UK - Nurse Lucy Letby, murder of babies, 7 Guilty of murder verdicts; 8 Guilty of attempted murder; 2 Not Guilty of attempted; 5 hung re attempted #37

[Ruthbullock]

I'm actually very familiar with this article as it was part of a literature review I did for my work last year. The air in his chest was seen on his first day of life, directly following the transient skin discoloration. He stabilized initially but then began to decomoensate after 24 hours. Later imaging was consistent with him having previously experienced air embolism. But he did not die until day of life 3, after suffering a pulmonary hemorrhage. He did not die of air embolism. The air embolism resolved. The damage caused was left behind and that damage is likely what led to his fatal pulmonary hemorrhage.

"Case 1

A male infant with a birth weight of 1 770 g was born by
normal vaginal delivery at 31 weeks' gestation. The infant
manifested significant respiratory distress from birth. Initial
chest radiograph confirmed severe respiratory distress
syndrome (RDS). A peripheral intravenous infusion was
inserted and infusion of Neolyte (Intramed, South Africa) was
initiated. The infant was intubated and transported to the
neonatal intensive care unit for mechanical ventilation. En
route, the infant's skin turned blue-black with blotchy redness.
The feet were extremely pale. The attending physician thought
that this was a 'reaction' to the intravenous fluid and replaced
it with 0.2% saline and glucose 5%. Over the next 10 minutes
central perfusion returned to normal, but the hands and feet
remained bluish. At this time an umbilical venous line was
inserted. No air could be withdrawn. The infant's condition
stabilised. Over the next 4 hours his mean blood pressure
varied between 30 and 48 mmHg and his pulse rate between
150 and 165/min. He received surfactant treatment and routine
intravenous penicillin. An anteroposterior chest radiograph did.
not reveal the classic picture of a pneumothorax or
pneumopericardium. However, an area of hyperlucency was
noted behind/within the left cardiac border (Fig.1). An
anterolateral chest radiograph revealed the presence of air in
the retrosternal area, anterior to the heart, as well as a
hyperlucent area within the heart border. In the retrocardiac
ORIGINAL ARTICLES
Fig. 1. Anteroposterior chest radiograph: No evidence for
pneumothorax or pneumopericardium. An area of hyperlucency is
noted behind/within the left cardiac border.
area a triangular shadow, representing aerated lung or free air,
was present. A diagnosis of a pneumomediastinum and
intracardiac air was entertained. The infant's clinical condition
stabilised, but within 24 hours of birth he developed
generalised myoclonic convulsive movements of all four limbs
and was treated with phenobarbitone. The cranial ultrasound
scan showed striking evidence of cerebral air embolism (Fig. 2),
as manifested by an echogenic density in the right lateral
Fig. 2. Cranial ultrasonography evidence of cerebral air embolisation.
An echo genic density in the right lateral ventricle created acoustic
shadowing with no through transmission.
December 2003, Vol. 93, No. 12 SAMJ
ventricle, which created an acoustic shadow with no through
transmission.' A C-reactive protein and a blood culture were
negative. On day 3 of life, the infant developed generalised
oedema and a metabolic acidosis, followed by a severe acute
pulmonary haemorrhage. Despite extensive resuscitation
efforts the infant died. An autopsy was refused."

As I have asked twice- where is that relevant to child A?

 

[magikarpmagikarp]

As I have asked twice- where is that relevant to child A?

The transient skin discoloration associated with air embolism. You are the one who brought this article up but your comprehension of what it says is incorrect.

 

[Ruthbullock]

The transient skin discoloration associated with air embolism. You are the one who brought this article up but your comprehension of what it says is incorrect.

I didn’t bring it up- tortoise did- it’s referred to in a video we were pointed to, where the scientist refers to this article and disputes Dr Lees assessment, as this is a case of a rash with an air embolism as seen in child A. I dispute that as the rash was 4 days prior. You have stated you are very familiar with the paper- so I would prefer your thoughts, rather than some random person on you tube.
ETA: apologies you have shared how you believe it relates to child A- but this is not what I was discussing, I was discussing the inane misinformation posted in a you tube video.

