Lucy Letby: Have you changed your mind?

[Kittybythelighthouse]

The other thread has had a lot of really interesting discussion but we are running out of pages so here’s a new one for those who are interested in continuing the conversation.

Whether you’re sure she’s guilty, sure she isn’t, or are somewhere in between, I’m interested in hearing how your opinion has evolved (or hasn’t!) since you first heard about the case,

Please try to be respectful - this is a heated topic. Its a matter of huge public interest with a lot of strong opinions, but we are all adults and can disagree with each other in a respectful manner.

Old thread is here (the poll still has a few days left):
https://www.mumsnet.com/talk/_chat/5388914-lucy-letby-have-you-changed-your-mind?page=38&reply=146359313

He said this on the ITV documentary, particularly iirc surrounding the theory of the punctured liver.

There was a second Dr (not the British neonatologist who was part of the panel who who believes the liver was punctured by an aspirating needle) who was also interviewed on the documentary. IIRC he was the one who first felt that yhd liver had been punctured. He made a very valid point - there is always going to be disagreement amongst medical experts, theres always grey areas, but all of these Drs including Mike Hall, the original pathologists who carried out the PMs, the hospital management even, did not see evidence of murder.

In response to this:

Look, I know your heart is in the right place here, but just think about that for a moment - you say you’d rather that these people’s babies had been murdered?
Don’t you think it will be far better, if still very tragic, if it turns out that they hadn’t been murdered?

That’s not what I meant. Of course I’d rather those poor babies were alive. What I meant is that if they didn’t die of natural causes and LL is responsible then at least they have the small comfort that justice has been served. If the hospital is in fact responsible due to failed care then for those parents sake I hope the truth comes out. Although I can imagine for some of them they just want this whole saga to go away as it must be so distressing having uncertainty and still being in the media.

Of course and behaviour is always viewed differently through different lenses.

This post was asking for people’s viewpoint and what they think. I don’t want to believe she is guilty and keep being torn. I can’t help having that niggle that something is off. But that’s human nature, we all see things differently.

There’s a case on the Sweeney podcast where Evans was a senior paediatric consultant at Swansea and a young boy died from Addisons disease due to serious failures in care. Evans wrote in support of the negligent GPs who had lied, falsified records and been abusive to the parents. He claims not to have been involved, but he was in charge at the time.

It's an odd one. The Times and Panorama make the same errors about what the panel actually said. I presume the Times lifted it all from Panorama, or perhaps there's a media briefing out there that distorts things.

Here is a link to the panel's two summary reports:

https://lucyletbyinnocence.com/#shoolee

The first summary report covers Children A, I and O, as well as children D, F, G and K.

The second summary report covers the other children.

Two things are happening here and in Panorama.

1. Hall is refuting things the panel never actually claimed - like baby A inheriting his mother's syndrome, baby O definitely suffering birth injury, baby I dying of or even with an infection of s. maltophilia.

2. Hall / the media outlets are claiming flaws when theories raised by the panel have already been heard (usually in quite different forms). But this is where we have to check ourselves and remember this isn't a parlour game.

If the international expert panel believed that a child was most likely to have died in a particular way, their commitment was to say so, not to scramble around finding an alternative the jury had had no hint of. Yes, it is inconvenient that the jury, hearing bombastic and ill-founded claims from the prosecution experts, has rejected different versions of some of their claims. But at a retrial, their job will be not only to describe, with integrity, the most likely cause of death, but also to describe the range of possibilities.

So to say:

we believe child A inherited antibodies from his mother's syndrome which raised his risk of blood clotting, but even without this syndrome, blood clotting was a risk (because of poor management of lines).

we believe child I's condition was exacerbated by s. maltophilia, but in the absence of s. maltophilia, the child still died, most likely, due to chronic respiratory issues.

we believe Child O is likely to have suffered a birth injury, but in the absence of the obstretics notes which neither we nor the prosecution have seen, this is very plausible but speculative. However the hematoma was acquired, whether by birth injury or not, its rupture and the failure to treat for haemorrhage are the obvious causes for death, and may have been exacerbated by accidental piercing of the liver ..

You can see the defence is criticized either way. If their theories have been "tested" by a lay jury, they may not be acceptable in appeal. But obviously genuine medical experts acting in good faith aren't going to change them for their reason! If they offer a range of possibilities, that is an ethically and scientifically acceptable answer to that problem. It is in fact the expert witness's job in court to do exactly that. But that doesn't stop the media jumping in claiming contradictions where there are none.

Still, the implication of all this is that the international expert panel is working with integrity and that the defence knows exactly what they are doing.

