Lucy Letby - have you changed your mind thread 4

[MistressoftheDarkSide]

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

I’ve taken some screen shots from earlier in the testimony to help.

Three judges - who quite likely do not have an A Level in science between them - are in no way, shape, or form, equipped to rule whether or not the research of an internationally esteemed neonatologist has been misused or not. Specifically, they are not better equipped than that expert himself. That is, frankly, ridiculous, and it has thoroughly embarrassed the British justice system on an international stage.

Judges spend their lives learning about the law, not science. Understanding the law is important, but it doesn’t make them experts on anything but the law. This goes to the very heart of why there are serious, serious, issues with how expert evidence is handled in British courts. We will keep having miscarriages of justice until this is fixed. That stands even if Lucy Letby is guilty. If she is it won’t be down to the genius of Dewi Evans. It’ll be sheer dumb luck that she was caught.

I think that baby A is the baby that Evans didn’t even know about the skin rash/discolouration until after he had arrived at his conclusion?

Did they not use any expert witnesses? The judges obv aren't expected to be experts in every field. It'd be unusual for them to be investigating highly scientific elements on their own with no support.

Thanks @Typicalwave

Here's what Johnson said about Child A in his opening speech for the prosecution

"Doctors observed "an odd discolouration on Child A's abdominal skin - flitting patches of pink over blue skin that seemed to appear and disappear". Mr Johnson said: "This proved to be the first of a series of similar presentations on the skin of babies suddenly and catastrophically collapsing at the CoCH NNU over the succeeding months. "It is a hallmark of some of the cases in which Lucy Letby injected air into the blood streams of some of these small babies."

Here's what Evans said about Lee and Tanswell in his examination re Child A

Right. Yes. First of all, just briefly about this
paper, that is paper by Lee and Tanswell. And it's probably the best known paper in relation to pulmonary vascular air embolism in the newborn. It's published in 1989. So despite being over 30 years ago, it's a very
well-known paper -- and the other reason it's well-known for British paediatricians is it was published in the Archives of Disease in Childhood, which is a monthly
academic journal that all paediatricians receive. So therefore it's the most so the Archives are the most widely read journal from paediatricians. Anyway, just to so this is not some obscure journal, you know, that nobody ever reads.

Right. In terms of this description, if babies
collapse they become hypoxic, and the usual change in colour is they go blue. Okay? So they become cyanosed. If their blood pressure drops, they may go white.
You know, because there's no circulation. So therefore the colour changes you find in collapsed babies, collapsed children, is a combination of blue and white
because they are white if there's no blood getting into the peripheries, into the skin, and they're blue if the blood that does get there is hypoxic, in other words
lacking in oxygen. So that's what we're used to seeing in babies who collapse because of infection or any other cause, whatever.

So therefore what we've got here is:
"Bright pink vessels against a generally cyanosed cutaneous..."
You know, relating to the skin. So the fact that it's bright pink, now, that is remarkable. It's very unusual. It shouldn't be pink. You know, or if it's pink, why has the baby collapsed? It doesn't make sense.

Their interpretation is absolutely correct. They attribute it to the direct oxygenation of red blood cells in other words, red blood cells have got oxygen in them and adjacent to free air in the vascular system. In other words, there's air in the circulation.
You know, air or oxygen in the circulation.

Q. So air is 21% oxygen?

A. And air is 21% oxygen. So this is remarkable. You should never, ever, ever have air in your circulation because of because it's dangerous. And if the tissues continue to be purely perfused and oxygenated so they are really saying this makes no sense because we've got pink colouration and yet
we've got collapsed patients. This shouldn't happen.

And they attribute it, quite correctly, to the fact that the cause is air embolism: air has got into the circulation.

And later:

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.

And from Johnson in his closing speech:

Mr Johnson lists the common events for the babies in this indictment by categorisation. Unusual discolouration: Child A, B, D, E, I, M, O, H.

Yes the media certainly seemed to seize on the comments about the strange rashes anyway, that's one of the main things I remember hearing about before I followed the trial.

This won't happen of course but it would be great to have a justice system where the jury had a debrief afterwards, with the information kept private unless needed for deciding on appeals where the jury could say which pieces of evidence/experts were most impactful.
Of course they couldn't go through everything but the current system involves guessing what had a major impact on the jury and what didn't. At least if there was some kind of recorded debrief then they would know.

Seems so, but in court he described his conclusions on baby A as air embolism a diagnosis of exclusion, reinforced by the unusual discolouration and air on the postmortem scan.

There's really no doubt he misinterpreted and misrepresented Lee and Tanswell here, and at other points in the trial.

We can't be sure how much this weighed with the jury, but the symptoms of air embolism are very general indeed without that special rash which the prosecution mentioned so often.

Crossings out there are a formatting issue, by the way - apologies. Not in the original and unintended.

https://www.bbc.com/news/uk-england-merseyside-64732275

When you consider this sort of reporting, I think the significance of the "rashes" was definitely hammered home to both the public and the jury.

That’s correct, or so he says. What is yoir point? In his evidence about baby a and b he relies quite heavily on skin discolouration and it being indicative of air embolism - see screen shots I posted

I know the CCRC call expert witnesses, and I know they would feature at an appeal hearing, but genuinely not sure if they'd be involved in reviewing request to appeal. There's no reference to expert advice in the final judgement, unless I've missed it.

"One of the things that came up in discussion was could this be air embolism, I can't remember who suggested it."

This quote from Ravi Jayaram stood out to me.

It implies the consultants were already discussing possible air embolism quite early on. Would this be before or after Dewi Evans came on board?

Apologies if this is common knowledge, I seem to be foggy in this area.

