Lucy Letby, Unanswered Questions.

It's 3 pages on my apparatus, maybe you have the large print version 😂

gentleshores

Anyway we're probably going round in circles and maybe it is time to stop commenting on this thread

Goodness me, 10 pages. I’m quite surprised some of you have so much time to invest in a case which has been ruled on by a court of law after a very lengthy and complex trial.

It has been resolved for the parents. There was a long forensic examination of the evidence. The murderer is in prison,

Thank you for starting this discussion, it has been incredibly interesting and informative from many standpoints! The families involved deserve the peace of knowing exactly what happened to each precious child and I hope that will be resolved soon for them.

Go on then, believe the mail on Sunday, dismiss the judge the jury and the parents

Sorry to bang on about this but there is now a lot in the media supporting it being a miscarriage of Justice - a few articles recently and then this one today by Nadine Dorries which explains exactly what the issue is with the expert medical witness who basically got Lucy Letby convicted. It also mentions the names of all the professionals who have written to the Government about the case. It's an archive link of the Daily Mail article as the Daily Mail article is behind a paywall.

archive.ph/Y9qVM

The Mail on Sunday today has revealed that a new audit shows Lucy Letby wasn't on duty when most of the babies started to deteriorate.

"A new audit of baby deaths at Lucy Letby's hospital has found that many of the most rapid deteriorations took place when she was not on duty, The Mail on Sunday can reveal.

The mortality data, which has been compiled from multiple sources, including Freedom of Information requests, is understood to show a broader spike in deaths during the period focused on by the police investigation – bolstering Letby's argument that the fatalities were caused by wider failures of care at the Countess of Chester Hospital."

www.dailymail.co.uk/news/article-14033933/Lucy-Letby-not-duty-babies-went-downhill-fastest.html?ns_mchannel=rss&ns_campaign=1490&ito=social-twitter_mailonline

She would have been there for most of the deaths as she was the most senior and experienced neonatal nurse and was often called for her advice when things went wrong, or called to come in.

Regarding your posts above about the authors of the book and their views - I think they missed some things out, or aren't quite up to speed.

The third baby was found to have the condition Hyperinsulinism, where a baby makes too much insulin all on their own. This baby had the correct test which proved which type of insulin it was.

They didn't mention Dr Jane Hawden's report. Dr Jane Hawden was a senior external specialist who was asked to do a report by the Police - which counteracted Evans report. She found the causes of the babies' deaths and demise to be sub optimal care by the hospital generally and no suspicious deaths. Although her report was submitted, the CPS advised the Police not to use it. As such it was not used in court.

Page one of this report is part of the Thirlwall enquiry and people are asking why the whole report isn't part of the Thirlwall enquiry.

They didn't cover the recent news that Dr Evans "changed his mind" recently - about something he claimed in court, that helped convict Lucy Letby. Not sure which baby it was but Dr Evans said she had injected air into the stomach splitting the diagram. It has now been shown that Lucy Letby couldn't have done that as the baby was born while she wasn't on duty and didn't come in again until two days after the x-ray. So that wasn't the cause of death - and if it was, it wasn't caused by Lucy Letby. What this does show is that a baby can have a lot of air in the stomach - enough to split the diaphragm - without anyone injecting anything into a feeding tube.

However it also completely undermines Dr Evans diagnoses and makes the trial a mockery.

No doubt if the prosecution barrister had that information he might say - ah well she might have sneaked in one day without anyone knowing.

The testimony of the Mother. These are my own views:

Prior to being informed by the Police that Lucy Letby had murdered or harmed babies, the parents all believed their babies had died natural, unpreventable deaths. The parents didn't raise any issues at all with the hospital or procedures.

Once the Police told them a nurse had murdered the children or harmed them, it would be understandable that they would start to see things more suspiciously, or misremember things in a traumatic or negative light. There’s an article somewhere that goes into great detail about the timings of that night and what the prosecution said. I don’t have it to hand but it explained the confusion over the timings of phone calls – and also showed some times the parents said must have been incorrect or misremembered due to a particular phone call. Sorry that’s vague. It’s not to do with is the Mother lying or is Lucy Letby lying. It’s to do with – did the prosecution get the facts right? Did the Mother, in her grief and anger, decide something was suspicious that previously she didn’t find suspicious.

