Draft:Lucy Letby Miscarriage of Justice Claims

The King v. Lucy Letby
CourtManchester Crown Court
Decided18th of August, 2023
VerdictLucy Letby found:
Case history
Subsequent action(s)
Court membership
Judge(s) sittingSir James Richard William Goss

Both during the trial and immediately following the announcement of the verdicts, individuals, including journalists, scientists and academics and researchers have questioned the reliability of the evidence used to convict paediatric nurse Lucy Letby. Letby was sentenced to life imprisonment with a whole life order on 21 August 2023 for murdering seven infants and attempting to murder six more while working as a neonatal nurse at the Countess of Chester Hospital in Chester, England.

Discussion of the possibility of a miscarriage of justice has thus far been limited to opinion articles, internet forums, blogs and interviews in opinion-oriented media outlets. An organisation calling itself 'Science on Trial' announced on the 24th of August its aim of ensuring a retrial for Lucy Letby who, it claims, received an unsafe guilty verdict. Aspects of the case which have been invoked as indicative of a possible miscarriage of justice revolve around the prosecution's substantial dependence on circumstantial evidence, the quality of the prosecution's medical and statistical evidence, and other explanatory factors pertaining to the condition and management of the neonatal unit itself.

Background

Lucy Letby's arrest came as a result of a number of consultants, primarily Dr Stephen Brearey, the neonatal lead, and Dr Ravi Jayaram, a consultant paediatrician, insisting that hospital executives involve the police. The consultants had began to accumulate circumstantial evidence since June 2015 when their suspicions against Letby first arose.[1] Despite raising their concerns, they were reprimanded by hospital executives for victimising and harassing Lucy Letby. She in turn raised a formal grievance against them.[2] During the trial, Lucy Letby identified four consultants who she believed "apportioned blame" on her as way to "cover failings at the hospital". The consultants were Dr Stephen Brearey, Dr Ravi Jayaram, Dr John Gibbs and one other consultant who was not named for legal reasons.[3]

The timeline of events at the hospital which culminated in consultants contacting Cheshire police is as follows:

