Lucy Letby - have you changed your mind thread 4

[MistressoftheDarkSide]

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

Evans's change of mind is on the record with the media. He may deny it. He may have changed his mind again. One could dispute whether it applies to one or more cases. But it doesn't matter: how an expert witness discusses a case, after trial, in the media, is part of the material the CPS may use to judge whether he remains credible and whether his cases need urgent review.

I agree. But until we're happy for the concluding statement to be "we don't really know", there's always going to be an element of uncertainty.

Evans has in any case apparently changed his mind about not having changed his mind, since in the recent BBC Panorama he parries the claim with "does it matter". (Yes, it does).

You can watch him on Panorama here.

It's worth commenting too that your source, in Frayn, is quite old by now. Chase, Shannon and others have been discussing new research in brief since after he made those comments. So Google hasn't much hope of telling you how credible Frayn is with reference to Chase, until Frayn comments on their research.

In my mind, the first question should have been "how exactly did these babies die?" rather than "how did Lucy Letby kill these babies ?"

If the answer was inconclusive, or even conclusive at post mortem, stating that the person there on many occasions must have been "doing something" is such a leap.

I still don't understand how the pathologists have been almost written out of the whole affair, as far as we know anyway. You'd think they'd be under review at the very least. I'd love to hear their side of it.

@GingerPower
I have a major issue with the insulin tests. We know that sometimes this type of test is wrong which is why they are not supposed to be used for forensic purposes. However the exact error rate is contested.

But why on earth are we even looking at the chances that two individual tests could be wrong in the first place? The investigation looked through all the tests that had taken place on the unit while Lucy was working there and clearly they only selected tests that gave unusual results.

It's like rolling twenty dice, four of which are sixes and asking someone what the chances are these four dice are all sixes, whilst refusing to reveal how many dice you rolled in the first place.

Unless Frayn has worked extensively with preterm babies, has 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.

No offence intended, but is this an assumption or do you have the medical expertise/insight to make that statement?

You may be right but I'm also reticent to assume that extensive prenatal experience is required for somebody who's worked with these assays for 50 year to have a good idea of their accuracy.,

Unless Frayn has worked extensively with preterm babies, has decades of experience using the tests.

He's been using the tests for over 50 years.

Frayn seems to be saying that the Dewi Evans thing is a bit of a red herring.

To put it another way if I show you 25 dice that are all sixes and ask how likely it is that this happened by chance you will probably conclude that it is very unlikely.

But if I tell you I rolled 125 dice altogether and 25 were sixes then it won't seem unlikely at all that this could happen.

Without knowing the total number of events it's hard to make any sensible judgement about something happening by chance.

And that's before getting into the expert panel's explaination of how these immunoassay tests can be wrong in premature babies.

@GingerPower - regarding Evans not having changed his mind on Baby C (and you may want to strap yourself in and put a neck brace on)

In 2017 Dewi wrote this about Baby C

*’One may never identify the cause of death if [baby c] but he was at great risk of collapse’ - this was in his first report (he’s written 9 to date, the 9th being over 12 months after the verdict) and was presented at trial.

Then - please see the screen shots of the trial reporting for baby C - wgere Evans flip flops all over the place (I think in part because he learned that Letby had not been on shift when an X-ray had been taken if baby Cs stomach and had never met baby C before that point)

NB - Evans said this in court of the air bubble in the stomach in court :

Mr Myers asks Dr Evans what evidence there is to support that air had been injected into the stomach on June 13.
Dr Evans: "The baby collapsed and died." Chester Evening Standard

Subsequently, these things happened:

on 3rd August 2024 Dewi Evans, in a signed statement to channel 5 says this:

The Prosecution Expert Medical Witness stated:
‘Babies were destabilised by an injection into the stomach, an opinion shared by other paediatric experts.’

Then this happened:

On the 1st October 2024 he told the Telegraph this:

“The stomach bubble was not responsible for his death," he said. "Probably destabilised him though." His demise occurred the following day, around midnight, and due to air in the bloodstream. "Letby was there. I amended my opinion after hearing the evidence from the local nurses and doctors. Baby C was always the most difficult from a clinical point of view. So I understand the confusion."

This was on the same day BbC radio four released this;

Lucy Letby: the broadcast that caused Dewi Evans to retract his diagnosis for Baby C - YouTube

Then in Panorama’s LLWTB documentary he said this:

When asked about his flip-flopping on the method of murder Dewi Evans asks
‘Does that matter?’
Moritz suggests that some thing it does
‘It does not.’ Panorama LLWTB 16:00

He has written a 9th report and sent it to Cheshire police amending

Last three screen shots from the trial reporting @GingerPower - sorry, MN limits the number per post

I think the important distinction is that neonates, especially pre-term neonates, are a specialised subset of humans. They have missed out vital development time on the womb for a variety of reasons, all of which might make their physiology unique, and require artificial compensation to bring them up to speed as it were.

