Lucy Letby: Specialists elevate doubts about medical proof introduced in court docket

Senior docs and scientists have instructed the BBC they’ve considerations about how essential proof was introduced to the jury at Lucy Letby’s trials.

The BBC’s File on 4 has examined how professional witnesses helped to construct the case towards the previous nurse.

The programme raises considerations about how courts grapple with circumstances of serious medical complexity – with the juries in Letby’s two trials introduced with enormous quantities of sophisticated medical proof relating to every youngster.

The specialists who spoke to the BBC elevate questions concerning the quantity of insulin she wanted to hurt infants in her care, the well being situation of one of many infants she was convicted of murdering, and pathology findings introduced to the jury.

A public inquiry is below solution to set up how Letby was capable of homicide and injure infants. At its opening Woman Justice Thirlwall was scathing about those that have questioned the verdicts, saying this was inflicting “huge extra misery to the mother and father”.

Final month a few of the households of the infants gave proof on the inquiry.

Every of the specialists interviewed by File on 4 acknowledge how troublesome it should be for the households to listen to doubts raised concerning the trials. Nonetheless, they are saying they really feel so strongly concerning the proof they felt compelled to talk out.

BBC File on 4 examines a few of the most contentious statistical, scientific and medical proof within the Lucy Letby trial. Listen to Lucy Letby: The Killer Questions

Accessible now on BBC Sounds and on BBC Radio 4 on Tuesday 1 October at 20:00, and Wednesday 2 October at 11:00.

Greater than 100 days of complicated proof was heard throughout Letby’s first trial, which led to August 2023. She was discovered responsible of murdering seven infants and making an attempt to kill six others between June 2015 and June 2016 on the Countess of Chester Hospital.

In a second trial held this yr, a special jury discovered Letby responsible of tried homicide – after the primary jury failed to achieve a verdict. She is serving 15 whole-life sentences and 4 judges have dismissed her try and attraction these convictions.

A lot of the specialists File on 4 spoke to weren’t current on the trials, and so they don’t provide an opinion on her guilt. They’ve studied key medical proof introduced in court docket. Their considerations – that a few of it was misinterpreted – type a part of the rising hypothesis round her convictions.

It comes after Letby’s new lawyer, Mark McDonald, instructed the BBC he plans to take her case to the Prison Circumstances Evaluate Fee (CCRC), which investigates alleged miscarriages of justice.

At her first trial Letby was discovered responsible of trying to homicide two infants – referred to in court docket as Child F and Child L – by including insulin to intravenous feed baggage.

The prosecution mentioned each infants have been doing nicely till Letby attacked them, and that it was suspicious she later looked for the mother and father on Fb.

The prosecution alleged it will have taken only some drops to poison every child, however File on 4 has spoken to a workforce of mechanical and chemical engineers who disagree – and who’re talking about their calculations for the primary time.

Prof Geoff Chase, from the College of Canterbury in New Zealand, has been modelling how insulin works in pre-term infants for greater than 15 years. He labored with chemical engineer Helen Shannon on a mathematical mannequin that calculated considerably increased portions of insulin could be wanted to hurt infants F and L, and to generate insulin ranges seen of their take a look at outcomes. Within the case of Child L they calculated it could possibly be as a lot as 20-80 instances extra.

There was no proof within the trial to recommend vital portions of insulin had gone lacking on the ward.

Chatting with File on 4, one other professional expressed considerations about the usage of the identical blood take a look at outcomes on the trial – one thing others have questioned within the media.

Dr Adel Ismail – a world-leading professional within the take a look at – instructed the BBC he believes the immunoassay blood take a look at can produce deceptive outcomes.

“In my analysis, I discovered the error fee is one in 200,” he mentioned, and added {that a} second, confirmatory take a look at in such circumstances was “completely important”. Within the case of Child F and Child L follow-up assessments weren’t carried out by the lab.

Some specialists, nonetheless, say the assessments are ok to depend on one set of outcomes. The hospital didn’t order additional assessments as a result of each infants recovered quickly after.

Letby was additionally discovered responsible of murdering a child referred to in court docket as Child C.

Key to the case was an X-ray taken on 12 June – it was referred to repeatedly through the first trial. In pre-trial reviews two prosecution witnesses mentioned it confirmed the infant had a swollen abdomen “most certainly as a result of deliberate” pumping of air into his feeding tube.

Nonetheless, neonatologist Dr Michael Corridor – who has spoken publicly about his considerations earlier than, and has written to the chair of the general public inquiry – instructed the BBC: “There are a variety of potential explanations for there being extra gasoline there.”

Dr Corridor, who was consulted by the defence however by no means known as to present proof, mentioned it’s prone to have been attributable to the respiratory help the infant was receiving and mentioned the X-ray steered there was a bowel obstruction.

Letby was not engaged on the day the X-ray was taken and had not been on shift since earlier than the infant was born – data the jury heard in her first trial. Letby’s former barrister Ben Myers additionally highlighted these particulars in his closing argument.

In his summing up the choose made clear to the jury this X-ray had been taken the day earlier than Child C collapsed, although he didn’t remind them Letby hadn’t been on shift. At attraction, the prosecution mentioned Letby might have visited the hospital whereas off shift, however didn’t put ahead any proof that she was there.

The BBC has additionally spoken to 5 senior clinicians who reviewed Child C’s medical notes made public at trial – though just one had entry to the infant’s full medical historical past. All of them famous the infant was excessive threat and will have been in a better stage unit.

Prof Colin Morley, a retired professor of neonatology from the College of Cambridge, instructed File on 4 he was “very assured” Child C died of pure causes.

On the trial, the X-ray was not the one proof used to convict Letby on this cost. The prosecution argued textual content messages confirmed she was determined to get into the room the place Child C was being handled, regardless that she wasn’t his designated nurse. One other nurse mentioned she discovered Letby standing over the infant’s cot when he collapsed. After he died, Letby once more looked for his mother and father on Fb.

Child O was one among triplet brothers born in good situation in June 2016. He was steady, Letby’s first trial was instructed, till the afternoon of 23 June when he suffered a “exceptional deterioration” and later died.

The pathologist for the prosecution, who reviewed the case, mentioned he believed Child O had suffered an “influence harm” to his liver akin to a highway site visitors collision.

There was different proof used to convict Letby of Child O’s homicide. She objected to the infant being moved to a different space of the unit to be extra carefully monitored. She was accused of falsifying medical notes, and there was a rash which prosecution specialists mentioned was in keeping with air being injected into the infant’s veins.

Nonetheless, a number one senior perinatal pathologist instructed File on 4 she agrees with the unique autopsy on Child O – that his liver harm and dying have been by pure causes.

The pathologist – who requested to not be recognized due to the controversial nature of Letby’s case – mentioned she has seen this sort of liver injury no less than 3 times in her profession. Every time there have been pure causes.

Not one of the specialists who spoke to File on 4 made any analysis of Letby’s guilt or in any other case, however added their considerations to rising hypothesis about how complicated medical proof was introduced at her trials.

In August, 24 specialists wrote to the federal government to share their considerations over the way in which statistics and the science round new child infants was introduced to the jury on the former nurse’s first trial.

The Crown Prosecution Service instructed the BBC: “Two juries and three attraction court docket judges have reviewed the proof towards Lucy Letby, and she or he has been convicted on 15 separate counts following two separate trials.”

It mentioned in Could the Courtroom of Attraction dismissed Letby’s go away to attraction on all grounds – rejecting her argument that professional prosecution proof was flawed.

This can be a distressing case, so if you happen to – or somebody you recognize – need assistance after studying about it, the main points of organisations providing help may be discovered on the BBC Action Line.