Yes.
Q. Okay. When they arrived, Lucy, at approximately 7 pm, how did that make you feel?
A. Who? Who arrived.
Q. Sorry, when Alder Hey arrived --
A. Oh.
Q. -- to obviously assist with the intubation and potentially take over the care of [Baby N].
A. I think we were all relieved and that's -- they'd arrived.
Q. Why was that?
A. Because they're the specialist team and we'd had anaesthetics over but they don't anaesthetise
children in the Countess of Chester so they're not familiar with neonates. We are a bit concerned
that they wouldn't have any more.
Q. Lucy, this profound desaturation at 19.40 hours, did you witness that?
A. I can't remember.
Q. Okay. Anything you want to ask? Is there anything else, Lucy, in relation to the collapse of
[Baby N] that you can tell us other than what we've discussed there and from you having a look at
the notes?
A. No. I just remember it being quite a chaotic afternoon. So we used this I-Gel airway, which is
something we never -- they're quite new, we'd never used them before on the unit, and I remember
there was a bit of -- bit of sort of asking around as to how we put it in and use it and things
like that, which is why it stands out, I think, and then just having all those people coming, it's
just not something that we experience usually.
Q. Lucy, is there anything further you want to say about [Baby N] other than what we have covered
and what you have mentioned there about the I-Gel?
A. No.
Q. Lucy, are you responsible for the attempted murder of [Baby N]?
A. No.
Q. Are you responsible for his attempted murder on those two dates that we've talked about --
A. No.
Q. -- 3 June 2016 --
A. No.
Q. -- and 15 June 2016?
A. No.
Q. Do you know what was wrong with him to have caused all these episodes during that day?
A. I think he had some sort of clotting problem, I believe; that's why he's had the factor VIII.
Q. What caused him to bleed in the first place?
A. I think if he had this condition, it caused the problem with the clotting which would make him
more prone to bleeding.
Q. Do you, are you or were you aware of him bleeding at all throughout the night shift?
A. I don't remember.
Q. Okay. The time by my watch is 12 minutes past 4 and the interview concluded.
A. Yes.
Q. Thank you.
So that was the first interview in respect of [Baby N]. The second one took place on 12 June
2019.
A. Yes.
Q. And began with introductions. Lucy Letby was reminded of her rights and she was cautioned:
I'm going to start off with [Baby N].
And the officers summarised the previous interview concerning [Baby N]:
Christopher Booth, who was the designated nurse for [Baby N] on 3 June 2016, says that when he
went on his break he had no concerns for [Baby N] at all. But when he returned, he was surprised
that [Baby N] had suffered a profound desaturation. Do you remember Chris Booth going on his
break, Lucy?
A. No.
Q. Were you surprised that [Baby N] suffered this profound desaturation at this time?
A. I don't recall that specific moment.
Q. Did you do something to [Baby N], Lucy, that caused this desaturation?
A. No.
Q. Did you attempt to murder [Baby N] at this time?
A. No.
Q. Lucy Letby was asked about the door fob data on 15 June 2016:
Okay, so let me just show you a copy of that. If you could have a look at the highlighted sections
there and just confirm the date and times for me, please.
A. It's 15 June at 07.12 and 15 June, 07.10.
Q. Okay. So there's one 2 minutes before the other. They might not have been in the right order,
but 7.12 and 7.10. So would that suggest that the one below is the first door that you've
activated, Lucy?
A. Yes.
Q. Okay. So what time would you normally start shift on a day?
A. Half past 7.
Q. Half past 7. Is there a reason on this particular day, Lucy, on 15 June, you've come on
early?
A. I quite often arrived on the unit early. I used to get changed prior to starting my shift,
would go and put my lunch away. It was quite often (sic) for staff to come in early so that you're
prepared and ready to start at half past 7.
Q. Okay. And on this occasion is that what you did?
A. I don't recall specifically.
Q. Jennifer Jones said she was in nursery 3 caring for [Baby N] and that you came into the
nursery at around quarter past 7 in the morning. Do you remember that?
A. No.
Q. Do you remember how many babies were in nursery 3, Lucy?
A. No.
Q. She was feeding another baby, caring for another baby at the time. When she looked over [Baby
N] was blue and mottled all over. Do you remember that?
A. Not specifically, no.
Q. Is there a reason why you would do that, Lucy, go straight into nursery 3?
A. To talk to Jen.
Q. Is that something you would regularly do?
A. Yes.
Q. What, you'd come on early into your shift?
A. Colleagues would -- yeah, I would talk to other colleagues on the unit before their shift,
yeah.
Q. Right, other colleagues. Who else would you come on early to speak to?
A. You don't come in early specifically to speak to somebody, but if you're on the unit early
quite often you'd have a catch-up with people that are on the night shift at that moment.
Q. So do you remember on this particular day, 15 June 2016, you coming on early?
A. No, I don't recall.
Q. Okay. Am I right in saying, though, having looked at swipe card information, that is?
A. Yes, and that is about the time I would usually arrive, yes.
Q. What did you do to [Baby N] at that time, Lucy?
A. I didn't do anything to [Baby N].
Q. Did you attempt to murder [Baby N] at that time?
A. No.
Q. It was then suggested that [Dr A] had attended post-collapse and Lucy Letby was asked if she
remembered that.
A. No.
Q. Do you remember if he came in on this particular day to assist with the care of [Baby N] after
he collapsed?
A. I don't recall.
Q. Am I right in saying, Lucy, that with [Baby N] being in nursery 3, he would have been
reasonably stable at that time?
A. Yes.
Q. Yet you've gone into the nursery at quarter past 7 and within minutes he's now unstable and
requiring an intubation?
A. Yes.
Q. Did you do anything to [Baby N] to cause that?
A. No.
Q. Did you attempt to murder [Baby N], Lucy?
A. No.
Q. The officers then summarised the opinions of Drs Evans and Bohin:
What did you do to [Baby N] to cause him to bleed in the throat, Lucy?
A. I didn't do anything to him.
Q. That was the end of the second interview.
A. Yes.
Q. We move on to the third, which took place on 10 November 2020:
Okay, Lucy, I'm going to move on to [Baby N].
The officers summarised the previous interviews concerning [Baby N]:
Have you got anything else you wish to add there?
A. No.
Q. In relation to what I've said, I've got a statement from [Father of Baby N], Lucy, who was the
father of [Baby N], and he evidences a telephone call he received from you on 14 June, saying that
[Baby N] had been unwell during the night but he was doing okay now. He says that 10 minutes
later, [Baby N]'s mum called him, saying [Baby N] was poorly and they needed to go to the
hospital. Do you understand what he said there, Lucy? He's saying he received a telephone
call.
A. Was it from me?
Q. Why did you tell [Father of Baby N] that [Baby N] was doing okay?
A. I don't recall that conversation.
Q. It was in fact, Lucy, that [Baby N] was poorly. Can you explain this?
A. No, I don't recall ringing anyone.
Q. Do you recall speaking to [Baby N]'s dad at all while you were caring for him?
A. No.
Q. Is that something you would do though, Lucy, update the parents if there was an issue?
A. Yes. Usually at that time in the morning it would be to ask them that they need to come in.
Q. [Baby N] had been stable for a couple of hours at the hospital when [Parents of Baby N] went
to collect some food between 11 and 12, during which time [Baby N] became unwell again. Can you
account, Lucy, for why [Baby N] became unwell the moment his parents left during that hour?
A. No.
Q. Is it a coincidence?
A. Yeah.
Q. Do you recall any issues with [Baby N]'s throat, Lucy?
A. Yeah, it was difficult to intubate.
Q. Do you remember anyone highlighting to you that he had a swelling at all?
A. I can't -- I don't know.
Q. Do you know how a swelling could have been caused to [Baby N]?
A. No.
Q. Tell me what the physical effects of a swelling to [Baby N]'s throat would have been? What
effect would it have had on him?
A. Difficulty in securing an airway for -- to put on an airway down.
Q. Okay. I've got a statement from Dr Mayberry who saw a swelling end of the epiglottis. Have you
got anything you wish to say about his evidence, Lucy?
A. No. Did they find a cause?
Q. Well, he said he went later to find out. He doesn't say whether he found a cause or not.
A. No.
Q. But are you aware of what the cause may have been?
A. No.
Q. Have you previously cared for a baby who suffered a spontaneous bleed, Lucy?
A. A bleed from where?
Q. So a spontaneous bleed of a sort. Have you cared for one on the NNU before?
A. [Baby E], but I don't know if that -- was that before that or after? I don't know.
Q. Have you had any experience of a premature baby causing an injury to their own throat or to
themselves --
A. No.
Q. -- so much for it to cause a bleed?
A. No.
Q. Do you know what haemophilia is? Have you heard of that before?
A. Yeah, I think it's something to do with the clotting. I don't know the full details but...
Q. Yeah, it's a blood --
A. Something about a clotting disorder.
Q. It's a blood disorder which impairs the body to make blood clots. Do you know what the
symptoms of haemophilia are?
A. Would it be bleeding, bruising?
Q. And?
A. And low blood count?
Q. And were you aware that [Baby N] had this condition?
A. I'm not sure without looking at the notes.
Q. Did you harm [Baby N], Lucy, knowing that he suffered from haemophilia?
A. No.
Q. We've recovered some Facebook messages, Lucy, which are exchanged between [Dr A] and yourself.
The tile numbers are there, my Lord, I am not going to go straight to them:
Do you recall that message exchange, Lucy, with [Dr A]?
A. Yeah.
Q. Why were you updating [Dr A] on this? What was happening?
A. I'm not sure if he asked me first because obviously there I'm apologising for how I came
across.
Q. Mm-hm. Were you trying to get some kind of point across to him in your message?
A. I was a bit, not -- well, not annoyed but Bernie had been faffing and I think I made the
situation a bit more difficult than it needed to be and I offloaded that to [Dr A].
Q. Why were you apologising to him for being off?
A. Because if I was off in that towards him then I wanted to apologise for that.
Q. Okay. You then sent a message to [Nurse E] at 13.17 hours. Why were you updating [Nurse E] on
[Baby N]?
A. I don't know whether she asked first or she just -- she's my best friend, I did tell her
things.
Q. Okay. Why did you feel you needed to tell [Nurse E] you were worried about [Baby N]?
A. I don't know but I think I said I was worried in response to her saying it was a bit worrying
with his haemophilia.
Q. Was this you again trying to get some kind of point across to [Nurse E]?
A. No. I think I might need to stop now, please.
Q. You want to stop? Okay.
And the interview was suspended in accordance with Lucy Letby's (inaudible).
I think in fact that was the conclusion of the interviews regarding [Baby N].
A. Yes.
Q. The next interview is [Baby O], known at the time at [redacted]. The first interview, 5 July
2018.
A. Yes.
Q. It begins:
Okay, so during this interview what we'd like to talk to you about is [Babies O, P & R].
A. Okay.
Q. So the first one is [Baby O]. I'll just give you a summary of [Baby O]. At 14.24 hours on
21/6/16, [Baby O] was born. He was the second born of triplets, delivered by caesarean section.
[Baby O] died at 17.47 on 23/6/2016. Okay? So what I'll ask you is: what do you recall about your
care of [Baby O]?
A. So I remember [Baby O]. I was also caring for his brother, [Baby P], as well on that day in
nursery 2. I remember [Baby O] was on Optiflow, which is a form of respiratory support, and I just
remember that he'd had a feed -- I think it was about 12 o'clock -- and then an hour later he -- I
found him vomiting. I noticed that his abdomen was distended and he was reviewed by the doctors at
that point. I think he had a sceptic screen carried out and was started on some antibiotics and in
the meantime, when those were given and the registrar left the room, [Baby O] deteriorated again,
and I called for help from the registrar who was in the nursery next door. And then there was some
confusion as to where we were going to move [Baby O] because ideally we wanted him to go into
nursery 1 and I think some of the babies had to be moved around to allow [Baby O] to go through
and then we moved [Baby O] into nursery 1 and he was ventilated in the nursery. And I remember at
some point the registrar left to go and update mum upstairs and that's when he had a further
deterioration and we had to call the doctor back down and I think he was re-intubated at that
point as well. And I remember his abdomen was quite distended and I think the doctors put a drain
into his abdomen. And also he was struggling with intravenous access and he required another form
which is called intraosseous access and that isn't something that we stocked on the unit, so
somebody had to go to the children's ward to get that equipment to do that, yeah. I can't remember
much else from memory clearly.
Q. Okay. So would you like to refer to the notes?
A. Yes, please.
Q. Lucy Letby explained a number of signatures related to a student nurse named Rebecca
Morgan:
So is it right that you were his designated nurse?
A. Yes.
Q. And you said that you worked for both [Babies O & P]?
A. Yes.
Q. Okay. At the same time?
A. Yes.
Q. Then there's reference to the note at tile 109:
Okay, so:
"Written for care given from 08.00 hours onwards. Emergency equipment checked. Fluids calculated."
Okay. The next part is:
"Observations within normal range. Remained on Optiflow. 4 litres in air. Nil increased work of
breathing. 2x12 feeds via NG tube. Minimal milk aspirates obtained."
So do those two feeds there relate to the two feeds that you refer to within your notes? Can you
say that?
A. Yes.
Q. So what time are those feeds?
A. At 10.30 and 12.30.
Q. Okay. Pausing there, thank you. If we go back to that larger paragraph, I think it says "ml"
and then I think it should probably say "nil increased work of breathing". I think that's a
typo:
Okay, so with regard to those two feeds, did you experience any problems with [Baby O] taking his
feeds?
A. No.
Q. Okay. How were they done exactly?
A. Via his NG tube.
Q. Lucy Letby confirmed that [Baby O]'s aspirates gave no cause for concern:
How long would that feed take?
A. He's only on 13ml so not long, a few minutes.
Q. And is that something that you would be present for all the time and make sure that feed is
--
A. Yes.
Q. Until the end?
A. Yes.
Q. You wouldn't leave the baby's side at that time at all?
A. No, we don't. It's not usual practice to leave the feed unattended, no.
Q. Lucy Letby did not recall doing the feeds at 10.30 and 12.30 but agreed that the signatures
suggested that she had fed [Baby O] at those times:
Okay. And in general terms how was [Baby O]?
A. I remember him to be well. I didn't have any concerns unduly apart from his abdomen.
Q. So there weren't any sort of associated risks with him in terms of an ongoing care plan or
anything?
A. No, just that he was receiving Optiflow, which is the respiratory support.
Q. Okay. Is that prongs up the nose?
A. Yes.
Q. Okay. Does that have an effect on how he handled?
A. In what way?
Q. I don't know, it might not do, that's my question.
A. No, so Optiflow can sometimes give them a full tummy because they can take in a gulp and the
air from the Optiflow and swallow that.
Q. Right. So is that something you need to be aware of --
A. Yes.
Q. -- when they're on Optiflow?
A. Yes. Any respiratory support, yeah.
Q. So the next part is:
"Abdomen appeared full but soft and non-distended, smear of meconium present at anus. Active and
alert."
So again, do you have any comments to make on that entry?
A. No.
Q. So they're good signs, are they?
A. Yes.
Q. So:
"Reviewed by [Dr A] at 13.15. [Baby O] had vomited undigested milk." Okay. So had he vomited prior
to being reviewed by [Dr A]?
A. Yes.
Q. Did you care for him in between the feed, him appearing obviously well and then the
vomiting?
A. Not that I remember. I could check to see if I did any observations in that period. So he had
observations at 12.30 and at 1.30.
Q. Okay, so --
A. So I don't recall having contact with him after that, though, after the feed.
Q. So after 12.30?
A. No.
Q. So he was reviewed at 13.15. Can you give us a time of -- what the time was when he
vomited?
A. No, but I -- I think he vomited when I -- the doctors was on the unit at the time I believe, so
I got him.
Q. You remember that?
A. Yes.
Q. Okay. And were you present when he vomited?
A. No, I don't remember. I think I went to him.
Q. Right.
A. I think his monitor was sounding that he was desaturating.
Q. And can you describe the vomit?
A. I don't remember it, so I don't remember it to be significant --
Q. Okay.
A. -- vomit. But it was a vomit as opposed a posset.
Q. Okay. Can you remember who was actually present in his nursery at the time?
A. No.
Q. Lucy Letby confirmed that [Dr A] was called at 13.15 immediately after the vomit:
Okay. The next one is approximately 14.40:
"[Baby O] had a profound desaturation to the 30s followed by bradycardia, mottled ++ and abdomen
red and distended."
So again, who discovered this?
A. From memory I believe it was myself and I think I went in to him because his monitor was
alarming.
Q. Okay, was anybody present in the nursery at this time?
A. Not that I remember, no.
Q. Was [Baby P] in there with him?
A. Yes, because I was looking after [Baby P].
Q. He was in the same room?
A. Yeah, and I think [Baby R] was in nursery 1.
Q. Okay. Had you noticed or become concerned about any or signs or symptoms that [Baby O] had up
to that point?
A. No.
Q. Was there any change in his care up to that point?
A. No -- well, other than we'd been placed him on the free drainage and he'd been given
antibiotics --
Q. Right.
A. -- and he'd also had an X-ray.
Q. Okay. So can you describe the mottled ++ for me?
A. So I remember it -- well, he was mottled all over his -- he was mottled all over and then he
had red -- he had a red abdomen. So mottling is a sort of blotchy purple/red rash and then as I
say he had this red abdomen as well.
Q. Right. What were your observations of that clinically?
A. That it was a deterioration.
Q. What's it a sign of?
A. It can be an infection, mottling. It could be that they've dropped their temperature, that
they're poorly perfused.
Q. Right. Then the other officer:
That mottled ++, is that something that you see regularly when you're dealing with a baby?
A. Yes, not usually to that extent, but a mottled appearance is something that neonates quite
often you will see, yes.
Q. Okay. So on discovery of this, what did you do?
A. I remember we -- I don't know if it was myself or another nurse but we called the registrar who
was next door in nursery 3 at that point.
Q. Which one was that?
A. Which registrar? [Dr A]. And then he came and I think that was when we had the discussion about
him needing to go into nursery 1 and have further support and observation.
Q. Okay but for -- up to that point you weren't aware of any deterioration, any real change in his care and he hadn't been displaying any other poorly signs or symptoms.
The next entry we want to talk about is:
"Doctors crash called 15.51 due to desaturation to the 30s with bradycardia. Chest movement and
air entry observed. Minimal improvement. Re-intubated."
Okay? So again talk me through this. Who discovered it and how you discovered it?
A. Okay. So I don't recall exactly how I discovered it. I think I was in the nursery with him at
the time. I don't think I would have left the nursery when he's ventilated and then I remember [Dr
A] had gone upstairs to so to speak to mum and dad and that's when we had to crash call him to
come back down.
Q. All right, okay.
A. Hence -- that's why he'd left the unit at that point and I think [Dr A] came and he needed to
be re-intubated and I don't remember the circumstances as to why that was.
Q. When you say "we", who were you with?
A. I don't remember but -- I don't remember putting out the crash call so I think I must have been
doing something with [Baby O] and then another member of staff called.
Q. Right, okay. And again, can you give any explanation as to how this desaturation occurred?
A. No.
Q. Okay. So you had no clinical observations that might indicate a deterioration?
A. No.
Q. So:
"CPR commenced at 16.19 and medications/fluid given as documented."
What was your role in his CPR?
A. I think I did some chest compressions.
Q. Okay.
A. And I think I did some drugs, but I'd have to check.
Q. Lucy Letby described events after [Baby O]'s death. She enabled his parents to spend some time
with him and continued to care for [Baby P]:
What activity did you perform during those arrangements?
A. So once he had passed away I just remember sort of facilitating them having some time with
[Baby P] and [Baby R] and I don't think -- and I don't think I did any of the handprints or
footprint or anything like that at that point, it was later on in the shift, and I think the
person that took over did that part. So I had to handover [Baby P] and then I believe the doctors
carried out a septic screen on [Baby P] and [Baby R] in view of what happened to [Baby O]. I
remember [Baby P] was quite difficult to obtain IV access on at that point. I remember the
consultant doing that and having several attempts.
Q. Okay. So obviously at this point [Baby O] has passed away. How were you feeling at that
time?
A. Shocked and upset.
Q. Can you give any explanation as to what happened to [Baby O]?
A. No. I just remember his abdomen kept swelling and they ended up doing, like, a drain into his
abdomen and I'd not seen that before and that was quite -- it's not a nice thing to see when you
haven't seen it before.
Q. Right.
A. And the same with the intraosseous access, that's quite a brutal form of access, and that stood
out in my mind, having to see him have that done.
Q. Is that all after he deteriorated?
A. Yes.
Q. Okay. So was his death unexpected?
A. Yes.
Q. Is there anything else, obviously about [Baby O], that you feel that we need to discuss or
raise?
A. No. I think we've covered it.
Q. And then Lucy Letby's solicitor said:
I think you mentioned to me before that the registrar cover was quite chaotic that day when he was
having to cover --
A. Because as I say, it was a busy shift, because we were having to try to get [Baby O], make room
for him in nursery 1, and the doctors were back and forth quite a lot. Usually if there's a
ventilated baby they would sort of be around a little bit more. I think they were getting pulled
in various directions that day.
Q. Has that got any direct influence on [Baby O]'s death?
A. I think there was an element of delay, obviously, and each time you have to call the registrar
to come there is an element of delay. But maybe if they were there at the time something may have
been initiated quicker and I'm not sure.
Q. Could that have prevented the initial collapse?
A. Are you referring to the collapse at 14.40?
Q. Either of them.
A. Mm. I don't think the collapse at 14.40 -- no, I think he had already been seen by the doctor
and we had plan in place and that was being implemented. I think once he had the profound
desaturation at 14.40 it was a bit more clear that he was unwell and obviously he was ventilated
eventually after that. He was left by the medical team.
Q. And the interview in respect of [Baby O] was concluded at that stage.
A. Yes.
Q. Moving on to the second interview in respect of [Baby O], which took place on 12 June 2019.
Following introductions and caution, the officers summarised events surrounding [Baby O]'s death
on 23 June 2016:
Do you remember this day, Lucy?
A. Yes.
Q. Okay. In your previous interview you were shown page 5, which shows Rebecca Morgan
countersigning the observation chart, the last being at 10.30. Do you confirm that, Lucy?
A. Yes.
Q. She states she left the nursery and that she would have been helping other babies elsewhere on
the unit. Do you agree with that?
A. I don't recall her specific movements. She was allocated to work with me.
Q. Could Rebecca Morgan have left the nursery --
A. Yes.
Q. -- to help other babies?
A. Yes.
Q. And if you go back to page 3 of the notes, Lucy, you signed the feeding chart at 12.30.
A. Yes.
Q. Do you agree with that?
A. Yes.
Q. And you said that you would not leave the babies as they were being fed.
A. I don't know. Yeah, that's -- I don't know. That looks like my writing.
Q. Is that your signature?
A. That's my signature.
Q. Is that your signature at the bottom?
A. Yeah.
Q. At 13.15 hours you were on your own, Lucy, in the nursery with [Baby O]. This was when he
collapsed; do you agree with that?
A. I don't recall from memory the exact times.
Q. Were you on your own when he collapsed though, Lucy?
A. I can't remember.
Q. Lucy, what explanation can you give us as to why [Baby O]'s condition deteriorated at this
time?
A. I can't.
Q. At 14.30 hours you completed a set of observations with [Baby O] and you stated -- you
confirmed on interview that you were in the nursery on your own when [Baby O] again collapsed at
14.40 hours and you were the first to go to him after he'd suffered a profound desaturation.
That's what you said to us on the previous interview.
A. Yes.
Q. Have you got any explanation for his collapse?
A. No.
Q. What did you do to cause the profound desaturation?
A. I didn't do anything to [Baby O].
Q. Shortly afterwards, Lucy, [Baby O] is moved to nursery 1 and was then ventilated.
At 15.51 hours [Baby O] suffered a further profound desaturation and collapsed. On your own
admission, Lucy, on interview you stated you were in the nursery with him at this time and that
[Dr A] had gone upstairs to speak to his parents, which is why he was crash called --
A. Yes.
Q. -- back down to the unit. Do you remember this?
A. Yes. Yeah, I don't -- I don't remember making the crash call myself, yeah.
Q. You remember doing something with [Baby O] at that time?
A. Yeah.
Q. Is this desaturation, Lucy, this further one that [Baby O] has suffered again, another
coincidence of you being alone with him at the exact time he collapsed?
