38 Comments
Jul 14Liked by Christopher Snowdon

If you listen to the LL is innocent brigade you get a really good story but that is all it is as it simply does not correlate to much detail in the actual case. These people seem to have made up their mind not to trust our institutions or doctors or police and instead trust a kind looking middle class white girl. The evidence against Lucy Letby is over whelming and that is why the jury found her guilty. it saddens me that many of these innocent advocates haven't looked in detail at the trial evidence much of which you can get from CrimeScene2 videos. Personally I am beginning to lose patience as the weight of the evidence is there. I too have listened to their arguments and believed she was innocent only to go back and look at the trial evidence which says otherwise but it takes a lot of time and patience to really look . The jury and apparently nearly all present at the full trial came away convinced of her guilt.. The innocent brigade are led IMO by a small group of conspiracy theorists and illogical thinkers that further erode our society, sometimes I wonder if that is their intent. Yes historically the police have screwed up but this is not such a case. Lucy Letby is guilty as generally convicted.

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The jury, and the journalists, listened for many days to Dr. Dewi Evans. He has been testifying as an expert in court for many years already. One could say he is a professional.

The evidence against Lucy is "far from overwhelming."

Of course the jury came away convinced, they were not given other, far more complicated, exonerating information. Those who think the conviction unsafe, will for years debate why the defense was so weak.

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You say that the NY and Telegraph articles "argue or imply that the Countess of Chester neonatal wards were full of very premature and sick babies who were at death’s door and that there was nothing suspicious about the spike in deaths in 2015-16 which could have been the result of chance or under-staffing."

The section in the Telegraph "A struggling baby unit" refers to an "alarming spike in the number of newborn deaths" not a merely explaining away of a chance occurrence. They spend time discussing the CQC findings that there were infection control issues. Many of the more serious risks around patient care can be attributed to HR but it's flippant to refer to it as simply "under-staffing" as though it just means they can't take as many coffee breaks. There are life and death consequences of hospital management resourcing. A facility which has wastewater leaks and storage in corridors is in trouble. Certainly I was aware of all these issues at the time and not because I work in public health. It was on the public record, but then easily forgotten when a nurse was available to explain it all away.

Most of the statistical arguments around probability in the decent discussions have referred not to the cluster of events but to the approach to determine how likely it is that one nurse should be on duty at the time (if not the exact place) that some babies died. Initially this was a million to one or less. This was challenged by the Royal a Statistical Society some years ago relating to other cases. There was undoubtedly an increase in deaths, and this will happen occasionally somewhere sometime but in countries where infant deaths are relatively rare they should be investigated.

You present sceptics/conspiracy theorists as though they are QAnon. There are different grounds for calling into question the safety of the conviction but some legal judgments around the right to appeal make this difficult. I personally suspect that, with the effective job done on demonising her in the media even before a verdict was reached (many stories smelling of misogyny in the way women are often treated more harshly than men in the same circumstances), nobody wanted to be the one to give her aid.

I'm sure you agree that if there is a chance there has been a miscarriage of justice this should be investigated, and that this should not be obstructed.

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Lucy worked more shifts than other nurses, as she lived close by the hospital. She was one of only two nurses on the ward who had advanced education re. caring for prematurely born. She took therefore care of the most vulnerable babies.

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If nothing else you've inadvertently created a discussion forum. There are links to other pages in the last diatribe's comments that have better grasp of the stats.

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Government statistical data on neonatal mortality shows that the number of deaths was pretty much what one would expect given the acuity of the cases. Many of those babies only had a 50-50 chance of surviving one week.

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author

But babies are not killed by statistics. As I try to explain in the post, you need to look at each case to see what caused the death and whether there was anything suspicious about it. If they had been "normal" deaths, you could write it off as a bad couple of years. If they had been the result of systemic problems in the hospital, you would have a non-sinister explanation. But, by and large, this does not seem to have been the case.

It is, by the way, a little ironic that people who claim (wrongly) that Letby was convicted because of crude statistics are using crude statistics to defend her.

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That has been done - look at each baby and try to figure out if there was anything suspicious about it. Answer: no. There were systemic problems in the hospital - it was admitting babies which it was not equipped or staffed to deal with. Your last remark is most peculiar. Many people were convinced by the spreadsheet. That spreadsheet is a statistic. I am not using crude statistics to defend her. MBRRACE does rather sophisticated statistics.

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What about the skin discoloration in the embolus cases? Everyone involved seemed to think that was suspicious

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Nobody who knows the symptoms of sepsis thought that skin discoloration suspicious. It is diagnostic of sepsis. Certainly there is not a single air embolus case there. Shoo Lee destroyed the air embolus idea completely

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And yet strangely, not in court

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Yes. UK criminal justice is a big joke.

