Lucy Letby - what's happening

[Viviennemary]

In the last few days I've heard conflicting news stories. One an ex coroner saying she is innocent. And another piece of news saying the Cheshire police want to charge her with more crimes believed to have been carried out at two other hospitals she worked at.

By the way nothing to do with her skin colour, I could tell the above and said it immediately after reading the reports of the trial.

That person you’re thinking of willingly gave an interview after the trial, which is completely different from giving evidence during a trial when you’re subject to all kinds of scrutiny. She never talked about past boyfriends but then she never (or rarely) talked about friends from what I recall from the trial and she had several of those. Maybe she was a very private person, The dad getting involved like that and the fluffy toys found in her room, yes unusual for someone that age but looking at that with the general picture, she wasn’t a quite unusual person at all.

Good post.

One piece of circumstantial evidence to link her can be considered flimsy but several factors point at her being the culprit for an overwhelming amount of babies that died in her direct care which otherwise were recovering fine … whats insulting is the outpour of sympathy for her because of her outward appearance. As for international medical experts, it’s their job to get their names on these studies for notoriety and they’re looking at it from a narrow medical lense re cause of death. It’s well known that it is difficult to establish that in premies especially given her choice of method.

I am not discounting the wider negligence that played a role in this. Letby could have been stopped much earlier on but to suggest that negligence alone caused the death of 20 plus babies in such a short space of time is absurd because for that to have happened staffing would have to be next to none.

International medical experts - Harvard professors, heads of prestigious neonatal units etc - have no need to get their names into UK tabloids to advance their careers. They are already at the top of the tree and many are widely published - to the extent of hundreds of scientific papers.

There is no strong circumstantial evidence in this case. If there were, people would be able to point to it. There's a lot of gossip, speculation, filling the gaps to suit the narrative, and cod psychology. The case would be just an embarrassment if such serious issues weren't at stake.

One piece of circumstantial evidence to link her can be considered flimsy but several factors point at her being the culprit

Nope. Multiple bits of weak evidence over different events don't add up to strong evidence.

It’s well known that it is difficult to establish that in premies

Indeed. So unsurprising if there is no credible medical evidence of murder. Which there isn't. And if we can't tell if its murder, she's innocent. (In legal terms.)

The panel of experts also offered explanations for some of the deaths that had been expressly discounted by the prosecution experts in the trial. Their evidence has not been tested - they did a press conference where they basically said all the deaths were natural causes despite several consultants feeling they were clearly not after about 3 or 4 of them. If it was such a shitty ward, why did they not have this number of deaths consistently over the years? Why only in 2015-16? There was a huge abnormal spike and LL's behaviour was damning outside the medical evidence. She had to be told repeatedly to stop going in to the nursery where one of the babies was and abandoning the baby she was down to care for. She seemed to delight in seeing the pain and anguish of the parents of the dead babies, she made various inappropriate comments, she altered timings in the medical notes to explain why she hadn't summoned help earlier and altered entries to make it seem that she hadn't been present. She also had a history of giving wrong medications/overdoses to patients, showed no remorse for this yet in the witness box claimed she never made mistakes. She had also been noted as having lack of empathy and had said she was looking forward to her first death to get it out of the way.

There was a huge abnormal spike

Looks that way to a layman, but it wasn't statistically significant. ...and the data was cherry picked.

Yes, this is why the medical evidence alone isn’t sufficient to establish whether she did it. Premies are complex as it is, one or two but for over 20 of them to have died in that space of time triggers and warrants an investigation. Medical experts cannot comment on anything outside of their field of understanding. That’s why you have the police investigating the wider circumstances of what was happening in and around those deaths. You have to take all the evidence together, all the strands of circumstantial evidence start to build a picture.

My god, it definitely was. They normally had 1-3 deaths per year, now they had over 20. It most definitely was a spike - the doctors were picking up that something wasn't right after the first few. They had decades of experience as neonatal consultants and they said something wasn't right and that the collapses made no sense. If she'd left it at 3 or 4 murders she'd probably have got away with it. But the repeated attacks, the lull when she was on holiday, the 'back with a bang' attacks, the fact that some of the babies miraculously improved as soon as they were transferred away from her care.
The jury heard month upon month of evidence in two trials and decided that she was guilty. If resources are wasted to give LL (another) retrial and a jury comes to the same verdict, I suspect that still won't satisfy people. Nothing short of a complete exoneration will do.

