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”

That may be true when it gets to the trial but an awful lot goes on before that. The Police investigate, when they feel they have a case it goes to the CPS and they decide if there is a case. On the other side the defense are working but their brief is different, they don't make any sort of judgement about their clients innocence or guilty, they just work to provide the best defense they can.

I've worked for the police, I've prepared cases for court, I've worked in murder incident rooms. I can't speak for every officer but I can say the senior officers running those investigations did not want to "win" they wanted to find the guilty party. They very much did want to find the truth.

It is obviously different when it gets to court, the prosecution side believe they have they guilty person, obviously they want to win.

There could be people who think she didn’t do it because she’s young, pretty, and white, but none of those people are here (as far as I’ve seen) and none of those people are quoted in the article the thread is about, either. I don’t think the medical and statistical points raised in both the telegraph and the guardian today are a front for the fact that people only have doubts because she’s young, pretty, and white, so that’s not really relevant.

The article says very little. Basically, some people have concerns but it’s not clear on what basis, and they admit they haven’t read the case files.

And they want to appear anonymous which
makes me think they don’t have a lot of conviction in their beliefs.

I followed the trial daily via the court reporting and the sentencing remarks and I place a lot more belief in them.

I’m aware of how the criminal process works. I did not, at any point, say the police want to ‘win’ (though there are certainly examples in history where police prioritised convicting someone over their professional integrity). I said the adversarial process is about winning. Meaning, the prosecution vs defence in a court of law. This is uncontroversially true to the extent that most law students will learn about it in first year law.

Regardless, the minutiae of how criminal trials in the UK work now, or how they might be improved, isn‘t really relevant to the article in discussion.

The adversarial system does seek the truth. It does so by testing evidence and arguments.

All systems employ defence and prosecution cases. That’s the basic and universal right to be heard in your own defence. That’s true of inquisitorial systems as well as adversarial ones. All lawyers want to win.

Inquisitorial systems of criminal justice are no more likely to find the truth than adversarial ones.

I certainly don’t think there’s a perfect system, but there are clearly issues with the current adversarial system as seen in multiple miscarriages of justice here - which is not to say that miscarriages of justice can ever be avoided completely.

I don’t want to derail the thread with what was only ever a hypothetical side point, but the inquisitorial system is generally agreed to be an official inquiry to ascertain the truth. The adversarial system uses a competitive process - prosecution v defence to (in an ideal world) determine the facts. We can agree to disagree though. It’s not the point of the thread anyway.

Can anyone even name a British female killer who isn’t white? Pretty may be a stretch but they’re all white and young ish.

It makes me laugh how many people think that it’s cut and dried because of the guilty verdict and can’t even contemplate that the jury have got it wrong, yet everyone is convinced MJ is as guilty as sin, despite the jury not finding him guilty.

Yeah the parallels between both cases and both legal systems are astounding, they may as well be twins.

🙄

I've just read the Telegraph article.

Correct me if I'm wrong but the air embolism and insulin theories..... are theories. And not proven. There is no evidence to corroborate a deliberate act?

I’ve just googled her and found another of her in the same outfit as the one you’ve pictured. She definitely isn’t very feminine looking, and a bit overweight. There is definitely a difference.

Thank you to everyone who has posted on this thread in a civilised and informative way. I feel like I've actually learned something.

I came here assuming that the case was based primarily on statistical arguments (as with similar previous trials). These types of arguments have been rightly denounced by statisticians. I have now learned (and I hope I'm getting this right) that the prosecution actually built their case primarily on the existence of medical evidence for multiple murders, with the subsequent argument being that it must have been Lucy Letby who committed them, based primarily on her exclusive presence at all events.

This is a much more reasonable argument, structurally, however in order for it to be a safe conviction we would require that the medical evidence of murder having occurred was in itself unassailable - beyond doubt - and compelling by itself, rather than just as part of a bigger picture. And whilst I'm not a medic, this seems untrue, based on the number of experts who have expressed just this - doubts - about such medical evidence (inadequate tests, diagnosis by exclusion etc).

What I suspect happened, in fact, is that the medical evidence was not 100% compelling, but that the jury, in practice, were heavily swayed by the statistics, and actually relied on this latter "evidence" when making their judgement. Everything I know about statistical cognition in laypeople tells me that the jury would inevitably have been strongly (and wrongly) influenced by the statistical data presented to them - even if they were explicitly instructed not to be. The number of people on this thread, many of whom seem very familiar with the case, who are nevertheless arguing from statistics (special dates, too many coincidences, etc) is testament to this. For the conviction to be truly safe therefore, I suspect we would require a retrial with a panel of expert jurors and perhaps some explicit guidance on statistical interpretation (and maybe more/qualified medics, although this is not my area).

