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

@EyeLevelStick What else have you got?

I mean are you sure you want me to list them all-there's so many just off the top of my head. Will start with yours first.

Watching a neonate to see if they self-correct rather than risk over-handling them? Standard.

I think I'll trust Dr Jayaram's opinion that you never wait that long with a baby of that size. This literally happened whilst another nurse was on her break in what would be 15 mins or less. He went in knowing something would probably happen to that baby if LL went in and what do you know it did.

Failing a module? Unremarkable, if all the other modules passed and the failed module passed at the next attempt.

Downplaying what was said by her assessor which was that she didn't even have the qualities necessary to be a successful nurse. This is exactly what we want in an assessor-someone who can spot the psychopaths and never let them get near potential victims.

Taking handover notes home and not disposing of them? Inappropriate, but not unusual.

The sheer number is. Less than 10 would be no big deal, over 250 certainly is.

Volunteering to work extra shifts? Pretty normal.

I don't think there's anything wrong with that however staying back after work for no discernible reason or going in on days off might be.

Wanting to work with the high acuity babies? Ambitious and keen.

Sure if she didn't ONLY want to work with them and literally get mad if she got put in the other nurseries and describe it as "boring" and she only wants to be in with the sicker babies. Or get angry that other staff have been put in room 1 when she just lost a baby so "needs another dying baby to get over the last one she lost"-very abnormal.

Making a medicines error while working under supervision? Not great, but not uncommon.

Potentially killing a baby if the mistake hadn't been spotted. Then claimed it was "escalated more than it needed to be" showing absolutely no sign of any guilt or regret and just anger that she lost drug privileges. Meanwhile the other nurse involved is so devastated she almost considers giving up nursing. A complete contrast of behaviours for two people involved in the same incident (only one went on to be suspected of purposely killing babies)

Facebook searching everybody, including patients’ parents? A bit weird, but not particularly unusual and certainly not sinister.

Searching parents when their baby has died that day? For what possible reason? And on anniversaries, and Christmas? Which means she's very involved in these parents lives to a concerning degree. She can only be looking to see their loss and grief as they're not likely to post anything else on the day it happened, Christmas and anniversaries.

Having a crush on a co-worker? Not appropriate, but incredibly common.

Making babies collapse so said crush could attend? Then using him for info about any possible investigations into the deaths.

Making typical "angel of death comments" like "he's not leaving here alive is he?" when baby isn't even close to death, shocking her colleague.

Being seen to be excited about making up memory boxes. Always putting herself forward for this.

Being seen to treat baby deaths as gossip in a "you'll never guess what" way.

Staying after her shift to fish a blood gas reading out of a bin when a colleague testified to having thrown it away.

Writing a draft note to all three triplets as if they'd ALL died and they're not here for their birthday, even though one survived.

Not leaving baby C's parents alone despite the fact she had no reason to be in the room and was even neglecting her own baby (the only baby her supervisor was worried about at the beginning of the shift) had to be told multiple times to leave and go look after her own baby.

Claims the entire conversation with baby E's mum didn't happen.

Claims a dad was on the floor crying when his baby died which the parents testified never happened.

Texting her mum about a baby death and then ending with "good thing I love my job!" I mean she's not even trying to hide who she is at that point. What do you love about your job Lucy? All the babies collapsing?

Saying "if they've got nothing or minimal on me they'll look silly not me"-why would they have anything even minimal on you if you're innocent?

Tube dislodgements on 4 out of 11 of her shifts at Liverpool even though it's supposed to happen less than 1%.

I mean shall I go on? I'm sure there's more. This is why people think she's innocent because it takes practically a book to write about all her concerning behaviour and most people don't have time to go through all her red flags. This took me ages. But at least I won't have to go through it all again next time someone asks!

@Firefly1987 Making babies collapse so her crush could attend is a theory, fishing gas readings out of the bin, also a theory, theories are theories, not behaviours.

The comment about the baby not leaving there alive makes sense given the circumstances and how no one seemed to know what to do and the doc was going out smoking during resuscitation, I’m sure more were thinking the same.

There’s nothing odd about the texts and no matter what she said in them you’d see them as a sign of guilt, if she never mentioned the babies you’d say that was a sign she was a serial killer, if she came across as cold you’d say she was a serial killer, if she said she hated her job you’d say she was a serial killer.

Minimal could have referred to minor issues with her practice.

I just saw on Reddit that Nick Johnson is representing the police at the inquests.

I didn't realise the police would have a barrister representing them at the inquests. I wonder how that works - does he just make statements on their behalf?