  • On June 8 2015 Child A, a premature newborn twin, suddenly collapses on the neonatal unit. Dr Ravi Jayaram, who responds to the emergency alert, later testified that he noticed "pink patches, mainly on the torso, which seemed to appear and disappear and flit around". He added: "I could not explain the sequence of events, why they had happened. I couldn’t explain why it had happened in the first place and couldn’t explain why the physiological responses to timely and appropriate interventions did not happen as they should have happened." Dr Jayaram does not mention the skin discolouration in the clinical notes he made three hours after Child A died. He testified "I didn’t appreciate the clinical significance of this whatsoever". When asked why he also failed to mention it to the coroner presiding over the inquest of Child A, Dr Jayaram replied: "My concluding remarks when I gave evidence is that I couldn’t explain how this had happened, It was not my job to say ‘it may have been this’ because at that time I had no evidence".[4]
  • Around midnight on 9 June 2015, Child B begins to desaturate. She displays signs of cyanosis, is not breathing and limp. She is resuscitated and makes a "remarkable recovery".[5]
  • In the early hours of 14 June 2015 Child C suddenly collapses. He is pronounced dead at 5:50am. An independent coroner later found that Child C suffered a heart attack after his breathing became compromised.[5]
  • On 21/22 June 2015, Child D collapses three times, the last one being fatal. Those present notice discolouration on the baby's skin.[5]
  • Towards the end of June 2015, after Child D's death, Dr Stephen Brearey notices that Lucy Letby is on shift for each instance of four collapses, three of them fatal, in the last two weeks. She is the only nurse present in each case. Dr Brearey shares this informal review with Dr Ravi Jayaram. He tells Dr Jayaram that nothing linked the deaths "other than one nurse". The deaths are reported by consultants to hospital's trust committee for serious incidents. The hospital classifies them as "medication errors" and not a "serious incident involving an unexpected death".[6]
  • By June 2015, Dr Brearey, Dr Jayaram and "other colleagues" all identify Miss Letby as a potential link.[7]
  • On 2 July 2015, Dr Stephen Brearey, Eirian Powell, a nurse and ward manager responsible for the nursing staff on the neonatal unit, and Allison Kelly, director of nursing at the hospital hold a meeting. Lucy's presence when the three deaths occurred is discussed.[8]
  • By October 2015, seven infants have died in unusual circumstances. Dr Brearey openly suspects Miss Letby is harming children. Miss Letby will go on to be convicted for murdering five of these infants. The remaining two, despite being investigated by the police, were never bought to trial.[8]
  • On 23 October 2015 Eirian Powell emailed the findings of her own review of these collapses to Stephen Brearey. She states "I have devised a document to reflect the information clearly and it is unfortunate she [Miss Letby] is on [shift] - however each cause of death was different, some were poorly prior to their arrival on the unit and the other were ?NEC or gastric bleeding/congenital abnormalities. I have attached the document for your perusal".[6]
  • In February 2016 Dr Brearey orders a half-day thematic review into the deaths and collapses with the help of Consultant Neonatologist at Liverpool Women’s NHS Foundation Trust Dr Nimish Subhedar. It finds several common links in nine unusual deaths since June 2015. Four of these were never brought to trial.[6]
  • On February 15 2016, The report is sent to Ian Harvey, the hospital’s medical director and second in charge, and Allison Kelly. It includes a table of the nine deaths identified in the review, showing Miss Letby is on shift for each one. Dr Brearey requests an "urgent meeting". Management determine Miss Letby's presence is a coincidence.[6]
  • On March 17 2016, Eirian Powell & Allison Kelly discuss via email how Miss Letby was a commonality in the deaths.[6]
  • On April 7 2016, Eirian Powell moves Miss Letby to day shifts to support her wellbeing because she had been present for so many of the collapses.[9]
  • On April 9 2016, Child M suffers a dramatic drop in heart rate and breathing.[5] Since this occurs during a day shift, the consultants and later the prosecution used this to suggest that deaths and collapses "follow" Miss Letby.[6]
  • In May 2016, Dr Brearey emails Allison Kelly, flagging Miss Letby's presence at the deaths and asking for a meeting. Allison Kelly forwards the email to Ian Harvey expressing alarm that a doctor was implicating a nurse. She tells Ian Harvey that there was no evidence but that a wider review might be needed. Allison Kelly asks senior nurse managers to examine any staffing trend linked to the deaths, adding that it was "potentially very serious".[8][6]
  • On 11 May 2016 Dr Brearey and other doctors meet Kelly and Harvey to discuss their concerns about Miss Letby. The senior managers produce a two page "assurance" document detailing why Miss Letby is not believed to be the cause of the unusual deaths. It suggested other NHS services may be to blame for the spike in deaths and that: "There is no evidence whatsoever against LL other than coincidence". They agree to review all the deaths and keep Miss Letby on day shifts for three months. Dr Brearey feels his concerns have been dismissed.[8][6]
  • On 16 May 2016, a senior doctor tells Eirian Powell during a meeting: "You are harbouring a murderer".[6]
  • On 23 June 2016 newborn triplet, Child O, dies after a number of collapses.[5]
  • On 24 June 2016 Child P, the brother of Child O, suffers an 'acute deterioration'. He suffers a number of collapses and is finally pronounced dead at 4pm. The coroner later recorded the death as 'prematurity'. The prosecution later claimed Miss Letby injected air into his stomach.[5] Stephen Brearey calls hospital nursing director Karen Rees to express his concerns. He no longer wants Miss Letby working on the unit. Rees insists there is no evidence against Miss Letby and says she will take responsibility for allowing her to continue to work.[6]
  • On 29 June 2016 the entire consultant body at the hospital hold a meeting concerning the collapses. Air embolism is one of the topics discussed. That evening Dr Jayaram conducts a literature search and comes across the 1989 medical paper titled "Pulmonary Vascular Air Embolism In The Newborn". Dr Jayaram will later testify to the court that the paper describes a series of accidental events of air embolism. The context within which the research paper studies air embolism is as an inadvertent complication of mechanical ventilation. Dr Jayaram emails links to the medical paper to colleagues the next day.[7]