It is up to the defence to convince the jury that there is reasonably doubt and, certainly in the first trial, they failed to do that. This was always a trial based on layers of circumstantial evidence. Each individual piece of evidence was always subtle and debatable but, layered on top of each other, they convinced a jury.

It’s actually for the prosecution to prove to the jury that there is no doubt.

The biggest piece of evidence not found of course was that she wasn’t caught in the act neither in person or on camera so everything is speculation.

I would be interested to hear though from other neonatal nurses with experience working on similar NICU wards, is it feasible that she was never caught in all of these incidents? Are there long stretches of only 1 nurse present? I know a lot of the crashes/deaths happened at night when there were fewer people around, but I wonder how she got away with so many without being caught in the act? Or if she was overdosing insulin, over feeding etc and someone passed by, would it not be obvious from a distance?

Think that’s where you are wrong. This isn’t just about Lucy this about so much more than that. Men ( doctors) have accused her of something so terrible, another group of men the police joined in, then the judicial system ( which tend to be predominately men) have sentenced her on a hypothesis not evidence. This could happen to any of us unless we allow this terrible unfairness to pass unchecked.

I think there is a general misapprehension these days that circumstantial evidence isn’t really evidence.

These days, with text messages, CCTV everywhere and DNA tests, juries want to have 100% proof. I think that is, partially, at least, the issue with rape cases which, virtually always depend on circumstantial evidence.

Even 40-50 years ago, nearly all cases depended on circumstantial evidence. That would be oral testimony and lists of events that pointed towards guilt etc. At that time, without a confession, it was very hard to prove 100% whether someone had committed a crime.

So, arguing that the evidence in this case was circumstantial is not per se an argument against conviction.

The prosecution's story requires Lucy Letby to have attacked babies A, H, M, N O and P at least in rooms full of people.

Shoo Lee's panel has pointed out that is you inflict an air embolism through an IV line, the collapse will be immediate, alarms will sound, and you will have to flush the line to cover up your crime. (In a room full of people now entirely focused on the baby you've allegedly attacked).

"Can you explain why you are so invested in this case? It would be interesting to understand"

You're coming across as a bit patronising here - just fyi - very 'man on mums net' vibes, but I'll answer you.

I think this case is of historical importance. If it is a Miscarriage of Justice (and I now believe that this is exactly what it will be shown to be) then it exposes deep rot at the heart of several seriously important British Institutions - The Judiciary, The police, the NHS, even the media. The repercussions of that spread across the whole society, far beyond the families involved, or Lucy Letby herself. This affects all of us deeply, as we rely on these institutions for our (and our loved one's) safety, security, and liberty. I don't know why everyone isn't invested, frankly, because the stakes are very high for all of us.

I'm also currently on bedrest for health reasons, so having followed this case closely for over a year, I decided to make a thread about it. Is that okay? 😂

"I think it is tremendously complicated and you need both a good knowledge of neonatal intensive care and statistics to fully understand it."

I fully agree that it is tremendously complicated. Do you think I'm unable to comprehend it for some reason? Have I said something that you find to exhibit my poor grasp of the facts? It would be interesting to understand.

"As a layperson, I probably do have a better grasp than most (mathematical science degree) but I still couldn’t be in any way sure one way or the other."

Your implication here is that I do not have as good of a grasp as you. I assure you that I have a very good grasp indeed. This is an odd thing to say. Have you found fault with my explanation of the faulty stats in the latest Panorama? If so, can you illustrate that? I am certain that I am correct, and I don't want to bog the thread down with maths for the sake of other people, but by all means show me otherwise.

Nobody can be 'sure'. That's not how law works. Or medicine for that matter. Does the evidence stack up or not? You aren't sure, that's perfectly fine. I am, at this stage, pretty sure. This is based on extensive research, which I assure you I'm perfectly well placed to understand. Others are free to have their own opinions.

"It is up to the defence to convince the jury that there is reasonably doubt and, certainly in the first trial, they failed to do that."

I am aware. Are you arguing that procedure is more important than justice? If so, I don't agree.

"This was always a trial based on layers of circumstantial evidence."

Another way to say this is: 'This was always a trial that had no strong evidence"

Circumstantial evidence can be very strong, but here it was not.

"Each individual piece of evidence was always subtle and debatable"

No individual piece of evidence is worth anything if there is no evidence that any murders actually occurred. Babies, sadly, do die in NICUs. There was a nationwide death spike that year. Other hospitals had worse spikes and no one is hunting for a serial killer nurse there. It's not the same thing as finding a body in the street with stab wounds.

