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Boomerlives - as someone who has been in an ITU with a patient going off there is no way at all that can be so. Its simply not credible to not notice or not take any action. the alarms do not get turned off accidentally - someone did that deliberately. Breathing tubes do not dislodge on their own either done deliberatly or accidentaqlly when moving the baby but in the latter case you check.. the baby would have been in obvious distress - basically going blue!
The idea that she did not notice or was paralyzed into not taking action is just not credible
Barrister Tim Owen KC....co-hosts a legal podcast, Double Jeopardy, which has examined the Letby debate.
Just having a listen, and it's very interesting. Recommended.
It's worth noting in the case of Baby K - the dislodged breathing tube that @tjagain is describing, the original jury couldn't reach a decision - and was the only death that they couldn't. This individual case had to go to a retrial
It's not exactly the same but in my last job I was involved in a complaint of sexual impropriety by a staffmember against a student. We reacted pretty much exactly as you'd hope, contacted the authorities, etc etc, he ended up getting done for it.
But during the trial it turned out that he'd been reported for the exact same thing at the previous 2 institutions he'd worked at and they'd circled the wagons "to protect the institution" and he'd been allowed to quietly resign and move on elsewhere. It was eventually reported he'd been kicked out of catholic seminary for sexual impropriety, which I'm surprised is even mathematically possible. And he'd floated around a couple of other jobs in the sector which look suspiciously like it was the exact same thing.
I wasn't shocked that it can happen once or that a few people can handle something like that wrongly but this was over and over for literally his entire career. And honestly I think it could still have happened with us if things had been just a little different, except that the dude was universally disliked.
Anyway thing is, in the end we got 100% of all the shit for it. "City university embroiled in sex abuse scandal". So it turns out they were in a horrible way right. There was next to no backlash against the other places because that was all boring and historic and what little there was, got painted over with "that was a different time, things were different" (the 2010s ffs), and just astonishingly little of "this place discovered the problem and made sure the guy got nailed for it". I can absolutely promise you that some people involved in the process were left thinking "well that was all a terrible mistake" and a whole bunch of people involved in the coverup at other places feel completely vindicated.
Alarms get turned off/silenced all the time because they go off very frequently when there's not really anything to worry about. A breathing tube could be accidentally dislodged by a baby, some of them are surprisingly active.
I tend to agree with TJ in feeling that she's probably guilty although I'm far from convinced that the was sufficient evidence to prove beyond reasonable doubt.
Alarms get turned off/silenced all the time because they go off very frequently when there’s not really anything to worry about.
Depends which alarms but basically when I worked in ITU we did not do this ever. You might turn the alarms off while carrying out a procedure, you would ALWAYS turn them back on afterwards. The equipment in the ITU I used you could put alarms on mute for a short period and they would come back on again. Its not clear to me which alarms were turned off but its in general a huge NO to turning them off.
A breathing tube could be accidentally dislodged by a baby, some of them are surprisingly active.
Very very unlikely as if it is ventilated as it will be sedated and paralyzed thus unable to move
A formal analysis of the odds of babies dying whilst she was on shift versus not on shift is needed, you can’t disregard other cases that died whilst she was not working. I have no idea whether she is guilty or not, but I understand relative risk and the notion of statistical significance. Comparison with reference data from other units should also be included - and other covariates - did she work on particularly challenging cases? What was the average patient staff ratio? Lots of areas where further analysis is needed.
I had previously presumed that there was more than circumstantial evidence. That there was not is troubling. Shipman was identified based on his practice being a very significant outlier. For that work David Spiegelhater should be thanked. I imagine he will be all over this data too.
A formal analysis of the odds of babies dying whilst she was on shift versus not on shift is needed,
IIRC this was done and the numbers pointed very firmly at her. Lots of statistical work to identify suspects. there is more than circumstantial evidence -There is also the consultant that saw her in a room with a baby with a dislodged breathing tube and no alarms. Most of the case is circumstantial however - as is normal in cases like this.
doesnt seem to have been done by actual statistics experts
Indeed. Ask Sally Clark how that worked out. Except you can’t. :-(. The Royal Statistical Society doesn’t weigh in lightly on legal issues.
