The Lucy Letby case

Note: [20 August 2023] This post is incomplete. It needs a prequel: the history of medical investigations into two “unexplained clusters” of deaths at the neonatal ward of the Countess of Chester Hospital. It needs many sequels: statistical evidence; how the cases were selected (the Texas sharpshooter paradox) and the origin of suspicions that a particular nurse might be a serial killer; the post-it note; the alleged insulin poisonings; the trouble with sewage backflow and the evidence of the plumber; the euthanasias. For the medical material, the site to visit is the magnificent

Lucy Letby, a young nurse, has been tried at Manchester Crown Court for 7 murders and 15 murder attempts on 17 newborn children in the neonatal ward at Countess of Chester Hospital, Chester, UK, in 2015 and 2016.

She was found:– Guilty of 7 counts of murder (against 7 babies)
– Guilty of 7 counts of attempted murder (against 6 babies)
– Not guilty on 2 counts of attempted murder (against 2 of the 6 babies she *was* found guilty of attempting to murder). No decision was reached on 6 counts of attempted murder against 6 different babies. However, 2 of those 6 she was also found guilty of a different count of attempted murder. [Thanks to the commenter who corrected my numbers.]

The prosecution dropped one further murder charge just before the trial started, on the instruction of the judge. Several groups of alleged murders and murder attempts concern the same child, or twin or triplet siblings. All but one child was born pre-term. Several of them, extremely pre-term.

I’m not saying that I know that Lucy Letby is innocent. As a scientist, I am saying that this case is a major miscarriage of justice. Lucy did not have a fair trial. The similarities with the famous case of Lucia de Berk in the Netherlands are deeply disturbing.

The image below summarizes findings concerning the medical evidence. This was not my research. The graphic was given to me by a person who wishes to remain anonymous, in order to disseminate the research now fully documented on, whose author and owner wishes to remain anonymous. Note that the defence has not called any expert witnesses at all (except for one person: the plumber). Possibly, they had not enough funds for this. Crowd-sourcing might be a smart way of getting the necessary work done for free, to be used at a subsequent appeal. That’s a dangerous tactic, and it seems to me that the defence has already taken a foolish step: they admitted that two babies received unauthorised doses of insulin, and their client was obliged to believe that too.

This blog post started in May 2023 as a first attempt by myself to blog about a case which I have been following for a long time. The information I report here was uncovered by others and is discussed on various internet fora. Links and sources are given below, some lead to yet more excellent sources. Everything here was communicated to the defence, but they declined to use it in court. Maybe they felt their hands were bound by pre-trial agreement between the trial parties as to what evidence would be brought to the attention of the jury, which witnesses, etc.

An extraordinary feature of UK criminal prosecution law is that if exculpatory evidence is in the possession of the defence, but not used in court, then it should not be used at a subsequent appeal, whether by the same defence team or a new one. This might explain why the defence team would not even inform their client of their knowledge of the existence of evidence which exonerated her. Even though, it is also against the law that they did not, as far as we know, disclose evidence which they had which was in her favour. The UK law on criminal court procedure is case law. New judges can always decide to depart from past judges’ rulings.

A very important issue is that the rules of use of expert evidence is that all expert evidence must be introduced before the trial starts. It is strictly forbidden to introduce new expert evidence once the trial is underway.

UK criminal trials are tightly scripted theatre. The jury is of course incommunicado, very close to its verdict, and I do not aim to influence the jury or their verdict. I aim to stimulate discussion of the case in advance of a likely appeal against a likely guilty verdict. I wish to support that small part of the UK population who are deeply concerned that this trial is going to end in an unjustified guilty verdict. Probably it will, but that will not be the end. So much information has come out in the 9 months of the trial so far, that a serious fight on behalf of Lucy Letby is now possible. Public opinion crystallised long ago against Lucy. It can be made fluid again, and maybe it can even be reversed, and this is what must happen if she is to get a fair re-trial.

As a concerned scientist who perceives a miscarriage of justice in the making, I attempted to communicate information not only to the defence but also to the prosecution, to the judge (via the clerk of the court), and to the Director of Public Prosecutions. That was a Kafkaesque experience which I will write about on another occasion. Personally, I tend to think that Lucy is innocent. That was however not my reason for attempting to contact the authorities. As a scientist, it was manifestly clear to me that she was not getting a fair trial. Science was being abused. I tried to communicate with the appropriate authorities. I failed to get any response. Therefore I had to “go public”.

Here is a short list of key medical/scientific issues, originally copied from an early version of the incredible and amazing website, with occasional slight rephrasing and some small, hopefully correct, additions by myself. That site presents full scientific documentation and argumentation for all of the claims made there.

  1. Air embolism cannot be determined by imaging, and can only be determined soon after death, and requires the extraction of air from the circulatory system, and analysis of the composition of the air using gas chromatography.
  2. The coroner found a cause of death in 5 out of 7 of the alleged murder cases. Two of them appeared to be, in part, related to aggressive CPR, two appeared to be due to undiagnosed hypoxic-ischemic encephalopathy and myocarditis, one of the infants received no autopsy, and the other infant was determined to have died due to prematurity. It is highly unusual for the cause of death to be altered years after the fact and using methodology that is not supported by the coroner’s office.
  3. The two claims of insulin poisoning are not supported by the testing conducted, and the infants (who are still alive and well) did not have dangerously low or dangerously high blood glucose levels for any period of time. There are many physiological reasons that could explain their low blood glucose during the whole period. In one of the two cases, assumptions are being made on the basis of one test taken at a single time point, clearly inconsistent with the other medical readings, and contravening the manufacturer’s own instructions for use (see image below). The report detailing the conclusions from that single test violates the code of practice of the forensic science regulator. Moreover, it appears that some numerical error has been made in the necessary calculation, resulting in an outcome which is physiologically impossible (or the person responsible did not know about the so-called “hook effect”). The mismatch between C-peptide and insulin concentration does not prove that the excess insulin found must have been synthetic insulin. There are many other biological explanations for a mismatch. No testing was done to determine the origin of the insulin. Similarly, there are many innocent explanations for the detection of some insulin in a feeding bag.
  4. The air embolism hypothesis is confusing because it fails to explain why some children apparently perished and others did not, and it has not been supported by the minimal necessary measurements.
  5. In at least one case, Lucy is blamed with causing white matter brain injury. This claim is utterly dishonest. The infant who experienced this brain injury was born at 23 weeks gestation, and white matter brain injury is associated with such early births. Further, there is sufficient evidence that demonstrates that enterovirus and parechovirus infection has been linked to white matter brain injury in neonates, resulting in cerebral palsy.
  6. At the time of the collapses and deaths of the infants, enterovirus and parechovirus had been reported in other hospitals. There is a history of outbreaks of these viruses in neonatal wards in hospitals around the world. They especially harm preterm infants who do not yet have a functioning immune system. It is reported that many parents of the infants were concerned that their ward had a virus (as was Lucy) and that Dr Gibbs denied this was so. To date we have seen no evidence to show they did any viral testing, and if they did what the results were.

Then a fact pertaining to my own scientific competence.

Both prosecution and defence were warned long ago about the statistical issues in such cases. Both have responded that they are not going to use any statistics. They are also not using the services of any statistician. Seems the RSS report has had the opposite effect to that intended. Amusingly, the same thing happened in the case of Lucia de Berk. At the appeal the prosecution stopped using statistics. She was convicted solely on the grounds of “irrefutable medical scientific evidence”. (Here, I’m quoting from the words both spoken by the judges and written down on the first page of their > 100 page report of the reasons and reasoning which had led to their unshakable conviction that Lucia de Berk was guilty. The longest judge’s summing up in Dutch legal history). I was one of the five coauthors of the RSS report. We were a “task force”, formally commissioned by the “Statistics and the Law” section of the society. I consider it the most important scientific work of my career. It took us two years to put together. We started the work in 2020; we had seen the Lucy Letby trial on the horizon since 2017 when police investigations started and the suspect being investigated was already common knowledge.