So, to summarise. I still lack confidence in the safety of the conviction, but for different reasons than before

though the RCPCH did not feel Letby was at fault.

The scope of the RCPCH did not include anything to do with Letby.

They were not asked to establish if they "felt" Letby was at fault, and they did not.

From a brief skim through this thread, you've got the time when LL started working in the NNICU wrong by 3 years, the interpretation of the post-it note wrong (vast majority of posters corrected it), the nature of the notes found in the bag in her house wrong, the scope of the RCPCH investigation wrong, and claimed (in a way that you simply cannot know unless you are actually LL) that she looked up parents on SM to "just to see how they were doing" (or words to that effect).

And this thread is supposed to be serious.

It was a damning report. The hospital was an absolute mess

The RCPCH didn't do a report on the hospital, so I'm wondering how you decided from it that the hospital was an "absolute mess".

@Onethreefiveseven

All your suppositions are wrong. The case was not based on the statistical argument and there was no lack of medical data/ eyewitness testimony or corroborating evidence. The whole case was built from ALL of that evidence.

While nothing can be totally fool proof it was done meticulously.

So, you’re getting mixed up in the numbers. The Statistician in the Telegraph article isn’t wrong.

Here are the figures from the FOI links you quote:

The FOI MBRACE figures for death of early + late neonatal babies:

2015: 8 early neos and 1 late neo = 9 total neonatal deaths

2016: 7 early neos and 1 late neo = 8 total neonatal deaths

This totals 17 deaths between 2015/16.

The Telegraph and the Guardian articles both correctly quote FOI estimates as 17 deaths.

Now, let’s clarify how that compares to how many babies Letby is accused of harming:

Letby has been convicted of killing 8 neonatal babies as of today’s date (9th July 2024).

17 total deaths minus 8 Letby deaths = 9 additional deaths not associated with Letby via successful criminal conviction.

This, of course, is the 9 additional deaths that the Statistician in the article is referring to.

So, your assertion that the number in the news article is incorrect is actually… incorrect.

But what about all those babies on the nurse timesheet?!?

Well, a lot of people are getting confused by the timesheet, thinking it reflects 25 babies who died when Letby was on shift.

Of course, 25 babies have NOT died.

The timesheet reflects 25 collapses OR deaths across 17 different babies (labelled baby A to Q).

The concern from the Statistician is that all of the collapses/deaths that occurred when Letby was not on shift we’re NOT included on that table.

I am unclear who wrote that timesheet.

Did Dr Brearey and Dr Jayaram on NICU at CoC hospital put it together before deciding to go to the police?

Did the police put it together with help from doctors during the criminal investigation period?

Did Dr Evans (the lead medical expert for the prosecution) put it together when giving testimony at the trial?

Memory of what I’ve read makes me think it was put together by the doctors before they went to the police - but if anyone else knows for sure, please do let me know?

Even if you know nothing about statistical mathematics, perhaps ask these questions instead:

• Who authored the table?

• Was that person a statistician?

• How did they decide that a collapse should be counted as suspicious/unexplained?

• How did they decide that a collapse was expected/explained and therefore should be omitted from the table?

• Why were those other instances of collapse/death not included on the table to see if Letby was on shift?

• Did they consider other variables relevant to estimating the probability of death (e.g. known statistics that babies born under 1kg have a 44% survival rate)

• Did they consider the variable of frequency of shifts (i.e. did Letby get the most crosses on the table because she did more shifts than all other nurses?)

• Did they consider the variable of assigning the most unwell babies to the more qualified nurses (i.e. did Letby get the most crosses on the table because she looked after the most unwell babies as one of the few highly qualified nurses on the unit?)

That timesheet gives no answers to any of those important questions to be considered when drawing association between shift pattern, baby collapse/death and guilt.

Both the Guardian and the New Yorker articles make it clear that Dr Evans, the lead medical expert witness for the prosecution, changed his inclusion/exclusion criteria for which collapses he considered to be unexplained/suspicious half way through the trial.

Alarm bells should be ringing.

To finish, let’s say I’m a hospital chaplain giving dying patients their last rights on a ward that suddenly has a spike in deaths.

