Doctors’ failings killed babies, not Lucy Letby, claim experts
Doctors’ failings killed babies, not Lucy Letby, claim experts
Doctors’ failings killed babies and not Lucy Letby, experts have claimed.
Presenting “significant new medical evidence” in the case of the convicted killer, a panel of experts in the care of newborn babies experts alleged they died as a result of the poor care they received.
On Tuesday, analysis conducted by a committee of 14 neonatologists was revealed at a press conference in central London.
Letby, 35, from Hereford, is serving 15 whole-life orders for the murder of seven infants and attempted murder of seven others between June 2015 and June 2016 at the Countess of Chester Hospital.
Dr Shoo Lee, a Canadian neonatologist whose work was cited by the prosecution in the original trial, was critical of the care received by the babies and told the hearing his work was misused by the Crown Prosecution Service (CPS).
Dr Lee said that doctors had failed to spot a dangerous bacterial infection in one baby which later died, saying it was a ‘preventable death’.
In the case of Baby K, Letby was convicted of attempting to murder the infant by dislodging her tube. But Dr Lee said the tube was never inserted correctly by a doctor.
According to the panel of experts, another baby died after getting a blood clot when doctors left lines into the body without an infusion.
It comes as the Criminal Cases Review Commission (CCRC) announced it had received an application on behalf of Letby for her case to be reviewed as a potential miscarriage of justice.
Sarah Knapton Science Editor. Tom McArdle
That’s all for today
Thank you for following our live coverage of the press conference.
For the latest updates, please check back on our homepage here.
Letby’s legal case completely unprecedented
Never before in British legal history has such a highly respected group of medical experts come together to challenge the evidence against a convicted serial killer, writes Sarah Knapton.
The 14 neonatologists who have reviewed the Lucy Letby data are world-class specialists, with thousands of medical and scientific papers published between them.
Their conclusion: there were no murders, only the precariousness of prematurity, coupled with the tragic incompetence of a failing baby unit at the Countess of Chester Hospital.
Read the full story here.
New evidence ‘has to be taken seriously’, says former DPP
Lord Macdonald said Tuesday’s press conference had seen a “quite impressive body of evidence from the best qualified people in the world” that “something may have gone wrong”.
Speaking to Sarah Montague on The World at One, he said: “If that’s their view and it appears to be a reasoned view, coming from their level of expertise, then it clearly has to be taken seriously.”
Asked how unlikely it would be for a case to go back to the court of appeals so soon after a conviction, he said: “It will be unprecedented in the sense that it will have come so quickly.”
“If these 14 very high level experts are right,” he continued, “it will represent a comprehensive trashing of the prosecution case at the trials and I think that would be significant and that would be very very troubling for all criminal justice practitioners.
“If Lucy Letby is innocent, what happened to her will have been appalling beyond description.
“Now I’m not saying she is innocent but if that’s where this ends up, obviously the questions for the criminal justice system will be stark indeed.”
Dr Lee got involved after evidence used to convict Letby was ‘wrong’
Dr Shoo Lee said he got involved in the Letby case when it became apparent his work may have played a part in “an innocent woman [going] to jail for the rest of her life”.
Speaking after the press conference, he said that he was first contacted about the case in relation to an appeal by the convicted child killer and, after looking at transcripts, he became “concerned that there was a problem with this conviction because the evidence that’s being used to convict her - regardless of whether she is innocent or guilty - was wrong”.
“Something more needed to be done and so I decided that I would step up, even though this is not in Canada - and really nothing to do with me if you want to think of it that way - but for me it was important because it is about right and wrong.
“It is about a young woman’s life. All of us our lives are precious. I could not see how we could send an innocent woman to jail for the rest of her life if in fact she was innocent.”
He adde: “So I decided to investigate and that’s when I approached the solicitors to say I would be willing to look at the evidence to see whether or not there was a problem with the evidence.
“And if there was then I would be willing to convene a panel that would have the authority and the weight to say this is what we think really happened and then people actually believe.
“Because this is no longer just one physician standing up to say Lucy Letby was wrongly accused, this is the panel of 14 of the world’s top experts.
“If you don’t believe them who will you believe?”
Press conference a ‘gamechanger’ for Letby
Mark McDonald, the barrister leading Lucy Letby’s legal team has described Tuesday’s presentation as a “gamechanger”.
Asked what he thought of the press conference, Mr McDonald said: “I’ve never known anything like it.
“You know, never before - and I mean it’s a grand statement to make - but never before have we had such an experienced credible body of experts come together across the world and say something has gone wrong, and I think it’s a gamechanger.”
Mr McDonald said he would like to see the matter “certainly referred to the Court of Appeal by the summer”.