The UK does not have anything like that because a jury of ordinary folk are the ones who (legally) determine guilt or innocence. This is a clever device which makes fighting a conviction very difficult; no one can know what arguments the jury had in their mind, no one knows what, if anything, was the key fact that convinced them of guilt. Ordinary people are convinced by what seems to be a smoking gun, they then see all the other evidence through a filter. This is called “confirmation bias”. In the Lucy Letby case, the smoking gun was probably the post-it note, and the insulin then seems to clinch the matter. The prosecution cross-examination convinces those who already believe Lucy is guilty that she moreover is constantly lying. More on all this in later posts, I hope.

Back to the insulin. Here are the instructions on the insulin testing kit used for the trial, taken from this website, the actual file is Notice the warning printed in red. Yes, it was printed in red, that was not something I changed later. (All this is not my discovery; the person who uncovered these facts wishes to remain anonymous).

The toxicological evidence used in the trial violates the code of practice of the UK’s Forensic Science Regulator (see link below). It should have been deemed inadmissible. Instead, the defence has not disputed it, and thereby obliged their own client Lucy to agree that there must have been a killer on the ward. The jury are instructed to believe that two babies were given insulin without authorization, endangering their lives. (The two babies in question are still very much alive, to this day. Probably now at primary school.)

The defence stated to me that they cannot inform Lucy of the alternative analysis of the insulin question. It appears to me that this violates their own code of practice. Do they feel bound by the weird rules of UK’s criminal prosecution practice? Their client, Lucy Letby, is herself essentially merely a piece of evidence, seized by the police from what they believe is a scene of crime. No one may tamper with it during the duration of her own trial, which is lasting 10 months! I think this constitutes an appalling violation of basic human rights. The UK laws on contempt of court are meant to guarantee a fair trial. But in the case of a 10-month trial on 22 charges of murder and attempted murder, they are guaranteeing an unfair trial.

Lucy’s solicitor refused to pass on a friendly personal letter of support to Lucy or to her parents because she had not instructed him to do so. Should one laugh or cry about that excuse? I have the impression that he is not very bright and that he may have been convinced she is guilty. If so, I hope he is changing his mind. In the UK, the solicitor does all the legwork and communication between the client and the defence team. The barrister does the cross-examinations and the court theatrics, but probably never builds up a personal relationship with his client. Lucy has been all this time prison, in pre-trial detention, far from Manchester or Hereford. This might explain the extraordinarily weak defence which has been put up so far. But it might be deliberate.

One must take into account the fact that funding for legal support is meagre. The prosecution has been working on the case for 6 or so years, with unlimited resources. The defence has had a relatively very short time, with very limited resources. Probably the solicitor and the barrister already put in many more hours than they are paid for. There are no funds for expensive scientific witnesses. It is very possible that the defence team well understands that they cannot put up a serious defence during the 9 to 10 months of the trial, but that precisely this time period, with a huge number of revelations being made outside the trial, material for a serious defence during an appeal has been “crowd-sourced”. It seems to me that this mass of high-quality independent scientific work provides plenty of grounds for an appeal, in the case that the jury hands down a guilty verdict.

Some links:

Sarrita Adams’ Science on Trial website


Scott McLachlan’s Law Health and Tech blog

LL Part 0: Scepticism in Action: Reflections on evidence presented in the Lucy Letby trial.

LL Part 1: Hospital Wastewater

LL Part 2: An ‘Association’

LL Part 3: Death already lived in the NICU Environment,

LL Part 4: Outbreak in a New NICU: Build it and the pathogens will come…

LL Part 5: The Demise of Child A

LL Part 6: The Incredible Dr Dewi Evans

LL Part 7: The Demise of Child C.

LL Part 8: The Death of Child D. Had she been left or resumed on CPAP, she might still be alive today.

Peter Elston’s “Chimpinvestor” blog

Do Statistics Prove Accused Nurse Lucy Letby Innocent? This splendid and comprehensive blog post also has a large list of links to reports and data sets. Yet more data analysis can and should be done. This site gives anyone who wants to a quick-start. And after that, two more outstanding posts…

Data obtained from FOI requests

FOI requests provided some fantastic data sets see especially×1.xlsx?cookie_passthrough=1

How forensic science should be reported in court

Forensic Science Regulator: statutory code of practice

One of numerous enterovirus and parechovirus epidemics in neonatal wards

Cluster of human parechovirus infections as the predominant cause of sepsis in neonates and infants, Leicester, United Kingdom, 8 May to 2 August 2016

Someone commissioned a pretrial statistical and risk analysis – results not used in the trial

Lucy Letby Trial, Statistical and Risk Analysis Expert Input. Who commissioned this analysis, and what did it yield? (I can give you the answer after the verdict has come out).

The RSS (statistics and law section) report – not used in the trial

Royal Statistical Society: “Healthcare serial killer or coincidence?
Statistical issues in investigation of suspected medical misconduct” by the RSS Statistics and the Law Section, September 2022

At a pre-publication meeting of stake-holders held to gain feedback on our report, a senior West Midlands police inspector told me “we are not using statistics because they only make people confused”. Lucy’s sollicitor and barrister knew well in advance of our report, were even given names of excellent UK experts whom they could consult, but did not bother to contact one of them. No statistics in our courts please, we are British! Yet the UK has the best applied statisticians and epidemiologists in the world.

Article in “Science” about my work on serial killer nurses

Unlucky Numbers: Richard Gill is fighting the shoddy statistics that put nurses in prison for serial murder. Science, Vol 379, Issue 6629, 2022.

Two subreddits on the Lucy Letby case (the Lucy Letby Science subreddit) (general)

Medical Ethics

John Gibbs, recently retired Consultant Paediatrician at the Countess of Chester
Hospital, defined Medical Ethics as “Playing God with Life and Death decisions.”
See article “Medical Ethics” on page 6 of The Messenger, Monthly Newsletter of St Michael’s, Plas Newton, Chester) – reporting on talk by Dr John Gibbs, retiring paediatrician at CoCH. Audio:

The state of forensic science in the UK “The UK’s forensic science used to be considered the gold standard, but no longer. The risk of miscarriages of justice is growing. And now a new Westminster Commission is trying to find out what went wrong. Joshua talks to its co-chair, leading forensic scientist Dr Angela Gallop CBE, and to criminal defence barrister Katy Thorne KC.”

Criminal Procedure Rules and Criminal Practice Directions

Revised rules came out earlier this year, so maybe they do not apply to a trial which started earlier. Still, they express what the Lord Chief Justice of England and Wales presently wants to promote. . See especially Section 7 of his “Criminal Practice Directions (2023)”

New expert evidence cannot be admitted once a trial is in progress

“The courts have indicated that they are prepared to refuse leave to the Defence to call expert evidence where they have failed to comply with CrimPR; for example by serving reports late in the proceedings, which raise new issues (Writtle v DPP [2009] EWHC 236). See also: R v Ensor [2010] 1 Cr. App. R.18 and Reed, Reed & Garmson[2009] EWCA Crim. 2698″. This quote comes from Note, a judge is always allowed to break with precedence. The rule is not actually a permanent rule, it is merely a description of current practice. Current practice evolves when and if a new judge sees fit to break with precedence. Obviously, he would have to come up with good legal reasons why he believes he has to do that. It’s his prerogative, his free choice. That’s the essence of case law, aka common law.

113 thoughts on “The Lucy Letby case”

    1. Dear L, That is a very mysterious webpage. I have no idea who Oldfield Consultancy worked for and what they did. They are clearly very expensive and work mainly for government agencies and big companies. Please let me know if you find out.

      1. Thank you so much for this revelatory expose of what seems to be yet another example of a corrupt kangaroo court in the UK. I’m used to reading about such kangaroo courts in the US but did not imagine that it was now happening in the UK. When I started reading this article I was hoping to see some statistical analysis of the cluster of fatalities associated with Lucy Letby’s time with these prem babies along with an indication of the probability of such a cluster occurring over the period of time involved, but all that I’ve seen so far is some fatality trends for the Countess of Chester Hospital Trust. I need to understand whether there is any significance in the claim of one of the doctors reported in the MSM that babies were dying at a high rate during the night shift when Lucy Letby was on duty and then the high rate started occurring during the day when she was transferred to the day shift. If true, this is the one bit of evidence that makes me think that perhaps she was guilty. I might add that I’m not convinced that the notes she wrote wherein she writes that she has killed some babies as they can easily be read as the thoughts of a tortured soul who thinks it’s her self imagined incompetent care that caused the babies to die.