My god, it definitely was. They normally had 1-3 deaths per year, now they had over 20.

Yup, sometimes things happen 6-20 times more often than usual. In fact, over a large enough sample it's inevitable.

The NHS realised a paper on it and gave it to defence and prosecution.

This isn't up for debate, Google letby+statistics and choose the source you prefer.

The case was never based on statistics. The high number of deaths that were unexplained alerted the consultants and they eventually contacted the police who investigated. It was never the case (as it was in Lucia de Berk's case) that the prosecution said "the chances of this number of deaths is 1 million to 1" or that "the chances of one person being present at all these deaths is 34 million to 1". That was never the case and if you say that is what the prosecution said, you are wrong because they didn't. The deaths did represent an abnormal spike compared to previous years and the doctors on the ward felt it was suspicious and they didn't feel they could be explained as just a coincidence. They noticed that one person seemed to be present for all of the suspicious deaths - only that person, nobody else was there for even half of them so there wasn't a toss-up as to who could be responsible. Again, not statistical reasoning - just an explanation for what alerted their suspicion. They then told the police, who investigated and found the deaths to be murder and LL was charged. But not based on anyone saying that statistically she must be responsible. Based on medical evidence and other circumstantial evidence which, yes, included that she was there for every suspicious collapse.

In Lucia de Berk's case, the prosecution called a statistics expert who said that the odds that it was a coincidence that the deaths happened when she was on shift were 342 million to one. Nobody said that in LL's case.

The case was never based on statistics.

So not relevant to say:

They normally had 1-3 deaths per year, now they had over 20.

I don’t think it can be considered whether or not it’s statistically significant that she was present, or the odds of this happening while she was on shift being a coincidence, because I think it’s quietly widely reported that there were further unexplained or sudden deaths on the unit that she was not charged for because she was not on shift. This is what completely undermines the fact that she was on shift when the babies she’s been found guilty of murdering died as a source of evidence - obviously she was, or there’s no case and she could not have been charged for causing those deaths. This is not a complete list of all of the deaths so is not evidence, circumstantial or otherwise.

Am I not also right in saying that the deaths increased when they started taking on more seriously ill babies and decreased when they were downgraded?

With this, the police, NHS and government are investigating what happened. They’ve arrested 3 members of senior management and then Lucy is being charged with more murders. There could be a chance another nurse or doctor etc could be involved and did similar crimes to what Lucy has been accused off. This is the point of the investigation, if it does come to alight - other medical professionals are involved then they should be rightfully charged. This doesn’t mean Lucy is innocent though as they want to charge her further with more babies death, so this could mean some evidence which the general public are unaware of?

In all honesty, regardless of public opinion or media experts or even my own opinion - we all need to let the professionals who have been assigned to this case do their job. They ultimately are aware of all the evidence they have and need time to investigate this case.

I'm saying that this is what alerted them to an issue. Yes, statistically it might be possible that you have 25 years of 1-3 deaths per year and then suddenly you have 20 and it's not because you have a killer on the ward. That could happen, say if there was some virus going around that caused premature births or for instance if other nearby units closed and diverted all their cases to CoC. Or there could be other explanations that weren't that there was a murderer. But if you worked there and you were used to 1-3 deaths and suddenly you were regularly dealing with collapses that you personally didn't feel you could explain or that made sense, you might think something was going on and start to ask some questions. You wouldn't just think 'ah well, just a coincidence, nowt to worry about' and go about your day.

There were medical experts saying that the deaths were due to deliberate harm. No, not everyone agrees with the prosecution experts but it's rare that you get completely unanimous views from medics. The ones saying they disagree have not been cross examined to have their views challenged. The prosecution were not saying 'well statistically, the likelihood of this being natural causes is next to nil based on the numbers the unit previously experienced'. Had that been the core of their case then it would have been based on statistics. It wasn't.

