Lucy Letby denied leave to appeal

[Viviennemary]

Just heard on the news Lucy Letby the convicted serial killer has been denied leave to appeal. Good decision I think. She should stay behind bars for the rest of her life.

I thought the point was that they didn't take the readings in isolation. It was the combination with high C-peptide levels plus other factors such as the babies' sudden collapses which were taken into account.

But why did that matter? A baby had abnormally high insulin levels but they never tried to find out why.

@MsCheeryble A C peptide reading would always be read in conjunction with the insulin reading, that’s not what he’s referring to.

What he means is - in isolation from any other evidence. In this case there was no evidence that exogenous insulin was used - as no sample was sent off for testing. There was no forensic evidence the TPN bag had ever been tampered with. Nor did anyone see LL or anyone else tamper with it. The hypoglycemia reported in baby L, for example, is not uncommon in preterm neonates due to their limited glycogen and fat stores, inability to generate new glucose etc.

In contrast with the Victorino Chua case - where clear signs that a TPN bag had been tampered with, and leakage on the floor, was the first piece of evidence. Investigation then found that saline drips and ampoules had been contaminated with insulin.

Incidentally, a nurse Rebecca Leighton was charged in connection with those events, but a further death, after she had been remanded in custody, indicated she was not responsible. If that had not happened, who knows what the outcome would have been.

You say yourself that it would be unethical to experiment to research the effects of air embolism so where would an expert be found to contradict the claims made in the Letby trial?

There is no expertise in this area because it's not possible to ethically research the effects in humans.

When nurses do IV training they are not taught that if you inject X volume of air Y will happen. We are simple taught it's dangerous and not to do it.

I was taught to always "prime the line" which means flushing any connectors or extensions with saline so you don't push air into the vein. But plenty of docs and nurses don't do this. Not really a problem in adults because that amount of air won't do any harm. But in a tiny neonate? Might stressed staff on a busy understaffed ward cut corners and skip this step?

Quite!!!

Science has moved on, yes, but research into air embolism in neonates has not. This 1989 paper is the study the suspicious consultant based his original suspicion on. It is also the study the prosecution based their evidence on. There is no more recent study on this subject, which is why it’s the one they used. It’s truly unsettling how many of you who are up in arms about this article are in the dark about important details like this.

@MsCheeryble to add, the whole rash business absolutely depended upon that 1989 study. Again, the man who wrote that study has stated that the rashes and general presentation of the supposed air embolisms in those babies were not in line with actual air embolism rashes and presentation. So, even though science has moved on since 1989, Dr Jarayam plucked this 1989 study out of the archives in order to find a nefarious explanation for deaths that had, years before, been ruled as natural. Yet, even the man who wrote that 1989 study said this is not in line with his research. That’s very weak.

I've honestly never seen a doctor or nurse not prime a line and all connectors.

I have. They just connect the line and then flush it to make sure it works.

You’ve probably never seen a doctor stick a breathing tube in the oesphagus instead of the trachea & then ignore signs it was incorrectly placed. But that happened in this unit.

They cannot be running a whole giving set worth of air into patients.

I actually have seen that, it went to court. I told the doctor it was in the wrong place but he wouldn't have it. 15 years in ICU I've seen plenty.

I'm not talking about the giving set. I'm talking about the lumen extension. Forcing the air inside that into a tiny baby would be more noticeable than in a fully grown adult. They can't say that the air embolism caused the baby's death. Just that it was present. And they can't say that its presence was because it was intentionally injected by LL or anyone else.

As Mirabai pointed out, a baby was also intubated incorrectly. Yet no one is accusing that doctor of trying to murder that baby. The fact is, that ward was an absolute shambled with many injuries and near misses. If they looked at any other incident that occurred on that ward, they would also be able to make the argument that it was done intentionally if that's what they had decided.

I understand that a much smaller volume of air would be detrimental to a neonate. I accept the unit was a shambles, I was simply responding to your assertion that plenty of doctors and nurses do not prime connectors, that is not my experience and I would describe doing such a thing as wilful malpractice rather than cutting corners.

It is, but nothing is done about it. This stuff happens in poorly run wards. Even on good wards with lazy or unprofessional staff. If you understand the type of ward these babies were on, how unprofessional it was, how understaffed it was, how low morale was, how unsupported people felt, you will see how all these mistakes and injuries can happen in an environment like that. But people don't like to admit to failure. It's much easier and face-saving to find something or someone else to put the blame on.

We don't know if LL intentionally killed these babies or if she was just a cog in the murder machine of a deadly ward.

I never see connectors primed, IV lines of course……although an anaesthetist did once tell me even an iv line worth of air wouldn’t kill an adult I would not want to try it.

She won't be the only one worrying it's a miscarriage of justice. So please don't speak for the rest of us. And you really don't need to speak down to people who have a different opinion than you.

Oh great, the Lucy Fan Club are back.
They were bad enough the first time around.

I think people need to examine their own prejudice and realise just how much their beliefs are centered around looks. The evidence against her is extremely strong, if you bother to find out about it. She’s a murderer, I’m pleased she’ll rot in jail and my only sympathy is with the families of the deceased babies and the (sometimes profoundly disabled) children who managed to survive

This is such a boring non argument. Not a single person here has said they don’t think she’s guilty because of how she looks. Nobody thinks that and it’s totally irrelevant to the questions raised in the New Yorker article, which is what people are actually discussing here. Casually dismissing people’s genuine questions about such a serious matter, as if they have concerns only because she looks nice, is childish and completely unsupported by any of the points that have actually been raised. Fgs.

Have you read the New Yorker article we've been discussing on this thread? You might not be so rock-solid certain about the case then.

Well of course they’re not going to admit it. But to deny that her looking “normal” isn’t a factor in the huge wave of support she’s had is simply obtuse.
If this was a black man, there’d be no fan club who barely bother to find out facts about the case.

Yes, and it’s hugely flawed. I followed the case closely and listened to the podcast which re-enacted the court room discussions and I’m 100% convinced she guilty. The NY article hadn’t changed my mind one bit, because I bothered to actually follow the case in detail

This has already been discussed at length. It has nothing whatsoever to do with the content of the New Yorker article, which is what we are actually discussing. Nobody here has said it. It’s irrelevant. Even if we secretly thought so it is irrelevant. The points raised in the article stand regardless of how pretty or young or white she is. Please stop deflecting from the actual salient points. It’s boring and childish.

I find the “how dare you suggest there might have been a miscarriage of justice when she’s a blond haired young white woman” posts really chilling.

It’s pure projection.

Luckily most people believe justice should be applied fairly to all no matter their age, sex, race or hair colour.