"but, layered on top of each other, they convinced a jury."

Yes, and a jury is not a magical group of wizards. They are a group of ordinary people, like any of us, perhaps some who are smarter, perhaps some less so. Juries have made the wrong decision in every single miscarriage of justice, ever. So appealing to their authority in this context is invalid. Also, they weren't all convinced.

"For instance, you mentioned the insulin test being 98% accurate. This means the chance of two separate tests both being inaccurate is 2%x2%=0.0004 or 4/10,000 (unless the results were somehow correlated). Is 9996/10000 beyond reasonable doubt?"

I think your working is a little off. Your “2% × 2% = 0.0004” claim makes the same mistake Roy Meadow made in the Sally Clark case. Meadow multiplied the probability of one cot death in a family by itself to get the probability of two, assuming the events were independent. He ignored that both deaths occurred in the same household, so they shared risk factors that made them statistically correlated.

Here, you multiply the 2% false positive rate (which is of course a rough number, but put that to one side) for an insulin immunoassay by itself to get the probability of two false positives, assuming the tests are independent. But they aren't independent. Both results came from the same hospital, lab, and testing process, meaning any systematic issue could affect both results. As in the Sally Clark case you've wrongly assumed independence when correlation was likely, you've ignored the base rates - Dr Brearey searched through years of hospital records, through all of the babies that were in the NICU on any of Letby's shifts, increasing the chance of finding two “rare” results. So, to answer your question, I don't think these two tests are proof of exogenous insulin beyond reasonable doubt at all.

"But it is not just these two tests. There was a host of other evidence, all questionable. But the total picture?"

Show me a single thing that stands up by itself. If nothing stands up by itself then there is no case. A whole pile of broken links doesn't somehow make a strong chain, it makes...a whole pile of broken links.

"The defence, of course, did (will again maybe) depend on challenging the minutiae of the evidence, as per the OJ Simpson defence."

This is nothing whatsoever like the OJ Simpson case. There were two bodies covered in stab wounds - someone killed them. There was a clear history of domestic violence, some of it very extreme. There had been previous death threats. That's where you're starting from. As I've already explained this case doesn't start with definite murders. Babies die in NICUs. There was a nationwide death spike. Men kill their wives not infrequently. Nurses are very rarely serial killers. Also, Lucy Letby isn't a multi-millionaire retired NFL star. She's an ordinary nurse from a cul de sac. Anybody working for her is doing it pro bono out of professional and moral integrity. It's ludicrous to compare the two.

"As I said, up above, it is unlikely we will ever 100% know and an innocent woman in jail for life is a horrible prospect."

It is a tremendously horrifying prospect, as is ignoring what this case says about the extreme issues with our most vital public institutions. The case doesn't exist in a vacuum. It has broad repercussions for our society if she is actually innocent.

"But we don’t have any better mechanism than a jury trial, so we have to go with it after all the avenues of legal defence are exhausted."

Thankfully the avenues of legal defence have not been exhausted. The case is currently under review with the CCRC. Let's see what comes of that.

In the meantime I'll continue talking about it if I wish, assuming that's okay with you.

The problem I have is not that it's circumstancial evidence. It's that, for starters, a great deal of the prosecution's story could not feasibly happen without additional eyewitness evidence. It requires Letby, in several cases, to be committing a crime and clearing up the evidence in a small room where several people are focused on the child in question.

Circumstantial evidence can be very strong, as in the OJ Simpson case you referenced earlier. It isn't strong here.

I get you. It has certainly all been very hard on them. They deserve the truth, as do the parents of babies who died but weren't on the indictment. I hope it all comes to a close swiftly for everyone's sake.

The expert witness system is in need of complete root and branch reform. This has been a known issue for years but the judiciary keep stuffing it back under the carpet. The Law Commission actually wrote an advisory report about this in 2011, but their recommendations were not taken on board.

@Kittybythelighthouse ,

‘You're coming across as a bit patronising here - just fyi - very 'man on mums net' vibes, but I'll answer you.’

Well, I am sorry if you feel that way, but it was a polite question and, perfectly reasonable given your passion about this case

‘Your implication here is that I do not have as good of a grasp as you. I assure you that I have a very good grasp indeed. This is an odd thing to say. Have you found fault with my explanation of the faulty stats in the latest Panorama? If so, can you illustrate that? I am certain that I am correct, and I don't want to bog the thread down with maths for the sake of other people, but by all means show me otherwise.’

It really isn’t! What I mean is that no one will understand it 100%. But those who were in the courtroom at least had 1,000s of hours to get to grips with it.