A. Yes.
Q. Have you got any explanation for this desaturation?
A. No.
Q. Are you responsible Lucy for harming [Baby O]?
A. No.
Q. Are you responsible for the murder --
A. No.
Q. -- of [Baby O]?
A. No.
Q. Lucy, anything -- and then "no". The officers summarised Dr Evans and Dr Marnerides' opinion
regarding excessive air in the abdomen and trauma to the liver:
Have you got any comment you wish to make?
A. I did not physically injure [Baby O].
Q. What injuries did you cause to [Baby O]?
A. I didn't cause any injuries.
Q. When [Baby O] vomited and when he collapsed on these occasions you were on your own, and
you've confirmed that to me, can you explain --
A. Alone with [Baby O], yes?
Q. Yes.
A. I don't recall if there was anybody else in the room.
Q. Yes, you explained that you were on -- you confirmed that you were on your own with [Baby O].
Can you explain this to me?
A. No.
Q. Just to confirm, you confirmed that you were on your own when [Baby O] vomited, just after
Rebecca Morgan had left the nursery, and again just after [Dr A] had left to update the
parents.
A. Yes, I was alone with [Baby O]. I don't know if there was any other --
Q. Yeah?
A. -- staff members in the room.
Q. Can you provide me with any explanation as to how [Baby O] sustained the significant trauma to
his liver?
A. No. I know there was a discussion after resuscitation with the doctors whether there could have
been -- there was. I know that it was found later on that he'd had a problem with his liver,
whether this had been caused by vigorous resuscitation.
Q. Did you subject [Baby O] to an air embolism Lucy?
A. No.
Q. Do you agree that these two collapses occurred during the two occasions when you were on your
own with him?
A. Yes. As I say, I don't know if there was anybody else in the room when I was on my own.
Q. What did you do to --
A. With [Baby O]?
Q. What did you do to [Baby O] on these two occasions, Lucy?
A. I'm not sure what care I was giving him, but I didn't do anything to harm him.
Q. Someone did, Lucy, didn't they? Someone has caused harm to him.
A. It wasn't me.
Q. This occurred, the collapses occurred, while you were with him both times. Lucy, are you
responsible for the murder of [Baby O]?
A. No.
Q. The third and final interview in respect of [Baby O], officer, on 11 November 2020.
A. Yes, that's correct.
Q. Following introductions and caution, Lucy Letby was reminded of her rights and she confirmed
that she understood:
Okay, Lucy, I'm going to talk to you now about [Baby O].
The officers summarised [Baby O]'s position and what had been discussed in previous
interviews:
Is there anything you wish to add regarding that?
A. No.
Q. Okay. Melanie Taylor states that when [Baby O] deteriorated, Melanie said to you that she
thought he didn't look as well as he did earlier and asked if you thought they should move him to
nursery 1 to be safe. She recalls you saying no and that you wanted to keep him in nursery 2. Do
you recall that conversation?
A. No.
Q. Why didn't you want to move him?
A. I don't remember the conversation so I don't know.
Q. Melanie was the shift leader at the time. Is there a reason why you wouldn't agree to her
request?
A. I don't remember her request but it may have been that you try and keep triplets together and
if they were int eh same room, that's what we would try and maintain as much as possible.
Q. So [Dr A] was briefly away updating [Baby O]'s parents on his condition when he deteriorated.
Was this another coincidence that [Baby O] collapsed when nobody was around him, Lucy?
A. Yes.
Q. What's your understanding of gaseous distension?
A. To be sort of air in the abdomen.
Q. What's your understanding of gas in the abdominal vessels?
A. I don't know the abdominal vessels are [as read].
Q. So in relation to social media, as I said, [Baby O] was born the 21 June 2016 and [Baby P] was born on the same day. [Baby O] died on the 23rd and [Baby P] died on the 24th.
On 23/6/2017, so that's the day [Baby O] died at 23.46 hours, you searched for [surname of Babies
O, P & R] on social media. Do you recall doing that, Lucy?
A. No.
Q. What would you be looking for by doing that search?
A. I don't know. I don't remember.
Q. In relation to the mobile phone records that we have on 22 June you were informed that the
triplets had been born and your reply at 14.11 hours -- your message to Jen was:
"Yep, probably back in with a bang lol."
Do you remember that?
A. Not specifically but I was away on holiday at the time and...
Q. What do you mean, "Yep, probably be back with a bang"?
A. I don't know if Jen had said something about it's going to be busy for me coming back with --
they had triplets on the unit.
Q. Were you intending on doing something to the triplets, Lucy?
A. No.
Q. At 08.14 hours on 23 June you messaged [Nurse E] and said:
"It's busy but no vents anymore. I've got triplets in 2. All okay but got a student and first day.
Two-hourly feeds, et cetera, no time to do anything lol. And Yvonne F in but said I can show her
around, et cetera."
What do you mean by "no time to do anything"?
A. So it's busy. I had the three triplets plus a student so it's a lot to have three babies on
two-hourly feeds plus have a student on her first day, obviously do all the introductions and
orientations with the student, so the fact I didn't have time to give her a proper induction.
Q. At 10.20 on 23 June you messaged [Dr A] and said that your student was not with you as she was
doing some feeds and chatting with parents. Do you recall that?
A. I don't remember sending that text but I know that I raised that I wasn't able to give her the
time that I needed and some other members of staff said that she could help them with some feeds
and parental care with the families in the other nurseries.
Q. Did that happen throughout the day, throughout that shift?
A. Yes.
Q. Were there other times when your student was doing feeds or carrying out other tasks?
A. Other than that day?
Q. On that particular -- on other babies.
A. Yes.
Q. [Baby O] died at 17.47. At 21.06 [that time in fact is wrong] you messaged [Nurse E] to tell
her. You then told her:
"Blew up abdomen. Think it's sepsis."
Do you recall sending that message, Lucy?
A. No.
Q. Who thought it was sepsis?
A. I think it was a discussion, that we all felt that he blew up his tummy and maybe it was
something like NEC or sepsis.
Q. Was that your thought then?
A. It was my thought but I think it was something that was discussed at the time as well.
Q. So is that description reflected anywhere in the clinical or nursing notes then?
A. I'm not sure without checking them.
Q. In the same conversation you said:
"Had big tummy overnight but just ballooned after lunch and went from there."
Was it necessary to tell her that his tummy was big overnight, Lucy?
A. I don't know. Maybe she asked what had happened or --
Q. Were you trying to blame the night staff?
A. Blame the night staff?
Q. For the condition of the baby?
A. No.
Q. Is that description reflected anywhere in the clinical or nursing notes regarding the tummy
being big overnight?
A. I don't know without looking at the notes.
Q. Okay. At 21.06 [and it's the same text, that should say 21.28] that day you messaged [Nurse E]
and said:
"Sophie had them last night. In a right state tonight."
Followed by:
Yeah, worried she's missed something."
Was that you again blaming staff, Lucy?
A. No, it's not me blaming staff. Sophie was really upset that evening, which I've stated she came
in in a right state.
Q. Do you recall that, then, that message?
A. Not specifically, no, but I remember Sophie and then I don't know. Yeah, she was worried she
had missed something. I don't know if that's a reply to something [Nurse E] asked me.
Q. You also said, "Not a good gestation". What do you mean by that and why is it not a good
gestation?
A. Because babies of that gestation can be a little bit -- like they're not prem prem, but they're
kind of in a different category to the ones that we kind of watch.
Q. And the interview as far as [Baby O] concluded there.
A. Yes.
MR JUSTICE GOSS: I think that's a good point to have a break. I know it's a little bit earlier, but just so that you know, members of the jury, this afternoon we're going to do until about 3.45 with interviews.
MR ASTBURY: Yes.
MR JUSTICE GOSS: Would that be sufficient time, do you think?
MR ASTBURY: We had 3.30 in mind.
MR JUSTICE GOSS: Until about 3.30, all right. We'll just have a short break now of a few minutes and then we'll do about another half an hour of interviews. We'll not finish these today, we'll finish them on Thursday. We'll just have a short break now and continue at 3 o'clock. (2.53 pm)
(A short break) (3.02 pm)
MR ASTBURY: Officer, the first questioning about [Baby P] took place on 5 July 2018.
A. Yes.
Q. This is the summary for that part of the interview. It begins:
Okay, so there were a number of events with [Baby P] and I will just go through them. At 18.00 on
23/6 [Baby P] was found to have a full, slightly distended abdomen.
At 09.50, the 24th, [Baby P]'s heart rate and desaturations dropped and CPR was started.
At 11.30, [Baby P]'s heart rate and oxygen levels dropped again and CPR was commenced.
At 12.28, [Baby P] deteriorated for a third time with a drop in heart rate and desaturations.
At 15.14, [Baby P] again started to desaturate and he became bradycardic. CPR was stopped at 16.00 and [Baby P] passed away.
So you remember [Baby P], do you?
A. Yes.
Q. Okay. So tell us about your care and your knowledge of the events where he's deteriorated.
A. Okay, so I just remember I was asked, on the day I was looking after him, whether I wanted to
look after him and [Baby R] again so that the family had some continuity --
Q. Right.
A. -- which I agreed to because apparently that was something the parents had said they would
like, if there was some continuity, so that was why I was looking after them both. I remember I
had handover from the nurse looking after him overnight and there had been some problems with his
feed and his abdomen, so she placed him nil by mouth and he'd gone on to fluids overnight. So I
remember her being a little bit sort of anxious as to -- quite overcautious with him, really, in
doing that in view of what had happened with [Baby O].
And I remember the -- the registrar was coming to do the ward round and when he came to do the ward round he had an apnoea that needed some intervention with a Neopuff and he just sort of deteriorated from there.
Q. Okay. But in terms of your view of his health on this day, the 24th, when you took over his
care was he stable, was he well?
A. He appeared so, yes. I think it was just -- we were just keeping an eye -- he was nil by mouth
at that time and keeping an eye on his abdomen.
Q. Okay. And you've already explained about overnight the designated nurse had some issues with
regards to maybe being a little overcautious with his feeding.
A. Yes.
Q. Okay. Who was that nurse, can you remember?
A. Sophie Ellis.
Q. The officer showed Lucy Letby [Baby P]'s feeding chart from the day before, 23 June, before
Sophie Ellis took over.
A. Yes, okay. So this is his chart here. So he's been fed at 8 o'clock in the morning and he has
been fed via his NG tube and that's via the student nurse and co-signed by myself.
Q. Okay.
A. At 10 o'clock he's received a further feed via his NG tube and again that was by the student
nurse and countersigned by myself. And them he's had another feed at 12 o'clock via his NG tube.
He's also had his nappy care done and he's had a small vomit and that was done by the student
nurse and co-signed by me.
There was another feed at 14.00 via his NG tube and that was done by the student nurse and co-signed by me.
Another feed at 16.00 via his NG tube and that was signed by the student nurse and then by myself.
And there was a feed at 18.00 via his NG tune and that's signed by myself.
Q. Okay. And is there a reason why Rebecca hasn't signed after the 4 o'clock?
A. Students usually only work an early shift so potentially she had gone home.
Q. Is there a reason why you've got entries for 4 o'clock and 6 o'clock?
A. So when a student nurse does a feed they have to inform someone that they've done it to get a
co-signature so I've co-signed that one and then I believe I may have done this feed for somebody
at 6 o'clock.
Q. You've done it for somebody? Is that common practice then to sign on someone's behalf?
A. No, I mean I've done the feed but I've done it on behalf of somebody if they've had to leave.
Yes, if they have said -- sometimes you go on a break or something and you'd say, well, would you
mind feeding my baby for me.
Q. Okay. Do you remember if that was the case?
A. No, I don't remember it specifically, no.
Q. Okay. And I think you've already said about overnight and the treatment with [Baby P] was a
little cautious. Did [Baby O]'s death have any other effect on the treatment of [Baby P]?
A. That he'd had a septic screen that evening as well and he was started on some antibiotics.
Q. So on page 5 the entry at 22.00, the 24th this is now, "Care given from 08.00". Was [Baby P] subject to any kind of review on the 23rd into the 24th?
The officers moved on to 24 June:
Who was the designated nurse this day?
A. Myself.
Q. Lucy Letby was asked about her nursing note which will be found behind tile 263:
Okay so the next entry is:
"Observations within normal range, [Baby P] nil by mouth. IV fluids: glucose. Peripheral line:
line occluding."
Is that?
A. "Occluding" it should read.
Q. Oh right, okay:
"High pressures. NG tube on free drainage. In tube. Abdomen full. Loops visible. Soft to touch."
Okay. So what you've written there, are there any concerns with that entry?
A. So I think there was a little bit of concern just that his abdomen was full and there were some
loops visible.
Q. So tell me how you clinically saw those?
A. So he was lying in the incubator undressed, so it's just through visually observing.
Q. What did you think of that?
A. Loops aren't something that we want to see.
Q. Right. What's it an indication of, loops?
A. Um, some sort of dilation in the bowel possibly.
Q. Had there been any concerns from the previous shift about [Baby P]? You took over at 08.00
from the night.
A. Yes, so -- I believe.
Q. From the night staff?
A. The night staff, that's when they had stopped his feeds and placed him nil by mouth due to a
distended abdomen and I believe he'd had some large aspirates and air obtained. And I think he'd
had a few desaturations as well.
Q. Overnight of the 23rd into the 24th?
A. Yeah.
Q. Right. What was the time between you making these observations about his full abdomen and the
loops and the ward round and the further observations by the registrar?
A. Um, I think the abdomen being full, I think, was noted from when I took over the care at 8
o'clock.
Q. Okay. Did you escalate that to anybody?
A. So from what I remember I mentioned it to -- I think it was the nurse in charge and talked
about bleeping the doctors and she said, well, the doctors will be here shortly for the ward
round, so wait for the doctors.
Q. Who was that? Do you recall?
A. I don't remember.
Q. Okay. It says here:
"Mottled appearance requiring facial oxygen and Neopuff for approximately 1 minute. Abdomen
becoming distended."
So was this while the registrar was there; is that right?
A. Yeah, from memory it was the registrar that carried out the Neopuff.
Q. Okay. So what action was taken by yourself at that point?
A. I don't remember. I think I was just supporting him in managing the airway and just assessing
him.
Q. Had you taken any action at the point where you realised his abdomen was full and the loops
were visible?
A. Just that I'd spoken to another nurse about it and they'd advised me to wait for the ward round
because the doctors would be there shortly.
Q. Okay. So at 9 am when [Baby P] had the apnoea, who else was present? There was obviously
yourself and the registrar.
A. I don't remember anyone else being there.
Q. Okay. And where you've described his abdomen being distended, how was it different from the
abdomen being full that you'd recognised earlier?
A. So a full abdomen can be soft whereas with distended it's more firm --
Q. Right.
A. -- and it looks firmer and it feels firmer when it's distended.
Q. Okay. And this mottled appearance, Lucy, how did that compare to [Baby P]'s brother?
A. I don't recall.
Q. Okay. So what can cause a tummy going from full and soft to distended and hard?
A. If there's some sort of problem with the bowel or the abdomen, so infections or obstructions.
Q. Right. Was he displaying any other symptoms during that time prior to the registrar
arriving?
A. Not that I am aware of, no.
Q. Lucy Letby believed it was [Dr B] who performed the emergency intubation during -- although
[Dr A] was also present. A decision was made to keep [Baby P] in nursery 2. She was asked:
Okay. So at this point, after what happened the day before, what were you feeling at this point
with regards to [Baby P]'s deterioration?
A. Panicked. I think we were all feeling quite on edge about it.
Q. The officers moved on to the events timed at 12.28:
Okay, so who was present during this further collapse?
A. So from memory I believe [Dr A] was inserting the chest drain at that time and I think [Dr B]
was present. There were a lot of people around all the time. I remember it being very chaotic. I
was trying to get in with drip stands and to connect medications and things and there were just
people everywhere.
Q. I this -- was this still ongoing from the previous event?
A. Yes.
Q. Right, okay.
A. I think there were -- there was things and an intervention was being done with him the whole
time, an X-ray coming in.
Q. Okay.
A. So we didn't have the equipment in the nursery so a lot of having to go out and obtain
equipment from the other nurseries to bring in.
Q. Right. Why wasn't he just moved to nursery 1?
A. From memory I think nursery 1 was busy and --
Q. Okay.
A. -- and it would be an issue having to move other babies and then have to move a sick baby --
Q. Okay.
A. -- like [Baby P] into another nursery, so they made the decision that as [Baby R] was already
in nursery 2 that we could keep them both in there.
Q. Right, okay. So obviously there are further deteriorations there within the notes. It refers
to the transport team arriving and a further collapse shortly after. Were you there at that
point?
A. Um, I think I was having a handover or giving part of the handover with the transport team.
Q. Okay.
A. And I think they were stood to the outside of the nursery at that point.
Q. Okay.
A. I remember him being baptised. I'm not sure whether I phoned the vicar or not.
Q. Okay:
"Parents held [Baby P] as he passed away and spent time with him and sibling. Dressed [Baby P] at
their request."
Is that yourself?
A. Yes.
Q. "... and taken photos of [Baby P] and [Baby O] together. Support given to parents and extended family. Time spent on suite. Mum discharged. Parents have gone to Liverpool Women's to be with sibling ([Baby R])."
What were your thoughts at that stage?
A. It was just devastating for us all and then to have to have them both...
And it says "crying" in brackets:
We put them top and tail in the Moses basket so I could take some photos for them.
Q. Who asked you to do that Lucy?
A. The parents.
Q. Were you happy doing that?
A. I wanted -- if that's what they wanted me to do, I wanted to do it. And as I say, they asked me
to dress him as well.
Q. Did they ask you because you were his designated nurse?
A. I think so, yes, and I think -- I usually offered, would they like to do, and I believe they
said no, no, could I do it for them.
Q. So was the death of [Baby P] unexpected then?
A. Yes.
Q. Two in 2 days. Did you do all the memory box stuff and everything?
A. No, I don't think I did any of the hand and footprints. This was quite later on in the shift so
I think I just took the photographs. And then I sustained a needlestick injury whilst dressing
[Baby P], so I had to leave to go to A&E. So I don't think I carried out any of the other
mementoes.
Q. On a few of the others, you know, we have asked you about your coping mechanism and who you
spoke to. This is a particularly traumatic time, isn't it? What was your outlet?
A. So we all spoke -- the staff that were on duty, we all spoke about it at the time and then I
remember with this one we also liaised with the transport team and sort of discussed it with them
as well at the end of the shift, yeah.
Q. Is there anything else that you want to add, Lucy, about [Baby P]?
A. No.
Q. And the interview concluded in respect of [Baby P] at that point.
A. Yes.
Q. Thank you.
We move on to the second interview for [Baby P], please. It took place on 12 June 2019.
A. Yes.
Q. Okay, Lucy, we're going now to move on to [Baby P]. In interview you said you were involved in
the care of [Baby P] on 23 June following the death of his brother [Baby O] up until you went off
duty and handed his care over to Nurse Ellis; do you remember that?
A. Yeah.
Q. In fact only minutes after [Baby O]'s death at 17.47 you were feeding [Baby P] at 18.00 hours,
so 13 minutes after his death you're feeding [Baby P]. This is supported by the feeding charts
that you've signed.
A. Yes.
Q. Is that your signature, yeah?
A. Yes.
Q. Around the time you were feeding him, Dr Gibbs reviewed [Baby P] and evidences a distended
abdomen and an X-ray's ordered. The result of that X-ray showed gas-filled bowel loops throughout
the abdomen. Do you have any comment to make regarding that, Lucy?
A. No.
Q. Are you responsible for putting air into --
A. No.
Q. Did you do anything that could have caused his stomach to distend?
A. No, not that I am aware of, no.
Q. Are you aware of anything else happening to [Baby P] to cause these symptoms, Lucy?
A. No.
Q. Moving to 24 June 2016, during this shift you were [Baby P]'s designated nurse again. Dr Ukoh records during his routine examination of [Baby P] at 9.35 on 24 June and notes that his abdomen was moderately distended and bloated but soft and his skin was slightly mottled.
Minutes later at 9.40 hours, and then at 11.30 hours, [Baby P] suffers desaturations and further
collapses. What do you put that down to, Lucy?
A. I don't know. He'd had problem with his feeds overnight and his feeds had been stopped.
Q. Lucy Letby was asked about the deterioration at 12.28 and whether the ETT had been dislodged,
despite [Baby P]'s medication to sedate him:
Do you have any explanation as to how the tube became dislodged?
A. No, whether there was tension on the tubing from the equipment -- I don't know if he was being
moved at the same time for X-ray or anything like that or if the tube wasn't secure in the first
place.
Q. Do you recall the tube becoming dislodged, Lucy?
A. I don't remember.
Q. Did you dislodge [Baby P]'s tube deliberately --
A. No.
Q. -- knowing it would cause him to collapse?
A. No.
Q. Did you do it accidentally?
A. No.
Q. Lucy, are you responsible for the murder of [Baby P]?
A. No.
Q. So they were the questions on 12 June 2019.
A. Yes.
Q. The final questioning about [Baby P] took place on 11 November 2020.
A. Yes, that's right.
Q. We'll go to that interview next, please:
I'm going to move on to [Baby P], Lucy.
The officers summarised the previous interviews concerning [Baby P]:
When you worked on the neonatal unit, Lucy, did you have any preferences as to which nursery you
wanted to work in?
A. On a day-to-day basis, do you mean?
Q. Yes.
A. No, I enjoyed the variety. I did like being in intensive care, but it was nice that we were a
unit where you could have babies and have them all the way through. You would know them in nursery
1 and then you would end up with them in nursery 4 preparing them to go home. I liked the variety.
Q. Why did you particularly enjoy working in nursery 1?
A. I enjoyed the learning aspect and I think that I am someone that -- I enjoy a fast pace and
felt that I could do well in that situation and I really enjoyed learning and carrying on from my
experiences at the Women's.
Q. Okay. And when you weren't working in nursery 1 and you were working in the other nurseries,
did that bother you in any way?
A. No. Quite often it was nice to see the babies further down the line that we'd looked after
previously and have a bit of a break from nursery 1.
Q. Okay.
A. It was nice to do other things like bathing them with parents and that, not purely doing ITU. I
think it's nice to be able to do feeds with the babies and bottle feeds and bathing and things.
Q. Do you know Nurse Kathryn Percival-Ward?
A. Yes.
Q. She said that:
"The only thing that started to worry us about Lucy was the fact that at times she didn't want to
be in the outside nurseries looking after babies and she would make her way and help in the
intensive care nurseries. I recall being involved in an argument with Lucy when I informed her
that she would be working in nursery 3 and she told me she wanted to be in nursery 1. Lucy told me
it was boring in the other nurseries and she didn't just want to do the feeds."
Do you recall having an argument with Kathryn?
A. No, I don't and I don't recall ever calling my work boring in any capacity.
Q. Do you recall ever asking her to be in nursery 1 when you'd been allocated nursery 3?
A. I can't remember that specific time. I may have done, I don't know.
Q. [Dr B] states that whilst [Baby P] was unwell you commented to her that he would not leave
here alive and was corrected by [Dr B] as he had good blood readings. Do you recall saying this
comment?
A. No. I don't know why I was -- had a conversation with [Dr B] about a baby not leaving the unit
unless they were really sick at the time.
Q. Why did you think that [Baby P] would not leave the NNU alive?
A. Well, I don't recall saying that so I don't think -- I don't remember saying that unless it was
at the point where he was physically ill.
Q. Do you remember any occasion when you thought that, that he wouldn't be leaving alive?
A. Once he started to deteriorate, yes.
Q. It was suggested to Lucy Letby that Dr Brearey had told her that she should take the weekend
off due to the traumatic events. Lucy was asked if she recalled any comment like that.