  • In late June 2016 emails are exchanged between nurses, doctors and hospital executives. One doctor recommends calling the police. Ian Harvey replies to the chain saying concerns were being "discussed and actions taken". Executive directors at the hospital meet and debate calling the police for the first time. They consider the impact of an investigation and arrest, and subsequent reputational issues and impact on the trust. They acknowledge the evidence is circumstantial and express their concerns about the unit's leadership. They fear the doctors are carrying out a witch-hunt. The trust do not contact the police. The neonatal unit is downgraded to level 1 so that the sickest and most premature children are sent to neighbouring hospitals. Ian Harvey and Tony Chambers, the hospital's chief executive, contacts the Royal College of Paediatrics and Child Health and asks them to review the neonatal unit's service level. The hospital's executives meet the doctors and tell them they considered contacting the police but decided to handle it in a different way.[6]
  • By July 2016 there has 14 neonatal deaths on the unit in just over a year. The nursing director conducts an internal review. It notes "higher acuity levels, higher activity and short staffing levels" may have been contributing factors. No mention is made of any concerns regarding any individual.[10] Miss Letby is called to a meeting with a senior nurse and a HR Manager. She is told for the first time of her association with the infant deaths. She is visibly upset and distressed. The decision has been to place her under supervision, alongside other staff.[6]
  • In mid-July 2016 Miss Letby is redeployed to the hospital's risk and patient safety office. Staff shortages on the neonatal unit meant supervision of her was not possible after all.[11][6]
  • In early September 2016, the RCPCH arrive and begin their investigation. Miss Letby is one of the first to be interviewed.[6]
  • On 7 September 2016 Miss Letby submits a formal grievance against the trust for victimisation and discrimination at being removed removed from the ward. This is after learning through her Royal College of Nursing representative of the concerns by doctors on the unit.[10]
  • In October 2016 the RCPCH submit their findings to Harvey and Chambers. They state the situation "appears unusual and needs further inquiry to try to explain the cluster of deaths".[6] A draft version of the report is drawn up. Concerns regarding lack of staff and clinical practices are expressed. It also states that increased volume of cases with increased acuity levels was an inadequate explanation for the high mortality rate. It also says there "no obvious factors which linked the deaths and that circumstances in the unit were not materially different from those which might be found in many other neonatal units". However it recommends detailed case reviews are needed for each of the deaths, including examination of obstetric, pathology, nursing and post-mortem indicators.[10] It also includes a confidential section linking the deaths with Miss Letby and the subjective concerns of Dr Stephen Brearey, the neonatal lead. This section is redacted from the version circulated to the board, the doctors and the bereaved parents.[6] Ian Harvey contacts Dr Jane Hawdon, a neonatalogist, asking her to carry out a forensic review of each death.[12] Hawdon produces a five page review but tells Harvey she did not have the time to conduct the thorough investigation the royal college had recommended. Nonetheless it cited four cases which could not be explained but would "potentially benefit from local forensic review as to circumstances, personnel etc."[13][10] The executive managers meet again and agree that not calling the police the was the right decision as the doctors' evidence was "unconvincing".[6]
  • In November 2016 two and a half months have passed since Miss Letby's grievance. During the investigation, Doctors who raised concerns about her causing harm to infants, including Brearey and Jayaram, were interviewed, with their union reps present, by an investigator. The investigation finds no evidence to justify calling in the police. Instead it finds the doctors are at fault for suspecting her of murder. "This behaviour has resulted in you, a junior colleague and fellow professional, feeling isolated and vulnerable, putting your reputation in question," the grievance inquiry told Letby. "This is unacceptable and could be viewed as victimisation".[6]
  • On 12 November 2016 HR prepare Miss Letby's return to the neonatal unit.[6]
  • On 22 December 2016 Miss Letby is issued with a full apology by Tony Chambers on behalf of the hospital. She and her family are told the doctors who had accused her would be reprimanded.[6]
  • In January 2017 the hospital board convene meeting to discuss the RCPCH review. Ian Harvey says the review found the incidents were down to issues of "leadership, escalation and timely intervention... not any single individual".[6] In a separate meeting, Harvey and Chambers tell seven clinicians, including Brearey and Jayaram, that "things have been said and done that were below the values and standards of the trust." He insisted on mediation between Miss Letby and both Brearey and Jayaram which would protect them should they be referred to the General Medical Council (GMC). They were also advised by a British Medical Association rep to write a letter of apology to Miss Letby.[6]
  • In late January 2023 the doctors write to Harvey. They ask "what is the reason for the unexpected and unexplained deaths? What should we as paediatricians do now?"[6]
  • On 28 February 2017 the doctors send Miss Letby a letter of apology.[8]
  • In March 2017 the doctors, still seeking an explanation for the deaths and collapses, consult the regional neonatal lead who agrees further investigation is justified for several of the cases.[10]
  • On 27 March 2017 Dr Brearey insists again to Harvey and Chambers on police involvement.[6] The hospital accede to this final demand and the deaths and suspicions are raised through the local child death and overview panel.[10]
  • On 27 April 2017 Detective Superintendent Paul Hughes meets Dr Brearey and Dr Jayaram at the Countess of Chester Hospital. The meeting proved decisive. Dr Jayaram said "the police, after listening to us for 10 minutes, realised this is something they had to be involved in". The very next day Operation Hummingbird is launched.
  • On 18 May 2017 a spokesperson for the hospital issues an official statement: "The Trust and its doctors have continuing concerns about the unexplained deaths and are very keen to understand that everything possible has been done to help determine the causes of death in our neonatal unit between June 2015 and June 2016... As a hospital we have taken the clinical review as far as we can. We have now asked for the input of Cheshire police to seek assurances that enable us to rule out unnatural causes of death.".[14]
  • On 3 July 2018 Miss Letby is arrested.

