• #2,801
  • #2,802
The sheer volume of investigations and inquiries into various hospitals across the UK over neonatal deaths- suggests it’s a widespread issue, so it’s not wrong to assume there are a lot of sudden and unexpected deaths everywhere that are currently unexplained.
What are you claiming is a widespread issue, exactly?
 
  • #2,803
<modsnip: Quoted post was removed due to link to non approved source>

It certainly is interesting in that just about all cases, Dewi Evans removed incidents when Letby was off duty and added incidents when Letby was on duty.

What are the chances of the original chart being incorrect in just about every incident when Letby wasn't there and the chart favoured Letby, and also incorrect in just about every incident when Letby was there and the chart favoured Letby? Yet, not incorrect in just about every incident when it didn't favour Letby? I think we need a statistician to come along and gives us the odds. I'm gonna push the boat and say it is highly unlikely.

As for: "it was ultimately up to the jury to decide if the incident was suspicious." I keep hearing this from various posters as some final analysis. I don't think these posters understand the core tenets of the legal system.

That being: the jury needs to hear all of the information before deciding, from both the prosecution and the defence. They didn't get it. They were presented with a chart that looked damning but not the evolution of that chart and its methodology which has led qualified, authoritative people to state: cheery-picked, misleading, scientifically and evidentially worthless.
The problem with your above claims is that Dewi Evans had no idea which nurses worked when. He could not know that any of the deaths which he termed 'not suspicious' were on days Letby didn't work.

So actually, that looks bad for Letby's defense, imo. Those determinations were made without knowing which nurses worked on which shifts, and it just coincidentally happened that the suspicious incidents all happened when Letby was on duty?


google:
Dewi Evans did not know anything about the nurses’ schedules (or duty rosters/shift patterns) when he was initially analysing the babies’ deaths and collapses.Evans, a retired consultant paediatrician, was approached by Cheshire Police (via the National Crime Agency) in May 2017 to review the clinical notes of over 30 babies who had died or collapsed at the Countess of Chester Hospital’s neonatal unit between January 2015 and July 2016. He has repeatedly stated that his medical analysis was conducted blindly with respect to staffing:
  • He explicitly instructed police: “I told Cheshire Police not to tell me if they suspected anyone of being responsible for criminality. In other words, I wanted to investigate the cause of the deaths of these babies. I was not there to investigate the crime.”
  • “At that time I was unaware of the name Lucy Letby or anyone else.”
  • “I approached it in a very clinical way. I only had access to the notes.” (The notes were electronic copies provided by the hospital via police; he had no other data.)
He reviewed each case individually on the medical evidence alone, identifying 15 babies whose collapses he could not explain naturally and later attributing some to air embolism, excessive milk/air injection, trauma, or (in 2018) insulin poisoning. Only after sending his reports did he advise police: “they needed to look at the duty rosters for each of the events, to see which nurses and which doctors had been on duty at the times when the babies were harmed.” It was the police who then cross-referenced the suspicious incidents against the rosters and identified Letby as the common factor. Evans himself only learned her identity (and the shift details) later, once the roster checks had been done. He has confirmed that each medical case stood alone on the clinical notes and did not depend on staffing information. (Note: Evans later received Letby’s shift data for statistical calculations during the Thirlwall Inquiry or post-trial commentary, but this was not part of his original medical analysis of the causes of death/collapse, which formed the core of his expert evidence at trial.)This process was designed to keep his medical opinions independent of any suspect or roster information. While critics have questioned how the police initially selected the 30+ cases (knowing Letby was often present), the evidence shows Evans himself had no knowledge of or access to nurses’ schedules during his core analysis.

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  • #2,804
By whom? Are you unaware? I feel like I'm educating people on the case here.
Not really--people do not often use 'whom' anymore...times are changing.
Right.

Detective Sergeant Jane Moore put together the original chart: "suspicious incidents". Letby was not on duty for roughly one third of those incidents.
'Detective" Jane Moore was NOT a medical expert. So she threw together the dates and names of virtually ALL of the patients deaths in that time period.

Dewi Evans, the prosecution's expert witness, revised the chart. He removed 10 incidents when Letby was not on shift; he added 5 incidents when Letby was on shift. Interestingly, 0 incidents from indictment babies were removed from the Moore chart when Letby was on shift. Feels like the chart is being rigged to tell a story. Hmmm, I'd want the jury to hear all of this (if that was my Sister).
Dewi Evans had no idea which nurses or doctors worked on which days.

He was only given the medical data and medical reports for each death. He had no information concerning the shift schedules.

That information ---that he had no idea who worked when---was given to the jury. So they did not need to concern themselves with that issue that you are working hard to create, imo.


In reality, it is very bad for your girl Letby, that a medical expert looked at ALL of the sudden deaths, using only the medical data, and took away 10 as being unsuspicious. And coincidentally, all of those happened to be on days LL was not on duty.

And he added 5 others as being possibly suspicious. And again, coincidentally, LL happened to be on shift.