The swipe door detail is quite important. Another two nurses were in charge of Baby K and the swipe detail shows when they came and left the unit for short times throughout the night. It indicates that Lucy Letby couldn't have been left alone with the child. It's true there are other doors in the unit that could have been used as well, but the swipe detail is categoric as to who entered and left through that particular door, which was right next to the room where baby K was - a room that was behind the nurses station and not near the other three rooms.

The reason it couldn't be used in the appeal is because of the way the law works. There is a LOT of new detail come to light since the trial, but it can't be used in an appeal.

To appeal a verdict there has to be "grounds" for appeal and the only grounds for appealing a verdict are - that the Judge made a mistake.

So her defence barrister had to argue that the Judge made a mistake by not dismissing Evans medical report. That is a much harder thing to argue than presenting new evidence.

Once someone is convicted it is very hard to unconvict them. I do know a bit about legal appeals and grounds of appeal - not as much as a KC barrister obviously - but that is why appeals get turned down. Nothing to do with evidence but to do with legal grounds.

Likewise with the recent appeal over the retrial for Baby K. The Barrister couldn't use the fact that Dr Jayaram's testimony has been shown to be unreliable - the only grounds of appeal he could use were - that the Judge had made a mistake. In the retrial he claimed the Judge shouldn't have ordered the retrial for Baby K as everyone had seen the media calling Lucy Letby evil and the jury would intrinsically be prejudiced by that.

That appeal was lost because the Judge accepted the prosecution's assertion about the "fade factor" - ie that it would have faded in peoples' minds after six months. Lucy Letby's defence barrister pushed really hard to show that wouldn't be the case and also highlighted Dr Jayaram's many media interviews, keeping the matter in peoples' minds.

The Judge at the recent appeal hearing made very clear afterwards that Dr Jayaram's testimony was unreliable and didn't match hospital records (he changed his story two or three times as well) - while also saying - nothing he could do about it! Because that related to the original trial - not to that appeal hearing and because it was not part of the "grounds of appeal". The irony being it was Dr Jayaram's evidence at the second appeal trial that got Lucy Letby found guilty of attempted murder of Baby K (at the first trial the jury couldn't decide on that one). So a 15th full life sentence on top of the others.

Insulin "evidence"

I don't think the authors of the book are up to speed on that one. Judith Moritz is just going by what she heard at the initial trial and that it was accepted by both sides. She didn't interview all the insulin experts.

There are many reasons premature babies can have high insulin levels or low blood sugar without having had synthetic insulin injected. The tests done don't even measure insulin - they measure antibodies to insulin - which is why they are unreliable and have a high fault rate. Without the correct tests being done (as was done with the third baby) it's impossible to know whether it was natural insulin or not.

The business about them speaking to people at the Liverpool hospital. They are journalists, not police detectives or forensic scientists. Somebody said this to somebody else - no more than gossip really once she's been convicted. Ooh yes I always thought she was a bit suspicious etc.

Having said that, it does suggest there may have been a history or previous suspicious incidents and that does make me wonder if she's guilty. But unless there is something concrete - proof and evidence - it is all just rumours and assumption.

The amount of media surrounding this case can lead to "confirmation bias" - people believe everything they read - it's widely publicised, so everything else then appears suspicious.

If she was suspected of something suspicious at Liverpool - why wasn't something reported?

The chart used in court is a big topic, but the Royal Statistical society actually wrote to the court and the prosecution before the first trial saying - this is wrong and misleading. It was ignored and not used as part of the trial.

If there were 13 (or 17?) deaths, why weren't all of them on the chart and why weren't Doctors on the chart as well. Evans response to that was the chart only shows the suspicious deaths (or the ones he claimed were suspicious deaths).

But this new audit in the Sunday papers shows details of when the babies deteriorated. And those were times when Lucy Letby wasn't there.

