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

Here it is: https://lawcom.gov.uk/project/expert-evidence-in-criminal-proceedings/

The report recommended giving trial judges a statutory duty to exclude expert evidence unless it met a clear reliability test. It proposed codifying an admissibility test requiring judges to assess whether the expert’s opinion was sufficiently reliale to be considered by a jury. It set out specific factors for assessing reliability including the soundness of the expert’s methods, whether the theory was generally accepted, whether it had been peer-reviewed, and the error rate etc.The aim was to prevent wrongful convictions based on speculative or junk science - cases like Sally Clark and Angela Cannings were examples that motivated it.

The government responded in 2013 but rejected implementing the recommendations in full. They decided not to create a statutory reliability test, arguing the existing common law rules (Criminal Procedure Rules, Criminal Practice Directions, and some case law) were adequate (clearly they are not).

They cited concerns over cost, delays, and complexity. As a result the recommendations were not enacted into law. This means that in England and Wales, admissibility of expert evidence is still governed by common law and procedural rules, not by a statutory reliability threshold like in the US Daubert standard. Critics (including some appeal judges) have said this leaves the system vulnerable to unreliable expert testimony in criminal trials.

I'd love to know what the original jury thinks now. They weren't even told about the RCPCH review which found huge problems with the ward; the supplementary case reviews that found different care might have produced different outcomes in at least 15 of 17 deaths and collapses examined; the spike in deaths even before the ones Letby is accused of causing; the fact that the lab that produced the insulin results produced an error on a test sample just like the two "suspicious" cases on her ward.

And since then we've found out that the consultants left vital information off reports to the coroner and gave the wrong information in court about Letby not calling for help. We've found out another child on the ward had insulin results like the Letby cases and they weren't considered poisoning. We've found out swipe card data was wrong and we can't tell who was on the ward when. Evans has conceded that the method of murder he described for three children is unheard of - although he told the court it was clinically evidenced! - and decided it wasn't the cause of death. And that's before we get to the new evidence and arguments from the expert panel on what actually happened in medical terms.

I think the original jury would have had reasonable doubts and not convicted, with the right information and the use of genuine experts. I don't think trial by jury was the problem here.

The thing that really bothers me is that even without consensus of cause of death, even if a dealt his unexplained tgat doesnt automatically mean murder and yet here we are.

Dr Hall is nowhere near as experienced as the experts on Lee's panel, but as you say - the point is that you need actual proof of murder before you say someone is a murderer. If murder is only one of however many possibilities you don't jump to that conclusion when the other possibilities are far more plausible. That's madness.

Again, if you hear hooves expect a horse before you expect a zebra. Expect a zebra before you expect a unicorn.

Serial killer nurses are vanishingly rare. Baby deaths due to natural causes and/or poor care in NICUs are (sadly) not. You need extraordinary proof in order to claim murder here.

"Unexplained" is not an uncommon finding in NICU deaths. Premature babies are very complex and varied even from baby to baby in terms of stage of development etc.

I’m the last person to be a supporter of the family court, but I oppose it being open, for many reasons.

Having the criminal courts being open hasn’t stopped ‘expert’ witnesses being used with little regulation and scrutiny.

I can understand where you're coming from. If the standard for expert evidence was higher, with better safeguards, I'd be more comfortable about it. The burden of proof is lower in family court too, I understand. FYI I think the family courts are no longer closed as of last year.

This is an important point.

Re the insulin results, a lot are making a big thing of antibodies binding to the insulin (are you neonatologists?).

So here is one study specifically looking at this in low weight premature babies.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10862284/

The results of the insulin/c peptide ratio was a mean of 0.42 and a range of 0.34 to 0.55 in a sample of 48 babies over a significant period of time.

One of the Lucy Letby babies’ ratio was 27! The other one was also way beyond that range.

So, yes, the tests could have been a pure mistake but arguing a correlation merely because they were pre term makes no sense relative to that study.

That's not what's being campaigned for though. The focus is on transparency and reporting where there's obvious conflict of interest.

"measured on day of life (DOL) 7 and at postmenstrual age 36 weeks".

No comparison with Letby's case.

https://observer.co.uk/news/national/article/child-abuse-is-never-above-the-law-not-even-if-youre-a-family-court-judge

This demonstrates clearly a conflict of interest regarding family courts.

@Oftenaddled ,

‘measured on day of life (DOL) 7 and at postmenstrual age 36 weeks".

No comparison with Letby's case.’

The 36 weeks was the second point. They were small premature babies.

Do you have another study that points to a different range of ratios?

I don't think it's feasible at all. Knowing the layout of the hospital at that time really helps get your head around this. It was tiny and cramped with multiple cots in the room. Multiple nurses assigned to the other babies. There are times when she's supposed to have done something wild like e.g. punch baby O in the liver - there were multiple people working on the baby at the time this is supposed to have happened. There was never just one nurse on duty.

There are videos of the NICU on YouTube I think. I can dig one out later if you can't find it.

