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 #38

[CatsnChickens]

I should also add the whole weird antibody thing only applies if the infants have had their feed of colostrum within the correct window of time.

Very premature babies may not of had this as they are small and weak and mum may not have been able to express in the time required. Any feed after time elapses the gut won't absorb the antibodies as it is only permeable to them for a few hours post birth.

 

[MrsAddick]

How is “the insulin c-pep ratio is only applicable to older children and adults, and does not hold true for premature babies” not new evidence?

That’s not ‘new’ evidence. No doubt this info existed in the world of medical science… but for whatever reason, the defence team wasn’t aware of it, or chose not to use it, to mount a rebuttal.

 

[WaneLyrical]

That’s not ‘new’ evidence. No doubt this info existed in the world of medical science… but for whatever reason, the defence team wasn’t aware of it, or chose not to use it, to mount a rebuttal.

The information may have existed, but it was clearly not easily attainable. The simple fact is, it now known the information given to the jury was unreliable and misleading.

 

[Marantz4250b]

That’s not ‘new’ evidence. No doubt this info existed in the world of medical science… but for whatever reason, the defence team wasn’t aware of it, or chose not to use it, to mount a rebuttal.

And this here is a real point; it's obvious that LL's defence team made a positive decision not to use lots of evidence or call expert witnesses that we know they had access to!

That decision wasn't made because her team was incompetent. It was made because they adjudged it as the best thing to do in defending her.

The problem with documentaries like the ITV one is that it's dead easy to round up some "experts" who had nothing what-so-ever to do with the actual legal process as it was and ask them to start picking holes in random pieces of evidence. Anything they come up with is going to sound convincing because you aren't employing anyone to give the counter argument and it's all completely out of context as regards a properly conducted trial. Nor are you privy to the reasoning behind the specific choices made by her defence team as regards how to respond to the various bits of evidence.

Unless you have a countering argument it's all pretty worthless.

 

[Sweeper2000]

i dont think allot of the points being disucssed actually hold much worth. in regards to the insulin it appeared to me to be more a point of dispute and then can be broken down to "its not the best/most conclusive test" but "its acceptable and more than enough". in a way thats similar to someone being diagnosed with the flu through symptoms rather than a microscopic exam of the bacteria present in their body, isolation of the relevant organisms, testing to see that there is enough bacteria to cause the symptoms present and then based on those results diagnosing flu. in other words the test isnt exhaustive but its enough to know whats going on.

 

[marynnu]

Hyperglycaemic preterm neonates exhibit insulin resistance and low insulin production

Objectives To explore and compare the relationships between postmenstrual age (PMA), insulin, C-peptide and blood glucose concentrations (BGC) in hyperglycaemic and euglycaemic preterm neonates (PMA <30 weeks).Design Observational.Setting Dunedin Hospital Neonatal Intensive Care Unit, New...

bmjpaedsopen.bmj.com

Premature babies do have a weird blood glucose/insulin thing that goes on.

My question is if the insulin hangs about longer due to this and this alone why don't ALL premature babies crash with very low blood sugar as this is what that explanation seems to suggest. The insulin binds to antibodies that results in naturally high levels of insulin without the high c peptide as it is already out of the system. This in turn should manipulate the infants glucose levels down to a point of collapse IN ALL CASES.

Clearly this doesn't happen, I am sure there is the occasional case here and there but the COCh seems to have again been very unluky with the number they suddenly and unexpectantly had. Along with the number of air embolism cases (which is even rarer) this is a very unlucky hospital indeed unless of course there is a psychopathic murderous nurse on the staff.

That's a very good point. Lots of prems have an unstable blood glucose, but with the judicial use of IV glucose and/or an insulin infusion it's almost always manageable. The seemingly intractable nature of these two episodes in otherwise stable babies is pretty unusual IMO.

 

[Dotta]

i dont think allot of the points being disucssed actually hold much worth. in regards to the insulin it appeared to me to be more a point of dispute and then can be broken down to "its not the best/most conclusive test" but "its acceptable and more than enough". in a way thats similar to someone being diagnosed with the flu through symptoms rather than a microscopic exam of the bacteria present in their body, isolation of the relevant organisms, testing to see that there is enough bacteria to cause the symptoms present and then based on those results diagnosing flu. in other words the test isnt exhaustive but its enough to know whats going on.

