The Lucy Letby case and how the hospital dealt with it

[JamesT]

One thing that really puzzles me. At the trial it was stated that she killed the first baby by injecting air into the veinous system. That could only have been determined by post-mortem examination, not years later when a criminal investigation started.
So if that was known at the time, why wasn't it immediately obvious that there had been a deliberate act that had led to that death and an investigation started then?

https://www.dailymail.co.uk/news/ar...dical-evidence-finally-caught-Lucy-Letby.html mentions X-rays taken at the time:

In two of the cases, Baby A and Baby E, X-rays taken shortly before they died revealed air bubbles in major arteries or veins.

My understanding is that the presence of an air embolism isn't definitive proof foul play has occurred. A mistake with an IV could potentially introduce air into the blood system. Though that would also be potentially something that needed investigating if staff performance wasn't up to standard.

The problem with an investigation after the first death is that as far as I can tell most of the evidence is cumulative, Letby was the only person on the ward during every death.

 

[adc82140]

My understanding is that the presence of an air embolism isn't definitive proof foul play has occurred. A mistake with an IV could potentially introduce air into the blood system. Though that would also be potentially something that needed investigating if staff performance wasn't up to standard.

Injection of an air embolism is certainly a "never event" ie one that should have safeguards in place to ensure it never happens. Whether caused by malevolent behaviour or a genuine error, it should still be the subject of a throrough investigation.

 

[JamesT]

Injection of an air embolism is certainly a "never event" ie one that should have safeguards in place to ensure it never happens. Whether caused by malevolent behaviour or a genuine error, it should still be the subject of a throrough investigation.

Most of the hits I was getting when searching for a natural cause of an air embolism was around divers and the bends. I'm not a medic, so I don't know if there's potentially another 'natural' explanation? If the only way it could have happened is an injection then as I said, there should have been an investigation. Though it's hard to see what an investigation would have found at that stage.

 

[lyndhurst25]

Most of the hits I was getting when searching for a natural cause of an air embolism was around divers and the bends. I'm not a medic, so I don't know if there's potentially another 'natural' explanation? If the only way it could have happened is an injection then as I said, there should have been an investigation. Though it's hard to see what an investigation would have found at that stage.

Air embolism can be a complication of mechanically assisted breathing.

Air embolism in the newborn: rare complication of intensive care therapy in children - PubMed

Systemic air embolism in neonates, either premature or full term, necessitating mechanical ventilation is a devastating and usually fatal condition. We describe three cases of this complication, two in mechanically assisted preterm babies, and one in a full-term dysmorphic patient. Causes and...

pubmed.ncbi.nlm.nih.gov