The Guardian today on the safety of the Lucy Letby convictions

[Kittybythelighthouse]

This article was apparently months in the making but it was delayed by the reporting restrictions https://www.theguardian.com/uk-news/article/2024/jul/09/lucy-letby-evidence-experts-question

“A Guardian investigation has interviewed dozens of these experts and seen further evidence from emails and documents. Those raising concerns include several leading consultant neonatologists, some with current or recent leadership roles, and several senior neonatal nurses. Others are public health professionals, GPs, biochemists, a leading government microbiologist, and lawyers. Several of those still working in the NHS have asked to remain anonymous, fearing the impact if they are named.

These experts said they were acutely aware of the suffering of the families involved and did not want to reopen their trauma, but were so troubled they felt compelled to become involved”

@samarrange

Did I say it was? The evidence that she is guilty is so complex and convincing that it would take days to discuss.

But if we are looking for a ‘why’ then her controlling behaviour in court is interesting. As is her keeping of trophies in a box under her bed in the form of handover documents and the resuscitation sheets for babies that died. All these things add up to a bigger picture of what she did and why she did it.

I don’t agree, but that’s alright. To me the notes are a red herring anyway. The article isn’t about the notes. It’s about concerns over the evidence for the alleged murder methods.

@Kittybythelighthouse

See, this is how people undermine themselves in debate. You are now saying that you suspect this was pinned to her by the police on purpose. That is quite the accusation.

You do seem to know a lot about the case. How do you think those babies died?

I didn't follow the trial. I've read several news pieces from people who did though, all of whom regard her conviction as safe.

For me the issue is the lack of direct evidence. Nobody saw her do anything to these babies and there could well be other explanations for their deaths. I agree that such a lot of circumstantial evidence would indicate her involvement but I don’t know if it’s enough for a conviction.

If you see ‘they went’, that’s fine. But the way you wrote it implied that it’s been accepted it says ‘they went’, which is misleading.

Yep, and one of the handover sheets was kept pristine in its own special box, so the handover sheets did seem to have significant meaning for her.

@MistressoftheDarkSide

Operation Hummingbird are looking at every patient she ever worked with. Serial killers escalate. Some are product killers who are looking to create something to play with and some are process killers.

The assumption about Lucy Letby must be that she came to enjoy the process. I suspect that they are looking for is any other case where she was playing with bringing a victim to the verge of collapse and they were brought back or she was interrupted.

Someone on one of the podcasts made the point that she’s have very little opportunity as a student nurse to be alone with patients.

You are not alone. I've been with my partner for over a decade, but his ex partner and first LTR was absolutely unhinged after we got together, and did some really scary and weird things for the first couple of years we were together.

A couple of times a year I will get morbidly curious and check a SM account she has where she used to post very worrying things on. I check partly out of morbid curiosity and partly for a sort of, I don't know, backwards catharsis to remember those times and process them in a safe way? I also will admit I check to see if the comments or things she is posting suggest there is any resurfacing of that behaviour.

I do agree that objectively there are all sorts of behaviours we all could indulge it which could be framed in a very chilling way if something bad happened.

Things I have been told by doctors and medical experts that contradict each other in relation to newborns:

"If you cause a baby a fracture like this it would be screaming it's head off"

"Babies don't feel pain in the same way so you might not know if they have a fracture"

"It can't be brittle bones because calcium levels are normal"

"OI is vanishingly rare"

"It is possible to diagnose child abuse by X-ray alone"

"It doesn't matter if numbers of fractures aren't accurate"

So yes, I do think medical evidence needs far more scrutiny in this case, personally.

It's horrific. Absolutely horrific.

The one thing that struck me at the time of her arrest was her Mum saying take me, I did it.
And her Dad calmly making her bed after she was arrested.

Just my own opinion, but neither of those reactions scream (and you would be screaming) my daughter isn't capable of this.

If people want to understand the conviction then they need to stop thinking of this case as hanging on one or two pieces of evidence. It’s not the doctor’s word against hers, nor is it all about the time sheets or Dewi Evans

It’s medical record + timesheets + expert opinions + handover sheets + the diary + hospital statistics + testimony from other doctors, nurses and parents + a load of other things. They all point to her.

