It is well known that the statistics used to convict Lucy Letby at her trial were fallacious. The most notorious example being the roster chart which did nothing more than show she was present at certain times when she was present, yet was used to create a sinister connotation.
What has not been done so far as we can tell at least in the public domain, is a proper review of the statistics. To that end, I have recently been taking part in a project to do just that. Collaborating in this includes Peter Elston, who has done extensive work on the statistics of the case already, as well as three other collaborators (all UK-based) who wish to remain anonymous for the time being.
For the exact same reasons as shown in my earlier blog post, I was as certain as one can practically be that a proper statistical analysis of the case would in no way point towards guilt, and indeed that appears to be the case based on our preliminary findings. With that said, all involved are committed to publishing the results regardless of whether they work for or against Lucy. Our ultimate commitment is to the truth. Above all, contrary to what many pitchforkers would have you believe, if I ever found evidence pointing to a serial killer of children, I would promptly make it known to the relevant authorities. I’m not Ravi Jayaram after all!
In the rest of this blog post, I will summarise some key preliminary findings as well as provide some formal housekeeping concerning data protection on this project as required by law.
The Rise in Mortality at CoCH:
Our preliminary findings show that, even with a very prosecution-friendly model, the rise in mortality at CoCH neonatal unit from June 2015 to June 2016 was of a statistical significance one would expect to observe in around one unit per year in the country.
This comes when one accounts, at least in part, for the following factors:
Number of IC patient days in a given period
Uncertainty in the estimate for the mortality rate per IC patient day
Interval length can be varied to produce the most statistically significant “spike” in mortality possible
Moreover, this model operates on the assumption that the hospital continued to perform just as well even in the face of a significant rise in IC days that CoCH was forced to cope with, most likely due to the maternity crisis in North Wales.
If one accepts the common-sense belief that the hospital would have struggled to cope with this increased burden, thus causing the per IC patient-day mortality rate to increase, then the chance of a rise in mortality will be substantially higher than our prosecution-friendly model suggests.
Our model also does not account for other factors. For example, Thirlwall showed that the number of infants with birthweights below <2000g increased during the June 2015 to June 2016 period, which one would expect to increase the chance of a spike in mortality even higher.
How was Lucy Letby Associated with so many Deaths?
This is the current part of the research we are focusing on developing the most, but we have a few preliminary observations.
Firstly, the number of patients in intensive care is substantially higher when Lucy Letby is on shift than when she is not. A potential confounder behind this was her status as the jointly most qualified nurse in her pay bracket. This likely meant that the cheapest way to staff the rota was to use Letby as much as possible for shifts with multiple patients in intensive care, for which she could be used with her QIS qualification, while using the less-qualified Band 5 nurses on shifts with only a single or no patient in intensive care. The fact that Letby was a young nurse and single likely meant she had greater flexibility allowing her to fit such a schedule.
Secondly, heterogeneity is a really important feature. The chance of a death occurring at a given time on the unit is not constant. It varies based on how many patients are present in intensive care at a given time, what their gestational ages and birthweights are, whether or not they are a multiple, whether or not the unit is understaffed at a given time, and any other comorbidities individual patients might have. If one assumes even a small amount of heterogeneity, the chance of an individual nurse being present for a large number of deaths rises dramatically. This is the same phenomenon as I observed in the case of Lucia de Berk, where even a small amount of heterogeneity, combined with correcting other fallacies, meant that the true probability of de Berk being present for the deaths she was at was 1 in 50, a far cry from the 1 in 342 million claimed at her original trial.
Of course, even a 1 in 50 event still implies that a nurse was unlucky to be present at many deaths. But in a country with thousands of nurses, hundreds of thousands in the case of England, you would expect this to happen to a large number of nurses quite regularly. Just as someone is statistically almost guaranteed to win the lottery somewhere, even if their individual chances of doing so are small, it is almost guaranteed that many nurses will be present for many deaths. It does not imply on its own that they were responsible for any wrongdoing.
We would like to develop this work further by using data such as gestational ages and birthweight to account for some of this heterogeneity and obtain a more precise estimate of the chance of a nurse being present for some minimum number of patient deaths.
Lessons for Use of Statistics:
There are several key lessons that should be learned from this story.
One key lesson is that, when the decision around what analysis to do is based on the same data one is analysing, extreme caution must be exercised. Even subconsciously, one can use the data to perform an analysis decision aimed at achieving the very outcome one wants, while ignoring analysis approaches that do not achieve that outcome.
This issue is illustrated repeatedly throughout the case of Letby, including, but by no means limited to, the following:
Defining “suspicious events”, “collapses” or “collapses leading to death” on the basis of whether Lucy was present there in the first place. It is known that at least 10 instances where it was initially thought a baby had been attacked or an otherwise “suspicious” event took place were dropped from the shift chart after Letby was found to be absent from the hospital at the time.
Choosing the specific interval over which to analyse the rise in mortality on the basis of whether a rise in mortality happened to occur.
Another key lesson is that null events are extremely important to keep in mind. The death of 10 patients out of 10 is far more suspicious than the death of 10 patients out of 1000. If an unusual event is merely the result of there being many opportunities for it to happen, and it just occurred eventually at some point, then the fact an event might be rare does not imply that a rare cause must be responsible for it.
Courts seem to be extremely poor at grasping this critical concept. This is evident when the court looked only at collapses when Lucy Letby was present while ignoring other “suspicious events” after it turns out Lucy was never there catastrophically fails to grasp this key principle. It’s rather like evaluating the performance of the Dutch National Football Team by looking at only the matches they have won, while ignoring their defeats like the 2010 World Cup final.
One potential reason courts are so poor at understanding this critical concept is that courts usually handle events that are inherently rare, such as a murder where there’s no dispute a crime has occurred and the only debate is who the perpetrator was. However, determining from observational data whether an exceptionally rare cause even happened at all (such as a serial killer nurse) is a very different task. The more one looks into the case of Lucy Letby, the more one appreciates how ill-equipped courts are for handling these sort of cases.
Data Protection Housekeeping:
The law on data protection in both the UK and EU requires one to fulfil a number of key principles when handling personal data. One of those is transparency, and it is in that spirit that I provide some data protection housekeeping here.
Rights of Data Subjects:
Any data subject is welcome to contact me, including via email, if they want any further information or clarification regarding the project, and we shall endeavour to answer all queries.
Data Subjects ordinarily have a number of rights, the full details of which can be obtained on the UK Information Commissioner’s Office website. See the following link for further details: A guide to individual rights | ICO
These rights include the following:
Right of Access: The right to access and receive a copy of one’s personal data.
Right of Rectification: One has a right for any inaccurate personal data about oneself to be corrected
Right of Restriction: One has a right to restrict how one’s personal data is used in certain circumstances
Right to Object: One has a right to object to the use of one’s personal data, although this right does not apply for processing done under Article 6(1)(e) for reasons of public interest, a provision we rely on (see later for more details)
Right of Erasure: One has a right to have one’s personal data erased in certain circumstances
It is worth noting that there can be restrictions on these rights. In particular, restrictions often apply when exercising the right would substantially impede the academic research we are conducting.
Data subjects also have a right to complain both to the data controller responsible for processing the data, as well as to the appropriate regulatory, in this case the UK Information Commissioner’s Office (ICO).
However, even though such a right to complain exists, we wish to emphasise that we want to work collaboratively with data subjects as much as possible and resolve any queries that they have. If a data subject identifies a flaw in our practices, we would like to work with them and remedy it wherever possible. We also would like the data to be processed in a way that leaves subjects genuinely assured that the use of their personal data in this research project will not result in any adverse effects against them, and we are more than happy to work with them as much as possible to achieve that outcome.
General Public Interest:
There are numerous reasons why this research is so vital, and why we believe it is substantially in the public interest to do:
To help ascertain what really happened at the Countess of Chester Neonatal Unit. In particular, we hope our research can help contribute to ascertaining whether or not Lucy Letby has been the victim of a miscarriage of justice, or if she is indeed guilty of the crimes she has been convicted of.
To provide lessons in the use and misuse of statistics in the legal setting, regardless of whether Lucy Letby has been the victim of a miscarriage of justice.
If it does contribute towards showing Lucy Letby was the victim of a catastrophic miscarriage of justice, there will likely be huge implications for the criminal justice system
Thirlwall has proposed wholesale changes to the NHS, including the abolition of no-blame culture, which will likely make patient care worse. This would be bad enough in any event; it is even worse if it is based on something that never happened. This research can help determine whether that is indeed the case.
Given the public debate around the case of Lucy Letby is likely to continue for the foreseeable future in any event, we hope this research can help make that debate healthier and better informed.
While the practitioners of this research make no secret that we come into it with a very strong prior that Lucy Letby has been the victim of a miscarriage of justice, we do wish to emphasise that our ultimate commitment is to the truth.