    1. Thanks. Try Googling “Lucy Letby”. This post is not completed yet, I will add background, and there will be several sequels. The charges were 7 murders and 10 attempted murders of newborn children at Countess of Chester Hospital, Chester, UK. Lucy is a young nurse in the neonatal ward. The cluster of events occurred in 2015, 2016.

      1. Evening Richard

        I am an NHS WHISTLEBLOWER (UHW Cardiff) who was unlawfully/illegally prosecuted and convicted (Cardiff Cown) Inorder to provide an indefinite Gagging Order (Gagged & banned from entering ANY NHS Trust!…

  1. After listening to a fair bit of the trial transcipts on YouTube, I have been incredulous as to what was put forward as “evidence”. I’m glad I found this page as I’m reading it on the day of LL’s conviction. As someone who works in the same field as LL, I agree with all the medical points you make. I’m very sad that this appears to be a big miscarriage of justice, and I’m also very sad for all the families that think that their precious babies were murdered, when that is very likely not the case.

  2. I too entertained the idea of reaching out to the defence team or anyone that could help with her case. Perhaps you and the gentleman from chimpinvestor could collate the findings/research and try again? would love to read more about what problems you faced when you tried to discuss this with her legal team

  3. I haven’t been able to go through all the details (who has?) but there is plenty here that smells wrong. I’m sure Lucy is innocent, and the Mass Media treatment of her is every bit as bad as anything MSM is capable of. The mere thought of what that girl has suffered/continues to suffer horrifies me. Where do we go from here?
    My every possible sympathy to Lucy and her parents.
    Keith Rushworth

    1. The media convicted her on day one because that was the most profitable story to sell. The jurors were probably influenced by that. The media ‘knew’ she was guilty without any evidence, but the jurors endured 10 months of evidence and deliberated for many (10?) days and could only give unanimous guilty verdicts on three of the charges.

  4. Will the cost of the Prosecution and the cost of the Defence, be disclosed to the Public? If there is a serious discrepencie between the two, then it is not a faair trial but mostly a “Witch Hunt”…

  5. I don’t know if Lucy Letby is guilty or not. But I do think the whole case stinks. It seems to me – and I thought this before reading your site (though the insulin cases are astonishing!) that she was always going to be found guilty. It was set up that way. If you look at how many babies and premature children die in the UK each year (there was a recent scandal at a hospital in Kent of hundreds of babies dying prematurely) then I can’t help but feel that Letby is an easy scapegoat for a very poor health service. It also makes me shudder at the rubbish I have written in diaries that no doubt, if I was ever wrongly accused, could be evidence of some guilt! That is all LL’s trial seems to amount too. I am appalled at the lack of questioning. And that someone could be branded Britains worst serial killer on the basis of circumstantial evidence alone. And this in the same week that a man is released in England after serving 17 years in prison for a crime not only he did not commit but that the police and CPS knew he had not committed 4 years after his sentence when DNA came to light. Lucy Letby’s conviction gives me no further hope in the criminal justice system.

    1. I agree with you as a retired Forensic Pathologist. The so called experts and statisticians were off the rails. I hope that she gets a fair appeal without the same biased Judge!

  6. You’re an absolute lunatic for wasting all your time and energy writing this. There is no need for the scientific method in a case where the killer’s written confession to the murders exists. Why you would choose to overlook that singular fact I don’t know

    1. That was no written confession. I am planning a post on the post-it note soon. Lucy herself explained it and so did her defence barrister.

      I am not going to tolerate personal abuse here. If you want to comment again, you will have to moderate your language.

      1. I see it as ‘imposter syndrome’ that affects women more than men. It was a bad day and she is bashing herself for not doing better, for being a failure – she feels she is a bad person. I think to get to understand this better you would have to read the whole journal. I did not know about the RCPCH critical report until just now. That gives some bad vibes.

    2. The post-it note is quite plausibly the anguished ramblings of someone suffering the extreme distress of being accused by her colleagues of killing the children and simultaneously doubting her own professional abilities, as the defence argued. Note also that the “confession” is not something that she made to anyone else or in any way published: it was something placed incame to light as a result of the police investigation, her arrest and the search of her home. Presumably the spurious roster evidence was a major reason why the police were convinced to treat her as a suspect. So if the roster evidence had been treated with the contempt it had deserved, Letby’s private musings to herself would in all likelihood remained private.

    3. You should, of course, feel free to state your case forcefully, if you disagree – but please do so respectfully, Darren – without resorting to making personal comments. (As far as I am aware, Richard Gill is trying his best to make a case; all you have to do is the same with your counter-case.)

      Regarding confessions: I am aware they can be powerful; on the other hand, there is such a thing as a false confession – often caused by a misplaced sense of guilt – and I think that idea ought, at least, to be explored…

      … Particularly since, as is explained by Richard Gill, himself, the confession was not a formal one given to the police.

    4. False confessions are made all the time, they certainly are not die hard evidence these days. However, in this case a post it note with ramblings written in panic at accusations being made, that say ‘I killed them because I’m not good enough to care for them’, cannot seriously be the main piece of evidence that puts a person away for life? What’s more, the fact that this was released to the public before the end of the trial says a lot about the trial judge. Most critical thinkers would not see this as a confession, more panic and distress at extremely grave accusations. This case has shocked and terrified me that we live in a society that where someone can be given a whole life tariff on a majority, rather than unanimous vote, and apparently weak evidence. In other cases where a whole life tariff has been given, the criminal and their motive were both indisputable to the judge and jury, and left no question that the defendant was a danger to society and was likely to remain so. From what has been released, that has not been shown in this case by the prosecution. Why were none of the other nurses who she worked with asked to testify, including those who were on shift when the babies died? Very concerning.

  7. Just FYI you’ve got the verdicts wrong at the top.

    She was found:

    – Guilty of 7 counts of murder (against 7 babies)
    – Guilty of 7 counts of attempted murder (against 6 babies)
    – Not guilty on 2 counts of attempted murder (against 2 of the 6 babies she *was* found guilty of attempting to murder)

    No decision was reached on 6 counts of attempted murder against 6 different babies. However, 2 of those 6 she was also found guilty of a different count of attempted murder.

    So no decision for 6 counts of attempted murder, but only 4 babies where there were verdicts at all.

    You’ve claimed she was found guilty of 9 counts of attempted murder and 4 hung juries, which isn’t accurate.

    I’m not saying your overall thesis is wrong, but it rings alarm bells for me that you haven’t managed to get the verdicts right.

    1. Sarah Gough, are you classing ‘no decision’ in your comment above as either ‘not guilty’ or ‘no verdict’ or just ‘no verdict’? Thank you.

  8. Thanks for your efforts! My stomach turned when I read about the Lucy Letby case on the BBC website, because it immediately reminded me of the Lucia de Berk case. You are spot on: we can’t be sure that Letby is innocent, but this trial had so many flaws that it can only be characterized as a flagrant injustice.

    And how on earth did they keep statistics out of this? My sister works as nurse with severly declined elderly people. I can only hope that this never happens to her, that by some fluke six out of ten of her patients would die within three weeks or so. She is very dedicated to their care… to the point where she would blame it on herself if more than ‘usual’ would die on her watch.

    Strangely enough there was no mentioning of the verdict in Dutch media outlets (as far as I’m aware of). If we could put the spotlight on this internationally, it might put pressure on the UK authorities.

      1. And importantly, international media need to start reporting the many doubts that are starting to be come up in the UK concerning the safety of Lucy’s conviction and the fairness of her trial and the fairness of the police investigation. The UK media are currently calling us “conspiracy theorists” and raging about how terrible this is for the poor parents of the murdered babies. This calls for investigative journalists who are prepared to contact the conspirators around the world, both in the UK and outside. Those journalists will need to call on their own network of experts (medical, statistical, psychology forensic…) to look at the material which we conspirators have put online. Within the UK, experts are terrified of being associated with that witch, terrified of spoiling the public’s long awaited witch burning.