@kkloo I didn't even mention the post it note, the "I don't like parents getting their hopes up because anything could happen" comment to Lynsey Artell (whose son coincidently then went on to have inexplicable issues) or the walking in with a treasure box and then laughing at the mum who thought it meant her child had died. OR the "I can't wait to get my first death out of the way" comment. All totally normal for a nurse 🙄

And the draft note to triplets naming them all as having died? What's your theory for that?

Why does she have a crumbled up bit of paper towel with resuscitation notes written on at all regardless of whether it was thrown in a bin or not?

I do think saying you love your job directly after you told your mum you unexpectedly lost a triplet in your care (right after you returned from Ibiza) is inappropriate in the least. Can only imagine her parents either figured out the truth at some point or are still in deep denial.

You'd excuse anything she did because you're too invested in her innocence to look at it objectively.

@Firefly1987

again no matter what she said you’d be picking fault with it, nothing about any of that is outside the realm of normal.

The note I saw names the triplets (blurred) and then further down the note said today is your birthday and you’re not here and I’m sorry you didn’t get to live the life you were meant to live or something like that.

it wasn’t naming the 3 of them as having died, there was other writing on the page also and the third triplet also isn’t living the life they were meant to live either, I’m sure anyone thinking of the triplets would be sad for all of them and thinking of all three.

I don’t know, she could have picked it up all off the floor.

Stop with the “you’d excuse anything she did” crap. It was old a year ago or more.

and you’re projecting again.

When things as generic as being enthusiastic about work or wanting more challenging work count as evidence of murder, and when you dig through every thing the person said/did over an extended time, you'd be surprised at how easily such a dossier can be compiled on almost anyone. Certainly on everyone in this conversation (interest in serial murder -- case closed!).

Re: tube dislodgements at LWH, we've been over this. They reviewed for all incident types. You can't compare the findings with expected rate of one incident type. That's just one of several issues with this statistical claim.

Tube dislodgements on 4 out of 11 of her shifts at Liverpool even though it's supposed to happen less than 1%.

Mangled statistics, again.

Your misunderstanding and doubling down around the failed module and the medicines error are ridiculous.

She passed the other modules, and passed the course overall. Nobody else raised any concerns.

Medicines errors happen. They shouldn’t, but they do. We don’t know what the investigation showed, but she may have been justified in being annoyed at the restrictions placed on her; remember she was in training so is not accountable for the decision to administer. Even if she wasn’t, being annoyed at being held back isn’t a crime. Voicing her annoyance was probably professionally unwise, but she was very young.

You view everything through the lens of being unswervingly convinced of her guilt (despite being shown, repeatedly, evidence of reasonable doubt) and see everything as evidence of malfeasance.

There’s little point discussing anything with you because you seem incapable of viewing the evidence neutrally.

I'm not saying most of them are evidence of murder I'm replying to the assertion that other nurses would find her behaviour "within the realms of normal"-she can be a shit nurse who should never have been a nurse and still not be guilty of murder.

The rest of the evidence outside of the above does prove murder though.

Statistics to the rescue again I guess-4 tube dislodgements out of 11 shifts not significant! Ok then. It happened at another hospital too so I can see your desperation to claim they don't mean anything.

Her behaviour is in the realms of normal. It’s not even close to being outside the realms of normal.

I actually have no idea what way it works. I just asked ChatGpt, obviously we know AI can be wrong but here’s what it said.

1. Representing Cheshire Police’s Legal Position

He will present the police force’s perspective on the evidence and help ensure Cheshire Police’s compliance with any legal or procedural obligations at the inquest. That includes making legal submissions to the coroner about how certain evidence should be interpreted or what matters fall within the scope of the inquest. 📄 2. Advocating on Law and Procedure A KC is a very senior barrister (called “taking silk”) with deep expertise in complex legal proceedings. At an inquest, he’ll advise on issues like whether the coroner’s questions are properly framed, legal principles that apply to admissibility of evidence, and how the police’s role and conduct should be legally assessed. 🔍 3. Making Submissions on Evidence Although the coroner calls and examines most witnesses, “interested persons” — like the police — can sometimes make submissions or ask questions through legal representatives, especially on points of law or serious factual issues that arise. 🧠 4. Protecting the Force’s Interests Because inquests can expose sensitive operational details and potentially lead to recommendations for change (including Prevention of Future Death reports), the police will want a high‑calibre advocate to help frame how those matters are presented or interpreted. A KC is well‑placed to navigate that complexity.

They are not comparing like with like. If you still don’t understand this I can’t help you.

