Lucy Letby could have harmed extra infants in her care, new proof suggests

New proof seen by the BBC suggests extra infants in Lucy Letby’s care had been harmed – and in a single case poisoned with insulin.

The previous nurse was discovered responsible of murdering seven infants and trying to homicide seven others – together with attempting to kill two with insulin on the Countess of Chester Hospital neonatal unit between June 2015 and June 2016.

BBC One’s Panorama has seen paperwork which recommend a 3rd child could have additionally been poisoned inside hours of Letby taking on the boy’s care.

Medical information reveal the toddler’s blood sugar stage plummeted and lab outcomes indicated he had suspiciously excessive ranges of insulin.

Panorama has additionally found that probably life-threatening incidents involving infants occurred on virtually a 3rd of Letby’s 33 shifts whereas she was coaching at Liverpool Girls’s Hospital in 2012 and 2015.

The programme’s revelations comply with months of criticism of the prosecution’s case in her first trial. A lot of specialists have challenged the medical proof used to convict Letby, in addition to the way in which statistics had been put ahead in court docket.

In August 2023, the 33-year-old was sentenced to life in jail, with no likelihood of parole. Letby was then discovered responsible of trying to homicide a seventh child at a second trial in July this 12 months, and sentenced to a fifteenth whole-life jail time period.

The nurse has been refused depart to enchantment towards the convictions from her first trial.

Panorama has examined mounting questions from main statisticians and medical specialists concerning the security of her convictions.

However as a part of the programme, new proof has additionally emerged of different sick and untimely infants probably being harmed whereas in Letby’s care.

When the physique produces insulin naturally, it additionally produces a substance known as C-peptide. Sometimes, the extent of C-peptide can be 5 to 10 instances larger than the extent of pure insulin.

Letby’s first trial heard blood checks from the 2 infants confirmed that they had excessive ranges of insulin and really low ranges of C-peptide.

The prosecution argued the insulin will need to have been given to them reasonably than naturally produced.

Letby’s legal professionals didn’t settle for the insulin proof utilized in court docket, however neither did they argue it was fallacious. When she was cross-examined Letby herself accepted the 2 infants will need to have been poisoned, however denied it was completed by her.

The brand new proof seen by Panorama reveals a blood take a look at from a 3rd child being cared for by Letby in November 2015 additionally recorded very excessive ranges of insulin and low ranges of C-peptide.

Lab outcomes indicated the insulin stage was in extra of 6,945 picomoles per litre – a really excessive studying. Had the insulin been pure, the C-peptide stage would have been between 35,000 and 70,000, however the blood take a look at confirmed it was simply 220.

On the time, consultants on the neonatal unit assumed the insulin should be pure. Assessments later revealed the child had congenital hyperinsulinism (CHI) – a situation the place the physique naturally produces an excessive amount of insulin.

However 4 specialists have instructed Panorama that CHI couldn’t clarify such an exceptionally excessive insulin studying for the toddler – partly due to the low C-peptide stage, but additionally as a result of a child with CHI would by no means produce that a lot insulin.

Medical information seen by Panorama present how rapidly the boy turned poorly after Letby got here on obligation. A blood take a look at taken at 06:56 confirmed the toddler had a standard blood sugar stage of three millimoles per litre (mmol/L).

Letby began her shift at 08:00, and by 13:54 his blood sugar stage had plummeted to 1 mmol/L – a dangerously low stage, and a powerful indication the child had an excessive amount of insulin.

The boy’s blood sugar stage remained low all through the nurse’s shift and he solely recovered after she went off obligation at 20:00.

Letby’s new lawyer, Mark McDonald, famous that the child had a specific downside with regulating his personal insulin. He additionally disputed the declare that the child’s situation couldn’t clarify the extraordinarily excessive insulin ranges recorded by the lab.

“It could be mentioned by one professional, however I’ve different specialists which have a very contradictory view,” Mr McDonald mentioned. “I am working night time and day on this case. If I assumed for a second that [Lucy Letby] was responsible, I would not be doing this.”

Some specialists have additionally questioned the accuracy of the straightforward take a look at used to measure insulin in all three of the circumstances, often called the immunoassay methodology.

They level out there’s one other, extra exact take a look at and that solely the extra superior take a look at can definitively decide ranges of insulin within the blood.

There are circumstances through which the immunoassay methodology may give flawed or deceptive outcomes, however the take a look at is broadly used and is often correct.

Panorama has spoken to main specialists on all sides of this debate. The programme discovered circumstances through which interference would possibly happen are not possible within the context of the infants within the Letby case. It’s much more unlikely that three lab checks performed inside months of one another would all be fallacious.

It’s some extent that Letby’s lawyer, Mr McDonald, disputes: “It’s accepted by all sides that there is an error score [with the test], nevertheless it’s the proportion of the error score that is not accepted.”

Panorama has additionally found that probably life-threatening incidents occurred on virtually a 3rd of Letby’s 33 shifts whereas coaching at Liverpool Girls’s Hospital in 2012 and 2015.

In a single case, from November 2012, a child boy collapsed and water was subsequently found in his respiration tube – a extremely irregular prevalence. The scientific notes verify that the nurse taking care of him was Letby.

As well as, a retrospective evaluation confirmed that infants’ respiration tubes turned dislodged on 40% of Letby’s shifts. The norm per nurse per child was 1%.

Cheshire Police is continuous to research different circumstances the pressure believes the nurse could have been concerned in, together with the Liverpool incidents.

Mr McDonald plans to take Letby’s case to the Legal Instances Evaluation Fee (CCRC) to use for it to be despatched again to the Court docket of Attraction.

Reporter Judith Moritz, who has coated the case from the beginning, investigates the questions which were raised about Lucy Letby’s conviction.

Watch Lucy Letby: Unanswered Questions on BBC iPlayer, or on BBC One on Monday 21 October at 20:00 (20:30 in Wales and Northern Eire).