I think its possible to think someone deliberately harmed babies on that unit because the evidence for that is overwhelming. Patients in inpatient settings do tend to behave with a high degree of predictability, so clusters of unexpected deteriorations in otherwise stable patients would be very alarming in any setting. The Guardian article implies the RCPCH report in 2017 attributed the deaths to understaffing. It did not. It explicitly found the deaths could not be explained and each needed to be investigated individually. It also found the unit was understaffed, but it did not suggest this caused the children's deaths.

So we have a strong picture BEFORE anyone goes to the police that unexplained deaths are happening on the ward and independent experts agree.

The police, when investigating, are not told of the internal suspicions re Lucy Letby. They are told there are unexplained deaths and they need to investigate as no natural explanation has been found.

They identify Letby as a suspect, investigate and charge her.

There is a deliberate decision NOT to admit statistical evidence at trial re the conditional probability that Letby is the culprit based on the relative frequency she is on shift versus other members of staff. This is because evidence of this nature, when used in other cases, has lead to miscarriages of justice because it can be so easily distorted if we do not assess the underlying true frequency of an event. Sally Clark is the obvious example. Each of her children's deaths was treated as an independent event, thus leading to an assessment that the likelihood of all three events occurring within one household was many million to one against. In fact they had the same genetic cause, meaning once we had established the cause of death one, deaths two and three were much more rather than less likely to be natural. The RCS produced a huge report on admissability of statistical evidence at the time.

The relevance of the shift pattern data is thus that it proves Letby COULD have committed the offences, not that she was the ONLY person who could have done it (although that is possible) or that it is more likely to be her than anyone else. To have any chance of proving its case the prosecution had to place Letby at the scene.

They then have to prove the deaths are not natural and make a case as to what caused them. The defence did not adduce alternative evidence on this at trial. In fact Letby agreed in oral evidence that the children killed with insulin poisoning must have died as a result of insulin poisoning albeit not by her.

Finally they have to prove Letby committed the killings. There the evidence is hazy and circumstantial, based on parents and colleagues recollections of her behaviour at the time, as well as things like the handover sheets, diary entries and facebook searches.

The recollections of witnesses I think are good evidence but inconsistent in demonstrating Letby's guilt - we have witnesses saying she was not responding to desaturation fast enough, or her demeanour seemed odd. But these things are easily distorted by hindsight. Of course this would all be trivial if anyone had caught her in the act of injecting insulin into a feeding line so its the best evidence we can gain as to her behaviour and the jury are entitled to assess it and the defence can present an alternative innocent explanation for it, which they did fairly well.

The documents used to suggest her guilt I have misgivings about. They are given to the jury on the basis the jury as ordinary members of the public can assess how likely it is or is not that an innocent person would write that diary entry or search for patients online. But that's actually really hard to know. The fact taking handover sheets home is bad practice won't make it uncommon. The fact her diary contains statements indicating distress or confusion doesn't seem to me conclusive either way. I am a HCP, in another field entirely. I am afraid some of my colleagues do facebook stalk patients. It isn't technically unlawful, or even prohibited in codes of practice for our professions. In supervision or team meetings where it has come up I strongly discourage it as inappropriate. I don't know what to conclude about the fact Letby searched for bereaved parents online but it does not suggest guilt or innocence to me.

I don't think any of us can know what we would have decided on that jury. But the fact remains, babies born between 28-32 weeks in special care are usually stable and just waiting for their lungs to reach sufficient maturity for them to go home. I have not seen any expert offer an explanation for why 13 of them died in a year at CoC and the Guardian does not offer any explanation for this either.

In the case of Child K, not only did Letby just stand there, someone had actually disabled the alarm. So all the factors add up:

1. Alarm deliberately turned off by someone
2. Lucy just standing there and not helping or calling for help when help is very near
3. A 692 grams baby sedated with morphine having had their breathing tube dislodged, which is just not possible for baby to do by themselves

It's cumulative.

Yes, this. I don't know if Lucy Letby is guilty, but anyone with a basic background in statistics (I've lectured on it at university level, have maths degree and quantitative PhD) should be horrified by the obvious misuse of statistics in this trial.

Would it surprise me if many individuals across several different organisations had made erroneous statistical inferences? Not at all.

During the course of a maths or statistics-based degree, one thing almost everyone experiences is the realization that our default statistical intuitions are terrible. This happens through initially getting things wrong and then learning how to get them right. (Google the Monty Hall problem if you want an example of this - it's a mistake that almost everyone makes initially, including maths students at top universities).