Both under academic standards and human standards, we will not hesitate to publish our research if at any time it were to point against our prior belief and suggest Lucy Letby was indeed guilty of the crimes she was convicted of. We believe the public interest behind our research goes far beyond the fate of one person, and our commitment to publishing our findings no matter the result reflects that belief.
Specific Data Used:
The data used in this project will include the nurse’s shift chart, as well as admissions data for 9 out of the 13 months between June 2015 and June 2016. Unfortunately, we don’t have data for the four months where there was no indictment event. The admissions data was obtained by Peter Elston from Lucy’s defence barrister, Mr Mark McDonald and, for the infants admitted to the neonatal unit in those 9 months, contain their gestational ages, birthweights, when they were in the unit and with what category of care (intensive care, high dependency care, special care, normal) on a given day.
How the Data will be Used:
The use of this data is necessary to compare the mortality at CoCH relative to gestational age and birthweight to that of other known environments. The admissions data also allows us to calculate the total IC days over a given time interval, which is also necessary for some of our modelling.
We may require using the data subsequently to develop models around the association of a particular nurse’s presence with mortality, such as discrete time survival models. Should this need arise, we will make sure not to publish anything that could theoretically be reverse-engineered to obtain the original dataset.
It goes without saying this contains very sensitive data, including what GDPR regards as special category data. We therefore make clear at once that nothing will be published that could possibly be used to identify any patient. For example, any graphical displays will be scrambled appropriately to ensure they cannot be reverse-engineered to obtain the original dataset. Nothing will be published pertaining to any individual patient either.
The only reason we use this data is to research the spike in mortality in the Countess, as well as the reasons behind a nurse being present for many of the deaths. In no way will the data be used to make any decision about any individual patient, and, given the summary nature of what we publish, nothing released will have any prospect of doing so either.
Legal Basis for Processing Data:
Formally, the legal bases on which we use this data are article 6(1)(e) (task in the public interest), article 6(1)(f) (legitimate interests) and article 9(2)(j) (archiving, research and statistics) together with section 1 paragraph 4 of Data Protection Act 2018 (DPA). The legitimate interests are the same as those expressed earlier as to why this research is so important, and they form the same reasons as to why we consider this research to be in the general public interest, a key requirement under Article 9(2)(j).
If necessary, at certain points to ensure the completion of the project, we also rely on Schedule 2, paragraph 27 of DPA (the research purposes exemption) and, if necessary, Schedule 2, paragraph 26 of DPA (the academic expression exemption). In particular, with respect to the latter, because the project is done with a view to publishing academic material and we believe that doing so is in the general public interest, this allows us to use the academic expression exemption whenever we reasonably believe a given provision to which the exemption is eligible to be applied would otherwise be incompatible with the academic purpose behind this research.
I’ve been invited to give a talk at University College Dublin, in the seminar of the School of Mathematics and Statistics. It will be on my usual favourite topic, the Lucy Letby case.
I’m particularly excited because I have never been in Dublin before, and it seems to be the place where my grandfather’s grandfather came from. He was a craftsman working with tortoiseshell, making spectacle frames, combs, and costume jewellery trinkets from it. But I’m also excited because of the many other fantastic things that Dublin has given to the world.
I needed to submit a CV, fast, for a new consultation job. I decided to ask Google AI for help. And it was very helpful indeed! Here’s the result.
The main resource used by the AI was of course my Google Scholar listing, https://scholar.google.com/citations?user=yJj_DosAAAAJ&hl=en. You will see there that I have an H-index of 50 (50 papers authored or co-authored by myself have been cited 50 times or more; but, alas, the 51st most cited paper was cited less than 50 times). We statisticians refer to the Hirsch index as the age-index. It is also thought of as a vanity index. It automatically increases with age. I’m presently one of the four most cited mathematicians in the Netherlands. We four are simply the oldest living academic mathematicians in this country. So I have a chance of 1 in 4 of becoming, though probably only for a short time, the most-cited academic mathematician in the Netherlands.
Anton Lorenz Vrba Independent Researcher, UK vrba@iow.onl
Richard D. Gill Mathematical Institute, Leiden University gill@math.leidenuniv.nl
29 September 2026
Abstract
We examine the logical and mathematical structure of Sanctuary’s recent paper (Quantum Rep. 2026, 8, 96), which argues that spin observables in the Bivector Standard Model (BiSM) are not jointly definable on a single Kolmogorov probability space, so that the CHSH quadruple cannot be formed and Bell’s and Fine’s theorems do not apply. The paper contains two constructions: local response functions of the analyser setting and a shared source phase, and a separate prescription that produces the correlation . We show that the first construction, as specified, meets the hypotheses of Bell’s theorem. Its outcome maps are defined on a common source domain with a setting-independent distribution, so the non-existence claim (Lemma 3, Corollary 3) does not hold for it, its product correlations obey the CHSH bound, and the paper’s own simulation of it yields the Bell triangle. The cosine is obtained instead from a scalar computed jointly from both stations’ phases and then digitised; it is not shown to be the correlation of the local outcomes. Execution of the supplementary programs further shows that the four BiSM_v2 populations do not form the partition stated in the paper, and that the doubled-angle harmonic attributed to the raw coherence data appears only after a sign convention is applied on the second half-cycle.
Introduction
Sanctuary’s paper “Spin Helicity and the Disproof of Bell’s Theorem” [3], together with [2], claimed that a bivector (quaternion) model of spin disproves Bell’s theorem. The published Comment [4] examined that claim. It concluded that the construction lies outside the hypotheses of Bell’s theorem rather than refuting it, and that the correlation is obtained by steps that “are heuristic mathematical procedures, not formal probabilistic identities”. In particular, the Comment identified the assembly of the correlation from separately computed polarisation and coherence contributions as “a modeling postulate”, for which “no general probabilistic theorem guarantees that such an additive assembly reproduces Bell-type statistics”.
In his Reply [5] the author accepted the first conclusion: “We agree that Bell’s theorem is mathematically valid within its stated assumptions. Our position is that bivector spin does not belong to the class of models Bell considered and therefore lies outside the scope of the theorem.” The Reply also defends the contextual construction of measurement domains, the statistical reconstruction of the phase relation, and a geometric account of the quantum limit. It offers no explicit probabilistic derivation resolving the objection to the split-and-recombine step, stating that “several issues raised by Vrba, particularly concerning the quantum limit and measurement structure, deserve fuller treatment than is possible in a short reply.”
Paper [1] develops that response. It does not supply the missing probabilistic derivation. Instead it isolates joint definability as a separate premise, which the model is said to fail, and it gives explicit rules: a phase uniformly distributed on , carried by local rotors to each station, and deterministic outcome rules. The present critique concerns the relation between the paper’s algebra and detector-level statistics. The explicit rules of [1] allow a sharper separation than was possible in [4] between two constructions: the local response functions, and the separate prescription that produces . The review that follows examines whether the joint-definability argument holds for the local responses (Section A), whether the correlation is derived from them or assembled separately (Section B), what the simulations compute (Section C), and which further claims rest on assertion rather than derivation (Sections D and E).
Unless stated otherwise, equation, section, definition and lemma numbers refer to [1]; the points of the present critique are numbered A1, B1, and so on. The supplementary material of [1] contains the programs BiSM_v1 and BiSM_v2 with their output files. Statements about the programs below rest on source inspection and output files.
A. The joint-definability argument
A1. Lemma 3 does not hold for the paper’s own definitions. Definition 12 introduces a context map , and Eq. (52) defines the outcome as . The composition is a function on for every setting , and likewise . Hence for every the four values
are simultaneously defined, and is a common domain of the kind Lemma 3 says does not exist. The proof of Lemma 3, whose argument is first set out in [5], rests on the sentence “observables are defined only after contextual instantiation”. That concerns which experiment is physically performed, not which functions are mathematically defined. Counterfactual definability in Bell’s sense requires only that the function be specified, not that the measurement be made.
A2. The explicit outcome rules are Bell-type local functions. The paper does not leave the outcome functions abstract. Eq. (15) gives the local phase for every and ; Eqs. (64) and (66) take the quantum-domain outcome as ; and Eq. (85) gives the polarisation outcome as , with the value assigned at zero. Each is a function of the local setting and the shared alone, which is Bell’s form . The sign-of-cosine rule is essentially Bell’s own illustrative model [6]; with a uniform source distribution and Bob’s opposite sign it gives the linear “triangle” correlation, as Figure 3 and Section 4.2.2 of [1] confirm.
A3. Geometric reality does not exempt from Bell’s framework. The paper states: “In the BiSM long–range EPR correlation originates from a common relative rotor phase established at separation and subsequently carried along the worldlines of Alice and Bob” (Section 2.1); the same description is given in [5]. Bell placed no restriction on the nature of : “It is a matter of indifference in the following whether denotes a single variable or a set, or even a set of functions, and whether the variables are discrete or continuous” [6]. A real, local geometric object created at the source and carried to both stations is the paradigm case of , not an exception to it. The local-response component of the model is therefore of exactly the kind Bell’s theorem addresses, and the statement that the bivector is “not a hidden variable in Bell’s sense” [5] does not hold for that component.
