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 find that concerning re the lab results then as could it have been residual c peptide from prescribed insulin ? How long is it in the body can it vary ?

The New Yorker article was interesting and did raise some good points, especially the bits about other baby deaths being left out & the high deaths in the maternity ward as well as the baby unit, but I still think she did it.

What really stood out for me from following the trial-

The testimony of Baby E's mum, she walked in on LL harming her child. She knew what time it happened because of phone records, yet LL tried to change the time of the visit and recorded it differently.

LL's texts to other people, moaning about looking after the less needy babies and wanting to be with the more interesting ones in nursery 1.

She also really seemed to love the attention she got from all the deaths / incidents. That is what I think her motivation was. She wanted everyone to see what a great nurse she was and praise her for it.

Also with regards to her putting insulin in a random TPN bag I don't think she did. I think she put it in the bag baby F was already attached to before she went home. When she wasn't there and the line was tissued, the line and the bag were supposed to be changed, as that is standard practice, but for some reason they only changed the line but not the bag. The staff were overworked and there wasn't always enough of them so it could have happened quite easily but the staff didn't remember that when they were questioned over it years later. Obviously this can't be proved but it seems likely to me.

I don’t have a firm position on either side yet, but I do think there are very real questions to be asked of this case and of the trial.

That said, there’s a version of this which doesn’t involve an active cover up. I think it’s possible that a doctor in a hospital that is coming under scrutiny, especially a doctor with a TV career, might see that one nurse is on shift for many of these incidents. Could she be causing the deaths? Is it not in fact our incompetence? That doctor might want this to be what’s happening, because it takes the heat off him/his fellow doctors/the hospital.

Once that accusation is made it snowballs. It’s a big dramatic emotive story and it offers comfort to many who otherwise feel that their jobs or reputations are at stake. On an individual level, if everyone else is saying it, then it might well be true.

Once you involve the police, whose job it is to find a culprit for a crime, not to say that no crime occurred, it takes on a life of its own. Once it gathers speed it becomes impossible to voice doubts because, as seen in a small way in this very thread, you’ll be smeared as a “baby killer fan”.

I think the way that this evolved could be complex and subtle and insidious. I think that version is perfectly plausible. If Letby has been wrongly convicted it doesn’t require a ‘gang of four’ in capes conspiring in dark corners to put an innocent woman away. All it needs is a misunderstanding of statistics and an emotional/financial/personal investment in her being guilty. You can believe absolutely anything if it’ll benefit you to do so.

6% is clearly now out of date.

@TeaOrCoffeeOrHotChocolate
She also really seemed to love the attention she got from all the deaths / incidents. That is what I think her motivation was. She wanted everyone to see what a great nurse she was and praise her for it.

Wouldn't she have already got that from actually doing her job? It seems everyone thought she was a great nurse before that. No doubt she also got a lot of praise and gratitude from the parents of the babies who were in NICU and ended up leaving after an uneventful time there, or for those who naturally had dips and turns.

It doesn't really add up to say that you think her motivation was that she loved the attention she got from all the deaths/incidents, but that also she wanted everyone to see her as a great nurse and praise her. You're not going to be seen as a great nurse if many of the babies you are looking after keep dying. You're going to be seen as incompetent at best.

Also was she even starved of attention in the first place? As she seemed to live, eat and breath work I would imagine she got plenty of attention and praise as it was.

Legal aid don't just award a certain amount of money, the defence are paid for the case type, indictment, how many trial days, pages of prosecution evidence that they have had to go through and all sorts of other things, usually they LAA add it all up when the case has concluded but in cases like this they can apply for an interim payment .

Expert witness are applied for separately , the money quoted by the LAA is just for the solicitors and barristers

*And the defence offered very little in response, presumably because the witnesses they had lined up were likely to end up damaging rather than strengthening her case.
*
Why are you ‘presuming’ this? There is no reason at all to presume this. There are potentially dozens of reasons why they didn’t, or couldn’t, present certain witnesses. It is possible that they were blocked from doing so for a labyrinthine legal reason that has not yet been shared with us, to give one possible example.