A. No.
Q. He said that you refused after [Baby P] and [Baby O] died.
A. I don't recall that conversation. I was due to go on annual leave after the triplets so I would
have been off work anyway. I don't recall that conversation.
Q. Looking at your mobile phone, Lucy, and the messages exchanged on 24 June at 23.38 [and again
that time is inaccurate but it's clear from the tile], you messaged Sophie and said, "Just blew
tummy up and had apnoeas, downward spiral similar to [Baby O]". Do you recall sending that message
to Sophie?
A. Yeah, I think so, yeah.
Q. Is that description or that description that you've given, would that be reflected anywhere in
the clinical records or notes?
A. That he had blown his tummy up? Yes.
Q. "So just blew tummy up and had apnoeas, downward spiral."
A. Yes, so the apnoeas should be documented in my nursing notes and on an apnoea chart.
Q. Okay. And what about the tummy being distended?
A. Should be as well.
Q. "Blew tummy up", that will be in the notes as well, would it?
A. Yes, it should be in my nursing notes and I believe the doctor was there at the time. I asked
him to review [Baby P] so it should be reflected in his documentation as well.
Q. And why did you send that message to Sophie?
A. I don't know if it was in response -- did she ask me how they were that day? I am not sure.
Q. At 9.34 on 26th you messaged [Nurse E] telling her that you were worried in case there was a
bug on the unit; do you remember that?
A. Yeah.
Q. Why did you suggest that to [Nurse E], that there was a bug on the unit?
A. There was a lot of discussion amongst staff about what was going on on the unit and how things
were being managed and bugs were mentioned, whether something had been either faulty with
equipment-wise or whether there had been some sort of equipment within the fluids or within the
water of the unit, things like that. People were just speculating.
Q. Who did you speak to about it, about the bug being on the unit?
A. I'm not sure.
Q. Do you remember who mentioned it to you?
A. No.
Q. Is it more a case that that's your own opinion, Lucy?
A. It is my own opinion, but it was discussed on the unit and again it was discussed about whether
equipment needed to be checked and fluids saved and sent away.
Q. By messaging [Nurse E] that you were worried about there being a bug on the unit, are you
suggesting alternative causes for [Baby P]'s death?
A. There had been discussions in the unit that maybe there was something wrong with the unit in
itself, either a bug or equipment, so yeah, there might be something that affected the boys.
Q. That concluded interviews insofar as [Baby P] was concerned.
A. Yes.
MR ASTBURY: Thank you.
MR JUSTICE GOSS: Well, it's a little bit early, but we'd then be moving on to [Baby Q]?
MR ASTBURY: Yes. There's three interviews for [Baby Q], my Lord, and four what were described as overarching which deal with general topics, so some more interviews to go yet.
MR JUSTICE GOSS: Yes. We'll come to those on Thursday.
Tomorrow is a day off for you, members of the jury. You'll be able to gauge -- I don't know, an hour and a half or something -- what remains of these interviews to get through, something like that. So can you please be ready to continue at 10.30 on Thursday morning?
Please remember your obligations and responsibilities as jurors: no communication with anyone about anything to do with this case unless you're all together in the room, in each other's earshot, and no research about anyone or anything to do with the case.
Thank you very much. 10.30, Thursday morning.
Source Transcript (PDF) - Police interviews Day 4
DS DANIELLE STONIER (continued) EXAMINATION-IN-CHIEF BY MR ASTBURY (continued )
MR ASTBURY: The first of these interviews regarding [Baby Q] took place on 5 July 2018.
A. Yes, that's correct.
Q. It began with the usual introductions and the officer began:
Okay, so during this interview we're going to talk about [Baby Q]. Okay? At 04.09 hours on
22/6/2016 [Baby Q] was born to [Mother of Baby Q] and [Father of Baby Q]. At 09.10 hours on
25/6/16, [Baby Q] collapsed. Okay? What can you tell us about the care that you offered to [Baby
Q], Lucy?
A. So I believe on that morning I was looking after [Baby Q] and another baby that was in nursery
1. [Baby Q] was in nursery 2 and from what I remember I was alerted by another member of staff
that he'd vomited and needed some support when I was in the other nursery. That's all I can
remember from memory.
Q. Lucy Letby confirmed that she had the relevant notes and that she had been [Baby Q]'s
designated nurse on the relevant shift. She was asked:
Okay. And, just generally, what can you tell us about the clinical position of [Baby Q] when you
took over his care on that morning?
A. Um, [Baby Q] had a low temperature, which had needed his incubator to be increased and also
that he was tachycardic.
Q. At the time you took over?
A. Yes.
Q. Okay. So what was being done about that?
A. So his be -- his incubator was being increased to combat the temperature.
Q. Okay. So in terms of what you needed to do with him from the beginning of the shift, moving
forward with his care plan, what -- what was in your mind that you were going to progress with
that?
A. With his care for the day?
Q. Yes.
A. I would be reviewing what medications he was due and when, how often he was needing
observations, if and when he was being fed and when they were due, when his nappy change would be
due.
Q. Okay. Was he ventilated?
A. No.
Q. Lucy Letby was unable to recall which other baby was in nursery 2 at the time, but she did
remember that Mary Griffith was the other nurse working in there. She was asked:
Okay. So with regards to his position when you took over that morning, were there any concerns for
him at that time?
A. That he had a low temperature.
Q. Okay. Sorry, just on that point, were you concerned such that you were happy to leave [Baby
Q]?
A. Leave in what way?
Q. Well, you said that -- at the initial start of the interview you gave you said you were
alerted to the fact that he'd vomited [as read].
A. Yes.
Q. So where were you?
A. I believe I was in nursery 1 with the other baby.
Q. Right, okay. So the point I'm saying is [Baby Q] was well enough to be left?
A. Yes.
Q. Yes. Okay. The next entry is at 9.10. Explain that entry to us.
A. Okay. So I have written that he was attended to by Staff Nurse Lappalainen, who I think was in
charge that day.
Q. Okay.
A. I think I'd been in nursery 1 and I came back out to come to nursery 2 and saw that [Baby Q]
was having intervention and that I've written, from here, he had vomited, mottled, desaturation in
(sic) and had needed Neopuff and suction and that [Dr A] had attended.
Q. Okay so at 09.10 when you handed him over, why was that?
A. I haven't handed him over. This -- Staff Nurse Lappalainen had attended to [Baby Q], so she had
gone to him for a reason.
Q. Because you were out in the other nursery?
A. Yes.
Q. Do you know what alerted her to go in and attend to him?
A. No.
Q. Okay. And you were elsewhere dealing with another baby?
A. I believe so, yes.
Q. Between 08.00 and 09.00 hours Lucy Letby explained that she'd completed [Baby Q]'s
observations, he'd had a slightly high respiratory rate, and she increased the temperature of his
incubator. And she was asked:
Would that -- is that something that needs any kind of treatment, the increased respiratory
rate?
A. No, so usually, you just find -- usually if they enter this other band in here on the chart --
Q. Right, okay.
A. -- then we would -- you would let somebody know or the doctors would review them when they were
next on the unit.
Q. Okay.
A. So the doctors usually attend to do the ward round at 9 o'clock. I don't think I escalated that
at that point.
Q. Okay. Can you remember any other treatment around the observations just prior to your
leaving?
A. No.
Q. Lucy Letby confirmed from the notes that she'd not fed [Baby Q] and he was receiving Babiven
and lipids. Question:
Did you communicate with any other members of staff that you were leaving the nursery?
A. I think Mary Griffith was in the room when I left and I think I told her.
Q. Okay. Do you remember when you told -- you think you told Mary what -- what might Mary have
been doing at the time?
A. I think she was with another baby in the nursery.
Q. Was she doing anything to that baby, treating that baby at all?
A. I think she was at the incubator, yes, from what I remember.
Q. Okay. When -- do you remember the words you said to her?
A. No.
Q. Okay. So how did you first become aware that [Baby Q] needed to be attended to?
A. I think from memory I came out of whatever I was doing in nursery 1 and saw that people with
[Baby Q] in nursery 2.
Q. What were they doing?
A. I think when I went in they were giving him support with the Neopuff.
Q. Okay. And who was that?
A. I think it was Minna Lappalainen.
Q. Just on her own?
A. No, I think -- I don't know if a doctor was there or Mary was there as well.
Q. Okay. So what did you do then? What observations did you make?
A. I don't remember entirely but I believe he was moved into nursery 1 and we started CPAP on him.
Q. Okay. Did you see the vomit?
A. I don't remember the vomit.
Q. Okay. So where put he'd:
"... vomited clear fluid nasally and from mouth, desaturation, bradycardia, mottled ++."
Were they your observations or were they what you were told?
A. I believe they were what I was told.
Q. Okay. And the Neopuff and suction applied, are they actions that you've done or actions that
people who were treating him have done?
A. No, I think they were actions by other people.
Q. Okay. So did you -- I don't know if I asked you, sorry, did you see the vomit?
A. No, I don't think I saw the vomit.
Q. But that's how it was described to you?
A. Yes.
Q. And so after you were told the description of what some of your colleagues have seen what did
you think about what had happened to [Baby Q]?
A. I was unsure as to why he would have been vomiting.
Q. Okay. What are the implications of a clear fluid, nasally and from the mouth?
A. That he's vomited, but he hasn't got anything in his stomach to vomit, so it's clearly bodily
fluids that he's vomiting.
Q. So when you left -- did you do a procedure for [Baby Q] then prior to leaving?
A. I've documented observations at 9 o'clock.
Q. Okay. Did you administer anything to [Baby Q] before you left?
A. I don't know from memory I'd have to check.
Q. If you could that would be great.
A. No, I don't think so.
Q. The observations at 9 o'clock, how long does that process take?
A. Not long because we read them from the monitor, then we count the respiratory rate.
Q. Are we talking seconds, minutes?
A. A minute maybe.
Q. I presume if you were concerned you -- would you stay with [Baby Q]?
A. Yes.
Q. Did you see the mottling on [Baby Q]?
A. I don't remember.
Q. Right, okay. And was this vomit and desaturation -- was that expected from your point of view,
from what you'd observed from [Baby Q]?
A. No, but sometimes babies do vomit and they can -- that can lead them to have a desaturation
because they have vomited.
Q. Okay. So the next line is:
"[Dr A] attended. Air ++ aspirated from NG tube. Transferred to nursery 1."
Okay. So the air ++, are they your entries and your observations?
A. I'm not sure whether I aspirated the tube or whether that was done by somebody else whilst I
was there.
Q. Right okay. So air ++ from the NG tube, how does that happen?
A. How do you get air in the --
Q. Yes.
A. I am not sure. Sometimes if babies are vomiting they can gulp down air.
Q. Right. Are there any other ways that air can get there, air ++ especially?
A. I'm not sure.
Q. Okay.
A. If the baby's maybe got some sort of blockage in the bowel, that air isn't passing through the
rectum.
Q. Any others?
A. No, not that I know of.
Q. Who contacted the registrar?
A. I'm not sure.
Q. Okay. Was he one of the people that were in attendance when you first became aware of members
of staff treating [Baby Q]?
A. I don't recall specifically who -- if he was there or not at that moment, no.
Q. Okay. And you don't recall whether you aspirated the tube?
A. No.
Q. Okay. Did you continue to care for him after that?
A. Um, I think so, yes.
Q. As designated nurse, I mean.
A. Yes.
Q. Lucy Letby explained that [Baby Q]'s parents visited later that day. They were upset that
nobody had told them about what had happened. She and [Nurse B] had apologised that it must have
been an oversight. Whilst [Baby Q] was being treated as the priority, they had not had chance to
contact the parents. And she was asked:
Okay, are there any other observations you've got regarding [Baby Q]?
A. No.
Q. Can you give us any explanation as to why this event happened, where he vomited and
collapsed?
A. No.
Q. And the interview, insofar as [Baby Q] was concerned, was suspended at that point.
A. Yes.
Q. Thank you.
Moving on to the second occasion when Lucy Letby was asked questions about [Baby Q], we can see
that took place on 12 June 2019.
A. Yes, that's right.
Q. It began with the observation:
Lucy, I'm going to ask you about [Baby Q].
The officers then summarised the previous interview concerning [Baby Q]. Ms Letby was told and
then asked:
Mary Griffith states Nurse Letby was also caring for a second baby in nursery 1. Which baby were
you caring for in nursery 1?
A. I think her name was B.
Q. That's our editing, the full name was given.
A. Yes, it was, yes.
Q. Well, certainly the first name:
You left the nursery shortly before [Baby Q] collapsed?
A. Right.
Q. Do you agree with that?
A. Yes.
Q. Lucy, explain to me what did to [Baby Q] before leaving nursery 2 to cause his collapse?
A. I didn't cause his collapse, I checked his observations.
Q. Okay. And what did his observations suggest? Was he stable?
A. That his temperature had decreased, so I've increased his incubator.
Q. Mm-hm. Was he stable at that time Lucy?
A. He's got a rise in respiratory rate and heart rate but it's not going completely into the
warning area so...
Q. Okay. Would you class [Baby Q] as stable at that time?
A. Yes.
Q. Would you have left the nursery if he wasn't?
A. No.
Q. What did you do?
A. And I've asked Mary to keep an eye on him in my absence.
Q. What did you do to him, Lucy, to cause him to collapse?
A. I took his observations, I didn't cause a collapse.
Q. There was two people in the room, Lucy, wasn't there, Mary Griffith and you?
A. Yes.
Q. Mary was treating another baby and then [Baby Q] collapses. Are you responsible for his
collapse?
A. No.
Q. Lucy Letby was informed of Dr Evans' opinion regarding air via the NGT into his, that meaning
[Baby Q]'s, stomach.
A. I don't think I fed him at that point, did I? I think I just did observations.
Q. [Baby Q] suffered a single collapse; do you agree?
A. Yes.
Q. Did you inject air into [Baby Q]?
A. No.
Q. Were you responsible for his collapse?
A. No.
Q. Lucy, are you responsible for the attempted murder of [Baby Q]?
A. No.
Q. Okay. It's quarter to 12 and the interview is now at an end.
That was the conclusion of that particular interview.
A. Yes.
Q. The third and final occasion when Lucy Letby was asked questions about [Baby Q] was on 11
November 2020.
A. Yes.
Q. The interview begins:
You were away from [Baby Q] when he suffered a desaturation and vomited. You denied causing [Baby
Q] to collapse and denied causing him any harm. Is that accurate?
A. Yes.
Q. Is there anything you want to add regarding that?
A. No.
Q. At 09.00 hours you completed [Baby Q]'s observations and he was due a feed. However, this was
not given. When Minna attends to [Baby Q] after his desaturation she evidences that he had quite a
bit of mucus and he'd been sick. If it wasn't feed, what had you given to him to cause him to
vomit?
A. I didn't give him anything. If it's not documented that I didn't feed him then I didn't give
him anything.
Q. Was it air that you administered?
A. No.
Q. Did you deliberately leave the room to blame the collapse on Mary Griffith and Minna?
A. No, the baby in nursery 1 was due cares at that time.
Q. Dr Lakin from Alder Hey Children's Hospital shows that he made a quick recovery. Do you agree
with that?
A. Yeah, that's actually what happened, yeah. That's not stay that he wouldn't have recovered if
he had stayed with us on the unit.
Q. The officers summarised the statement of [Dr D], who describes [Baby Q] as having been stable
overnight on the shift on the 24th into 25 June:
Is that just a coincidence then, is it?
A. Yeah. Babies can deteriorate any time.
Q. At 13.30 hours on the 25th you messaged [Nurse E] and said in speech marks, "Aspirated". Was
he aspirated?
A. I don't recall, but I think "aspirated" meant that when a baby's vomited and then inhaled the
fluid back into their lungs, that's an aspiration.
Q. Do you remember doing that?
A. Doing what?
Q. Aspirating.
A. No, so aspirated would be me withdrawing the feed from him and aspiration -- if I'm saying that
he's aspirated, it means he's been sick and then inhaled some of the fluid, which is like
pneumonia.
Q. Okay.
A. I am saying he's aspirated then, that's the context I think.
Q. At 22.46 hours on the 25th you messaged [Dr A] and asked if you should be worried about what
Dr Gibbs was asking; do you recall that?
A. Yes.
Q. What was that about then, Lucy?
A. I became aware that Dr Gibbs had been asking why -- either why or where I was when [Baby Q]
collapsed, why I wasn't in the nursery with him, and it was discussed that obviously I had two
babies in separate nurseries and I was concerned that I was going to be -- you know, be a problem
that I wasn't there at the time.
Q. Were you trying to seek his reassurance?
A. Yeah, I suppose so, yeah. I wouldn't have just left a baby unattended: Mary was in the room and
Minna was just outside at the desk.
Q. That wasn't trying to blame the others?
A. No, there was no blame to be apportioned. It was just that I had not left the nursery
unattended to tend to my other baby.
Q. At 16.44 on the 26th you messaged [Nurse E] and told her [Baby Q] had NEC and that [Dr A] had
told you; is that correct?
A. I don't recall that specifically, no.
Q. Did [Baby Q] have NEC?
A. I'm not sure without looking.
Q. [Nurse E] tells you that [Baby Q] may have volvulus; do you remember that?
A. No.
Q. Were you concerned people were talking about [Baby Q] and what was going on with him and why
he deteriorated?
A. I don't think I was worried. I think it happened because we were concerned why it had happened
to him, yeah. And if [Nurse E] had -- I don't remember that, but if [Nurse E] had heard that he
possibly had volvulus she would have wanted me to know that.
Q. What is a volvulus?
A. I think it's like a twist in the bowel, in the abdomen. I'm not 100% sure.
Q. Okay. Thank you.
Then:
Okay. That's the end of the interview.
And the time is given as 11.06.
A. Yes.
Q. I'm just asked to confirm that when Ms Letby initially confirmed which nursery she'd been in, that was a point before she had the notes before her; is that right? I think it's in the first interview.
If we go to [document redacted] -- it's the second interview, in fact.
A. Yes.
Q. At the bottom of [document redacted]:
"Which baby were you caring for in nursery 1?"
And then at the top of [document redacted] we have the name given.
A. Yes.
Q. Do you recall whether Ms Letby had her notes in front of her at that time or was that from
memory?
A. I believe she would have had her notes with her in front of her at that time.
Q. Okay. Those notes presumably would have been the notes from [Baby Q], not the other baby?
A. Yes, that's right.
Q. Thank you. Now, we move on to what's described as OA. Now, the interviews didn't just centre
on the babies themselves, although that took up most of the interviewing; is that right?
A. Yes, that's right.
Q. There were more general questions about, for example, exhibits found at Ms Letby's home?
A. Yes.
Q. And also certain general events at the hospital and practices; is that right?
A. That's correct.
Q. The next four interviews again have been distilled into that sort of topic and where babies
were mentioned that's been taken out and put in their individual interviews; is that right?
A. Yes.
Q. And these are described as overarching interviews, hence the OA?
A. Yes.
Q. And there are four in total?
A. Yes, there are.
Q. Thank you. So the first of those that we're going to look at took place on 3 July 2018; is
that correct?
A. Yes, that's correct.
Q. It took place in the evening. Just to remind everybody and to put it into context, that was
the very day that Ms Letby was arrested for the first time?
A. Yes, that's right.
Q. Okay. So introductions and caution repeated again. It's a similar situation there are a number
of interviews but they've been reduced to just the relevant parts; is that right?
A. Yes.
Q. Lucy Letby was asked to tell the police about the note that she'd written with the exhibit
reference NAC10; is that correct?
A. Yes, that's correct.
Q. Again just to remind people that's the small Post-it that was inside the diary in the chest of
drawers?
A. Yes.
Q. Can you give the answer, please?
A. I just wrote it because everything had got on top of me. It's when I'd not long found out I'd
been removed from the unit and they were telling me that my practice might be wrong, that I needed
to read all my competencies, my practice might not have been good enough, so I -- I felt like
people were blaming my practice, that I have hurt them without knowing through my practice and
that made me feel guilty and I just felt really isolated. They made -- they stopped me speaking to
people and...
Q. Do you want to elaborate on some of the things that you've put down in there?
A. I was blaming myself, but not because I'd done something, because of the way people were making
me feel, but like -- I'd only ever done my best for these babies and then people were trying --
trying to say that my practice wasn't good and that I'd done something and I just couldn't cope.
And I just didn't want to be here any more.
Q. Do you remember what you wrote down?
A. I think I do.
Q. And then Ms Letby's solicitor interjected:
I have read it out to her.
And she was asked:
Yeah, would it help if we go through it then, Lucy?
A. Yes.
Q. So at the top of the note -- I think you have seen a copy of the note, like you said.
The solicitor confirmed that. Then the officer quotes:
"Not good enough", you've written and underlined. So my colleague is just putting it there in
front of you.
A. Because I felt like I was good enough, that people were trying to suggest that, that I hadn't
been good enough for them.
Q. Which people were they?
A. The trust and the staff on the unit.
Q. What sort of things were they saying?
A. Just that I'd been there for a lot of the deaths and they were going to review all my
competencies because at that point they didn't know -- hadn't a clue what had happened and they
wanted me to redo all my competencies in case there was something wrong with my practice and
competencies.
Q. You go on to say, "There are no words, I can't breathe, I can't focus". Do you want to go
through what was going through your mind at that time?
A. I just felt it was -- it was all just spiralling out of control, I just didn't know how to feel
about it or halves going to happen or what to do.
Q. When was this written?
A. I think it was the July time, after I'd been removed from the unit.
Q. So July 2016?
A. Sorry, yeah, 2016.
Q. And then you go on to say, "Kill myself right now, overwhelming fear and panic". Do you want
to describe how you're feeling there?
A. Pardon?
Q. Can you describe to me how you were feeling there?
A. As I put there, it just felt that it was all -- it was all happening out of my control.
Q. Did you talk to anyone about that?
A. I went to the GP.
Q. Your own GP?
A. Yes.
Q. Did you get any help?
A. Yes, just some antidepressants.
Q. When you say, Lucy, that the trust said they were going to review your competencies, can you
be more specific with that?
A. So when I was removed from the unit, it happened in July, and I met with the head of nursing
and they told me that there'd been a lot more deaths and that I'd been linked as somebody that was
there for a lot of them and they also said that there were some other people that had been flagged
as being on shift for a lot of them and myself and these other people are going to have to be
going and redoing our competencies.
Q. What do you mean by competencies?
A. So competencies, to do things on the unit. So equipment competencies and transfusion
competencies. We have competencies for most things, clinical care that we give on the unit.
Q. And who assesses those competencies?
A. The practice education development nurse on the unit.
Q. Right, okay. So who were those other people?
A. I was never told who.
Q. Right, okay.
A. I was just told that it -- the process wasn't happening just for me, it'd be happening for a
number of people.
Q. What do you think was going on with your competencies up to that point? Were you okay?
A. Yes.
Q. Did you feel confident?
A. Yes.
Q. Okay. So then on the back of that, did you have any concerns that there was a rise in the
mortality rate?
A. Yes.
Q. Okay, so tell me about that. What concerns did you have?
A. I think we'd all just noticed as a -- as a team in general, the nursing staff, that this was a
rise compared to previous years, um, and that we were meeting babies that had a lot more complex
needs that we -- we weren't seeing a few years ago and it was talked about that this was something
that was unusual.
Q. Okay, and what happened when that was recognised?
A. Well, I believe things happened behind the scenes with management and the nursing team and they
just carried on and just supported each other --
Q. Okay.
A. -- and carried on as a team.
Q. At which point did it all become sort of the extent where you're saying things like, "kill
myself now", "overwhelming"?
A. It was when I was removed from the unit in the July of 2016.
Q. Right. Why at that stage did it culminate in those feelings?
A. Because I suddenly felt that things had been directed towards me.
Q. Why was that?
A. Because they were saying they were going to have to review my competencies, so I took it to
mean my practice hadn't been good enough.