A4. A single Kolmogorov space is used explicitly. The paper places on with density (Eqs. (16), (70)) and uses this same space for every analyser separation: “Every segment in the simulation has the same free–flight singlet state”. The supplementary programs use a common finite grid of values for all settings, which is likewise a single space. With measurable response maps, the pushforward of under is a joint distribution reproducing the pairwise distributions of these local responses. Corollary 3 (“no global joint probability distribution exists for the CHSH quadruple”) therefore does not hold for them. The pushforward need not reproduce the separately generated pair distributions of the cosine branch (Section C).
A5. The author’s statement of Fine’s theorem, applied to the local responses. Section 5.5 states correctly that a joint distribution for the four observables “is equivalent to a deterministic Local Hidden Variable (LHV) representation”. Definition 15 asserts: “Individual measurement outcomes are real, discrete, deterministic and local.” The label alone would not settle the matter, but points A1, A2 and A4 show that the paper supplies local response functions on a common source domain and a source distribution that does not depend on the settings. For correlations formed as averages of products of these local outcomes,
for every , and integration against gives the CHSH bound; by the equivalence the author quotes, a joint distribution exists. The paper does not address the resulting alternatives:
either the reported correlations are averages of products of these local outcomes, in which case CHSH is satisfied;
or they are obtained from another quantity, in which case the locality of the response functions does not carry over to them.
The simulations (Section C) show that alternative (ii) is what occurs.
A6. Assumption 3 is not independent of Assumption 2 in the paper’s representation. The paper lists “Joint Definability” separately from “Outcome Definiteness”. Assumption 2 (“For each hidden parameter , the outcomes , are well-defined”) is stated for the settings generally; in the functional representation the paper supplies, any four settings then yield four defined values for fixed . Rejecting 3 while retaining 2 requires restricting 2 to the setting actually used, a restriction the paper does not state.
A7. The scope of Fine’s theorem. Fine’s theorem [7] concerns the scenario with two settings per party and two outcomes per setting: pairwise distributions with consistent single-observable marginals admit a joint distribution if and only if the full family of Bell–CHSH inequalities holds. A family that violates those inequalities is an instance of the theorem’s conclusion, not a case in which the theorem does not apply. Conclusion 5 of [1] states that “Bell’s theorem and Fine’s characterization remain mathematically valid within their stated premises”, which is narrower than the “inapplicability” of the title.
A8. Notation and analogy do not alter the common domain. The semicolon in is said to indicate “that is not merely another argument”; the notation does not change the domain or existence of the function. The proof of Lemma 2 moves from distinct function values, , to “distinct domains”; that step is not justified. Distinct instantiated domains need not be denied: the decisive point is that the context maps pull the observables back to the common source domain (A1). The induced-dipole analogy (Remark 1) illustrates this: a polarisability tensor fixes the response to every field direction simultaneously, so the counterfactual dipoles are jointly defined.
A9. The common-domain structure is already present in Bell’s representation. The paper states that “Bell did not isolate this common probability–space structure as a separate premise under the name of joint definability; it entered tacitly through the hidden–variable representation”. Bell wrote , and explicitly [6]. Joint definability is a consequence of that representation rather than an additional assumption, which is why it required no separate statement.
B. The correlation derivation
B1. The cosine is the scalar part of a joint product. Of the ellipsis in Eq. (13) the paper states: “We added the dots to emphasize that the two rotors do not cancel but are carried as independent phases by the separated EPR pair. The dots have no mathematical meaning expressing only locality by the product.” Eq. (14) nevertheless evaluates as the scalar part of the product of Alice’s and Bob’s rotors, in which cancels and results. The paper’s own second line of Eq. (14) shows the alternative: the product of the separate scalar parts, , which it states “obeys the CHSH bound”. The cosine is thus obtained from the scalar part of a product formed from both stations’ rotors, not from the product of the two locally generated Boolean detector outcomes. Joint processing is not itself the issue: ordinary coincidence analysis also compares records at a common later stage. The issue is which function of the records is computed.
B2. The cosine holds event by event. Eq. (20) gives the relative phase for every , so the scalar of Eq. (71) equals for every pair. Section 4.2.2 states that the correlation “emerges only statistically from the ensemble of rotor phases ”. The source phase affects the individual local quantities, but averaging over it is not what produces the cosine in : that cosine already holds event by event. The required identification of this scalar with the correlation of local Boolean outcomes is not supplied by the cancellation.
B3. The singlet operator is the identity. Eqs. (9), (13) and (72) define . Eq. (73) then writes
Inserting the identity between and yields directly. The target correlation thus enters through this algebraic representation, and no argument is given that the representation describes the detector statistics. Eq. (73) also combines matrix transposition with geometric-algebra products and uses , both as angles and as vectors; a clarification of the representation would help.
B4. The plotted mustache is a residual. Eq. (71) is the trigonometric addition identity,
The legend of Figure 3 reads verbatim “Mustache = Quaternion – Bell”, and the caption calls the mustache “Their difference”. The plotted mustache is therefore the residual between the target and the triangle; it is neither the continuous coherence term of Eq. (71) nor an independently derived contribution to a detector correlation. The cosine itself enters through the identity applied to the jointly held phases (B1, C1). The Comment [4] had described the corresponding split-and-recombine step as “a modeling postulate”.
B5. The split-and-recombine step is not connected to detector statistics. The Comment [4] identified the assembly of the correlation as a sum of separately computed polarisation and coherence contributions, , as “a modeling postulate” for which “no general probabilistic theorem guarantees that such an additive assembly reproduces Bell-type statistics”. Neither the Reply [5] nor [1] supplies the missing connection. The operators do not appear in [1], and how they relate to the continuous terms of Eq. (71) and to the populations of Section 4.3 is not stated. In [1] the recombination appears as Eq. (71), , with the two terms described as “complementary projections of a single underlying quaternion rotor” (Section 4.1). The algebraic sum is well defined and follows from the chosen rotor product. What is not established is its identification with the product of the recorded local Boolean outcomes, or with that product’s expectation. Describing and as complementary sectors does not supply this measurement relation, and the subsequent digitisation (C2) samples a new coincidence variable with mean rather than showing that the local detector products have that mean.
B6. The term “polarisation” is used for three different quantities. The term is used for: (Eq. (14), second line), which is not rotation-invariant; (Eq. (71)), which averages over to ; and the digitised triangle (Figure 3, Section 4.3). Moreover, Section 4.3.3 states that “The symmetric combination Equation (71) reconstructs the scalar invariant and produces the piecewise linear correlation”, whereas Section 4.2 states that the same equation yields . These two statements contradict each other.
B7. The Boolean benchmark is one member of the Bell-local class. The second line of Eq. (14) is said to follow “from Equation (11) by dropping the off–diagonal terms in the scalar product, ”, which “represents complete removal of the bivector phase structure”. The paper does not say which physical operation this prescription represents, or how it relates to the detector rule it specifies. The resulting product, , is then used as the Boolean benchmark that obeys CHSH. It is one example of a Bell-local correlation. Bell’s theorem, however, concerns the whole class of local response functions under a common preparation, so a comparison with this single product does not establish how the model stands in relation to that class.
B8. The rotor scalar is not shown to be a detector expectation. For a binary coincidence variable , and normalisation give , so Eq. (22) is a legitimate identity once the rotor scalar is known to be such an expectation (with the paper’s convention ). That identification is the step not supplied. The accompanying statement (“Since they are constructed from a product state of two independently propagating local rotors their use is consistent with locality”) asserts the locality of the construction rather than showing it.
C. The simulations
C1. The abstract’s description of BiSM_v1 differs from its construction. The abstract states: “Numerical simulations reproduce this correlation using only local detector events.” Section 4.2 states of : “It is not a local detector click and is never used to generate either Alice’s or Bob’s local Boolean outcome”, and Section 4.2.2 adds: “The scalar is not Bell’s response function .” is computed from both stations’ continuous phases together (Eq. (71)). The quoted statement holds for the local clicks of the Bell control, but the per-station outcomes of the cosine branch are generated from (C3).
C2. The digitisation step reproduces any prescribed mean. Eqs. (74)–(75) set whenever , with one auxiliary uniform random number per pair. Then
exactly, for any function with values in . Any correlation function with is “reproduced” in this way, including one whose four-setting CHSH combination exceeds the Tsirelson bound . The procedure samples a prescribed mean; it is not a test of whether that mean has a Bell-local realisation. The source of BiSM_v1 states that “No Malus probability P_eq=(1+R)/2 is formed or used anywhere in event generation”; the uniform threshold is nonetheless mathematically identical to sampling with that probability. The reported maximum error of (Eq. (78)) verifies the trigonometric identity in floating point.