Fair enough
Very late to this discussion, but lots of it seems to centre around clinical questions, but evidence was found at her home reflecting her state of mind - I understand that this isn’t evidence as such, but it is a clear indication of her state of mind. To be fair, it is desperately sad that any individual could be in such a dark place.
I cannot understand her defense team at all tho - they seem to be complete rubbish.
Here's the thing about her defence - if expert medical witneses could have supported her case, they'd have called them. Instead, they called a plumber to the stand. Note too that she used the same team for the appeal, so she doesn't think a different team would do anything better.
There are stats experts who would testify the methodology is suspect. Some of the actual medical evidence is just wrong ie the idea that injecting air into a feeding tube could cause an embolus. .Unless something has got lost or confused there. Injecting air into an IV line can cause an embolus, injecting air into a feeding line does not cause an embolus. It would be no problem to get someone to testify to that.
I think there was a hunt for "evidence" that stretches the bounds of credibility in the attempt to make a strong case. Thats does not exonerate her but it does make the conviction dodgy
Why none of this was challenged is beyond me
The use of statistics and probability in criminal trials of this magnitude needs to be carefully regulated. There are a lot of worrying aspects to this, both in terms of the medical evidence and the way the numbers were presented to a lay jury.
Doesn't mean she's innocent, but frankly, the NHS employs a lot of people in patient facing roles whose personality defects and weird private lives might raise eyebrows if scrutinised in such circumstances.
Here’s the thing about her defence – if expert medical witneses could have supported her case, they’d have called them
This is provably wrong. She was accused of murdering several of the children via an air embolism based partially on a old research paper. One of the authors wasnt called in the case but were in the appeal and they were clear they didnt agree with the prosecutions use of the paper.
The appeal court dismissed that evidence since it wasnt "new" but that just raises the question mark about the competence of her defence lawyers vs her guilt or not.
but frankly, the NHS employs a lot of people in patient facing roles whose personality defects and weird private lives might raise eyebrows if scrutinised in such circumstances.
Who me? Not guilty yer honour!
A lot of it is institutional negligence.
I know as my late father successfully sued the NHS for 50k.. It didn't bring his wife or my step mum back, and the consultant who was mostly to blame was simply moved sideways rather than struck off.
It makes me wonder how much of the NHS bill on the tax payer is paying out for clinical negligence cases.
I think there was a hunt for “evidence” that stretches the bounds of credibility in the attempt to make a strong case. Thats does not exonerate her but it does make the conviction dodgy
Why none of this was challenged is beyond me
The inference is that the defence assumed that the court officers were competent to test and verify the methodology used in the statistical analysis.
Most of us should be aware that assumption is the mother of all **** ups! They trusted but failed to verify in attempt to save court time and the conviction is now suspect as a result.
Edit: suspect and the legal profession are circling the wagons to protect themselves rather than ensuring justice is being served. (Very similar attitude to the Birmingham Six convictions).
This is provably wrong. She was accused of murdering several of the children via an air embolism based partially on a old research paper. One of the authors wasnt called in the case but were in the appeal and they were clear they didnt agree with the prosecutions use of the paper.
The appeal court dismissed that evidence since it wasnt “new” but that just raises the question mark about the competence of her defence lawyers vs her guilt or not.
If the evidence was dismissed from the retrial as it wasn't new, how is that proof that her lawyers weren't competent?
The inference is that the defence assumed that the court officers were competent to test and verify the methodology used in the statistical analysis.
I don't think she was convicted solely on the basis of the statistical analysis.
No, but take that away, and some of the medical evidence, and suddenly you start to wonder whether the case is anything like as strong.
This is a nice summary of some of the deficiencies in the statistical evidence and is worth a read https://www.scienceontrial.com/post/shifting-the-data
The data was selected by non-statisticians to support their cause (i.e., guilt). The simulation presented in the analysis above is rather damning. And relatively straightforward to conduct. There are some nice methods to look at probability of what seem like rare outcomes, and of course these were not presented in this instance. They were in the case of eventual acquittal of the Dutch nurse in similar circumstances.