Flu is caused by viruses - not bacteria.

Influenza virus.

That is why it can't be treated by antibiotics.

There are 4 types of influenza viruses:
A, B, C and D.

 

[WaneLyrical]

The points being made are two-fold though. There’s one argument being made that the test is not reliable or of forensic quality. Fair enough, not sure how much it truly matters.

But the second point is even if the test was reliable, the inference drawn during the trial was erroneous. What I would like to see is a comparison of results with other premature babies who’ve been screened as a result of hypoglycaemia, to see whether these two really are outliers. Comparing their results to adults is meaningless, it if is known that other substances in a premature baby are known to bind to the insulin/ assay.

The question still boils down to why did the babies have hypoglycaemia. There are many reasons for this that do not involve insulin, e.g. sepsis. We know from what we’ve been told about how the investigation unfolded that these cases were assumed to be poisoning in hindsight, with very little attention paid to them at the time.

So the question still boils down to: can these episodes of hypoglycaemia be explained by anything other than poisoning. If the answer is yes, then it follows that the jury was misled.

 

[marynnu]

The points being made are two-fold though. There’s one argument being made that the test is not reliable or of forensic quality. Fair enough, not sure how much it truly matters.

But the second point is even if the test was reliable, the inference drawn during the trial was erroneous. What I would like to see is a comparison of results with other premature babies who’ve been screened as a result of hypoglycaemia, to see whether these two really are outliers. Comparing their results to adults is meaningless, it if is known that other substances in a premature baby are known to bind to the insulin/ assay.

The question still boils down to why did the babies have hypoglycaemia. There are many reasons for this that do not involve insulin, e.g. sepsis. We know from what we’ve been told about how the investigation unfolded that these cases were assumed to be poisoning in hindsight, with very little attention paid to them at the time.

So the question still boils down to: can these episodes of hypoglycaemia be explained by anything other than poisoning. If the answer is yes, then it follows that the jury was misled.

No attention was paid because the results took so long to come back, by which time the babies were fine. An oversight for sure but that is what happened. The outstanding issue was the high insulin level vs. the low c-peptide. I'm not sure either baby had sepsis, did they?

 

[Sweeper2000]

just so people know prof hindmarsh has received coms about this issue. it seems he will defend his position given during the first trial but due to the potential for new charges is not in a position to do so. so he is aware of the doubts, presumably is aware of the contents and still stands by his original position.

i think the mods will allow this apologies before hand if not. the onyl reason im putting this here is that its the only talk from hindmarsh about this issue.

https://twitter.com/x/status/1904846603287933018

"
I wrote;

Please find attached statements from expert witnesses instructed by Letby’s barrister, casting doubt on the safety of the Baby F conviction. In addition, one expert states you made three errors in your analysis.

Do you wish to comment on these? More broadly, have you considered the possibility that you might have been wrong in your analysis?

Please let me know either way if you wish to respond, and may I have your response tomorrow by 4 PM?

Many thanks

Dr Phil Hammond

He replied:

Thank you

This case is subject to a potential appeal as well as further charges that the CPS are considering

As such it would not be right to comment at this stage.

Regards

Peter Hindmarsh

"

 

[May72031]

The question still boils down to why did the babies have hypoglycaemia. There are many reasons for this that do not involve insulin, e.g. sepsis.

There was no evidence the babies had sepsis. This is the second time in a few days I have seen this baseless claim.

 

[JosieJo]

The points being made are two-fold though. There’s one argument being made that the test is not reliable or of forensic quality. Fair enough, not sure how much it truly matters.

But the second point is even if the test was reliable, the inference drawn during the trial was erroneous. What I would like to see is a comparison of results with other premature babies who’ve been screened as a result of hypoglycaemia, to see whether these two really are outliers. Comparing their results to adults is meaningless, it if is known that other substances in a premature baby are known to bind to the insulin/ assay.