C3. In the cosine branch the station outcomes are assigned after pairing. The paper describes the digitisation of into the coincidence variable (Eqs. (74)–(76)), but not how outcomes for Alice and Bob are then obtained. The source of BiSM_v1 shows this step: after is drawn, a further random number assigns an equal event to or , and an unequal event to or (“The equal pair is ++ or – with equal marginal weight”). The station-resolved counts in the output file are generated in this way. Alice’s recorded outcome in this branch is therefore not a function of her setting and : whether it agrees with Bob’s is decided by , a function of both settings. The marginals remain uniform, but the joint law is not of Bell’s form ; the program’s own Bell control, which is of that form, gives the triangle. Since identically (Eq. (20)), the retained phases carry exactly the difference of the two settings. Any experiment that records its analyser settings, as all Bell tests do, could generate the same coincidence data by this procedure.
C4. The paper’s local-outcome analysis is consistent with Bell’s theorem. Section 4.2.2 states that analysing the local records gives “the conventional Bell result of the piecewise–linear correlation”; executing BiSM_v1 confirms this, its Bell control giving at and at . Eqs. (80)–(81) present the two computations as analyses of “the same experimental results”. Both use the same enlarged simulated record, but they apply different functions to it, and the cosine branch also generates additional random pair labels. The enlarged record contains continuous phases and “retained local rotor geometry” (Eqs. (67)–(68)), and the paper does not establish that these are accessible detector records. The statement that “The same digitized coincidence statistics observed experimentally are thereby recovered” therefore compares a simulation using additional, jointly processed quantities with experiments that record only outcomes.
C5. The BiSM_v2 rules are not derived, and Eq. (88) does not describe the program. Several event rules are given without derivation from the bivector dynamics: the phase offsets in Eq. (84), which the program describes as implementing singlet preparation by antipodal source orientations; the factor in Eq. (85); and the “larger signed contribution” rule of Eqs. (86)–(87). Eq. (88) states that “Each event contributes to one of the four populations”, whose counts sum to . The supplementary program instead evaluates both the polarisation and the coherence rule for every event; its own comments state that “EQP+NEQP = 1 and EQC+NEQC = 1 separately” and that “the four fractions are NOT intended to sum to one”. Execution confirms that the four fractions sum to 2 at every angle. Eq. (88) therefore does not describe the implemented algorithm.
As implemented, is an average of products of local coherence outcomes, additionally averaged over absolute analyser orientation. Being generated by local functions of under a common preparation, such averages are subject to the CHSH bound (A2, A5); a harmonic shape in this angular summary does not by itself indicate a violation, which would require four consistently defined setting pairs. The program’s run report compares with on the interval only; its behaviour over the full cycle is taken up in C6.
C6. The doubled-angle harmonic appears only after a sign convention. Section 4.3.4 states that “the coherence imbalance exhibits the smooth doubled–angle, two–period harmonic”, and Section 4.3.6 that it “exhibits a doubled angular dependence and therefore has period in the analyzer separation”, from which the double-cover interpretation is drawn (E8). The implemented coherence rule does not produce this. Under the doubled-angle terms that select the blade are unchanged, while both single-angle phases change sign; away from threshold ties the coherence outcome therefore reverses, and . Execution of BiSM_v2 confirms this: , whereas . Over the full cycle the Fourier coefficient of is ; its dominant component is the first harmonic (coefficient of about ). On the data do follow , consistent with Eq. (94), , when is read as the separation folded into ; that function is not -periodic in .
The program then defines, for its portrait, an “oriented” coordinate for , describing this as a convention that “does not alter EQC or NEQC”. Only this coordinate carries a component (coefficient ) and is -periodic. The paper describes the portrait as the ordered pair of Eq. (95) and does not mention the sign reversal. The figure-eight thus contains an imposed orientation convention, and the doubled harmonic on which Section 4.3.6 relies is a property of that convention rather than of the raw populations. The lemniscate of Gerono, , illustrates the shape obtained from these two harmonics; the implemented polarisation coordinate is approximately triangular rather than exactly . The experiment proposed in Section 5.1.2 would require an operational means of controlling , resolving the two sectors, and deriving their observable statistics under that controlled preparation; the paper does not yet supply these.
D. Framing of the result
The introduction states that “Section 3 questions Bell’s locality theorem” and that “Failure of either locality or joint definability leads to failure of Bell’s locality theorem”. It also states that the work “does not challenge Bell’s derivation”, and Conclusion 5, like [5], calls both theorems “mathematically valid”. These positions are compatible only if “failure” means that the theorem’s hypotheses are not met; a theorem whose hypotheses are not met does not thereby fail.
The introduction states that “The CHSH bound applies to correlations constructed solely from Boolean outcomes ”. The bound is ; is the per- value (Eq. (62)). The same passage attributes the violation to “additional geometric effects” before any argument is given.
The paper states that “Entanglement is not required since the quaternion carries their common phase”, and that the bivector singlet of Eq. (9) “is not entangled”. Whether such a construction yields a Bell-local model depends on the conditions set out in A5: local response functions, a common setting-independent distribution, and correlations formed from products of outcomes. For the model’s local responses these conditions are met (A1, A2, A4); for the cosine they are not shown (B1, C1).
E. Physical claims made without derivation
E1. follows from the chosen function. It is obtained by maximising , which the paper calls “the simplest symmetric measure”. The maximum at is a property of that chosen function, not a consequence of symmetry as such (the equally symmetric has a minimum there), and no evolution or stability analysis links the extremum to a dynamical bifurcation. The quantum limit thus remains what [4] called a “structural postulate”.
E2. The Dirac-equation step is asserted. The coupled equation of Eq. (42) does not by itself imply the separate equalities and of Eq. (43). These require an independent restriction on the operators or their domains, which is asserted on the grounds that and act in opposite parity sectors but is not shown; a parity label is not an annihilation property. The statement “This occurs, as we show, at ” is not supported by Eqs. (37)–(44), in which does not appear; any dependence on would need to be exhibited.
E3. and Noether. The identification of with the angular momentum of the spin-1 state is asserted, without stating whether a component or a magnitude is meant. The statement that spin “does not become classical as unlike continuous variables governed by Noether’s theorem” attributes to Noether’s theorem a content it does not have: the theorem connects continuous symmetries of the dynamics with conservation laws, and does not classify discrete observables as exempt from classical limits. A fixed-spin limit and a large-spin semiclassical limit are also different and should be distinguished.
E4. No quantitative account of beta decay. Section 5.2.1 states that “A cleaved and free blade is indistinguishable from a neutrino”; Section 5.2.3 states that “There can be no neutrinos produced in the BiSM with its intact blades”. The paper distinguishes cleaved from intact blades, so these statements need not contradict each other, and it states that “no detailed BiSM reaction or assignment of charge is proposed here”. Until such a model is given, the proposal does not account quantitatively for the continuous beta spectrum and the energy and angular-momentum balance of the decay, which the neutrino hypothesis was introduced to explain.
E5. Assigned parity does not establish conservation in the decay. “The BiSM electron is odd to party [sic] while the Fermi electron of the SM is even to parity. This difference demonstrates that parity is not violated in the BiSM.” Parity assigned to one state does not show that the decay dynamics conserve parity or reproduce the asymmetry measured in the Wu experiment.
E6. Rhetorical claims supply no evidence for the alternative. Section 5.5.7 states that developments in quantum information “have no rational explanation”. The paper elsewhere acknowledges the experimental success of quantum mechanics and questions its interpretation; the statement expresses a philosophical position and supplies no mathematical evidence for the proposed alternative. Similarly, the assertion that “control of these new parameters restores determinism” (Section 5.1.1) would require preparation procedures and detector-response predictions for and , which are not given.
E7. The coherence analogy does not establish Bell-local correlations. Section 5.1.4 likens EPR correlations to “lasers, superconductors, superfluids, and Bose–Einstein condensates where collective behaviour emerges through long–range phase coherence”, and Section 4.3.5 to the double-slit experiment. The ordinary double-slit pattern invoked there is a single-particle distribution, whereas Bell’s theorem concerns joint statistics at two space-like separated stations with freely chosen settings. Macroscopic coherent systems are described quantitatively by quantum mechanics, and the analogy does not by itself supply a local model of two-station correlations.
E8. The double-cover claim is not established by a frequency ratio. Section 4.3.6 states that the original blade configuration is restored only after “a total rotation of of the blades”, and calls this “a geometric realization of the double cover ”. Unit quaternions do carry the standard double cover: with acting on vectors by , and induce the same rotation, and a physical rotation through lifts from to . Establishing that the proposed blade dynamics realise this structure requires showing how rotations about different axes, and their compositions, lift; a fixed frequency ratio about one axis does not establish it. Moreover, the period- dependence offered as its statistical signature is not present in the raw coherence data (C6). The same claim appears in [5].