  9. What a relief to stumble across this piece and that of Chimpinvestor. I too ,have been scratching my head as to how this flawed and unfair outcome is welcomed and accepted (unquestionably), by so many people. I hope that this Miscarriage of Justice will one day, hopefully soon, come to light . In the name of Logic and reasom as well as justice .

  10. Hi Richard, I commend you for your analysis and for being well ahead of the curve in your work.

    I wanted to mention that I wrote a Reddit post, which analyses the so-called ‘confessional’ note:

    I prefer to leave the scientific and medical inquiry to those who are qualified to do so, but I am a pretty well published writer and author; it’s my job to analyse words, and, actually, to generally analyse information. Unfortunately, people can often have the wool pulled over their eyes quite easily, and I have lost count of the number of people who have stated “of course she killed them – she confessed to it!”.

    I’ve outlined my view fully in the post, but I just wanted to say that you’re more than welcome to reference or use material from the post if you feel that it would be helpful.

    I hope this case can be reopened because what has been presented in court as ‘proof’ of multiple murders, in my opinion, falls considerably short of the standard that should be required to convict someone, and then effectively throw away the key.

  11. What is going on in a jury’s mind? Once a jury has chatted enough to manoeuvre itself into trying to decide which side is presenting the most plausible narrative (even as the Crown’s case may rest on flimsy and inconclusive evidence), we are in effect operating at a civil rather than criminal standard.

    1. I sat on a jury recently and even I found the entire process so strange. My case was also based on wholly circumstantial evidence. We submitted a number of questions asking for more evidence and was told there wasn’t any/it couldn’t be had (which I now know is because that’s the way the trial is set up – madness!) So it felt like we were making a decision based on limited information. The only comfort I felt after returning the guilty verdict is that we were then told that the defendant had previous convictions for similar crimes.

      1. I am a 73 year old retired, trained nurse and have followed these blogs with great interest. It is shocking to read from Mr Richard Gill and other scientists that maybe Lucy Letby didn’t have a fair trial. The more I read, then the more I am thinking this could be true. I just don’t know what to think now or who to believe.

        My heart aches for the suffering of the tiny babies and their families.
        It appears harsh that these families are going to be put through much more suffering whilst there are more investigations.

        I must admit as well that the post it note is looking mighty different now that it has been explained to us. though some people are still saying it is a confession.

        In my 40s I did some jury service. I remember at the time thinking that as an ordinary member of the public I knew very little about the law. I wondered what on earth I was doing there. The theatre of it seemed archaic to me and strange as you say Nikki.
        I was swayed back and forth by the barristers. Fortunately we were advised by the judge as the defendant was very obviously not guilty.
        A man was recently released from jail in Manchester after 17 years. He was wrongly convicted . There have been many cases of nurses wrongly convicted too. If Nurse Lucy Letby is innocent after all this , then thank god for people like Richard Gill and the other scientists. but where does it leave our faith in the police and the whole of the justice system.?

      2. Thanks, Ann! I’m afraid we won’t know what to believe till there is a retrial. And it is terrible for the families. Still, if Lucy is innocent, then what has happened is very terrible indeed.

    2. In almost every case, juries are given a standard direction that it is the prosecution which brings the case and it is the prosecution which must prove it – ordinarily, a defendant has nothing to prove whatsoever. They are directed about the individual elements of each offence and also directed that, in almost every case, it is for the prosecution to prove each and every element of that offence. (Burden of proof).
      They are also directed that the standard of proof – and this relates to each element of each offence – is ‘beyond a reasonable doubt’. In most cases, this is explained simply, and without embellishment, to the jury by saying it means no more than being ‘sure’ about something.
      That is what the jury in this case should have been doing – and we hope was doing – rather than trying to work out which side may or may not have been telling the truth, and deciding accordingly, which would have been a wholly inappropriate approach.

      1. One might hope that that was what they were doing. However, suppose they were convinced by false “scientific” evidence supplied by unqualified “experts” who were not challenged by the defence? Then they might have concluded from just one of the many cases that Lucy is a murderer and hence also a damned liar. How do you think they could judge any of the other cases on its own merits? Despite the instructions they were given, it is humanly impossible.

  12. What do you think of the evidence that Lucy Letby was on the ward every time one of the babies health started failing? She was the only one recorded to be there for 25 instances, every other nurse or consultant was only present for 1-14 of the instances (one of whom was an expert consultant and only called in for severe health concerns). Apologies I can’t remember the full details but they covered it on the panorama show

    Not saying I disagree with your findings just curious your thoughts on that and how it links with everything else you’ve debunked

      1. Hi Richard
        The evidence from the plumber concerned me greatly and he may have been the most honest witness.
        With raw sewage coming up the sink in the nursery it points that there is serious risk of infection from Enterovirsuses to the neonatal babies exposed in this environment.
        Lucy would have been working in a potentially contaminated environment which could cause illness and in some cases death with many of the symptoms raised.
        It is quite a problem in the NHS.
        I think there was a splke in Enteroviruses cases in 2015 and 2016. (just can’t remember the reference it was in)

      2. Hi Richard
        The evidence from the plumber concerned me greatly and he may have been the most honest witness.
        With raw sewage coming up the sink in the nursery it points that there is serious risk of infection from Enterovirsuses to the neonatal babies exposed in this environment.
        Lucy would have been working in a potentially contaminated environment which could cause illness and in some cases death with many of the symptoms raised.
        It is quite a problem in the NHS.
        I think there was a spike in Enteroviruses cases in 2015 and 2016. (just can’t remember the reference it was in)

      3. Yes, there was a spike in Enteroviruses cases in 2015 and 2016. There was even a major epidemic at a nearby hospital. See my blog …

      4. Hi Richard
        The evidence from the plumber concerned me greatly and he may have been the most honest witness.
        With raw sewage coming up the sink in the nursery it points that there is serious risk of infection from Enterovirsuses to the neonatal babies exposed in this environment.
        Lucy would have been working in a potentially contaminated environment which could cause illness and in some cases death with many of the symptoms raised.
        It is quite a problem in the NHS.
        I think there was a spike in Enteroviruses cases in 2015 and 2016. (just can’t remember the reference it was in)
        The consultants should have been looking for this in the babies when the became unexpectedly poorly.
        Raises more questions about the care and the state of repair of the hospital.

      5. Hi Richard
        The evidence from the plumber concerned me greatly and he may have been the most honest witness.
        With raw sewage coming up the sink in the nursery it points that there is serious risk of infection from Enteroviruses to the neonatal babies exposed in this environment.
        Lucy would have been working in a potentially contaminated environment which could cause illness and in some cases death with many of the symptoms raised.
        It is quite a problem in the NHS.
        I think there was a spike in Enteroviruses cases in 2015 and 2016. (just can’t remember the reference it was in)

  13. The rubbish being presented here as fact is laughable. The insulin tests you have shared here were not the ones used (there were TWO different tests used for the TWO different victims). The statistics you bang on about are irrelevant because it wasn’t mortality rates but UNEXPLAINED and UNEXPECTED mortality rates that were in question (if you’d bothered to read the RCPCH report in detail, you’d know the definition of these).

    Most importantly, you have completely ignored the evidence of the mother of baby E which completely contradicted Letby’s version of events (and was even corroborated by the SHO/Registrar that Letby claimed to have called). Unless you can confidently prove the mother was lying, any appeal for Letby will fail.

    You managed to get Lucia off because there were serious errors made in her presence at one of the events (i.e the prosecution got it wrong and she was on holiday when they claimed she was with the victim). None of that has happened here because electronic door records and electronic medical notes (which did not exist back in Lucia’s day) have backed up the prosecution case.

