Experts tell BBC about Lucy Letby medical evidence concerns

Senior doctors and scientists person told the BBC they person concerns astir however important grounds was presented to the assemblage astatine Lucy Letby's trials.

The BBC’s File connected 4 has examined however adept witnesses helped to physique the lawsuit against the erstwhile nurse.

The programme raises concerns astir however courts grapple with cases of important aesculapian complexity - with the juries successful Letby’s 2 trials presented with immense amounts of analyzable aesculapian grounds relating to each child.

The experts who spoke to the BBC rise questions astir the magnitude of insulin she needed to harm babies successful her care, the wellness information of 1 of the babies she was convicted of murdering, and pathology findings presented to the jury.

A nationalist enquiry is nether mode to found however Letby was capable to execution and injure babies. At its opening Lady Justice Thirlwall was scathing astir those who person questioned the verdicts, saying this was causing “enormous further distress to the parents”.

Last period immoderate of the families of the babies gave grounds astatine the inquiry.

Each of the experts interviewed by File connected 4 admit however hard it indispensable beryllium for the families to perceive doubts raised astir the trials. However, they accidental they consciousness truthful powerfully astir the grounds they felt compelled to talk out.

BBC File connected 4 examines immoderate of the astir contentious statistical, technological and aesculapian grounds successful the Lucy Letby trial. Listen to Lucy Letby: The Killer Questions

Available present connected BBC Sounds and connected BBC Radio 4 connected Tue 1 Oct 1 astatine 20:00, and Wed 2 Oct astatine 11:00.

More than 100 days of analyzable grounds was heard during Letby's archetypal trial, which ended successful August 2023. She was recovered blameworthy of murdering 7 babies and trying to termination six others betwixt June 2015 and June 2016 astatine the Countess of Chester Hospital.

In a 2nd proceedings held this year, a antithetic assemblage recovered Letby blameworthy of attempted execution - aft the archetypal assemblage failed to scope a verdict. She is serving 15 whole-life sentences and 4 judges person dismissed her effort to entreaty these convictions.

Most of the experts File connected 4 spoke to were not contiguous astatine the trials, and they don’t connection an sentiment connected her guilt. They person studied cardinal aesculapian grounds presented successful court. Their concerns - that immoderate of it was misinterpreted - signifier portion of the increasing speculation astir her convictions.

It comes aft Letby’s caller lawyer, Mark McDonald, told the BBC helium plans to instrumentality her lawsuit to the Criminal Cases Review Commission (CCRC), which investigates alleged miscarriages of justice.

At her archetypal proceedings Letby was recovered blameworthy of attempting to execution 2 babies - referred to successful tribunal arsenic Baby F and Baby L - by adding insulin to intravenous provender bags.

The prosecution said some babies were doing good until Letby attacked them, and that it was suspicious she aboriginal searched for the parents connected Facebook.

The prosecution alleged it would person taken lone a fewer drops to poison each baby, but File connected 4 has spoken to a squad of mechanical and chemic engineers who disagree - and who are speaking astir their calculations for the archetypal time.

Prof Geoff Chase, from the University of Canterbury successful New Zealand, has been modelling however insulin works successful pre-term babies for much than 15 years. He worked with chemic technologist Helen Shannon connected a mathematical exemplary that calculated importantly higher quantities of insulin would beryllium needed to harm babies F and L, and to make insulin levels seen successful their trial results. In the lawsuit of Baby L they calculated it could beryllium arsenic overmuch arsenic 20-80 times more.

There was nary grounds successful the proceedings to suggest important quantities of insulin had gone missing connected the ward.

Speaking to File connected 4, different adept expressed concerns astir the usage of the aforesaid humor trial results astatine the proceedings - thing others person questioned successful the media.

Dr Adel Ismail - a world-leading adept successful the trial - told the BBC helium believes the immunoassay humor trial tin nutrient misleading results.

“In my research, I recovered the mistake complaint is 1 successful 200,” helium said, and added that a second, confirmatory trial successful specified cases was “absolutely vital”. In the lawsuit of Baby F and Baby L follow-up tests were not carried retired by the lab.

