UK - Nurse Lucy Letby Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #6

[obelix71]

No but he could show that there a potential the prosecution witnesses have come to new conclusions on reviewing each other’s reports as he’s been asking them by having his own defence witnesses to give a plausibility to a different cause of death.

His issue will always be however that no matter who he finds, they will never be able to say definitively that AE isn’t a possible a cause. Because the fact is, it is.

I don't think he needs to say definitively that AE isn't a possible explanation, and as you say he can't, because, as you say, it is. What he needs to show is that there are other explanations, explanations that are perhaps more feasible. The prosecution's job is different. Its job is to show beyond a reasonable doubt that there is only one possible explanation: malfeasance by LL. In theory this makes the prosecutions job harder because the bar is set much much higher but in some ways it is easier because of the way jurors tend to think - they tend to think that the prosecution side is more trustworthy.

 

[Observe_dont_Absorb]

Yes

https://twitter.com/x/status/1580549767217958912

The recap of the defence opening has Myers calling into question the prosecution's medical experts and saying 'doctors and experts' don't always have the answer. Surely if he had his own experts he would say 'but we will present evidence from specialists who disagree with their findings'.
I could be wrong, and to be fair if the defence do have medical experts who say that the babies died in other ways, or even that there is no way of knowing why the babies died, then that could change everything

It seems from what he said that there are defence medical experts due to speak as to their findings? Regardless the prosecution must present everything they have to say first and that includes the full opinions and reports of their own experts.

Personally, from what we have heard so far, I imagine it would be exceptionally hard to prove that these babies died of a single cause that can be attributed to any one human being, JMO MOO. Their short lives are so hard to read about

 

[obelix71]

But whatever his experts have to say would have been shared with the prosecution's experts. That's how it works in this country. He can't do a 'Ta da, gotcha' at the last minute.

So everything you can hear the prosecution and their experts saying now is based on what they also know of the defence's theories. And just like Myers mentioned the 1989 study a few times, if he had other studies or other evidence, he'd be using it now to cross examine these experts.

But he isn't.

I don't think that is correct. Defence would have to share details of its witnesses with the court and therefore the prosecution (perhaps done already but not yet public) but not with the prosecution's experts. And it would not need to disclose in opening arguments. Myers is laying the ground for his experts, planting a bit of doubt in the jurors' minds, that's all. Credibility of defence medical testimony has to come from medical experts, not from him. Anyway, I suppose ultimately this was about whether he will call his own experts, not what they will say if they are called. Latter is speculation. As for the former, there is nothing he has said imo which suggests he will not be calling his own experts. If there weren't any there wouldn't be a trial. And if there are some he'd be negligent if he didn't call them.

 

[JosieJo]

I don't think that is correct. Defence would have to share details of its witnesses with the court and therefore the prosecution (perhaps done already but not yet public) but not with the prosecution's experts. And it would not need to disclose in opening arguments. Myers is laying the ground for his experts, planting a bit of doubt in the jurors' minds, that's all. Credibility of defence medical testimony has to come from medical experts, not from him. Anyway, I suppose ultimately this was about whether he will call his own experts, not what they will say if they are called. Latter is speculation. As for the former, there is nothing he has said imo which suggests he will not be calling his own experts. If there weren't any there wouldn't be a trial. And if there are some he'd be negligent if he didn't call them.

I've no idea if there will be Defence medical experts. But even if there wasn't there would still be a trial?

 

[Observe_dont_Absorb]

This is something that has puzzled me too. I am British but live in Canada and I use the BBC as my news site. It is of course, the Canadian version. The reporting for this case is non existent. One day a few weeks back, I stumbled upon a short article about the case and tried to find out more but its so sporadic and scattered. I haven't had anything on BBC Canada since about the LL trial and I was following the Chester Standard live reporting until I found you guys here.
TLDR: I'm puzzled as to why there is such a small coverage of the trial also.

It's getting a daily mention in the print media but I guess as the trial is going to be so long and convoluted, the TV / live news media are waiting until there's more cohesive stuff to discuss.

 

[Observe_dont_Absorb]

Not sure on LL's tactics here. She says she can't remember these specific babies but looks up the families months later numerous times and also texts her colleagues how much their deaths have upset her.

We still have absolutely no idea of LL as a person?
Is she cold and calculated, or emotional and overbearing?