As to overfeeding - that theory has been retracted by Evans and widely ridiculed by neonatologists as ridiculous and implausible. She was still convicted though. However, even if it were somehow possible to kill a baby this way, those tubes are very fine. She would have to pump food/liquid through, wait for it to clear the tube, then pump more. Neonatal nurses have commented saying this is just silly. It would take ages and the chances of no one ever noticing? Not plausible, but as I say, it's been retracted and debunked anyway.

There are also serious logical questions around the fact that no insulin was recorded as missing, but a lot of insulin would have been needed to successfully affect the baby (insulin is known to bind to the plastic of TPN bags and to tubes etc) as well as with the structure of the actual bags and the plausibility of having been able to inject them without tampering being obvious. The bags were not as depicted on Panorama in the reenactment. Again, I'll get that TPN bag info later if desired.

I agree. At first, when Lucy Letby was convictedl l, along with the vast majority of the country, thought that she must be guilty. However, l have been convinced for a long time that she is innocent and was made a scapegoat for the hospital's failings. If there was not a strong possibility that this was the case, why would all those experts be speaking out on her behalf, many of them without charging a fee?

I'm aware of that, yes.

Both factors - seventh day of life and 36 weekers are irrelevant to Letby's cohort. Hers were younger in terms of days of life and (for the second point) gestational age. That's at a stage when days are crucial.

These are also as far as I can see - I haven't read beyond that point - not babies suffering from either hypoglycemia or sepsis? It's not relevant.

No, I can't offer you another study for children as in Letby's cohort. That's the emerging research discussed by the panel. One may choose to disbelieve them - I don't - but nobody's arguing you can google and find their data online. Yet.

@Newbutoldfather The maths mistake you have made is assuming that only two insulin tests were carried out and calculating the probability they were both wrong. In reality many blood tests will have been done over the period that Lucy worked on the ward. If for example one hundred tests for insulin were done over this period then two incorrect tests would be exactly as we would expect (if indeed 2 % is the right figure, I think the defense experts would say it is not in the case of neonates)

Now I don't know how many tests were carried out. But what you have to also remember is that any blood test showing anything unexplained would have been used against her. It needn't have been insulin. It could have been Potassium or something else.

So the real probability to consider here is of all the blood tests carried out on the unit over the whole time Lucy was working there what are the chances that any of them could be unexplained or wrong in a manner that could be interpreted as malfeasance.

This was my trajectory also. You need a wild conspiracy theory to explain why all these eminent people are coming from top research hospitals all over the world, where they hold senior positions, to make stuff up in order to defend a nurse from Chester - and to do it pro bono. Unless she is literally a witch? Perhaps there are some that would argue it! I wouldn't be at all surprised if Dewi Evans said so at this stage.

Posted too soon. I was about to add that the cases this reminds me of were those of Sally Clark, Angela Cannings and Trupti Patel who, around the turn of the century, were wrongly convicted of murdering their own babies. These poor ladies had suffered several cot deaths but Roy Meadows, who was subsequently struck off, stated that the chances of more than one cot death occurring in the same family were millions to one. Dr. Dewi Evans seems to be a similar type of expert witness and the more holes that appear in his "expert" evidence, the more the likelihood of Lucy Letby suffering a huge miscarriage of justice rises.

@BanditLamp ,

This wasn’t a random blood test with a weird result. It was taken directly after the baby crashed.

I do take your point about randomly searching for anomalous results though. Thank you.

‘She is said to have struck after midnight on a night shift on 4 August 2015 as the baby, referred to as Child F, received a new feed of nutrients via a bag connected to an intravenous line.

Shortly afterwards his heart rate surged and his blood sugars plummeted, jurors at Manchester Crown Court have been told.

Blood samples taken from Child F returned an "extremely high" insulin level of 4,657 and a very low C-peptide level of less than 169, indicating synthetic insulin was in his system.’

How does that description of events undermine @BanditLamp 's point, though?

She's not talking about people undertaking tests randomly - of course there was a reason to test.

She's talking about the results being random - in the sense that if you look at the results of all the tests carried out on the ward, you will get some, randomly distributed, extremes, outliers and errors.

its a bit difficult for her to strike if she wasn’t there, though. And for both of the insulin cases she was not there.

@Oftenaddled ,

‘She's talking about the results being random - in the sense that if you look at the results of all the tests carried out on the ward, you will get some, randomly distributed, extremes, outliers and errors’

But random results and errors don’t cause babies to crash, and not in precisely the way the test result would indicate would happen.

An ex of mine, I was with him at the time, was on the Original PC Blakelock Murder Trial Jury

A jury who convicted 3 innocent men on the evidence they were given

And we all know where the evidence came from in that

it actually broke him. He was signed of work for months and ended up taking early retirement . He never trusted the police or the justice system after that

Does anyone know why Lucy wasn't charged with attempted murder for the third baby on the unit that had a blood test showing high insulin and low c peptide?

Is it because in that case they did further tests at the time and found an explanation or because she was on holiday or something?