Lucy Letby - have you changed your mind thread 4

[MistressoftheDarkSide]

With thanks to the original poster @kittybythelighthouse and @Tidalwave for continuing the discussion.

In addition the hospital wanted Letby to just quietly disappear on a limited constructive dusmissal claim as they risked her going for cd with a whistleblowing element - costly and reputational damage to the hospital, and having her bavk seemed like they felt was going to be all to difficult for them. The subsequent police investigation potentially made that all go away for them (abx for Breary because CD with a whistleblowing element might have attracted further external scrutiny?), including a limited constructive dismissal claim - in my opinion.
@kittybythelighthousedid the forensic investigation mentioned in this email end up going ahead do you know?

You twist everything, I don't have an issue with 'you guys'...I have an issue with 'you guys only believe this because she's blonde', you guys only think this because blah ...on every post, didn't think I would need to elaborate seeing as I've said it lots of times....it's just annoying, but it says more about your way of thinking rather than ours so whatever carry on.

As for there being a pile on, I didn't comment to you for a long time until it just got unbearable to listen to, particularly YOU of all people accusing another of not engaging in good faith etc etc 😂😂😂

Also I don’t remember telling anyone they’re a fan of a baby killer. So unless you want to quote me and give me a chance to address it and/or apologise I’m going to assume I didn’t use the words “fan of a baby killer” to describe anyone on here.

You have repeatedly said people are her cheerleaders and that they are defending a baby killer, which is the same even if you didn't use the word fan, not bothered checking.

Anyway this really will be my last response to you, so I just hope anyone who reads knows you're twisting everything in your responses, like you trying to make out I was throwing out an armchair diagnosis about you when you literally said you thought you had BPD yourself 😂

And it's fine that if the threads die in between developments, that's what they used to do before, no issue there. Doesn't stop things happening behind the scenes.

There’s certainly a frightening ‘challenge us and see what happens’ element here, isn’t there?

I don't get why he didn't contact Dr Shoo Lee in the first place, that's not ruling out air embolism categorically, but to at least throw doubt on the paper.
If that had happened then would Dewi Evans have carried on with that theory leaving out that paper? And if so would the defence have been allowed to say in court to the jury that Evans had initially based that on that paper or would the jury not have heard that evidence?

As a juror I personally wouldn't expect the same expert to be able to rule out everything, because I know they would all have different areas of expertise, but when you don't have any expert on the stand ruliing out any of them then I think that looks worse.

And if they couldn't categorically have ruled anything out I wonder would the defence have got away with using saying stupid things like when " Mr Myers asked Dr Marnerides whether vigorous CPR could be "categorically excluded" as a possibility for Child O's injuries.
And Dr Marnerides compared it to the hypothetical discovery of a dead man in the desert with a pot next to him, saying it could be "possible" that a helicopter flew over and dropped the pot on his head, but that it was not "probable".

This is what I'm thinking too.
I was reading the CPS website in relation to gross negligence manslaughter and the processes seem to far more robust, see the section at the link 'experts and processes'. https://www.cps.gov.uk/legal-guidance/gross-negligence-manslaughter#:~:text=The%20offence%20of%20gross%20negligence%20manslaughter%20requires%20breach%20of%20an,so%20bad%20in%20all%20the

Surely it should be the same for cases such as these.

That is not my reading of the screenshot you’ve posted. My reading is that it simply sets out the position on potential liability resulting from a constructive dismissal claim which either does or does not have a whistle blowing element to it. And that in accepting that potential liability the advice is still to keep her off the ward and take the risk of a CD claim anyway - for patient safety reasons as well as the consequent (and now very clear) reputational damage of having a baby killer working on the ward.

Fair enough that ‘Sue’ would be doing what she could to reduce the risk of a CD claim - that is what any responsible employer would do (albeit no comment from me here about whether CoCH was or wasn’t a responsible employer).

It could be read that way too.

I felt that the wording surrounding patient safety was more to do with the difficulties potentially caused by rifts in working relationships

That was how I read it too.

Particularly given that it’s noted the RCPCH found no evidence of LL being an issue and the noting of even if the forensic review planned ground the same there were concerns to do with managing the return.

