Lucy Letby - Specifically those who think she is guilty…

[BEAchDays2]

I’ve just been reading massive amounts of posts of Facebook following the new doc out about LL. (Blame a long train journey!) and it got me thinking, those who still think she is guilty what are your reasons?

It does feel like the tide has turned generally. I haven’t watched the new doc yet, likewise has anyone seen it, and is it worth it?

I’ve seen a panel of very experienced clinicians, challenge the evidence presented in court - regardless of whether she is innocent or guilty, this is still really concerning if you believe in an open and fair justice system

Yes of course he would.
You don’t reach that level of eminence as a scientist without having the rigour to be able to report results honestly even when they’re not what you expected. Science depends on people not hushing up or faking their results. It’s clear you have no familiarity with how academics work. Good ones change their minds regularly when prevented with new evidence.
Plus, in that scenario Shoo Lee would be able to publish it as a new and interesting contribution to knowledge and a further contribution to our nuanced understanding of how we can diagnose air embolism in babies.

Dr. Shoo Lee was cross-examined by prosecuting counsel Nick Johnson KC at the UK Court of Appeal regarding his testimony over skin discoloration and vascular air embolisms, and (in my observation) he is always very neutral and science based. So to say he's not been challenged is bizarre. Also, in the panel he convened each expert looked at the available evidence from the court case independently. One of his conditions was that every opinion would be formed independently and all would be published. There were 14 experts on that panel. None of them found evidence of deliberate harm, though they did find evidence of substandard care.

The thing about this trial that I find so odd is that when the babies were originally autopsied no murders were found - there was no suggestion of any deliberate harm at this point. Then, during the first internal investigation again, no deliberate harm was found when the autopsies and results were re-examined.

The ONLY thing that seemed to point to any wrongdoing was some doctors feelings and a statistical correlation (which some actually say isn't as pronounced as presented) between Letby being on shift and harm occurring. But naturally these statistical correlations do sometimes happen without there being a causal link, which is something humans are spectacularly dim, seemingly, at understanding. The Lucia de Berk case is another example of this.

There are just too many unanswered questions. Why, if Letby HAD found injecting air a method to murder would she switch to insulin when - if the medicine store had proper record keeping - this would almost inevitably be found out? None of it makes sense.

The biggest questions for me though, and for society, is why someone who was not particularly well qualified and seemed to have an unnatural interest in the case who put himself forward was paid out of taxpayers money as the main expert for the prosecution. And also why her defence was so piss poor, not calling any experts themselves. It almost reeks of stitch up.

What SHOULD have happened is that as soon as those concerns about a correlation were raised, Letby was taken off shift. That would be a good safeguarding response both for the babies (assuming another qualified nurse could take Letby's place) and for Letby herself, and if she's innocent I bet she's wishing they'd taken those safeguarding steps sooner. There was a huge safeguarding failure - I hope someone is criminally prosecuted for this.

The reason that didn't happen, it seems clear, is they were understaffed in terms of qualified and experienced medical personnel appropriate the the level of care needed.

A few years previously they'd got rid of a lot of very senior nurses with lots of experience. I hope the CEO who made those decisions is held to account.

That doesn't follow Lee's panel could have found deaths unexplained, or suspicious causes of death other than air embolism. Or they could have found features actually diagnostic of air embolism. It wasn't a case of either these children have Evans's imaginary symptoms of venous air embolism as proof of murder, or there are no murders.

Just replying to the first part of this post, what people like me are saying about SL and indeed other potential witnesses not being challenged is be careful what you’re listening to and be mindful of the forum in which they’re speaking and the context. Is it a channel 4 documentary or the Court of Appeal? You remind us that SL was cross examined in the CA. Well indeed. You’ve made my point for me there!

IIRC Shoo Lee didn't say 'we found no murders' he said in the evidence they reviewed 'there was no evidence consistent with murder by the methods proposed'. That's quite a different thing. Obviously the media will spin it as 'we found no murders'.

Edited to add: Yes, it's important to be aware of the source. But ultimately, there is a truth in terms of what happened here and the truth matters.
Whether procedure was followed in the police investigation is another question and one where truth matters.

Im afraid you don’t recall correctly. It’s extremely clear in my memory which is why I said earlier that I was recalling it verbatim. I haven’t paraphrased and it isn’t media spin. Media spin is exactly what I’m speaking out against, so that’s a bit ironic. He said we found no murders. The wording, as you say, is important.

