Lucy Letby in the news

[Viviennemary]

I've just been watching the BBC news and apparently some experts have been questioning the validity of Lucy Letbys conviction. I must say when I read the details of the trial she did sound 100% guilty. But it would be a tragedy if she is innocent Personally I don't think she is but who knows. Somebody on the news said the only person who knows is Lucy Letby.

She had an excellent defense team but it's impossible to defend someone who is guilty of heinous crimes.

😴
Did you come up with that all by yourself?

They also added two extra consultants to deal with staffing pressures.

2 extra consultants when they downgraded? How many should they have had before they downgraded? 🤔

Doesn't really add up though does it? seeing as she was vilified by the press before!
Did they get mixed up at the time and think she was a Muslim transwoman?

I realise that this hit a raw nerve - based on your previous posts you are heavily emotionally invested - but your implication that she wouldn’t have been treated worse by the press if she was a member of a minority is laughable.

It didn't hit a raw nerve.
What you said doesn't add up simple as that.

She was vilified by the press and most thought she was pure scum. Now people are looking at the evidence (or lack of) more closely and that's why some think that this may have been a miscarriage of justice.

But in your head you've decided that it's because she is white..even though she was also white when she was vilified by everybody 😂

What good is the wnquiry?

We are talking about staffs reaction and the processes surrounding a 'never event', an event which is so rare and grievous that imo no safeguards can truly help. If the convictions are safe I think in a sense a lot of people are going to blamed possibly unfairly for not having 'psychopathic neonate killer' as a possible cause of a spike in mortality rates. I don't think this is fair.

Take for example the manager of the neonatal ward (presumably a senior nurse). The nurse may have been aware of the spike in mortality rates and passed the concern on about the rise to her leadership but it wasn't her responsibility to start viewing staff as Hotmail killers when reflecting on the data; this would be perverse. The nurse in question like any good manager would have faith in all their staff and be supportive to them all in a possibly emotive environment which would exist when any baby dies. If the managing nurse had no reason to believe the outlandish idea she had a nurse systematically killing babies (which is reasonable) isn't her approach justified? I don't think having a nurse at this level (ward manager) named openly in the public and grilled by barrister in the national spotlight will help her mental health especially as she she possibly has a huge regret. We have to treat at least some of the hard working staff here sympathetically.

Similarly if no one took immediate action to stop a killer i.e. evidence at least at first was circumstantial and not compelling maybe the trust did exactly the right thing by taking their time in reviewing mortality figures in much the same vein mortality figures would be reviewed for other medical categories e.g. geriatrics. Remember we are talking about a vulnerable cohort of patients so sadly on a month by month basis enter would be mortialities so the figures would be discussed in the context of a whole hospital metrics at board level and there would have been a lot of other matters to discuss at these meetings. It certainly wouldn't be someone the case of a senior trust member piping up about a theory of psychopathic nurses causing distortions in data.

Similarly the NMC may have acted reasonably in not instantly reacting to any allegations against Lucy when they were uncorroboarated. Staff in any sort of investigation are innocent until proven guilty akin to a court of law and it takes months of not heard for the NMC to set up disciplinary panels to investigate poor conduct and there would have been reluctance to set up the panel to discuss criminal matter because the NMC could reasonably day 'why weren't the police called?'. If Lucy was investigated on a competency issue then evidence of poor performance would have to be evidenced and she was a good nurse, the review would then have set out poor performance areas so explaining the deaths by poor protocol or negligence, not murder.

I think the whole exercise is not looking to find answers but to apportion blame. People and institutions seem to be throwing down mea culpa to mitigate against criticism when they may have acted in a reasonable manner. I feel many of the witnesses may be grilled in an adversarial manner in terms of why they delayed on various actions or didn't report concerns about a vanishingly unlikely scenario is most staff's lives (thankfully) which is unfair.

It seems there is an appetite from the public and maybe state to show something is done about this tragedy and there are going to be demands heads roll which may actually be very unfair. There will be potentially careers ruined because no one took the bold and let's face it extreme view that in a ward of vulnerable patients there was a killer on the loose; one who was praised at being good at her job and possibly popular.

As an aside I think mentioning of the Liverpool tracheal tube data was interesting. If the investigation was a live sensitive one involving the police why mention it suddenly at an enquiry about another hospital? In fact one couk d argue the inquiry should be dealt d as you are not giving potential Liverpool victims families a chance to be heard or there wouldn't be a similar scope of review there. It does seem odd.