Q. Did you ever recognise that it wasn't? Did you ever make any mistakes?
A. No.
Q. So in terms of "overwhelming fear and panic", what were you afraid of?
A. That they were going to think that I'd done something wrong.
Q. Okay. And how would that -- what would happen if they thought that?
A. If they thought that I'd done something wrong?
Q. Yeah.
A. That this would happen --
Q. Right.
A. -- that the police would get involved and I'd lose my job.
Q. And was it a job that you enjoyed?
A. Yeah. Yeah, I loved my job.
Q. How does -- in your area, how does competencies or, you know, when people call into question
your competencies, how does that lead to a police investigation?
A. I don't know. I just panicked. I just thought if they found my competencies weren't good
enough, it'd be assumed that I hadn't done -- like, missed something or not done something doing
that I should have, that the babies had died or become unwell.
Q. Okay. How does that become a criminal matter though?
A. I'm not sure. I thought they might refer me to the NMC and I didn't know if that went to the
police.
MR JUSTICE GOSS: NMC?
MR ASTBURY: It's on the next page, my Lord.
The officer asks the same question:
I don't know what that is.
A. The Nursing and Midwifery Council who has our registration, who we are registered with. Just
panic.
Q. What's the difference between being incompetent or somebody saying you're incompetent or
criminal in your world?
A. For the criminal it's something that's done deliberately, whereas you're not being competent
would be that you're not competent in something that can give you a result that wasn't
intentional.
Q. Okay. So in terms of where you say, "Kill myself right now", is that something that you were
considering?
A. Yes.
Q. Why was that?
A. Because I just felt so isolated and alone and --
Q. Other than the doctor, did you speak to anyone else, family, friends?
A. At the time I was because I was told I could only speak to two friends and I didn't want to
tell them too much about it. The same with mum and dad, nobody knows.
Q. Did you get any support from work?
A. They referred me to occupational health and things, yeah.
Q. You mentioned there that you were panicking. What were you panicking about?
A. Just that it was all out of my control.
Q. So you were panicking about your -- personal emotions?
A. Yes.
Q. In your own mind, had you done anything wrong at all?
A. No, not intentionally, but I was worried that they would find that my practice hadn't been
good.
Q. Are there any particular practices that you think might not have been as good as they should
have been?
A. No.
Q. What made you think that they might find something that was wrong or something that you
shouldn't have done?
A. It was more that I was worried that obviously they'd already gone to the lengths of redeploying
me and moving me from the unit and banning contact. I didn't know how it was going to go. I didn't
think that they'd find that I'd been incompetent, but I was worried that they might try and assume
that I had been just because I was there for all these babies.
Q. Were you there for all those babies?
A. Yes.
Q. In this note here you've written down:
"Police investigation forget."
What was going through your mind at that time?
A. I was worried that the police might be involved.
Q. Like I said before, was there a reason why you thought?
A. I think it was just panic at the time.
Q. Another word, "Slander, discrimination, victimisation".
A. Because I felt that the trust and the team were trying to imply that it -- it was something
that I had done.
Q. Was there any individuals that implied that?
A. Yes, all the consultants.
Q. Go on, tell us who they are.
A. Ravi Jayaram and Stephen Brearey.
Q. So what can you tell us about them?
A. I just found out that they were the ones who had raised concerns about myself being the common
factor in the deaths and that they felt that I'd deliberately harmed them.
Q. So do you want to tell us your professional relationship with Ravi Jayaram and Stephen
Brearey? Did you have any issues with them?
A. I felt we'd always had a good working relationship. I've worked more with Ravi than Steve, but
that was just through circumstances, who was on shift. But I always felt that we'd had a good
working relationship.
Q. So do you think they -- can you give a reason why they might want to victimise you or point
the finger towards you?
A. It had crossed my mind at times whether they were trying to put the blame on me for something
that somebody else had done.
Q. Are you aware of somebody else doing something?
A. No.
Q. So when it crossed your mind what were you thinking?
A. If they were questioning my competencies, that maybe they were questioning -- well, they told
me they were questioning other people's as well or there'd been a competency issue with somebody
else. They were trying to make it my problem because I was there.
Q. So up to that point that you say they might have discriminated against you or victimised you,
you had no real issues with either Stephen Brearey or Ravi?
A. No.
Q. No? No fallings out with them sort of professionally or?
A. No.
Q. How did you get on with them personally?
A. I didn't really know them in a personal capacity, only professional.
Q. Professional, okay. You go on to say in your notes:
All getting too much, everything. Taking over my life. Everyone. I feel very alone and scared."
When you were writing these down, where were you, these notes?
A. At home.
Q. Again, did you speak to anyone about this other than the doctor?
A. No.
Q. Were you particularly close to anyone at work, Lucy?
A. Yes.
Q. Who was that?
A. My best friend is [Nurse E].
Q. Okay. Did you speak to her at all about how you felt?
A. Not to the extent of wanting to kill myself, no.
Q. And then you put:
"How will things ever be like they?"
There on the sheet, what did you mean by that?
Then the officers added:
And overwritten with "hate".
A. How will things ever be like they used to.
Q. So what was going through your mind at that time?
A. I'd been removed from the unit, I'd been banned contact with everyone, I couldn't see how it
was going to go back to how it used to be.
Q. Why did you think that?
A. Because the redeployment would go on my record, it would affect my practice, everything.
Q. So when you were redeployed, exactly what did they say to you when you were moved from the
unit? Did they give an explanation?
A. There'd been an increased mortality rate and that they needed to have an external review done.
Until that was complete they wanted me to redo all my competencies. And then it transpired they
didn't have the staffing to facilitate that, so they redeployed me and said it would be on a
temporary basis until the external review had been done and it was for my own protection.
Q. But you were thinking at this time thing aren't going to be the same again? But you were still
employed up to this point as a nurse?
A. Yes.
Q. Whereabouts was it?
A. After? When I was redeployed?
Q. Yes.
A. So the Risk and Patient Safety team in the Countess.
Q. What kind of department's that?
A. It's a -- it's still part of the corporate nursing team. They look at incidents and complaints
and things that have come into the trust.
Q. Right.
A. So I was moved into that department, office based.
Q. Lucy Letby then named the friends with whom she keeps in touch outside of work. And she was
asked:
Okay. When you said you were lonely, and if we sort of take out people from the Countess, that you
didn't have a massive support network, is that how you felt?
A. Yeah, yeah.
Q. Okay, so was that quite a big thing for you, leaving the unit and being told not to
communicate with people? Is that where the isolation --
A. I'd lost everything, and obviously mum and dad were down in Hereford. And I thought we were a
good team regardless who was my friends. We were a good nursing team on the unit and I'd just lost
that. We were like a little family and I felt like I'd lost that.
Q. But what's the format of this? Obviously these are sort of emotional outpourings, would you
say. How would you describe the thing as a whole?
A. I think it was just a way of me getting my feelings out on to paper. It just helps me process
it a bit more, I think.
Q. Okay. Is that all in one session, if you like?
A. I believe so, yes.
Q. Is this how your emotions would manifest themselves, an outlet?
A. Yes.
Q. Okay. Lucy, you then go on to say that:
"I don't deserve to live. I killed them on purpose because I'm not good enough to care for them. I
am a horrible, evil person."
A. I didn't kill them on purpose. I felt if my practice hadn't been right, then I had killed them
and that was why I wasn't good enough.
Q. So in what way do you think your practice might have been the reason why these babies had
died?
A. I didn't know. I thought maybe I had missed something, maybe I hadn't acted quickly enough.
Q. Give us an example.
A. I hadn't played my role in the team. I'd been on a lot of night shifts when doctors aren't
around. We have to call them. There are less people and it just worried me that I hadn't called
them -- quick enough or.
Q. And you felt evil?
A. Other people would perceive me as being evil, yes, if I had missed something.
Q. "I'm a horrible, evil person"; that's your take on you?
A. I think it's how this situation made me feel.
Q. "I don't deserve mum and dad."
A. I felt so guilty that they had to go through this, that I wasn't good enough for them or any of
them and it was all just becoming a big mess and I'd just be better off out of it for everybody.
Q. You put down there, Lucy, that you "killed them on purpose".
A. I didn't kill them on purpose.
Q. Do you believe there's a potential that you caused their deaths?
A. Not intentionally.
Q. Okay. So do you believe that you were carrying out practices that weren't competent?
A. No.
Q. Okay. So where's this pressure that's led to having these feelings come from?
A. I think it was just the panic of being redeployed and everything that happened.
Q. Okay.
A. It makes more sense now, but at the time I did think that they might think I was incompetent,
that I might have unintentionally caused something.
Q. Lucy Letby explained that she'd reviewed her competencies since being removed from the unit
with Yvonne Farmer:
Is that on your neonatal unit or your new unit?
A. We didn't do them on the unit, we just did them in an office environment and went through all
the competencies. We didn't do a practical on the unit.
Q. Okay. And that was last year?
A. Yes.
Q. Okay. So I think, just to make it clear what you just said there, it was implied that your
level of competency may have resulted in deaths and that's where you got all these feelings from,
but the trust didn't say it directly, and you don't think that you failed with regards to your
care and the competencies offered to the babies?
A. That's correct, yes.
Q. Okay. Which competencies was -- could you be failing with that would result in a death of a
baby?
A. I suppose the thing that come to my mind was medications, because that's something that we do a
lot of on the unit, and the babies are on a lot of medications.
Q. What part of your competency would you be failing with if it wasn't being done correctly? So
going through the process of when you administer medicine to the baby, what part of that process
would cause the death if it wasn't done correctly?
A. The wrong drug or the wrong dose.
Q. Are there any other competencies that you might think, if you didn't do that correctly, it
could cause a problem with the baby?
A. Maybe if I wasn't competent with a piece of equipment.
Q. And do you feel competent with all the equipment you use?
A. Yes.
Q. With regards to your parents, you mentioned, "I don't deserve mum and dad". Is that purely in
relation to the problem you were having on the unit and being removed?
A. Yes.
Q. Okay. So was nursing something that they were particularly proud that you were doing? So tell
me about that.
A. Well, it was -- it was a big thing. I was the first person in the family to get into university
and to move away and come and do nursing and, yeah, they were really pleased. So I just felt
anything like this -- well, anything that's in the note, they'd be disappointed, and they were.
They were really, really upset about it.
Q. What were they disappointed and upset about?
A. That I'd been removed from the unit.
Q. Did you need to tell them?
A. Yeah.
Q. Why?
A. I didn't want to lie to them.
Q. Okay. The only other thing is that in terms of, I think, within that note, you were
questioning maybe, "What does the future hold?" What were your thoughts around that?
A. I think I just didn't know what was going to happen. It just all overwhelmed me at the time. It
was hard to see how anything was ever going to be okay again.
Q. So moving forward prior to this point, what did you envisage your life being, moving
forward?
A. I was very career-focused.
Q. Right.
A. And I was worried that all of this would stop anything like that, that I'd lose my job or that
it'd just be on my record, other people would change their opinion of me.
Q. Lucy Letby described her family with whom she was very close and she was asked:
Okay. You then go on to say in your notes Lucy, "The world is better off without me". What do you
mean by that?
A. That they'd all be better off without me.
Q. Why?
A. Because I disappointed them.
Q. And in capital letters, "I AM EVIL, I DID THIS".
A. Because that's how it had all made any feel at the time.
Q. That you'd done something wrong?
A. Yeah. Not intentionally, but I felt if I'd done something, if my practice wasn't good enough or
people didn't think I'd done something in the right way, then it made me an evil person because I
couldn't do the job properly.
Q. "I am an awful person and I pay every day for that right now."
A. Because I felt like I was having to pay for something that I didn't do, being away from my jobs
and my friends and having to go to a new area where I didn't know anyone.
Q. So this is all how others are making you feel and how you were feeling yourself?
A. Yes.
Q. "I'll never have children or marry. I'll never know what it's like to have a family."
What did you mean by that, Lucy?
A. Just that I'd never meet anybody and therefore I'd never have a family.
Q. Why did you think that?
A. Because nobody would want to -- if you say to somebody you had to be redeployed, then people
make assumptions, don't they, and if my practice had caused these problems then I wouldn't deserve
to have children myself.
Q. Purely because you had been redeployed off one unit?
A. Yes, because at the time it was huge.
Q. You then put down:
"I hate myself so much for what this has -- I did this, why me?"
A. Again, I was made to feel I had done it through not being not competent.
Q. Did what?
A. Well, did something that -- that had led to these babies collapsing, dying.
Q. Did you ever consider that it might have nothing to do with you or your incompetency?
A. Not that moment in time, I just...
Q. Okay. What about now?
A. No, I don't feel it is my competencies.
Q. So what changed between these kind of thoughts and now that you're confident that your
competencies weren't lacking enough to cause any serious collapse or death?
A. Time. And I've re-done my competencies and had that grievance procedure and nothing was sort of
raised through that or any of the other investigations that have taken place to sort of suggest
that I'd been incompetent in something.
Sorry:
That I hadn't been competent in something.
Q. "No hope, despair, panic, fear, lost."
Is that how you felt, you had no hope?
A. It just made me feel like no hope for anything, yeah.
Q. If you knew that you'd done nothing wrong?
A. Well, at that point I was made to feel that maybe I had, so I was worried that maybe I had in
terms of my practice and my competencies.
Q. Who had made you think that?
A. The trust.
Q. Lucy Letby explained that she was informed on behalf of the trust that she was being
redeployed as her competencies were an issue:
Has anyone ever said that you have done something wrong?
A. I found out via the grievance procedure and the Royal College of Nursing that some of the
consultants had made comments.
Q. The comment that's in there referring to the note presumably, "I did this. Why me?", what does
that refer to?
A. That I just caused the disappointment.
Q. What's the "why me"?
A. I felt -- well, why was it happening to me? Because at the time they were saying that I was a
common feature but so were other staff.
Q. Okay.
A. But then it was only myself that was redeployed, so obviously but why me, why is it just me
that it's happening to?
Q. What was the "I did this"?
A. The upset and everything that I caused those people. I felt that it was me, not intentionally
but through that situation, through the redeployment.
Q. Lucy Letby then explained that the period up to her redeployment had been a low point:
Okay, what made the first part of 2016 so challenging then?
A. Well, just reflecting all the year that we had had before and I think it just affected morale
on the unit. We were all feeling -- it's a shock, we're not used to deaths like that. And when
you're involved with them...
Q. Okay. At which point did the unit start to feel like that?
A. I'd say about earlier in the year, perhaps January.
Q. January. Why particularly then? What had happened?
A. I'm not sure specifically, it is just with it being the New Year and things people just were
hoping for a better year and then things happened again.
Q. "Things happened again", what do you mean?
A. We continued to have sick babies and lost some babies.
Q. Were there any in particular that you lost that you recall?
A. When? At that time period?
Q. Yes.
A. I can't remember specifically then, no.
Q. When you say "we" -- you refer to "we were feeling quite low". Who were you referring to as
the "we"?
A. The nursing team.
Q. Who do you class the nursing team as, everybody?
A. Yes, the nurses and the nursery nurses on the unit.
Q. You talk about the babies being specifically sick. What was the difference from another
year?
A. I think we were seeing more babies who had complex needs, we were having babies with chest
drains that we don't get very often, babies with stomas that we don't care for a great deal. We
had quite a few that were quite extreme prem babies with congenital abnormalities, a lot of twins
and then we had the triplets.
Q. In terms of emotional outlets for coping, you know, your coping mechanisms, what would you
use?
A. Usually just talking things through with the team or with my friends.
Q. Is this an emotional outlet, doing things like this?
A. Yeah.
Q. Right. Okay. Do you use social media and stuff?
A. Yes.
Q. And that's the way that you used to speak to your friends?
A. Some of them, yes.
Q. Okay. We'll take a break there and I think the time is 24 minutes to 9.
The interview concluded.
A. Yes.
Q. If we go to the next overarching interview, please, that took place on 5 July 2018, 2 days
later?
A. Yes, that's correct.
Q. It began with introductions and:
Okay. In terms of the investigation, and obviously this is your opportunity, is there anything
that you feel us, us as an investigation, need to look at concerning the amount of deaths and
collapses over a short period of time?
A. I think the staffing maybe needs -- I'm not saying that staffing has caused it, but I think
staffing levels were quite poor at times with an inadequate skill mix sometimes.
Q. Okay.
A. And I think a lot of people, like myself, were doing a lot of additional shifts and overtime
and having shifts changed round at short notice. I think a lot of people were feeling the strain
physically and emotionally. I don't think a lot of support was offered to the team throughout this
event with the deaths and things. There's also some issues with the unit just in terms of it's
very small, we don't always have the equipment that we need, we have to go and get it from other
units, or are pushed for space and trying to look after sick babies in not always ideal
environments and I personally just found during this that there wasn't always a very clear and
supportive sort of management, structural, medical support particularly towards nursing staff.
That's a personal opinion.
Q. How was staffing levels different during that period than they were a month before [Baby A]
collapsed and died and a month after [Baby Q] collapsed and died [it says], for example?
A. I don't recall specifically, but often sort of from May, June onwards, we are short of staff
due to people taking more holidays.
Q. Right.
A. And I remember at that time we had a lot of new starters that had just started on the unit, so
we were quite bottom-heavy in terms of having more inexperienced staff that needed support on the
unit -- and I think we also had a couple of members of staff that were on long-term sick leave
during these times as well.
Q. Okay. So do you think any of these deaths and collapses occurred due to poor care?
A. I don't think anybody intentionally gave poor care, but I think maybe if staffing had been
better people may not have been caring for as many babies at once or would have had different
shift patterns, maybe, or the doctors would have been more readily available.
Q. What about equipment? Do you think any of these babies had collapsed or died because of the
equipment that was around or the lack of equipment?
A. I think there's been delays with them having some of the support that they need because we've
had to go and get equipment, yes.
Q. Would any of the lack of equipment or staff cause the collapse of a baby, the initial
collapse?
A. No, I don't think it would cause the collapse, no.
Q. It's clear that the babies that we've been speaking about over the last few days we're saying
aren't just unexpected but suspicious.
A. Right.
Q. Do you understand that?
A. Yes.
Q. That's the initial collapse --
A. Yes.
Q. -- as opposed to subsequent collapses.
A. Okay.
Q. If you say lack of staff, lack of equipment, doctors not reacting maybe as quickly as they
should do, can you apply any of those three factors to the babies that we've spoken about
here?
A. Yes, for some of them I think if staffing had been better then maybe there would have been more
people around for that baby.
Q. And who -- can you recall who they were specifically?
A. I think [Baby Q] is one because I was stretched between two --
Q. Yes.
A. -- nurseries which is not ideal.
Q. I think you alluded to that in the interview for him, yeah.
A. I recall the day that I had [Baby G] and she was down in nursery 4 and I had a number of other
babies at that time as well.
The day with [Baby M], the nursery was very busy in nursery 1 and he was not in a correct space. Either he was in just parked in the corner which -- it wasn't ideal.
I don't remember -- and then I just remember we had a lot of junior staff that we were supporting during that time as well.
Q. Okay.
And Ms Letby's solicitor said:
I think that when you gave the initial interview with regard to [Baby P], I think you described
that as quite chaotic when they were actually trying to --
A. Yes.
Q. -- resuscitate.
Then the officer says:
I understand that. They are certainly factors that could affect every walk of life, aren't they,
but what we are saying is that we are treating the babies' collapses and deaths as suspicious; you
understand that, don't you?
A. Yes.
Q. Okay. In general terms, the investigation's looking into a number of deaths between 2015 and
2016 and other babies who have collapsed and survived. So a direct question is: between those
dates and that amount of babies, have you done anything to intentionally harm those babies?
A. No.
Q. When did you first become aware that there was an unnaturally high rate of mortality on the
unit?
A. In a formal way it was said to me by the unit manager -- I think in the May 2016.
Q. Okay. What do you mean "in a formal way"?
A. Well, she took me into the office and I think it was at that point I was moved on to day shifts
and she explained that there had been an increased rate and she was currently working on some
tables to work out the statistics.
Q. Okay. So informally when did you have the realisation or were told that this is really an
unnaturally high level of mortality for Chester's unit?
A. I think at the very beginning when we lost the three babies, when we lost [Baby A], to have
three so quickly, that in itself was unusual and it was probably more deaths than we usually have.
Q. In a year?
A. Mm.
Q. Okay. In that first month, I think from what you were saying earlier, that's more deaths than
you've experienced since you've worked in neonatal?
A. I think so, yeah.
Q. Okay. When you were first made aware of the investigation that the hospital were doing, were
you told specifically the names of the babies that they were investigating?
A. No.
Q. So even the ones here, the ones that resulted in death for example, were you told formally by
them?
A. No, no.
Q. Okay. In terms of the investigation from the Countess' point of view, but also from the police
investigation, have you done any form of research into any of the babies or any of the deaths?
A. In what way do you mean research?
Q. For example, you know who died because you were there or who collapsed, you're aware of the
babies' names. When you were still on the neonatal unit would you research their medical notes,
for example, that sort of thing, kind of thing?
A. I think I'd reviewed their medical notes, yes, at some point, yes.
Q. And what was the purpose of that?
A. Just as a recap, really, to think -- to take things in better when it's not happening at the
time.
Q. Okay. For what purpose?
A. I think it just helps to go back in to read what happened, so obviously you have it clear in
your mind that everything was done.
Q. At the time of collapse or death, you mean, or as a result of the subsequent
investigation?
A. What do you mean, sorry?
Q. All right then, take [Baby A]. Did you do any research yourself with regards to [Baby A]?
A. So did I access his notes after he died?
Q. Yes?
A. I might have done. I don't recall specifically.
Q. Okay. All right then, any of these babies that you looked into after death or collapse, what
was the purpose of that?
A. Just for clarity and for sort or my own debrief as such, just to recap.
Q. How close to the death or collapse was that?
A. I don't remember.
Q. Okay. Was that research as a result of the investigation launched by the hospital?
A. No, I'll not sure. I might have looked after and before. I might have done that prior to the
investigation, I'm not sure.
Q. Okay. With regards to the police investigation, at which stage did you become aware of the
babies' names that we were investigating?
A. I don't think I did until now.
Q. Okay. So on 7 April you were moved to a day shift and you've kind of told us how that made you
feel. You said that you felt that people's attitudes towards you had changed and you'd doubted
your own capabilities. Is that a fair --
A. Yes.
Q. Okay. So you were moved on to days. And after you were moved on to days in the June, as we've
just discussed, [Baby O] and [Baby P] both died and [Baby Q] collapsed. So what are your thoughts
on that?
A. That they have collapsed?
Q. Yes. After you've been swapped on to days.
A. I am not sure.
Q. Okay. So a lot of the collapses and deaths prior to you getting moved on to days have been
during the night-time, on a night shift.
A. Yes.
Q. Okay. After you get moved on to days there are two deaths and a collapse within 3 days of each
other.
A. Yes.
Q. Okay. Do you have any comment to make about that?
A. I can't explain that, no.
Q. Do you have anything in your possession which relates to any of the allegations for which
you've been arrested?
A. What do you mean? Sorry.
Q. Paperwork, medical records, anything.
A. No. Not that I know of, no.
Q. Okay. Have you ever taken anything relating to the babies that we've discussed home?
A. No. I don't know if -- I might have sometimes taken handover sheets accidentally home with me.
Q. Okay.
A. Not medical notes, no.
Q. No. Not just sticking to medical notes, anything relating to --
A. I don't know specifically to them. I think sometimes I have brought handover sheets home, yes.
Q. Why? What's the purpose of that?
A. Just inadvertently. They've just been left in my pocket.
Q. Okay. And I think we asked you sort of a little bit throughout whether you would take any
mementos from the babies yourself and I think you said no; is that right?
A. No.
Q. I just wanted to ask you a few more things about the note, NAC10. Did you write all that at
the same time?
A. I don't remember specifically, but I think so.
Q. Okay. Is there a reason why it's written in that format? You see that some of the writing is
to one side and some on the edge of the page.
A. I think I've just done it when I was very upset and it all just kind of come out at once in
different ways.
Q. Okay. And where were you when you wrote that?
A. At home.
Q. What was going through your mind at the time?
A. I just felt like I'd let everybody down, that I'd let myself down, that people were changing
their opinion of me, that I thought I'd lost my job and I was isolated from my friends.
