Lucy Letby - have you changed your mind pt. 5

[Typicalwave]

New thread

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

You're making huge assumptions about how the data was calculated at Liverpool Women's Hospital there. We've been given raw numbers. There is absolutely no indication that they have been adjusted, and it would be improper for the BBC to present them without mentioning adjustments.

So I'd reiterate - eleven shifts is not a representative sample and four events taking place during these shifts therefore tells us nothing at all of interest.

Yes but presumably that was taken into account

What are you presuming this for?

It tells us her stats are WILDLY outside everyone else's. What happened to her would be expected over 400 ventilated shifts (if that) not 11!

Because they looked at unexpected tube dislodgements.

Bad data is worse than no data.

It tells us nothing.

It doesn't say "unexpected". That seems to be a bit of an assumption. It just says tube dislodgements "happened" on those shifts.

Also I'd like to know how the 1% figure is arrived at, because that sounds like an overall "average". Is there a chart somewhere of who was on duty each time a tube dislodgement happened, similar to the one produced for the trial?

Is there a comparison of tube dislodgements per nurse present? Anyone who worked the same 11 shifts as LL would have 4 dislodgments on their "record" so they'd have to do quite a few "clear" shifts to get to 1%.

That's Dr Brearey on the vomiting, an incident for which he wasn't present and which he describes differently from the doctor on the spot, Dr Alison Ventress.

In any case, a paediatrician never having seen something before, encountering it for the first time in a premature baby, is not a suspicious fact in itself. Doctors frequently see things they haven't seen before, and that's presumably all the more common when they are working most of their time away from a specialism.

FFS any tube dislodgement would qualify as unexpected, because ideally it shouldn't happen.

It seems you have a ghoulish preoccupation with the idea of the Lucy Letby prowling the wards just waiting to pounce and "escalating".

By the way, have you got a theory on the liver injury yet? Something that doesn't involve witchcraft or Satanic ritual? Something realistic and plausible?

Where is that term used?

I take it you've never seen a baby projectile vomit.

One of mine managed to fire vomit over the top of the sofa and down the back from where they were in their bouncer. I was panicked, but the doctor chuckled when he heard and said he'd seen far more impressive projectile vomits from younger babies.

I don't think there's any point trying to explain the data here any more though. If people don't understand statistics then often they don't realise how much they don't understand, so think they've got a great grasp, when they're just showing their ignorance with every "I understand it better than you" comment.
I really think understanding statistics should be on the compulsory school syllabus so that at least people have a chance of knowing that they are totally at sea.

It's a bit like the learner tennis player who turned up at the men's top team practice and demanded to join in because "they'd be really impressed with how good she was." In all honesty she wasn't good even for a learner, but she was so poor she hadn't the capability to know how bad she was.

It didn't just happen "to her" though did it? Stats-wise those 4 incidents happened to everyone who was working those 11 shifts.

Anyone working those shifts who didn't have over 400 ventilated shifts for that year without any other tube dislodgments couldn't have had only a 1% stat.

When she returned the baby was “freaking out, screaming and just looked so puzzled”, she told police, and Letby was stood over the cot with another colleague.

That is a very sad and worrying experience for the parents. But it is an account of an ill child in distress, not of an attempted murder. Similar scenes must occur on NICUs around the country every day.

In the Panorama doc

Which doesn't mean much really! Where did they get it from, is it written in anything official?

How the 1% figure was arrived at has been left pretty vague. At the Thirlwall Inquiry, the representatives of Liverpool Women's Hospital stated that the shifts Lucy Letby worked had been audited for any unusual events - but there was no suggestion that there were any wider audits.

There are a few reasons to be sceptical about that 1%

I linked upthread to a study from an NHS unit which saw a significant "rise" in unplanned extubations after introducing a reporting obligation, a few years ago. It's not clear this data is tracked

1% was frequently cited as a figure to aim for, in the 2010s, but not as a figure that was being achieved without specialist programmes, of which there don't seem to be records at LWH for that period.

LWH did an audit on its own numbers that came up with less than one unplanned extubation per 100 ventilated days - but this was in 2022/23, by which time there was more emphasis on getting older babies extubated sooner. And of course, we still don't know how many "ventilated days" the average nurse, or Lucy Letby, had per shift.

I'd be surprised if there's anything even as robust as the chart shown at the first trial, on this one.