The book they have written is already out of date. The current situation is her new pro bono (acting free) barrister is taking the case to the CCRC to try and get a further appeal on the original conviction – he has a lot of experts on her behalf. However, usually the only reason the CCRC will do this is if there is “new” evidence – that has come to light since the first trial. And it would be very hard to find new “evidence” when it all happened about eight years ago now – no drains to be swabbed, nothing to physically investigate in the hospital.
In fact the neonatal unit she worked on – the buildings – are no longer there. They built a new unit in 2020. So any evidence is destroyed and would have been too historic anyway.

I can see the analogy about pieces of a jigsaw, but there is also the analogy of adding 2 plus 2 and making 5.

gentleshores

I don't think he (Coffey) said specifically. He said in the Panorama programme that he changes his mind week by week. There are some things that made people think - she must have done it, and that almost convinced me for a while. Apparently amending times on nursing notes on the night of a death. This was latterly I believe, and the other explanation by then could be fear of being accused of being in the wrong place at the wrong time as she knew the Doctors suspected her by then.

So either it is guilt - or fear. If you've done nothing wrong it must be extremely nerve-wracking knowing your every move is being watched.

This reminds me of what the judge said as he sent the jury out to deliberate, as recounted in the Unmasking Lucy Letby book.

//The jury, he said, did not have to ‘resolve every conflict in the evidence, nor were they expected to reach their verdicts by examining each piece of evidence separately. The prosecution case, the judge noted, relied ‘substantially, but not wholly’ on circumstantial evidence – in other words: ‘pieces of evidence relating to different facts, none of which on their own directly prove that the defendant is guilty, but which taken together, lead … [according to the prosecution] to the inevitable and irresistible conclusion that the only explanation for them is that the defendant is guilty of the offences upon which she is charged.’ In other words, the prosecution’s case rested on the full combination - or ‘constellation’ - of evidence, rather than individual pieces of evidence on their own.//
(Chapter 10, ‘But How Do We Know It Was Lucy?’ page 317)

Circumstantial evidence is like a jigsaw. All the pieces put together give you the picture - a picture that is difficult or impossible to explain unless the defendant is guilty. Each piece on its own is not strong evidence, but together the pieces are strong evidence.

I think looking at one piece of evidence at a time can probably lead to flip-flopping between the view that LL is innocent and the view that she is guilty.

Just a note on reasonable doubt. (Even though that phrase doesn’t figure in jury instructions any more, it appears a lot in online discussions). Reasonable doubt doesn’t mean just any possible doubt. It means doubt with good grounds. Doubt that has good justification.

It’s possible that aliens landed, put up an invisibility shield, and killed the babies while making sure that Lucy Letby was always in the right place at the right time to be in the frame. But it’s not very likely.

I haven’t seen any doubts that are well grounded enough to outweigh the strong case that was made in court.

OldFrill

*Coffey is not 100% convinced of LL's guilt, though Moritz is or nearly*

Have the authors said why they doubt the convictions?

why they doubt the convictions

This is speculative, but I suspect that Jonathan Coffey was unduly swayed by his interview with Dr Michael Hall, the defence medical expert who was not called to give evidence. Dr Hall felt this could have made a difference.

However, I don’t see how Dr Hall could have discredited the insulin evidence – possibly one reason he was not called: that would have looked bad under cross-examination – so I’m not sure how much difference he really could have made.

I would say I’m 99% convinced of LL’s guilt, and I imagine Judith Moritz would say the same.

I wouldn’t say 100%, because few things are that certain in this life. As they say, nothing is certain but death and taxes. There is always that chance that new evidence will emerge. But in this case, I think it’s unlikely.

OldFrill

*Coffey is not 100% convinced of LL's guilt, though Moritz is or nearly*

Have the authors said why they doubt the convictions?

Yes, they do discuss some reasons for doubting the convictions in two chapters. I will give a summary.

(If anyone is interested, I recommend reading the book for a fuller picture. I am sure most local libraries would order it in if they didn’t already have it.)

Chapter 10, ‘But How Do We Know It Was Lucy?’

They first go into why two reasons for thinking she is guilty and why they may not be as sinister as they seem: Facebook searches and taking home and hoarding hundreds of handover sheets. (I agree with them: on their own these facts are not necessarily sinister.)