No, but take that away, and some of the medical evidence, and suddenly you start to wonder whether the case is anything like as strong.
Of course, if you take ALL the evidence away, she's not guilty in the slightest.
However, the evidence exists, and the jury convicted.
If the evidence was dismissed from the retrial as it wasn’t new, how is that proof that her lawyers weren’t competent?
Sorry not sure what you are trying to say here?
It was the appeal and dismissed since they could have called them at the trial and didnt.
So if we return to your claim that if they could have called an expert witness they would have done so and so inferring that helps show she is guilty.
Do you still stand by this and if so why?
Of course, if you take ALL the evidence away, she’s not guilty in the slightest.
I don't think anyone is saying that. As @tjagain has said, the evidence of Baby-K is damning, a doctor essentially said he saw her just standing there doing nothing while all the alarms were going off. That's pretty strong. On the other hand, the Excel with her name all over the shifts seems now to be largely non-evidence. There seems to be evidence that some of the other deaths on the unit were ignored becasue they didn't involve Letby or fit any pattern, and the unit itself was understaffed, had recently seen an increase in baby deaths, was criticised by a CQC report. I think it points to an overall impression that neither trail was particularly robust.
Why none of this was challenged is beyond me
I think Letby's defence barrister did [by all accounts] a stand up job in his cross examination of expert witnesses. think they chose a strategy that it's up to the prosecution to prove guilt, and their evidence was largely circumstantial. Rather than to try to prove innocence.
Re alarms on critical care monitors in healthcare settings,
If an alarm is triggered that is considered serious, it will produce an audible tone and a flashing visual signal.
This can be silenced by a button press, but has a time out, so if the alarm condition is still relevant, will alarm again once the timeout has finished.
This would give a staff member time to deal with the alarm cause without the added distraction of an annoying noise and flashing light.
To physically 'turn off' an alarm is a very deliberate act and would involve going into a menu system or changing a configuration, both of which may have been captured on an events log within the monitor.
It makes me wonder how much of the NHS bill on the tax payer is paying out for clinical negligence cases.
https://blackwaterlaw.co.uk/7-stats-latest-nhs-resolution-figures/
NHS budget is about 180bn, so about 1.5% And i think I read they are insured, but if you have standard losses every year around the same amount I can't see why an insurer would take on at a premium below what they 'know' they are going to pay out, insurance is cover for the unforeseen.
Of course, if you take ALL the evidence away, she’s not guilty in the slightest.
She was convicted on the sum total of the evidence, statistical, medical and circumstantial. If a large chunk of the evidence that convinced the jury was flawed or misleading, obviously that may have an impact on the verdict. The prosecution shouldn't just be allowed to make stuff up and present it as fact, or cherry pick circumstantial evidence, however sure they are that she is guilty.
She may have killed none, some, or all of those babies, but fishing for data which supports that premise while ignoring data that disagrees with it is a recipe for a miscarriage of justice.
As a side note, I read back through some of the court reporting, and there was testimony from a former colleague that suggested the Baby K breathing tube incident was not entirely straightforward, as the alarm had been muted (by someone), plus the baby was described as 'active' and could have dislodged it by themselves. Letby here certainly appears unprofessional, negligent, and incompetent, but this incident in isolation is still a long way short of proof of malice and murderous intent.
But if you take stuff like this, add in a dollop of evidence of a disordered personality, some questionable statistical and medical evidence, and suddenly things start looking much worse.
I don't know much about this case beyond what was reported, but I'm reminded of the Cleveland child abuse scandal. Circumstances are very different, but reliance on experts was a huge problem
In February 2007, Sir Liam Donaldson, the Chief Medical Officer, who was the regional medical officer at the time of the scandal, said of the original diagnoses: "The techniques that have been used have not been reliable and it does look as if some mistakes have been made" https://en.wikipedia.org/wiki/Cleveland_child_abuse_scandal
More like the Meadows cot death scandal, where an incompetent duffer made up some totally bogus stats and no-one involved in the defence apparently had enough of a clue to challenge him. I recall at the time assuming that the reporting was sloppy as the main claim repeated in the press was so obviously wrong (in at least two important respects) that no respected expert could possibly have made such a stupid statement in court. How wrong I was.