Numerous issues identified by panel
During the presentation by Dr Lee, the panel’s general findings were also listed. These were:
- 1.Inadequate numbers of appropriately trained personnel
- 2.Lack of training for assigned nursing roles
- 3.Inadequate staffing
- 4.Work overload
- 5.Poor plumbing and drainage, resulting in need for intensive cleaning; this was a potential factor in Stenotrophomonas maltophilia colonisation and infection
- 6.Poor environmental temperature control in facility
- 7.Difficulty in finding a doctor when need arose
- 8.Congestion at medication cabinet and preparation trolley
- 9.Lack of appropriate facilities for sterile preparation, e.g. IV drugs prepared in corridor
- 10.Some high risk infants who should have been born and cared for at higher level institutions were born and cared for in Countess of Chester Hospital because of a shortage of beds at higher level facilities where they should have been admitted
- 11.There were delays in transfer of sick infants to higher level facilities when the need arose
Case should’ve gone to experts before charges were brought, says lawyer
Mark McDonald, the barrister leading Lucy Letby’s legal team, said details should have gone to “highly experienced” neonatologists and pathologists before it got “anywhere near a criminal charge”.
“In this case, the lead prosecution expert who was a retired paediatrician of 15 years, described in a podcast how he contacted the police, how he jumped in the car and drove to a police station,” he said.
“How he, he says, was handed a set of notes, and within 10 minutes whilst drinking a cup of coffee had identified the baby had been murdered and that was the start of the process.
“That was not the way to start this case at all.”
Letby’s defence team will be back in Court of Appeal ‘very soon’
Mark McDonald, the barrister leading Letby’s legal team, said they would be back in the Court of Appeal “very soon”.
He said: “There is overwhelming evidence that the conviction is unsafe.
“And if Dr Shoo Lee and the panel are correct, no crime was committed.
“And if no crime was committed, that means a 34-year-old woman is currently sitting in prison for the rest of her life for a crime that just never happened.”
Hospital with similar record would be shut down in Canada, says panel chair
Dr Shoo Lee said the medics treating the babies perhaps “didn’t realise their own deficiencies”.
Asked about the Countess of Chester Hospital during questions from journalists at the Lucy Letby press conference, the retired medic from Canada, said: “I would say if this was a hospital in Canada, it would be shut down.
”It would not be happening.”
”It would not be happening.”
Countess of Chester Findings by panel
- 1.Medical histories were incomplete
- 2.Failure to consider the obstetric history
- 3.Disregard for surveillance warnings about bacterial colonisation
- 4.Misdiagnosis of diseases
- 5.Caring for patients that were beyond their designated level of care
- 6.Unsafe delays in diagnosis and treatment of acutely ill patients
- 7.Poor skills at resuscitation and intubation
- 8.Poor supervision of junior doctors in procedures like intubation
- 9.Poor skills in basic medical procedures like insertion of chest tubes
- 10.Lack of understanding about respiratory physiology and basics of mechanical ventilation
- 11.Poor management of common neonatal conditions like hypoglycaemia
- 12.Lack of knowledge about commonly used equipment in the NICU
- 13.Failure to protect at risk patients e.g. haemophilia, from trauma during intubation
- 14.Lack of teamwork and trust between the health professionals
Panel found no evidence of murders
Dr Lee told the hearing: “In summary, we did not find murders.
“In all cases death or injury were due to natural causes or just bad medical care.
“Lucy was charged with seven murders and seven attempted murders. In our opinion, the medical opinion, the medical evidence doesn’t support murder in any of these babies - just natural causes and bad medical care.
“Our full report will go to Lucy’s barrister later this month and then it will be up to him and the courts to decide what next to do.”
Babies may not have been poisoned at all
Interesting new data coming out on the insulin charges. Letby was convicted of attempting to murder two babies by poisoning their feeding bags with insulin.
The convictions were based on blood test readings that showed high insulin levels but low c-peptide levels in the blood - a clear sign that artificial insulin has been administered.
However Professor Geoff Chase, a world expert in insulin, from the University of Canterbury in New Zealand. says that the prosecution and police were basing their readings on ratios from adults and children.
In fact, he says the ratio of c-peptide to insulin was completely normal for a pre-term infant.
This is important because even the defence accepted that the two babies had been poisoned. They just said it wasn’t Letby that was responsible. Now it appears they may not have been poisoned at all.
Babies died from poor care and were not killed by Letby, panel says
The doctors at the Countess of Chester are not being cast in a good light.
The new medical review suggests that many of the babies died from sub-optimal care at the hospital.
In the case of one baby, Dr Lee said that doctors had failed to spot a dangerous bacterial infection called ‘Stenotrophomonas maltophilia’ and so failed to give life-saving antibiotics.
“This was a preventable death,” he told the press conference.
According to the panel of experts, another baby died after getting a blood clot when doctors left lines into the body without an infusion.
