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

Indeed, they were particularly ‘specific’ given that there appeared to be at least three different descriptions of these ‘tastes’ - all quite different from one another, and no one thought them so weird they needed to do anything about them

I really hope she’s innocent. Those poor babies 😢

This is quite a spin attempt! Are you suggesting that Lee hasn’t had as much hands on experience as Evans?

First, Lee has a tremendous amount of front line patient focused experience. Many of the roles you dismiss as “shiny” are direct patient care roles, they are just at very senior levels in leading hospitals that Evans likely doesn’t even know the name of. Indeed, one of the reasons why there are known issues with expert witnesses in British courts is because experts like Lee do not want to take time away from front line patient care in order to spend vast amounts of time (in order to collect vast amounts of money) working on court cases that add precisely zero to patient care or research.

Second, Dr Evans was not even a neonatologist. Attempting to argue that he’s in any way equal to any of the experts on that panel is frankly silly.

I think that is quite possibly the case, yes.

I can’t see that any of the appointments you listed for Shoo Lee in your earlier post are patient facing - which do you think are?

Without trawling through his career, I'd expect his last major appointment, as Paediatrician in Chief at Mount Sinai hospital (2008-19) to be both patient facing and leadership oriented - like Steven Brearey's role in the much smaller facility at Chester, and like Evans's at Swansea. Some differences being that Lee's was at a larger and more specialized facility than Brearey's, and that he practised medicine during the years when Lucy Letby was on the wards, unlike Evans.

https://news.ontario.ca/en/release/1050/improving-care-for-ontarios-youngest-patients

Certainly his work would always have included research, but my experience is that university medics combine this with practice and training in hands-on care. Lee kept his registration active to practice in Ontario until he retired in 2019.

They didn't just decide it, they ruled out everything else until deliberate harm was the only thing left. How would you expect them to prove air embolism if she is in fact guilty? You want them to say "oh well these rashes we've never seen before could be due to some other reason so even though all the evidence points at Lucy, let her off?"

Ben Myers already tried to get all the air embolism charges dropped from the trial but failed so...

Do you know who was the first to even mention air embolism risk on that unit before anyone else even thought of it? Take a wild guess...

Sure, but I think he has held at least some of his other appointments at the same time as the Paediatrician in Chief role, so that would inevitably eat into whatever clinical time he might (or might not) have.

Yes, but this is usual for high fliers. I understand that you believe expert witnesses should focus purely on clinical practice, but with respect, I don't agree or see the rationale. So I'd be perfectly happy with Lee having this combination of relevant roles and experience.

If he's the man called by clinicians to look at puzzling cases, the man reviewing the photos of any unusual rashes, the man coordinating attempts to explain any unexpected events: that sort of seniority on a specialist neonatal unit, even with time out to enhance and apply his knowledge in other senior roles, seems perfect to me.

The man is obviously a mad workaholic too! What was he up up, five years into retirement with his gold-plated pensions? Running a farm. I imagined a sweet little cottage farm maybe, but no, it's a full-on ranch with cereal crops!

I don’t think I’ve said anything about what I believe an expert witness should or shouldn’t be. We only got onto this because I’m fed up of seeing comments that suggest that Dewi Evans had essentially zero relevant experience and that a doctor like Shoo Lee who takes on lots of additional roles is somehow inherently better. My belief is that doctors like Lee are incredibly ambitious and often quite status-driven, but not necessarily better or more experienced (they might be, but certainly not by definition) than physicians who have spent more of their careers patient-facing. I also do not believe that the term ‘world-leading’ has any actual meaning in medicine.

I have no problem at all with medical expert witnesses who have a mix of clinical/research/leadership background, but I’m also not going to assume that they’re any better on that basis alone than someone who has worked day in and day out for many years seeing firsthand many of the clinical possibilities and outcomes that are in question.

Sorry to have misrepresented you there. Yes, fair enough.

My position is: if the argument used by the prosecution was that something very unusual happened on this ward, they should probably have used someone with more than hands-on experience. Unusual things do happen, but you need to be on top of research, and not just drawing on your own experience and practice, to comment fairly on them. So leaving aside the neonatologist / paediatrician distinction - and it seems there is a significant overlap in the two roles - Evans was not the man for this case. I'll omit any other comment on his performance, since I'd like to address your point.

As to Lee, I'd be as happy with "internationally recognized and respected", but world-leading has been an unavoidable term in all areas of academic research in the UK for twenty years now, medicine included. Blame the research councils. And Lee's academic endeavors are important here since he wrote the famous article, and its recent update. It's not hyperbolic to say he is better qualified to interpret these works than than anyone else concerned.

