To think the Lucy Letby case needs a judicial review?

[Edenspirits73]

2 more detailed articles in main stream papers today questioning the Lucy Letby verdict - mirroring the well known New York Times article that wasn’t allowed here during her trial- surely with this much questioning, there should at least be a judicial review?

aibu?

If she is guilty after review then fair enough, but yet again convictions are being viewed as unsafe.

https://www.theguardian.com/uk-news/article/2024/jul/09/lucy-letby-evidence-experts-question

https://www.telegraph.co.uk/news/2024/07/09/lucy-letby-serial-killer-or-miscarriage-justice-victim/

I hadn’t read about that @Firefly1987

Rare does not mean it does not happen. Also - as rare as murder by air embolism? And do they mean in babies who survive (the minority) or babies who don’t, or both?

The doctor writing under pseudonym “Jamie Egan” whose blog I linked thinks baby O died of sepsis. There’s a particular kind of coagulase-negative staphylococci species that can cause haemorrhaging.

It would explain the post-mortem findings of free, un-clotted blood in the peritoneal (abdominal)space from a liver injury. There was damage in multiple locations on and in the liver. (subcapsular haemorrhaging)with blood present in the peritoneal cavity. <> I have no doubt that Baby O had sepsis.

https://jameganx.notepin.co/technicals-of-sepsis-kfnhbjxr

(There’s also a complication of sepsis called DIC causes both clotting and haemorrhaging).

Well presumably if they developed infection from the raw sewage in the area then sepsis could easily follow.

It seems that the causes of death aren't definite and can be explained through natural causes in many cases.

I wonder what the blood around the mouth incident was caused by. I think they were claiming it was some sort of sharp or solid implement like a wire introducer. I've searched, but it doesn't say what came up at post mortem - if there was evidence of trauma.

So people are making the mistake again of chasing one type of evidence- the hand over sheets in themselves are not suspicious, except that she was also obsessively searching the families AND she was present in all cases before a baby collapsed AND she had been caught by both Jayram and a mother near babies as they collapsed AND the strange collapses (not deaths but the odd collapses in previously healthy or recovering babies) stopped when she was suspended.

Not forgetting that she also doctored, no pun intended, medical notes to make sure she wasn't placed at the scene of some collapses.

And not forgetting that, in spite of the "Texas Sharp Shooter Fallacy!!" screaming posters, I wouldn't like to try to calculate the odds of babies repeatedly collapsing on "man made" milestone dates.

If they didn't have enough detail about the five other cases to judge whether or not they could be seen as suspicious, how could they possibly claim that they should have been included in the chart of shift patterns?

Before Covid we didn’t have printed handover sheets, used to go home in uniform my patient/ task list in my pocket.

Did you ask end up with 257 of them that you took with you hrough a house move, and never disposed of or shredded ..... even though you had a shredder that you did use to shred your personal documents?

Did yours include blood gas records etc.?

I've just spent an hour on that blog. If nothing else it reinforces the idea that a case like this is massively dangerous to put before a jury of lay people. It is surely impossible to rule out every differential diagnosis in the light if the symptoms.and events recorded and definitively prove Lucy Letby guilty to a degree where one is "sure" she did it.

The insistence that it's not just the medical evidence it's a bigger picture hinging on Lucy Letby's character and behaviour is a bit baffling because the medical complexities cast doubt on whether the deaths were murder at all. So the continual argument that she must have committed the crimes because she was there all the time is somewhat moot.

Those babies were not full term healthy and stable - their backgrounds and medical history clearly show that.

Particularly enlightening is the story of the triplets. Did anyone else know that two babies can be in one amniotic sac and a third in a separate one? And that infection could possibly occur in one sac but not the other? I had no idea. Why would I? I'm not a neo-natal physician. But that certainly ramps up the possibility of complications, doesn't it?

This case definitely needs further evaluation.

What kind of evidence has there been in other cases like this one that weren't in any doubt? What was the medical evidence like in the Charles Cullen case does anyone know? Some people are saying you just couldn't murder so many people and there not be any hard physical evidence but is that definitely true?

There were more than five other cases. But they were never investigated because Lucy wasn't in duty. The New Yorker doesn't have detail of these cases, and presumably the same level of detail wasn't established for any of them. So it can't give that information.

You see, the chart wasn't from an investigation into deaths and collapses. It was from an investigation of deaths and collapses with Lucy Letby present

I want to know about the insulin.

Where did she get it? Were supplies controlled? Was there a discrepancy in quantities wherever it was kept? If it wasn't prescribed for any babies on the ward at the time how did she access it?

Here's the relevant paragraph from the New Yorker on cases not on the chart:

"Letby’s defense team said that it had found at least two other incidents that seemed to meet the same criteria of suspiciousness as the twenty-four on the diagram. But they happened when Letby wasn’t on duty. Evans identified events that may have been left out, too. He told me that, after Letby’s first arrest, he was given another batch of medical records to review, and that he had notified the police of twenty-five more cases that he thought the police should investigate. He didn’t know if Letby was present for them, and they didn’t end up being on the diagram, either. If some of these twenty-seven cases had been represented, the row of X’s under Letby’s name might have been much less compelling. (The Cheshire police and the prosecution did not respond to a request for comment, citing the court order.)"