‘I think your working is a little off. Your “2% × 2% = 0.0004” claim makes the same mistake Roy Meadow made in the Sally Clark case. Meadow multiplied the probability of one cot death in a family by itself to get the probability of two, assuming the events were independent. He ignored that both deaths occurred in the same household, so they shared risk factors that made them statistically correlated.’

My workings are perfect and, if you had actually bothered to read my post, I mentioned that correlations would change this. But then you actually need to start attaching numbers to the correlation to see how much.

‘Show me a single thing that stands up by itself. If nothing stands up by itself then there is no case. A whole pile of broken links doesn't somehow make a strong chain, it makes...a whole pile of broken links’

This is where I (respectfully) disagree with you. If each single thing has some value in shifting the probability towards guilt, even if not hugely, a whole pile of these things will make a strong case.

‘This is nothing whatsoever like the OJ Simpson case. There were two bodies covered in stab wounds - someone killed them. There was a clear history of domestic violence, some of it very extreme. There had been previous death threats. That's where you're starting from. As I've already explained this case doesn't start with definite murders. Babies die in NICUs. There was a nationwide death spike. Men kill their wives not infrequently. Nurses are very rarely serial killers. Also, Lucy Letby isn't a multi-millionaire retired NFL star. She's an ordinary nurse from a cul de sac. Anybody working for her is doing it pro bono out of professional and moral integrity. It's ludicrous to compare the two.’

I think you are misunderstanding my analogy here. The similarity is that both defences tried to pull apart the evidence strand by strand, as opposed to challenging the major thrust of the prosecution case. Each tried to introduce shreds of doubt into scientific tests, procedures etc.

‘Thankfully the avenues of legal defence have notbeen exhausted. The case is currently under review with the CCRC. Let's see what comes of that.

In the meantime I'll continue talking about it if I wish, assuming that's okay with you.’

Agreed and absolutely. You are looking for a combative tone in my post which just wasn’t there.

Think it has to come from the medical profession, lay people would find it difficult to interpret a level of medical evidence they would have to have a level of education. How do we know someone on the jury understood any of the evidence & just went along with well she looks weird. It has to be factual evidence, rather than gut feelings, rumours, gossip & hypotheses.

The problem with this is that selecting a professionally qualified jury runs counter to the entire rationale of the jury system which is that guilt is decided by the man on the street. You have the same issue with complex fraud cases where people will say that the evidence is too complex for the man on the street and finance professionals should be on the jury. The problem is - and we've seen it in this case and in the Sandie Peggie tribunal - doctors swarm around each other to cover up.

I'll never forget the getaway chase with OJ Simpson prior to arrest. Watched it live on Channel 4.

I think someone should make a documentary exposing Dewi Evans tbh!

Is there any more information about the report by The Law Commission? It seems incredible that they made suggestions of how to improve things so long ago but nothing has been done (or is it just everything takes so long to get moving?)

I can well understand that a jury could have trouble understanding what's what in complex cases )not just medical ones either) yet are expected to make decisions that could have enormous consequences.

Just to address this, these babies were in a level 2 NICU (LNU) which I think everyone agrees the COCH should never have been upgraded to, and which it was immediately downgraded from when Letby was removed. As a result it was taking in babies of a much higher acuity than it was capable of handling at that time.

None of those babies were "doing well" according to every expert that has examined the same evidence the prosecution experts had. They also say that there were abundant signs of decline that were missed. So the babies didn't just collapse out of the blue.

The consultants - who were paediatricians and not neonatologists - only did two ward rounds a week. They should have been doing two per day.

Nurses notes were full off signs that babies were deteriorating, as well as notes about problems and delays getting a doctor on site, particularly during the night (which is when most of the deaths happened).

Doctors missing signs of deterioration, not being present enough, not being experienced in the unique physiologies of premature babies (where some organs may be underdeveloped etc), will lead to collapses that the doctor might characterise as "unexpected" but that's just because they weren't paying attention.

One million percent! Most of his work has been in the closed family courts though, which is a bit scary.

https://www.theguardian.com/commentisfree/2024/jan/31/fought-family-courts-journalists-report-hearings

Louise Tickle has widely reported on closed family courts.

For instance, you mentioned the insulin test being 98% accurate.

I’m not sure what accuracy is supposed to mean in this case. It certainly doesn’t mean that the immunoassay can accurately detect insulin alone and you can be sure it has not cross-reacted with pro-insulin or antibodies in 98% of cases.

It may mean, for example, that the test will produce the same results from the same sample in 98 out of 100 cases.