There is indeed a shameless expert in this case. Hint - it isn't the internationally esteemed neo-natologist who put together an world leading panel of experts when he realised the prosecution's chief expert was actually so inexpert he misunderstood the academic paper he was citing. It is not shameless, it is honorable, to stand up and call out misuse of your academic research.

It is shameless to boast about how you "never lose a case", twist the evidence to support your side rather than act impartially as required to do so by your duty to the court. It is shameless to jump at every opportunity to join the media circus to boast about how you were able to determine that murder had taken place in 10 minutes over a cup of coffee rather than putting in the hours of painstaking research and to brag that your fees from acting as an expert witness kept your son in cars and your daughter in horses.

I have been an expert witness and Dewi Evans behaviour appalls me.

Whatever you think of Dewi Evans I don’t think it’s fair to say that he didn’t put in hours.

And if we’re talking media circuses, then on the evidence so far Shoo Lee is really not averse either.

He put in the hours to find the evidence that supported his initial 10 minute assumption rather than putting in the hours with the evidence before drawing his conclusion. That is really troubling especially when you read accounts of how he identified "murders" and then changed his mind when he heard LL could not be implicated. He was not impartial (as he should have been) and was criticised by a more senior judge in another case for this behaviour.

Shoo Lee had the experience of going to the Court of Appeal and explaining that his paper had been misrepresented and being dismissed on the grounds that this was not new evidence. So he went to the trouble of doing a new research project and writing a new paper to further strengthen the point and recruited an international panel to review other areas that troubled him. Before he did this he got the defence to agree that the findings would be published regardless of whether or not they supported LL's defence - how an expert should behave. No wonder he therefore wanted to ensure that the press picked up the new evidence. Lawyers and judges in the criminal courts (some commercial barristers are v good at it) are usually pretty poor at scientific and statistical evidence so it helps Shoo Lee's panel to have the evidence out there for those who do understand it to review widely.

ETA Shoo Lee is also not sitting there boasting about how much he's made as an expert witness - oh maybe that's because he and his fellow experts are all acting pro bono.

Can you say a bit more about how the prosecution misrepresented Shoo Lee’s paper? Because the CoA judgment seems pretty clear that they didn’t.

Wouldn’t Shoo Lee himself be better placed to argue if his wirk has been misrepresented? Rather than 3 judges who are not scientists?

Precisely.

The actual issue which both Dewi and the judges missed was that the evidence about rashes and emboli related to arterial embolism and LL was accused of venous embolism via an iv line and the rash does not appear in such cases. So Dewi misinterpreted the research and the judges missed the point again.

Sure

There are lots of examples throughout the trial of the prosecution expert witnesses relying explicitly on Shoo Lee's paper for something it didn't say.

Here's the first that came to hand, re baby A, examination of Dewi Evans:

If members of the jury and others accept what Dr Jayaram and others say about the pattern of discolouration, you know, the pattern of discolouration and flitting movements and the redness and the pinkness as well as everything else. If -- if that evidence is accepted, that is what you get in air embolus.
Q. And you base that upon what you've read, the description
in the report by Lee and Tanswell, don't you?
A. Yes.

https://lucyletbyinnocence.com/transcripts/prosecution+defence-evans-babies-ab.pdf

(This is from the 82nd page)

Okay. But as Lee has pointed out, the description he has given there didn't apply to venous air embolism, which Lucy Letby was accused of inflicting. It would only happen (and rarely) with arterial embolism, and his paper explained the mechanisms, which could only apply to arterial air embolism.

Shoo Lee's paper was very precise on the type of discoloration he meant. But, not content to apply it to the wrong sort of air embolism, the prosecution stretched it to claim that babies A, B, D, E, M and O all suffered the same sort of discoloration. This is frankly objectively untenable, because when you read the descriptions, you see that they are very different. Hence Bohin smoothing things over with, you can see different colours of rash.

Can you? Yes, of course - in any terminal event. Air embolism stops circulation and oxygenation, and the skin will mottle in various ways as the brain tries to draw oxygen away from less important organs (skin) to itself.

So what have we seen here? Evans and others repeatedly cite Lee and Tanswell - as did the consultants as far back as their first report to the police. Johnson too. But when a little handwaving is needed, Bohin departs from that track to state the very obvious: children who are desaturating, in cardiac and/ or respiratory arrest, show a variety of discolorations.