 

[Sweeper2000]

I recommend watching a video called 'don't be fooled by Lucy Letby's slick PR campaign' uploaded yesterday on YouTube channel 'Back to the Science'. She (Dr Oliver) commented on Dr Lee's new paper on a site called PubPeer and he responded to her comments. PubPeer - Vascular Air Embolism in Neonates: A Literature Review

JFYI she often gives a shout out to @CS2C 's channel for the transcripts he's put up.

JMO

interesting. in Dr lee's comment he states that the "rash" or discolouration was used as a centrally identifying symptom of AE in the trial which isn't true.

"Skin discoloration is not central to the diagnosis of air embolism and was mistakenly identified by the prosecution expert witness as such."

PubPeer - Vascular Air Embolism in Neonates: A Literature Review

There are comments on PubPeer for publication: Vascular Air Embolism in Neonates: A Literature Review (2025)

pubpeer.com

 

[magikarpmagikarp]

I didn’t bring it up- tortoise did- it’s referred to in a video we were pointed to, where the scientist refers to this article and disputes Dr Lees assessment, as this is a case of a rash with an air embolism as seen in child A. I dispute that as the rash was 4 days prior. You have stated you are very familiar with the paper- so I would prefer your thoughts, rather than some random person on you tube.
ETA: apologies you have shared how you believe it relates to child A- but this is not what I was discussing, I was discussing the inane misinformation posted in a you tube video.

I do agree with Dr. Oliver's (Back to the Science youtube channel) understanding of this article. I don't think she misunderstood it. I think the article is strong evidence that skin discoloration can be associated with venous (eta - paradoxical venous to arterial?) air embolism since later imaging supported that diagnosis. I agree with Dr. Oliver that Dr. Lee's reclassification of the case as being caused by mechanical ventilation is disingenuous, unsupported by the clinical evidence in that case (no evidence of air leak) and likely motivated by a desire to exonerate Letby. For whatever my opinion is worth - it's only my opinion.

 

[Sweeper2000]

Professor Kinsey didn’t participate in the inquiry and I have to say whilst trying to search out answers to others queries- her testimony in court was hardly reliable:
Prof Kinsey told the court the skin discolorations observed on Child A had "cemented" her concerns that he had suffered an air embolus.
She said it was a very "rare" condition and that she had not seen it herself, but had read about it in medical literature.
"It was a pretty stark description of what sounded to be air embolus to me," she said.

What medical literature is she proclaiming to have read about it in- people have been searching for years for a medical paper to back that up and not found one yet- according to the article it was a 1989 article she had just happened across in the BMJ.

She also testified in court:
She told the court that no blood disorder would account for the sudden deterioration suffered by Child A.

From this comment, you must surely draw the conclusion that child A did have a potential blood disorder, and not that she said it wasn’t possible.

Lucy Letby: Baby's catastrophic bleed not spontaneous, trial told - BBC News

A blood expert tells nurse Lucy Letby's murder trial a baby's internal bleed was "not spontaneous".

www.bbc.co.uk

im not sure if im misreading what you are saying or the context but Dr lee's paper was published in 1989 but your quote is reminiscent of Dr Jayaram who "alighted" on the same one.

 

[Sweeper2000]

Professor Kinsey didn’t participate in the inquiry and I have to say whilst trying to search out answers to others queries- her testimony in court was hardly reliable:
Prof Kinsey told the court the skin discolorations observed on Child A had "cemented" her concerns that he had suffered an air embolus.
She said it was a very "rare" condition and that she had not seen it herself, but had read about it in medical literature.
"It was a pretty stark description of what sounded to be air embolus to me," she said.

What medical literature is she proclaiming to have read about it in- people have been searching for years for a medical paper to back that up and not found one yet- according to the article it was a 1989 article she had just happened across in the BMJ.