Very much this. It was pure Texas Sharp Shooter Fallacy.

It is evidence. It just makes it less compelling but it’s still evidence. There were six other deaths that were not considered suspicious. There has been no confirmation that LL was not on duty for any of them. Even if she wasn’t and we added them to the chart and the person present for the most amount on the chart apart from LL (8) also happened to be present for all six additional deaths (unlikely), you’re still looking at a disproportionate presence from LL that isn’t anywhere close to anyone else and absolutely explains why she was always the number one and only suspect. It doesn’t by itself prove guilt of course but it’s one piece of evidence among many that the juries considered.

But if you worked there and you were used to 1-3 deaths and suddenly you were regularly dealing with collapses that you personally didn't feel you could explain or that made sense, you might think something was going on and start to ask some questions.

Yes, and then you'd build up a theory. Then you'd draw up a spreadsheet which, with no knowledge of statistics would draw you to a completely incorrect conclusion. Then you'd start to cherry pick medical evidence to fit what you "know" to be the case. Then the police would get involved, and with no knowledge of statistics or medicine it would look like an open and shut case. So it would be easy to find an expert to flesh out what's already known with some more confirmation bias. Amd before you know it you've got a conviction based on confirmation bias and schoolboy statistical errors.

That's exactly what happened.

Maybe they got lucky and she really was guilty (guilty of which babies? How could they know which were murder and which were natural causes), alternatively maybe she's innocent. We don't know.

Even if she wasn’t and we added them to the chart and the person present for the most amount on the chart apart from LL (8) also happened to be present for all six additional deaths (unlikely), you’re still looking at a disproportionate presence from LL that isn’t anywhere close to anyone else

EVERYTHING you've just written is statistically WRONG. Go and read up on it or watch a video.

For someone who says the case wasn't about statistics you seem to be spending an awful lot of time thinking about statistics.

I hardly think their approach was unusual for suspected deaths at a hospital. There will obviously be normal deaths and collapses given the nature of the patients on the ward. Hospital is probably the most common place to die along with home and nursing home. So you're always going to struggle because the killer will say that the patient died of natural causes and was old/ill/a neonate etc. So to start off an investigation it's usually because someone else has suspicions, often that the death doesn't make sense or that there are unusually many deaths - more than expected. That by itself doesn't prove guilt but it is a basis for suspicion. Eg Beverley Allitt, Ben Geen, Victorino Chua and LL all involved a suspicion based on a perceived spike in supposedly unexplained deaths where only one person seemed to be present for all of them. Victorino Chua was specifically suspected on the basis of being the one common denominator for all suspicious deaths (and there were several other non-suspicious deaths at the time). I don't see panels of experts up in arms about his conviction. Interestingly police also found a letter in Chua's flat (also apparently written at the suggestion of a therapist - maybe they shouldn't recommend this stuff) saying he thought he was evil. There isn't anything really odd about LL's case or how it was approached. She came under suspicion because she was there every bloody time there was a death or collapse that the doctors found suspicious.

I'm saying that's why she was suspected. She was always there. Just like Beverley Allitt. I don't think anyone is that interested in statistical likelihoods. As I said, not why she was convicted. I'm just saying that even if you made a chart and included six other deaths in there and say that you think some of them are suspicious, she'd probably still be my number one suspect if I was a police officer.
There was evidence given that the deaths were murder (I know you disagree with the evidence, and that some doctors disagree with the evidence (some also agree with it), it is still medical evidence given and accepted by the jury that it was non-accidental). To prove murder you have to prove an unlawful killing and the jury felt the prosecution had done this to the appropriate degree.
She was there for every death that was non-accidental. Nothing to do with statistics but obviously if she wasn't there, she couldn't have done it but she was there for each murder she was charged with.
There was also quite a bit of additional evidence that was non-medical in nature about her specific behaviour that also pointed to her guilt. Again, you might disagree and think there could be other explanations for it. You weren't on the jury and it's the jury's assessment of the evidence that matters.

Deaths increased when the unit was upgraded and they took on more seriously compromised babies.

I don't think anyone is that interested in statistical likelihoods.

They normally had 1-3 deaths per year, now they had over 20.

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