He said it at the press conference in front of the world’s media. It was on the news and in later documentaries. I saw it a number of times.

And Evans said ‘something must have happened.’

I genuinely don’t know why ‘we found no murders’ is an unacceptable thing to say if you didn’t find any murders.

Maybe he said it in conversation but I don't think that was how he put it in his report. He's always been very clear his conclusions are based on the information available to him.

If there's some alternative 'smoking gun' e.g. a witness to Letby doing something, then I'm sure Dr. Lee would accept that. But there isn't.

Dr Evans appears to have decided there was guilt before finding a supposed mechanism of murder (that doesn't stack up, and which he's changed his mind about). That's even less professional than saying 'there were no murders' if you didn't find any evidence of murders.

The jury found her guilty, if there are grounds for appeal she does that. What the facebook warriors think is irrelevant, it is a process of law.

But yes I think she is guilty from my limited knowledge of the case she practically admitted it in a diary/notebook and there were just too many coincidences of her being alone with a baby and it then dying or becoming ill. The jury studied it all in detail and found her guilty.

I’m with you on this, I am fairly sure he put it in exactly those words.

I’ve told you where he said it, have you read my post? I posted that he said it at the press conference in front of the world’s media, so no, not in conversation at all. That press conference where David Davis called him the ‘star of the show’.

"In summary, ladies and gentlemen, we did not find any murders. In all cases, death or injury were due to natural causes or just bad medical care"

It's an hour and fifteen minutes into the press conference. I don't see any problem at all with his having said it.

If you were splitting hairs you could say that we did not find any murders is different from, there were no murders. But they found natural causes or medical explanations for all the deaths, so obviously they did not find any murders.

But you don't apply any of this to Dr Evans...

Dr. Shoo Lee was cross-examined by prosecuting counsel Nick Johnson KC at the UK Court of Appeal regarding his testimony over skin discoloration and vascular air embolisms, and (in my observation) he is always very neutral and science based.

Thought he got absolutely trounced by Nick Johnson.

The thing about this trial that I find so odd is that when the babies were originally autopsied no murders were found - there was no suggestion of any deliberate harm at this point. Then, during the first internal investigation again, no deliberate harm was found when the autopsies and results were re-examined.

The post mortems weren't done forensically. It's my understanding that you need specialist tests for air embolism (something about submerging the heart in water) and this wasn't done because no one was looking for deliberate harm. So it's no surprise they didn't find any evidence of air embolism.

The ONLY thing that seemed to point to any wrongdoing was some doctors feelings and a statistical correlation (which some actually say isn't as pronounced as presented) between Letby being on shift and harm occurring.

No they managed to place her cot side for the majority of the collapses, not just on shift. And a few of these weren't her designated babies which completely rules out scapegoating. They wouldn't have blamed Letby for deaths/collapses that happened under another nurses care unless they could place her cot side at all the incidents-and they could, and the only way they could do that is because she's guilty.

There are just too many unanswered questions. Why, if Letby HAD found injecting air a method to murder would she switch to insulin when - if the medicine store had proper record keeping - this would almost inevitably be found out? None of it makes sense.

Yes but the medicine store didn't have proper record keeping and she'd know this-and she wasn't found out at the time. She used insulin because she'd attacked their twin siblings (the insulin babies are both twins) with air embolism and needed to be off shift otherwise two twins collapsing on two separate occasions under her watch would be very suspicious.

The biggest questions for me though, and for society, is why someone who was not particularly well qualified and seemed to have an unnatural interest in the case who put himself forward was paid out of taxpayers money as the main expert for the prosecution.

Dewi Evans has decades of experience and other very experienced experts also found harm. Why on earth shouldn't he/they get paid for their work.

And also why her defence was so piss poor, not calling any experts themselves. It almost reeks of stitch up.

Because she's guilty and her defence experts wouldn't have been able to rule out deliberate harm either (unlike Shoo Lee, apparently) it was ultimately her decision not to call anyone. It only looks like a stitch-up if you've already convinced yourself she's innocent. It makes perfect sense if she's guilty.

I think as I said a few posts ago, @Ginnyweasleyswand has actually made my point about SL better than I have without even trying to, when they said that it’s not true to say that SL has never been challenged (not that I was saying he’s never been challenged, just that speaking out of court is not the same as being under scrutiny and cross examined and subject to the rules of evidence).

Hey presto, when he was put under the forensic microscope, what happened? Leave to appeal refused.