F. Procedural note
The paper cites the two Quantum Reports articles [2, 3] addressed in the published Comment [4] and the author’s Reply [5], but does not cite either, or explicitly identify its responses to their specific objections, although both precede it and bear directly on its Sections 3.5, 3.6 and 5.5. The legend of Figure 3 defines the plotted mustache as the difference between the quaternion and Bell curves, the construction the Comment described as a modeling postulate. The paper’s central joint-definability argument restates, in new terminology, the argument of the Reply. The difference is that the paper now specifies explicit local response functions and a common source distribution (Eqs. (15), (16), (85), Definition 12). It is these, rather than the labels “local” and “deterministic”, that bring the local-response component within the scope of Bell’s and Fine’s theorems (A5).
G. Summary
The analysis establishes three related findings:
The local response functions of the model are defined on a common source domain with a setting-independent distribution, so Lemma 3 and Corollary 3 do not hold for them (A1–A4, A8).
Their product correlations therefore satisfy the CHSH bound, and by the equivalence the author quotes a joint distribution exists; the paper’s own simulation of these outcomes yields the Bell triangle (A5, C4).
The correlation is obtained from a scalar computed jointly from both stations’ phases and then digitised; it is not shown to be the correlation of the local outcomes (B1, B5, C1–C3). The supplementary programs further show that the BiSM_v2 populations do not form the stated partition, and that the doubled-angle harmonic appears only after a sign convention (C5, C6).
Declaration on the use of generative AI
This document was written with the assistance of Anthropic’s Claude Opus 5.5, under the direction of the authors, using material from the cited publications and the supplementary programs in [1]. Drafts were also reviewed for consistency and accuracy using OpenAI models (ChatGPT and Codex), and resulting suggestions were incorporated following manual review. Every claim in this document has been independently verified by both authors.
References
B. Sanctuary, Joint Definability, Context–Instantiated Geometry, and the Inapplicability of Fine’s Theorem, Quantum Rep.2026, 8, 96. doi:10.3390/quantum8030096 (including Supplementary Data: quantumrep-08-00096-s001.zip).
B. Sanctuary, EPR Correlations Using Quaternion Spin, Quantum Rep.2024, 6, 409–425. doi:10.3390/quantum6030026
B. Sanctuary, Spin Helicity and the Disproof of Bell’s Theorem, Quantum Rep.2024, 6, 436–441. doi:10.3390/quantum6030028
A. L. Vrba, A Collective Comment on “Spin Helicity and the Disproof of Bell’s Theorem” and Sanctuary’s Bivector Spin Framework (2023–2025), Quantum Rep.2026, 8(2), 56. doi:10.3390/quantum8020056
B. Sanctuary, Reply to Vrba, A.L. A Collective Comment on “Sanctuary, B. ‘Spin Helicity and the Disproof of Bell’s Theorem’ and Sanctuary’s Bivector Spin Framework (2023–2025)”, Quantum Rep.2026, 8, 57. doi:10.3390/quantum8030057
J. S. Bell, On the Einstein Podolsky Rosen paradox, Physics Physique Fizika1964, 1, 195–200.
A. Fine, Hidden variables, joint probability, and the Bell inequalities, Phys. Rev. Lett.1982, 48, 291.
I use this rule, Bayes’ rule, repeatedly, each time taking account of another part of the evidence. It is named for Thomas Bayes, a presbyterian minister and mathematician, who was interested in using it to find a mathematical proof of the existence of God. https://en.wikipedia.org/wiki/Thomas_Bayes
The likelihood ratio for the question at hand, based on some part of the evidence, is the ratio of the probabilities of that part of the evidence under the two competing hypotheses. More precisely, one uses the conditional probabilities of that fact given previously incorporated evidence. We have to start somewhere and we start by describing two alternative hypotheses and our probabilities or degrees of belief or personal betting odds for those two hypotheses, before further evidence is taken into account.
Let’s start with the news reports of a police investigation of a possible killer nurse at a neonatology unit in the UK; the investigation being triggered by a disturbing spike in the death rate on that unit.
I think that in the last fifty years there simply hasn’t been been a case in the UK of a killer nurse on a neonatal ward, except possibly the case of Beverley Allitt. One might argue that there do exist doubts as to the safety of her conviction, or one might argue that there can have been serial killer nurses who completely evaded detection. Did Alittit work in an intensive care unit? I also think that in recent years, every year has seen a scandalous calamity in a UK neonatal ward, leading to avoidable deaths of quite a few babies. So a priori: the relative chances of a killer nurse being responsible for the spike, or simply poor care, is in my estimation 50:1 in favour of poor care in a failing hospital unit rather than activity of a killer. If you disagree, give me your arguments for both those rates and hence their ratio. If you would like to take a different starting point, try that. Eg, what is the chance a random nurse is a serial killer? At some point one will have to use the information that this was a neonatal unit and one will have to take account of the “normal” rate of deaths on the unit. I think my choice is reasonably specific. One could argue that the prior odds should be 10 to 1, or 100 to 1, instead of 50 to 1. I expect that most people will at least agree that killer nurses on neonatal units are very rare, disastrously poor care on a neonatal unit in the UK is not rare at all.
So we are back in 2017 and hear the news and rightly we should be sceptical that there really is a case here. But clearly there are grounds to investigate what is the cause of that spike, and maybe there is more information which the police already have.
Then, many years go by. A particular nurse is detained for questioning in two successive years; and finally arrested in a third year. Two more years go by (Corona). At last, a trial begins. It turns out that roughly seven years of police investigation has uncovered no direct evidence at all (neither medical evidence, toxicological evidence, witness testimony or CCTV recordings, finger prints or DNA) of unlawful action by the nurse who has been under intensive investigation all that time. And not just no evidence against that nurse – no direct strong evidence of malevolent activity by anyone.
One might want to argue that the insulin evidence is strong toxicological evidence. We could argue about that for a long time. Even if one or two babies were given unauthorised doses of insulin there is no direct proof that Lucy Letby did that herself. There is the possibility of accidental administration (twins in adjacent cots). The argument that Lucy did administer insulin seems to have been that we know at some point she carried out other murderous attacks and it is unlikely that there were two murderous nurses working in the unit. But why do we believe there are murderous nurses working on the unit? This argument can only be made after hearing all the other evidence in the case.
So we have to estimate the probability of a 7 year police hunt for evidence of murder by a particular nurse finding no direct evidence of any malevolent activity at all by anyone, if Lucy Letby actually was innocent, and if she truly was a serial killer. In my opinion ,what we actually observed is much more likely under the innocence hypothesis than under the guilty hypothesis. If she truly is innocent the chance of finding powerful directly incriminating evidence must be rather small; if she truly is a serial killer then it must be unlikely that that no baby can be definitely proven to have been murdered or attacked. I guess the two probabilities of no hard evidence to be 95% and 5% respectively. These are probabilities of 19/20 and 1/20 respectively, so a likelihood ratio of 19. I’ll be a bit more cautious and call it 10.
We already had odds of 50:1 in favour of innocence. We have a likelihood ratio of 10:1 in favour of innocence, having learnt that police investigation uncovered no strong and direct proof of malevolent harm to any baby. The odds on Lucy being innocent are therefore now 50 times 10, or 500 to 1.
Let’s now bring in the evidence from psychology. Are there reasons to believe Lucy is a psychopath? Which surely she must be, if she is a serial killer of babies in her care. It seems there is no reason at all to suspect she is a psychopath. I think that there very likely would be strong independent signs of psychopathy in her life history if she really is a serial killer, but obviously not so likely if she is completely innocent. [Clearly she could be both a psychopath but did not actually harm or try to harm any baby. I don’t think this is an interesting hypothesis to explore. I will also not pay attention to the Munchhausen by proxy idea, that she was trying to attract the attention of an older male doctor. All the evidence says that he was more romantically interested in her, than vice versa.]
Put the likelihood ratio at 2, ie twice as likely to see no evidence for psychopathy if innocent, than if a serial killer. Actually I think it should be closer to 10. We should ask some psychologists. Lucy Letby did not sadistically kill little animals when she was a child. By all accounts, she was a dedicated nurse and cared deeply for her work.
We were at 500 to 1 for innocence. Factor in a likelihood ratio of 2 for psychological evidence. Now it’s 1000 to 1. But we are not done yet.
Next, I would like to take account of the statistical evidence that the spike in deaths is quite adequately explained by the acuity of the patients being treated in those 18 months. I would say that this is exactly what we would expect if Lucy is innocent but very unlikely if she’s a serial killer. I think this hypothesis is very adequately supported by published MBRRACE-UK statistics, and what we know about the acuity of the babies in the case. We know why acuity went up in around 2014 and we know why it went down midway in 2017. The spike seems to have been caused by hospital policy which was being made and implemented by the consultants on that unit. They should have expected it.