And here's the next paragraph from the New Yorker, on an uninvestigated "insulin" case:

"Among the new suspicious episodes that Evans said he flagged was another insulin case. Evans said that it had similar features as the first two: high insulin, low C-peptide. He concluded that it was a clear case of poisoning. When I asked Michael Hall, a retired neonatologist at University Hospital Southampton who worked as an expert for Letby’s defense, about Evans’s third insulin case, he was surprised and disturbed to learn of it. He could imagine a few reasons that it might not have been part of the trial. One is that Letby wasn’t working at the time. Another is that there was an alternative explanation for the test results—but then, presumably, such an explanation could be relevant for the other two insulin cases, too.
“Whichever way you look at this, that third case is of interest,” Hall told me"

It was prescribed for a baby on the ward at the time, the witness was deliberately misleading.

I am referring to child F here because I am not familiar with many of the details regarding Child L yet.

It was being prescribed to Child Fs twin Child E who was in the same room with him.

The judge made the witness clarify afterwards that she didn't mean the entire stay on the unit, she just meant on the 4th and 5th. Child E died on the morning of the 4th and Child F was apparently poisoned on the 5th. Of course the soundbite and headline that went around the world was "Lucy Letby, insulin not ordered for any baby on the unit, trial hears"

There was NO mention of whether there was any remaining insulin left for Child E and if so if it had been disposed of or returned to a different department to be disposed of or what had happened to it.

It was actually very interesting to me that the prosecution didn't claim that Letby used Child Es insulin to poison Child F, after all that would have been the easiest way to get it surely? Instead they tried to make out that there should have been none there...maybe that was because they didn't want the jury to think that it could have been an accident?

The defence either didn't notice when the prosecution witness tried to claim that no insulin was on the unit at the time, or they didn't want to bring attention to it.

Here's the New Yorker on the "insulin". These look like verifiable statements, if true:

"The insulin test had been done at a Royal Liverpool University Hospital lab, and a biochemist there had called the Countess to recommend that the sample be verified by a more specialized lab. Guidelines on the Web site for the Royal Liverpool lab explicitly warn that its insulin test is “not suitable for the investigation” of whether synthetic insulin has been administered. ... But the Countess never ordered a second test, because the child had already recovered.

"Brearey also discovered that, eight months later, a biochemist at the lab had flagged a high level of insulin in the blood sample of another infant. The child had been discharged, and this blood sample was never retested, either. According to Joseph Wolfsdorf, a professor at Harvard Medical School who specializes in pediatric hypoglycemia, the baby’s C-peptide level suggested the possibility of a testing irregularity, because, if insulin had been administered, the child’s C-peptide level should have been extremely low or undetectable, but it wasn’t."

Hmm. Thanks. You'd have thought the availability and accessibility of the alleged insulin would have been a simple and indisputable fact established early on.

And the testing - well. That's a whole can of worms. Sheesh. What a tragic, bloody mess.

You see, none of the insulin cases were investigated at the time. The insulin levels were mentioned in the babies' discharge letters. Months later, the letters were read as part of the investigation, and police started to ask about possible insulin poisoning.

So I suppose we wouldn't have much context. But also - no massive red flags from those tests at the time. Nobody claimed attempted murder or even requested another test.

The Paediatric pathology expert Dr Andreas Marnerides said that forceful CPR could not explain the liver injury - what are your credentials for saying he is incorrect? I assume you saw the autopsy / medical notes

There is evidence of air injected - air bubbles were found in brains and blocks of air found in spinal columns shown in x-rays. We aren’t even talking here about the mottling skins patterns noted, that you are obviously referring to saying no studies have been undertaken.

The autopsy listed CPR as a possibility.

Also important to note that while Dr Andreas Marnerides did say that CPR couldn't have caused it, when asked if he could categorically exclude it his response was "if a man is found dead in the Sahara desert with a pot next to him, it could be possible that a helicopter flew over and dropped it on his head - but it's not probable"

The judge should have forced him to give a yes/no answer there.

The presence of insulin was an agreed fact in court, by both parties. There was some dispute over the levels but Letby even agreed under cross exam that someone had poisoned the babies, but it wasn’t her.

There is a difference between watching a saturation and watching a saturation when an ET tube is displaced.

Didn’t the strange air embolism cases (which the moving rash) begin just after she’s had her air embolism training?

We were discussing the legitimate presence of it on the ward at the time when child F was there. That part wasn't an 'agreed fact'. It was a fact all right in the true sense of the word though. But the prosecution tried to mislead the jury.

Mr Johnson said no other baby on the neo-natal unit was prescribed insulin so child F could not have received the drug intended for some other child by negligence.

https://www.chesterstandard.co.uk/news/23040451.lucy-letby-trial-countess-chester-hospital-nurse-tried-poison-new-born-twin-insulin/

It was an agreed fact that the insulin was added unlawfully and Lucy agreed in court with the prosecution, how are they misleading the jury - it came from her own mouth.

Nick Johnson KC, cross-examining Letby for a second day, asked her if she agreed that “someone” had “unlawfully” given Child F and Child L insulin. She agreed, saying that the feeding bags must have been tampered with by either someone on the unit or before the bags arrived on the ward.
“Insulin has been added by somebody – how or who I can’t comment on, only that it wasn’t me,” she said. “I don’t believe that any member of staff on the unit would make a mistake and give insulin.”

Letby was told test results showed insulin in the babies' bloodstream, and asked how she could explain it.

It's not her job to explain it. Sure, if she was responsible, she knows. If not how can she give a reason any more than anybody else?

It would not be part of her job or expertise to know that the test conducted was not the right type to demonstrate presence of insulin, or that the C Peptide results suggested no insulin. It would have been good if the defence had been aware of these issues, but all that happened here is that Letby was told there was insulin and agreed someone must have introduced it then.

The test doesn't test directly for insulin. It tests for a reaction triggered by insulin, but it's not able to establish that synthetic insulin is present and isn't for use in legal investigations. Letby presumably didn't know this, since it wasn't acknowledged in court.