Lucy Letby case expert witness was under fitness to practise investigation

[ITMA2000]

Wow! Pot, kettle, black? Need a new investigation?
Lucy Letby case expert witness was under fitness to practise investigation during trial | Lucy Letby | The Guardian

This calls his suitability to have been an expert witness into question.

I wouldn't go that far. He's certainly qualified in the relevant field. I'd imagine that if you scrutinize any doctor with a long career, you'll unearth some complaints against them.

I'm more troubled by the fact that things he presented as certain have since been questioned by other credible experts. And by him using theoretical guesses of how much insulin sticks to tubes, when that's easy to measure experimentally. And, most of all, by him (and all others) ignoring the increased chance of finding some odd tests of some type when looking through many tests of many types for many babies.

The existence of the fitness to practise investigation may or may not have any bearing - we don’t know what it was about, and it may well have been completely irrelevant. The lack of disclosure to the court is the problem. It’s dishonest and brings his suitability into question.

Likewise, he was no longer an honorary consultant at GOSH, but answered the question about his employment status as though he was still a consultant there. It was a questionable approach.

I agree the quality of his evidence is also questionable. It’s surprising non-one has studied how “sticky” insulin is onto PN bags and sets. Although I suppose the tricky assay would make it expensive.

Geoff Chase - the expert working with the defence on biochemical issues with the insulin cases - was one of a team who published a study on the stickiness of insulin in 2019 (some details at https://ieeexplore.ieee.org/abstract/document/8856797).

The report he and Helen Shannon submitted to the CCRC last year featured, among other things, their calculations on the stickiness of insulin in the scenario Hindmarsh described. They found that he had underrated the stickiness. https://archive.is/LPfEE

That’s a great article, explained well in lay terms, thank you. The link to the abstract doesn’t work. Do you have the title of the paper please? I may be able to get it via work.

Sorry about that - here is a different link

https://www.sciencedirect.com/science/article/abs/pii/S2468601818301627

The article is:

Knopp, Jennifer L., Anna R. Hardy, Sarah Vergeer, and J. Geoffrey Chase. "Modelling insulin adsorption in intravenous infusion sets in the intensive care unit." IFAC Journal of Systems and Control 8 (2019): 100042.

Obviously it's not about TPN bags, but the giving sets would still be relevant anyway, and the methods are presumably transferable with adaptation.

In contrast, here is now Ben Myers summarised his exchanges with Dr Hindmarsh on sticky insulin:

There's a lot of bag changes over the 56 hours. And we say that to suggest that there is sufficient insulin from any one of them to keep sticking but to keep delivering is unlikely in the extreme. When Professor Hindmarsh was first asked questions about the topic on 24 February, and it was explained to him there was a question about whether or not giving sets were changed, but considering the position of sticky insulin his initial response was a smile and he said, "Yes, that's a tricky one now". "Yes, that's a tricky one now."

And then I cross-examined him about that on 24 February and I was asking him whether it would ever run out or do we simply have an inexhaustible supply of sticky insulin for days? I said:

"Question: I'm going to ask, surely that must run out at some point? There can't be an inexhaustible supply of sticky insulin over a period of about a day and a half running through this, can there?"

And we say, with a wry smile, he said:

"Answer: That's correct.

"Question: Right. Is it the case that sticky insulin could be operative over a certain period potentially?

"Answer: I don't think anybody's actually done those kind of studies, to be honest. I think the answer is we simply don't know."

https://lucyletbyinnocence.com/defence-closing-full.html

There is no reason why Dr Hindmarsh would need to know these things to be an excellent clinician, but I think the comparison between this exchange and the type of work Geoff Chase was producing gives you a sense of the gulf between the prosecution expert witness team and the new defence experts.

Why is it ok for you to stick to your opinion but I'm expected to change mine?

You're just repeating the same things over and over and over from the trial and thinking that people can suspend all their knowledge of everything that has come out since then and be convinced by Dewi Evans and handover sheets.

That vid you linked was handy actually because it gave a list of all the expert witnesses. Want me to list them?

Dr Andreas Marnerides, forensic pathologist and histopathologist

Professor Owen Arthurs, consultant paediatric haematologist

Professor Sally Kinsey, consultant paediatric haematologist

Professor Peter Hindmarsh, consultant paediatric endocrinologist

Professor Stavros Stivaros, consultant paediatric neuroradiologist

Dr Simon Kenney, consultant paediatric surgeon

ALL of them saying she's guilty as hell too. You're being totally disingenuous saying this is all about DE and handover sheets.

Kenny, Stavros, and Arthurs didn't argue for Lucy Letby's guilt. They excluded or confirmed particular conditions or infections or (in Arthur's case) gave evidence of findings that might be consistent with (but didn't prove) air embolism. Arthurs himself confirmed this.

You need to bear in mind that experts are supposed to stick within the confines of their expertise and serve the court, not the defence or prosecution. The fact that people appeared as expert witnesses for the prosecution doesn't mean they supported Lucy Letby's guilt

Here for example are the statements to the court by Kenny (https://lucyletbyinnocence.com/transcripts/witness-statement-simon-kenny.pdf) and Stavros (https://lucyletbyinnocence.com/transcripts/witness-statement-stavros-stivaros.pdf)

Kinsey is more complex. She claimed to be persuaded by the famous air embolism rashes but she was relying on the same misreading of Lee and Tanswell as everyone else. Hindmarsh, Marnerides and Bohin were more prominent: we've spoken about some of the problems with Hindmarsh's evidence above, and about the fact that Bohin and Marnerides didn't work independently of Evans in previous discussions.

You know well at this point that procedures were not followed, you also know that there are huge problems with the evidence, it's gone past confirmation bias now for you, instead you are being wilfully obtuse, it's intellectual dishonesty.