She also testified in court:
She told the court that no blood disorder would account for the sudden deterioration suffered by Child A.

From this comment, you must surely draw the conclusion that child A did have a potential blood disorder, and not that she said it wasn’t possible.

Lucy Letby: Baby's catastrophic bleed not spontaneous, trial told - BBC News

A blood expert tells nurse Lucy Letby's murder trial a baby's internal bleed was "not spontaneous".

www.bbc.co.uk

yeh think i found it and yes is in the bmj 1989 and yes is from dr lee's paper.

Pulmonary vascular air embolism in the newborn. | Archives of Disease in Childhood

ETA. i'm not sure though. i cant seem to trace that writing to a piece in an edition of the bmj 1989 although it makes sense that if Dr Lee published it in 1989 then the BMJ would feature it as its one of a kind.

ETA in fact I think yes. That is in the archives of "diseases in childhood" which is a section of the bmj.

ETA. confirmed feature of april, 1989 edition of the bmj.

last research article. see link.

Table of contents | Archives of Disease in Childhood

Table of contents​

April 1989 - Volume 64 - 4 Spec No


#feeling proud

 

[Sweeper2000]

dbm

 

[mrjitty]

There is so much wrong with Lee's approach that I don't even know where to begin.

If there's bias that means the whole process lacks objectivity. If Lee has pre-determined that none of these babies suffered death or collapse because of air-embolism, you have to find something else, that is not an objective process.

They are not putting their necks on the line if they are not realistically going to testify to their opinions, or if they are proposing health conditions or medical care that were already known about and acknowledged, but discounted by trial experts. It's not exactly controversial, as saying deliberate harm is.

Why do you need 14 experts from around the world in the same specialty, to look at one baby per pair? That is not going to draw together important connections between cases, where there are similarities (such as bleeding swollen throats, one is not as extraordinary as four or five for example), and no one is going to feel ultimately responsible for her fate, reporting on one baby, as the trial experts must have felt. The experts at trial also dedicated their lives to saving babies, as did the doctors who worked alongside Letby, and it is far more onerous on them, and requires far greater care, diligence and certainty to testify under oath that someone deliberately caused harm and death to babies, with the consequences of that.

The defence actually had two experts they didn't call. To think that all seven of the prosecution's experts, from differing and more relevant fields, got it wrong and somehow colluded in mistaken diagnoses so that the case fit like a glove with all the patterns of her shifts and her fraudulent record-keeping, and with the consultants' suspicions, is just ludicrous. MOO

Thanks T, and also to others for the info posted here.

Looks like the learning curve for me is too high so I will wait for the report, and any subsequent appeal court action (if any)

I tend to agree with you about the dangers of assembling a panel after the fact to litigate in the media. Of course sometimes they can be correct!

 

[mrC]

What is the new challenge to the evidence used to convict Lucy Letby?

Letby’s legal team has submitted a fresh case to the body that investigates potential miscarriages of justice

www.theguardian.com

 

[mrC]

seems like this chaity thought the doctors were lying Charity refused to engage with Letby whistleblowers over ‘red flags’ in testimony

 

[joltz]

seems like this chaity thought the doctors were lying Charity refused to engage with Letby whistleblowers over ‘red flags’ in testimony

seems like this chaity thought the doctors were lying Charity refused to engage with Letby whistleblowers over ‘red flags’ in testimony

1. Article by Sarah Knapton

2 it wasn't really just a standard whistle blowing case was it. One of their colleagues was murdering the babies and she was getting the backing of the management.