I didn't pay such attention to the Letby thing while the trial was ongoing and the details are different but it stinks in all the same ways. There's simply no way she did what she was convicted of, she may have done some incompetent and/or malicious things but not all she was convicted of. The only question now really is how long she will rot in jail while the establishment tries to misdirect, delay, and otherwise evade their responsibilities.
There’s simply no way she did what she was convicted of
I'm interested to see what evidence you think unequivocally supports this statement, or is it just a belief you have?
I didn’t pay such attention to the Letby thing and the details are different
It's obvious given that there were lots of incidents and she was accused precisely of causing the things that happened when she was there and none of the things that happened when she wasn't there. It's completely implausible that every single unfortunate event that happened due to chance or other people/bad performance, happened when she wasn't there.
It's obvious to everyone that the spreadsheet "evidence" is completely bogus and dishonest, right?
Sorry not sure what you are trying to say here?
No, I'm sorry - in the cold light of day I think I've tried to make a singular point based on two seperate strands. Really shouldn't post late at night....
It was the appeal and dismissed since they could have called them at the trial and didnt.
So if we return to your claim that if they could have called an expert witness they would have done so and so inferring that helps show she is guilty.
Do you still stand by this and if so why?
I don't think I made that claim, but if there's a suggestion that the defence didn't call witnesses out of incompetence, I think it's equally valid to suggest that they WERE competent and had very valid reasons not to call expert witnesses. After all, she was happy enough to keep the same team for the appeal.
Without access to the defence's case notes, we're all just speculating, to be fair.
On the other hand, the Excel with her name all over the shifts seems now to be largely non-evidence.
At the very least it puts her at the scene of the crimes.
At the very least it puts her at the scene of the crimes.
I think the main question is, are we sure crimes were committed?
It's not like it's a typical murder where you have a body and signs of violence so you know someone did it. In these cases (like the 1 in 73 million cot death case) it seems so unlikely that we just assume a crime must have been committed.
The prosecution shouldn’t just be allowed to make stuff up and present it as fact, or cherry pick circumstantial evidence, however sure they are that she is guilty.
I don't think they made anything up, but I think they absolutely do have to present the factors that indicate guilt, that's their job just as much as it is the defence's to present factors that indicate innocence. Whether either team believed her innocent or guilty is kind of irrelevant, both sides are there to win.
At the very least it puts her at the scene of the crimes.
Sure, but y'know, she worked there, it's not a massive surprise. As others have pointed out, the expert defence witnesses offered enough of an explanation to doubt whether crimes were committed.
yes – 100%
OK, the next question is, are you 100% certain about the exact number of crimes that were committed?
The jury were.
Ignorance, not casting doubt on peoples assertions but the 1/73m cot death thing; is there a link or can someone explain simply why the claim is false. I'm not a statistician so I'm sure the answer is statistics; I (thought I) understand probability though.
I think part of the problem is that people are much more likely to accept an explanation they can easily understand than one that they need a lecture and at least 20 minutes with a pencil and paper to figure out.
For me, one of the most alarming thing in that "shifting the data" post is not the dodgy stats, but this assertion:
Human rights and criminal defence Barrister Mark McDonald states, "It is almost impossible to get defence experts in the UK to give evidence in cases involving children, they are too scared. You have to go overseas, usually to the US."
OK, the next question is, are you 100% certain about the exact number of crimes that were committed?
No.
Human rights and criminal defence Barrister Mark McDonald states, “It is almost impossible to get defence experts in the UK to give evidence in cases involving children, they are too scared. You have to go overseas, usually to the US.”
The defence had experts ready to testify and chose not to call them.
“ At the very least it puts her at the scene of the crimes.”