Say a likelihood ratio of 10. That brings us to 10,000 to 1 she’s innocent; a posterior probability of 99.99%. I haven’t yet brought in the facts of an investigation driven by tunnel vision and coached by doctors who, as we now know, were making quite a few deadly mistakes themselves. I haven’t brought in yet the innocent explanation of the post-it note. In my opinion, the post-it note is powerful evidence for innocence; it makes absolutely no sense under the hypothesis of guilt. The irrelevance of the handover notes and the notations in her diary. Facebook searches? Her alleged lies (about what she was wearing when she was arrested). Anything else?
Anyway, I am now well above 99.99% sure that Lucy is innocent and since the press conference and the report of Shoo Lee and his colleagues, we can all be even more sure that that is the case.
A year ago on LinkedIn, I was discussing the possible use of AI in criminal court proceedings with psychometrician Dr. Timo Bechger. LinkedIn uses AI to make suggestions of groups one might like to join. One day, out of the blue, it came up with the suggestion that I join the LinkedIn group called “NRA Member”, see the screen shot at the top of this post.
That led to a bantering conversation with Timo, during the course of which I wrote the following remark.
Later, I deleted it that remark. What’s left on LinkedIn is the following:
Richard Gill
Prof.dr. (em.) at Leiden University and at Richard Gill Statistics
LinkedIn has gone crazy. I make a post about Lucy Letby and they ask if I want to join the LinkedIn group for NRA members.
BTW, I agreed that it [the idea of freeing Lucy by some Rambo-like action] might have been in my unconscious mind. It certainly wasn’t in my conscious mind till Timo somehow triggered it.
Timo Bechger
Senior Scientist TCS
I understand the frustration of the scientist fighting injustice. You fight with arguments and formulae. Some may find these more scary than an AK47. In any event, the ‘target’ is to help make judges take the right decision. Given your track record they can only appreciate your involvement.
Richard Gill
In this case, the decision is made by 12 ordinary folk who have been incommunicado from the outside world for 9 months while inundated under a steady streams of lies and innuendo and pseudo-science. They (the jury) must make their own decision based on what they heard and saw in court and based only on what they heard and saw in court, together with their common-sense general knowledge of the world and of human beings. I don’t want to interfere with the legal process. I want to communicate with the authorities who allowed this to happen. And who have the power to expedite an appeal and a new fair trial and a public enquiry. Legal reform is urgently needed in the UK. And a deep look at NHS mismanagement and under-funding. Education is also in a poor state. It’s a class society and its institutions seem designed to favour those on top: those who can pay for private medical treatment, private education, expensive lawyers. And support the Conservative Party through donations, receiving peerages in return and hence yet more influence. It’s one of the last remaining theocracies. The King is head of the state church and head of state. The other is Iran. The case of Israel is discutable. There is no civil marriage in Israel.
Richard Gill
A screenshot from that post [about the AK47] is now trending news on Twitter. Someone has complained to Leiden University about me. They send me aggressive messages on Twitter. They seem to me to be a bit unhinged, I wonder who they are.
Timo Bechger
The algorithms must have picked up something hidden in your subconscious. Makes you wonder how long it will take before psychologists are replaced by chatGPT.
Fabio Rigat, PhD
Executive Director, GI Strategy Head, Late Oncology Statistics
This LinkedIn conversation started with me asking Dewi Evans to connect to me. I was amazed that he accepted. I guess my request contained a brief message too, but this is not recorded in my LinkedIn account. I suppose Dewi has it in an email sent to him from LinkedIn. It would be nice to see it.
Dewi – are you there, reading this?
Feb 3, 2024
Dewi Evans sent the following message at 11:46 AM
11:46 AM Dear Richard. I’ve read your comments re the importance of statistics in court cases. I can’t comment on specific cases currently because of reporting restrictions. I would welcome discussing this with you, as it’s a matter that is worth exploring.
Richard Gill sent the following messages at 12:30 PM
12:30 PM I agree! I am looking forward to the reporting restrictions being lifted. Hope to talk to you within a year from now…
12:32 PM Do take a look at the case of Lucia de Berk. The case is horrifically similar to that of Lucy Letby. I helped get her out of jail. Also an Italian nurse, Daniela Poggiali. I acted as expert on the applications to the CCRC of Ben Geen. I am sure he is innocent but UK criminal justice is nowadays badly tilted in favour of the prosecution.
Dewi Evans sent the following message at 12:36 PM
12:36 PM With a bit of luck reporting restrictions will be lifted after the end of the retrial due in June.
Richard Gill sent the following messages at 12:44 PM
7:03 AM I’m visiting Liverpool to give a lecture next week, dept of statistics. Will probably also check out Chester. Would you like to meet? I’m not interested in reporting restrictions. They are unfair and immoral. Science must not be stopped. Chester police sent Dutch police to my door in the night to intimidate me. This only made me speak out more loudly.
7:21 AM Do you have an email address? I’d like to send you some links and materials
8:11 AM By the way, reporting restrictions means reporters cannot write in newspapers about evidence supporting Lucy’s innocence. However, it allows the Daily Mail to publish week by week horrible stories about how evil she is, her cushy life in jail, her friendship with another killer … You and I are not reporters. There is no law against us exchanging information. You can tell me about medicine, I can tell you about forensic science. I’m sorry for you that you live in a police state. In the Netherlands there are also disturbing developments. The state is eroding civil rights. In the UK the process has got much further.
8:12 AM Fortunately, many investigative reporters are working on the case and many scientists are working on the case. The dam is starting to crack and it won’t be long before it crashes down.
Dewi Evans sent the following message at 9:37 AM
9:37 AM No problem having a private discussion. But reporting restrictions are reporting restrictions and all that. I’ve no wish to contaminate due process. I’ve no idea re Daily Mail articles. Never read it (apart from the one where they covered the Letby story after speaking to me. My easy access email is xxxx@xxxxx.xxx
Richard Gill sent the following message at 10:48 AM
10:48 AM Thanks for the email address! I do not wish to contaminate due process either. I wish to ensure due process. I can promise in advance of any discussion with you total confidentiality.
Dewi Evans sent the following message at 10:48 AM
10:48 AM Thanks Richard
Richard Gill sent the following messages at 11:37 AM
6:56 PM You asked for all the deaths and all the collapses in the period January 2015 to July 2016. They gave you all the deaths but only collapses when Lucy was there. There must have been at least 50 collapses when she wasn’t on duty, given the acuity of those infants. You were lied to, you were used.
Feb 23, 2024
Dewi Evans sent the following message at 10:31 AM
10:31 AM That is incorrect. I received information re numerous collapses. I separated them into those that were explained by the common causes- infection, haemorrhage etc and those that were not explained, ie suspicious. The name Lucy Letby was not known to me at the time. As for “at least 50 collapses” I don’t know where you got that figure from.
Richard Gill sent the following message at 10:54 AM
10:54 AM Interesting. Your story does not match the story one gets from other sources (for instance, the police themselves). I got my figure from several neonatologists and a similar figure from nurses with experience in neonatal intensive care. Secondly, “not explained” is not synonymous with “suspicious”. This confusion of words in the minds of on experts was exactly what led to the conviction of Lucia de Berk. I recommend you study it carefully!
Dewi Evans sent the following message at 11:17 AM
11:17 AM Away this weekend. Back Tuesday. Content to engage post the appeal and retrial. Information from the police was all disclosed to the Defence presumably. Those are the rules. No idea which other neonatologists involved. 2 gave reports for the Defence. They were not called. That’s a Defence issue. Read the Lucia de Berk story via Wikipedia weeks ago.
Richard Gill sent the following messages at 11:35 AM
11:35 AM I know, the defence was useless. Scandalous. The newspapers were appalling. Social media too. This was not a fair trial.
11:37 AM Lucy Letby was a whistleblower and got crushed by the NHS. Much better to put the blame on a killer nurse than on lax consultants and poor management. Focussed on cost cutting at the expense of patient care.
11:51 AM Have a. nice weekend! I just had a great visit to Liverpool and to Chester. Wonderful to see Welsh mountains in the distance from the city walls of Chester.
