Lucy Letby’s scribbled notes

[Figmentofmyimagination]

At times when I’m feeling acutely distressed, it’s not at all unusual for me to scribble all sorts of dreadful thoughts down on paper eg die die die, hate hate hate, I hate you, I hate you, what’s the point of you, my fault, stupid me, etc etc etc, usually scribbling them all out so nobody can see what I’ve written. I’m pretty sure this is quite a common response to acute mental distress. I agree with this article that it feels very surprising that Letby’s scribblings were used as evidence of a ‘confession’.

www.theguardian.com/uk-news/article/2024/sep/03/i-am-evil-i-did-this-lucy-letbys-so-called-confessions-were-written-on-advice-of-counsellors

@Mirabai so are you saying that Dr Evans, Dr Hindmarsh and the other expert witnesses called by the prosecution were all so bad at their job they shouldn't have been allowed to testify? Isn't that the argument that was already rejected at appeal? But you go on, if you know better with your internet research....

one expert witness who goes off on a wildly improbable theory supported by dodgy stats - then they find expert witness colleagues to buy into the group-think and support them.

Maybe do some reading around how Evans came to the conclusions he did and his methodology?

It's already been asked and refused - for good reason. The opinions he gave were fit for purpose and reasonable. If the defence had alternative theories, they were welcome to posit them. But they couldn't call the witnesses - likely because they didn't have an alternative narrative which would have stood up to the cross in court. And the appeals judge agreed about that, as well.

That’s not true. The deaths fell as soon as the department was downgraded in July 2016. Instead of 27 weeks and 800g they were taking 32 weeks and higher minimum weight.

That is a drastically different and less unstable cohort of patients.

Indeed had the unit been downgraded a year previously - most of the babies in the case would not have been the unit at all.

Indeed had the unit been downgraded a year previously - most of the babies in the case would not have been the unit at all.

Not true.

Maybe do some reading of biology?

Evans methodology was as follows: I have ruled out smothering, poisoning with potassium chloride and wild bears and I arrived by diagnosis of exclusion at air embolus for which I have invented some symptoms.

This is what the previous judge had to say about him:

“He either knows what his professional colleagues have concluded and disregards it or he has not taken steps to inform himself of their views.
Either approach amounts to a breach of proper professional conduct.
No attempt has been made to engage with the full range of medical information or the powerful contradictory indicators. Instead the report has the hallmarks of an exercise in ‘working out an explanation’ that exculpates the applicants.
It ends with tendentious and partisan expressions of opinion that are outside Dr Evans’ professional competence and have no place in a reputable expert report.
For all those reasons, no court would have accepted a report of this quality even if it had been produced at the time of the trial.”

Had that judge presided over this trial - Evans’ evidence would have been thrown out.

Go and look for yourself and the gestational age and weight.

The podcast I’m listening to did mention that some of the babies who died were below the new threshold. One of them (Baby G I think) was stable enough that they were thinking of sending her home before her health abruptly deteriorated.

It’s also interesting how a lot of the attacks happened during the night, but when LL was put on day shifts from April 2016, the attacks happened during the day and early evening.

The timeline is damning for her.

It isn't. That's one of the things Dr Breary decided when he started to point the finger at Letby too.

Random distribution explains it.

Even without that, most of the deaths were at night, which would be expected. There are fewer staff around, often no senior doctors, and the evidence is that more infant deaths (and deaths generally) occur at nighttime / early morning. Bear in mind Chester was already understaffed.

Letby was associated with fewer deaths after moving to day shifts, which is what you'd expect in a perfectly orderly distribution of events. We don't know if course when other deaths on the unit took place. But there is nothing suspicious in these events as they stand.

Expert witness testimony:

That’s right, the cause of death is: random distribution, and of course, night, was a contributing factor.

So, let that be a warning to hospitals to prevent further unnecessary deaths - don’t allow night, or random distributions.

Random distribution isn't a cause of anything. Here it just means that a small number of events without linked causes can be spread out, or clustered, in many different ways. You expect this until you have a large enough number to start predicting patterns.

So if you live in an island with a population of 6,000, you might expect 9 people to die of natural causes each year, but those deaths won't be spread evenly throughout the year.

60,000,000, you expect a much more predictable pattern.

They also should have looked at what was happening in other poorly/ underperforming hospitals during the same time period. Had they also experienced spikes in deaths? If so, that could indicate that what was happening in this particular hospital was not unique. Unless they all had a serial killer on staff, of course.