Given that “crime” was defined as “untoward event that took place with Letby on duty” that’s an utterly meaningless statement.
She was there when she was there. So what? It’s not even evidence that there were any crimes at all, still less that she was guilty of any, let alone all of them.
I don't think we'll be able to decide whether she's guilty or not here. I think it's more a question of whether the case that was built looked convincing to the jury but once some of the details became public then others were able to look at it and say, 'Wait a minute, you cherry picked that data.'
It did a good job of convincing the jury but unfortunately it also served to undermine public confidence in the conviction.
Of course, I'm sure there is more evidence but manipulating data is a major red flag. Something the people who were prosecuting her should have known.
Ignorance, not casting doubt on peoples assertions but the 1/73m cot death thing; is there a link or can someone explain simply why the claim is false. I’m not a statistician so I’m sure the answer is statistics; I (thought I) understand probability though.
Some cot deaths are likely due to genetic abnormalities outside of current medical knowledge, therefore if you had one of those genetic abnormalities in your family, you could expect an increased risk of cot deaths. So having more than one unexplained death isn't de facto evidence that it's foul play.
She was there when she was there. So what? It’s not even evidence that there were any crimes at all,
No-one has suggested that her being at work is evidence of a crime. But you can guarantee that, if she was off-shift for every unexpected death during that period, she would not now be in prison.
The spreadsheet alone is proof enough of that. Even after it’s been explained why it’s bogus there still seem to be people here who think it means something.
The only deaths that were on there were the ones thought to be suspicious or unexpected. Happy for you to explain why unsupicious deaths should have been included.
Of course, I’m sure there is more evidence but manipulating data is a major red flag. Something the people who were prosecuting her should have known.
Is that defamatory? 🙂 What data manipulation took place?
Guilty ? Personally I dont think so.
Sorry long winded explanations concerning feeding tubes or anything else I couldn't comment on. Just feel this is a miscarriage of justice and its more likely poor consultants and a general poor practice over all.
All in a ward that has a natural high death rate due to the very poorly condition of the babies using it.
I wonder what the conviction rates were before they discovered sudden infant death syndrome was actually a thing. All convicted on strong medical evidence or professional evidence. Yup, on that score that had all the mothers down convicted as murderers.
Of course, I’m sure there is more evidence but manipulating data is a major red flag. Something the people who were prosecuting her should have known.
Assuming that they understand that that is what they were doing. It's possible that they were incompetent (with stats) and failed to realise that they were producing a chart of data that had already been filtered.
The only deaths that were on there were the ones thought to be suspicious or unexpected. Happy for you to explain why unsupicious deaths should have been included.
As far as I can tell, once you take away the deaths Letby was suspected of, you're still left with 8 deaths. That's more than twice as many as the average (3.5).
I'm sure it's possible she was responsible for more deaths than she was convicted of, but it still needs explaining. Otherwise, like I said, it starts looking like the data is being manipulated and that is something that, quite rightly, makes people start asking a lot of questions.
The only deaths that were on there were the ones thought to be suspicious or unexpected. Happy for you to explain why unsupicious deaths should have been included.
Because of bias. The Excel was produced to demonstrate to the hospital malmanagement that Letby was "the missing link" to all the deaths that they thought were inexplicable, when statisticians have demonstrated that sometimes unexpected or random deaths are just what happens and there's not a pattern.
Is that defamatory? 🙂 What data manipulation took place?
Defamatory? Sounds like you're fed up and want to shut down the discussion.
I'd say if you are showing that Letby was the only common factor by removing the 9 deaths (bearing in mind 3.5 is the average) where she wasn't present that is manipulating the data.
https://www.scienceontrial.com/post/shifting-the-data
Any research or statistical exercise which approaches data with a preferred outcome in mind is vulnerable to bias, even if it is unconscious bias. That is why there is a duty for the prosecuting authorities not just to cherry pick data which supports their premise. Disregarding data which undermines your pet theory can leave you with something highly misleading.