That's why they compared 100 shifts that didn't have Lucy involved otherwise she'd skew everyone else's' numbers.

They haven't claimed to have compared 100 specific shifts with Lucy Letby. They're talking about an average.

Panorama do cite a source for this, in the updated version. It's "the Thirlwall Inquiry". So they say "The Thirlwall Inquiry heard that breathing tubes generally became dislodged on less than 1% of shifts at the Liverpool Hospital, but on 40% of shifts that Lucy Letby worked."

And here is the only mention of this issue at the Thirlwall Inquiry:

"You will hear evidence that dislodgment generally occurs in less than 1% of shifts. As a sidenote, an audit carried out by Liverpool Women's Hospital recorded that, while Lucy Letby was working there, dislodgment of endotracheal tubes occurred in 40% of the shifts she worked".

https://thirlwall.public-inquiry.uk/wp-content/uploads/2024/09/Transcript-of-Legal-representatives-of-Core-Participants-Opening-Statements-12-September-2024.pdf, page 36.

There's absolutely no indication here that the 1% figure comes from Liverpool Women's Hospital, or from 2015, at all.

I really don't think they did compare 100 shifts - unless you have a source for that? And for how many nurses? How were the nurses and how were the shifts selected?

You're saying that those 11 shifts would skew everyone else's numbers, but that means you're saying that she was definitely responsible for those 4 incidents. They're "unplanned" not "unexpected". At times it's as if you think there were zero other staff on duty and she was just allowed to go around merrily wreaking havoc among the patients.

That's not the updated version because they changed it to 36%. That's why I brought up Panorama again because they've updated that section. It's 100% from Liverpool. But feel free to write in and complain about the stats (for the second time!) not being accurate.

All the info I have is from Panorama. Give it a watch. The tube dislodgement stats are right at the end.

You're saying that those 11 shifts would skew everyone else's numbers, but that means you're saying that she was definitely responsible for those 4 incidents. They're "unplanned" not "unexpected". At times it's as if you think there were zero other staff on duty and she was just allowed to go around merrily wreaking havoc among the patients.

Of course she's responsible. It's not one giant coincidence that tubes came out that many times on her shifts and no one else's' is it. How long does it take to remove a tube?

Really? You're certain of that are you?

It's the second version. 40 is just 36 rounded up. No problem with that. Have a listen to the second version. Here's what it says:

The current police investigation involves a second hospital. In 2012 and 2015, Letby trained briefly at Liverpool Women's Hospital. A hospital review looked at unplanned extubations, that’s breathing tubes coming out unexpectedly. The Thirlwall Inquiry heard that breathing tubes generally became dislodged on less than 1% of shifts at the Liverpool Hospital, but on 40% of shifts that Lucy Letby worked.

Critics say the figures aren’t credible, and there are any number of reasons why breathing tubes could become dislodged more often. We’ve looked into the review. Here’s what we understand. Liverpool Women’s Hospital went back to review the records of what are called ‘ventilated shifts’. These aren’t working shifts; they’re a 12-hour period where a baby has been on a breathing tube. The review found that for every 100 ventilated shifts where Lucy Letby wasn’t involved in the care of a baby, tubes came out unexpectedly in less than 1.

The same review looked at ventilated shifts in 2015, where Lucy Letby was involved in the care of a baby. It found there were 11, and that tubes came out during 4 of those ventilated shifts. That’s 36%. We also understand breathing tubes came out during ventilated shifts involving Lucy Letby in 2012. We don’t have the figures, but understand it happened much less often than in 2015.

It's quite slippery stuff, but if Thirlwall is their source, there's no indication that data came from Liverpool. And elsewhere at Thirlwall, Liverpool representatives referred to audits of Lucy Letby's shifts only.

Notice they are still comparing Lucy Letby's working shifts with ventilated shifts for other nurses.

This whole section is a nightmare of bad data and poor journalism. Shocking stuff. I hope Ofcom will come down heavy on them.

I'm certain that what you've quoted is just the account of a distressed child, yes. Was there more too it that you left out?

What do you mean, they didn't come out on anyone else's shifts? Do you think she was working alone in a 16 cot NICU?

How on earth can you say with such confidence? Were you there?! Is there some particular reason you're so keen to discredit all doctors and parents in this case that WERE there?