The question still boils down to why did the babies have hypoglycaemia. There are many reasons for this that do not involve insulin, e.g. sepsis. We know from what we’ve been told about how the investigation unfolded that these cases were assumed to be poisoning in hindsight, with very little attention paid to them at the time.

So the question still boils down to: can these episodes of hypoglycaemia be explained by anything other than poisoning. If the answer is yes, then it follows that the jury was misled.

Yes there could be other reasons but those other reasons were not present...even if they had been the whole point is these babies did not respond to iv glucose

 

[Marantz4250b]

just so people know prof hindmarsh has received coms about this issue. it seems he will defend his position given during the first trial but due to the potential for new charges is not in a position to do so. so he is aware of the doubts, presumably is aware of the contents and still stands by his original position.

i think the mods will allow this apologies before hand if not. the onyl reason im putting this here is that its the only talk from hindmarsh about this issue.

https://twitter.com/x/status/1904846603287933018

"
I wrote;






He replied:






"

He's wrong about it being inappropriate to comment due to any potential appeal. There is no appeal at all in the works; she currently has no right to appeal anything at all so there is no potential sub-judice consideration.

Even if there were an appeal likely to be granted, that is in front of judges who are deemed not to be subject to influence from public statements. But, it hasn't been so irrelevant.

Similarly, as regards the ongoing investigation and the possibility of further charges; same thing, proceedings are not "active" (she hasn't been arrested, let alone charged) so there is no possibility of any any contempt issues.

Edit: although he may have a point if he were likely to be advising the prosecution or in the frame to be a witness.

 

[WaneLyrical]

Yes there could be other reasons but those other reasons were not present...even if they had been the whole point is these babies did not respond to iv glucose

Is there anything at all suspicious about Baby L if those insulin/c-pep readings weren’t present?

Hypoglycaemia present at birth, persisting for 2 days, resolved once the infusion was increased accordingly (to 15% I think). Shoo Lee is saying it’s a normal case of hypoglycaemia in an infant, the dextrose given and/or the rate wasn’t sufficient to resolve it, but once it got there it resolved immediately. He’s critical of the staff for not increasing the dextrose sooner.

Or is this presentation so completely unusual that it makes more sense that a nurse poisoned 5 bags to create low level hypoglycaemia drama when she wasn’t on shift?

 

[Sweeper2000]

He's wrong about it being inappropriate to comment due to any potential appeal. There is no appeal at all in the works; she currently has no right to appeal anything at all so there is no potential sub-judice consideration.

Even if there were an appeal likely to be granted, that is in front of judges who are deemed not to be subject to influence from public statements. But, it hasn't been so irrelevant.

Similarly, as regards the ongoing investigation and the possibility of further charges; same thing, proceedings are not "active" (she hasn't been arrested, let alone charged) so there is no possibility of any any contempt issues.

Edit: although he may have a point if he were likely to be advising the prosecution or in the frame to be a witness.

i think hes referring to the conference tbh. as its in the process and does mean if its granted as new evidence by the courts then he might get dragged back into court. especially as the conference directly contradicted what he said was the case.

lotta questions and stuff kinda up in the air atm. possible dr lee's conference gets admitted and possible she gets charged with new cases. tbh all thngs should be put on a back burner up until we ee what happens with both of those possibilities. new charges would be more damning and the conference could throw a whole new dimension into it. the conference is a big question mark and we all thought new charges would be possible.

 

[Baileyboo]

Hyperglycaemic preterm neonates exhibit insulin resistance and low insulin production

Objectives To explore and compare the relationships between postmenstrual age (PMA), insulin, C-peptide and blood glucose concentrations (BGC) in hyperglycaemic and euglycaemic preterm neonates (PMA <30 weeks).Design Observational.Setting Dunedin Hospital Neonatal Intensive Care Unit, New...

bmjpaedsopen.bmj.com

Premature babies do have a weird blood glucose/insulin thing that goes on.

My question is if the insulin hangs about longer due to this and this alone why don't ALL premature babies crash with very low blood sugar as this is what that explanation seems to suggest. The insulin binds to antibodies that results in naturally high levels of insulin without the high c peptide as it is already out of the system. This in turn should manipulate the infants glucose levels down to a point of collapse IN ALL CASES.