Evidence

Medical Experts

Dr Dewi Evans

Dr Dewi (David Richard) Evans, a retired paediatric consultant, sent an email to the National Crime Agency in May 2017, nominating himself for involvement in the investigation:

"Incidentally I’ve read about the high rate of babies in Chester and that the police are investigating. Do they have a paediatric/neonatal contact? I was involved in neonatal medicine for 30 years including leading the intensive care set-up in Swansea. I’ve also prepared numerous neonatal cases where clinical negligence was alleged. If the Chester police had no-one in mind I’d be interested to help. Sounds like my kind of case. I understand that the Royal College (of Paediatrics and Child Health) has been involved but from my experience the police are far better at investigating this sort of problem."[15]

Dr Evans' offer was accepted by the National Crime Agency and he was recruited as a medical expert.[16] Chester Police supplied Dr Evans with copies of "the clinical notes of over 30 babies who'd either died or had collapsed between January, 2015 and July 2016".[17] From these clinical notes, Dr Evans identified 15 babies whose collapses or deaths he felt could not be explained as having a natural cause. Instead he felt these babies had died as a result of air embolisms. Dr Dewi Evans stated "it was as if someone had injected air into the circulation directly".[17] Other babies, he felt, had been overfed with milk. There were also more babies who were found with blood around their mouth and throat. Finally in 2018, two separate lots of twins were found with extremely high insulin levels which was taken by the prosecution to be an incontrovertible piece of evidence indicating deliberate harm.[17]

Three months into the trial, Lucy Letby's defence barrister, Ben Myers KC, applied to have Dr Evans' evidence thrown out citing that his witness testimony lacked the crucial requirements of being independent, impartial and objective. He accused him of "reaching for things to support the allegations rather than reflecting the facts". Judge James Goss however denied the application stating it was for the jury "to determine, as with any witness, his (Dr Evans’s) reliability, having regard to all the evidence in the case".[18]

Dr Sandie Bohin

Dr Sandie Bohin, a consultant paediatrician, became involved in 2018 when she was approached by the National Crime Agency to "peer review the findings of Dr Evans".[19] This involved reviewing the same medical notes of babies who had either collapsed or died in "unusual circumstances" that Dr Evans had investigated.[20] Dr Bohin also identified "large columns of air in the blood vessels" in some of the babies after looking at their x-rays. After noticing this she recalled thinking to herself "it has to be deliberate". Dr Bohin was called as an expert witness for the prosecution multiple times during Letby's ten month trial.[21]

Dr Andreas Marnerides

Dr Andreas Marnerides, a neonatal pathologist, was tasked with re-examining the original post mortems of the six of the seven infants Letby was convicted for murdering.[22] A post mortem was not conducted for one of the infants (Child E) and so Dr Marnerides was unable to offer an opinion.[23] At the time the infants died, their official cause of deaths according to their postmortems were determined to be from natural causes. However Dr Evans was suggesting deliberate harm and Dr Marnerides (along with Dr Bohin) supported these conclusions, and testified as such in court. This medical evidence which was accumulated by the prosecution ended up being central and crucial.[24] During cross examination by the defence Dr Marnerides accepted that he relied "upon expert reports from Dr Dewi Evans, Dr Sandie Bohin and other clinicians".[25] At one point during the trial, Dr Andreas Marnerides was asked whether forceful CPR could explain an "inflicted traumatic injury" to the liver of one of the babies. Dr Marnerides replied: "We are not discussing possibilities here, we are discussing probabilities. When you refer to possibilities, I am thinking for example of somebody walking in the middle of the Sahara desert found dead with a pot and head trauma. It is possible the pot fell from the air from a helicopter. The question is ‘is it probable?’ and I don’t think we can say it is probable".[26]

Air Embolisms

The basis of the air embolism suspicions against Letby started when consultant paediatrician Dr Ravi Jayaram began noticing the "strange discolouration" on the skin of infants who had suddenly collapsed. His first experience of this phenomenon, which he "could not explain", began with Child A who he observed had "pink patches, mainly on the torso". Dr Jayaram admitted he "didn’t actually record it in the notes" less than three hours after Child A died because he "didn’t appreciate the clinical significance of this whatsoever". He stated his "focus at the time was on airway, breathing, circulation". He also admitted he failed to mention any "discolouration in a July 2015 statement to the coroner presiding over the inquest of Child A".