Is she capable and professional or prone to mistakes and poor at her job?

Considering she had been a nurse for a few years and had no doubt seen her fair share of bad times working in the neonatal ward I don't understand her apparent level of upset when she's texting her colleagues.


Could this possibly be a tactic to throw suspicion away from her?

It's probably a tactic to ensure this case is solely about what evidence is there to accuse her of such an horrific crime and not about what she 'seems like' which is nothing to do with evidence of murder. We have a lot more to hear but it seems she was referred to as being a competent, capable, hardworking, reliable and responsible employee. Maybe we'll find out she wasn't and was slapdash and shoddy and late for work or something, who knows, but even that would hardly mean she murdered anyone.

 

[obelix71]

I've no idea if there will be Defence medical experts. But even if there wasn't there would still be a trial?

My point was that if there was not a single medical experts who could suggest an alternative explanation, that would mean the evidence against her was so overwhelming that LL would have had no choice but to plead guilty, thus rendering a trial unnecessary.

 

[JosieJo]

My point was that if there was not a single medical experts who could suggest an alternative explanation, that would mean the evidence against her was so overwhelming that LL would have had no choice but to plead guilty, thus rendering a trial unnecessary.

Many defendants plead not guilty even if the evidence is overwhelming

 

[May72031]

In opening arguments, defence barristers need to get juries to like them. By mentioning defence witnesses, Myers would have created the image of confrontation i.e. prosecution experts versus defence experts. That is where the confrontational aspect is. No need to mention it. Doesn't mean he won't/can't call them.

If Myers was going to bring in expert defence witnesses, it seems odd that, today, he is saying "there are things that experts and doctors can't explain". His own argument can be used against him if he brings in any expert witnesses...

 

[Observe_dont_Absorb]

If Myers was going to bring in expert defence witnesses, it seems odd that, today, he is saying "there are things that experts and doctors can't explain". His own argument can be used against him if he brings in any expert witnesses...

But there ARE things that even the best of medical experts can't explain and that means they are inexplicable. When things are inexplicable they cannot be blamed on a person as murder. He is setting the scene for that doubt. Having those words used against him would be nothing more than re-stating the case.

 

[Tortoise]

Updated Prosecution Medical Expert Opinion Summary - to include Child D


Child A

Dr Dewi Evans

"He rules out other conditions such as sepsis, a lack of fluids or hypoxia as causes, or contributing factors to the collapse.
He said he had "only one" conclusion, that Child A had received an air embolus, "through an IV line".

"there was no way this could have been done by accident"."

Recap: Lucy Letby trial, Tuesday, October 25



Dr Sandie Bohin

"Mr Johnson: "What, in your opinion, killed [Child A]?"
Dr Bohin: "[Child A] was killed by an air embolus."

Recap: Lucy Letby trial, Tuesday, October 25


Child A's mother wept in the public gallery as Dr Bohin said she was left with only one "plausible explanation" for her son's collapse and death, which was an air embolism."

Lucy Letby: Disturbing pattern in baby deaths, nurse's trial told



Child B

Dr Dewi Evans

"He says the cause of her collapse - like her brother Child A - was an air embolism, 'there was nothing else to explain this collapse, which was so sudden and unexpected', he said"

https://twitter.com/MrDanDonoghue


Dr Sandie Bohin


"Dr Bohin said other factors, such as infection or cardiac arrhythmia, could be discounted, and the only conclusion left was "air embolus"."

Recap: Lucy Letby trial, Wednesday, October 26


Child C

Dr Dewi Evans

"He says infection was a part of Child C's status. He adds it did not cause Child C's death."

"He says while Child C had an infection, he was recovering from it, as he had gone off CPAP support, on to Optiflow.
"Respiratory wise, he didn't stay the same, he was improving."

"He said there were three clinical scenarios - injecting air into the stomach that interfered with his breathing, or that air was injected intraveneously, or from a combination of the two"

Recap: Lucy Letby trial, Tuesday, November 1



Dr Sandie Bohin

"This was not a baby who was ill, this was a baby who was improving."

Dr Bohin's conclusion was that he had pneumonia, but that did not cause the collapse or kill him.

She added babies such as Child C do not collapse suddenly and without warning.
She said an infection would not be the cause as that would lead to a gradual deterioration in the baby, not a sudden collapse and no response to resuscitation.

