Lucy Letby - have you changed your mind pt. 5

[Typicalwave]

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Part 4 here - https://www.mumsnet.com/talk/_chat/5400564-lucy-letby-have-you-changed-your-mind-thread-4?utm_campaign=thread&utm_medium=app_share

Originally started by @kittybythelighthouse

So because she herself didn't work 100 shifts there it's all meaningless? How convenient. Maybe Liverpool were setting her up as well giving her babies more likely to dislodge their tubes. Even though it's incredibly rare. Everyone is just out to persecute that poor woman wherever she goes aren't they 🙄

The sample size that matters was 11, not 100.

There was definitely some shifting in their seats! How anyone can think they're going to get her out is beyond me. Even Dr Hall said they will only hurt her case. He basically said you can't rule out deliberate harm, so it's a bit odd that this panel are suddenly so sure they can 🤔

Actually a 1% occurrence is not ‘incredibly rare’ it’s rare, but not incredibly so.

And it’s even more meaningless because she worked ONLY 11 and not 50 shifts, and in events that occurr fairly rarely (eg 1%) you need a sample size of over 1500 if working to a margin of error of aroubd 0.5%

On top of that you need to make sure you're collecting good data -

• You still need robust, unbiased data collection and careful control for confounders.

Dr Hall was unable to rule out air embolism because it's impossible to rule out air embolism.

I'm sure many people have had the experience I've had of sitting with a dying relative, leaving the room only when nurses are caring for them, and then being told they have died in that time.

How can I know a nurse didn't hasten their death with an air embolism? I can't, technically, rule it out, but that's not to say I believe it for a minute.

Hall seems to be a man of great integrity who won't hide inconvenient facts like that.

I think you are deeply misunderstanding whay smile Hall is saying. You’re also deeply misunderstanding that being unable to rule something bevause it’s impossible to prove means that it must have happened. In the burden of proof to claim causation you need positive evidence - simply saying ‘we can’t completely rule it out’ is proof of nothing.

Unlike Dewi Evans who actively changed his mind and came up with brand new causes of death on the witness stand bevause integrity is not in his dictionary

The definition of unplanned extubation is elastic and hasn't been established for these cases.

The tubes either came out unexpectedly or they didn't. No need to overcomplicate it.

The likelihood of a baby self-extubating depends on many factors, including their age and the intubator's skill.

How do you know? Do you work there? We've seen the data-less than one out of 100 ventilated shifts. You're just inventing hypothetical scenarios when the stats would all take this into account and still arrive at a figure less than 1%. Why is SHE the terribly unlucky one it's happening to? (again and again)

It's not clear from the language used by BBC whether Lucy Letby was caring for the children in question.

Why is that relevant? She was on shift, thus had the opportunity to dislodge the tubes.

People who would like that statistic looked into would still very much like that statistic looked into.

Why? What's the point? She only worked 11 ventilated shifts-that's all there is to work with. You don't think it's enough data. What else can you be expecting to be looked into if you don't think the sample size is big enough?

I'd like to know why the Liverpool investigation seems to be focusing on dislodged ventilation tubes. Could it be that they picked this metric because they found some while LL was on shift and she did so few shifts there that there's really no evidence of anything else?

Presumably they ought to look for any suspicious deaths/insulin incidents/collapses/over feeding/air embolism or whatever.

The investigation has been going on a while now. Does this mean that they haven't found anything else and it's just Top Trumps with the "best" number being tubes dislodged?

She did far more shifts at the CoCH. What are her stats there?

No because that's not what I'm saying. My point was the expert panel seemingly HAVE ruled deliberate harm out even though we're in agreement this isn't actually possible in a case like this. Why did they do that when Dr Hall couldn't do you think?

Hall seems to be a man of great integrity who won't hide inconvenient facts like that.

@Oftenaddled I agree he is-unlike the expert panel!

@Firefly1987
Of course it's relevant if she was caring for the babies, it's completely relevant. For all we know LL was off doing something else at the time which would have made it impossible for her to have been anywhere near the babies whose tubes were dislodged.

@Firefly1987
Of course it's relevant if she was caring for the babies, it's completely relevant. For all we know LL was off doing something else at the time which would have made it impossible for her to have been anywhere near the babies whose tubes were dislodged.

We actually don't know yet. It was Panorama that looked into the dislodged tube stats. The police have sent off a whole file of evidence. I wouldn't be surprised if it's very damning for her and much worse than dislodged tubes. She was involved with 2 deaths at Liverpool IIRC.