I'm presuming this because it seems to me incredibly unlikely that in a trial of this gravity, scale and profile the defence would have been blocked for dozens of potentially 'labyrinthine' legal reasons from proffering any witnesses (other than the defendant and a plumber) without that in itself forming part of the defence's case.

I agree she thrived on all the drama of the babies getting seriously ill and dying . And all the drama of the grief of the parents. I have no doubt about her guilt. Similar to Beverly Allit. Another nurse murderer.

My thoughts too re- on the fence but leaning towards innocent.

Also look at the news in the last week about the transfused blood scandal from 30 years ago.

This: “I'm presuming this because it seems to me incredibly unlikely that in a trial of this gravity, scale and profile the defence would have been blocked for dozens of potentially 'labyrinthine' legal reasons from proffering any witnesses (other than the defendant and a plumber) without that in itself forming part of the defence's case.”

Is a completely different point to this, your first statement: “And the defence offered very little in response, presumably because the witnesses they had lined up were likely to end up damaging rather than strengthening her case.”

We can agree that there may be a labyrinthine legal reason why they did not call expert witnesses. That’s in no way the same thing as not calling witnesses because witnesses were likely to damage, rather than strengthen, the defence’s case.

@Kittybythelighthouse I don't think it's a different point at all? I'm saying that if the defence had thought it was a good idea they would have put forward more witnesses, and that I very much doubt they were legally blocked from doing so to the extent that they were then left with only the defendant and a plumber.

They were given fast acting insulin a week earlier which is daily normal for babies born that prematurely he’d been managing his blood sugars on his own for a week right up until about 1/2 an hour after the TPN bag was hooked up.

Even if he had been prescribed insulin at the time it’s never given via the TPN bag.

The only points where his blood sugar levels came back up were when the TPN bag was removed due to the line tissuing and when it was removed again in the late afternoon. That’s despite being given huge amounts of dextrose to bring them back up. When the TPN bags were stopped totally he was fine within 2 hrs and has had no issues since.

When taken with the test that showed high levels of insulin and no c-peptide which indicates synthetic insulin the most logical conclusion is the bag was spiked. Nothing else really makes any sense.

That is a different point entirely. A labyrinthine legal reason that disallowed them from calling certain witnesses would be something handed down by the court. This happens. So your actual position is that they didn’t call witnesses because they didn’t think it was a “good idea”? Given that even the most obviously guilty defendant with the worst legal team imaginable will call witnesses of some description this doesn’t hold water. As I say, it’s odd no matter which side you stand on in this case. It’s objectively odd. It certainly doesn’t add to her appearance of being guilty.

You’re overlooking the fact that the lab that returned the insulin test result have explicitly stated that this particular test can return false positives and shouldn’t be relied on forensically. It is merely indicative of the possibility. There is a further more accurate test that should have been taken in this situation, but wasn’t. In addition there was a third baby whose bloods also returned the same result, but this baby was excluded from the case because Letby couldn’t have tampered with that baby’s TPN bag.

So there is another alternative explanation: that none of the babies were poisoned with insulin at all.

And it still doesn't explain why, at the time, no one thought a high insulin level in a baby who was not on insulin warranted any investigation. I've never once in my career not repeated a test after it came back with an unexpected result. There must be a reason why they didn't think it was significant. Maybe they knew this particular test wasn't reliable.

It did warrant an investigation. There was an internal investigation at the time. The result of which was the TPN bag had been tampered with and then they did nothing. Something for which the hospital really should be taken to task about for covering up.

They didn't investigate it until after the fact. I'm talking about the doctor(s) who reviewed the result at the time. Why did they just ignore it? Like I said, the normal thing to do is to repeat the test if the result is unexpected. There will have been a reason they dismissed it rather than repeat to confirm it or send a sample for proper verification.

Given the fact that the lab is explicit in that the test shouldn’t be used forensically and can return false positives, it seems not unlikely that they didn’t take it further at the time because they knew that test in and of itself isn’t definitive. Then the babies got better so they felt there was no need to send the samples for further (more expensive) testing. It’s egregious of course, but it seems likely.