The care of premature or dangerously ill neonates is fraught with unpredictable outcomes. Sometimes there are deaths which are hard to explain, babies can deteriorate quickly. Nevertheless, if you have a unit which has a spike in poor outcomes, that needs to be looked into in case there is a common factor.
In this case they had a spike, found that Letby was a common factor, but then worked back from that to see if any postmortem results from 'her' babies indicated foul play. Whether they did or not is a matter of argument, but the case continued.
I suspect that those who conducted the initial audit were not really looking for alternative reasons for the spike - were their cohort of babies sicker, smaller, more vulnerable? Were staffing levels adequate? Were conditions on the ward safe in other ways? It was much easier to find a common human factor than blame it on pure chance or systemic failures at the hospital.
Again, none of this rules out the possibility that Letby was the killer of one or more of the babies. But when you start digging into some of the really quite devious and inventive methods she was alleged to have used, and whether postmortem evidence supports these theories, it starts getting less and less plausible that things unfolded in quite the way that the prosecution suggested.
Because of bias. The Excel was produced to demonstrate to the hospital malmanagement that Letby was “the missing link” to all the deaths that they thought were inexplicable, when statisticians have demonstrated that sometimes unexpected or random deaths are just what happens and there’s not a pattern.
I understand much of the evidence is circumstantial - that being the case, her being present every time there was a unexpected or suspicious death is hugely relevant, surely. That unexpected or random deaths sometimes happen does not really inform this case - these were otherwise stable babies suffering sudden, unexpected and catastrophic collapse, often numerous times, many with air in their bodies where air should not be. If a natural explanation as to why this kept happening can be found, I'd be genuinely interested to hear it.
Defamatory? Sounds like you’re fed up and want to shut down the discussion.
Pff, whatever. Defame away if you want to. 🙂
I’d say if you are showing that Letby was the only common factor by removing the 9 deaths (bearing in mind 3.5 is the average) where she wasn’t present that is manipulating the data.
What if those nine deaths were neither suspicious nor unexplained?
her being present every time there was a unexpected or suspicious death
My understanding is that is not what the chart shows.
It shows that she was present every time that there was an unexpected or suspicious death that they have decided to prosecute her for which is an entirely different thing.
If there are a number of excess deaths, and they've decided to only prosecute her for some of them because she was present for them then the chart means nothing. It's circular logic.
That's not what the Beeb reported.
"He [De Evans] added that the cases on the rota were there because, after reviewing all the deaths and collapses, he thought only they were suspicious or unexpected.
He said he had not known at that point that Letby had been on duty and this had only been revealed afterwards by Cheshire Police.
Dr Evans also made the point that none of those raising concerns had seen the patient notes."
Anyway, clearly I'm wrong again so I'll leave you all to it. 😉
her being present every time there was a unexpected or suspicious death is hugely relevant, surely.
Except, there were also unexpected deaths at which she was not present. The medical evidence that these were 'otherwise stable babies' has been challenged, and air can be introduced into the stomach as part of a resuscitation attempt. The whole air in the stomach thing is controversial, and the mechanism proposed by the prosecution has also been challenged.
These were all babies considered sick enough to be in PICU. Sure, you wouldn't expect them to be dying en masse, but they are all at increased risk of collapse and sudden death. That's why they're there. And there are lots of factors in their quality of care which can influence their recovery, positively or negatively.
these were otherwise stable babies
According to the expert witness that her defence team decided not to call, many of the babies that the prosecution described as well, were in fact not very well at all. As others have said, we can't decide guilt or otherwise, but it's pretty clear from the post trial investigations that the jury heard just one side of the story, and that story was founded on - it turns out, at least highly contestable evidence.
What if those nine deaths were neither suspicious nor unexplained?
Well then that's quite an increase from their usual 3-4 per year.
The problem with only including the suspicious deaths was that the alarm was first raised about Letby in July 2015:
For every death after that (and possibly from even earlier) if Letby is present then it is going to be suspicious. Her presence automatically makes people suspicious. And then you make a chart showing that she was the only common factor in the suspicious deaths.
Of course she was.
Like I said, this proves nothing one way or the other. As far as I know there was more evidence than just the 'one common factor' chart.
