Lucy Letby: have you changed your mind - thread 3

[Typicalwave]

New thread for those following or wishing to comment - originally started by @kittybythelighthouse.

Yes, I think that's reasonable.

I'd rather see a sensible discussion of the case that drops all the false and melodramatic pattern seeking. Twins and triplets, Facebook searches, the minute the parents left etc etc.

That does give way to an assumption, if you think she's guilty, that, well, she had no special reason for targeting these children - and may have targeted others. So that brings us back, always, to the scientific problems - have we any more reason to think these children were victims of a serial killer than anyone else on the ward - or anyone else else on any other ward. And what we can't do - and I appreciate you aren't doing - is then revert to the multiples-facebook-timing patterns.

My assumption is that there were other potential cases that were dropped, but also that the police were keen to push charges in some cases that seemed to have stronger circumstantial evidence, to suggest a recognisable pattern of offending. So babies C and E: weak cases that the prosecution experts didn't initially identify as murder, got pushed for the text messages, the twin factor, the mother's testimony. But - take away the prosecution insistence on patterns and does the jury find Lucy Letby guilty at all, given the paucity of scientific evidence?

On the question of TPN bags, I’ve been thinking about this. I’m not a nurse, so happy to be guided by anyone who is.

According to court testimony (Ian Allen 29th November 2022 and Lucy Letby's defence examination of 5th May 2023) there are two layers of security on TPN bags.

1. The TPN bag is sealed inside a sterile cellophane bag which has to be torn open to get to the actual bag.
2. The port on the TPN bag (totally contained within the cellophane outer bag) is covered by a hard plastic tamper-proof cap. Something like this one: albiox.com/product/tamper-evident-caps-for-iv-bags/ with a tamper evident seal over it.

You can’t just poke a needle through. You’d have to somehow manipulate the tamper-proof seal off the cap through the cellophane (without tearing the cellophane), screw off the cap to access the port (and hold onto it still within the cellophane), poke the syringe through the cellophane (without visibly tearing it) and through the septum, close the cap (still working through the cellophane outer layer) and then replace the seal so that it looks like it hasn’t been touched.

All without leaving any evidence of it. All while working through an fiddly cellophane bag. And all while never tearing the cellophane.

From LL’s testimony on the 5th May 2023:

Q; So in order to get insulin into the bag once it's come up to the ward, if it's still in it's cellophane wrapper, you have to somehow get through the - you have to get the insulin through the cellophane wrapper.

A (Letby): Yes.

Q: You have to get the cap off the bag; still in it's cellophane wrapper.

A; If it was put in through that port, yes.

Q: Yes.

A: I don't know, the bag was [overspeaking]

Q: I know you don't know, but the jury may want to consider whether this is possible, you see. You have to get a needle through the bag and through the tampered cap?

A: Yes.

I have questions about the logistics here.

Are the questions: how did the jury buy Dewi’s Evan’s conclusion (and what conclusion number was this - bevause Hes already made others hadn't he?) that a nurse had successfully not only predicted that baby Fs TPN line would fail so she’d need to spike a second bag but she also managed to successfully spike the correct two bags AND do it through two lines of tamper control whilst ALSO managing to obtain insulin without trace (no missing insulin, no buying a controlled drug from somewhere inside the dark web)?

I think the answer is that if you state someone has harmed or killed a child in a court of law, that's all they really hear in most cases. Plus, the naivety of assuming that it wouldn't get to court without compelling evidence.

Mea culpa, despite my own experiences, when I heard about the case, I fell into the latter trap somewhat, because after so many high profile cases demonising mothers and HCPs, some of which have been overturned, I really wanted ti believe they couldn't get it wrong again, not on this scale. Also, I'm aware of my own potential bias towards the system, and have been castigated for it.

It was after the verdicts, and seeing the huge doubt coming from professionals who, to be frank, shy away from controversial cases for fear of reputation or being wrong (because that's also possible) that i started to look at it from a forensic point of view.

Stuff the highly dubious circumstantial evidence, and the lurid hoopla, I wanted to know HOW she did it. And I couldn't make any of it make sense at all. Especially the insulin.

In fact, the simple fact that the test relief upon is not suitable for use as forensic evidence should have been enough reasonable doubt regardless of the rest of the unfeasibility.