Q. And just confirm when you think roughly, the time, month year?
A. I know it was after when I'd been -- I'm not sure of the exact time but it was some time after
I'd been removed in July 2016.
Q. You particularly got the word "hate" there. I'm right in saying that's the word "hate"?
A. Yes.
Q. Which is circled with a big black circle, "hate" in bold letters. What's the significance of
that?
A. That I hate myself for having left everybody down and for not being good enough.
Q. And just confirm to me why you think that you're not good enough when you wrote that down?
A. Because I'd just been removed from the job I loved, I was told that there might be issues with
my practice, I wasn't allowed to speak to people, I was having to do a job that I didn't enjoy
with people that I didn't know.
Q. And this was within a couple of months of being removed?
A. Yes, I think so, yes.
Q. And all these emotions, these feelings that you put on this stage, had this come to a
head?
A. Yes.
Q. Had anything triggered on this particular day for you to write that?
A. I don't recall specifically, no.
Q. Have you ever shown that note to anyone?
A. No.
Q. Can we have a look at that for me again and where you specifically say, "I don't deserve to
live, I killed them on purpose". Can you explain to me again what you actually meant by that?
A. That -- that's how I was being made to feel, that if my practice hadn't been good enough and I
was linked with these deaths, then it was my fault and I had done it and they thought that I was
doing it on purpose, not that I had done it on purpose, but that's how I was made to feel.
Q. Specific words:
"I killed them on purpose and I'm evil. I did this. [And] I'm an awful person. I pay every day for
that."
A. It's because I felt I was awful because I -- I maybe hadn't been good enough.
Q. You're being very hard on yourself there if you haven't done anything wrong.
A. Well, I am very hard on myself.
Q. "I did this. Why me? I did this."
What did you do?
A. I felt that I wasn't good enough. That's -- that's what they were implying, that I hadn't --
that my competencies hadn't been good enough, they were removing me. I felt that I had -- bad
person, I wasn't good enough, I had caused them, I had caused them to think that.
Q. "That I did this." What is this?
A. I don't know. I felt the situation had been caused by them implying that, that I hadn't been
competent.
Q. Lucy, were you responsible for the deaths of these babies?
A. No.
Q. Okay. We shall take a break.
Then the time is given and the interview concludes.
A. Yes.
Q. Two of those interviews we've heard are on the first occasion when Ms Letby was arrested. The
next interview is 10 June 2019.
A. Yes.
Q. So this interview would have taken place during the second arrest; is that correct?
A. Yes, that's correct.
Q. It begins with the introductions, caution and the explaining of legal rights.
A. Yes.
Q. Lucy, prior to starting this interview you've mentioned before about a handover process that
takes place at the start of your shift with the nurse previously; is that correct?
A. Yes.
Q. Okay. Are you given any documentation during that handover?
A. Yeah, we have a handover sheet of -- of the patients that are on the unit at that time.
Q. Okay. Explain the purpose of those handover sheets.
A. Well, to relay information between staff so that each member of staff's got the brief outline
on each of the babies.
Q. Okay.
A. Then we get a more in-depth handover on your own baby.
Q. Who has a copy of this handover sheet?
A. All members of staff on the unit.
Q. Where are they kept during the shift?
A. In our pockets -- in the staff's pockets.
Q. Why's that?
A. So we can make reference to it throughout the shift if we need to.
Q. Okay. And when you were personally given handover sheets, Lucy, what did you used to do with
yours?
A. Keep it in my pocket for the shift.
Q. And when you finished your shift, what would you do with the handover sheets?
A. Um, ideally put it in the confidential waste bin.
Q. And why would that be?
A. For confidentiality, so the public can't pick up the sheets.
Q. Mm-hm. Then where's that situated Lucy?
A. On -- by the nurses' station.
Q. Okay. Is that what you would do with your handover sheets?
A. Yes. Not every time though. There have been times when they've come home with me.
Q. Okay. Is there a policy in place around handover sheets, Lucy?
A. Not that I know of.
Q. What does generally happen to them then with the other colleagues on the unit? What do they do
with them?
A. They put them in the confidential waste.
Q. Is that at the end of the shift?
A. Yeah.
Q. Okay. So there's no filing system for them at all?
A. No, they're just discarded at the end of the day by that member of staff.
Q. Okay. When you were previously arrested, Lucy, you were aware that your home address was
searched and a large quantity of these handover sheets were found at your home address. Can you
explain that?
A. They're just sheets that have inadvertently come home with me in my pocket. I have no emptied
my pockets before coming home.
Q. Okay. Can you explain why you kept these at your home address?
A. Um, no. There's no specific reason. They just came home with me and I didn't do anything with
them.
Q. Can I ask what you actually wear when you're a unit?
A. A set of scrubs, so a pair of trousers and then a tunic top that's got two pockets here and a
pocket at the top.
Q. So which pocket would you put the handover sheet in?
A. One of the bottom pockets.
Q. Bottom. Either left or right or?
A. I don't remember having a specific pocket --
Q. Okay.
A. -- that I put it in.
Q. And tell me at what point when you got home did you realise that you were still in possession
of these handover sheets?
A. When I have got home and taken my uniform off.
Q. So talk me through then when you have taken your uniform off and you've found these handover
sheets, what did you do with them?
A. I just put them all in one area.
Q. Which area was that?
A. They were all together in a folder in the spare room.
Q. Okay. Explain to me why you put them all together in a folder?
A. Because I didn't know how to dispose of them, so I didn't dispose of them.
Q. You didn't know how to dispose of them?
A. No.
Q. Whose permission did you have, Lucy, to remove these handover sheets from the hospital?
A. No one's.
Q. Who else knows you've got them at your home address?
A. No one.
Q. Have you shown them to anyone?
A. No.
Q. Whilst they've been in this folder at home, what have you used them for?
A. I haven't.
Q. How often have you looked at these handover sheets, Lucy?
A. Hardly ever.
Q. Did those sheets that are in your folder that you've kept at your home address, Lucy, relate
to babies which you were the designated nurse for?
A. Yes, they're all babies that are on the unit at that point, whether you look after them or not,
so yeah.
Q. Okay. Have you ever previously taken any of these handover sheets home and disposed of
them?
A. No, I don't think so, because I haven't got a shredder and that's how I would -- that's how I
would have to get rid of them.
Q. Okay. So why would you have only kept some of the handover sheets in a folder, Lucy?
A. Because they're just the inadvertently ones that have come with me [as read].
Q. Have you retained in any way any other documentation from the hospital of any description?
A. No. I have some printed-out policies --
Q. Okay.
A. -- but I don't know if that's not allowed.
Q. Have you retained any other confidential documentation at home?
A. No.
Q. Have you retained any other documents from any other hospitals that you've previously worked
at?
A. Again, I've -- I've got policy sheets from different hospitals, but not patient information.
Q. When you say policy sheets, describe them to me.
A. Like guidelines for how different hospitals do things, I've printed them off and brought them
home for assignments and things.
Q. So specifically what policy sheets are you referring to?
A. I think I've got some on -- loads because I did my ITU course and we had to have policies for a
lot of the -- so I've got things on feeding, on jaundice, on hypoglycaemia, on necrotising
enterocolitis, I've got various.
Q. Okay. Where are those policies kept that you've printed off?
A. Um, some are within the -- my intensive care folder, some are just loose. I'm not sure exactly
where all of them are.
Q. Okay.
Then you ask your colleague:
Do want to ask anything?
You say that the handover sheets that you put in your pocket relate to being -- to you being a
designated nurse for these babies; yes?
A. So the handover sheet has every baby on the unit at that time.
Q. Right, okay.
A. And it's not just the baby you're looking after, it's every baby.
Q. Would you have had cause to take some out of the waste, Lucy?
A. Out of the clinical waste? No.
Q. Okay. So just to confirm, Lucy, when I've asked you why you decided to keep the handover
sheets, you've confirmed that you weren't aware, didn't know how to dispose of them, therefore you
kept them in a folder?
A. Yes, at the time I've got home, realised they're there, and I've just not done anything about
it.
Q. Moving on, Lucy, I would likes to talk to you about your mobile phone and telecoms. Would you
have used it at work?
A. Yes.
Q. Okay. Is that permitted? Is there any issue about allowing you to use it at work?
A. We're advised not to use it, like, near to the patients, but on breaks and out of the clinical
area.
Q. Where would you keep whilst you were at work?
A. Either in my pocket or in my bag.
Q. Lucy Letby could not recall the exact device she would have had in 2015 and 2016, but it would
have been an Android with access to social media and she was asked:
Okay. Does anyone else have access to your phone? Do you give it out to anyone or lend it to
anyone?
A. Not particularly no.
Q. Okay. So you obviously use your phone at work during work time. If you've got any -- a bad day
or issues going on at work, who would you sort of use your phone to contact? Who'd be your first
port of call?
A. Um, a friend.
Q. Any particular close friend that you would use your phone to?
A. [Nurse E].
Q. Okay. And [Nurse E], she works at the [redacted]?
A. Yes.
Q. Okay. Are there any other close friends that you would contact or your family?
A. I've got a couple of different close friends over the years that I probably would have
contacted, yeah.
Q. Right, okay. And how often would you contact them in regards to anything that was going on at
work? Would that be frequently?
A. I'm not sure. It would depend on what was going on at the time.
Q. Lucy Letby confirmed that she would use WhatsApp, text or Facebook Messenger, not iMessage, as
she didn't have an iPhone:
Did you discuss the welfare of babies at all with any of your friends?
A. Um, oh yeah, I've discussed patients at times, yeah.
Q. Okay what sort of things have you discussed?
A. I'm not sure exact details now. I've communicated with friends when babies have been unwell or
if they've passed away.
Q. Right. So would that be sort of straightaway or within the same sort of shift a few hours
later?
A. I'm not sure, I can't --
Q. So, you know, we discussed, the first time you were brought here and arrested, and the babies you were involved in the care of.
And then Lucy Letby was nodding her head. It's not recorded, obviously, audibly:
So would you have contacted friends following those?
A. Yes.
Q. And how often would that communication go on for generally?
A. About the babies specifically?
Q. Yeah.
A. I'm not sure.
Q. Would there be a purpose for you doing that, contacting friends?
A. Yeah, they were -- they're my support network.
Q. So did that make you feel better when you communicated with them?
A. Yeah and it was somebody in the same profession that could -- rather than speaking to a family
member who didn't understand the unit and things, it's helpful to speak to a colleague.
Q. Did you discuss theories about what was going on?
A. I'm not sure, possibly.
Q. Or individual patients?
A. I don't know. Possibly.
Q. What about family members? Did you communicate with them at all?
A. Yes, I used to speak to my parents every day after I'd finished work -- well, every day,
anyway, but...
Q. Okay. And after the collapse of a baby, which family member would you turn to?
A. My mum.
Q. For the same reasons, to help you get through?
A. Well, for her support -- I wouldn't talk to her about it in the level of detail that I would
with a colleague.
Q. So can you just describe to me how it made you feel, discussing this with friends and family,
how it sort of helped you with the whole process?
A. I suppose I just saw it as -- that was a safe way of me sort of offloading how I felt to
somebody I trusted. I wasn't somebody that would go home -- I lived alone. I wasn't somebody that
would go and necessarily seek out somebody to speak to in person. That was my way of thinking
through things.
Q. Okay. And did it help?
A. Yes.
Q. In what way?
A. Well, because they would have been supportive or, you know, share -- a nurse knows how you feel
when things happen and it's just having that common ground with somebody and a bit of support from
them.
Q. Okay. Did you ever seek advice regarding the treatment of a baby or what was going on through
the use of your phone through social media?
A. No, I don't think.
Q. As in one of your colleagues who might be experienced?
A. Um, I'm not sure. I think I rang -- um, had ran some things past one of the doctors that I was
friendly with at the time.
Q. Who was that?
A. [Dr A].
Q. Okay. And what sort of advice did he give to you?
A. Just, I suppose, reassurance. Just somebody on another level to talk to about what was
happening or if I was having a difficult day.
Q. So you'd -- she'd be the first person you'd turn to and after [Nurse E]?
A. Well, at different times [Dr A] was -- I was close to [Dr A] in the later stages. I had other
friends: [Nurse A], Minna Lappalainen.
Q. Okay. So you've committed with all those over the years?
A. At some point, yes.
Q. And this would be during and after work?
A. Yes.
Q. Is there a reason why you wouldn't get advice or support face to face?
A. We get support sometimes on shift, but it would depend who you were working with and what was
going on in the unit, and who it was that -- well, whether you felt able to talk to that person or
not. When we've had a difficult day on the unit, a baby's been unwell or it's been particularly
busy, I don't know, somebody had phoned in sick or anything that was a bit different on the unit,
out of the normal, I might seek support from somebody.
Q. Okay. And when you were asked about occasions that you have messaged colleagues for advice
relating to work, you have said it was for reassurance. Explain what you meant by that.
A. I can't remember specific -- but I know I -- I've mentioned [Dr A] before now in terms of when
we'd lost certain babies. I know he'd gone to like debriefs and different things that nursing
staff weren't invited to and I think I checked some different policies with him over time.
Q. And explain why you were particularly interested in those debriefs.
A. Because they were babies that I'd had involvement with --
Q. Okay.
A. -- or been present for.
Q. Okay. And you said that you weren't invited to these debriefs; is that correct?
A. Not all, some. Some of them.
Q. Right?
A. Some you're not and then there's things were discussed at medical level only and things, so...
Q. Okay. The next area I want to talk to you about Lucy is your training and, correct me if I'm
wrong, but our understanding from the investigation is you qualified as a band 5 nurse some time
in 2012. Can you confirm if that's correct?
A. September 2011.
Q. Okay.
A. And I started working on the unit January 2012 and that was my first job.
Q. Lucy Letby discussed her training in administering blood transfusions and blood components, her mentorship for students, and acquiring credits towards a master's qualification. She explained that she had qualified in specialty training at Liverpool Women's Hospital in February 2015.
She was asked:
Okay, during the training, obviously, you have described to me what it involved and the
competencies. What about any risks or dangers dealing with neonatal babies? Were you taught
anything specifically in relation to that?
A. Yeah, we had different lectures and things about different neonatal conditions.
Q. Mm-hm.
A. We spent time going out with the resus coordinator -- we had somebody that is on shift that
attends any collapses or resuscitations or births at that point and we spent time with that person
to go out and get experience of the acute sort of emergency setting.
Q. And how did you find that?
A. Just very different to Chester. It's just not something that we would see and do and they're
sort of like -- I went to a lady that was delivering in the corridor and things. That's just
something that I'd never seen before.
Q. So all these areas was (sic) knowledge you could potentially bring back --
A. Yes.
Q. -- to the unit?
A. Yes.
Q. And amongst the staff on the neonatal unit, Lucy, were there any other nurses of band 5 who'd
done this training?
A. Yes, there was myself and Bernie Butterworth. We were the only two --
Q. Okay.
A. -- which is why I found I was quite often allocated these babies because I was on shift with
people that didn't have the ITU course and therefore weren't able to care for them.
Q. Yes.
Lucy Letby described further training in basic life support and infection control, breastfeeding
support and annual neonatal updates:
Okay, moving on, Lucy. In May 2015 there was a competency assessment for "Safe administration for
medication by bolus/intermittent via a long line, Broviac line or umbilical venous catheters" [as
read]. Do you recall that training?
A. Yes.
Q. Can you explain to me what that involves?
A. Okay, so we didn't have any training as such, it came from -- when you've done the intensive
care course, you are then eligible to access these sort of lines and to do the competency. So
usually you would just work with another nurse and then they would support you and watch you in
drawing it up and preparing whatever needs to be given via that line. Then there's a competency --
of questions that they ask you as well.
Q. Okay. So did you say, sorry, that there wasn't a specific training?
A. So there wasn't any -- no, there wasn't a specific --
Q. Right.
A. -- training aspect. No, it's just something you sort of learn on the job.
Q. And how long does that take place for?
A. I think you'd have to be watched three times, if I remember correctly.
Q. Okay. And do you recall who you were assessed by?
A. I think one was Chris Booth.
Q. Mm-hm.
A. Somebody, [Nurse A], I can't remember.
Q. And explain to me how, this training, you would then apply it to your role?
A. I'd then be able to give baby medications via these sorts of lines. Rather than just being a
second checker I would actually be able to --
Q. Okay.
A. -- have access to those lines.
Q. Okay. And how often would you then use that method, so be able to give medication?
A. Quite frequently.
Q. Mm-hm?
A. Most of the babies on the unit have some form of central access and when you're new to having
learnt something, they are usually quite keen for you to get as much experience as you can --
Q. Yes.
A. -- so you end up doing a lot of the drugs and things.
Q. Okay. How did you find that?
A. Okay, I think it was certainly very different. It was very different learning about those
separate lines to just a normal peripheral line. Obviously there's a little more risk and sort of
learning. You have to learn where the line placement is in terms of X-rays a little bit and it's
more responsibility.
Q. When asked about the risks involved, Lucy Letby identified infection, the line moving or the
line leaking and was asked:
Okay. And having done the training, would you class yourself as competent in that area?
A. Yes.
Q. Is there any part of that training, Lucy, that you're not that happy with?
A. Um...
Q. Or are you fully confident with?
A. I think the only thing we -- we don't see a lot of babies on the unit with a Broviac line.
Q. Okay. Moving on, Lucy, you've also completed in May 2015 assessments for the safe
administration of medication by bolus and by bolus [as read] and also safeguarding children as
well. I'm guessing those are two separate areas of training?
A. Yes.
Q. So the first area then, the safe administration of medication, what can you tell me about
that?
A. I don't remember that training specifically.
Q. Did you do or did you attend any specific resuscitation training for neonatal babies?
A. Yes, we attend the neonatal life support programme. That's done every 4 years. That's lasts for
4 years.
Q. And what did that training involve?
A. Resuscitation scenarios and skill stations and at the end of the day you're assessed. Then you
get called through and it's sort of like a random scenario and you have to manage that.
Q. Is there any other training, Lucy, that you received while you're a nurse on the neonatal unit
that I haven't gone through with you?
A. I attended an IV study day at Alder Hey.
Q. When was that?
A. That's when I first qualified to be able to give medications via a line. That had a competency
assessment. And I've attended various study days, but they were just for my own --
Q. Yeah.
A. They weren't assessed study days.
Q. Okay.
A. I don't think there's anything else that I've been assessed in.
Q. Is there any training that you've failed at all, Lucy?
A. No, not that I'm aware of, no.
Q. Okay. In relation -- we've touched on it before when speaking to you, Lucy, in relation to
insulin training. Tell me about any specific training you've had about that.
A. Well, I don't recall having any specific training in insulin specifically, no.
Q. Have you received any inputs around it?
A. Um, hypoglycaemia and hyperglycaemia. It isn't something that's really discussed at updates,
no.
Q. So explain to me then how you become aware of how to deal with a situation involving
hypoglycaemia then?
A. Through just experience, experiencing it on the unit, and from when the different pathways that
come out. Usually they did change the pathway a couple of times, then you get a little bit of an
email sent round, maybe with a new policy, but then you would have to wait until you had a baby to
then sort of fully get your head round it.
Q. Okay. And you've mentioned to me these pathways. Describe to me how you're taught about
them.
A. You're not really taught about them, they're just sort of uploaded to the guideline system.
Q. Right.
A. You're told if there's any changes and you're expected to go and look and --
Q. Okay.
A. -- and familiarise yourself with anything.
Q. And what about air embolisms, Lucy, did you receive any training in relation to those?
A. No.
Q. Okay were you aware of them or?
A. Not really, no.
Q. Have you heard of them before?
A. Um, yeah.
Q. When was that?
A. I've heard of them more from an adult perspective.
Q. And tell me what that was in relation to.
A. I don't know specifics. Like sometimes we've had mums on the unit who have been unwell and it's
been found they've had a PE, pulmonary embolism, so that's just how I've heard of it, via that.
Q. Specifically whilst working on the neonatal unit have you ever come across it before?
A. No.
Q. Then you ask your colleague:
Is there anything you want to ask?
And they say:
Has the air embolism training ever popped up in respect of dangers with other training that you
might have had, done things incorrectly?
A. Not that I can think of specifically.
Q. No? Or any of your sort of general nursing training before you qualified?
A. It's been mentioned in terms of line care: you'd have to be mindful that you don't leave a line
open and things like that.
Q. Mm-hm.
A. But it's not something that's discussed frequently in any detail.
Q. When you say line care, you needed that competency assessment in May 2015 that we talked
about, the safe administration of medication by the different lines. Is that the type of training
that you're referring to?
A. Yes. I'm not sure if that's on the list or not.
Q. Okay. And have you had any concerns during care duties, what's the protocol if you had
concerns in relation to your baby?
A. You'd escalate it to a band 6 or the shift leader.
Q. Okay.
A. And they would take it from there usually.
Q. Mm-hm. Did you feel comfortable in doing that in your role?
A. Yes, sometimes. It would depend who the member of staff was. Some people are more amenable than
others but I think -- but, yeah, I think when I needed to escalate I did.
Q. Okay.
The particular interview concluded there.
I'm moving on to our final interview in the summary bundles. This is an interview on 10 June,
again, 2019, a little later in the day.
A. Yes.
Q. Introductions and caution. Lucy Letby identified her personal diaries. She agreed that she
would record various matters within shifts, personal thoughts, events, and some of the collapses.
She confirmed only she ever wrote in it -- sorry, only she ever wrote in and had access to those
diaries:
My colleague asked you if you used your diaries, Lucy, to express your thoughts and feelings and
you said sometimes. What would or explain to me what would trigger you to write that down?
A. If there was something I was particularly struggling with or something that I felt I just
needed to write down and express myself without telling anybody.
Q. Okay. And you said -- when he asked you the question, you said "sometimes". Can you quantify
that? How often would you do that?
A. So there have been points when it's been daily, when something's been difficult for me. Other
times it might be weekly. I'm not sure.
Q. Right. And then my colleague asked you about the collapses of the babies and you said that you
recorded those as well. Why?
A. I think I've made reference but I don't know in what way I've recorded them, but...
Q. Okay. Can you explain that to me in more detail?
A. I suppose it is just a way of me thinking things through myself in my own time and expressing
those thoughts on paper.
Q. Okay. Explain to us what type of things you wrote, Lucy?
A. I don't remember specifics but there have been times when I've really struggled and I thought
maybe things were my fault and that people were blaming me, I've not been good enough, things like
that, but I don't know that I've described -- that I've written down every collapse --
Q. Right, okay.
A. -- or the detail of that collapse.
Q. Why would you want to reflect on those, Lucy?
A. Because that's just how I cope with things. I don't talk to anyone about it, I just internalise
things and do it in my own time. I think some of the diary entries I have made have been about how
I feel about being potentially blamed for things, yeah.
Q. Okay. So do you remember when you started doing that, putting entries in diaries in respect of
that?
A. I think it was once I was removed from the unit.
Q. Okay. So we're looking, what, post-July 2016?
A. Yeah, I think it was at a time when we were particularly busy and there were lots of staffing
issues and I think I started to write things because I was starting to be used as second on call.
Q. What was the purpose of writing that down?
A. I'm not too sure. I think it was just my own record of knowing of who I looked after and when,
how many babies I have per shift.
Q. Is there no method at work to do that?
A. Um, not unless you were -- not unless you went through each of the nursing notes. You'd have to
look. There's no way of looking who looks after which baby on which days, no, without going into
the nursing notes.
Q. Lucy Letby explained that the names appearing in the 2016 diary are those of the babies for
which she was the designated nurse:
Were there any concerns or issues on the unit at this time, Lucy?
A. Yeah. There'd been mention about the concerns, that there had been a rise in mortality rate and
we had staffing issues.
Q. This had been raised in February?
A. I think it was early, yeah, I think so.
Q. Does that coincide as to why you have documented names?
A. Yes.
Q. To what purpose?
A. So I would know who I have looked after and how many babies.
Q. Okay. So you've also written things in red. Again, they're personal home points, are they?
A. Yes.
Q. Lucy Letby was then shown a specific note from her diary, the exhibit reference KL4. Officer,
that's the larger A4 sheet that was inside the diary; is that correct?