We're those figures quoted to try and suppress debate about the innocence of Lucy and specifically about individual children known by letters by broadening the scope of vitims? Ip was it an attempt to reinforce Lucy's guilt so people wouldn't think there were grounds for questioning the evidence for those cases brought to court as actually the cases brought to court were just a sample of the potential criminal acts?

Neither of those things. Previous possible warning signs about LL are clearly potentially relevant to the question of ‘what went wrong/how did this happen?’ which is the obvious remit of the enquiry. Lady Justice Thirlwell has made it crystal clear the enquiry is not about guilt or innocence, which has already been litigated thoroughly.

In checking meetings across the NHS it is a daily occurrence to document clinical incidents for reporting and lesrning. This is entirely a good thing and actually a frequent mundane task for all clinical groups. One of the underlying philosophies of this is the incident is described and acted in but names are not mentioned in the report to avoid scapegoating and to promote a culture where people aren't reticent in coming forward with concerns. It's (theoretically) a no blame culture which I actually support.
one thing that may arise is that this philosophy is compromised and the high minded judiciary suggest naming is routinely used when clinical incidents occur to get and identify the next Lucy (?). I think if this is suggested it should be resisted; I don't think the NH S would benefit from groups of people correlating clinical incidents with names as a matter of duty. The scope for bullying and shaming is obvious as well as reputations damage to individuals. We don't want an NHS where a response to sub optimal practice is 'who's done it ' in the first instance.

@eastern

@eastern

The question is will there be a separate enquiry about Liverpool to allow similar scrutiny of the hospital and allow potential victims there a chance to see any failings at Liverpool brought to light. Does this not open up a whole new raft of prosecutions of Lucy and therefore it would have been sensible to delay the enquiry until those investigations had occurred ?

I just feel Liverpool was mentioned to show the scope of offending may have been wider and therefore those that are looking to speculate on Lucy's innocence in the media do not overly focus on the baby's mentioned in court (A, B etc.) by trying to show Lucy's guilt was unquestionable as the criminality was wider than the cohort brought to court.

Personally I feel it should not have been mentioned and there are obviously a lot of parents of Liverpool animated with questions (and there won't be a further enquiry)

Sorry that was for eastegg

I think one philosophical consideration is that we can't prevent all perversions human nature in a free open society. It is a price of liberty that we may ourselves open to such events. An extreme example of this is the US where there is the liberal right to carry weapons yet it would be very easy to question this policy. In reality it is part of the US constitution on which their nation is founded aligned to liberal principles.

In order to realistically prevent another Lucy the procedural changes that would be needed to be introduced into a complex organisation employing 500 000 people that look after the most vulnerable in society would be unrealistic. We cannot routinely refer clinical incidents of medications of morbidity or mortality day to the police; there simply aren't the resources. The NHS is ill equipped at best to routinely audit clinical outcomes so how is it envisaged you add new layers of bureaucracy and protocol to prevent rare perverse criminality?

Someone once said that you can't legislate against human nature and this is a perfect example of this. Human nature throws up distorted personalities and possibly it will be ever thus. Can we really ever combat this?

I think spending money on an enquiry on a thankfully extremely rare never event might be counter productive. We will haul a number of hospital employees before a comittee , many of them in employment with due consideration of their careers and realtionships, to be asked why they delayed response to a previously unimagible event, that of a psychopathic nurse that was adept at using her medical knowledge to kill I'll neonates, for what purpose?

Do we want to see this public castigation because ultimately there , s only one person to blame, Lucy. Is it fair to start apportion blame in a scenario most right mixed people will not conceive of? Is the purpose of the enquiry a visceral societal reaction that we somehow have to expand the blame and there is some unknown panacea to prevent the killing nature of some humans?

I can understand Grenfell as you can put policies in place to prevent the use of flammable cladding in future in building and there is realistic proababilitybwith out the enquiry the disaster may have been repeated and, yes, there was blame in terms of disregarding fire regulations knowingly.

However this, what are we actually going to learn?

modulation of morbidity and mortality

I haven’t read the whole thread so sorry if this is repeating old news but it looks like The New Yorker has redacted some of the original article. It looks to be the part about Dr Lee and skin discolouration.

I always thought she wasn’t guilty however I watched the documentary last night about Beverly Allitt and I’m now less convinced she’s innocent. I

I think because my head can’t wrap around the fact that someone could do that to babies. I’m looking for alternative explanations as I can’t comprehend someone could be so evil.

Having watched that documentary though, no one caught Allit, it was circumstantial. I do believe she done it, she was always smirking and smiling and the interview tapes she appeared cold, the monster.