    The trouble with being a dinosaur and not evolving your practice with modern technology and modern investigation techniques is you are stuck in a world that does not exist anymore. Modern investigative and police forces aren’t beat cops reliant on external statisticians and data crunchers to make their case. They HIRE some of the most brilliant young statisticians and data scientists as police and NSA officers, and have the advantage you don’t, of advanced AI driven modelling and scenario analysis. The RSS paper you took 2 years to churn out, my team of fresh grads could smash out in 6 months, while also doing their day job of designing the systems that make many statisticians redundant. You’re an ivory tower academic with no practical experience in a non research profession – and that’s why you have never won an appeal in England and Wales. And never will. In fact, there’s a reason you have never won an appeal in a jury based legal system – because the burden of evidence to even get to trial is a lot higher than in the Netherlands and Italy.

    Intelligence isn’t just being a subject matter expert in a topic you’ve fixated on for 40 years. Intelligence is common sense, the ability to evolve your assumptions and hypotheses as the world around you changes, and most importantly the ability to admit being wrong. You don’t care about justice, you only care about making a name for yourself as the statistician who changed how legal systems engage with statistics. That’s why all your peers have distanced themselves from you and you’re drumming up engagement on social media.

    You’ll still be here shouting into the void as everyone – the surviving victims, their parents, everyone involved in the trial, will move on with their lives. The investigation took as long as it did exactly because CPS wanted to protect against any risks of appeal. You have a tenuous grasp of how and when to use statistics to make a point, which has been your eventual downfall from respected statistician to crackpot warned by the police for interfering with the justice system.

    1. Dear Chloe, you raise some good points but also make some very serious mistakes. I will come back on this later. Will be away for a couple of days. I object to your personal comments on my intelligence. However, they will allow me to make some remarks on my own evaluation of your intelligence. It is amusing that you refer to Cheshire Constabulary as a crack modern police force. That remark really made my day. ROTFL!

      1. Cheshire police hired the NSA – those were the intelligence analysts that gave evidence at the trial and built the case, liaised with all the experts and prepared the various workforce management scenarios that have led to the famous chart of her presence. Yes, I do think the NSA is a crack intelligence and security agency. If they weren’t I’d be a bit concerned about national security of the UK, wouldn’t you. As I said, you are a highly intelligent man but your starting assumption that the investigation was run by idiots is your own cognitive bias and not based on facts.

      2. What was the NSA hired to do and what did they say in court? Cheshire police had 6 years and millions of pounds and 60 detectives but they found no hard evidence that any murders were committed at all.

      3. PS you write “I think the NSA is a crack intelligence and security agency” because they compiled that spreadsheet? Any single bachelor student of my own could do that job in an hour or two. Collate data from two hospital spreadsheets and a list of incidents supplied by top scientist dr Dewi Evans? Asked in court if he was a scientist, his answer was “no”. Well, the NSA indeed has a good reputation, so you may be confident they didn’t make very many mistakes in doing the menial task they were asked to do. And it is certified correct, so irrefutable.

    2. Chloe, I am a statistician working at one of the top universities in the UK, and I can assure you (and everyone else reading your defamatory comments) that Prof. Gill is highly respected in the UK and elsewhere. Your derogatory comments about Prof. Gill’s work and reputation are total nonsense.

    3. Chloe, you write “The RSS paper you took 2 years to churn out, my team of fresh grads could smash out in 6 months, while also doing their day job of designing the systems that make many statisticians redundant.” Are you an academic or a business woman? I challenge you to invite me to give a seminar to your team. I’ll take your post as my challenge, and go through each point in turn. We’ll let your team of fresh grads debate. It would be cool, right?!

    4. I would love to see the ‘advanced AI driven modelling and scenario analysis that you believe the NSA used? Interestingly, 57 convictions were overturned by the court in 2021 alone by CCRC referral. Judge and jury are only human after all, and mistakes are made all the time, especially in emotive cases with a high media profile. After all, the judge only directed a majority verdict in this instance (possibly due to the length of time the jury was out for, I’m not sure about that) which is quite shocking considering the gravity of the sentencing.
      It would be interesting to see the information that you has that has made you certain of this conviction, if you wouldn’t mind sharing it to put my mind at rest that we don’t live in a country with a terrifyingly draconian justice system?
      Many thanks.

    5. Chloe, amongst all you write I was attracted to this, “You don’t care about justice” (aimed at Richard). I would suggest that it is H. M. Constabulary, CPS, and our courts of law who are not interested in justice. The countless number of overturned convictions is indicative of this. To lighten the tone, in the 1980’s when rugby was amateur, the England team had a police officer and a solicitor in its pack of forwards. In the dressing room before a big game the police officer said to the solicitor, “You people get criminals off on technicalities”. The solicitor responded, “The technicalities you speak of is their innocence”.
      Chloe, Richard is not hiding behind a name, he is Richard Gill, the well know statistician. Who are you?

    6. Having read your tirade here, has just moved me a step nearer to thinking this is an actually a miscarriage of justice. There is nothing worse than reading a patronising arrogant piece such as this. If Letby is found innocent further down the line I would like to think this would come back to haunt you. I would add I have stayed on the fence on this case. I took an interest in the case after the guilty verdict and was quite shocked at all the procedures in this case and the lack of any scientific evidence. I’ve been in the position of being accused of something I did not do (admittedly not in the league of Letby’s case, but a case that could have seen me go to prison), but was lucky enough to be tough, bright and with the financial means to hire a good defence. I have seen how the police get it incredibly wrong , do not collate evidence correctly and how incompetent the CPS can be in such cases and also how ‘witnesses’ see things they don’t actually see. In my case it was thrown out of court after 1 hour. Three years later I was diagnosed with cancer. To this day I am convinced the stress greatly contributed to this. As I keep saying I don’t honestly know if Letby is guilty or innocent, but I do know the evidence I am hearing, reading and absorbing does not convince me the prosecution had a concrete case. If you had challenged the author of this site with counterpoints of intelligence instead of this condescending tirade of abuse , you may of convinced people of Letby’s guilt and the good performance of the prosecution and all the agencies you herald.. Sadly you haven’t.

    1. I have tried to give that letter to her parents. Her lawyers stopped me from doing that. I did also post them a letter to their home. I got no reply. I wrote to the Bishop of Chester, asking if he could help. No reply. I have now written to the pastor of Lucy’s former church, and the church of her parents. No reply.

      1. I wouldn’t advise anybody to try contacting Lucy, her parents or her friends. There will be plenty of malevolent people trying the same, trying to get hate mail to her. I also want to show her my support. The best thing is probably to hope that one of her friends finds this blog and contacts you first. I hate to think how isolated and despised she might feel. Maybe we could write a book on the subject and make sure it reflects the support she has from people like us.

    1. In terms of evidence, I can see what’s irrelevant—the so-called “confession”, the work documents kept at home, the Facebook searches, her demeanour during police interviews or during the trial.

      However, the critical evidence is the statistics and the opinions of the medical expert witnesses at the trial. I’m not a statistician and I’m not a medical expert, but I need to have confidence in that evidence to be satisfied that the verdict is safe. In his comment above, Gyan Fernando, a former forensic pathologist, notes the difficulty of diagnosing air embolisms. This is concerning.

      Mistakes have happened before in terms of determining the causes of child deaths. A particularly notorious example was Dr Charles Randal Smith, a pathologist who “wreaked havoc in Ontario’s criminal justice system”. There’s a 2011 article about the fiasco in the newsletter of the Ontario Bar Association:

  14. I read about the case for the first time during the verdict and immediately thought of you, only to find this post already existing for months. I never did pass STan but I trust you when you believe there needs to be done more in terms of research. Hope you are able to get to the bottom of it and find a way to have your voice heard.

  15. I feel certain we have witnessed one of the worst miscarriages of justice in British history; my heart goes out to Lucy, and her parents. I keep telling my friends and family that I will go to my deathbed protesting Letby’s innocence.
    #TrialByMedia #MisscarriageOfJustice #Scandal #Missinformation #Missatribution

  16. This case is so sad, the whole thing. Please go to the independent police complaints commission about the conduct of the investigation, the police are required to follow all lines of inquiry there failure to do so should lead to a complaint. It tragic that so much suffering has been cause by cognitive bias and statistical errors.