A. Yes, that's correct.
Q. If you look to the bottom left, there's a -- highlighted in a box the words "Kill me".
A. Mm.
Q. Why have you written that?
A. Because I wish sometimes that I was dead and someone would just kill me.
Q. Why is that, Lucy?
A. Because at that point I had lost everything and wasn't working on unit and was being -- I
didn't really know what was going on and I hated working in the office.
Q. There's another box there, this box here, where there's a bit written in and then crossed out.
Do you know what that says?
A. No.
Q. So you don't remember when you did this?
A. No.
Q. Because you didn't date or time it?
A. No.
Q. Do you think you might have done it at work?
A. I think -- looking at it, it started off as some notes about work and then I've just used it
then as a doodle thing and added more to it.
Q. Then it's your way to express yourself, is that what you're doing?
A. Yeah.
Q. I mean, would you put things that weren't sort of accurate or truthful?
A. Well, I am not sure. Some of it is just doodling, it's something that comes in my mind at that
time.
Q. Why have you kept this piece of paper, Lucy?
A. I am not sure. I think I -- it was obviously put inside my diary and then just left there.
Q. But that suggests that it was -- to you, that suggests it was written around the time that you
were using the diary.
A. Yes, yeah, and I would say -- because it's some of this is relating to the work that I was
doing in the office. It's from when I was removed onwards.
Q. Okay. Thank you for that, Lucy. We have come to the conclusion of this particular interview
now. Is there anything else you want to ask or tells us about the diaries?
A. No, thank you.
Q. How are you feeling now?
A. Well, I'm just a bit exhausted now.
Q. You feel exhausted? Okay. We'll turn this -- we'll complete this interview now anyway.
And we're given the time and the interview concludes?
A. Yes, that's correct.
Q. Thank you. That's the conclusion of our summaries?
A. Yes.
MR ASTBURY: I have no more questions. If you could wait there, please.
MR JUSTICE GOSS: Have you got many questions?
MR MYERS: No, I think perhaps, my Lord, about 10 minutes or so.
MR JUSTICE GOSS: All right. We are scheduled for a break.
MR MYERS: It may be, unless of course your Lordship or the jury wish for a break immediately, that I could conclude the questions for Sergeant Stonier now and then her evidence is completed insofar as we understand.
MR JUSTICE GOSS: All right. We'll do that.
Cross-examination by MR MYERS
MR MYERS: Sergeant Stonier, I just want to ask you a little bit about the process that we're dealing with here, the interview process, and how it applied in this case.
We're going to receive some agreed facts that give us dates and timings, so I am not expecting
you to recall everything or us all to remember it all, but we know, and could you confirm, Ms
Letby was arrested on three occasions?
DS: Yes, that's correct.
BM: The first was 3 July 2018?
DS: Yes.
BM: The second was 10 June 2019?
DS: Yes.
BM: And the third was 10 November 2020?
DS: Yes, that's right.
BM: And on each occasion that she had been arrested, she was interviewed whilst held in police
custody?
DS: Yes, that's correct.
BM: So the interviews that we've been through are the interviews that took place after those
arrests?
DS: Yes, that's right.
BM: Now over the period that she was interviewed and held in police custody she'd remain at the
police station; is that right?
DS: Yes, that's right.
BM: And when someone is in that position -- this isn't personal to, Ms Letby, it is just the
procedure -- their possessions are removed them, their personal possessions, things like that?
DS: Yes, they are, when you first arrive at the custody suite --
BM: And they are logged and when they leave they are given back, aren't they?
DS: Yes, that's correct.
BM: And save for those times when they come to the room to be interviewed or go to the lavatory,
they're kept in a cell? That's just what happens.
DS: Yes.
BM: And they're told they have various rights whilst they're in police custody; that's right,
isn't it?
DS: Yes, that's correct.
BM: One of those rights is that they can have a legal representative if they want?
DS: Yes, that's right.
BM: And we know that Ms Letby had a legal representative with her during these interviews.
DS: Yes, she did, throughout them all.
BM: What happens with the legal representative, and what happened here, I'm just going to ask you
to confirm, is when the representative came, he would speak to the police and be given what's
called some advance disclosure; is that correct?
DS: Yes, that's right.
BM: And advance disclosure in this case meant that he received documents -- certain documents that
related to the events that you were looking at and you were going to ask questions about?
DS: Yes, that's correct.
BM: In the case of each child that Ms Letby was going to be questioned about, she and her
solicitor were provided with documents, like nursing notes, where she'd made them -- this is
before the interview?
DS: Yes.
BM: And also some of the key charts that we've been looking at in this trial; is that right?
DS: Yes, that's right.
BM: So things like the feeding chart or the observation chart for that child?
DS: Yes, that's correct.
BM: The solicitor would have the opportunity to speak to the police about what was taking place
--
DS: Yes.
BM: -- whilst at the station and then also Ms Letby and her solicitor had time to speak about the
interview that was coming up before it was held each time; is that correct?
DS: Yes, that's right. They were afforded the opportunity to speak in confidence.
BM: Then she would be able to go into the interview and answer questions if she chose to do
so?
DS: Yes.
BM: And of course one of the rights that everybody has is not to answer questions if they wish not
to do so?
DS: Yes.
BM: And they're reminded of that at the start of each interview?
DS: Yes.
MR JUSTICE GOSS: And also the consequence of not answering.
MR MYERS: And the consequence, which is that it could be, putting it in loose terms, potentially
held against them if they don't answer questions.
DS: Yes, that's right.
BM: Thank you, my Lord.
Just so that we understand the scale of this, the documents that Ms Letby received wouldn't
amount to the type of, I don't say this critically by the way, but it's not the suite of documents
and collection of evidence we have on the sequence of events, things like that, was it?
DS: No, as I recall, as you've pointed out, it was the collection of nursing notes, feeding charts,
ITU observation charts where Ms Letby had made reference or documented herself personally.
BM: Yes. So this is just an illustration, but if we just go to the [Baby O] divider, also [Baby O], which is in the second interview bundle, just behind the first divider, page 2, please, Sergeant Stonier, ladies and gentlemen.
MR JUSTICE GOSS: About halfway through this. The tab is [document redacted].
MR MYERS: It's the first of the [document redacted] tabs, just page 2, just to illustrate
something if we could. It's the first tab it's the tab with [Baby O] actually written on it. And
if you look behind there in red it's got at the top corner "[document redacted]".
DS: Yes.
(Pause)
BM: Next to the tape counter that says 0203, having been asked about [Baby O], Ms Letby then goes
through in some detail there about how she remembers him, who she was caring for and aspects of
his care in that long paragraph, doesn't she?
DS: Yes, that's correct.
BM: So we can follow, that takes place after she's received notes that she has made and relevant
documents relating to [Baby O], doesn't it?
DS: Yes.
BM: So this is after she's had the time to review that and speak about it?
DS: Yes, that's correct.
BM: You were involved in a number of the recordings, weren't you?
DS: Yes, I was.
BM: We're going to see, and this is just so I can deal with this now, that there are about 13
interviews or 13 tapes after the first arrest?
DS: Yes.
BM: That's the arrest on 3 July. There were 14 interviews held after the second arrest on 10 June.
And there were three interviews after the third arrest on 10 November?
DS: Yes, that's correct.
BM: Right.
MR JUSTICE GOSS: Forgive me, Mr Myers, I don't want to interrupt, but can I just be clear, you've used tapes and interviews.
MR MYERS: I'll be quite clear. The figures I've given -- when I say 13 interviews, I'm referring
to 13 sessions with the tape running.
DS: Yes.
BM: So it could be regarded as one interview process over the whole of her period of arrest, but
we're going to see there are 13 separate tapes recording interviews, is that correct --
DS: Yes, separate recordings.
BM: -- between the 3rd and 5 July after the first arrest --
DS: Yes.
BM: -- and 14 after the second arrest on the 10th, and three of those after the third arrest on 10
November 2020?
DS: Yes, I believe so.
BM: Yes. In each case, whichever babies Ms Letby was going to be asked about, there would be some
disclosure about them in advance of that tape or that interview taking place?
DS: Yes, at the start of that recording there would be.
BM: So we've got a series of opportunities to have memories jogged and then answer questions?
DS: Yes.
BM: In some of the interviews, the focus was on just one baby; is that correct?
DS: Yes, it depends how long that particular interview took in relation to that baby as to did we
then move on to another baby or finish that interview.
BM: In some of interviews a number of the babies might be dealt with one after the other in the
course of that one interview, or interview tape rather, that we are listening to?
DS: Yes, within that same recording.
BM: As the jury have been told, what we have here is that those interviews have been split up so
they can be organised according to the children?
DS: Yes. As you say, a number of babies were covered within one recording on occasions.
BM: I'm going to just illustrate that if I could -- I'm coming to the end of what I want to ask
you, by the way, bearing in mind the 10 minutes. I want to ask you to illustrate that with one of
the interviews and the interviews towards the end of this process with [Baby N].
DS: Okay.
BM: We're going to look at some interviews in both folders, ladies and gentlemen, but the first reference I'm going to is in the folder that you should have open already, folder 2, but behind the [Baby N] tab, so [document redacted] and we're going to go to tab 3 for [document] redacted] and if we go to the first page behind tab 3, which will have at the top right-hand corner "[document redacted]". Let's just check we've all got that.
If we just look at the information on the front of that page, can you see Sergeant Stonier it's
got the time of the interview? It says, about five or six of the lines down:
"Time: 10 November 2020. Time: 21.05 to 21.22."
DS: Yes.
BM: That relates to the time of the interview when it was dealing with [Baby N], doesn't it?
DS: Yes, that's correct.
BM: We can see, from the way it's been done here, that the actual interview commenced at 20.27 and
finished at 21.22?
DS: Yes, that's correct.
BM: And we can see this is the interview, an interview on 10 November 2020, just above that?
DS: Yes.
BM: Which of course is the third occasion that Ms Letby had been arrested and then interviewed
over the period of this part of the investigation?
DS: Yes.
BM: I say that because she had already been interviewed about [Baby N] on earlier occasions after
earlier arrests, hadn't she?
DS: Yes, she had.
BM: If we just go towards the end of that interview, page 32, [document redacted], towards the
bottom of the page we can see, as the questioning continues:
"I think I might need to stop now, please."
Can you see that?
DS: Yes, I can, yes.
BM: And then, over the page, the solicitor confirmed at page 33, "You want to stop?"
DS: Yes.
BM: And Ms Letby says, "Okay".
DS: Yes.
BM: And that, in fact, concluded the interviews that day, didn't it?
DS: For that day, yes, it did.
BM: As it happens, that day, Ms Letby had been interviewed about a large number of the babies
we're dealing with in this case, hadn't she?
DS: Yes, she had, yes.
BM: And I'm just going to show that -- and again this isn't done as a criticism of the process,
it's just so we understand what she was dealing with.
DS: Yes, of course.
BM: I'm going to go to file 1, ladies and gentlemen, if I could. We'll get the hang of what I'm
doing fairly rapidly once we start, but if we go to the [Baby A] tab, it's the first tab in file 1
and go behind tab 3 for [Baby A]. So the page says [document redacted]. Have you got that,
Sergeant Stonier?
DS: Yes, I have.
BM: This is 10 November, you were one of the interviewing officers. This part of the interview ran
from 15.56 to 16.14?
DS: Yes.
BM: Can you see that? It was part of an interview that, as a whole, ran from 15.56 to 17.38, if we
look below that.
DS: Yes, that's correct.
BM: So this is the first interview held on that day, isn't it?
DS: Yes.
BM: It dealt with [Baby A]. Then if we move behind tab 3 for [Baby B], [document redacted], it's
tab 3 behind [Baby B], we can see there, during that interview, the next child to be dealt with
was [Baby B]; is that correct?
DS: Yes, that's correct.
BM: If we move forwards to [document redacted], please. Next was [Baby C]; is that right?
DS: Yes.
BM: He was dealt with after that?
DS: Yes.
BM: Then we go to [Baby E], tab 3, please, not [Baby D]. On the first page behind tab 3 for [Baby
E], we can see that she then was asked questions about [Baby E] during the same interview; is that
correct?
DS: Yes, that's correct.
BM: And in fact we don't need to repeat the process for all of these, I can just summarise it. In
this interview between 15.56 and 17.38 you and your colleague went on to question Ms Letby about
[Baby F] and [Baby G]. We can confirm it if you like but --
DS: It's okay, yes.
BM: That was between 16.45 and -- 15.56 and 17.38. A second interview took place that evening,
didn't it?
DS: Yes.
BM: That's the one which we've looked at which concluded with [Baby N], didn't it?
DS: Yes.
BM: And that took place between 20.26 and 21.22. And if we were to repeat the same process, we'd
find that the babies that Ms Letby was asked about then were [Baby H] -- do you want to confirm
it, sergeant?
DS: It's okay, I can see.
BM: [Baby H]; that's correct, isn't it?
DS: It is, yes.
BM: [Baby I]?
DS: Yes.
BM: [Baby J], [Baby K]?
DS: Yes.
BM: [Baby L]?
DS: Yes.
BM: [Baby M]?
DS: Yes.
BM: And then finally [Baby N]?
DS: Yes, that's correct.
BM: And it was at the end of that she said she was tired and would like a rest?
DS: That's right.
BM: The questioning finished then and you moved to the remaining babies the following morning,
didn't you?
DS: Yes, we did.
BM: You didn't need to return to [Baby N] though?
DS: No.
BM: Those were what might be regarded as the concluding interviews in the investigation?
DS: Yes, they were.
BM: So you covered quite a number of the babies in each interview, didn't you?
DS: Yes, we did.
BM: In the earlier interviews there might be one or several babies but not usually at that rate,
would that be fair to say, in the earlier parts of investigation?
DS: Yes, they were more in-depth interviews with going through the notes (overspeaking) --
MR MYERS: That's right. All right.
Thank you very much Sergeant Stonier.
Re-examination by MR ASTBURY
MR ASTBURY: Only a few questions, my Lord.
Officer, you were asked about the -- a detained person's property being taken from them in the
police station. Why does that happen?
DS: To protect both themselves and ourselves as interviewing officers. The same happens to every
person that's brought into police custody: all their personal property is removed from them,
documented on the custody record, and then returned to them once they leave the station.
PA: The custody record, just very briefly, what's the custody record, please?
DS: The custody record is a document that's completed by the custody sergeant, through a booking-in
process, with the detained/arrested person where everything is documented, so their rights, their
property, their medical health, it documents the time and date of arrest.
PA: Is anyone in particular responsible for the welfare of a detained person whilst in a police
station?
DS: Yes, the custody sergeant is responsible.
PA: Right. Whilst in custody, does the custody sergeant have to ensure the treatment of that
detained person is in accordance with the rules and regulations?
DS: Yes, they do, which is set out by PACE.
PA: Does that include a period of rest when required?
DS: Yes, it does.
PA: A night's sleep?
DS: Yes.
PA: Refreshments when required?
DS: Yes, we obviously take that on board too during the interview process.
PA: And meals at recognised mealtimes?
DS: Yes.
PA: All right. Now one of the rights you have also been asked about is a right to have a solicitor
for the purposes of legal advice; is that correct?
DS: Yes. That entitlement is afforded to everybody who's arrested.
PA: Could you confirm, please, that it was the same solicitor who attended on all three of the
dates that we've heard about?
DS: Yes, that's correct.
PA: That solicitor was present through each and every one of the interviews that we've heard
about?
DS: Yes, he was.
PA: Same person, continuity; is that right?
DS: Yes, that's correct.
PA: We heard that that solicitor would be given disclosure before an interview took place.
DS: Yes, he was.
PA: And would they be then given the time to sit with their client, whoever it would be, and give
them suitable advice based on that disclosure?
DS: Yes. As I say, they were afforded as much time as they required.
PA: Does the solicitor's responsibility continue during the course of the interview?
DS: Yes, throughout the whole interview process.
PA: Are they at liberty to interject if they feel appropriate?
DS: Yes, at any point.
PA: Did we see, on a number of occasions, Ms Letby's solicitor interjecting during the course of
these interviews?
DS: Yes, he did on a couple of occasions.
PA: And if, for example, a solicitor were to say, please may we have a break because my client is
tired, what would your reaction be to that?
DS: Yes, absolutely, and I think that did happen on an occasion where a break was afforded to Ms
Letby.
PA: Thank you. And we've heard about the recording of the interview.
DS: Yes.
PA: Was the interview recorded both by audio recording --
DS: Yes, it was.
PA: -- but also a video recording?
DS: Yes, it was. So all interviews have been video recorded as well.
PA: And they are available if any issue arises as a consequence?
DS: Yes, they are.
MR ASTBURY: I have no more questions. Does my Lord have any?
Questions from THE JUDGE
MR JUSTICE GOSS: PACE. You referred to PACE, the Police and Criminal Evidence Act, which is the
governing statute under which there are codes of practice that have to be followed?
DS: Yes.
MR JUSTICE GOSS: And one other thing by way of clarity: once arrested, a person can only be
detained in police custody for a certain period of time. Applications can be made to extend that
period of time to the court.
DS: Yes, that's correct.
MR JUSTICE GOSS: And then they have to be released or charged?
DS: Yes, that's right.
MR JUSTICE GOSS: I'm sure no one wants to -- if the jury have televisions, which I anticipate they do, they've probably seen programmes that have people taken into police custody, which is actually filmed in a police station generally. It's not a drama that's created, so it is actually what takes place.
MR ASTBURY: Yes.
MR JUSTICE GOSS: All right. Thank you very much.
Thank you very much indeed, Sergeant Stonier, that completes your evidence. Thank you for coming.
It's later than anticipated, but we will have still a break though. A ten-minute break, members of the jury. (12.18 pm)
(A short break) (12.30 pm)
MR JUSTICE GOSS: Mr Johnson.
MR JOHNSON: My Lord, Eirian Powell, please.
MS EIRIAN POWELL (recalled)
Examination-in-chief by MR JOHNSON
MR JOHNSON: Welcome back, Mrs Powell. I think you were last with us on 14 December last year,
where you gave the jury some evidence about [Baby G].
EP: Yes.
MR JOHNSON: Would you wait there, please, because I understand there are some more questions for you.
Cross-examination by MR MYERS
MR MYERS: Mrs Powell, I just have some questions for you, general questions relating to some of the matters we're looking at, not about any particular baby, but just on the unit. If you could help me with this, I'd be grateful.
Just to remind you, at the time we're looking at in 2015 through to 2016, were you the ward
manager on the neonatal ward at the Countess of Chester?
EP: I was.
BM: Was that a position that you held between 2011 and the end of 2017?
EP: It was.
BM: So in fact you would have been a ward manager over the time that Ms Letby was working as a
nurse on the neonatal unit itself?
EP: I was, yes.
BM: What stage of her career was she at when you first met Lucy Letby?
EP: That was before -- well, I think it was before 2011, I'm not sure of the exact time, as she was
a student at that time.
BM: So you met her when she was a student; is that correct?
EP: Yes.
BM: Had she come to the neonatal unit as part of a four-week placement?
EP: She was indeed, yes.
BM: And that was her nursing training?
EP: Yes.
BM: And that was at the University of Chester, wasn't it?
EP: It was indeed.
BM: Was she somebody who, so far as you could assess at that time, was striving very hard to
achieve good standards as a nurse?
EP: She was indeed, yes.
BM: And seemed to be very keen to improve her practice?
EP: Yes, she did strive to -- to get where she wanted to be.
BM: And you were able to see her from that period onwards to the point that that she was working
on the unit; is that correct?
EP: Yes.
BM: And would it be fair to say that in the time you saw her working there, on the unit, she
always struck you as an exceptionally good nurse?
EP: Yes, she was.
BM: We know now from the case that there's different bands or level of nurse on the unit.
EP: Yes.
BM: For a nurse to be able to look after intensive care babies, does he or she have to become
specifically qualified for that?
EP: She does, yes.
BM: Right. Was that something that Ms Letby did in due course?
EP: She did. She did a few sessions in Liverpool Women's Hospital. She did her preceptorship with
us on the unit, which is -- because it's a specialty, it needs to be a twelve-month preceptorship.
And then she went on to Liverpool then to do an induction programme, which was a ten-week
placement.
BM: Do you know in the period we're looking at, say from 2010 to 2015, roughly when she would have
done that ten-week placement?
EP: It's usually done within 12 months that they'd been on the unit because sometimes they're not
suited, they don't know that that's not for them, so they move on, and therefore the investment in
doing the induction programme wouldn't be worthwhile. So they need to show that they've got a keen
interest before they go on these programmes. So they have the preceptorship, they actually pass
them through to go on the induction programme, and then that will have taken them to the first
12/18 months' time on the unit.
BM: Right. And through that period, she was, so far as you could see, committed to what she was
doing?
EP: She certainly was, yes.
BM: And she wanted to develop in her progress as a nurse; is that correct?
EP: Yes, she was.
BM: Did she eventually go on what we've heard is the qualified in specialisation course, QIS?
EP: She did.
BM: Is that what qualifies a nurse so that he or she can then look after the intensive care
babies?
EP: It is.
BM: And they're the most poorly babies on the unit?
EP: That's right.
BM: And was that something she qualified in during 2015?
EP: I can't be sure of the timeline.
BM: But that, again, is a particular course that she had to go on; is that right?
EP: She has to, yes.
BM: And was that at Liverpool Women's Hospital --
EP: Again, yes.
BM: -- as well? And Liverpool Women's Hospital, is that what's called a tertiary unit?
EP: It's a level 3.
BM: A level 3?
EP: Yes.
BM: So that deals with the most intensive, prolonged level of care for babies?
EP: And the most premature.
BM: And the most premature?
EP: Yes.
BM: In terms of the work Ms Letby did, and I'm looking particularly at the period we're looking at
in this case, 2015 into 2016, is she one of the nurses who, as it happens, did do a lot of the
work with the intensive care babies on the neonatal unit?
EP: I can't remember exactly for that time. She must have done 11, 12, 13 -- yes, she would have
done, yes.
BM: Because she'd got her QIS qualification --
EP: She was (sic), yes.
BM: And did she strike you as somebody who was very hard-working and flexible in terms of
shifts?
EP: Yes, she was. Extraordinarily so.
BM: And that meant, I'm going to suggest, and ask you if this is right, that she ended up looking
after the intensive care aspect of the babies very often?
EP: Yes, she did, and certainly there was a swing sometimes between the intensive and high
dependency and vice versa.
BM: Yes.
EP: Because even though they step down to high dependency, they can as easily become high -- um,
intensive care, you know, until they stabilise enough --
BM: Yes.
EP: -- to actually become special care.
BM: And throughout that period, from what you could see, her standards remained as high as --
EP: Yes.
BM: -- you could have hoped for?
EP: Yes.
BM: And so did her commitment?
EP: It was indeed. As I have mentioned, she was very particular and -- attention to detail.
BM: We know that in or around April 2016, Ms Letby was moved in general to day shifts.
EP: Yes.
BM: We see, in fact, she also did cover night shifts from time to time, but most of the shifts
were day shifts; is that right?
EP: Yes, it was.
BM: Now, that was after a time when there had been a number of deaths on the unit, hadn't
there?
EP: There was.
BM: And Ms Letby had been identified as someone who'd been on duty and present at a number of
those deaths, hadn't she?
EP: She had.
BM: So that we all understand the reason for the shift at that point, was the purpose of that to
give her some more support by putting her on the day shifts?
EP: Yes.
BM: It wasn't meant to be a punishment of some sort?
EP: No.
BM: And why was going on to the day shifts something which would give her more support? What was
the difference?
EP: Well, because there were more people about to be able to support her. There were the
opportunities for debriefs with the consultants and the other doctors to sort of help at that
time. There were also debriefs 10 days later. There were opportunities for some HR support,
occupational support, you know. So there was, in the daytime, better opportunities for her.
BM: That sort of support?
EP: That's right.
BM: But, as it happens, the unit remained busy, didn't it --
EP: It did.
BM: -- in terms of babies?
EP: Yes.