This is, unfortunately, how it works. In practice: at the application to appeal stage, judges do not consult experts. They, themselves, consider expert evidence that has been submitted by the applicant (or, less commonly, by the Crown in response). They rely on the evidence and arguments already made formally before the court. If specialist knowledge is needed, it must come through the proper adversarial process.

In other words, the judgement made on Dr Shoo Lee’s evidence was about procedure, not justice, and it was dismissed by experts in law, not science.

Dewi Evans

Perjury?

Just going through Dewi’s testimony on Baby A and something struck me: see screen shots I’ve posted below and then compare with what he said in Panorama and the Guardian article (Guardian article is a nice synopsis of his spectacular flip-flopping on Baby C - whom he is now no longer allowed to talk about according to yhd transcript of his full interview with John Sweeny - but he goes on to talk about snyway in that interview)

At court - baby A&B evidence - see photos: pretty misleading whrn you compare 👇🏻

On Panorama he said:

‘My concerns were pretty rapid, you know, within a matter of minutes really. It stuck me that this baby was a victim of significant inflicted injury, and that we were already looking at some kind of criminal event’ - Panorama: Lucy Letby - Who to believe? 09:20 minutes in.

And in the below he said:

Guardian ‘My kind of case’: intense focus falls on Lucy Letby trial expert witness | Lucy Letby | The Guardian

He said:

Evans, then 67, a retired consultant paediatrician, says when he looked at postmortem photos of that first baby he saw bleeding over the liver. “I thought, ‘Oh my God. This baby has suffered trauma.’ We knew instantly that something suspicious had gone on.”

Yet another of the many times Dewi Evans has contradicted himself.

Depends on which account of Jayaram’s you believe - Hes given at least two accounts of vastly different dates of whrn he said he discovered Lee’s 1989 paper - but iirc they were before Dewi came on board in mid 2017

I suppose what I'm getting at is whether air embolism was considered during all the "suspicious" collapses / deaths, and if anything was done about it.

Surely if accidental air embolism was suspected, a review of best practise would have been the most minimal but logical response. And where deaths had occurred wouldn't they have flagged it with the pathologists?

There appears to be a flip flop around "it was all baffling and we had no idea what was going on" and "we had some ideas but didn't pursue them for quite some time (even though we suspected babies lives were at stake) "

In addition - see below

And yet repeatedly in interviews, I’ve only highlighted two of them but there have been several, he has said he knew straight away (I’m paraphrasing) that Baby O had been deliberately harmed.

And…he also says the child A was the first case he looked at….

Harkness, Jayaram, I think another Dr and a nurse all noted strange discolourations, at least one of them described it very differently between theif police interview and court testimony , but they were all struck by it abx yet none of them recorders ig in their contemporaneous notes (which would explain why Evans didn’t initially know about it) It was oddly professionally incurious of them.

I read an article earlier looking at both sides. One criticism of all the experts chiming in is that they're a bit too focused on the air embolism bit when it was the insulin that was the bigger factor in the trial. I can't remember their reasoning behind that but it was well explained.

Can anybody summarise what the critics are saying about the insulin bit? I will read up on it when I have time but I'm up at 4am tomorrow so need to hit the shower etc shortly.

https://www.theguardian.com/uk-news/2025/feb/07/strong-reasonable-doubt-over-lucy-letby-insulin-convictions-experts-say

This article gives a broad summary along these lines.

There has been alot of debate and back and forth about the reliability of the initial test and it's suitability as "forensic evidence" for a start.

There's alot of material out there, I think the main criticism is that insulin poisoning was presented as a smoking gun at trial, and was in fact no such thing.

Thanks for that. Will have a read.

The issue I find is that for every claim there's a counter claim that sounds equally plausible at face value. For example, I asked google about Geoff Chase's credibility and it returned the following discussion.

And while they address the traditional claims of attack on the insulin evidence (which was only touched upon by Dr. Lee in his attack on the convictions), they end the article with this:

>Keith Frayn, an emeritus professor of human metabolism at the University of Oxford who has been using immunoassay for insulin since the 1970s, rejected the notion that the tests were unreliable. “I don’t think many people who know about insulin assays would say you can disregard those tests,” he said. “They are very clear.”

>He acknowledged there was a small margin for error but said the Letby case results were far outside that, given the two babies had insulin between ten and 40 times the normal level. Crucially, C-peptide was undetectable in one baby and very low in the other. Given that natural insulin produces with it higher levels of C-peptide, the only explanation was insulin introduced from outside. “There are most unlikely to be analytical errors,” Frayn said.

>He agreed with other experts that follow-up insulin assays to confirm results would have been desirable but insisted the insulin levels in both cases were so far outside the margin of error that it was unlikely to have made a difference.

It seems premature and pointless to make so much noise about air embolism and Dewi Evans when the actual heart of the case remains absolutely unweakened since trial.

And Dewi Evans seems to be refuting the claims that he changed his mind.

"I am not in receipt of any information that indicates that the Appeal Court judges were mistaken."

Expert denies he 'changed his mind' in Letby case

https://www.google.com/amp/s/www.bbc.com/news/articles/cz6l0dynz7zo.amp

And this is the problem with the whole case frankly.

And why so many people, myself included, question whether the adversarial nature of our justice system is equipped for such complex trials.

Essentially instead of "beyond reasonable doubt" we got "balance of probabilities" and alot of extraneous hammering home on things that are utterly irrelevant if murder isn't actually the cause of these babies deaths.

Unless Frayn has worked extensively with preterm babies, his decades of experience using the tests (which are not all the same and have changed over the decades) are not so relevant as they may appear.

The idea that the insulin cases could be at the heart of the case once you have eliminated the air embolism cases doesn't stand. The prosecution worked very hard to demonstrate that nobody needed to be present on the ward to spike the bags with insulin. So without the other charges, Letby is no more likely to have done this than anyone else on the NICU payroll.