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You are correct. But they can be killed by a pathogen called Pseudomonas Aeruginosa.

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Jul 14Liked by Christopher Snowdon

Statistics also can be used to show their is a reasonable chance of an anti social personality type being employed at any one time within the NHS that employs 1.5 million people.

Your stats are just general, broad indicators that ignore the babies actual state i.e. whether they are stable or infected, have certain conditions etc. So the stats you are using do not account for the actual facts whereby the neonates in question were just prior to their collapse seen as not likely to have collapsed. This is the essence of the case.

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Yes I know. My calculation of the posterior odds given everything we know presently comes out at 100,000 to 1 in favour of Lucy’s innocence. I think it’ll soon be 1,000,000 to 1 since there are more revelations coming. I’m a mathematician, probabilist and a statistician, remember, and I am perfectly at home in frequentist and Bayesian paradigms.

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PS there is plenty of evidence Lucy does not have an anti-social personality type. Get real, please.

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The evidence and verdicts would indicate she is no Mary Poppins.

I note you replied above with jargon...on thin ice are we Richard?

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Anything you'd like me to explain? The verdicts indicate she is no Mary Poppins. The evidence indicates she was a caring careful professional nurse and everything we know about her indicates she does not have an anti-social personality type

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Jul 14·edited Jul 14

No Richard, the evidence says she attacked the babies, your evidence and those in your camp is abstract to the reality. I take it Lucy Letby, her solicitors and Ben Myers can read and if that is the case why didn't they enlist your services. Answer the arguments the innocent camp advocate does not counter the weight of other evidence the prosecution used against her.

Also looking you up on Wikipedia you allegedly stated Beverley Allit deserved a retrial and then Ben Geen also.

You would appear to be attracted to cases of accused medical professions?

Remember stats can only set a boarder picture and it is the details that actually existed case by case that determine the real probability of a crime being committed. Frankly I don't see the relevance of your case and obviously many others must agree with me.

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Regarding Baby A. The mother of the twins A and B had a health condition, which meant she had been arranging to have the births at another hospital under the direct supervision of a specialist consultant in the problems her condition gave rise to during pregnancy and after birth. An emergency Caesarean was required at CoCh due to the mother having problems with very high blood pressure - an additional risk for the twins. She testified she was very upset that her plans had not worked out. Instead after transfer to the neonatal units their care was left to a junior doctor, who had multiple problems inserting lines. The transfer from labour ward to the unit did not happen for 5 hours after birth and no records of care during these hours is provided. Fluids were not given for at least 4 hours before collapse and could have been even longer. The collapse 20 minutes after Letby came into the room could have been triggered by the Letby and the day shift designated nurse administering fluids through an incorrectly placed line. The junior doctor changed his account over the years from saying the line was slightly out of position to it was correctly positioned. Baby A’s lactate readings were high when measured at 2pm - they were not checked again. All this is ignored with Dewi Evans and Co determining air embolism over 2 years later because the death was sudden, unexpected and unexplained with recalled unprovable descriptions of skin discolouration. Really?? Or maybe the signs of deterioration following inadequate care during the day were missed by a junior doctor!

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Not forgetting the New Yorker stating “A pathologist observed that the baby had “crossed pulmonary arteries,” a structural anomaly,”

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Well it’s 24 hours since I as a defender of Lucy Letby gave an explanation of Child A’s death and there has been no response. Here is the CofA summary of how Dewi Evans diagnosed air embolus as the cause of death! How about getting a scientist to support this diagnosis!

53. His conclusion that air embolus was the cause of the collapse was therefore based upon a combination of factors. Individually none of those factors was diagnostic of air

embolus. He accepted that changes in skin colour viewed in isolation could not lead to a particular diagnosis. He accepted that the diagnosis of air embolus was a diagnosis

of exclusion, in the sense that you have excluded other explanations for the collapse, but he said that sometimes there is additional information, either discolouration or the

presence of air in an x-ray, and those factors will enable you to firm up your diagnosis.

Finding someone guilty of murder by injecting air into a baby’s veins based upon firming up a diagnosis from a combination of factors that individually are not diagnostic!! Is that really how low the UK Justice system has sunk - zero plus zero equals a hundred!!

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You are forgetting Dr. Marnerides. He declared previous autopsies incorrect. He stated that the bowels of the babies were normal - where the Alder Hay pathologist had seen NEC. He ruled out pneumonia as a cause of death stating "they died with pneumonia".

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If there were so many staff who described how the skin discolourations were unusual, strange and something they had never seen before, why was there a complete failure to document them at the time. Did all the accounts of the skin discolourations only get documented at police interviews several years later, which should result in the descriptions being treated with extreme caution? By the way how many conditions in premature neonates result in skin discolouration?