BM: And she was still required from time to time to work at night, as it happens, wasn't she?
EP: I believe so, but I'm -- I can't be specific.
BM: I'm not going to ask you to recall particular shifts, Mrs Powell. Thank you.
Moving on from there --
EP: Yes.
BM: -- we know Ms Letby was moved to a non-clinical role --
EP: Yes.
BM: -- in early July 2016?
EP: Yes.
BM: I'm going to ask you some questions about that.
EP: Okay.
BM: That was a role working in a different part of the hospital, in an office-based role; is that
correct?
EP: It was.
BM: And did that happen round about the time of her return from annual leave in 2016? Do you
recall that?
EP: I don't recall.
BM: We've got a couple of emails. I'm going to show you the first one. Tab 226, please, Mr Murphy.
We're going to see it says from Yvonne Griffiths, but if we just go right down to the bottom of
this, can see it's:
"Kindest regards, Eirian Lloyd Powell."
EP: Yes.
BM: Which is you, isn't it? This is Friday, 15 July 2016 at 11.16. I'll read it through, if I may,
but with your name at the end of it, do we presume you must have sent this out and under the
Yvonne Griffiths email?
EP: No, Yvonne would have sent it out under my email.
BM: Under yours?
EP: Yes.
BM: Can I read it to see if you're familiar with it:
"Hi everyone. In preparation for the external review, it has been decided that all members of
staff need to undertake a period of clinical supervision. Due to our staffing issues, it has been
difficult to determine how we undertake this process. We can only support one member of staff at a
time, therefore we have decided that it would be useful to commence with staff who have been
involved in many of the acute events, facilitating a supportive role to each individual.
"Therefore Lucy has agreed to undergo this supervision first, commencing on Monday, 18 July 2016. I appreciate that this process may be an added stress factor in an already emotive environment, but we need to ensure that we can assure a safe environment in addition to safeguarding not only our babies but our staff. This is not meant to be a blame or a competency issue, but a way forward to ensure that our practice is safe. It will probably be developed into a competence-based programme to be undertaken every 2 to 3 years in line with our mandatory update training."
It's signed off in your name, but you recall, or you believe, by Yvonne Griffiths?
EP: That could have been me doing it and asking her to check it over, yes.
BM: Right. Now, this coincides with a period, roughly, that Lucy Letby was taken off the unit and
put on non-clinical duties, doesn't it?
EP: Yes.
BM: And, in fact, was it explained to Ms Letby, certainly at the outset, that competencies would
be reviewed across the staff generally and she would be the first?
EP: Yes.
BM: She did actually become quite upset at being removed, didn't she?
EP: She did.
BM: And as it appeared that competencies were in question she became more upset, didn't she?
EP: I don't recall the exact timing. I just think it was upsetting that she was being removed.
BM: Yes. Was she in due course told that her competencies would be reviewed or tested?
EP: No, it's just that she had to go through the competencies to come back on the unit.
BM: That's what she was told?
EP: Yes.
BM: Now, in fact, was this something which, in reality, was taking place only with Lucy Letby or
was it --
EP: At that time, yes.
BM: At that time.
EP: Yes.
BM: And was it something which took place also because there were doctors on the unit who wanted
her to be removed from it as well? Was that part of what lay behind this?
EP: Um... At that time -- what time are we discussing, July?
BM: This is July 2016, yes.
EP: So that was after June. Yes, I believe that one -- yeah.
BM: I'm not going to ask for specific details, but just to keep pace with where we are with
everything.
EP: Right.
BM: Now, as part of what was happening with Ms Letby was there a meeting that was held with Sian
Williams, a lady called Sian Williams?
EP: Yes.
BM: And to assist everybody, Sian Williams was the Deputy Director of Nursing at the Countess of
Chester.
EP: Yes.
BM: And that's a meeting I'm going to ask you about that took place again in early July 2016.
EP: Yes.
BM: Round about the time of --
EP: Yes.
BM: -- we're looking at now.
EP: I have got a timeline on my computer, so -- but I have no access to it. Not my computer, my
work's computer.
BM: It's the period that we're looking at, so I think that will be all right. If we do need to
look at it, we can. There was a meeting that took place with Sian Williams at about this time.
EP: Yes.
BM: I'm going to suggest to you one of the things that happened was that Sian Williams told Lucy
Letby not to talk to other staff members about what was taking place with reviewing her
competencies. Do you recall anything like that?
EP: I don't recall that, no.
BM: Do you recall that Sian Williams wanted to create the impression that what was taking place
with Lucy Letby was voluntary, although Lucy Letby didn't actually want to do this? Do you
remember something like that taking place?
EP: Um... I remember the meeting was very upsetting and certainly for Lucy and myself.
BM: Yes.
EP: I can't remember the actual details. I know it was suggested that she needed to come off.
BM: Was she told that she wasn't to be talking about what was taking place with her with other
members of staff?
EP: I don't recall that, but then I don't recall very much of that meeting --
BM: All right.
EP: -- other than we were both quite upset because we went to HR straight after that.
BM: Again, tell us if you can recall this or not, but I'm going to suggest that it was made plain
that there were a couple of people who she got support from, who she could talk about these things
with, but not with everybody. Do you recall something like that being said?
EP: No.
BM: Anything about Minna Lappalainen and [Nurse E] and [Dr A] being people she could have -- speak
with about what was taking place?
EP: No, I don't. I don't remember it.
BM: But was Ms Letby upset --
EP: Yes.
BM: -- at what was taking place?
EP: Yes, very.
BM: And she didn't want --
EP: I remember that.
BM: -- to come off the unit and be treated --
EP: Well, I don't think --
BM: -- in this way?
EP: -- she had much choice because she was distraught at that point.
BM: And that's it. She didn't have much choice, did she? She was being told what she was going to
have to do?
EP: Yes.
BM: Yes, and that made her more upset as well, didn't it?
EP: Well, I think she was upset by the -- what was said in the meeting, you know.
BM: And was that that there was a problem with her practice?
EP: Not necessarily practice, but what was suggested.
BM: That she was responsible for things that had happened?
EP: Yes.
BM: Yes, and she was upset?
EP: Very.
BM: Can we go forwards to another email that was sent, please, Mrs Powell.
It's at tile 263, Mr Murphy, on the post-indictment schedule.
Again, this is an email that says "from Eirian Powell" and it's dated --
EP: And that would be -- yeah.
BM: That's you?
EP: Yes.
BM: Tuesday, 9 August 2016 at 14.19 hours:
"Dear all. There are currently opportunities for staff to apply for secondments throughout the
trust. It has therefore come at an opportune time for us and we were able to facilitate this for
Lucy. Lucy is currently seconded to the Risk and Patient Safety Office for a period of 3 months.
Laura is currently seconded to the haemodialysis unit and will be returning in November 2016.
Should anyone have an interest in other areas, please discuss this further during your appraisal
or come to me directly."
EP: Yes.
BM: We can see we've moved forward to August 2016 at this point. The email talks about this
opportunity coming at an opportune time and it was possible to facilitate this for Lucy. Do you
see that?
EP: Yes.
BM: Was the reality in fact that it wasn't really something she had picked to do, it was something
she was being compelled to do, wasn't it?
EP: Yes.
BM: And that was something that upset her as well, wasn't it?
EP: I don't know whether she was upset about this email, sorry.
BM: She was upset during this period?
EP: Yes.
BM: And increasingly so as she learnt some of the things that were being said about her; is that
right?
EP: Yes.
BM: And the kind of allegations that were being made?
EP: Okay, yes.
BM: Do you agree with that?
EP: Yes, I agree.
BM: Do you recall whether anybody else was taken to have their competencies reviewed or looked at
again in the way Lucy was or is it something that only happened to Lucy Letby?
EP: Well, it was because in the midst of all that was going on at that moment and everybody has
their competencies reviewed.
BM: Yes, all right.
EP: But not to that degree, because we were trying to get Lucy back on the unit, so we had to try
and prove that the competency issue wasn't the problem.
BM: And not with those sort of things being said about them by other people?
EP: No.
MR MYERS: All right. Thank you, Mrs Powell. That's what I wanted to deal with.
Re-examination by MR JOHNSON
MR JOHNSON: Just two issues I'd like to ask you about, Mrs Powell, and I just want to accurately remind you of a couple of the things that you've just said, first of all.
First of all, you were -- do you remember at the beginning of the evidence you were being asked
about Lucy Letby's training and her commitment?
EP: Yes.
NJ: You were asked this question:
"And throughout that period, from what you could see, her standards remained as high as --"
And you said "yes".
"-- you could have hoped for", said Mr Myers.
And you said "yes".
Then this was said to you:
"And so did her commitment?"
And you replied:
"It was indeed. As I have mentioned, she was very particular -- and attention to detail."
Was she a very competent nurse?
EP: Yes, she was.
NJ: Did she make mistakes?
EP: Like everybody makes mistakes, and she was very good at reporting her mistakes as well as her
colleagues' and indeed her friends'. It made no difference: a mistake was a mistake, no matter how
small it was. She was very good to relay them.
MR JUSTICE GOSS: Carry on.
MR MYERS: You said something about reporting her colleagues and her friends as well.
EP: Yes.
MR JUSTICE GOSS: I was just going to clarify that.
So she would report any mistake that she made?
EP: Yes.
MR JUSTICE GOSS: And she would report any mistake that any other --
EP: Yes.
MR JUSTICE GOSS: -- nurse practitioner made?
EP: Yes, irrespective of the seniority or whatever, it was an error, and she would also ensure that
she would see me, when I'd come on, to explain what had happened.
MR JUSTICE GOSS: What about medical staff?
EP: Yes, it wouldn't matter.
MR JUSTICE GOSS: It didn't matter? Nurse, doctor, she'd report them?
EP: Yes, it didn't matter.
MR JOHNSON: Later in the questioning, you were asked about Lucy Letby being upset at being moved.
Do you remember that series of questions?
EP: Yes.
NJ: You said:
"I remember that. I don't think she had much choice because she was distraught at that point."
EP: She was.
NJ: And it was said to you:
"Question: She didn't have much choice, did she?
"Answer: Yes.
"Question: That made her more upset as well, didn't it?
"Answer: "I think she was upset by the -- what was said in the meeting."
EP: That we were in.
NJ: Yes.
EP: Yes.
NJ: What was said at the meeting?
EP: Well, that she would have to come off the unit and I just -- honestly, I cannot remember what
Sian actually said.
NJ: The next question that was put to you:
"Question: "And was that that there was a problem with her practice?"
"Answer: Not necessarily practice, but what was suggested."
Then Mr Myers said to you:
"Question: That she was responsible for things that had happened?"
And you agreed with that. What was being suggested?
EP: Well, that she was the predominant -- no, she was the commonality within all the deaths that
were there. That's all I could say.
NJ: When you agreed with what was put to you by Mr Myers, that she was responsible for things that
had happened, and you said yes, what was being suggested?
EP: Well, there was nothing suggested.
NJ: So you should have answered, what, "no" to that question?
EP: Okay.
NJ: Well, I don't know. I'm asking you.
EP: I don't know. It was just that that was the decisions that the heads had made.
NJ: What was it that was upsetting her, Mrs Powell?
EP: That she thought that she'd caused the deaths of the children that were involved, that were in
the report that I'd actually compiled.
MR JOHNSON: Thank you. Does your Lordship have any questions?
MR JUSTICE GOSS: No, I don't, thank you very much.
Thank you, Mrs Powell, for coming back and giving evidence again. That completes your evidence and you're free to go. Thank you.
(The witness withdrew)
MR JOHNSON: My Lord, I'm going to ask for a slightly extended break, please, so we can resolve a few issues between us.
MR JUSTICE GOSS: Yes. Just so that we can have, if possible, some update as to timetable, because days are increasingly precious.
MR JOHNSON: Oh yes.
MR JUSTICE GOSS: They're always precious, but we've seen there are unavoidable circumstances which mean that we're going to have a bit of a sporadic run from now on. Is it anticipated that the prosecution evidence will end today?
MR JOHNSON: Yes.
MR JUSTICE GOSS: Right. So we will reach that stage. There you are. On that note, we will break off now. How long would you like, Mr Johnson? Don't underestimate the time because there's nothing worse than everyone coming here expecting to start and being told, no, we're delayed and delayed.
MR JOHNSON: 2.30.
MR JUSTICE GOSS: Right. This is in relation to the outstanding evidence?
MR JOHNSON: So the jury knows what's coming, there's no secret, there's some agreed facts and it's literally dotting Is and crossing Ts.
MR JUSTICE GOSS: And checking them. So an hour and a half we're going to have until 2.30, please, ladies and gentlemen. When we do finish today, at whatever time that is, I will give you the revised non-sitting day list for you. Thank you very much.
(In the absence of the jury)
MR MYERS: Only a brief matter, thank you, my Lord. By way of the agreed facts, we anticipate we will have dealt with and cut through a good deal of evidence that would otherwise have come from the police officers. One officer who we had originally intended to have to give evidence was Detective Chief Inspector Hughes, who was the officer in the case originally. In fact, the issues that would have been dealt with in his case have been resolved one way or the other and there is one matter which will remain -- and having considered this with Mr Johnson, remain as a matter of comment, but I want to explain to your Lordship what it is so it doesn't create any surprise for your Lordship when we make it. It's only a small matter.
Your Lordship may recall it was put to Dr Evans by me at an early stage in his evidence that he would have heard about the suspicion of air embolus before he came to write his reports and he was keen to say that that isn't what happened, he got there independently.
It's a contention we make, given the nature of the investigation, that he will have heard about that at some point from someone, whether it's at the NCA or the police. He says he didn't. If Detective Chief Inspector Hughes gave evidence, it's a matter we would put to him, but the view taken -- and we understand this -- is in fact he can hardly account for who might have said what, where or when and there is no way of auditing that at all. It is something that could be said and the evidence from Dr Evans is he didn't say it and our contention is that --
MR JUSTICE GOSS: Unless it's said to him, to the detective chief inspector, that's the only way that he could give direct evidence of that.
MR MYERS: Yes. That would seem to be right. So rather than leaving it in that speculative way with him, it's a matter still that we maintain, it's a matter Dr Evans, in terms of evidence, disagrees with, but it seemed appropriate to let your Lordship -- it remained an issue of contention between us so that the court didn't form the view that we were pursuing something without having -- the prosecution know it's something we would have otherwise put to the officer in the case.
MR JUSTICE GOSS: So what you're saying is you will still make the comment --
MR MYERS: We will.
MR JUSTICE GOSS: -- and address the jury in due course in relation to that aspect --
MR MYERS: Yes.
MR JUSTICE GOSS: -- but that issue has not deliberately been avoided but the fact is (overspeaking) I understand entirely.
MR MYERS: We know -- we have the history of events so far as they're in evidence and we will work with that. But insofar as it can't be said that he can possibly account for who has said what to who or where, it's an artificial exercise, just so your Lordship isn't concerned by it being raised when it might not appear to have been dealt with in evidence, I let your Lordship know now.
MR JUSTICE GOSS: Thank you very much. That's helpful to know.
There is then -- there will come a point when we're going to address the timetable. We may do that this afternoon then --
MR MYERS: Yes, of course.
MR JUSTICE GOSS: -- if that will be convenient when we've completed the evidence for the prosecution. You can then raise matters you want to raise.
MR MYERS: And it may be your Lordship may wish to deal with, I know not, before the jury have departed, in case there's any directions to give to them as to when they might be required again. A matter for your Lordship.
MR JUSTICE GOSS: I will. Thank you very much. Good, thank you. 2.30, please. (1.00 pm)
(The short adjournment) (2.30 pm)
(In the absence of the jury)
MR MYERS: My Lord, we're grateful -- just before the jury come in, we're grateful for the time to finalise the admissions, which has been done. There's one matter which is agreed but will be introduced during the defence case, so that your Lordship is appraised of it, and it relates to additional Facebook searches by the defendant.
That's been reduced to a schedule with some preliminary points as to the nature of those searches. That's all been agreed. There's one or two entries on the schedule to finalise. But the view has been taken, and we understand it, it's better introduced as part of the defence case, so it won't appear in the admissions, but it will be admitted at that stage. Thank you.
MR JUSTICE GOSS: I was anticipating that it would be introduced in some way or another because I was aware of it.
MR MYERS: We've reached agreement, just the final points on the schedule, but otherwise we'll wait for the defence case.
MR JUSTICE GOSS: Thank you very much. I did prepare an updated non-sitting days. As you'll see, I have put "As at 27/04".
MR MYERS: Yes, that's today's non-sitting dates.
MR JUSTICE GOSS: Yes, exactly. All right. Thank you very much. Jury, please.
(In the presence of the jury)
MR JUSTICE GOSS: I think you've been given the updated sheet. You'll see I've put "As at 27/04", today's date. Right, thank you very much. So that's obviously for you to take with you when you leave later this afternoon.
Summary of agreed facts (read)
MR ASTBURY: My Lord, we are moving on to some more agreed facts. Could I ask for the documents to be distributed with the members of the jury.
(Handed)
We've had some agreed facts before, if I can remind everybody, behind divider 3 of jury bundle 1, and they follow sequentially.
My Lord, the admissions numbered 26 to 31 in sections 5 and 6 were read in fact before DC Johnson gave evidence. The jury will remember about the searches, so I don't think there's any reason to read them back into the record unless my Lord would wish me to do.
MR JUSTICE GOSS: No, I don't see any need for that. We can just put those in.
MR ASTBURY: These are just paper copies of what we heard on that particular day. I'm going to pick this up at section 7 if I may and read into the record then once everybody's ready.
Section 7 bears the heading "Interviews under caution and charge".
Number 32. Lucy Letby was interviewed under caution at the western custody suite Chester on the following dates between the following times.
It's represented in a table, my Lord, and it indicates:
Interview 1. 3 July 2018, between 4.10 and 4.20 in the afternoon, 16.10 and 16.20. It contains the
references should they become relevant.
Interview number 2. 3 July. 19.29 to 20.35.
Interview number 3. 4 July. 10.23 to 12.04 hours.
Interview 4. 4 July 2018. 13.41 to 14.17 hours.
Interview number 5. 4 July 2018. 18.54 to 20.08 hours.
Interview number 6 on that date, 4 July, 20.17 to 20.58.
The interviews then continued the next day:
Interview number 7. 5 July 2018. 09.43 to 10.07.
Interview number 8. 5 July. 11.05 to 11.48.
Interview 9. 5 July 2018. 13.15 to 13.44.
Interview number 10. 5 July 2018. 14.25 to 14.49.
Interview number 11. 5 July 2018. 15.34 to 16.26.
Interview number 12. 5 July 2018. 18.05 to 19.14.
My Lord, the jury will notice there's an asterisk next to the reference. That will be explained in a moment.
Interview number 13. 5 July 2018. 20.27 to 20.34, described as a welfare interview.
Moving on:
Interview 14. 10 June 2019. 12.24 to 13.39.
Interview 15. 10 June 2019. 14.41 to 16.14.
Interview 16. 10 June 2019. 18.13 to 19.29.
Interview 17. 10 June 2019. 20.00 hours to 21.03.
The following day, interview 18. 11 June 2019. 13.27 to 13.40 hours.
Interview 19. 11 June 2019. 14.16 to 14.58.
Interview 20. 11 June 2019. 17.44 to 18.36.
Interview 21. 11 June 2019. 19.22 to 20.39.
Interview 22. 11 June 2019. 21.13 to 21.39.
Interview 23. The following day, 12 June 2019. 09.40 to 10.15.
Interview 24. 12 June 2019 between 11.20 and 11.45 hours.
Interview 25. 12 June 2019. 13.36 to 14.00.
Interview 26. 12 June 2019. 15.55 to 16.10.
Then at the end of that particular day, interview 27, 12 June 2019, 16.35 to 16.40, a further welfare interview.
Moving on to the third date of arrest -- sorry, interview 28 on 10 November 2020, 15.56 to 17.38.
Interview 29. 10 November 2020. 20.26 to 21.22. A double asterisk on this occasion, which we'll come to in a moment.
Finally, interview 30 on 11 November 2020 between 10.35 and 11.06 hours.
Admission number 34 or agreed fact number 34:
"At the commencement of each interview (save for after the breaks in the interviews marked star
and double star above when it was not repeated), the defendant was cautioned in the following
terms:
"You do not have to say anything but it may harm your defence if you fail to mention when
questioned something that you later rely on in court. Anything you do say may be given in
evidence."
That she, Ms Letby, was legally represented with her solicitor present throughout and the interviews were visually recorded.
Each and every interview was fully transcribed. The recordings and full transcripts are exhibited in this case.
Finally, agreed fact number 36. The summarised/edited transcripts presented during the trial are accurate reflections of the relevant parts of the above interviews agreed for presentation between, agreed that is, the prosecution and defence.
So that's that section, my Lord.
MR JUSTICE GOSS: Thank you.
MR ASTBURY: We'll move on to some more agreed facts if we may.
MR JUSTICE GOSS: Yes, certainly.
(Handed)
MR ASTBURY: If these can go in divider 3 behind the last set, please. There are some exhibits to show alongside these, so if we pause for a moment while we give Mr Murphy a chance to catch up.
(Pause)
It'll take 5 minutes, I'm sorry. I've got an index for the interviews to hand out, if that doesn't cause too much confusion, and we could to use the time --
MR JUSTICE GOSS: I think we can cope with that.
MR ASTBURY: Thank you, good.
My Lord, in respect of the two interview bundles, as requested, we've done an index.
MR JUSTICE GOSS: That will be helpful. Let's do that. You remember I thought it would be helpful to have for each of the files an index as to where they come. So one for each, I anticipate. Is that right?
MR ASTBURY: Two sheets, one to go in each of the bundles.
(Handed)
(Pause)
MR JUSTICE GOSS: Whilst we're waiting, Mr Astbury, I have a recollection from many months ago, I mean the early part of the trial, when the jury were played video recordings of the neonatal unit and a question arose about when it was that those recordings were taken. I know that a lot of witnesses were asked questions by reference to plans and some of the recordings. I think it was said that you were going to try and find out when the dates were. Does it come in this?
MR ASTBURY: It's in the document, we have remembered, I'm pleased to say. It's 3 October 2021 when we get there. So it was a little late in the piece but that's when it was --
MR JUSTICE GOSS: I hadn't read on through these, but I just thought, whilst we were filling in time, before I forgot -- we have dealt with it?
MR ASTBURY: No, we have incorporated it. Thank you.
MR JUSTICE GOSS: It is a long time ago that we saw those.
MR ASTBURY: Yes. We're nearly there, I'm told. Thank you.
(Pause)
MR ASTBURY: There are a number of exhibits which are mentioned in the admissions, so we thought it best to have them available. I am very grateful to Mr --
MR JUSTICE GOSS: That's absolutely fine.
(Pause)
MR ASTBURY: We thank Mr Murphy for his efforts and we're ready to move on.
We have, hopefully behind divider 3, admission 37, which follows on from our earlier agreed facts, under the heading "Telecommunications" and the sub-heading "Telephone handset".
Number 37. Items seized from 41 Westbourne Road, Chester, in July of 2018, included the following communications device: an HTC One Mini 2 internet-enabled smartphone. The exhibit reference follows, JB31, and of course the date upon which it was seized, 04/07/18.
The digital contents of that exhibit, JB31, have been extracted and stored in a file entitled "JB31 04/07/18 device examination report". This extraction is the source of the relevant WhatsApp, SMS text and Facebook Messenger communications relied upon by the prosecution.
So all those messages, my Lord, we see in the sequence of events charts --
MR JUSTICE GOSS: Have come from that phone?
MR ASTBURY: -- come from that phone.
The images of a thank-you card from the [Babies E & F] family. That exhibit reference is SGO300419-2. And two images in particular, 5300 and 5301, were recovered from the images file on the handset JB31.
I'm going to ask Mr Murphy if he can put up, please, J2462 and the following page, please.
Those two images found on the handset. My Lord, they also appear in the sequence of events chart for the [Babies E & F] family.