The question before the Court of Appeal was whether Evans had wrongly interpreted Lee AND in so doing, had relied on this misinterpretation to present the case.

The court of appeal did not disagree with the science of Lee's interpretation of his own work, though their response was muddled. They argued that Evans had not relied on the feature he had misunderstood in Lee's paper, that is, that the difference of interpretation did not affect the outcome.

This showed (in my opinion) a very limited understanding of the science, since the other features the court claimed Evans relied on are so common. But the court of appeal decided that they were sufficient for the convictions - correctly I think on the matter of law since we had at least one air embolism case - baby N - where a conviction of injury by air embolism was made purely because the baby was crying.

Lee, in other words, was brought in on a legal point - what did the prosecution rely on to secure the conviction. He was not there to discuss the individual cases from the clinical notes, alternative causes of death, or anything resembling the reports since submitted to the CCRC. There is no reason to believe that the case put to the CCRC relies on his work on air embolism as presented at the Court of Appeal (or the work @Firefly1987 cites Dr Colin Ferguson). While these are obvious signs of problems with Lucy Letby's conviction, we would be more likely to hear of them again in the event of a retrial, if the prosecution sticks with the air embolism theory, which seems pretty unlikely.

If your opinion is that it would be impossible to rule out air embolism without opening the heart underwater, and this wasn't done, how would you expect the defence experts to rule out air embolism whether it happened or not?

@Oftenaddled exactly you can't so why did Shoo Lee?

Lee's argument is that there's no evidence they died of air embolism and there are obvious natural / iatrogenic causes of death.

I don't know whether the panel argued it's impossible that any of them died of air embolism in his fuller reports. There are some hints in his summary (around timing and alarms) that he might.

@Firefly1987 is correct though, that Lee did rule out air embolism. It’s there in the quote and clip that you just posted yourself. He said there were no murders and death in each case was due to natural causes or bad medical care. Sounds like ruling out air embolism to me.

He said, we did not find any murders

It's not clear whether he argued in his reports that air embolism was a technical impossibility in all cases. He made the scientifically grounded argument that none of the empirically established signs on which we diagnose venous air embolism were present, so there were no grounds for diagnosing it.

The argument that you see online sometimes, that in theory it could have been present despite none of these signs being present, because we can't prove it never happens without these signs, is of course no basis for a charge or conviction. How many thousands of nurses could you lock up every year for not impossible invisible air embolisms? Lee is engaging in science. Evans's more desperate defenders are engaging in irrelevant speculation.

You’re putting it better, but the quote you yourself posted above , what he actually said, is the less scientifically grounded ‘death in each case was due to natural causes or bad medical care’. That goes further than saying there were insufficient grounds for finding air embolism. That surely rules out air embolism.

It’s an uncomfortable position isn’t it, because on the facts it’s surely difficult to completely rule out air embolism. And yet like it or not that is what Lee has done. And he did it in a forum where it wasn’t being scrutinised and tested and subject to the strict rules of evidence. Problematic to say the least.

Not really, no.

When a doctor is asked about cause of death, they are looking for the most likely reason a person died, indicated by whatever postmortem findings and clinical history are available. That's what cause of death means. They will make different decisions as to what to weight how where a death is multifactorial. They will list immediate and root causes. They will be able to point for evidence supporting their findings. It's a formal exercise with these outputs, and this is what medical science requires.

Notably, they don't tend to add, for example, although this pneumonia was sufficient to kill the patient and the signs are that it did so, we haven't ruled out unique presentation of any other disease for which there are, uniquely in documented medical history, no significant indicators. The fact of not adding this disclaimer doesn't mean they haven't found a cause of death. That's not a standard disclaimer for obvious reasons. And that is all that could be said of venous air embolism here.

The venous air embolism stuff is an invention, but a very convenient one, because the prosecution stripped it of its unique identifying features and thus rendered it mostly unfalsifiable. (The "airlock causing immediate collapse" detail specified by Evans on a recent documentary might certainly be falsifiable, depending on details I don't have, and alarm and line systems might make it falsifiable in some cases, but obviously I have no idea how the panel is dealing with these things in the full reports). But for the purposes of offering most likely cause of death, the stated aim of the panel and the normal aim in investigating a death, Lee follows the standard professional course here: most likely cause of death, no disclaimer ruling out every possible invisible imaginary cause of death, because most likely cause of death natural or iatrogenic, we found no murders

(There are certainly instances where the panel explicitly rules out air embolism or other charges like overfeeding, but without reading full reports, I don't know how many this applies to).