Similar skin discolouration was also noticed on Child D who died in July 2015 and who Lucy Letby was ultimately convicted of murdering by injecting air into their bloodstream.[4] Some time after Child D's death, Dr Jayaram encountered upon a research paper written by Canadian scientists from the University of Western Ontario in 1989 titled "Pulmonary Vascular Air Embolism In The Newborn".[27] In court, Dr Jayaram testified that the paper "described a series of accidental events of air embolism".[4] The context within which the research paper studies air embolism is as an inadvertent complication of mechanical ventilation. In 1989, research into this phenomenon was underdeveloped but today "inadequate mechanical ventilation" is well known to be the most common cause of "Air Leak Syndrome" in neonates. One of the conditions associated with Air Leak Syndrome is the type of air embolisms Lucy Letby was convicted of deliberately causing.[28] Furthermore the 1989 research paper cited by the prosecution begins by stating that air embolism in newborns caused by mechanical ventilation are "almost invariably fatal".[29]

According to the research paper, diagnosis of the embolism is usually made from a radiograph but there are "associated phenomena". One of these is "blanching and migrating areas of cutaneous pallor".[30] Researchers also observed "bright pink vessels against a generally cyanosed cutaneous background".[31] They attributed both phenomena "to direct oxygenation" of red blood cells "adjacent to free air in the vascular system, while the tissues continued to be poorly perfused [supplied by blood] and oxygenated".[32] At the time the research paper was being compiled, the researchers asserted that enough cases "have been reported"[33]that a profile of infants "most susceptible to pulmonary vascular air embolism" when using mechanical ventilation has been developed. 91% of the air embolism cases involved in the study matched the following criteria:

  • Premature infants with a mean gestational age of 30 weeks
  • A mean birth weight of 1328g
  • Average age of onset was three days
  • Male:Female ratio of 2:1 (33:16)

In his first police interview in July 2017, Dr Jayaram spoke of the skin discolouration he noticed on Child A. During cross examination by the defence he denied being influenced by what he read in the paper, only regretting that he had not raised this finding earlier.[4]

Dr Evans, and in turn Dr Sandie Bohin, who corroborated Dr Evans' findings, relied principally on this same research paper as Dr Jayaram, in their diagnosis of air embolisms. Whilst the paper does offer an explanation of the skin discolouration, the context of the air embolisms as discussed in the research paper, namely occurring as a consequence of inadequate mechanical ventilation, was not suggested by the defence. Instead they attacked the theory of air embolus altogether. It pointed out that in the case of Child A, no mention of skin discolouration was made in the clinical notes nor to the coroner. It further stated that the scientific evidence of air embolism used by the prosecution was so inadequate that it couldn't be used to support the allegations.[34]

In the 'Pathogenesis' section of the research paper, the history of how the postulation that mechanical ventilation can cause air embolisms in humans is detailed: Two Doctors, Gregory and Tooley, claimed that air embolism can occur as a consequence of 'air being injected into pulmonary veins' by mechanical ventilation. A later study involving a number of dogs suffering from 'Pulmonary Interstitial Emphysema' (PIE), developed pulmonary vascular air embolisms when mechanically ventilated. This partially confirmed Gregory and Tooley postulation. A final study by 'Bowen et al' eventually empirically demonstrated that a connection on a cellular level exists in humans between the airway and the pulmonary interstitium (support tissues in the lungs). This was based on a human infant who died from a pulmonary vascular air embolism when under ventilatory treatment and was subject to a 'barium study'.[35]