The review panel believes a blood clot built up at the spot where the line entered the body, and when the infusion was switched on, it, dislodged and travelled to the brainstem, causing sudden collapse.
In the case of Baby K, Letby was convicted of attempting to murder the infant by dislodging her tube. But Dr Lee said the tube was never inserted correctly by a doctor.
“The consultant did not understand the basics of resuscitation, air leak, and mechanical ventilation,” he said.
Prosecution’s skin discolouration claim was incorrect, says Dr Lee
Dr Shoo Lee, an eminent Canadian neonatologist, and Head of the Division of Neonatology at the University of Toronto, is now giving evidence about each of the babies.
His research paper from 1989 was a key plank in the prosecution’s case that some of the babies had died from air embolism.
Dr Lee had found that in some cases of air embolism, the skin goes blue with bright pink blood vessels standing out - a skin discolouration that doctors claimed was present in some of the Letby babies.
Crucially, the prosecution never contacted Dr Lee to check if their interpretation of his work was correct. It wasn’t.
Dr Lee has since found that injecting air into a vein never gives that pattern on the skin.
“If that was true it would be the first case ever described,” he told today’s press conference.
Report is for families to know ‘what really happened’
Dr Lee, who co-authored a 1989 academic paper on air embolism in babies which featured prominently in Letby’s 10-month trial, told the press conference that the panel’s thoughts were with the families of the babies who died.
“We understand their stress and their anguish, and our work is not meant to cause more distress,” he said.
“Rather, it is meant to give them comfort and assurance in knowing the truth about what really happened.
“We know that they want to know the truth and that is why we are here to tell the truth.
“Should they have any queries or concerns, we’d be pleased to discuss them with them.”
Experts who reviewed evidence revealed
Dr Lee is now going through the names of the experts who have reviewed the latest medical evidence on the panel, writes Sarah Knapton.
There are some big names here including Ann Stark, Professor in Residence of Paediatrics at Harvard University and Professor Mikael Norman of the renowned Karolinska Institute in Sweden.
Prominent professor could help Letby
The appearance of Professor Neena Modi on the panel is a big deal for the Letby defence team, writes Sarah Knapton.
Prof Modi is the past president of the Royal College of Paediatrics and Child Health (RCPCH) and a highly respected academic at Imperial College.
She also leads the UK National Neonatal Research Database (NNRD).
If Prof Modi thinks there is something wrong with the medical evidence in this case then that lends a great deal of weight to claims that there has been a miscarriage of justice.
Letby’s case to be reviewed for potential miscarriage of justice
Lawyers for convicted child serial killer Lucy Letby applied to the Criminal Cases Review Commission to investigate her case as a potential miscarriage of justice on Monday, the organisation said.
A CCRC spokesman said: “We are aware that there has been a great deal of speculation and commentary surrounding Lucy Letby’s case, much of it from parties with only a partial view of the evidence. We ask that everyone remembers the families affected by events at the Countess of Chester Hospital between June 2015 and June 2016.
“We have received a preliminary application in relation to Ms Letby’s case, and work has begun to assess the application. We anticipate further submissions being made to us.
“It is not for the CCRC to determine innocence or guilt in a case, that’s a matter for the courts.
“It is for the CCRC to find, investigate and if appropriate, refer potential miscarriages of justice to the appellate courts when new evidence or new argument means there is a real possibility that a conviction will not be upheld, or a sentence reduced.
“At this stage it is not possible to determine how long it will take to review this application. A significant volume of complicated evidence was presented to the court in Ms Letby’s trials.
“The CCRC is independent. We do not work for the government, courts, police, the prosecution or for anyone applying for a review of their case. This helps us investigate alleged miscarriages of justice impartially.”
Letby maintains innocence despite having two appeals rejected
The former nurse lost two bids last year to challenge her convictions at the Court of Appeal - in May for seven murders and seven attempted murders, and in October for the attempted murder of a baby girl which she was convicted of by a different jury at a retrial.
At the first of those appeals, a bid to admit fresh evidence from Dr Lee was also rejected as three senior judges concluded there had been no prosecution expert evidence diagnosing air embolus solely on the basis of skin discolouration.
Dr Lee has said he has recently updated his academic paper and found no cases of skin discolouration linked to air embolism by the venous system.
She maintains her innocence.
Why is there a press conference?
Letby’s defence team is set to announce “significant new medical evidence” from 14 of the world’s leading neonatal experts regarding the safety of the convictions.
A team of medical experts has already been reviewing the baby deaths, and has determined that at least two infants died from natural causes.
Tuesday’s press conference in central London will also hear from Dr Shoo Lee, a Canadian neonatologist whose work was cited by the prosecution in the original trial.
Dr Lee is expected to tell the press conference that his work was misused by the Crown Prosecution Service (CPS).
It is due to start at 10am.
Comments
Post a Comment