This, and the other, common symptoms described for air embolism - sudden collapse, sudden cry, death, air in postmortem following CPR - all enabled the appeal court to argue that the Lee discolouration wasn't used, alone, to diagnose air embolism. And it wasn't. But the other symptoms were so common as to be trivial, and it's hard to imagine they'd have made much impression on the court and jury without the claims about a special, unusual rash which was all over the prosecution case.

That I think is rather unfair to Shoo Lee, who has done one press conference - extremely important in shifting public and press opinion - having paid to travel to London from Canada to do so, presumably because he knew this would be more effective than an online link.

He's also done a Times interview, BBC radio, and I think one of two other appearances, since February. He's worth hearing from, he's speaking to his own area of expertise, and his intervention seems to me entirely proportionate.

Not to mention the fact that there were at least 3 different types of skin presentations described and all were quite different from each other, 2 in particular sounded nothing like Shoo Lee’s description in his paper.

To add to my comments above, Johnson also referred at the end of his closing speech to "common features" of various events, and "unusual discolouration: Child A, B, D, E, I, M, O, H" (not, various rashes). The "unusual discolouration" was associated, throughout the trial, with the Lee and Tanswell paper. The fact that Bohin momentarily lapsed into truth-telling certainly wasn't allowed to undermine that for the purposes of the prosecution's closing speech.

Okay, but in the section of the extract you’ve referred to Evans goes on to be really clear that skin discolouration is not diagnostic of anything. Certainly from that section I can’t see how the Lee & Tanswell paper bit would have been particularly persuasive to the jury compared to the other elements of Evans’s rationale for diagnosis that they go on to cover.

I think, with no criticism of the jury, that producing a research paper to back up this area of the claim would have been significant. The focus was on a "special kind of rash" and broadly speaking, I think given the volume of "medical evidence" and jargon, it might well have been something they seized on.

Problem is, given the number of babies involved, and the various descriptions of the rashes / discolouration you cannot definitively assertion it was the tell tale sign of air embolism.

Given that there are a couple of references to "never having seen" this before, if am somewhat surprised that no attempt was made to photograph these "rashes" with a view to getting further opinion, especially as the consultants were already suspicious that "something" was being done, and allegedly it kept cropping up in various forms.

I think that when the expert and author of the paper used to at least bolster the prosecutions case questions its application, he and his research deserve further examination, especially given the discrepancy between the arterial / venous issue.

Saying "it's not diagnostic" doesn't really help when it was used as part of the body of evidence used to convict Lucy Letby. The evidence should be as accurate as possible - and this just .... wasn't.

Evans is talking about discoloration generally there though, isn't he, not Lee's sign?

Definitely, we should expect some discoloration when children have infections, shock, desaturation, circulatory problems. What we see is the prosecution going back and forth between the two, but relying heavily - right up to Johnson's closing speech, which I've quoted above, on an unusual discolouration (which at various points they cite as specific to air embolism).

I find the lack of concrete evidence concerning, I do in any case where it's one word against another, much as I support the victim must be heard mantra, that doesn't actually make the accused guilty of the crime.

I don't know if LL is innocent or guilty but there are enough things (like cherry picking data, the Dr claiming one thing and then emailing the opposite, doubts as to actual murders occurring and lots more) for an appeal or possibly even a retrial - I don't know which it would be, my personal view is a retrial would be best, with hard evidence presented and LL with counsel who would challenge (either by questioning or by alternate experts) but I'm not legal.

They are referring to it all as just discolouration in that section, including the bit you quoted about the Lee and Tanswell paper - no mention of Lee’s sign as being distinct from that.

No, the Lee and Tanswell reference is obviously to the specific "unusual" discolouration: Evans says "the pattern of discolouration and flitting movements and the redness and the pinkness as well as everything else. If -- if that evidence is accepted, that is what you get in air embolus".

You can see his discussion of the paper in those terms earlier in the examination. Have you read the paper? There's not much to it.

Certainly the fact that Evans then goes on to suggest that he has excluded any natural cause of death could be expected to impress the jury. I'm not so sure about the other symptoms discussed but - Evans is good at his job and speaks with conviction. We can't judge how far the "unusual rash" persuaded the jury, of course. But it's absolutely undeniable that Jayaram, Evans, Kinsey and Johnson at least misinterpreted Lee's paper.