‘Major miscarriage of justice’: Experts raise questions over Lucy Letby conviction

Legal and medical experts question the fairness of the trial and conviction of UK neo-natal nurse Lucy Letby.

Letby, 33 was sentenced to life imprisonment on Monday after she was found guilty by a jury of the murder of seven babies, and the attempted murder of another six.

The case related to a series of deaths in the neo-natal unit of the Countess of Chester Hospital in 2015-16.

‘There is something wanting about her defence’, said medico/legal expert Dr. Scott McLachlan in an interview with Norman Fenton, a professor of mathematics. ‘There are questions that haven’t been answered.’

McLachan, whose PhD was in ‘learning health systems’, also has legal and nursing qualifications, and is a lecturer in the Faculty of Nursing at King’s College in London.

McLachlan wondered whether Letby’s lawyer Ben Myers KC had his ‘hands tied’.

1. Some researchers & legal scholars are expressing concerns about the #LucyLetby trial. Today I interviewed one such prominent researcher @LawHealthTech to discuss his concerns pic.twitter.com/WsSBnHIa7I

— Prof Norman Fenton (@profnfenton) August 22, 2023

‘One of the grounds of appeal could be trial counsel competence. That’s not to say Ben was incompetent, but that’s a way to get in an appeal, that her defence was wanting,’ he said.

Experts are questioning the safety of the verdict, claiming crucial evidence which could have raised a reasonable doubt was not presented to the jury.

Richard Gill a mathematician who specialises in the statistical analysis of wrongful conviction cases wrote on his blog recently, ‘I’m not saying that I know Lucy Letby is innocent. As a scientist I am saying this case is a major miscarriage of justice. Lucy did not have a fair trial. The similarities with the famous case of Lucia de Berk in the Netherlands are deeply disturbing.’

Gill was a key expert witness in the appeal and retrial of Dutch nurse Lucia de Berk, who was convicted of the murder of three babies and the attempted murder of another four in 2003. In a 2010 retrial she was found not guilty and later came to a financial settlement with the Dutch government.

‘Science on Trial‘, a website maintained by an expert in rare paediatric diseases said:

‘Based upon published peer-reviewed research, and with the guidance, advice and insights of other scientists, it is the view of Science on Trial that the scientific information put before the court by the expert witnesses is simply inaccurate, misleading, and in many places false. The expert witnesses in this case are likely aware that the claims they have made lack necessary scientific findings, and if they were to write these claims up and attempt to submit them for publication, their submission would be quickly rejected.’

Documents obtained by researchers through a Freedom of Information request showed there were 31 baby deaths in the neo-natal unit during the relevant period (2015-16), of which Letby was charged with 8, a number that was reduced to seven at the beginning of the trial.

McLachlan said, ‘the average prematurity on the ward was something like seven weeks and it went as high as ten or twelve. Based on the prematurity of the baby and the weight of the baby the unit were normally required to refer the worst – the babies who were the most immature or the babies who were under 800 grams, they were required to refer those babies out to a more specialist unit. During that period the Countess of Chester upgraded the units so that they could keep the more severe, the more sickly babies.

‘So you had a situation where you had a unit which had a lot of babies, and they were very busy. You had staff who were supposed to be looking after those babies in one-to-one relationships… and unfortunately for most of that period what we see is actually that many of the staff were looking after two, sometimes three, instead of one… the staff were working outside the guidelines and we know that there were a much larger number of babies that died.’

The roster chart shown to the jury, and reproduced in varying forms by mainstream media, was inaccurate, McLachlan claimed. The chart showed Letby had been working at the time when the victims died, but McLachlan said, ‘their [the police] method of investigation to arrive at that chart has been to go and look at all the babies who died, and then filter that list down to the point where you’ve got 100% Lucy in a column… we could go and do that for any of the other 36 or so nurses who were on the unit, and bear in mind that chart did not include doctors….You could probably get the doctors in a range of 12 or 15 or 18 of the 30 babies that expired on the unit.’

‘One of the nurses that worked with Lucy Letby was correlated with at least 3 of the first 4 babies that I analysed. Why wasn’t she in the frame for it? Why was it ‘we’ve just made a chart with Lucy’?’

‘I’m wondering whether what they did was started with all 30 babies and kept taking a baby out, a baby out, a baby out, until they found the nurse that had the most correlations, and went ‘ok that’s the nurse we’re investigating.’

Other issues McLachlan idenitified in the case were:

• Baby deaths peaked in 2018, at a rate higher than when Letby worked there
• Most of the doctors on the ward were trainees or in their first or second year out of university
• A key police expert witness had little experience with neo-natal care, and actively touted his services to the prosecution before and during the investigation
• Letby’s defence did not raise arguments based on the babies who had died and for which she was not charged
• Witnesses who were to give evidence in support of Letby, including many of the nurses she worked with and her parents, were not called

Leaking waste pipes above the neo-natal unit

It was common knowledge the waste pipes running in the ceiling space above the unit were poorly maintained and prone to leakage. A plumber who gave evidence in court said he was called to fix the problem on average once a week.

Waste water regularly leaked into the unit from the ceiling and pooled on the floor. No testing of any of the surfaces for pathogens was conducted, and if it was, it wasn’t presented in court, said McLachlan.

‘There is no evidence from the court case, and there is no evidence from the hospital records that they ever tested it… despite the fact they not only had sewerage leaking in that space above [the unit], but they’d also, by the plumbers own admission, and by Lucy’s evidence, which led to the plumber being there, they’d also had hospital waste water from the hospital’s toilets etc mixing with the waste water from the showers, and it came up through the floor, such that at one point they were walking through it.’

McLachlan referred to other cases of UK hospitals where pathogens from poorly maintained plumbing had led to severe illness or death of patients, including the case of a brand new neo-natal unit in which a number of babies died. In that case police also focused their investigation on neo-natal staff until a team of expert epidemiologists discovered the new unit was infested with deadly pathogens.

Letby was accused of killing the babies by injecting them with air. No one saw her do this, but McLachlan said this was inferred from the presence of air in the stomach or outside the stomach of the babies during autopsies. ‘Several of the bacterial pathogens I’ve started to investigate… have symptoms that have been recorded in other neo-nates, [they] caused air to be either collected in the duodenum in the small intestine, or they’ve got into the blood vessels and caused the air to be outside the intestine itself.’

Evidence of other phenomena, such as the purpura – the purple spots seen on some of the victims, could also be explained by the presence of the bacterial pathogens, McLachlan said.

‘Many of the symptoms that were discussed for each of the babies, you can actually go back and look at these bacterial pathogens… especally when they get to a stage where they can cause NEC (Necrotising Enterocolitis)… these bacterial pathogens [can] cause NEC, which then can cause these ‘unexpected crashes’ and these other symptoms which were discussed.’

Letby has been in custody since 2020. She is yet to file an appeal.