Some experts, however, accidental the tests are bully capable to trust connected 1 acceptable of results. The infirmary didn’t bid further tests due to the fact that some babies recovered soon after.

Letby was besides recovered blameworthy of murdering a babe referred to successful tribunal arsenic Baby C.

Key to the lawsuit was an X-ray taken connected 12 June - it was referred to repeatedly during the archetypal trial. In pre-trial reports 2 prosecution witnesses said it showed the babe had a swollen tummy “most apt owed to deliberate” pumping of aerial into his feeding tube.

However, neonatologist Dr Michael Hall - who has spoken publically astir his concerns before, and has written to the seat of the nationalist enquiry - told the BBC: “There are a fig of imaginable explanations for determination being excess state there.”

Dr Hall, who was consulted by the defence but ne'er called to springiness evidence, said it is apt to person been caused by the respiratory enactment the babe was receiving and said the X-ray suggested determination was a bowel obstruction.

Letby was not moving connected the time the X-ray was taken and had not been connected displacement since earlier the babe was calved - accusation the assemblage heard successful her archetypal trial. Letby’s erstwhile barrister Ben Myers besides highlighted these details successful his closing argument.

In his summing up the justice made wide to the assemblage this X-ray had been taken the time earlier Baby C collapsed, though helium didn’t punctual them Letby hadn’t been connected shift. At appeal, the prosecution said Letby could person visited the infirmary portion disconnected shift, but didn’t enactment guardant immoderate grounds that she was there.

The BBC has besides spoken to 5 elder clinicians who reviewed Baby C’s aesculapian notes made nationalist astatine proceedings - though lone 1 had entree to the baby’s implicit aesculapian history. They each noted the babe was precocious hazard and should person been successful a higher level unit.

Prof Colin Morley, a retired prof of neonatology from the University of Cambridge, told File connected 4 helium was “very confident” Baby C died of earthy causes.

At the trial, the X-ray was not the lone grounds utilized to convict Letby connected this charge. The prosecution argued substance messages showed she was hopeless to get into the country wherever Baby C was being treated, adjacent though she wasn’t his designated nurse. Another caregiver said she recovered Letby lasting implicit the baby’s cot erstwhile helium collapsed. After helium died, Letby again searched for his parents connected Facebook.

Baby O was 1 of triplet brothers calved successful bully information successful June 2016. He was stable, Letby’s archetypal proceedings was told, until the day of 23 June erstwhile helium suffered a "remarkable deterioration” and aboriginal died.

The pathologist for the prosecution, who reviewed the case, said helium believed Baby O had suffered an "impact injury" to his liver akin to a roadworthy postulation collision.

There was different grounds utilized to convict Letby of Baby O’s murder. She objected to the babe being moved to different country of the portion to beryllium much intimately monitored. She was accused of falsifying aesculapian notes, and determination was a rash which prosecution experts said was accordant with aerial being injected into the baby’s veins.

However, a starring elder perinatal pathologist told File connected 4 she agrees with the archetypal post-mortem connected Baby O - that his liver wounded and decease were by earthy causes.

The pathologist - who asked not to beryllium identified due to the fact that of the arguable quality of Letby's lawsuit - said she has seen this benignant of liver harm astatine slightest 3 times successful her career. Each clip determination were earthy causes.

None of the experts who spoke to File connected 4 made immoderate valuation of Letby’s guilt oregon otherwise, but added their concerns to increasing speculation astir however analyzable aesculapian grounds was presented astatine her trials.

In August, 24 experts wrote to the authorities to stock their concerns implicit the mode statistic and the subject astir newborn babies was presented to the assemblage astatine the erstwhile nurse's archetypal trial.

The Crown Prosecution Service told the BBC: “Two juries and 3 entreaty tribunal judges person reviewed the grounds against Lucy Letby, and she has been convicted connected 15 abstracted counts pursuing 2 abstracted trials.”

It said successful May the Court of Appeal dismissed Letby’s permission to entreaty connected each grounds – rejecting her statement that adept prosecution grounds was flawed.