That is in the summary I linked. I've pasted it below:
SUMMARY OF JOINT OPINION
In the report we present convincing new evidence from multiple sources that the Roche immunoassay test used can give rise to falsely high insulin results due to the presence of antibodies that can react with this type of immunoassay test. We also highlight evidence these antibodies can pass across the placenta to unborn babies and cause hypoglycaemia and apparently high insulin levels in the newborn period.
Furthermore, new evidence has been
published which increases our awareness and understanding about hyperinsulinism in the neonatal period. This information has provided greater insight into how adverse perinatal factors can cause hyperinsulinism in some newborn and premature infants. This is termed Perinatal Stress-Induced Hyper-Insulinism (PSIHI).
We have concluded that the Jury were misled in important areas as follows:
a) Medical facts: the evidence for sepsis, leakage of the central line into surrounding
Vssues, and consideration of alternative causes for the hypoglycaemia.
b) Evidential facts: errors in the glucose results presented, changes in the glucose levels in response to TPN infusion connection/disconnection, ward-based blood glucose tests presented as if they were laboratory results.
c) Testing: that the results of the immunoassay tests can be relied upon, and that the Roche immunoassay method used at the Royal Liverpool University Hospital (RLUH) was specific for identification of insulin alone (endogenous or exogenous)- neither of which are correct.
d) Background error rate: this is at least 0.5-2% despite excellent quality control for the
type of insulin immunoassay test used, which the jury were not made aware of.
e) Quality Control testing information was not revealed to the Court in expert witness
evidence. The results showed a quality control test with high insulin and a low C-
peptide.
f) Abnormal results: it is essential requirement according to published standards to undertake confirmatory testing of the immunoassay result using a different, more specific methodology, such as liquid chromatography mass spectrometry (LC-MS).
g) Reference ranges not applicable in small preterm infants for C-peptide results and
insulin/C- peptide ratios. Studies in adults and older children were quoted which are
not relevant, and the limited appropriate information was not referred to.
h) The testing did not meet acceptable forensic standards at the Liverpool laboratory in terms of analytical specificity, chain of custody, control testing for interfering substances, and obtaining confirmatory result using alternative available methods or another laboratory.
The new evidence undermines the validity of the results of the insulin and C-peptide testing presented in Court and shows that these immunoassay results cannot be safely relied upon (without undertaking further confirmatory testing).
There is now evidence that:
• shows that the presence of antibodies (IAA insulin autoantibodies and other
antibodies such as HAMA) can interfere with the immunoassay result and cause falsely high insulin results
• demonstrates that insulin autoantibodies can be transferred from mother to baby
during pregnancy causing hypoglycaemia in the baby and falsely high insulin levels
• that IAA (insulin autoantibodies) can be found in pregnancy and in the umbilical cord
blood of infants, that this is not rare, and that the prevalence can vary over time
• In the context of a falsely high insulin result the insulin/C-peptide ratio is meaningless
• demonstrates there are alternative medical explanations which explain the
hypoglycaemia in both babies, such as line failure, sepsis and perinatal stress-induced
hyper-Insulinism (PSIHI). These alternative possibilities were not considered.
• indicates that the testng undertaken did not meet acceptable standards of clinical,
laboratory or forensic practice, and therefore cannot safely be relied upon
Our inescapable conclusion is that this evidence significantly undermines the validity of the assertions made about the insulin and C-peptide testing presented in Court.