I’d be sweating into my dog collar if someone with similar incompetence at statistical mathematics as the Letby case took a look at my work timetable and drew the conclusion that I was always the present when these patients died, so therefore must have committed murder…

It was when her housemate said, "I'd have to hear her admit to it or I can't believe it," that I started to question things. Surely, if you were living with someone who was a child serial killer, you'd pick up on some weirdness, right? There would likely be a sense of performing a normal self or just an 'off vibe'.

You seem to have misread my post

But this is because the table in question is not making a statistical argument about the deaths - that's the answer to nearly all of your questions. The prosecution did not put forward an argument on the basis of statistics. The table establishing means and opportunity where the cause of death has been determined through expert testimony to be unnatural, that is all.

How can you be sure that the 17 deaths referenced in the MBRACE data happened at the Countess NNU, given that MBRACE data categorises babies by their place of birth not their place of death?

And if there were indeed 17 deaths at the Countess NNU, where has it been established that LL was not on shift for the 9 that she was not charged with having caused? Could it be for example, simply that there was insufficient evidence in these cases to charge her, though she was present? I have found a number of media sources that suggest that she was on shift for several more, or possibly all of the remaining deaths. For example the earlier Guardian article which stated that there were 13 deaths and LL was present at each of these. They reported this as though it was the finding of the RCPCH investigation.

I have to admit that the information available on this in the public domain is rather unclear and frequently contradicting, even from the same publication. But that only makes it seem more obvious to me that the public are not in a good position to critique this case.

I would assume that LL's defence could very easily have made the case that 9 babies died in her absence, if this were true?

That is the position of the experts in both articles, yes.

I think we’re both using the same fact to make different points.

It’s like Schrödinger’s cat.

When the cat is in the box with poison and you can’t see whether it’s alive or dead, it is statistically both simultaneously alive and dead at the same time.

If we only look at times of collapse/death when Letby was on shift, we only see Letby as guilty.

If we only look at times of collapse/death when she was not on shift, we only see Letby as innocent.

We have to look at all data together.

You may not see the statistics of the timesheet as important to the prosecution, so let’s but the timesheet in the bin for now and agree to disagree.

As for FOI information, you’re right - I can’t be sure it’s accurate.

But neither can you be sure it’s inaccurate.

Finally, I’d like to point out the following:

• No person saw Letby directly harm a baby at any point

• There is no physical evidence of method of harm (e.g. used syringes, insulin vials)

• The RCPHC investigated the unit in 2016 after the fallout between Letby, the doctors and HR. They concluded that failings of the neonatal service (short staffing, poor training), as well as increased issues on maternity were factors in the increased neonatal deaths

• The RCPHC did not raise concerns about any individual’s practice leading to increased deaths at the time of the report

• Pathologists directly examining the deceased babies did not find evidence of foul play suspicious of murder. They had the best chance of any individual at identifying evidence of murder.

• Coroners examining each case drew the same conclusion

What the prosecution did rely on was circumstantial evidence:

• Doctors got together to look at shift patterns and put the most crosses by Letby’s name. Things escalated quickly.

• The police gathered medical records and testimony, prosecuting on the basis of natural or unexplained death verdicts, which is common in neonatal cases

• Prosecution called in a medical expert who hasn’t worked clinically in decades

• Unlike the pathologist, the medical expert hasn’t directly examined the bodies of the deceased (for obvious reasons)

• The medical expert repeatedly diagnoses air embolism as the cause of death, I) despite having never directly observed this phenomenon in his clinical practice and II) basing it on an article written 35 years ago

• The medical expert changes cause of death from air embolism to smothering when it’s pointed out one baby never had an IV line in situ to inject air

• The judge acknowledges no clear method of harm has been established, but instead directs a jury to apply one theoretical method to all cases

I mean… if that’s the other fantastic evidence you think builds a rock solid case irrespective of the time sheet statistics…. come on?!?

I agree that apparently easy to digest, if misleading, statistics such as the staff rota used in this case (which was referred to by the prosecution several times) are likely to be more compelling to a jury of people unfamiliar with medical jargon than complex medical evidence, no matter how well presented. That’s a good point.

@Mollypolly45 @Tinylittleunicorn

I think it's important to recognise that even if the prosecution did not explicitly argue that the statistical tables were evidence of guilt, the jurors may still (very likely did, IMO) interpret it that way. I've seen hundreds of people doing just that on threads like these. And this would introduce a bias towards guilt that would render the conviction unsafe.

I agree. I think that’s a really valid point.