If Evans had no idea about who was on shift when, then this information looks really bad for poor Nurse Letby. imo
 
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  • #2,805
<modsnip: Quoted post was removed>

Cyclical patterns of events are expected to happen. We live on Earth, where everything cycles, starting with the seasons. Sometimes we can say why cycles of events happen, sometimes we can't.

But if we can't, it would be expected to rule out natural reasons before one starts looking for serial killers on the units. Not that they can't happen, but with such outliers, one has to rule out the real reasons first.

They never invited the external observer to look at their own practices. They just said, "we did everything as before".

And then when Lucy Letby is already in jail, we find out that Dr. Jayaram has poor understanding of ventilation principles, that dr. Breary lacerated the baby's liver,
Breary did not lacerate the liver --that has been debunked.
that Dr. Gibbs didn't see a neonate under his care for three days, and that there was Pseudomonas on the unit.

BTW, what these doctors did, IMHO, falls under "mistakes inevitable on a very busy unit, with limited funds, and overwhelmed medical personnel", nothing else. But why put a nurse behind bars for it? On no evidence?
Some of the above are problematic and are because of understaffing etc----but that does not make Nurse Letby innocent.

Two things can be true simultaneously:
----The clinic was understaffed and underfunded and it affected some services
and
----There was a serial killer in the unit wreaking havoc
 
  • #2,806
You're mistaken. I'd probably revisit the case, do a bit of reading, that sort of thing.

What I would say is that he wasn't the only one involved in amending the chart, although he was a major influence, nor was Moore the only one involved in compiling the original chart.

Either way, the jury didn't hear the evolution of this chart. Shame,

The biggest problem of this case?
The way it is presented, it does not fit the XXI century.

It reminds me of an astrologer who asks for the exact date, place and time of your birth to make the most "precise" horoscope. Some people believe them, even tailor their lives according to the predictions.

The truth is, that at the moment a child is born, neither the mom nor the OBGYNs/nurses are in a position to look at the clock. They go through the regular steps, and only when mother and child are taken care of, the first chart entry is made. The time when the charting nurse looks at the clock is the "exact time" when your baby was born.

Once, an astrologer made a "very precise" horoscope for my kid. Then I asked her to move the time of birth 20 minutes back and redo the horoscope. It all looked different.

COCH NICU staff rotas and "untoward events" remind me of that horoscope. For starts, the idea of a unit serial killer sounds off, but maybe Breary watched one inspector Barnaby too many. Then Breary used the staff rota as a mini-predictive model. It spat out some names (and then he rolled them in his head, "nice Lucy" or "not so nice", introducing more subjectivism). And then the good doctors started feeding this homebred model different data, what's an adverse event, what's not, who was vacationing and when. The analysis became even more subjective, making Dr. Breary anxious, obsessed and scared. Didn't he tell the German magazine that he wanted to leave but felt "the need to protect the babies"? This I believe. His case is probably the example of self-hypnosis merged with superstition, but at least I don't see secondary gain in his behavior, just a clinician on edge, perhaps.

I can't say the same about Drs. Jayaram or Evans. Their behavior reflects neither fear nor superstition. Sadly, what they did affected everyone: the patients, the unit, the accused nurse, their own colleague Breary, and sadly, the parents.

But I do hope for a retrial and then, there is the name for certain choices.
 
  • #2,807
I just wanted to make a remark. Perhaps such cases, not only complex but highly professional, especially if a person is accused of murder (and we know how easy it is to accuse medical professionals), should be decided by specially designed medical bodies, not mere jurors.

For a jury, medicine is too specific. For a plane accident, there is NTSB. If there is a nuclear plant disaster, IAEA is involved. If technology is complex for a jury trial, how is medicine easier?

I remember how eons ago I was translating a lecture on emergency medicine to a foreign audience. The lecturer said, "so we got a patient in status epilepticus...speaking of it why do people have seizures?" Vague responses from the audience followed. "For one thing" he said, "people forget their medicines, and for another - people seize".

And this is probably answer to half of medical questions, because medicine is both practice, art, and intuition. In medicine, answers are often split between solid logic and, GOK ("God only knows").

Lucy Letby's case might be the example of the situation when the GOK part failed. "What did we do wrong?" is the first question of any doctor. The answer was "nothing". After that, the self-talk is either, "let's consult peers" or "GOK, just a bad streak, let's wait, we'll perform post hoc analysis and get the answer later". Instead, the doctors rushed to ad hoc analysis, which often fails. It is obvious that they were experts in neither statistics nor human behavior. It is interesting to know what else was at play. (I lean less towards "scapegoat" theory and more towards "shared panic".) Panic is a mass event; when panic guides you on presenting the case to an unprofessional jury, fear enlarges like circles on the water. IMO, it was essentially fear that sent Lucy Letby to jail, and now we are dealing with the consequences.

So private trial experts may not work, anywhere. Evans is not the only example, why. Jury trial in this case arrived at unsafe conviction.

There should be some better options, and worldwide so.
 

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