Moreover, being rubbish at stats is really commonplace, even among professionals who are supposed to be competent at them. Gerd Gigeranzer, for example, has done some interesting (but depressing) research on statistical competence amongst medics (spoiler: it's really, really poor).

If there was one good thing to come out of this awful trial, it would be a greater public understanding of stuff like this. As well as, perhaps, the definition of a conspiracy theory.

It is natural to want to blame someone when something awful happens - you only have to read the threads about the driver whose car killed the two schoolgirls when she had a seizure and wasn't in control of it.

The families want answers and I can well imagine it suits some, e.g. the hospital, to hold one person rather than systemic, institutional failure responsible.

A very measured response. Absolutely this.

Lucy Letby worked in that NICU without issue for three years before the spike in deaths.

No, she worked on the unit for 3 years, not the NNICU.

(And not for the whole period as she did placements in another hospital).

She didn't qualify to work in the ICU of the unit until 2015.

Well that’s just not true. The media reported:

“ also kept detailed handover sheets relating to 13 of the children she was either killed or hurt.”

“A further 99 contained information on babies she treated while she was working as a student nurse.”

It’s difficult to engage with you as you keep making spurious claims without backing them up with any evidence.

Please read my actual posts. I literally said, 'I have no idea if she's guilty or not'. Not a single one of my posts has claimed innocence or guilt either way, because I don't know. I was pointing out how relying on podcasts as 'fact' was a false resource.

You should read the ones that regard it as unsafe for balance.

The problem with comparing death rates before and after Lucy Letby was removed from the neonatal ward at this hospital is that other things were changed at the same time. The hospital stopped (or was stopped from) accepting very premature babies, since they had never been equipped to do so. Staffing ratios were also improved, as per the Royal College of Paediatric & Child Health (RCPCH) recommendations. So the waters were instantly muddied.
Anyway, to get an idea of the other problems with the prosecution, it's a good idea to read the Guardian article. It is troubling. Another poster wondered why Letby would write "I am evil. I did this." in her diaries. Who knows.
But what if you were innocent of such a hideous charge when everyone else is telling you that you are the only common factor and nothing else explains what has been happening. She could well have been, I would think, very distraught about the accusations and could have begun to doubt herself (essentially the effects of gaslighting - whether deliberate or not). She could have begun to think she must have committed these awful crimes (my twin boys arrived at 30 weeks, and one died aged 15 days in a London NICU ward, so I understand the anguish of everyone involved - I often wonder (reasons) if his care was optimal). But the whole picture painted by New Yorker magazine article and this Guardian article is unsettling, to say the least.

But what you’ve just written is the case. You’ve listed a LOT of ‘coincidental’ factors with ‘yes could be viewed suspiciously, but hard to say…’

Like I said one or two of these items would never have brought the case to court.

There’s a lot of misunderstanding and mistrust of coincidental evidence on here, probably because people watch a lot of ‘smoking gun, true crime’ type stuff on Netflix and expect that surely if a crime has been committed there would be hard and unequivocal evidence to discover.

Remember many crimes have been solved via circumstantial evidence which have received nowhere near the challenging this case has - for instance the conviction of Levi Bellfield relied on the fact his flat was close to the scene of abduction of Milly, and his unusual behaviour in the days after the abduction:

www.bbc.com/news/uk-england-13792659.amp

I appreciate in his case he was already a convicted killer and this in itself will draw inferences, but there still has to be evidence, and like Lucy’s case this was very circumstantial. Would you reopen it?

I would also ask those who value statistics to think about the likelihood of a baby collapsing on its 100th day alive anniversary, followed by collapsing on its due date.

Or a baby being transferred with its prospects considered "optimistic" by medics, collapsing shortly after LL declares to a Dr. that "he's not making it out of here alive, is he?"

Or any of the other e.g. fathers day and imminent discharge collapses.

Even the first example would appear so statistically unlikely as to have to have been "(wo)man-made".

She wrote that she felt responsible for the deaths. "I am evil, I did it". Did what? Failed to deliver optimum care? Deliberately killed them? Was an inadequate nurse?

I've gone home from shifts feeling guilty over things I failed to do for whatever reason. I didn't express my guilt in words and I didn't ever do anything deliberately. I've made mistakes and it was only through good luck that nobody came to harm. Every nurse has! Neonates are extraordinarily fragile. Perhaps Letby was ill suited to such critical type nursing on the most fragile of lives. Perhaps she was a crap nurse. Perhaps she was just unlucky.