She said one conclusion for Child C's collapse was CPAP accumulation of air, the other being deliberate injection of air. She said the doctors did not appear to have a concern as they had noted the abdomen to be "soft".

Recap: Lucy Letby trial, Tuesday, November 1



Child D

Dr Dewi Evans

Dr Evans says his conclusion in Child D’s case is that death was caused by an injection of air into her bloodstream.

Ben Myers KC, defending, asks Dr Evans why he thinks this. Dr Evans gives 5 reasons. 1. D’s collapse was rapid and v striking. 2. The presence of discolouration on D’s body “a pattern experienced [nurses and doctors] had never seen before and never since and it came and went.

3. Attempts to resuscitate D were unsuccessful. 4. The presence [at post mortem] of air in D’s blood vessels and 5. None of the other issues, eg pneumonia were relevant.

“What we have in [D’s] case is a full house of clinical characteristics consistent with her having suffered an air embolism, ie air has been injected into her.” says Dr Evans.

https://twitter.com/MerseyHack


Dr Sandie Bohin

"Taking into account the sudden nature of the collapses and the very quick recovery...I was very clear it wasn't infection, so the conclusion had to be something unusual and odd." Other conditions were crossed off as they 'didn't fit'.
She concludes the collapses were caused by intravenous air administration either through the UVC or the cannula.
Dr Bohin says with air embolus, the speed and quantity of the air administered depends on whether it is fatal. She says the first two administrations of air would have been small, but the third would have been larger to cause circulation to stop. Dr Bohin says the suddenness of the collapse, with skin discolouration, fitted with cases of air embolus, as did the presence of air found in the 'great vessels' on post-mortem x-rays. Dr Bohin adds she believed Child D died with pneumonia, not because of pneumonia.

Recap: Lucy Letby trial, Friday, November 11

 

[Cando]

My first post, although I have been following since the beginning. I live in the area and so we had local news reporting from the beginning. It has all gone quiet on local as well as national news now.

 

[Honeybirdette]

My point was that if there was not a single medical experts who could suggest an alternative explanation, that would mean the evidence against her was so overwhelming that LL would have had no choice but to plead guilty, thus rendering a trial unnecessary.

If only it worked like that lol

 

[obelix71]

Updated Prosecution Medical Expert Opinion Summary - to include Child D


Child A

Dr Dewi Evans

"He rules out other conditions such as sepsis, a lack of fluids or hypoxia as causes, or contributing factors to the collapse.
He said he had "only one" conclusion, that Child A had received an air embolus, "through an IV line".

"there was no way this could have been done by accident"."

Recap: Lucy Letby trial, Tuesday, October 25



Dr Sandie Bohin

"Mr Johnson: "What, in your opinion, killed [Child A]?"
Dr Bohin: "[Child A] was killed by an air embolus."

Recap: Lucy Letby trial, Tuesday, October 25


Child A's mother wept in the public gallery as Dr Bohin said she was left with only one "plausible explanation" for her son's collapse and death, which was an air embolism."

Lucy Letby: Disturbing pattern in baby deaths, nurse's trial told



Child B

Dr Dewi Evans

"He says the cause of her collapse - like her brother Child A - was an air embolism, 'there was nothing else to explain this collapse, which was so sudden and unexpected', he said"

https://twitter.com/MrDanDonoghue


Dr Sandie Bohin


"Dr Bohin said other factors, such as infection or cardiac arrhythmia, could be discounted, and the only conclusion left was "air embolus"."

Recap: Lucy Letby trial, Wednesday, October 26


Child C

Dr Dewi Evans

"He says infection was a part of Child C's status. He adds it did not cause Child C's death."

"He says while Child C had an infection, he was recovering from it, as he had gone off CPAP support, on to Optiflow.
"Respiratory wise, he didn't stay the same, he was improving."

"He said there were three clinical scenarios - injecting air into the stomach that interfered with his breathing, or that air was injected intraveneously, or from a combination of the two"

Recap: Lucy Letby trial, Tuesday, November 1



Dr Sandie Bohin

"This was not a baby who was ill, this was a baby who was improving."

Dr Bohin's conclusion was that he had pneumonia, but that did not cause the collapse or kill him.

She added babies such as Child C do not collapse suddenly and without warning.
She said an infection would not be the cause as that would lead to a gradual deterioration in the baby, not a sudden collapse and no response to resuscitation.