Brilliant. So you understand then and hay something being impossible to rule out because you can’t prove it’s presence is a pretty weak SDT of evidence for putting someone in prison. You understand that it creates circular reasoning.

Fabulous. We’re getting somewhere.

And the panel said they did not find evidence of deliberate harm - because there is no evidence. As often addled already pointed out air embolism for eg doesn't really leave any.

I also think you need to re listen to Dr Mike Hall - bevause nowhere dies he say that the expert panels finding will harm Letby’s case ‘In terms of the summary reports of the, erm, panel: the bottom line is that I agree with them that there is no evidence of inflicted injury in the babies’ - 12 minutes in.

She was involved in the care yes, that's what they looked at. They are 12 hour periods of babies being on a breathing tube. Of course she would have plenty of opportunity at some point in her shift.

I'm not entirely sure, Firefly, but I think "unplanned" as they use it doesn't necessarily mean "unattended". So if the nurses are moving a baby for some reason the tube can become dislodged. Some people have also said that the babies themselves can dislodge the tube. I think it's one of the things they record happening because the babies' skin is so delicate that it can cause trauma to have to reinsert the tubes. It's not like they can say "Oh, I saw that happen" so it doesn't count in the stats.

The reason that 11 shifts isn't really enough data to be working with is that you can get outliers. The 4 tube dislodgements could have all been one rogue baby for all we know. Presumably it's so long ago that the data no longer exists, nor do we know who was in the room at the time each event happened.

If you toss a fair coin 6 times then on average you should get 3 heads and 3 tails, but you it's not unheard of to get 6 heads in a row. If you carry on tossing the coin 600 times then you ought to have approximately 300 heads and 300 tails. At that point, if you've got a ratio way off that then you can say the coin isn't a fair one.

So you admit that the expert panel cannot possibly rule out deliberate harm then despite all their claims-fabulous!

And it was all the evidence put together that made it beyond reasonable doubt-you'd never be able to find any healthcare serial killer guilty by your logic. Presumably you don't want nurses and doctors to be free to harm and kill the vulnerable just because you think the prosecution would resort to circular reasoning.

How long on average would it take for them to notice that the breathing tubes had become dislodged?

You understand what the burden of proof is, right? Just because you cannot rule out deliberate harm because theres no evidence of it diesnt mean it happened.

And I don’t think the prosecution resorted to circular reasoning - it DID resort to circular reasoning.

And it’s a very good argument for scrapping our jury system as it stands because it’s unsafe and unfair to expect people off the street to understand highly technical evidence.

I don’t want innocent people thrown in prison ‘just to be on the safe side’

You're just inventing hypothetical scenarios when the stats would all take this into account

That is your key error. When you have enough events, they take into account all the possibilities: older children, post-operative children coming out of sedation, serial dislodgers, poor intubation.

When you don't have enough events - over just eleven shifts, for example - one or more of these possibilities could skew things. A child with a difficult airway, a serial dislodger and fidgeter, even - depending on your definition of unplanned intubation - a child with infection and vomiting - can bring you up to four incidents in no time at all.

You can't ignore factors like this, count up totals, and call the results a statistical analysis.

It's true that there's never going to be much you can do with four events out of eleven shifts to prove guilt, but a like for like comparison of the four extubations with other events at Liverpool would quite possibly prove that the four were not such an anomaly.

There's lots of reading you can do on unplanned extubations, but even this one-page presentation of an NHS case study shows some of the complexities which mean that counting events just doesn't mean much.

https://qicentral.rcpch.ac.uk/wp-content/uploads/sites/9/2025/05/7945.pdf

Even the Panorama team has acknowledged that the accusations around Lucy Letby's time at Liverpool don't include her being responsible for any deaths.

She had care of two children who died; this would not be surprising in a hospital which sees several deaths a month among neonates, due to its specialist nature.

Yes, a child being moved for care needs or bonding with parents is a common cause of extubation.

I've yet to see any sign of a lack of integrity in the expert panel.

The burden of proof was met. What you want re evidence will never be possible. That's just how it goes. Can't let serial killers free just because they happen to work in healthcare. There's mountains of circumstantial evidence.

We have a panel who can't rule out deliberate harm, and don't have plausible reasons for natural causes because they've either been brought up and dismissed in court already or don't apply to the babies in question (ie birth trauma which categorically didn't happen) and yes Mike Hall did say they wouldn't help her. "It seems to me that there's a real danger it will rebound. In that the flaws will be seen and we find ourselves no further down the road" 24 mins in.

How would you determine if someone in the healthcare profession is guilty or not guilty then? Or are they all innocent by default?