Agreed fact number 40. Further analysis of the metadata from these images establishes that they were taken on the same device, JB31, at 03.40 hours on 20 November 2015. The GPS coordinates indicate it was taken in a location in the south corner of the Women and Children's building at the Countess of Chester Hospital.
Can I ask Mr Murphy next, please, to go to J13163. Agreed fact number 41 reads:
"The images of a sympathy card addressed to the [Baby I] family."
And the exhibit reference SGO300419-1 and the images 5292 and 5293 were recovered from the images file on the handset JB31.
If we can maybe look at the second page as well Mr Murphy, thank you.
MR JUSTICE GOSS: That's just an enlargement of the first page. Can we go back to the enlargement on the first page because, for my part, I couldn't read it in the smaller form, just to remind ourselves what it said.
MR ASTBURY: So it's a card addressed to:
"[Mother of Baby I], [Father of Baby I] and family. There are no words to make this time any
easier. It was a real privilege to care for [Baby I] and get to know you as a family, a family who
always put [Baby I] first and did everything possible for her. She will always be a part of your
lives and we will never forget her. Thinking of you today and always. Sorry I cannot be there to
say goodbye."
I think the second image was the other side of the interior of the card, signed "Lots of love, Lucy".
MR JUSTICE GOSS: And that was the day of the funeral, which she couldn't attend?
MR ASTBURY: Yes.
Reading on to agreed fact number 42:
"Further analysis of the metadata from these images establishes that they were taken on the same
device, [that being JB31] at 07.34 hours on 10 November 2015. The GPS coordinates indicate they
were taken in a location in the south corner of the Women's and Children's building at the
Countess of Chester Hospital."
43:
"A full copy of the original and complete extraction has been provided to the defence."
That's the extraction from the entire phone. Under the sub-heading "Facebook and email":
"On the 26th and 27 June 2019, a digital forensic investigator accessed Lucy Letby's Facebook and
email accounts..."
It then gives the address, [redacted]:
"... and downloaded the entire contents of the profile and messages."
My Lord, these are in italics but there's no significance in that. The times and dates of these Facebook searches placed before the jury are accurate. So they're specifically the searches that appear in the sequence of events chart.
Section 9 entitled "Other exhibits":
"The shift rota for Lucy Letby with the exhibit reference KTL14B has been accurately compiled from
the original nursing rotas obtained from the Countess of Chester Hospital for the relevant
period."
Pausing there if I may, that's a document that appears at the front of jury bundle 2. If everyone would like to go to that, please, so we can remind ourselves which document that is.
I think it was left at the front. It should probably be slotted in now to divider 23. It's the coloured chart, my Lord, with shifts on. Thank you, Mr Murphy.
MR JUSTICE GOSS: So you want us to put that in section 23?
MR ASTBURY: 23, I think, which is the next available divider.
MR JUSTICE GOSS: Right, thank you.
(Pause)
MR ASTBURY: I just wonder if Mr Murphy can scroll through the remaining pages so we familiarise ourselves with the contents. We can see June and July of 2015 with the relevant colour coding. Continuing through...
(Pause)
And the last long day shift being 30 June 2016.
Thank you, Mr Murphy.
If we move, please, to agreed fact 47. Can I please distribute the document that this refers to?
(Handed)
The next divider in jury bundle 2, please, for these.
(Pause)
This was shown in the opening, but we'll look at it in a bit more detail now if we may, please.
If everyone keeps it out in front of them, I'll read the admitted fact first, 47:
"The schedule entitled 'Staff presence -- temporal analysis'..."
If I ask Mr Murphy to put it up on the screen. Thank you:
"... is an accurate record of the paediatric medical and nursing staff on duty on the NNU of the
Countess of Chester Hospital at the time and dates of the events under consideration and in this
trial."
If I can ask, please, everybody to look at page 1. It suggests page 3 of 6, but there was a frontispiece, as you've often seen on other exhibits, and we didn't burden you with that.
Looking at this, everybody will see, down the left-hand side of the first column, the events which the prosecution say are significant in this case.
Pausing there, everyone will notice that for [Baby P], near the bottom of that column, there are two entries. You'll notice that the first of those entries was the event that the Crown say is significant the night before his death when he was fed and an X-ray was taken.
Along the top of the document we can see the names of the staff -- and in fact this spreads across pages 1 and 2 because there are so many staff to be considered. In the body of the chart is a cross where the presence of a particular member of staff coincides with the particular incident on the left-hand column.
You will see from page 2 it includes not only nursing staff but doctors and indeed the consultants on the furthest right of the second page.
The Crown suggests it gives an easy representation of who was present and when. The column in light blue shading is the column for Lucy Letby.
The very bottom row gives you a tally of the number of occasions upon which any particular individual was present on the events the Crown rely upon. That's an introduction to pages 1 and 2. You'll have it in your bundle and you can consider that at the appropriate stage as and when it becomes relevant.
If we move to the third page, what's entitled chart 3, it's what's sometimes called a heat map,
described here as:
"A total presence combined staff heat map."
It details each member of the staff under the heading of their job description and, very much in the same way as the row at the bottom of the previous two pages, tallies up presence for those 24 occasions. It shows in descending order of frequency the number of times each member of staff was present.
So concentrating for a moment, as the Crown would invite you to do, on the list of nurses, Lucy Letby appears on all 24 occasions. The next in the list, and there are five of them, appear on seven occasions.
There is, if it assists, in the bottom right a key to show why the colours have been chosen.
So that deals with agreed fact 47 and the associated exhibit.
MR JUSTICE GOSS: So that goes behind divider 24?
MR ASTBURY: Yes, please.
MR JUSTICE GOSS: Which is?
MR ASTBURY: Bundle 2.
MR JUSTICE GOSS: And after that I just have one more divider marked S, I think, S for spare.
MR ASTBURY: Yes. I think it may remain like that for now.
If I can move on to agreed fact 48, please:
"The video presentation of the NNU at the Countess of Chester Hospital [and we have the exhibit
reference for completeness, RC20/21] was recorded on 3 October 2021."
Agreed fact 49:
"The videos of various medical procedures and equipment played for explanatory purposes have been
prepared at the request of the prosecution by medical staff not involved in these proceedings."
My Lord, that covers all of the videos and presentations that we've had.
Moving on, please, to number 50, and could I ask Mr Murphy to put up J26510. The jury will
remember that image, I'm sure, from the [Baby G] case. And the agreed fact reads:
"The photograph annotated by Ailsa Simpson, exhibit reference AS4, was selected from pictures of
the relevant location taken by Ricky Crellin, a crime scene investigator."
If we can move on next, please, to agreed fact 51. I'll ask Mr Murphy to put up image 25368:
"At 9.45 pm on 24 August 2020, CSI Ricky Crellin attended nursery 2 at the NNU within the Countess
of Chester Hospital and took a selection of photographs. Ashleigh Hudson was present and was asked
to set up the cot, room and lighting as she remembered it on 7 September 2015. She having done so,
he [Ricky Crellin] took a series of six images at differing exposures. Ashleigh Hudson was asked
to select which she felt best reflected the lighting on the night in question. She selected the
image subsequently produced in evidence."
Which is this image, my Lord.
Moving on to agreed fact 53, please, could I ask Mr Murphy to put up page J11. Thank you.
This exhibit, CLM2, is:
"The competency assessment for administration via IV lines (exhibit reference CLM2) was obtained
from, amongst other items, Lucy Letby's HR file at the Countess of Chester Hospital."
This was a document that was discussed in the parts of the interview that we heard this morning. I'm going to ask Mr Murphy to take us through page by page and perhaps enlarge it a little to see what the nature of this particular competency involved.
We see the heading:
"Assessment for safe administration of medication by bolus/intermittent administration via a long
line, Broviac line or umbilical venous catheter."
We can see Lucy Letby's name on the top, various other information, including the name of the assessor, who, as she recalled in interview, was [Nurse A].
Scroll down, please, Mr Murphy. Again, everybody can look at this, it'll be on the iPads, my Lord, in due course. One can see the competencies that are required.
(Pause)
Move on, please, Mr Murphy, to the next page.
First of all, the additional boxes.
(Pause)
Could we look at the lower part, which includes the date, please, upon which this was completed?
(Pause)
Thank you. If we could move on to agreed fact 54, please, page J60, Mr Murphy, thank you.
Fact 54 reads:
"The blood transfusion workbook (exhibit reference CLM6) was obtained from, amongst other items,
Lucy Letby's HR file at the Countess of Chester Hospital."
I'll ask again Mr Murphy, please, if you can take us through the document. In particular, the handwritten entries.
So references to when they are used, how they are secured and, the Crown would say, complications of having a UVC or a UAC in situ. There are four complications listed there.
MR JUSTICE GOSS: No, no, that's not strictly accurate. It says:
"Give 4 potential complications of having a UVC/UAC in situ."
And those are the four that have been written in.
MR ASTBURY: If I didn't say that, I'm sorry, that's what I meant to say. Thank you.
Then if we look at the lower part of the form, please, Mr Murphy. Reference there to spotting an air bubble in the line and what to do. Other recommendations about the position of UVC and UAC.
Continue, please. This perhaps is the type of information that can be looked at at leisure. If we scroll through, please. Thank you. Some small handwritten entries on the form.
Thank you, Mr Murphy. We can move on in the document and look at the handwritten entries again, please.
The lower half, please. Thank you.
Further handwritten entries, or certainly tick boxes, further down the form, please.
Again, it appears to have been signed off and there's a date on the right-hand side of the form.
We can move on, please, to agreed fact 55:
"It is agreed that the handwritten notes (exhibit reference PMB8), seized from 41 Westbourne Road,
Chester, on 4 July 2018 are the resuscitation notes written at the time of [Baby M]'s
resuscitation."
Moving on to the next sub-heading, "Swipe data", which everyone will recall appears in some of
the sequence of events charts and not others:
"On 22 April 2021, officers seized a computer base unit with an exhibit reference TTL3, which
records the use of swipe fob entry data for secure access at the Countess of Chester Hospital.
This data was extracted and analysed."
57:
"Insofar as the dates with which this indictment is concerned, the data was limited to periods
between 12 May 2015 and 16 July 2015 and 22 October 2015 until 31 January 2018. There was no data
available for the intervening period."
58:
"Officers also found individual dates within those periods when data was unavailable. However,
where data was available for relevant dates, it accurately appears within the sequence of events
charts."
Finally, moving on to section 10, which is headed "Lucy Letby". Fact number 59:
"Lucy Letby was born on 4 January 1990. She has no criminal convictions, cautions or reprimands
recorded against her."
60:
"The NNU at the Countess of Chester Hospital was reclassified as a level 1 unit on 7 July 2016.
This decision was made by the trust itself."
MR JUSTICE GOSS: Mr Astbury, can I just check? You gave some J numbers there for various documents that Mr Murphy put up on the screen. Can I just confirm, are they on the iPad presentations or not? And if they are -- I see he's nodding.
MR ASTBURY: They're in the post-indictment section and in the additional exhibits, but at the moment I think they just appear with J numbers, so one of our housekeeping tasks is to ensure that the description matches that which has been read out, but that's going to be attended to very soon.
MR JUSTICE GOSS: Right. Well, I don't know whether the jury were making notes of those J numbers but it might help, while you have this document in front of you and it's fresh in your mind, to make a note of these J numbers in case you wish to refer to any of them in due course. So going back to agreed fact 39 on the first page of this section, section 8, telecommunications, 39. The thank-you card from the [Babies E & F] family. You've got the exhibit reference number. The J numbers are J2462 and J2463. Some of you had already written that down, I think.
41, the sympathy card to the [Baby I] family, J13163.
Down to 46. Other exhibits, section 9. The shift rota you've now got in section 23 in your second jury bundle, so I put JB23 there, just to remind you that's where it is.
Over the page, number 47. The schedule entitled "Staff presence -- temporal analysis", CEH16A, that's in JB24.
Halfway down that page, 50. The photograph by Ailsa Simpson that she selected is J26510.
51, a photograph that Ashleigh Hudson selected, J25368.
Over the page, 53, at the top, a competency assessment for administration via IV lines, CLM2, is J11 to J14. I just made the note that that was completed on 31/5/15 (sic).
54, the blood transfusion workbook, CLM6, is J60.
That's it, I think, Mr Astbury.
MR ASTBURY: Yes. Thank you, my Lord.
MR JUSTICE GOSS: Right.
MR ASTBURY: I'm reminded, that was completed 11 May 2016.
MR JUSTICE GOSS: 11 May 2016, yes. Although it was in her HR file, it doesn't actually have her name on it.
MR ASTBURY: No, that's right. It's unsigned by the subject of the training, yes.
My Lord, that concludes the prosecution case.
MR JUSTICE GOSS: Thank you very much, members of the jury. As you anticipated, we were going to complete the prosecution evidence this afternoon, and that stage has now been reached.
Mr Myers, I think -- is the best thing just to have a short break now?
MR MYERS: Yes, my Lord, it is.
MR JUSTICE GOSS: Will 10 minutes be sufficient?
MR MYERS: Maybe we should take 20. There are a couple of matters to consider. Fifteen minutes, just in case we run over, but 10 might be a little short.
MR JUSTICE GOSS: I'll say this will be at least 15 minutes, it may be 20 minutes. The reason for this is I'm trying to make some enquiries to ascertain what happens hereafter and determining when you're going to be required again. All right? This is done in virtually every case, certainly any case of any substance at this stage, at the end of the prosecution evidence before we go any further, and it needs to be done in this case. All right? Thank you very much. So at least 15 minutes.
(In the absence of the jury)
MR MYERS: We're grateful, my Lord, for the current rota of non-sitting days. We keep that in mind.
MR JUSTICE GOSS: Yes.
MR MYERS: Before we proceed, so far as the defence are concerned, there are two matters for the court to deal with. The first one is a matter of law, which I'll provide now to your Lordship, of course, and to the prosecution. I've indicated the general nature of that, but of course they will need time to consider that and respond.
The other matter to be considered, although having discussed this briefly with Mr Johnson, we don't anticipate it will take very long, are any particular arrangements for the court to take to assist Ms Letby with the process of giving evidence. Your Lordship's been provided with a bundle and submissions on that.
MR JUSTICE GOSS: Yes.
MR MYERS: The principal matter to be dealt with before we move to the giving of evidence, which is anticipated by Ms Letby, is the question of no case to answer. So it comes to me to serve that and for my learned friends to consider how long they would need. But it would seem to me at this stage that at the very least that will have to be considered and whatever response they see fit to make wouldn't be capable of resolution alongside the defence argument until tomorrow. So that at least would be required to deal with that matter of law.
It would seem to me it would take at least tomorrow for the court to deal with that and then, looking forwards, if I may, to assist your Lordship -- we're obviously waiting to hear what my learned friends say --
Dealing with the submission will take tomorrow and it's possible could go into Tuesday. Possible.
We don't anticipate that the arrangements concerning Ms Letby's giving evidence would add greatly to the timescale. So that would mean that, depending upon the way matters go and how your Lordship were to determine -- to deliver any ruling that follows, and of course sometimes that can be done quickly with reasons to follow later, howsoever your Lordship determines, the soonest we would come to the start of the defence case and the calling of Ms Letby to give evidence would be this coming Tuesday. That would be the soonest.
There's a possibility, if matters took longer than tomorrow to resolve, or the earliest part of Tuesday, that it may be the next available date would be when her evidence would commence, which would be Friday, 5 May. That's possible.
I just observe this, but it may be there's little we can do about it: naturally, when considering her position and the defence case, and looking at the dates we have, if evidence -- if Ms Letby were to give evidence, which we anticipate would happen, and were that to start on Friday, 5 May, there would then follow in fact a weekend and 3 days, which is a five-day break after the first day of evidence.
Were it possible to avoid that, it seems to me that would be desirable. At the same time I recognise that we have a rather fragmented period ahead of us whatever we do. So maybe we just have to wait to see where we get to when we get there.
MR JUSTICE GOSS: Well, I've been thinking, as you would expect, about this, as we've been losing days. On the basis that the defendant will be giving evidence, her evidence will take some time, will spread over many days, I expect.
MR MYERS: Yes, or weeks.
MR JUSTICE GOSS: Well, exactly. Many days. So I don't think that saying that we're going to have a four-day gap or a five-day gap in fact is prejudicial to anyone because the evidence is going to span a long period in any event.
MR MYERS: Yes.
MR JUSTICE GOSS: Therefore given that we are losing so many days, of necessity, I don't want to lose any more unless it is by reason of necessity. So my inclination at the moment -- I'm not saying this as a final decision but I thought it might help if I expressed my view at this stage and I will hear what Mr Johnson says -- my inclination is that as soon as we are in a position to proceed with the defence case and whatever evidence is called on behalf of the defence, then we start that, even if there's going to be a four-day gap after that.
MR MYERS: Well, I should say, with respectful agreement, that whereas ordinarily that would be something we would strive to avoid, given the inevitability of breaks in the course of Ms Letby's evidence, if that is where we go, whatever we do there are going to be breaks here and there. Therefore, we understand why your Lordship takes the view you do.
To assist as best as we can at this point, it would seem to us that it is unlikely we would start again with the jury until Tuesday.
MR JUSTICE GOSS: That's what I'm thinking at the moment. What I'm thinking, and I will hear from Mr Johnson, but if it's anticipated that essentially tomorrow is going to be taken up with legal argument and discussion about arrangements so far as the defendant giving evidence is concerned, and I can say this to assist you, that I am understanding of the difficulties --
MR MYERS: Thank you.
MR JUSTICE GOSS: -- and there will be accommodation.
MR MYERS: We're grateful for that, my Lord.
MR JUSTICE GOSS: I'm conscious of (a) the situation of the defendant giving evidence in stressful circumstances and there will be breaks and the total period per day will not be what I consider to be excessive.
MR MYERS: We're grateful. We'll deal with that and assist the court when we come to it, but so far as we can assist right now that seems to be the way the timings are with evidence to commence on Tuesday, or possibly Friday if Tuesday is required for any further legal deliberations.
MR JUSTICE GOSS: Yes. In other words, I don't think the discussion about the arrangements will take very long at all.
MR MYERS: We don't think it will either, my Lord.
MR JUSTICE GOSS: I would have thought minutes, frankly.
MR MYERS: Certainly not as long as the size of the bundle might perhaps have otherwise led the court to believe.
MR JUSTICE GOSS: There we are. As I said, I understand what the situation is. I'll hear what Mr Johnson says. Is there anything else you want to say, Mr Myers?
MR MYERS: Not at this stage, no.
MR JUSTICE GOSS: Mr Johnson?
MR JOHNSON: Nothing constructive to contribute, thank you, my Lord.
MR JUSTICE GOSS: I think as far as the jury is concerned, we can say they won't be required tomorrow but they should be prepared to attend, and should attend, on Tuesday --
MR JOHNSON: Yes.
MR JUSTICE GOSS: -- unless tomorrow afternoon they are informed to the contrary.
MR JOHNSON: Yes.
MR JUSTICE GOSS: The usual arrangement with which they're familiar.
MR JOHNSON: Yes. Mr Myers and I have discussed the essential basis, or at least I believe we've discussed the essential basis, of the submission and if we receive something in writing, we'll try and have something in writing with your Lordship by tomorrow morning. Necessarily, given the limited number of hours between now and then, it won't be very long, but it may be all the better for that, because it's a fairly fundamental point.
MR JUSTICE GOSS: Well, let's wait and see. I entirely agree that that's the appropriate way of dealing with it. So that's what I'll do, then: call the jury back and say that they won't be required tomorrow but will, subject to some notification to the contrary, be required on Tuesday.
MR JOHNSON: Yes.
MR JUSTICE GOSS: Good. Thank you very much indeed.
(In the presence of the jury)
MR JUSTICE GOSS: You will recall many months ago when we first met and this case started that I said I would deal with all questions of law that arose. I've got to deal with an issue of law, I can't deal with it this afternoon, it's going to require tomorrow for it to be dealt with. So what I'm saying is that tomorrow you will not be required to attend at court. It will be the start for you of what will be a four-day weekend because it's then Saturday, Sunday and Monday is the first of the three May public holidays.
But you will be required on Tuesday to come back and continue with the trial, unless for some unexpected reason, so I'm saying that in the spirit of optimism, you are notified to the contrary tomorrow afternoon in the usual way that you are if you're told you're not required to come on the next sitting day.
You've got your list here. You know that we're coming up to a period where we are sitting intermittently, essentially, rather consecutively.
So looking at the document, Tuesday will, unless you are notified to the contrary, be a sitting day. Then we have Wednesday and Thursday off. Friday will then be the next sitting day. Then we have another public holiday. Then we've got Monday, Tuesday and that Wednesday off, the 9th and 10th, then we're back on Thursday and so on and so forth. All right?
That's the best I can do. All right? Thank you very much for your patience, your understanding and continued diligent attention to this case and to your responsibilities as jurors in the case, which I remind you, for the umpteenth time: no communication by any means with anyone about anything to do with this case and no research about anyone or anything to do with this case.
Tuesday of next week, please. Thank you very much.
(In the absence of the jury)
MR JOHNSON: Just for the record, my Lord, and to reflect what I understand is the agreed position, it's actually incorporated in the admissions that all the interviews are in in case anything has been edited out that's relevant or becomes relevant, I should say, and the same applies, by an understanding, as I understand it to be, about the Facebook material as well. There's an awful lot of material. There's a schedule to come, but I understand the position that as between us we are agreed that should anything arise in the course of the defendant's evidence that converts something from apparent irrelevance to relevance, then there's no issue about it being referred to.
MR MYERS: That's agreed, of course, my Lord. It goes both ways.
MR JUSTICE GOSS: Exactly. Clearly it's evidence in the case and, if required and if necessary, reference can be made to it, even though it's not directly been referred to at this stage.
MR MYERS: No, we understand.
MR JUSTICE GOSS: Whilst we've been going through those agreed facts in relation to interviews it occurred to me because when I was cross-referencing the summaries of the interviews that were given to the jury, helpfully, at the end of each baby, I realised there were slight, very slight, differences, but that's not in the least bit critical. I think it's very helpful to do it in the way it was done. If I may say so. The jury will appreciate that they've got just a small proportion of the total interviews, which would otherwise run to many volumes.
MR MYERS: Enormous, yes.
MR JUSTICE GOSS: Good.
MR MYERS: We're grateful for the work that's actually gone into them, no criticism, but they were huge to begin with.
MR JUSTICE GOSS: I know. You knew that I was encouraging as much editing as possible and it was on that understanding that they were all in evidence and it was just basically trying to put before the jury what was salient.
MR MYERS: I know certainly Mr Astbury, Mr Maher and Ms Clancy have been heavily involved in reducing them and we are both grateful to them for doing that work.
MR JUSTICE GOSS: I'm very grateful for all the work that's been done.
I'm not going to spend time now going through the proposed arrangements so far as the defendant giving evidence are concerned, I'd rather that we all got your document and started reading that at this stage. But as I've indicated, unless Mr Johnson wants to make any specific representations I'm essentially, so far as timetabling, of the mind that we should have around one-hour slots, then a more substantial than ten-minute break, so that we have essentially in the region of no more than 4 hours a day.
MR MYERS: We'd be grateful for that. We can look at the actual timing when we look at the arrangements, but we were going to ask for something along those lines, my Lord. We'll come to that.
MR JUSTICE GOSS: Exactly. All right, good --
MR MYERS: I should say the submission has now been sent. We are putting together a bundle of documents to assist because certain transcripts are referred to, so we shall put those together and make sure your Lordship and my learned friends have those as quickly as possible, but we certainly didn't want to delay the receipt of the submission itself because it will be plain enough what we're referring to from the submission.
MR JUSTICE GOSS: That's helpful. Thank you very much.
Mr Johnson, as and when, don't worry too much about rushing your response. I'd rather that you were content that you had covered the ground you wanted to cover, not necessarily in as much detail as you may want, but at least address the points you want to make, whatever they may be.
Mr Myers?
MR MYERS: Yes, we would be grateful if we could see Ms Letby now.
MR JUSTICE GOSS: Thank you. The court will sit at 10.30 tomorrow then. (3.43 pm)
(The court adjourned until 10.30 am on Friday, 28 April 2023)