In their witness testimony both Dr Evans and Dr Bohin relied extensively on assertions and their own previous experience to determine air embolisms as a cause of death to the exclusion of other presenting symptoms. For example in relation to Child E, Dr Evans provided the following witness testimony: "Child E had massive haemorrhaging from his upper gastrointestinal system and that is not something that occurs as a result of some kind of natural phenomenon." and "I cannot be 100 per cent certain what caused the trauma to the gastrointestinal system but it had to be some kind of relatively stiff (equipment) which was sufficient to cause this extraordinary bleeding." When asked by the prosecution whether there could be an "innocent explanation" for the haemorrhaging, Dr Evans replied: Dr Evans replied: "No. The other explanation for this is a bleeding ulcer. I have never seen a bleeding ulcer cause this sort of presentation."[36] Dr Bohin also testified that she had "never seen a baby have a gastrointestinal haemorrhage in this way".[36] While indeed rare, upper gastrointestinal bleeding is well documented in neonatology. Hemorrhagic disease is a common cause of gastrointestinal haemorrhaging among neonates[37] and if the haemorrhaging is acute, it is well known to be life threatening.[38] According to research conducted in 2023, where upper gastrointestinal bleeding occurs in neonates, severe hemorrhaging (0.25%-0.5%) may result.[39]

In an interview after the trial, Dr Dewi Evans stated "With injection of air, unless someone sees you doing it then you can't prove that anything... it would have been difficult to prove these babies were placed in harm's way".[40]

Insulin

As part of Operation Hummingbird, Dr Brearey was asked by detectives working on the case to specifically look at the care of "siblings and twins" on the unit. On 13 February 2018, Dr Brearey was reviewing the medical records of Child F, a seven-day old infant.[8] He noticed that a blood sample showed "extremely high" insulin and "very low" C-peptide.[41] The insulin levels for Child F, a seven day old neonatal infant, were 4,657 and a C-peptide reading of less than 169.[41] After recovering, Child F was discharged and was not reported to have suffered any medical consequences.[42] Another blood sample for Child L indicated insulin levels of 1,099 and a C-peptide reading of 264.[43] Child L also went on to make a full recovery.[5]

When produced naturally by the body, both insulin and C-peptide are found in relatively equal quantities. The discrepancies for Child F and Child L were taken to be the "smoking gun".[44]

A fatal dose of insulin for an adult human being is in the region of 1000 units.[45]

Media

In an article published in The Mail on Sunday on 23rd of September 2023, Peter Hitchens asks: "What if Lucy Letby is not guilty?"[46] . Reminding readers of the long-standing miscarriage of justice of the Birmingham Six, Hitchens states the jury's decision to convict Letby relied "almost entirely on the basis of circumstances". Judge Goss also stated during the trial that the prosecution's case "substantially, but not wholly" relied on circumstantial evidence. The article also draws parallels in the Lucy Letby case with the wrongfully convicted Lucia de Berk, a Dutch paediatric nurse who was sentenced to life imprisonment in 2003 for the murder of four patients and the attempted murder of three other patients. De Berk was subsequently exonerated in 2010 after flaws in the medical evidence she was convicted on were brought to light.

Writing for The Daily Sceptic, Dr David Livermore, a professor of medical microbiology at the University of East Anglia points out that at the same time Lucy Letby was moved to a desk job, the neonatal unit was downgraded to a Level 1 Special Care Unit meaning it was no longer looking after neonates with gestational maturity of less than 34 weeks.[47] Before the downgrade there were 15 infant deaths on the unit between April 2015 to July 2016. After it was downgraded, a report by the RCPCH found that "significant gaps in both medical and nursing rotas", "poor decision making", "delays in seeking advice" and "delayed retrieval of infants to tertiary units".

Statutory Inquiry

On the 4th of September 2023 Health and Social Care Secretary, Steve Barclay, announced in the House of Commons that the inquiry, initially announced on 18th August, the day of Letby's conviction, had been further upgraded to a statutory inquiry, thereby enabling it to compel witnesses to give evidence under oath. This, he said, would provide families of the infants who died the "answers they deserve, to hold people to account, and to make sure lessons are learned". Whilst the scope of the inquiry is yet to be officially announced, Barclay stated "this inquiry will examine the case’s wider circumstances, including the trust’s response to clinicians who raised the alarm, and the conduct of the wider NHS and its regulators". Kathryn Thirlwall, was appointed as the judge to lead the inquiry.

Between 2009 and 2010 Thirlwall chaired an inquiry into patient deaths at Airedale General Hospital which occurred between 2000 and 2002. Anne Grigg-Booth, a night nurse practitioner, was arrested in 2004 on three counts of murder, one of attempted murder and 13 counts of administering noxious substances with intent to cause harm. In 2005 while awaiting trial she died of an overdose of Mirtazepine, an antidepressant. Despite West Yorkshire Police claiming Grigg-Booth may have killed up to twenty patients, Thirlwall's report concluded the nurse was unlikely to have deliberately set out to harm any patients instead stating the deaths "occurred as a result of a combination of individual and systems failure".