It's fine to state one's expertise and confidence with regard to the usual application of these tests, but if you don't also have advanced knowledge of premature neonates physiology, which can vary greatly, it could be an overstatement of reliability.

In the Guardian article I think, it mentions that the babies in question didn't show certain signs associated with insulin poisoning, such as seizures.

All of these variables apparently disregarded in order to secure the conviction of Lucy Letby, don't make for a fair and transparent trial IMHO.

Both these babies had twins that she was suspected of murdering or attempting to murder though, so wouldn’t that make it a bit less straightforward in terms of probability that it was them that happened to have had the incorrect test results?

Stirling work @TypicalWave x

Thank you.

So far as we can tell from Thirlwall, Jo McPartland is politely unconvinced by the court's findings, but, as she pointed out, she has not been able to review her own notes and the medical records because the police have retained them. (McPartland conducted some of the autopsies initially, and reviewed others later, as part of the hospital's external enquiry).

The other pathologist, George Kokai, is said to be quite unwell, but one can presume he too has no access to his own records.

There has been criticism of their findings on the basis that they did not know they should be alert to the possibility of deliberate harm. However, the coroner of the time pointed out at Thirlwall that there was no difference in the rigour applied - the difference was that a forensic autopsy would be carried out in the presence of the police. It's possible that they were excluded from giving evidence on the grounds that their final review of the postmortems was part of the Royal College of Paediatric and Children's Health review, and we know that the judge did not allow discussion of that review in court. But that last is purely my own reasoning.

He's welcome to express that view of course, but it's hardly relevant to his expertise in immunoassay tests.

Only if you start from the assumption she did indeed murder the siblings, surely?

It's the Letby vortex - insulin has the strongest evidence for deliberate harm. But how do we know who did it, if anyone could have tampered with the TPN bags? Well, we assume it's Letby because she did all these other things. But the evidence for those things is pretty weak? Ah, but look at the insulin ...

And so on, ad infinitum. The insulin cases could never have stood alone. If the rest fall, they fall.

Sorry, that "has" decades of experience should have been "his" decades of experience.

Anyway, the point is that unless he has worked with these tests for premature neonates specifically, he's not in a position to say whether these test values are extraordinary for premature neonates, regardless of how well he knows the tests. Because he wouldn't know the other data - the insulin and antibody measures for premature infants. Therefore the extent of any testing error would be unclear.

It's unlikely he used premature neonatal samples in his scientific research because these children don't have enough blood in them for experimental samples to be taken. But in any case, he expressed these views before Chase, Shannon and others explained their approaches, and I'm not aware that he has responded or commented since.

Well yes, suspicions were raised in relation to LL deliberately harming their twins and then a long time afterwards it was discovered that these two babies’ test results were off the charts. I’m not a statistician but I can’t help thinking that the probability of those two tests being wrong would be quite different than just a random 2% or whatever it is of all immunoassays being wrong.

Well, we know that three children had comparable results on the unit in 2015 and 2016, and the two who had twins who died were brought to trial. We know Evans or Brearey or both did a trawl of twins' / triplets' results. So I think what you're observing arises from the construction of the case.

I wonder if it's a case of the test results being regarded as anomalous rather than "wrong". They were worthy of further investigation imho. I think the big problem is that they were used to "prove" a crime, with no recourse to further testing as by the time they were flagged, the samples were long gone.

For me, it's the way the test results were used and interpreted to fit the narrative that's the issue.

Never mind the construction of the narrative around how the insulin was administered, which requires an extraordinary amount of "luck" and happenstance, given that Lucy Letby went off shift half way through the drama.

(Which prompts a side thought - if Lucy was doing it for attention, wouldn't she have hung around to see the conclusion?)

Essentially we have an anomalous result, no recourse to corroboration, neonatal physiology with all the variables associated with that etc. I also wonder if there is any connection between the twins, as one of them HAD been treated with insulin. Whether it was some genetic thing or transference in the womb or some possible error on the ward, (and I appreciate this is probably all wild speculation) you'll never convince me that serial killer nurse is the most likely explanation, especially given bith babies survived.

Did they only trawl twins and triplets results?

I have a vague memory that a natural cause had been established for the third baby’s result, but I could be wrong about that.

Only if their twins were actually deliberately harmed I would assume?

Yeah that baby was diagnosed with hyperinsulinism (not sure if that's the correcr name) at another hospital but Dewi Evans said he thinks the diagnosis was wrong.

They trawled twins and triplets; then, having found some anomalous insulin results, Dr Brearey ordered all insulin results from that lab.

The third case is supposed to have had a later diagnosis of congenital hyperinsulinism, but that wouldn't explain a result which allegedly showed exogenous insulin, i.e. poisoning. If that child could have such a result naturally or by lab error, so could others.