Ok if you say so, obviously not going to convince you otherwise. It's rather sad you have such low expectations for nurses.

I understand. It's not "rigorous" enough for you. It paints enough of a picture for me, especially with all the evidence we have from COCH. She's not getting anything added to her sentence for dislodging tubes at Liverpool so I guess it's a small win for you.

Saying something is normal or abnormal is nothing to do with my expectations. It’s just saying what’s in the realms of normal

In statistics, significance depends on how data was gathered. "I saw a coin land 'heads' 10 times in a row." Wow! "Forgot to say, I threw the coin 10,000 times". Oh... No statistic is surprising in itself -- it is surprising or not relative to the process used to obtain it.

Description of LWH review:

"Following contact with Cheshire Police in Summer 2018, a review of case notes was undertaken for both periods when Letby worked at LWH. The process that was followed is outlined below (data relates to both time periods, 2012 and 2015). In order to review any potential suspicious events at LWH a review was undertaken. All incidents reported in the incident reporting system that included the name LL were examined. All deaths occurring on the days when LL was on duty were reviewed. The electronic patient record system (Badger system) was searched to identify any note entries made by LL. She had contact with 33 babies on a total of 324 patient days. Each of these days of care was reviewed by a neonatal consultant to identify any unusual or suspicious deterioration in the patient's condition. In addition, all babies who were on the neonatal unit on the days when LL was on duty were identified using the Badger system. Each of these days of care were reviewed by a neonatal consultant to identify unexpected cr unexplained deterioration in clinical condition. There were 257 babies on the unit during those days with 1,308 days of care requiring review"

This was a non-blind review centered around Letby, increasing the chance that an incident will be judged "unusual or suspicious". They looked for "all incidents" of any type (not just tube dislodgements). They looked specifically at Letby's known contacts and notes, yet found nothing. They then looked at "all babies who were on the neonatal unit on the days when LL was on duty" (not just those she had known contact with), for any of many possible types of events. Finding four events, among so many chances for an event to occur, is not surprising.

A win for me? Grow up. Engage with the substance of the issue.

What you have posted is evidence-free and context free. 4 dislodgements on 11 shifts may be less than would be expected, if there’s one baby that dislodges his/her own ET tubes. There’s no information about the number of babies affected.

If you care about facts and evidence you could read this https://archive.is/Nw0b0 but I know you are not interested in learning.

@Firefly1987 If we assume that of the 1,308 days of care, 25% to 35% were ventilator days (it's a tertiary hospital), that's 327 to 458 ventilator days, and assume that 1% of ventilator days have an extubation, you'd expect 3 to 5 extubations. So how is 4 even an outlier?

@Firefly1987 Although, 1308 covers both 2012 and 2015 placements, while the 4 dislodgements don't include 2012 counts. You'd need either the 2012 dislodgement counts or the separate 2015 days of care. But the whole approach of comparing the number of events found by looking for events of any type, to the expected number of events of one type, is incorrect.

@Firefly1987
you’re the only one treating this like a game to win.

”The tide has turned”
”It will all be over soon”

you sound like a football commenter at times.

@Dolphin37 we don't have that data and I doubt it'd ever be possible on this planet to have the full data statisticians seem to require. Perfect seems to be the enemy of good here. We have the stats we have, she only worked 11 shifts. Statisticians would always argue it wasn't enough. That's why they mostly get ignored. Because they never do anything but complain and don't come up with any stats themselves that'd help us understand.

Talk about missing data-you're not taking into account this was in a very short space of time over 11 shifts not 100.

But how many babies were on ventilators on each shift? A shift with 20 vented babies is 20 times more likely to have a dislodgement than a shift with 1. So 4 shifts may be unexpectedly many if all 11 shifts had 1 vented baby, and unexpectedly few if all 11 shifts had 20 vented babies. When you may get opposite answers depending on data you don't have, there really is not enough data to get an answer.

We have mangled stats from an incomplete data set. These are not statistics in any meaningful sense, so are not “good” at all - they are useless and dangerous.

Statisticians can’t just come up with stats “to help us understand” if the data is incomplete (and by the way the data will exist; it just needs to be provided, but it hasn't been). They can, as Dolphin has, provide you with illustrations, but you’d still need to try to engage with them to understand what she’s saying.

Have you bothered to read the link I posted yesterday?

In the simplest of terms, a single self-extubating baby may dislodge the tube many times over 11 shifts. We have no idea whether this is the scenario.

And before you come back with your usual “What are the chances?” - we don’t know. We don’t know the chances because we don’t have data.