So there shouldn't have been any questions asked about why more babies were dying, because, random distribution?

The questions absolutely needed to be asked, and it turned out that these deaths couldn't be handwaved away because the babies were young or premature, or because the unit was understaffed, or because sewage was backing up, or any of the other reasons that apologists are now saying.

If any of these were the reasons for the deaths, dont you think the defence would have said so? Each baby was taken in turn and the expert opinion for the deaths given. There was ample opportunity for the defence to have presented this at trial. But they couldn't. Because at the time of collapse each baby was stable and expected to do well, and when they did collapse, resus didn't work.

To make the defence more than 'I can't remember what happened, and I didn't do anything', the jury needed to hear an explanation of how this could be happening that didn't involve Letby, and they didn't.

To make the defence more than 'I can't remember what happened, and I didn't do anything', the jury needed to hear an explanation of how this could be happening that didn't involve Letby, and they didn't.

That's not how our legal system works.

Each baby was taken in turn and the expert opinion for the deaths given

statements like this perfectly illustrate the problems with this trial and why the jury decided to convict.

The expert - ie the pathologists who performed the autopsies - opinion already existed.
A retired paediatrician's opinion was given at trial. He is neither a neonatologist, nor a pathologist, nor an endocrinologist. And he hasn't even worked as a paediatrician for the last fifteen years!

The defence did say so.
They just didn't bring in any expert witnesses (even though they should have),

Yes - the 11 units which suffered worse spikes than Chester at that time don't seem to have been investigated for murders.

I'm glad they haven't been because who on earth would work in those circumstances.

Why didn't the defence give an alternative, then, @Tandora ? Can't really blame a jury for running with the only narrative presented at the time? And why didn't the appeal court allow this appeal, if the evidence and defence was so shoddy?

Is it because the police, hospital, experts and KC were all rubbish and conspiring to cover up failures in the hospital by scapegoating Letby? The air embolism, insulin overdose, and trauma just didn't happen, and there's a good alternative explanation for the observations?

Not sure why taking each baby in turn was a problem either. Letby was found innocent of many charges, and unanimously guilty on some. The jury's work here should be respected.

The defence did say so.
They just didn't bring in any expert witnesses (even though they should have)

Why do you think that was? Did they just forget?

the 11 units which suffered worse spikes than Chester at that time don't seem to have been investigated for murders.

Why would they, if the deaths were not suspicious?

The reason for an investigation in Chester was because the deaths could not be adequately explained.

There should certainly have been questions about why there was a spike in deaths.

The questions should have been asked with an understanding that a spike in deaths did not offer independent evidence that something was wrong at the unit. However, when this spike was investigated it turned out that there were indeed problems with the unit: https://www.theguardian.com/uk-news/article/2024/sep/08/a-superbug-doctor-shortages-and-a-neonatal-unit-out-of-its-depth-failures-at-lucy-letby-hospital-revealed

The questions should also have been asked with the understanding that once a spike happened, for whatever reasons, the funding that a single full time staff member would be involved in each child's care for a set number of the deaths - let's say 7 out of 16 - was not particularly low.

That's the key problem. The seven deaths Lucy was accused of were all attributed to natural causes. The further investigation by the Royal College of Paediatrics and Child Health found the same.

What led to these deaths being retrospectively framed as sudden and unexpected? We've seen no definition to support this category, and neonatologists have expressed doubts about the alternative explanations, and the about need for alternative explanations.

So there shouldn't have been any questions asked about why more babies were dying, because, random distribution?

The questions absolutely needed to be asked, and it turned out that these deaths couldn't be handwaved away because the babies were young or premature

It means the data should be approached with caution due to random distribution and fluctuation.

Of course there should be questions asked - there were questions asked - that’s why the RCPCH and Dr Hawdon were commissioned to review - the response was suboptimal care which the consultants didn’t like so they went to the police.

There are 9 additional deaths that are indeed being “handwaved away” as premature/congenital defect/infection. (In other words the similar causes of death as the “LL” deaths). That’s a second cluster 3 times the number of deaths in the previous year. How do you explain them?

IIRC there were several other staff members who were present at six of the seven deaths, so you'd only need one to be ruled natural causes to have multiple people who had the opportunity.

That's not me saying "serial murder happened, but it was someone else" btw, just pointing out that the argument for her being present at all of the suspect deaths falls down if even one of them was ruled to indeed be natural causes at investigation