However, we're thankfully at a stage now where any sign of manipulating numbers in these type of cases makes people immediately suspicious. It could be she's still very guilty but drawing a line under it is not the best way forward until all the extra deaths can be plausibly explained.
“ But you can guarantee that, if she was off-shift for every unexpected death during that period, she would not now be in prison.”
She was off shift for about half of them, so they decided that this half was just bad luck and the half that happened when she was there were all murders, every single one of them. They could have done exactly the same for any staff member and come up with a spreadsheet that looked just the same.
She regularly did overtime as she was saving for a house, the unit was always short-staffed so plenty of work available.
You may find this interesting, from the blog of Norman Fenton, Professor of Risk.
A lot of babies in neonatal care aren't necessarily "sick", they have been born prematurely and need support to get them in a condition to be allowed home. The three main things they need is to be able to feed, breathe and retain heat. They might be in neonatal care due to being underweight and needing to effectively fatten up. A baby is pretty much fully developed way before being full term and spends a long time just putting weight on to make them more resilient at birth. The unit she worked on wasn't for the most sick babies so I don't think it would be normal for there to be a lot of deaths.
if expert medical witneses could have supported her case, they’d have called them.
Only if they were prepared to testify on her behalf. If not then once summons they would just no comment everything. The real problem is if it wasn’t her then what were the patients consultants doing and the consultant heading the unit? That bit seems to have been ignored with her conviction and I imagine the consultants don’t want looking at too closely. The reason everyone has a named consultant is because they are the one legally responsible for their patients care.
Puts rather a different spin on the notes she wrote:
These were all babies considered sick enough to be in PICU.
A friend of mine worked as a nurse in special care baby unit. I asked her how she coped with the death of babies. Her response was that you celebrate the ones that get to go home because if your in that unit the odds are stacked against you in the first place
as someone who has been in an ITU with a patient going off there is no way at all that can be so. Its simply not credible to not notice or not take any action
So coz it's against training and your experience, the only other explanation is baby murder? That's a bit of a leap.
It's rigid thinking like that, that can scapegoat someone for the failings of an entire department rather than looking further. Maybe that's the NHS way.
I’m not a statistician so I’m sure the answer is statistics
There is always a naive presumption that events are independent. So two rare events occurring in the same individual is simply related to the probability of each event squared. For some events, that are truly random, like winning the lottery, that premise is true. In the case of cot deaths the events may not be independent, and as mentioned, some underlying but unidentified risk factor may be present in both newborns that predispose. An analysis suggested that the true rate could be as high as 1/200 for two deaths when one had died already. For Sally Clark, it was not disclosed that the first child had a bacterial infection that may have hastened death. And hence the second death could have simply been chance. That rare events occur at all is simply the result of the huge number of trials (statistical term not legal event) - someone wins the lottery most weeks, despite the low individual probability.
For a paediatric ICU, one can calculate the risk of being on watch for any proportion of deaths, presuming they are independent. The closed form solution will be challenging, but the simulation shown in the link I provided shows that it is very easy to generate data that was used to convict. That "evidence" should be disregarded completely. In the dutch case discussed by the RSS, the miscarriage of justice was that no offence had been committed, the mortality rare for that unit at that time was an outlier.
Presume that the mortality rate for any shift is 10%, and there are 20 beds in the ICU. The probability that at least one baby dies in any shift is 1 - (1-0.1)^20 = 0.87 or 87%. And that is per shift. Without any wrongdoing. If shifts are staffed evenly, one can expect a distribution in number of shifts worked with a death. And it is possible that one poor nurse will be present for more than others. If you don't adjusts for number of shifts worked, this is even more likely.
It's not really a question of stats in this case. They had decided a few years previous to fit her up so along with a whispering campaign to undermine her confidence (hence the counselling!), they treated any incident while she was present as suspicious, while sweeping other events under the carpet. N years later, of course it looks like a bit more than coincidence.
The whole idea that she killed babies by pumping air into their stomachs is just nonsense. What an absurd suggestion.