I’m not a nurse, but I do know about the preparation of these bags.

There are usually three ports on a PN bag.

One is for filling the major components (amino acids, glucose), which is sealed after filling and cannot be opened without breaking.

One is for additives, which is sealed with a tamper-evident cap. This can be flipped off to put additives in, and then is covered by a different tamper evident cap which could be removed with force but can’t then be reattached. Sometimes additions aren’t made so the original flip cap is on.

The third port is the giving port which takes a large spike once only.

The whole lot is sealed inside a bag (to protect from dust, really) before supply. This might not be a heat-sealed bag, but apparently at Chester it was.

The idea of being able to wrestle off a tamper evident cap, inject through the wrap and the port, and replace the same cap without breaking anything or tearing the wrap is quite a stretch. I can’t see that anyone would try this because of the risk of it all going horribly wrong, and it would take minutes rather than seconds.

“The idea of being able to wrestle off a tamper evident cap, inject through the wrap and the port, and replace the same cap without breaking anything or tearing the wrap is quite a stretch. I can’t see that anyone would try this because of the risk of it all going horribly wrong, and it would take minutes rather than seconds.”

Yes, I agree.

Re: the additives port

If no additives had been prescribed for a TPN bag, is it possible to reattach the original additives cap and the fact that it had been removed and the reattached be undetectable?

Sorry @EyeLevelStick- ignore me. I misread.

It’s OK. In my experience, accidentally putting on the cap too early is a bit of an expensive catastrophe, because you don’t get a second chance.

However, I don’t know exactly which design of bags were used at Chester. I will read the link above later.

Definitely understand your reasoning here, but I think if anything the same back and forward about the same things over and over (not your fault) would make people less likely to keep up and follow anyway. Look how much better it is today with people actually asking questions for the sake of knowing the answers instead of the bullshit from that other poster 😂

I have to say I’ve started a few replies, but changed my mind. I admire Kitty and Typical’s tenacity…

I see they're looking for help on tattle for help in responding to Kittys post 😂😂

Apologises if this comes up as a double post, I included the link in the last post and MN hid it until they look at it.

I only had a look to see if I could spot that poster bitching and sure enough 👀😂

The Jury is back on TV this week. If anyone has not watched the last one, where they had 2 juries which came to different conclusions it is well worth a watch. It made me really worried about how the jury system works. I think in cases where there is a lot of complex technical information presented, juries are probably the least good way to try the case. Not saying bench trials are infallible. I actually think the American system where jurors can discuss their process after has something to be said for it.

Yes if you are starting from the premise that it’s beyond reasonable doubt that she harmed some babies, I think it’s fair to say that which baby got the (supposedly) contaminated bags is irrelevant.

However there’s scant evidence for any of the deaths or collapses being anything other than natural causes or iatrogenic harm. Certainly the evidence of insulin poisoning is very thin. No evidence LL conducted internet searches when she searched for everything else. No realistic method of contaminating the PN and insulin adsorbs onto the plastic of the PN bags anyway. No other method of covert administration suggested. Lab results questionable…

Ok, then

I don’t think @Firefly1987, Dewi Evans, Cheshire police even, sees a problem with starting from a presumption of ‘murder’ and ‘guilt’ and then going to look for the evidence that supports it.

Thank you @Hotflushesandchilblains- I meant to watch the last one and then forgot all about it

Gosh, Tattle Life is ...... interesting.....

@EyeLevelStick- would it be possible to put a needle through one of the ports on a TPN bag and no one would be the wiser?
Asking for a friend

I can't get over things like the volume of insulin required to produce the alleged effects being waved away as inconsequential. If the devil is supposed to be in the detail he's falling short in so many areas of this case and rendering forensic analysis as pointless.

Well why not, renowned paediatrician, Dewi Evens even says himself, it doesnt matter how LL killed the babies, it just matters that she did.

Also, statistics are irrelevant - I guess the Royal Society of Statisticians REALLY wasted their time writing their paper to try to help the judiciary understand them and how they do and don’t apply in criminal medical cases.

I don’t think so. The tamper evident seals are… tamper evident. If you go in via the giving port or through the side the bag leaks.

I thought so.

thank you

I definitely prefer to not be on the merry go round!