JMO

 

[mrC]

oh chris mullins got involved Ex MP links false Birmingham Six convictions to Lucy Letby's case

 

[Ruthbullock]

An interesting article about the background to the CCRC, the issues caused by restricting access to court documents in the UK. It fleetingly mentions LL and doesn’t have an opinion on her case other than the cost of the court transcripts- but may also explain and depending on your POV justify why things are being pushed so publicly and crudely.
Brian Thornton
Senior Lecturer in Journalism, University of Winchester

Convicting the innocent: how a rotten system ensures miscarriages of justice will continue

Why are so many innocent people still being convicted of crimes they did not commit?

theconversation.com

 

[Ruthbullock]

1. Article by Sarah Knapton

2 it wasn't really just a standard whistle blowing case was it. One of their colleagues was murdering the babies and she was getting the backing of the management.

JMO

I’m trying to break down in my head the whistle blowing aspect a little more- I couldn’t read the article shared as you need to log in, so if anyone has an archived version it would be appreciated.
Have we got anywhere through the Thirwall inquiry (or even outside of the inquiry) as to why the doctors were initially not taken seriously and their concerns were dismissed? They had several avenues they could pursue- internally and externally, and they also have access to the BMA as their union representatives- so 3 avenues. Can we discuss again what we feel went wrong and what needs to improve. This case still fills me with angst- not because I have an opinion yet on her guilt or innocence, but because I fear the door is currently wide open for this to still happen tomorrow.

 

[Ruthbullock]

So Dr J and his colleagues first went to the safeguarding board in spring 2017- why not earlier? The BMA union representatives was worried about the doctors prior to that as a parent had said they were going to report the doctors to the GMC, and the union representatives from the BMA only really got involved later on when LL had put in a grievance about the doctors and a meeting was held. They only seem to action anything when they themselves are being threatened- what stopped them proactively seeking out support?

https://thirlwall.public-inquiry.uk/wp-content/uploads/2024/10/Thirlwall-Inquiry-8-October-2024.pdf

 

[Ruthbullock]

Also of note in that testimony is the royal college report had been briefed prior to their report about the doctors concerns, but it was redacted, so they and the union were unaware at the time.

 

[Furore]

So Dr J and his colleagues first went to the safeguarding board in spring 2017- why not earlier? The BMA union representatives was worried about the doctors prior to that as a parent had said they were going to report the doctors to the GMC, and the union representatives from the BMA only really got involved later on when LL had put in a grievance about the doctors and a meeting was held. They only seem to action anything when they themselves are being threatened- what stopped them proactively seeking out support?

https://thirlwall.public-inquiry.uk/wp-content/uploads/2024/10/Thirlwall-Inquiry-8-October-2024.pdf

I actually posted whistleblowing guidelines for Worcestershire trust earlier in this thread (and all trusts are similar) it is quite literally in the policy that you are expected to escalate up through the directorate to medical director to chief exec before going to external agencies, there really is no drama or word behaviour here. IMO we should not be questioning the doctors, who did whistleblow, who did escalate, who did go to management, who did go to the regional leads about deaths…and ask why management did not act on these concerns.

Here is whistleblowing document for Worcs again. Page 10 of 22, about external contact.

I am certain that whistleblowing guidelines will be reviewed in view of this enquiry, IMO.

It is without a shadow of a doubt to me that any functioning board would submit concerns about a murderer to the police.

https://www.worcsacute.nhs.uk/documents/our-trust/whistleblowing-raising-concerns-policy-and-procedure/?layout=file

 

[mrC]

are so they were going to be reported to the gmc before there confrontation with lucy letby

 

[WaneLyrical]

So Dr J and his colleagues first went to the safeguarding board in spring 2017- why not earlier? The BMA union representatives was worried about the doctors prior to that as a parent had said they were going to report the doctors to the GMC, and the union representatives from the BMA only really got involved later on when LL had put in a grievance about the doctors and a meeting was held. They only seem to action anything when they themselves are being threatened- what stopped them proactively seeking out support?

https://thirlwall.public-inquiry.uk/wp-content/uploads/2024/10/Thirlwall-Inquiry-8-October-2024.pdf

Incidentally this was also the first mention from Jayaram about baby K, despite him believing he caught Letby attempting to murder the infant, more than a year after the event.