Doubts

1.
//what if there were other incidents that the prosecution’s experts didn’t pick up on and that Lucy Letby wasn’t present for? … shortly after Dewi Evans started working on the case in 2017, officers sent him the medical notes of around thirty babies to look at … Thirteen were deaths – and deaths are black and white, so there’s no possibility of selection bias there. That leaves around seventeen cases of baby deteriorations … What counted as a deterioration and who decided?//

A:
a) //At some point, we have to rely, at least provisionally, on what the staff on the unit told police about which events they considered to be suspicious …

b) In 2012, she spent six weeks on a professional induction programme at Liverpool Women’s Hospital, and in 2015, she returned to Liverpool Women’s to complete specialist training in intensive care … The police have been tight-lipped about their enquiries concerning Letby’s time in Liverpool, but we’ve done some digging of our own … We spoke to someone familiar with the investigation who told us there were ‘incidents that I was concerned about’ … they were ‘convinced that something was going on in Letby’s early period at Liverpool Women’s Hospital’. In other words, the suspicion is that Letby was harming babies as early as 2012 …

c) We have spoken to one highly respected consultant neonatologist who played no role in Letby’s trial but who has been asked to examine a number of further incidents at the Countess of Chester Hospital involving babies whom Lucy Letby was caring for. The consultant identified ‘more than one case where there were unexplained clinical deteriorations in an infant’s condition which correlated with Lucy Letby’s involvement in their care’. At least one of the incidents predates those in Letby’s trial and, according to the consultant, appeared to involve one of the methods of harm identified by Dewi Evans in his initial set of reports. From what we understand of these cases, the correlation between Lucy Letby’s involvement with the babies and their unexplained and rapid decline is both stark and highly irregular …

d) [a] third insulin case looks like further evidence that someone was poisoning babies in the Countess of Chester neonatal unit. It also places Letby at the scene at the time of the crisis.//

In other words, there is reason to think that there were other deaths and collapses that did involve Lucy Letby that were not brought to trial.

2.
// What if all of the science in the Letby case was wrong? … what if the prosecution experts all got it wrong and no harm events occurred at the Countess of Chester Hospital?//

A: //[The insulin evidence] does appear, despite its imperfections, to show that someone at the Countess of Chester Hospital was harming babies.//

(There is also the discrepancy between LL‘s evidence and the evidence of the mother of Baby E. The mother had no reason to lie, and her version of the sequence of events was backed up by phone company data and the evidence of a midwife. If there was no harm event, why did LL lie?)

3.
//During Letby’s trial, the prosecution made reference to ‘door swipe data’ , which it said gave precise timings for individual staff members entering and exiting the unit. However, this data was flawed.

A: //the erroneous door swipe data is unlikely to impact fundamentally on the circumstantial case against Letby - for several reasons.

a) … the error relates to one door in the neonatal unit. We understand there were five doors between the unit and the rest of the hospital. Four of these five doors required swipe access, and the erroneous data applied to only one of these doors. The error also appears to have no bearing on movements within the unit itself, as internal doors didn’t require swipe access.

b) … door swipe data played very little role on its own in placing Letby at the scene of suspicious incidents. For the most part, the recollections of Letby’s colleagues were the key basis for placing her at key places in the unit at particular points in time … Letby’s own clinical notes and those of her colleagues were also evidentially important in tracking her whereabouts and activities.

c) … the CPS … notified Lucy Letby’s defence team about the mislabelled door swipe data six-and-a-half weeks before Letby appeared at the Court of Appeal in April 2024 ... Had the swipe data had a material impact on Letby’s convictions, her defence team would surely have raised it as a point of appeal. They didn’t//

Chapter 12, ‘Behind the Mask’

More doubts:

4.
She has always claimed she is innocent, including looking at the judge as she was being taken down at the end of her retrial, and saying, ‘I’m innocent.’