That is a different point entirely. A labyrinthine legal reason that disallowed them from calling certain witnesses would be something handed down by the court. This happens. So your actual position is that they didn’t call witnesses because they didn’t think it was a “good idea”? Given that even the most obviously guilty defendant with the worst legal team imaginable will call witnesses of some description this doesn’t hold water. As I say, it’s odd no matter which side you stand on in this case. It’s objectively odd. It certainly doesn’t add to her appearance of being guilty.

@Kittybythelighthouse It's really not a different point. Firstly, I'm not sure why you're referring to 'labyrinthine legal reason' as if that's a thing rather than a plain old legal reason. And as per my original point I believe that if the defence had been disallowed by the court for calling any witnesses other than the defendant and plumber then there would have been some reference to that as part of the defence case. Equality of arms is a key tenet of English law and both parties should be afforded a fair balance of opportunities to make their case.

Secondly, it's really not that unusual for a defence to call no witnesses. Particularly if as a strategy they are primarily intending to rely on the jury being unable to be sure of the defendant's guilt. So yes, it is my actual position that the defence didn't think it was 'a good idea' to call any other witnesses.

I say labyrinthine because many decisions based on “plain old legal reason” are, in fact, labyrinthine. By necessity, often, but still labyrinthine and in any case unknown to us.

Your second point implies a lack of foresight and due diligence on the part of the defence. Again, proof of nothing but a weak defence.

Whether you feel no witnesses were called because of a weak defence or because there was an unknown reason why witnesses were disallowed, the result is not further proof of her guilt. It’s just further proof of an unfair trial, if anything.

Whether you feel no witnesses were called because of a weak defence or because there was an unknown reason why witnesses were disallowed, the result is not further proof of her guilt. It’s just further proof of an unfair trial, if anything.

I really don't see how having a weak defence means it is inevitably an unfair trial. It is for the prosecution to prove their case, not the defence (and obviously if a defendant is guilty then of course their defence will be weak..). However, I am also very sure that if the defence had had the sort of prize/mic drop witnesses it was suggested earlier in this thread had been withheld, then they would have used them.

Nope. There was no evidence that a TPN bag was ever tampered with. No TPN bags were tested or retained. The doctors at the time sent off the blood test, but they did not pursue a further test to establish the presence of exogenous insulin.

The anomalous insulin levels were not revisited until by Dewi Evans later on.

Also wasn't the level of 4657 pmol/L extremely dangerously high? If a result was extremely dangerous high then shouldn't it almost certainly have been tested again properly? If it wasn't that surely shows that they thought that the reading wasn't possible?

Baby F had been prescribed insulin on 31 July, so 5 days prior. He was being treated for respiratory distress and suspected sepsis.

It is not true that the blood glucose only came back up to normal when the TPN bags were removed. It fluctuated throughout the day, rising at several points, before rising definitively in the evening. This may not have anything to do with the TPN bag.

There are other causes of a hyperinsulin reading other than exogenous insulin - eg presence of insulin antibodies, infection, adrenal suppression, liver problems. The test also cannot be considered reliable in the presence of CKD, some drugs, alcohol, or of course issues around testing, storage, processing.

Poor representation from the defence is one of the potential grounds for an appeal.

It's interesting to me that Letby seemed to use the same team to apply for the appeal though. But then I wonder if she is able to speak to others. From the New Yorker it seems that it's very difficult to contact her. I don't think an immediate appeal would have been successful anyway. If an appeal is successful it will no doubt be with a new team a good few years from now.

Yes technically it's for the prosecution to prove their case, but practically the defense gets them off by picking holes in everything that they possibly can as you well know, even if they are to bring in some expert who points to something unlikely but at least possible.

There would have to have been some experts who could have picked some holes in those theories, yet the defence got no one or else didn't put anyone on the stand. That is extremely worrying. If it's a case that they were afraid to because of the damage to their reputation by giving their honest expert opinion due to the internet age then that is extremely worrying and makes the idea of a fair trial impossible for these high profile cases.

There doesn't need to be mic drop/slam dunk witnesses. Often there isn't. There is just an expert or experts throwing a bit of doubt on the prosecutions expert or experts and that's all they need, a bit of doubt to sow the seed in the jurys mind that the prosecutions experts might be wrong.