That made me reassess, because obviously someone has committed such heinous crimes. She was said to have MBP so that was her motive. So yeah it just got me thinking that maybe it’s the same for LL…

This article is what caused a bunch of Americans to become emotionally invested in the case. It was incredibly biased. When I read it I thought well there is clearly a miscarriage of justice, until I read more and saw what they deliberately omitted.

Exactly. I remember seeing that bit and wondering why they were claiming that the prosecution case was that deaths were down to air embolism only because they couldn't think of anything else, when that was clearly not what either the prosecution or the expert witnesses were saying. It was seriously misleading, which may be why that bit has been redacted - unless they were misrepresenting what the Canadian expert had said.

The problem is that they reduced well before the unit was downgraded, as soon as Letby stopped working there. And in fact a number of the babies who died or collapsed would still have qualified for the unit after it was downgraded, because they weren't that poorly before they went in.

And how do you account for the fact that it was so much lower in the two years before she turned up, despite taking the sickest babies?

This is untrue. The two things happened in July 2016.

The shift from 27 weeks and 800g to 32 weeks (and higher minimum weight) is a drastically less unstable cohort. The unit is still only a Level 1 unit to this day.

One thing that intrigues me is that Lucy does not have a psychiatric diagnosed illness as far as I am aware. There was no mitigation of insanity during the trial and no mention from the defence of any illness. If Lucy does not have an illness then she would be defined as 'sane'. However sanity by definition means executing reasonable rational judgment and so we have a question about the definition of sanity.

I would think it is extremely likely Lucy does suffer from a psychiatric illness not yet diagnosed and I am actually quite surprised one hasn't been announced. The nature and symptoms of an illness I think may have some bearing on the enquiry and indeed act to fill in gaps about motivation.

I think there is a question about motivation and it is not quite clear whether Lucy was deriving some kind of sadistic satisfaction from the events or wetther as suggested by the prosecution causing neonates to be ill was an attention grabbing exercise either to endear her to a colleague (consultant) or portray herself as a hero in a drama.

I think theere are two separate motivations here and I don't how you can clarify this.

You haven’t said anything about the other 2 points Clockwise has made, and which I made yesterday, on this point.

1. Three of the babies Lucy Letby was convicted of murdering were over 32 weeks and would still have been on the unit if it had been a Level 1 unit at the time she was there. (Babies D, O and P.) That’s 3 ‘Level 1 baby’ deaths in 12 months. Yet in the 7 years after she left only 1 baby died out of all the ‘Level 1 babies’ treated there.

That’s a change from 3 deaths in 1 year to 1 death in 7 years, just looking at babies born at 32 weeks plus.

2. Just before she arrived, when the unit was Level 2 and took sicker babies than it has since 2016, the death rate was only 2-3 a year. Yet from June 2015 to June 2016 13 babies died.

3. Babies died during the night when LL was on night shifts and during the day when she was on day shifts.

Baby O and P were triplets and should have been in a Level 3 unit. The cut off is higher for triplets.

Baby D’s mother was not given antibiotics when her waters ruptured late preterm contrary to guidelines. Baby D could have been given intravenous abs but was given no abs for 4 hours, along with many other care failures. Dr Hawdon’s review concluded “major suboptimal care”.

From Thirwell Enquiry:

In February 2018, Child D's case was discussed at a meeting with Margaret Bowron QC and described as "indefensible".

The Inquest into the death of Child D was adjourned sine die in November 2020, when the Coroner was informed of the CPS' decision to prosecute Lucy Letby.

A review of the Coroner's file reveals no correspondence from the COCH to the Coroner to inform him that major failings had been identified in the care provided to Child D, or to disabuse him of the impression that he might have reached upon reviewing the COCH statements and case reviews from 2016, which describe the care provided to Child D as in line with accepted practice and state that "antibiotics were commenced within the recommended time limit".

LL started work at the NNU in 2012. When the unit was downgraded in 2016 the RCPCH reported advised to take on 2 new consultants including a neonatologist. The unit had been running at Level 2 without the resources to do so. Training was also recommended for UVCs - a common failure across all the cases.

COCH is one of several hospitals that experienced neonate spikes 2013 -2017 and COCH was not the highest.

Sherwood Forest Hospitals experienced 13 neonate deaths in one year in 2013 and no-one called the police. The COCH spike in 2015 & 2016 are not so marked as to not be accountable by random variation. When you look at the medical data and see how bad the care was - suboptimal care + spike in activity and acuity, + pseudomonas outbreak could easily explain the variation.