I don't actually, it's opinion that's all. From people who are biased against the system. Scratch the service just a little bit and you'll find out that most of them have grudges against the police etc. I just found out Steve Watts was investigated himself. And you can tell in the video he's getting worked up about Lucy. He doesn't even think she should've been arrested! I mean it was slightly ridiculous she was arrested 3 times, but then it's an unprecedented case. Just imagine thinking you don't need to arrest a dangerous serial killer you can just invite her in for a chat! This coming from an ex police officer! Everyone wants Lucy to have special treatment it seems.

He's completely unaware of his own bias, yet at the same time talking about the police having a bias. You couldn't make it up. That Stephanie Davies too, not that I blame her after what she says she's been through. But it doesn't make either of them impartial in the least. They see themselves in Lucy but they're barking up the wrong tree.

Ask yourself whose likely to have more bias, someone who has something against the system or someone who doesn't?

As previously stated I'm not trying to get you to change your opinion, all most of us want is for you to engage respectfully but you're not capable of that.

@kkloo can you point out where I've not been so I can moderate my debates?

Yes you do. You're being wilfully obtuse and that's all it is.

I just looked up what he was investigated for, I can only see he was investigated for alleged breaches of the official secrets act, following which he was fully cleared and received an official apology. Or is there something else?

Steve Watts having a firm opinion now that you disagree with doesn't mean that he formed that opinion through being biased.

I do agree with you re arresting her if they believed she was a serial killer, but at the same time she shouldn't have been arrested because it wouldn't have got to that point in the first place if they had investigated properly.

The thing is that both Watts and Davies can point to an event, point to the relevant guidance, and state objectively that this guidance wasn't followed.

Whatever biases they or others may or not have, they have expertise and they can back up their claims. That's why digging into their relationships with the police doesn't really change anything about their credibility

Many of us have pointed it out repeatedly. You can't go more than a few comments without making digs or making out everyones part of some fan club.It's goading behaviour and you know it is, and it's an easy and lazy way to try to ignore all of the new experts etc that have come out.

I'm not I simply disagree with you/don't know enough about police investigations. Just because certain individuals say they investigated wrong doesn't make it true. And even if certain parts of the investigation weren't done 100% by the book (a big IF) doesn't mean her conviction isn't safe. Easy for Steve Watts to criticise this and that say he'd have done it all differently even though his own actions have been brought into question in his career!

I do agree with you re arresting her if they believed she was a serial killer, but at the same time she shouldn't have been arrested because it wouldn't have got to that point in the first place if they had investigated properly.

I mean there you go declaring she never would've even been arrested if they'd investigated properly. How on earth do you know? Oh right you can't see the evidence so it doesn't exist and she's innocent...

I genuinely don't remember doing that recently. I said there was a letby camp that's it! Just an easy way to refer to your "side" for want of a better word.

The point he made about the arrests was that the police said in their various publicity pieces that ‘we had no choice but to arrest her’ and ‘we had to arrest her in order to speak to her’. This was untrue as she had volunteered to come in to speak to the police. They didn’t have to arrest her in order to speak to her, they could have asked her to come down for a chat. They most definitely didn’t need to arrest her at 6am in her nightwear and take her away in handcuffs. It was excessive use of force.

"favourite nurse"
"Whole army of fans"
"probably be calling themselves Lucys army soon if they haven't already'.

It's not an easy way of saying side. It's goady. If it's for 'want of a better word' then why not say MOJ side and leave out the provocative comments.

Thanks. I’ve seen these but I would really like to see some relevant studies on insulin in PN bags.

Adsorption onto the giving set surfaces can’t really be extrapolated to adsorption onto the interior of PN bags - they are made of different materials with different characteristics (although we do know it does adsorb, which is one of the several reasons insulin is never added to PN).

The amount of insulin that would be lost to adsorption is a factor of both surface area and how much the bag material encourages adsorption.

Insulin assays are tricky, but it would surely be worth someone’s time and money to experiment with a few bags with different amounts of insulin added, left for a while to replicate the alleged advance spiking, and to see how much insulin makes it out the other end of a giving set.

It's not a big IF at all, we know that they didn't conduct it properly. There you go again being wilfully obtuse.

Oh yeah I forgot about those 😆to be fair I was talking about the people making youtube vids etc. for most of those.

I am sure that's what Chase and Shannon have put in the CCRC report but I can't imagine it's out there as a study apart from that - you just wouldn't have any reason to model it apart from in this case, since you wouldn't administer insulin that way.

Maybe police shouldn't arrest anyone then...look I've had family members arrested (for much lesser crimes obvs) one was guilty the other most certainly wasn't. It wasn't at 6am but he still got arrested and wasn't anything to do with the crime the other family member was doing. He probably could've sued but didn't. Police arrest people all the time and let them go when they realise they have nothing to do with it. It's only a big deal if they're charged. If she goes down for a chat they can't raid her house can they? She would've gotten rid of all evidence before she goes for her friendly little chat at the police station.

You also have to remember the families involved and they'd most likely be very upset if they found out the person suspected of killing and harming their children wasn't even arrested. She doesn't get special rules because she's a young woman and a nurse. I don't see why you think she should? It wasn't excessive force at all, what an insult to people who are actually manhandled and worse by the police! For much lesser crimes!

Oh yes, I do mean something specific for this case. We’ll just have to wait patiently!

If he was investigated himself then obviously he was thought to be doing something wrong or not following procedure. I don't see how it's any different to what he's accusing the police of. He should know better than anyone what those kind of allegations can do. Same with Stephanie Davies, they've both been accused of this from what I can see. They're not objective. Maybe they'll apologise to the police when/if it comes out they didn't do anything wrong.