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This foes get away from the central point that the doctors were looking for an explanation because there was a cluster. But unexplained deaths are normal; clusters are expected; and Jayaram's contemporaries case notes do not record the symptoms that he now argues were there and are consistent with air embolism.

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The number of deaths on the unit continued to be high when Lucy was put on administrative duties (no longer present on the ward).

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^I’m in no way qualified to pass judgement on the science^

That much is clear from the post.

Baby A was left without fluids or glucose for 7-9 hours and had red flags for sepsis.

If you want to understand why Baby A died read Jamie Egan’s 400 page blog on the medical evidence, or listen to Dr Michael McConville on the “We need to talk about Lucy Letby” podcast and its follow up “The other side of Lucy Letby” in which he analyses the medical data on each baby starting with Baby A.

Suffice to say it would be surprising if a neonate did not collapse with the suboptimal care Baby A received.

All the cries of “stable”, “unexpected” and “never seen anything like that before” are the medical equivalent of “It came away in my hand ma’am”.

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Interesting note-- "Nurse Percival Calderbank checked on Baby D and found her to be settled and stable. She checked again 10 minutes later and found her to be satisfactory. Shortly after this, the monitoring alarm went off and Baby D was found desaturating and with her heart rate dropping."

So does this mean Letby snuck in behind Calderbank and caused an air embolism, even though she must have known the baby was being monitored closely and consistently? What kind of risk would that have entailed?

As to Snowdon's footnote regarding Dr Lee, the Dr himself feels his contribution would have made quite a difference, regardless of what the appeal judges state. Why he wasn't called ? One reason is it seems her defense team wasn't very good, as shown in a number of

"why did / didn't they do this?" questions that have come up.

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As with the prosecution, you're leaning very heavily on the fact that the deaths were unexplained.

From the New Yorker piece:

'“One of the problems with neonatal deaths is that preterm babies can die suddenly and you don’t always get the answer immediately,” Brearey told me. A study of about a thousand infant deaths in southeast London, published in The Journal of Maternal-Fetal & Neonatal Medicine, found that the cause of mortality was unexplained for about half the newborns who had died unexpectedly, even after an autopsy.'

I don't know the exact study Aviv is referring to here, but it's easy to find studies saying similar things. We should also remember that the infants at CoCH were more vulnerable than typical newborns. So, even one of the very doctors who initiated the suspicions against Letby admits that preterm babies can die suddenly, and the epidemiology suggests such deaths are *very* often left unexplained, even with an autopsy.

Do you not see how this is an *enormous* problem for the reasoning used by the prosecution at the trial? Unfortunately it seems the defence failed to make the jury aware of these salient facts.

I also think it's very unfair of you to spend so much time talking about the skin discolourations yet relegate Shoo Lee's assessment of them to a brief footnote. None of the prosecution's witnesses were experts in air embolism, an exceptionally rare medical event. They relied on Lee's published work on it. The fact that he totally rejects their interpretation should be very significant in anyone's book.

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Jul 27·edited Jul 27

It’s very odd that Shoo Lee’s study was even mentioned as it is on pulmonary vascular embolisms as a consequence of positive pressure ventilation and as such has little relevance to intentional embolism without ventilation. Further his main observation of discolouration is “pallor”, only one baby in the study had a specific rash and not one of the babies in the LL case had anything similar. (Except the one Dr J described in court which sounded suspiciously like a retrofit given he didn’t mention it at the time either in his clinical notes or to the coroner. )

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As I understand it, it was not a scientific study, but a 4-page "talking paper" intended to start a discussion about this issue.

I am also puzzled why Dr. Jayaram, who"felt a shiver over his spine" when he read this paper, did not immediately try to contact the author(s) for more information.

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If you had done your "homework" you would know that the New Yorker bought court transcript - they even mentioned how hard it was to choose - as these transcripts are expensive.

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Trial transcripts were obtained by the UK YouTuber Crime Scene 2 Courtroom. His channel has several hours of them being read, especially the ten days of Letby testimony. Very interesting. My biggest takeaway is the prosecuting barrister was excellent. Also, CS2C attended several days of the trial and has personal observations of Letby as a witness.

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author

Thanks

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The Prosecutor was very effective in turning the cross examination into Lucy Letby having to prove her innocence. So who did poison the babies with insulin if it wasn’t you? What caused the baby’s collapse if it wasn’t you? You cannot prove staffing issues were the cause can you?

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Few things are so easy as to destroy a person. Especially a person who has been hounded for several years already, arrested twice, interrogated, her house searched, her garden dug up, her scribbles leaked to the press, was arrested again, put in prison waiting for her trial, while the media turned her into the UK's most hated woman. Yep.

Sounds like how in Spain they used to hit the bull in the kidney-area first, before he was allowed into the arena to meet the matador.

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