  17. An incredible piece of work. With a background in law, I have felt all along that this case, trial, direction of the jury, judgement and sentencing were all shocking. I do believe those who can see past the emotive media hoo hah over the tragic deaths in this case can see that the trial was botched. Perhaps we can work together to get justice for Lucy? If nothing else, if the trial was botched, and the wrong person has been punished, not only is this a sickening injustice on an individual who, if innocent has had her life ruined and her public image absolutely attacked by the revolting British media, not to mention the damage done to her family, but there is a frightening possibility that infant patients are still in danger. Not to mention we would then live in a country where someone can have their freedom unjustly denied, which is one of the most terrifying situations to be in.
    We must be able to do something about this – could anyone contact her parents, or even an investigative journalist about bringing this to the public spotlight?

  18. The Science on Trial website is having a first meeting over the web on Sunday. I detect a degree of schism between those on here and those there. I hope that can be dealt with and all those who are doing great work here – mainly Richard Gill – can come together at that meeting.
    Keith Rushworth

    1. Well, Sarrita and Peter are probably still angry with me, which I think is due to a heap of misunderstandings, but it’s OK by me, they are doing fantastic work using the methods they like best. I have my own way of doing things, and I will continue with that. I don’t want to intrude on their meeting since I’m sure they don’t want me there. I hope to hear from others, how things went. I will also continue to let them know of any progress I make. And when journalists approach me, I tell them all about Sarrita’s and Peter’s fantastic work. This is what I always wanted: that I should become superfluous. That’s why I worked on the RSS report: in order not to have to have anything to do with the Lucy Letby case. I got involved as the trial proceeded, quite unwillingly.

      1. Professor, do you think it’s right that somebody should lie about holding a PhD from Cambridge and libel and attack and make false allegations against anybody questions her about it?

      2. Of course it would not be right. But Sarrita Adams did essentially complete a PhD from Cambridge, department of biochemistry, though her thesis was mostly written at Stanford and is in the field of molecular biology. She says that her thesis was examined and approved. She did not finish the bureaucratic requirements needed to get it into public internet data bases. I think that that was foolish, but I do understand her difficult personal situation at the time. I can email you a copy of the thesis if you like. Three very well cited papers came out of it, two published in very decent journals and one in a book (she was invited to contribute to a book with numerous scientists contributing separate chapters). Sarrita is a very gifted woman, but she herself has been the victim of serious injustice. She has been viciously attacked by trolls after Cheshire Constabulary doxed her. She wished to remain anonymous, for sound personal reasons. I’m glad however that she has now “come out”.

      3. I have done some more checking, and Sarrita has told me a little. It seems that she didn’t complete the formal bureaucratic part of the process of getting her degree, because of difficulties in her private life which came to a head as she approached the finishing line. She submitted her thesis, it was examined, it was accepted, she just had to make some minor corrections, but as far as I can tell she never got around to sending them in. Probably some deadline elapsed some time ago. Hence the PhD degree never got formally awarded. But she deserves it and could maybe get it if only she would take this up with Cambridge University. I was told by the head of the Dept. of Biochemistry that they cannot say anything at all to anyone about this, only to Sarrita Adams herself.

        But: the whole thing about science is that it stands on the actual content, not on the perceived authority of who says things. So in fact, it doesn’t really matter. People have already been building on what she has done so far. Let’s hope they will give her the credit which is due to her. When Lucy is out of jail and the true history of the whole matter is written, she will have a star role in it. And more scientific information will come out as the process of enquiry and/or appeal continues. Science is never finished, it is always just “the present state of affairs”.

  19. “not lovely Lucy” was a much reported quote from somebody who found it hard to correlate the accusations of murder with the person they knew – or thought they knew. The focus on first name “Lucy” seems unhelpful in considering the case. Pictures of Letby drinking prossseco, etc are neither here nor there. That Letby appeared ordinary i.e not a loner. a childhood torturer of cats or any other cliche the popular media likes to attach to killers has meant the tabloids have struggled for copy but equally shouldn’t be used as some presumption of innocence for those with doubts. In many social media comments one senses that those with doubts.are all too willing at the first sign of any possibility of the science being contested to jump in with “I knew Lucy couldn’t be guilty’. Equally unhelpful is that some experts/academics on social media promoting the need for an appeal are also in other posts casting doubt on Covid vaccinations and the like. For any appeal to stand a chance of proceeding and succeeding it must be on the science alone not on suggesting that Letby couldn’t possibly have done it. I am personally not qualified to make an evaluation of the refuting science presented here and I doubt many are. The poor old jury of lay people in the trial had to make a judgement on what they were presented with in court and on that basis probably reached the only conclusion they might – that of guilt. If and it is a big if the science was not correctly or fully explored or disclosed and the scientific arguments presented here are correct then there may well be grounds for an appeal and a judgment that the conviction was unsafe. That last part is crucial it is unlikely that Letby would be found innocent or that there has been miscarriage of justice rather it will be deemed that the conviction is unsafe. As the thrust of the counter evidence is not that the babies were harmed by another party but rather owing to a range of different factors in other words they are part of an unexplained cluster then sadly the parents will never know why their babies died or rather they will be told that the original reason at the time of death given was the right one and sorry they weren’t murdered or we can’t be certain they were. One can only imagine the anguish. Equally nobody will ever be sure that Letby is innocent.

    1. That’s a thoughtful comment, but I disagree with a number of your points. Take the Lucia de Berk case. Right now, nobody with a sane mind thinks she was guilty. The thing is, we now so well understand all the things that were wrong at her hospital and how the investigation was launched and how many errors were made by doctors, that there quite simply is no need whatever to entertain the hypothesis that Lucia was one of the much less than 1 in 2 million nurses who might be active as a serial killer in any given year.

      I predict that in about 5 years the same thing will be the case for Lucy Letby.

      Now you make some remarks about scientists being tainted by being associated with other controversial topics such as Covid origins, masks, vaxination. This is called an “ad hominem” argument. Obviously, to the public and to the establishment, such scientists might not be effective defence experts, because the other side will use ad hominem arguments to discredit them. But their published arguments on the science in the case at hand are not made invalid by their interest in controversial issues. And most importantly: their published arguments can just as well be presented by other qualified scientists who are not “tainted” in this way.

      I do not intend ever again to be an expert witness in any serial killer nurse trial so I am not bothered with possibly being tainted in any similar way myself. In fact, stirring up vicious attacks by uneducated loonies on Twitter is one of the ways I stimulate myself to do good stuff for Lucy, it helps me wake up in the morning, better than coffee even. (According to the main stream media, I am biased because I already helped get other nurses out of jail, so my motives are just a hunger for yet more fame, money, whatever).

      Yes, the jury made the inevitable decision, given the fact that the defence did not even try to defend Lucy and pre-trial already agreed with the prosecution that an insulin murderer was active on the ward. And one wonders if anybody on the jury had an advanced scientific education? Maybe, just the jury member who quit, near the end. Or maybe that one was a nurse who knows what goes on in hospitals when mistakes are being made. Anybody who looks into the insulin evidence and who has a scientific education can see that. Anybody who doesn’t can at least try to follow the logic and see the contradictions in the prosecution arguments for this. The jury was not told what a good defence should have told them. One suspects that a deal had been made pre trial that Lucy was going to be convicted. The defence team would go through the motions, play their part in the theatre. The main stream media would play along, enthusiastically. The jury would do the right thing. Problem solved. (Problem: another NHS catastrophe and cover up).

      1. Hi again Richard,

        The following is my own opinion and is gained from personal experience. I totally understand too that we all have a certain element of bias.

        As an old retired nurse I do know what goes on in hospitals when things go wrong.
        I have also been a whistle blower twice. I can tell you that it is the most horrible distressing thing to do. It causes many sleepless nights. Your colleagues do not always support you. I get this as mostly they are frightened of doing harm to their own careers. The public have absolutely no idea what really goes on in NHS care units. Often nurses were shunned and treated badly by colleagues for speaking out There would be a toxic culture. .I think maybe that has changed now as they say nurses are encouraged to report bad care or behaviour these days. But I wouldn’t know for sure. I personally think not, but that is my opinion.