Feb 24, 2024
7:31 AM All deaths in the period when Lucy was fully qualified and full time (with very much overtime) at CoCH, and 15 non-fatal collapses *selected by the gang of four* and exclusively at times when Lucy was on duty. How much of the time do you suppose she was in the ward? “Since the start of our enquiries and, as the information gathering process has continued, the scope of the investigation has now widened. We are now currently investigating the deaths of 17 babies and 15 non-fatal collapses between the period of March 2015 and July 2016” https://www.chesterstandard.co.uk/news/16329278.healthcare-worker-countess-chester-hospital-arrested-suspicion-murdering-eight-babies/
9:25 AM Hi Dewi, maybe it’s time we had a chat? I don’t want to blame you. I blame NHS underfunding. Really bad police work, “experts” who don’t follow the rules (and apparently don’t know the relevant science either). The jury system, the contempt of court rules, a biased judge, a weak defence. The farce of her appeal being rejected but the CPS appeal accepted. The CCRC is utterly unfit for purpose and the next stage is going to take five to ten years. This certainly is the biggest miscarriage of justice since those big famous ones which led to the setting up of the CCRC. Of course in public you will presumably, for a while, go on saying you believe Lucy is guilty. I know all about obstinacy! Anyway: my suggestion is we do a Zoom chat, not recorded, Chatham house rules for just us two. Clear the air. I’ll tell you some things you don’t know yet, and vice versa. Win win.
Jul 8, 2024
Dewi Evans sent the following message at 10:42 AM
10:42 AM Currently getting over Covid, so back to normal next week. Afraid I don’t agree with you re the verdict. Letby was as guilty as they come. And to date, I’ve not seen a single comment from a suitably qualified person or institution that offers a reasoned defence. As for social media – best to give it a big ignoral. CCRC? As a witness of course one has to work within the system, but recognise its limitations. As for other cases, I expect that the police are investigating them. They involve displacement of breathing tubes for no apparent reason. And of course Lucy Letby was the nurse looking after the baby at the time. I’m not in touch with the police or the investigation any longer, so it will be interesting to find the outcome. My hunch is that there are quite a lot of other cases out there. [Interesting that since she was suspended in July 2016 (and I knew nothing about that before the trial) there have been few deaths at Chester apparently, and no ‘suspicious’ events.]
Jul 25, 2024
Richard Gill sent the following message at 7:27 PM
7:27 PM You would say that, wouldn’t you. Sorry, you are going to end up on the wrong side of history. “No apparent reason” does not equal “murder”. There are plenty of reasons breathing tubes get displaced. A person who gives expert evidence must be completely neutral and mention alternative explanations and margins of error. They must be fully qualified too. I’m sorry, but you are going to be in deep trouble.
Dewi Evans sent the following message at 8:07 PM
8:07 PM Richard. Just asking. Have you seen the clinical records of the babies? Have you seen / read the statements of the local medics and nurses? Have you read the statements of the parents? Were you at the trial? Does your medical experience extend beyond knowing which side of the bandaid you put on the wound? Cheshire Police are reviewing the notes of all babies at Chester, with the aid of an experienced neonatologist – I’m not involved and unaware of the findings. Don’t know if they are employing a statistician. So, Richard. Stick to your opinion. I’m still waiting for your evidence. But, for the record. None of my reports was based on “statistics”. It was based on Evidence. Look up its meaning. Her arrest, her charging, her guilty verdict had nothing to do with “statistics”. It was based on the Evidence of 6 independent experienced doctors, and the evidence of numerous local nurses and doctors. Evidence dear boy, Evidence! As for the Defence. It was their decision not to call evidence from independent clinicians and pathologists. Why do you think that was? Apart from the local plumber of course. Does one therefore assume that they consider your opinion less useful than that of a local plumber. Finally. Please do NOT make accusations about my evidence, or alleging that my evidence is not impartial. Half of my reports in criminal cases are at the request of the Defence. My most recent report for the Defence, just a few weeks ago, led to the Prosecution withdrawing the allegations within 2 hours of the opening of the trial. As for breathing tubes getting displaced for a number of reasons. For once you are correct. If you had listened to my evidence you would have known that I did not allege deliberate displacement of a breathing tube in any of the cases where I gave evidence. So, I’ll stick with the facts. Endorsed so far by judge and jury, Appeal Judge and 3 Appeal Court Judges. Not too bad I suppose. I look forward to your answers to my questions. I’m sorry if the facts (that word Evidence once more) get in the way of your opinion. But there you are. That’s a problem for you to address. Don’t see much point in engaging in a continuing dialogue. But thought that I should respond once.
Jul 26, 2024
Richard Gill sent the following messages at 11:08 AM
11:08 AM Thanks. I hope you will keep your mind open to new evidence as it comes to light, like a real scientist always does. I hope you will also bear in mind the growing criticism against our judges and courts. UK criminal justice is just as broken as the NHS. I too stick to the facts. The fact is that Brearey and Jayaram ran to the police when they realised that they were in deep shit due to the RCPCH findings. The fact is that you violated the duty of a scientific expert, but of course, as you said, you are not really. a scientist.
11:11 AM PS thanks for keeping the line of contact open! I still think that you have a fantastic opportunity to display wisdom and integrity. Do not let yourself be led by pride and vanity. Read the RSS report with great care. I talk to enough doctors who are better qualified than you to interpret those clinical notes, and many of them have access to those notes now. The arguments of appeal judges just show what big fools those people are. Also puffed up with vanity.
Dewi Evans sent the following message at 2:31 PM
2:31 PM Not seen the RSS report! You are welcome to send it, or send me the link. But as I said, my evidence had nothing to do with statistics.
Richard Gill sent the following messages at 4:07 PM
4:13 PM The defence didn’t understand medicine, didn’t understand science, didn’t understand statistics. Yeah – lawyers. Defence scored an own-goal by not disputing the interpretation of the immunoassay results. I just talked to a prominent UK professor of paediatrics. I asked him what he thought about the insulin? He basically said it was just bollocks and he explained why. This means that the evidence of Hindmarsh, Milan and Wark was just bollocks too. It may take 10 years, knowing UK criminal justice, but Lucy is going to walk free, you mark my words. Cheshire Constabulary have made enormous fools of themselves, costing the UK taxpayer millions, and by digging themselves in they are only making the debacle for themselves worse.
Dewi Evans sent the following messages at 4:54 PM
4:54 PM Who’s this professor of paediatrics Richard?
4:55 PM I’ll read the 64 page report over the weekend.
Jul 27, 2024
Richard Gill sent the following messages at 6:18 AM
6:18 AM I can’t tell you that professor’s name, sorry. Enjoy your weekend! Let me know if you have any questions about the report. It went pre-trial to defence, to prosecution, and in fact to all concerned parties. The man from the CPS said to me (at a pre-publication try out at the Newton Institute in Cambridge) “we are not using any statistics in the Letby case. They only makes people confused”. The defence too just did not understand the statistical issues, which are issues of scientific research methodology. And of forensic scientific investigation methodology. They got comprehensive advice from a very competent statistician but did not understand a word of it.
6:23 AM Sarrita Adams and I sent her medical analyses to the court during the trial, as an amicus brief. It was intercepted by Cheshire Police who sent Dutch police to my door in the night to deliver an intimidating letter. It threatened arrest next time I visited UK, two years in jail, and the cost of re-running the whole trial. The witch-burning mob doxed by mother’s address in a care home in Marlow, Bucks, and planned a demonstration outside. My Mother was 97. They also disrupted a lecture I gave at Liverpool University. The Mirror wrote that I was a sick and deluded conspiracy theorist and that I was attempting to corrupt the youth of England at the university, so the university authorities were evil too. Yep. All in a day’s work when you stand up against a witch hunt. Just so you know you are not the only guy getting publicly attacked in the media.
5:47 PM A friend – professor of mathematics – recently asked me: “I can’t understand why medical experts seem to often be so dishonest”. Here is my answer: “They are not scientists. They are trained to be rapid judges and executioners. That’s one thing. The other thing is the medical hierarchy, and clan forming. The paediatricians are more concerned with the paediatricians than with their patients. The youngest and least paid always have to get the blame to protect the reputation and earning power of the older and most highly paid.” These are unfortunately easily verifiable true facts! Think of all those who kept on supporting Prof Sir Roy Meadow. Maybe he was a good children’s doctor. He was however a lousy statistician and a lousy psychologist and this caused enormous disasters. No doubt he was a charming and amicable man. I always invoke Hanlon’s razor. Stupidity is a more likely cause of despicable behaviour than malice.
9:12 AM Here’s a name for you. Dr Svilena Dimitrova, NHS consultant neonatologist. Neonatologists against the paediatricians? CoCH had no neonatologist. Your friend well-known bully Dr Stephen Brearey “had an interest in neonatology” but was not a neonatologist. RCPCH (paediatricians!) told CoCH to recruit a neonatologist immediately.
9:14 AM I’m not saying it’s all your fault. Police lie and cheat. This has been proven again and again. Cheshire Constabulary have an especially bad reputation in this respect. I think you should cut all links with the bad guys and change sides as fast as possible, if only to save your own skin.
9:16 AM The momentum is growing. The Lucy Letby case is the biggest miscarriage of justice in the UK since the Guildford 4 and the Liverpool 6 (or were they 7 or were the numbers the other way round?). Just like the Lucia de Berk case in the Netherlands. The two cases are carbon copies of one another, but things panned out much worse in every respect in the UK. Utterly failed NHS, utterly failed CJS. Appalling gutter press. You should give an interview to a quality newspaper for a change.