She said one conclusion for Child C's collapse was CPAP accumulation of air, the other being deliberate injection of air. She said the doctors did not appear to have a concern as they had noted the abdomen to be "soft".

Recap: Lucy Letby trial, Tuesday, November 1



Child D

Dr Dewi Evans

Dr Evans says his conclusion in Child D’s case is that death was caused by an injection of air into her bloodstream.

Ben Myers KC, defending, asks Dr Evans why he thinks this. Dr Evans gives 5 reasons. 1. D’s collapse was rapid and v striking. 2. The presence of discolouration on D’s body “a pattern experienced [nurses and doctors] had never seen before and never since and it came and went.

3. Attempts to resuscitate D were unsuccessful. 4. The presence [at post mortem] of air in D’s blood vessels and 5. None of the other issues, eg pneumonia were relevant.

“What we have in [D’s] case is a full house of clinical characteristics consistent with her having suffered an air embolism, ie air has been injected into her.” says Dr Evans.

https://twitter.com/MerseyHack


Dr Sandie Bohin

"Taking into account the sudden nature of the collapses and the very quick recovery...I was very clear it wasn't infection, so the conclusion had to be something unusual and odd." Other conditions were crossed off as they 'didn't fit'.
She concludes the collapses were caused by intravenous air administration either through the UVC or the cannula.
Dr Bohin says with air embolus, the speed and quantity of the air administered depends on whether it is fatal. She says the first two administrations of air would have been small, but the third would have been larger to cause circulation to stop. Dr Bohin says the suddenness of the collapse, with skin discolouration, fitted with cases of air embolus, as did the presence of air found in the 'great vessels' on post-mortem x-rays. Dr Bohin adds she believed Child D died with pneumonia, not because of pneumonia.

Recap: Lucy Letby trial, Friday, November 11

It would certainly be unusual if prosecution witnesses contradicted the prosecution's case. As for me, I shall wait to hear from the defence's experts then weigh up the two arguments. Even then, I will need to be aware that the accounts are those in the media/press, not from court transcripts.

 

[obelix71]

If only it worked like that lol

Exactly, that is my point. There are always two sides and I will wait to hear both of them.

 

[obelix71]

If Myers was going to bring in expert defence witnesses, it seems odd that, today, he is saying "there are things that experts and doctors can't explain". His own argument can be used against him if he brings in any expert witnesses...

I don't think it could be. What could be used against him was suggesting his experts could explain things and theirs couldn't.

 

[Supernovae]

I’m a bit bothered by it being stated that these lines of gas on the X-rays are also seen in cases of SIDS. When babies are known to die suddenly and without any clear cause, and this gas presents, that feels like something significant to me. How can experts say the only remaining option is deliberate air embolism, when there is also an option that it was a sudden unexplained death?

It’s also odd that Child D’s final fatal collapse, which allegedly involved more/faster air, didn’t produce the skin discolourations, but the earlier collapses did.

I’m so glad I’m not on this jury.

I did wonder about this as well, as SIDS is a diagnosis of exclusion and definitionally unexplained. I'm speculating, but the only relevant difference I can think of is that there may be a difference in postmortem changes if the death occurs overnight (as is often the case) and isn't discovered for some hours in a normally heated family home. Also the parents may attempt CPR out of desperation even if the death had occurred some time ago, where medical professionals wouldn't.

As with the skin discolourations the experts are telling a story, maybe even a compelling one, around these findings but there's not a massive empirical body of evidence to interpret the significance of these findings. It is a problematic aspect of this case.

 

[obelix71]

Many defendants plead not guilty even if the evidence is overwhelming

True, which is why I used the term "so overwhelming" not "overwhelming". There are always two sides and I will wait to hear both of them.

 

[Observant-ADHD-ENFP-BSc]

It's getting a daily mention in the print media but I guess as the trial is going to be so long and convoluted, the TV / live news media are waiting until there's more cohesive stuff to discuss.

Thank you. That makes sense, they are predicting 6 months for the trial, right? So it would make sense they would wait until closer to the end and just report on any big news up until.

 

[Music2022]

That's the mother's interpretation, but I can't believe [the midwifery team] would have allowed...the baby to be fed or stay on the post-natal ward in that condition."

(Dr Bohin said the above). With the amount of scandals in negligent maternity and baby care in the nhs coming to light lately in the news I wouldn’t be so sure.