A: //Do guilty people say they’re innocent? Yes. All the time. Even serial killers whose guilt is not in question. Dr Harold Shipman, the GP who murdered up to 260 of his patients, maintained he was innocent until he took his own life in 2004. Rose West continues to claim she’s innocent.//

5.
//Her supporters say that there is nothing in her personality or background - at least nothing that anyone has found out about - that fits with her being a killer … We must also presume that, with the important exception of her searches for parents and families of babies, the police found nothing of interest in Letby’s search histories or devices … outside of the events of the case, Lucy Letby’s life looks spotless.

A: //“We spoke to the renowned American criminologist Katherine Ramsland. … According to Dr Ramsland, ‘It’s certainly possible for kids from seemingly normal circumstances to develop violent thoughts and impulses.’ Also, ‘just because you haven’t dug up information about someone’s childhood doesn’t mean it’s not there … We have lists of issues and conditions that come up in [serial killers’] backgrounds,’ she said. ‘But none is a confirmed precursor [for murder]’// (I e a definite sign that somebody will commit murder.)

6.
Friends and managers who think, or did think, she is innocent. Her friend Dawn in Hereford does not believe she is guilty, and she says she speaks for Lucy’s other friends there who feel the same. A close friend from university also believes she’s innocent, as does someone else who knew her at university. The married doctor she seems to have been interested in was still seeing her a year after she had been removed from the neonatal unit, so presumably he also thought she was innocent, up to that point at least. Two nurse managers at the CoCH hospital defended her.

A:
a) //another of Letby’s childhood friends gave us a different perspective, saying, ‘I don’t think maintaining a lie like this [that she is innocent, if she isn’t] would be as difficult for Lucy as it might be for somebody else.’ …

b) it is also possible that Letby’s friends are wrong … There were many people within the orbits of both Shipman and Allitt who struggled to accept their guilt. The Allitt Inquiry team interviewed the nurse’s colleagues and reported that: …

'One or two of the people we have interviewed said that it was no surprise, once they knew that someone was suspected of attacking the children, to find that it was Allitt. On the other hand, a greater number said they could not believe it until after she was convicted, and some did not believe it even then, still thinking there had been a terrible mistake.'

When Harold Shipman first came under suspicion, it was hard for many of his patients to accept, and a number felt that he was innocent and being unfairly targeted.//

- Unmasking Lucy Letby by Jonathan Coffey and Judith Moritz
amzn.eu/d/dhtm0oz

I was replying to the previous question :-)

gentleshores

Anyway we're probably going round in circles and maybe it is time to stop commenting on this thread

And yet you're still going...

I don't think he (Coffey) said specifically. He said in the Panorama programme that he changes his mind week by week. There are some things that made people think - she must have done it, and that almost convinced me for a while. Apparently amending times on nursing notes on the night of a death. This was latterly I believe, and the other explanation by then could be fear of being accused of being in the wrong place at the wrong time as she knew the Doctors suspected her by then.

So either it is guilt - or fear. If you've done nothing wrong it must be extremely nerve-wracking knowing your every move is being watched.

Coffey is not 100% convinced of LL's guilt, though Moritz is or nearly

Have the authors said why they doubt the convictions?

gentleshores, I'm not sure you've taken in what I wrote. Coffey and Moritz examine all the objections they have come across from insulin experts and answer them.

Coffey is not 100% convinced of LL's guilt, though Moritz is or nearly so, and they do discuss the case fairly objectively.

Why do you think there is a conflict of interest between being a BBC journalist and writing a book giving the public further information about an important issue?

Anyway we're probably going round in circles and maybe it is time to stop commenting on this thread

I think the insulin cases are more explainable than some of the others though.

The big thing recently was when one piece of medical evidence from Dr Evans, used to show she killed one of the babies, was found to be impossible.

It was clear from the Panorama programme that Judith Moritz had decided Lucy Letby was guilty - due to her demeanour in court. She has been on TV a lot recently promoting their book. A big scoop for a journalist! A murder trial.

Their book makes a case for her guilt and they are profiting from the sales of the book. It was probably written after the trial. I think it's wrong that two Panorama journalists produced their own book on the case. Surely a conflict of interests.

They are not the only journalists commenting on the case and there are other insulin experts who disagree.