        Am I right in thinking that Lucy reported problems on her unit with the drains and also the standard of care? If so, I guess she was not liked for it. My own opinion again .
        I also find it incredible that no one saw Lucy doing anything wrong We nurses are nosey. It is one of the qualities that makes for a good nurse.. we generally knew most of what was going on where we worked. We spent so much time there. Why wouldn’t we.?

        I just heard today Richard that Lucy is going to have a re trial next year. It is for one of the children. Will this help in the fact that she could possibly get a better defence and maybe when the truth comes they will see that maybe there was a miss carriage of justice somewhere.

      2. Yes, Ann. Lucy was reporting this stuff for two years. Most of the nurses liked her and admired her for it. The doctors wanted her off the ward because she pissed them off. The CEO of the hospital Tony Chambers (originally himself a nurse), and then the RCPCH, supported Lucy. When the report came out the doctors went to the police. Against the orders of the directors. According to TV doctor Ravi J on a recent YouTube TV channel, “it was going to us, or her”. He has been very busy recently promoting himself as one of the hero’s of this story. Just like his colleagues, and like Dewi Evans, and like Cheshire Constabulary. I suspect Evans and the Gang of Four already knew one another very well. Several of them have signed petitions to have several disgraced paediatricians (including Prof Sir Roy Meadows) reinstated as doctors.

      3. “The jury was not told what a good defence should have told them. One suspects that a deal had been made pre trial that Lucy was going to be convicted. The defence team would go through the motions, play their part in the theatre. The main stream media would play along, enthusiastically. The jury would do the right thing. Problem solved. (Problem: another NHS catastrophe and cover up).”
        Was that a belief you carefully considered before declaring (that there was collusion between all parties prior to trial that convicting Lucy was a done deal)?

      4. Yes, I suspected this for a very long time, and recently Mark Mayes (great guy on YouTube) has found a whole lot more support for this idea. As well as for collusion between police, Dewi Evans, and the Gang of Four. I will be writing more about this.

      5. Richard, words are damn tricky creatures, they can easilly be misinterpreted/misunderstood. I want desperately to understand what you are saying. Are you saying 1/ That Lucy Letby was the fall guy for all of the non-malevolent – but scandalous – things going on at CoCH hospital which led to the deaths of a number of babies and harm to others. That consciously and knowingly, she was set up/or there were convenient pointers which were seized upon and exploited? Or that all parties, including the defence, agreed at the outset that there was genuinely (in their minds)y sufficient evidence of guilt, but it was necessary to go throught the motions of trial?

      6. I am saying that the hypothesis that Lucy Letby was the fall guy for all of the non-malevolent – but scandalous – things going on at CoCH hospital which led to the deaths of a number of babies and harm to others, deserves investigation. I am not saying she was consciously and knowingly set up. I believe that convenient pointers were seized upon and exploited, initially in self defence. It is possible that a small group of persons who are all withholding information from one another and who have a common enemy become an effective conspiracy. The idea that the cluster of deaths was caused by a single nurse naturally can occur to anybody, especially to an incompetent doctor.

      7. Thanks for that. I have pursued this (trying to pin you down) too far, it is good of you to be patient with me. I look forward to the piece you are going to write.

      8. You don’t go too far! This is such an important matter, I value it so much when people engage in discussion with me. I learn from it, too! My opinion is not cast in stone. I can and do change it when required by getting new information. I want to have my thinking processes observed and criticised.

  20. Thanks Richard. That is very interesting. However, one should remember that hospital managers and chief executives must be protected at all costs. Until evidence such as this is aired on Panorama, nothing will be done.

  21. Hi Richard,

    I find it very disturbing that there are so many conflicting issues in the case of Nurse Lucy as you say. Why weren’t these picked up on by her defence.

    I am not in any way a conspiracy, theory believer. Some nuts on Reddit are calling people who believe there has a miscarriage of justice. conspiracy theorists. I don’t understand this.

    I was watching a programme on television earlier this evening. It was about the murder of Jill Dando. A beautiful young and successful journalist whose life was cut short by murder.

    I was not surprised to find that the police arrested a man and he was charged with her murder . He spent 8 years in prison. Only to get a re trial and was found not guilty.
    My goodness how often does this happen?.. So absolutely terrifying for everyone.

    I like history and especially that of the tudors. A young woman queen was wrongly charged in 1536 of many things she hadn’t done. She was executed. It happened to many others too. Thank god we don’t have the death penalty now. people would still be executed wrongly. Goodness me , why haven’t we progressed to making trials more fair? Nearly 500 years ago that kind of thing happened , and we are still getting it wrong. Injustice is alive and well!

    This is all my opinion again. There are many words entering my mind that I cannot write here.

    I am going to stop writing on here for a while now. As I keep thinking of the poor babies, the family’s and poor Lucy. I will pray for them all.

    I hope and pray that the people who are more qualified and intelligent than me will sort it all out.
    Thank you Richard for the work you are doing.

  22. I am currently preparing a detailed analysis of the insulin cases and would like a pointer to stats if there are such that could show the initial witchhunt was wrong or that there was a wider increase in such incidents apart from just the COCH.

    1. Send me an email about this. The insulin cases are rather different from the rest. It is pretty clear that there was no insulin poisoning at all. The story of the identification by Dr Brearey of those two cases is very different from the story of the identification of the other cases by Dewi Evans. The cluster of events which initially surprised and alarmed everyone seem related to sepsis and the sewage and hygiene problems. Also, since we have many twins and triplets, there are statistical dependencies between events which cause an increase in variance. Over dispersion. Bigger variance than you would expect from Poisson approximation.