Clearly this doesn't happen, I am sure there is the occasional case here and there but the COCh seems to have again been very unluky with the number they suddenly and unexpectantly had. Along with the number of air embolism cases (which is even rarer) this is a very unlucky hospital indeed unless of course there is a psychopathic murderous nurse on the staff.

Antibodies to insulin are rare and only occur after exposure to insulin. I Think either the mother would need to be on insulin or the baby have received it to have the Antibodies. The Antibodies from the mother pass through the placenta to protect the baby from infection after birth. Premature babies have less of these Antibodies then term babies.
I think the defence would have been aware of insulin antibodies affecting the c peptide to insulin ratio. Ben Myers says in his opening speech he's going to call a professor to discuss alternatives reasons other then poisonings but then never called him.
One of the consultants said at the Thirlwall inquiry that it wouldn't be possible for baby F to physically make the huge amount of insulin in his blood. I don't think the theory that both insulin poisonings were caused by insulin antibodies would have stood up in court.

 

[JosieJo]

Is there anything at all suspicious about Baby L if those insulin/c-pep readings weren’t present?

Hypoglycaemia present at birth, persisting for 2 days, resolved once the infusion was increased accordingly (to 15% I think). Shoo Lee is saying it’s a normal case of hypoglycaemia in an infant, the dextrose given and/or the rate wasn’t sufficient to resolve it, but once it got there it resolved immediately. He’s critical of the staff for not increasing the dextrose sooner.

Or is this presentation so completely unusual that it makes more sense that a nurse poisoned 5 bags to create low level hypoglycaemia drama when she wasn’t on shift?

I'm sure there will be neonatal staff that can answer this much better than me ..and only from memory I would have to go back and read the evidence...but from memory the baby had hypoglycaemia straight after birth (which is not uncommon) but instead of following the usual path of correcting through feed and glucose it persisted for much longer and required much higher doses of glucose with no apparent cause

 

[Tortoise]

Is there anything at all suspicious about Baby L if those insulin/c-pep readings weren’t present?

Hypoglycaemia present at birth, persisting for 2 days, resolved once the infusion was increased accordingly (to 15% I think). Shoo Lee is saying it’s a normal case of hypoglycaemia in an infant, the dextrose given and/or the rate wasn’t sufficient to resolve it, but once it got there it resolved immediately. He’s critical of the staff for not increasing the dextrose sooner.

Or is this presentation so completely unusual that it makes more sense that a nurse poisoned 5 bags to create low level hypoglycaemia drama when she wasn’t on shift?

Yes, it is suspicious that baby L's blood sugar plummeted when Letby came on the day shift, and his twin collapsed due to air embolism. Exactly mirroring the cases of twins E and F eight months earlier.

Baby L's hypoglycaemia had resolved during the previous night shift, his blood sugar reading was 3.6 at 1am.

I wouldn't agree that Letby was poisoning bags of glucose to create low level drama, she was found guilty of trying to kill him. Poisoning the very remedy that she knew they would apply to correct his hypoglycaemia.

 

[WaneLyrical]

Yes, it is suspicious that baby L's blood sugar plummeted when Letby came on the day shift, and his twin collapsed due to air embolism. Exactly mirroring the cases of twins E and F eight months earlier.

Baby L's hypoglycaemia had resolved during the previous night shift, his blood sugar reading was 3.6 at 1am.

I wouldn't agree that Letby was poisoning bags of glucose to create low level drama, she was found guilty of trying to kill him. Poisoning the very remedy that she knew they would apply to correct his hypoglycaemia.

The prosecution alleged Letby poisoned a bag at noon on 8th April. So how does a reading of 3.6 at 1am on 9th April support that?

 

[Tortoise]

The prosecution alleged Letby poisoned a bag at noon on 8th April. So how does a reading of 3.6 at 1am on 9th April support that?

No they didn't. The bag was hung at noon on 8th April, his blood sugar stabilised by 1am the following morning, and the same bag was poisoned before 9.30am.