Just in case anyone is still around... here's some quotations from the Unmasking Lucy Letby book by the two Panorama journalists, Coffey and Moritz, which I have just finished reading. I found it clear and informative. I think they do a good job of looking at the arguments for and against LL's innocence as objectively as possible, and weighing them all up.

This is from their chapter on the insulin evidence, Chapter 9 - ‘The Search for the Smoking Gun’

Questions about the insulin evidence:

1.
// blood samples can become unsuitable for testing because of cell destruction or clotting.//

A: //However, had this been true of the blood samples in the Letby case, the lab would almost certainly have rejected them. The lab would not have performed an insulin / C-peptide test on an unsuitable sample//

2.
// Baby F was found to have had an insulin concentration in his blood of 4,657 picomoles per litre–abbreviated as pmol/ l. This is huge and would be enough to cause death or severe brain damage. And yet Baby F survived. So does this not suggest that the 4,657pmol/ l reading was unreliable?

A: Again, there’s an obvious counterargument. Insulin itself doesn’t kill or harm. It’s the effect of insulin on the body’s glucose levels that does the damage. Left untreated, 4,657pmol/ l of insulin would indeed stop the body releasing glucose, leading to a very harmful drop in blood sugar. However, the medics on the neonatal unit at the Countess of Chester Hospital were on the case. They could see that Baby F’s blood sugar was plummeting so they were pumping him with glucose to counteract the harm. Had they not done so, Baby F may well not have survived. As it turned out, Baby F does suffer from acute learning and other difficulties//

3.
// A significant delay in a sample reaching the lab could lead to the sample degrading, and we know there was a delay in getting Baby L’s blood sample to the lab.// Could this cause misleading results?

A: If the blood sample had degraded, //the insulin and the C-peptide would both have degraded. Degradation would not lead to a sky-high insulin reading and a very low or zero reading for C-peptide.//

4.
//is it possible the lab test simply failed to detect C-peptide - even though C-peptide was actually there in the blood sample? There is a phenomenon in laboratory testing known as the ‘Hook effect’. The Hook effect occurs when a testing procedure becomes overwhelmed and incorrectly records a zero for the substance it’s trying to quantify.//

A: //This looks like a serious argument–but it isn’t for one simple reason. Baby F had an insulin level of 4,657pmol/ l, while Baby L’s blood insulin was 1,099pmol/ l or more. According to the experts we’ve spoken to, no baby could produce these levels of insulin naturally. It’s not physiologically possible. What that means is that the C-peptide produced by a newborn baby would never reach the level that could supposedly lead to a Hook effect and a false reading of zero. Indeed the insulin levels for Baby F and Baby L are so high that you don’t even need to know what their C-peptide readings were to know that the insulin in their blood can’t have been natural. It was simply far too high.//

5.
//So what are the chances that the high insulin values for Baby F and Baby L that came back from the lab were wrong? This is one of the questions that the New Yorker journalist Rachel Aviv tackled in her explosive May 2024 article about the Letby case.//

A:
i) //The first issue is Aviv’s claim that the lab’s website featured a warning that its insulin test was ‘not suitable for the investigation’ of whether synthetic insulin had been administered.

That’s technically true, but according to the lab, the point of the warning was that measuring insulin on its own is not enough to determine whether the insulin is synthetic. You need to measure C-peptide as well. But that’s exactly what the lab did in the Letby cases. They measured both insulin and C-peptide.

ii) … Other experts have noted that labs like the one in Liverpool often add a further disclaimer about their insulin test. The test is not guaranteed in all circumstances to detect every variety of synthetic insulin. Some synthetic insulin might go undetected.

… it’s important to be clear on what [this] would mean for the Letby case. If a baby had been poisoned with exogenous insulin, it is theoretically possible that the lab test might not detect that synthetic insulin. In that event, the lab result would simply show that no exogenous insulin had been administered to the baby. What the test wouldn’t do is give a false positive: the test would not falsely identify synthetic insulin where there was none. If anything, this limitation would work in favour of a poisoner.

iii) //But what about the expert based in Sweden cited by Rachel Aviv who said that the testing method provided by the Liverpool lab [immunosassay] was ‘not sufficient for use as evidence in a criminal prosecution’? Is this true?