In terms of his roles and experience, I think it's a bit of a red herring anyway, because, beyond the interpretation of his own article, all of his contributions have been as part of a wider committee presenting a consensus view of each case. For "hands-on", I was impressed to note one summary which made its argument based on records of the state of the child's nappy. Good practical stuff where needed, from the international panel; cutting edge research too.

What do people think about the case of Victorino Chua? The evidence seems quite thin on this as well.

Another suspect confession note (never ever write anything down on the advice of occupational health if you work in a hospital) and apparently spiked insulin bags with no real link back to the accused.

Starting to wonder how many innocent nurses and other people there could be in UK jails.

Anyway interested if anyone knows more.

There is a long and brilliant article on the Jolly Contrarian blog that asks whether a systems problem could be leading to false accusations in healthcare. Victorino Chua features. I think it's a pity there's such a long lead-in to this section, because it's very good, and worrying. If you want you can scroll down to the paragraph ending footnote 13, and start there:

https://jollycontrarian.com/index.php?title=Healthcare_serial_murder

It would be interesting to read a serious book, perhaps a medic/lawyer/statistican collaboration that examined the evidence for the uk's convicted medical serial killers to see how robust it was.

The Victorino Chua case, does on the surface at least, seem very strange. It took the jury three weeks to decide. I wonder if they knew that another nurse had been charged before him.

Apparently they found the bags had been tampered with. If not him then who? Is this just about people wanting to be the one to crack who the "real" murderer is and refusing to believe the police actually got the right person?

https://www.theguardian.com/uk-news/2015/may/18/stepping-hill-hospital-poisonings-operation-roxburg-manchester-police-victorino-chua

Foil seal showing puncture marks consistent with a hypodermic needle.
Twenty-four-year-old Zubia Aslam was next. On examination, it emerged that her saline drip contained high amounts of human insulin. When the bag was examined by a forensic scientist, it was noticed that there was a small v-shaped cut to the rubber septum of the resealable bung and two puncture holes to the inner membrane of the bung consistent with a hypodermic needle.
Panic set in. Police were again called and products were removed. On testing it emerged that a glucose bag, saline bag and antibiotic bag had needle puncture holes consistent with the insertion of a hypodermic needle. Another saline bag had been contaminated with Lidocaine, a local anaesthetic

I'm sure people are grasping for any reason to believe he could be innocent too since he penned a very similar note to Letby 🤔

I wonder if the Stepping Hill case was inspiration for Letby and where she got the idea of poisoning TPN bags 🤔

There is no doubt whatsoever that insulin was added to some medicine containers in the Stepping Hill case.

However, I do not know how sound the evidence was that a) the patients who died were poisoned, or b) Chua is the one who injected insulin into the containers.

Another nurse was arrested and released before Chua was, which was high profile news at the time, so it doesn’t seem likely that the entire jury was unaware.

If you read that article carefully you will see that he was chosen as the perpetrator based on a statistical analysis and trawl of previous cases again. The police have no training in this (probably no requirement in terms of qualifications to go beyond gcse maths) so I wonder if they got a statistician to help. I doubt it.

It does seems clear that medical products were actually tampered with in this case.

If not him then who? Any of the other people who worked on the ward or had access to it. They actually charged one of them before changing their minds.

Anyway I really don't know enough about the case to be sure about anything to do with it.

Why do you bother asking what people’s motives are for being interested? Youvd been told several times by several peopke on this thread why they are interested - you take zero notice anyway and continue with your musings designed to make peole look unhinged.

I'd say that's unlikely, since his case suggested it was obvious when bags had been tampered with.

It is a bit of a glass house and stones situation there. If I had the posting record both here and elsewhere that individual does, I'd probably keep schtum about other people's.

Oh? Not sure what you mean, sorry

I actually think it could be where the police got the idea from.

But in Lucy's case not only do they lack evidence she tampered with the bags they lack evidence any bags were tampered with in the first place.

I think the reason there has been so much pushback in Lucy's case is because the evidence is so weak of any crimes being commited at all.

However I don't think the police methodology that was applied to her case came from nowhere. It seems to be a systemic problem with the way these things are investigated.

I am not saying by the way that I think these other nurses are innocent as I really do not know. Just that some of the evidence against them doesn't seem very good.

I know people aren't a huge fm or Liz Hull on here. But the latest podcast interview with Dr. Hall is interesting.