Appeal

Lucy Letby currently remains imprisoned for a whole life order in HM Prison Low Newton, a maximum security prison in County Durham. On the 15th of August 2023 the Court of Appeal confirmed it had received an application for permission to appeal all of the convictions.

References

  1. ^ Halliday, Josh (18 August 2023). "Lucy Letby whistleblower says babies would have lived if hospital had acted sooner". The Guardian. Retrieved 11 October 2023.
  2. ^ "Lucy Letby: Doctors who raised alarm were accused of 'harassing and victimising' killer nurse, says ex-hospital boss". Sky News. 24 August 2023. Retrieved 11 October 2023.
  3. ^ "'Gang of four' consultants pinned baby deaths on me, murder accused nurse Lucy Letby tells trial". ITV News. 18 May 2023. Retrieved 11 October 2023.
  4. ^ a b c d Thomas, James (25 October 2023). "Lucy Letby: consultants tells murder trial skin marks 'didn't fit'". Hereford Times. Retrieved 3 October 2023.
  5. ^ a b c d e f g Wells, Andy; Manning, Ellen (21 August 2023). "Lucy Letby: What happened to each baby murdered by nurse". Yahoo! News. Retrieved 11 October 2023.
  6. ^ a b c d e f g h i j k l m n o p q r s t u v w x Lintern, Shaun; Collins, David (21 August 2023). "'You are harbouring a murderer'". New Zealand Post. Retrieved 11 October 2023.
  7. ^ a b c d e f Halliday, Josh (19 August 2023). "'Trust me, I'm a nurse': Why wasn't Lucy Letby stopped as months of murder went by?". The Guardian. Retrieved 9 October 2023.
  8. ^ Dowling, Mark (6 April 2023). "Lucy Letby 'worried' she was 'in trouble' over baby deaths". Chester Standard. Retrieved 11 October 2023.
  9. ^ a b c d e f Dunhill, Lawrence (18 August 2023). "Revealed: How trust execs resisted concerns over Letby". Health Service Journal. Retrieved 11 October 2023.
  10. ^ Hull, Liz; Bunyan, Nigel (18 August 2023). "The ten missed opportunities to stop Britain's worst modern child killer: Nine babies could have been spared if only bosses had listened to doctors about Lucy Letby... instead they told them to APOLOGISE to her". Daily Mail. Retrieved 11 October 2023.
  11. ^ Raffray, Nathalie (22 August 2023). "Royal Free expert asked to examine Lucy Letby baby deaths". Ham&High. Retrieved 11 October 2023.
  12. ^ Halliday, Josh (20 August 2023). "Lucy Letby NHS trust chair says hospital bosses misled the board". The Guardian. Retrieved 11 October 2023.
  13. ^ de Lucia, Carmella (18 May 2023). "Investigation launched into deaths of eight babies at Countess of Chester Hospital". Cheshire Live. Retrieved 11 October 2023.
  14. ^ Dowling, Mark (7 March 2023). "Medic denies 'touting for job' helping Lucy Letby police probe". Chester Standard. Retrieved 8 October 2023.
  15. ^ Pilling, Kim (18 August 2023). "Bid to exclude evidence of prosecution medical expert was refused by judge". Evening Standard. Retrieved 1 October 2023.
  16. ^ a b c Jones, Branwen (22 August 2023). "Welsh doctor who helped prove babies killed by Lucy Letby were murdered says victims and their families were 'failed'". Wales Online. Retrieved 1 October 2023.
  17. ^ "Bid to exclude evidence of prosecution medical expert was refused by judge". Bracknell News. 18 August 2023. Retrieved 8 October 2023.
  18. ^ Bunyan, Nigel (10 February 2023). "Baby's 'inconsolable' crying 'proved' that nurse Lucy Letby had injected air into the stomach of infant she murdered, expert tells trial". Daily Mail. Retrieved 3 October 2023.
  19. ^ Gauson, Roisin (22 August 2023). "Lucy Letby: Paediatrician who gave evidence in child killer's trial joins calls for public inquiry". ITV News. Retrieved 1 October 2023.
  20. ^ Evans, Holly (28 August 2023). "Lucy Letby witness reveals moment she realised someone was harming babies heard screaming in pain". Independent. Retrieved 8 October 2023.