… [With immunoassay] there are circumstances where the antibodies in the immunoassay might ‘mistake’ another substance for insulin. Where this happens, it’s known as ‘ interference’ , and where there’s interference, the test could give a misleadingly high insulin value – a false positive. In other words, it could give the impression that there is lots of insulin in a particular blood sample when in fact there isn’t…

the insulin evidence in the Letby case used the fallible immunoassay method and not the gold-standard mass spectrometry method. Therefore it can’t be trusted. But is this argument as worrying as it appears? …

a) We checked with several experts and they all agreed that the immunoassay used by the lab in the Letby case would not have mistaken proinsulin for insulin: proinsulin would not ‘interfere’ with the immunoassay.

b) There is, however, another substance that can ‘interfere’ with immunoassays. Some people’s bodies produce antibodies that the lab-produced antibodies in the immunoassay test mistake for insulin. Where this happens, it’s possible that a lab test on a sample of their blood might mistake those bodily antibodies as insulin and potentially give a misleadingly high insulin reading. This is sometimes seen in people who’ve been receiving exogenous insulin for a long time. People suffering from Type 1 diabetes are a good example. It may also be seen, albeit rarely, in people who have developed antibodies in response to animals in their environment–for example, rodents in their home. Newborn babies in a hospital neonatal unit clearly don’t fit into any of these categories. They haven’t been receiving medical insulin for a long time and they haven’t been exposed to animals//

Coffey and Moritz's conclusion on false positives:

//From what we can tell, the likelihood that the high insulin values in the Letby case are false positives caused by interference with the immunoassay is low. Here’s why. First, although the immunoassay method is not infallible, it is still very reliable…

[Second,] the clinical condition of Baby F and Baby L. If the high insulin values for Baby F and Baby L were false positives and were simply the result of interference by antibodies in their system, it is unlikely that these babies would have shown symptoms associated with excessive insulin. But the reality is that both babies did show such symptoms. They were severely hypoglycaemic. Their blood glucose level was very low and the only reason it wasn’t fatally low was that medical staff were pumping them with glucose. This is further compelling evidence that there was indeed excessive insulin in their systems, as opposed to antibodies masquerading as insulin…

[Third,] Baby L had a low potassium value. A low potassium value is further evidence of there being too much insulin in the system.

6.
//According to Joseph Wolfsdorf, a professor at Harvard Medical School who specializes in paediatric hypoglycaemia, the baby’s C-peptide level suggested the possibility of a testing irregularity, because, if insulin had been administered, the child’s C-peptide level should have been extremely low or undetectable, but it wasn’t.//

A: //We spoke to Professor Wolfsdorf ourselves. We were also able to provide him with more information about Baby L than Rachel Aviv appeared to have, including the baby’s blood glucose level and other results from his blood test.

… Other experts … offered some possible explanations…

With the exception of Dr Jones in Sweden, none of the experts we spoke to - including Professor Wolfsdorf - argued that Baby L’s puzzling C-peptide result indicates that the insulin / C-peptide test result is incorrect.

… Professor Wolfsdorf told us: … the surest conclusion we can draw from Baby L’s test result is that he was poisoned with insulin.

… It’s also worth noting that in the case of Baby F, the C-peptide value was so low that it was unmeasurable. In other words, even if we discount the case of Baby L, Baby F remains a compelling case of apparent insulin poisoning.//

Coffey and Moritz's overall conclusion on the insulin results:

//The insulin evidence is imperfect. But it is very persuasive–and by far the best evidence in the Letby case as a whole. It does appear, despite its imperfections, to show that someone at the Countess of Chester Hospital was harming babies.//

@Luminance. Thank you. Yes I think that is what the medical experts are saying. They know it's hugely emotive for the parents but feel the truth is important for everyone.

I do of course have empathy for the parents. The post was started after a Panorama programme on the topic and doubts about the fairness or validity of the trial are much in the news at the moment.

The parents perhaps could have rested so much easier believing their children died of natural causes and were not taken so cruelly. That is my only reason for thinking that perhaps it is important to know the truth of every individual case.

Give it a rest, gentleshores, and have some empathy for the parents.