Sep 13, 2024
7:07 PM Intelligent life outside the M25: what do you think of me then?
7:11 PM Babies do just suddenly drop dead. The Lucia de Berk case made that clear.
7:17 PM Unexplained and unexpected actually does happen all the time.
7:24 PM How did you exclude infection?
7:38 PM There is not one unrecordable explanation of a low C-peptide level. One of the explanations is that it is too high!!!!
9:37 AM Hi Dewi, yet again, I want to suggest you change sides! Become a hero. I know you do have the guts to do it, you are not a scared little man. I hope you’ve now studied Marks and Wark (2013) https://pubmed.ncbi.nlm.nih.gov/23751444/. It has a great summary of recommendations at the end. You see, Lucy Letby is innocent, 100% (ie, 99.99% certain, at least). Shall I show you the calculation? Science thrives on the clash of theories. As Niels Bohr once said “now we have a contradiction, at last we can make progress”. I honestly wish you well and know you are a good guy at heart. Forensic aspects of insulin – PubMedpubmed.ncbi.nlm.nih.gov
11:28 PM So you made a nice start, changing your expert medical opinion on three cases! But you are still convinced Lucy Letby was responsible. Surely that can only be by a statistical argument? But where are your statistical calculations and statistical qualifications? As far as I know neither police nor prosecution used testimony from a statistician. Lucy was often present at unpleasant events, but she worked the most hours of any nurse on that unit, and eagerly took the hardest shifts. Lucy’s defence team let her down badly, the judge was disgustingly biased. The whole disaster was not your fault. NHS managers and lawyers have a lot to answer for. Many reforms are needed. But they can only come if the system admits its failings.
11:32 PM I offered my services to defence, prosecution, and to the court. But no one wanted to know. Cheshire constabulary threatened me and sent Dutch police to my door in the night, to deliver a letter in person which I’d already received by email. Very intimidating. They needed legal proof I’d received their warning.
I just recently became aware of a deep connection between Countess of Chester hospital and radical restructuring of the NHS in the early 90’s, which brought in new layers of bureaucracy and internal competition. Don’t coordinate and distribute. Instead, let hospitals compete, survival of the fittest, dynamic leadership,and innovation! We’ll end up with better health care for less money.
The connection is Sir Duncan Nichol, former chairman of the Countess of Chester hospital trust. That’s a higher management level than the hospital executive board. Side effect of the innovations was more managers with even bigger top salaries. But Nichol is not just any manager. He’s a former NHS chief-executive, “part tycoon, part mandarin”. Read all about Sir Duncan’s innovations here: https://www.managementtoday.co.uk/uk-profile-sir-duncan-nichol-nhs-chief-executive/article/409550
Here are some more quotes from Management Today, emphasis added by myself.
“Nichol helped oversee the greatest shake-up in the health service since the war. Out went the old-style consensus management where low-grade administrators charged round trying to keep high-grade doctors happy; in came a whole raft of modern business nostrums: greater pressure on cost-efficiency and customer satisfaction, the introduction of ‘internal markets’, the separation of key functions like purchasing and service provision, and, of course, the increasing use of snappy titles like chief executive and general manager.”
“Some, still seething at the enforced changes, argue that you cannot apply market doctrines to the basic tenets of caring and curing. Others, especially those working in conventional businesses, remain unconvinced that any amount of fancy tinkering will change the nature of the beast. The last few years, they note, have still been dotted with high profile examples of cash squandering on a massive scale.”
I would recommend everyone interested in the Lucy Letby case to carefully study the 58 page appeal judgement – a board of three judges refused Lucy’s application to appeal. It is only 58 pages, it is well written and carefully argued… It is just built on heaps of false assumptions. What it says about the insulin evidence is particularly significant.
Three points specifically concern the insulin babies, babies F and L: points 14, 30 and 104 [and another on the evidence of Prof Hindmarsh, which I won’t go into right now.] Here they are in italics; my underlining.
14. A proposed ground 4 (that the jury were wrongly directed on evidence relating to the persistence of insulin in the bloodstream) was withdrawn following the refusal of leave to appeal by the single judge.
30. At trial, the integrity of the blood samples and reliability of the biochemical testing was challenged by Mr Myers. However, in her evidence at trial, the applicant [Lucy Letby!] admitted that both babies had been poisoned by insulin, but denied that she was the poisoner. The prosecution relied upon the unlikelihood of there being two poisoners at work on the unit. As the judge expressed it shortly before the jury retired to consider their verdicts: “If you are sure that two of the babies…had Actrapid, manufactured insulin, inserted into the infusion bag that were set up for them 8 months apart in August 2015 and April 2016 respectively, and you are sure that that was done deliberately, you then have to consider whether that may have been a coincidence, two different people independently acting in that way or were they the acts of the one person and, if so, who.”
104. The prosecution made some general points to rebut the allegations of bias and unreliability, including that almost every opinion given by Dr Evans was corroborated by another expert. In addition, it was pointed out that Dr Evans was the person who had identified that two of the babies had been poisoned by insulin (Baby F and Baby L). This was a matter which had eluded the treating medics and went to prove that someone was committing serious offences against babies in the unit; and it was particularly important independent evidence, bolstering Dr Evans’ credibility and reliability. Further, when Dr Evans reached his conclusions, he did so without knowing about other circumstantial evidence relied on by the prosecution in establishing guilt, including the applicant’s Facebook searches, the shift pattern evidence, and the “confession” in the note recovered from the applicant’s home on 3 July 2018
Richard’s comment on point 30: the applicant was told during the trial that it had been proven that two babies had been poisoned. Her reply was not that she admitted this fact, it was more like “well if you say it is proven it must be true. But I didn’t do it”. Notice that for the prosecution, six experts all say that this was true: Evans, Bohin, Hindmarsh, Milan, Wark; the hospital doctors had concurred (Gibbs, in particular). The defence had apparently not even looked for an expert on the insulin matter. They had raised problems about the reliability of the tests but these are ignored because Lucy herself agrees that the babies were poisoned with hospital insulin.
How can a young nurse agree or disagree with a deduction made by half a dozen senior medics that the immunoassay results proved deliberate insulin poisoning? All doctors and nurses have been taught in doctors’ or nurses’ school something about insulin metabolism and know that the ratio of insulin to C-peptide (after someone has been fasting for three hours) should be about 1 to 6. They are not taught anything about the forensic determination of deliberate insulin poisoning, which tells us that an anomalous ratio is a warning sign for something that might have been happened but it should be followed up with completely different tests which exclude a numerous sets of artefacts which can each also cause an anomalous ratio of immunoassays’ numbers. The test result comes back from the lab with a warning note printed in red with exactly this information. It was ignored by hospital doctors. The specialists weren’t called in and never told about it. The babies were nicely recovering from their hypoglycaemia and were rapidly transferred elsewhere.
Note that according to point 14 the defence had submitted and withdrawn a “ground for appeal” concerning the insulin. [I don’t know what it was, someone should find out!]. Note that the insulin is seen by all concerned as proof of presence of a murderer on the unit. The court of appeal sees it as ludicrous to suggest there are two murderers on the unit! They believe that the other evidence (air embolism etc etc) proves Lucy is a murderer. The insulin evidence shows someone tried to murder babies F and L. There can’t be two murderers. Therefore Lucy also tried to murder babies F and L.
The logic of the argument is impeccable. Just the premises of the argument are wrong.
These points do show the utter incompetence of the defence team.
One of the prosecution experts (Gwen Wark) has even published a paper Marks and Wark (2013) with a concluding list of recommendations which state that the immunoassay only suggests a possibility; in order to prove it other tests must be done. https://pubmed.ncbi.nlm.nih.gov/23751444/ They were not done. No sample was saved so they never can be done. Both babies F and L are alive and well to this day though one has cerebral palsy … linked to problems experienced during birth.
At the trial Dr. Wark confirmed the other experts’ claim that insulin poisoning had been proven. How could she? What had she written in any written testimony provided pre trial to police or CPS? Richard Thomas (Lucy’s solicitor) says that the defence team can’t say whether or not any documents exist and whether or not they saw them. The jury is not shown any such documents.
People say “the jury was given so much more, information…”. That is quite simply not true. The jury in a UK criminal trial hears what is said and it observes the body language. That’s all. It does not receive copies of written testimony of scientific experts. (This is a consequence of “open justice” with a trial by a jury of your peers).
What was the fifth ground in the original application for an appeal? The one which a single judge scrapped and the defence team then scrapped too?
Maybe some journalist should chase after that. I’m afraid the defence team is unlikely to tell us. They are not obliged to, and they can only do it if Lucy instructs them to do so. And nobody is able to talk to her.