  23. Hi, this is a very interesting website. I first became interested in the Lucy Letby (LL) case when my wife referred me to a 10h podcast entitled: “The Case of LL; The Facts – Crime Scene 2 Court Room”. Since, I have searched for further background to this case. Richard Gill’s website raises issues around imbalance between the prosecution and the defence, or lack of it! Also, there was toxic atmosphere at the Countess of Chester (CC) neonatal unit and LL reported problems. I worked for over 25y anaesthetizing children down to 500g, in addition to adult anaesthesia, as well as expert witness experience. I also spent 6m attached to a Neonatal Unit. The question of whether LL committed the alleged crimes is a difficult one to answer as (a) no one actually witnessed her doing the alleged crimes, (b) there is no obvious motive, (c) the actions would be very hard to achieve and (iv) there are other alternative explanations that were not explored by the court case, or at least the 10h transcript.
    The Countess of Chester baby unit: The main purpose of the unit was a nursey to look after and feed babies too small and fragile to leave hospital, born at the CC. There was a small 4 bedded-neonatal unit in addition to the 4 nursey rooms. LL probably wanted to gain neonatal experience hence her involvement with the 17 cited cases.
    Neonates and vulnerability: Small preterm babies easily deteriorate and die. Their organs are still developing and without the advent of neonatal units in the 1980s most would die. It is only today that a baby born prematurely before 28 to 32 weeks has a good chance of survival.
    Staffing levels, staff experience and standard of care: LL was only 25yoa at the time and had only been a neonatal nurse for a few years. That is not very long and she lacked experience! She still needed further training in Liverpool to advance her career. Yet, she seemed to be one of the most senior neonatal nurses (band 5) on the unit and nowhere in the transcript do we find an older, more senior or experienced colleague other than a charge nurse who managed the duties and was not hands on. Similarly, it appears that medical cover was by paediatricians who also covered the wards and there was no doctor solely on duty for the unit. Therefore, when compared to other bigger units (i.e. Alder-Hey) the level of care was limited, so it would not be surprising if a baby deteriorate, and that happens with “prems”, outcomes are not as good. So, the evidence suggests that the CC was not up to standard, and it was an overflow unit for Alder-Hey. The CC neonatal unit has since been closed down. So were the cited incidents and deaths really due to LL or a result of a poorly supported / under-funded unit looking after sick neonates that should have been elsewhere?
    The prosecution case focused on a number of methods of harming babies used by LL: (i) Distending the stomach by giving too much feed or (ii) injecting air into the stomach, (iii) injecting air into the circulation causing sudden collapse, (iv) traumatising the airway and causing bleeding, (v) dislodged tracheal and chest tubes, and (vi) adding insulin to the intravenous feed. The discussion of the pathophysiology of these mechanisms was disjointed and difficult to follow. However, the connection of LL to the sudden deteriorations and deaths in 7 was very compelling. However, I have to take issue with a number of the prosecutions assertions.
    (i) Over distending the stomach with feed to an extent to cause collapse and projectile vomiting. I don’t have any experience of tube feeding prems, but projectile vomiting can be a reaction to bad / infected milk? Was LL in hurry to feed the baby? I find it hard to believe this was an attempt at murder.
    (ii) Most obvious was the air in the stomach and intestines at post mortem. LL must have injected air via the gastric feeding tube, or how else did it get there? Well anyone who works in theatre or resuscitation knows during mask ventilation, which all these babies had (i.e. Neopuff), that it is very easy to blow up the stomach and intestines with air / anaesthetic gases, especially if ones technique is not perfect. I regularly had to pass a suction catheter to empty the stomach of gas at the start of surgery to deflate the stomach and improve ventilation. I even did a study on the carbon dioxide levels that often reached the level of expired gas. However, the role of the Neopuff as a potential cause never mentioned. So what is more likely, LL injected the air or the air got there through resuscitative efforts by stressed staff.
    (iii) Some of the babies suddenly collapsed and developed a strange rash on the abdomen. Some recovered rapidly. This was said to be due to LL injecting air into the circulation. Air was found to be in the blood vessels at post mortem in some deaths. The premature baby can revert to a foetal circulation (by passing the lungs) when they become unstable and this can take time to treat (revert back). Sometimes “persistent foetal circulation” manifests itself during anaesthesia until the ductus closes fully. Point not mentioned in the case but could explain the above. Also, chest compression would cause significant sucking in of air to the heart if intravenous access lines were left open to air during the resuscitation after injecting a drug (adrenaline). LL sent a Datex about a line being left uncapped by one of the doctors. So there are other explanations and mechanisms by which air could have entered the circulation.
    (iv) One of the cases had trauma to oral airway and significant blood loss, I think this was one of the twins with Haemophilia, a blood clotting disorder. LL was accused of traumatising the airway. I cannot imagine how. The likely explanation would be repeated intubation attempts, not an attempt to murder the baby by LL. I recall up to seven attempts as the neonate was difficult to intubate!
    (v) LL was also accused of dislodging an endotracheal tube and a chest drain which lead to deterioration in two patients. Preterm babies are very small, endotracheal tubes can easily move and become dislodged however carefully one secures them, particularly if the neck is flexed or extended! Similarly, with chest drains, the baby had bilateral drain presumably as a result of premature lungs, and one drain became dislodged / was not working and a third drain was needed. These things happen so just because LL was present does not automatically mean it was her fault. Then there was the incident with deliberate liver injury, which equally could have occurred during chest compressions by someone else?
    (vi) The addition of insulin to intravenous feeds has already been mentioned by Gill from a biochemistry and reliability of blood test perspective. I don’t fully understand this one. One baby was receiving regular intravenous nutrition made up in sealed bags from pharmacy. The baby had unexplained hypoglycaemia. For three bags it persisted and when LL was not on duty the hypoglycaemia resolved. Blood were analysed insulin and C peptide. Hypoglycaemia is common in preterm babies because their mechanisms to maintain blood glucose levels are immature (i.e. glycogen stores in the liver). The child may have had an infection as Gill says there was virus circulating. That being said it difficult to image how LL managed to injected the correct and same amount of insulin into a sealed bag on three separate occasions. There is a rigid nursing protocol involving two nurses when a new bag is put up to maintain sterility. Then there was a further insulin contaminated Dextrose infusion in a second baby. BTW LL was not the only nurse present for both these cases.
    Hence, I find it very difficult to accept the verdict that Lucy Letby was responsible for all 7 deaths and a further 6 attempts at murder. I think that her case needs to be reviewed by someone with a better understanding of neonatal medicine and how a premature baby unit is run.

    1. Your comments are fantastic and I will make sure they are disseminated widely. You say: “her case needs to be reviewed by someone with a better understanding of neonatal medicine and how a premature baby unit is run”. One such person is Sarrita Adams, the power behind the Science on Trial website, Another is Scott McLachlan, author of I will pass on your comments to them.

      1. I read the comments from Lester at 2 am. My heart was hopping. This is so good. Here is a person who appears to understand that the Lucy Letby arrest and subsequent trial could have been a complete ,and utter shambles. I am just an old RGN., not a genius, but I know there needs to be an investigation by proper experts!

  24. It is likely, even more than probable, that Lucy will be cleared of all charges and released from jail………. at some future time. This happening could easilly be many years off, there is a remote chance it could happen in the months ahead. When this happens it will be all too apparent that the agents of the state involved – H. M. Constabulary, CPS, and the crown court itself – together with the gang of four doctors, all conspired (I do not think that too strong a word) to inflict on an innocent young woman a grotesque whole life sentence. And the label of Britain’s most evil murderer, a baby killer. Will the gang of four, the lead investigating police officer, CPS officer(s), prosecuting counsel, and judge, suffer any consequences. Will they be prosecuted? Of course not, perhaps the GMC might lightly admonish the gang of four. “they acted in good faith” would be their conclusion. But the agents of the state will remain in place to enact further misdemeanours.

  25. I don’t take notice of silly things which people say about me when they are angry and emotional. Especially if they later change their minds. I’m interested in the science and the results. The important thing is to get Lucy Letby out of jail. I am treading carefully and cautiously (and talking to lawyers) and right now I think this is the way to go.

    1. I also hope it goes through – you joining up with SoT. At present there are four sites campaigning for Lucy, and there has been friction (and the appearance of competition). People need to get rid of their egos and remember the cause, the cause trumps egos with something to spare. One campaign, one site, Sarrita, Richard Gill, Scott McLachlan, Peter Elston working together. All and sundry (the media and enemies of justice) have witnessed the vitriol, an end to the vitriol and an end to egos.

  26. Dear DCM 359. Yes, there is one cause. There are many egos and many ulterior motives, just as many as there are supporters of Lucy Letby. I don’t think there has to be “one site” because “there are many ways to skin a cat”, and we don’t know in advance, and one can’t know in advance, which way will be most effective. In fact, from my experience with past cases, what is most effective is a multi-pronged attack with, indeed, the option of any one of the attacking teams to claim ignorance of, and no responsibility for, what the other teams are doing (this is called “deniability”; or god cop, bad cop). After all, we need to convince politicians, lawyers, medics, the public, … that this was a miscarriage of justice. We need to work with journalists, scientists, opinion makers, .. The medical world is a world in itself, medical doctors are not scientists. Statisticians are hated by everyone but needed by everyone. Society is stratified and also split vertically. One must work at grass roots level, but also at the level of the old boys networks in the elite. Convince both readers of the Daily Mail and of The Times. The UK is a closed system but UK politicians are sensitive to what people think of the UK in the US, and even in Europe. So: I am not worried about the existence of different teams – some big, some small; some comprehensive, some narrow in scope. Some with big ambitions at a higher level. “Let a hundred flowers blossom” said Chairman Mao. My ambition is to allow free exchange of information, and mutual respect, between the different groups which are presently active. I do not believe in one overarching hierarchical organisation. I greatly admire what SoT is doing and I want to support it as much as possible. I will remain my own boss and I will do what my moral compass and my science tells me I have to do.

    1. I am sure that your approach is wise. Discussion is good but adverse controversy is capable of impairing good work on Lucy L’s., behalf and could be helpful to those who have different intentions.
      Best wishes with your work.

  27. I began believing that Lucy L., needed a fair trial. I now believe that she harmed no one intentionally and that she was caught up in a situation where accidents were waiting to happen. The actions of others led to her arrest and once this occurred there was no way back- disaster.

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