  21. ^ Hull, Liz (19 August 2023). "The medical evidence that finally caught Lucy Letby: How case against killer nurse hinged on crucial study into air being injected into a baby's blood". Daily Mail. Retrieved 3 October 2023.
  22. ^ Parashar, Arthur (30 March 2023). "Triplet baby boy 'who was killed by nurse Lucy Letby' suffered liver injury akin to a road traffic collision, her trial hears". Daily Mail. Retrieved 3 October 2023.
  23. ^ Clayton, Laura (21 August 2023). ""Harrowing" trial concludes with whole life sentence for killer nurse". Bailiwick Express. Retrieved 8 October 2023.
  24. ^ O'Donoghue, Daniel (30 March 2023). "Lucy Letby: Bruises on baby not caused by CPR, trial told". BBC News. Retrieved 3 October 2023.
  25. ^ Dowling, Mark (30 March 2023). "Letby trial: 'Forceful CPR' could not be cause of baby's liver damage". Chester Standard. Retrieved 8 October 2023.
  26. ^ Lee, SK (1 April 1989). "pulmonary vascular air embolism in the newborn" (PDF). BMJ. Retrieved 3 October 2023.
  27. ^ Jeng, Mei-Jy (1 August 2012). "Neonatal air leak syndrome and the role of high-frequency ventilation in its prevention". Journal of the Chinese Medical Association. Retrieved 8 October 2023.
  28. ^ Pulmonary Vascular Air Embolism In The Newborn (1989), p. 507.
  29. ^ Pulmonary Vascular Air Embolism In The Newborn (1989), p. 508.
  30. ^ Pulmonary Vascular Air Embolism In The Newborn (1989), p. 508.
  31. ^ Pulmonary Vascular Air Embolism In The Newborn (1989), p. 508.
  32. ^ Pulmonary Vascular Air Embolism In The Newborn (1989), p. 507.
  33. ^ O'Donoghue, Daniel (27 June 2023). "Lucy Letby: Prosecution experts made evidence fit theory, jury told". BBC News. Retrieved 8 October 2023.
  34. ^ Pulmonary Vascular Air Embolism In The Newborn (1989), p. 509.
  35. ^ a b Pilling, Kim (18 November 2022). "Wire could have caused baby's 'extraordinary bleeding', court hears". Chester Standard. Retrieved 9 October 2023.
  36. ^ Kher, Pawani; Verma, Rita P. (26 June 2023). "Hemorrhagic Disease of Newborn". StatPearls Publishing LLC. Retrieved 9 October 2023.
  37. ^ Upchurch, Bennie Ray (1 September 2021). "Upper Gastrointestinal Bleeding (UGIB)". Retrieved 9 October 2023.
  38. ^ "Pediatric Gastrointestinal Bleeding Treatment & Management". Medscape. Retrieved 9 October 2023.
  39. ^ "Lucy Letby EXCLUSIVE: The Man Who Took Down 'Evil' and 'Depraved' Baby Murdering Killer Nurse". Youtube. 18 August 2023. Retrieved 9 October 2023.
  40. ^ a b O'Donoghue, Daniel (30 November 2023). "Lucy Letby trial: Astonishing level of insulin found in baby, jury told". BBC News. Retrieved 9 October 2023.
  41. ^ Dowling, Mark (24 November 2023). "Letby trial: 'Poisoned' baby had 'extremely high level' of insulin". Cheshire Standard. Retrieved 11 October 2023.
  42. ^ Dowling, Mark (15 February 2023). "Recap: Lucy Letby trial, Wednesday, February 15". Chester Standard. Retrieved 11 October 2023.
  43. ^ Rodger, James (19 August 2023). "Lucy Letby: Hospital bosses 'didn't allow investigators to see clinical notes' related to baby deaths, expert says". Sky News. Retrieved 9 October 2023.
  44. ^ Marks, Vincent (6 January 2006). "Hypoglycaemia: accidents, violence and murder. Part 2". Practical Diabetes International. 22 (9): 352–358. doi:10.1002/pdi.875. Retrieved 9 October 2023.
  45. ^ Hitchens, Peter (23 September 2023). "PETER HITCHENS: I wish someone else would ask this: What if Lucy Letby is not guilty?". Daily Mail. Retrieved 30 September 2023.
  46. ^ LIVERMORE, DAVID (11 September 2023). "Lucy Letby Must Be Allowed an Appeal". The Daily Sceptic. Retrieved 30 September 2023.
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