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Safety Critical Industry - Are you different to the NHS (Lucy Letby)

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So coz it’s against training and your experience, the only other explanation is baby murder? That’s a bit of a leap.

Its not a leap at all.    There is no other explanation for this one.  3 dif6fert things that can only be deliberate acts.  One could be innocent mistake?  3 together.  Not a chance.

Its really basic stuff.


 
Posted : 03/09/2024 11:06 pm
pondo, silvine, silvine and 1 people reacted
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The whole idea that she killed babies by pumping air into their stomachs is just nonsense. What an absurd suggestion.

Why?


 
Posted : 04/09/2024 1:10 am
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its really basic stuff

What is basic is that hospitals exist to help people get better. Given that, it's surprising how often they make people get a whole lot worse/dead.

The Bristol scandal might have looked a whole lot different if one doctor, or one nurse could be shown to have been on shift for 50% of the deaths.

It may have been 'The Butcher Of Bristol' and the rest of the failings could have been quietly dealt with.

What about the other 50%? They'll just be ignored as outliers, like in this case.


 
Posted : 04/09/2024 6:56 am
zomg, cinnamon_girl, zomg and 1 people reacted
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Being married to a social worker during the old "shaken baby syndrome" I'm more open minded on this.

But we need to be very aware in our online bubble that some families have been through hell and this isn't about us having fun with our theories.


 
Posted : 04/09/2024 6:58 am
burntembers, jamiemcf, silvine and 5 people reacted
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The Bristol scandal might have looked a whole lot different if one doctor, or one nurse could be shown to have been on shift for 50% of the deaths.

The Bristol case was an excellent example of how taking a blinkered view of your own clinical outcomes can contribute to disaster. It's almost the reverse of this situation, but in favour of the clinicians involved. They looked at their cases of babies who died, and there was always a 'reason' why - the babies were sicker, had more complex heart defects etc - and they ploughed on because they thought it was just a spike and results would improve as they overcame the natural 'learning curve' for the new procedure. In many ways this was true for UK paediatric heart surgery at the time - too many small units all trying new stuff at the same time. Other units also had poor results, but Bristol was the clear outlier and had a whistleblower prepared to say so.

The key thing there was at what point they should have put aside the ego, stopped, and asked for help. And at what point management should have intervened.

What it teaches you is that humans have a habit of looking for the answer that suits their situation, either hiding behind complexity, or ignoring it in favour of a more convenient answer.

It doesn't mean that Letby is innocent, simply that we have to look harder for counter-arguments to the position we've taken, and guard against the temptation to squeeze evidence until it fits that position, or discard it if it clearly doesn't.


 
Posted : 04/09/2024 9:34 am
roli case, mert, mert and 1 people reacted
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Because it’s just a completely stupid way of trying to kill a baby and there was no meaningfully valid diagnosis or evidence in most of the cases.


 
Posted : 04/09/2024 10:46 am
crossed and crossed reacted
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Because it’s just a completely stupid way of trying to kill a baby and there was no meaningfully valid diagnosis or evidence in most of the cases.

Ah, well - if I'd known you were going to be so scientific about it, I wouldn't have got involved!

I know I said I was going to step away (and I will) but this is me just repeating something I've already said, which doesn't count. 🙂 For most of the babies she was accused of killing through injecting air, air was found in them where air shouldn't be.


 
Posted : 04/09/2024 11:06 am
ehrob and ehrob reacted
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https://www.theguardian.com/uk-news/article/2024/jul/09/lucy-letby-evidence-experts-question

This is along the same lines as the Private Eye articles.

Air being found 'where it shouldn't be' is obviously a nice, neat way of presenting all that to a jury, but where there is no consensus, and even an element of conjecture as to how that air got there, we need to make sure that any alternative expert views are also put to the jury. Then we can look back a few years later and see that a fair trial has taken place, prosecution evidence has been robustly challenged, and we can be confident in the verdict.

It's not helpful when idiots like David Davis are advocating on your behalf. Standing up in Parliament and declaring her innocent is equally wrong-headed.


 
Posted : 04/09/2024 11:41 am
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Air being found ‘where it shouldn’t be’...

I'm kind of summarising from the appeal's 58 page judgement there. 🙂

... is obviously a nice, neat way of presenting all that to a jury, but where there is no consensus, and even an element of conjecture as to how that air got there, we need to make sure that any alternative expert views are also put to the jury. 

PResumption is a dangerous thing, but I presume the defence would have done that were there credible alternatives?


 
Posted : 04/09/2024 11:55 am
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PResumption is a dangerous thing, but I presume the defence would have done that were there credible alternatives?

Indeed it is (presumption).  There can be many reasons why a defense might not present an expert witnesses.  You can't just assume it's because they didn't have anything to say that might have helped their case:

https://davidallengreen.com/2024/07/the-lucy-letby-case-some-thoughts-and-observations-what-should-happen-when-a-defence-does-not-put-in-their-own-expert-evidence-for-good-reason-or-bad/


 
Posted : 04/09/2024 12:35 pm
slackboy, poly, slackboy and 1 people reacted
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There can be many reasons why a defense might not present an expert witnesses. 

Such as?


 
Posted : 04/09/2024 1:06 pm
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You know you could just read the link I posted but OK, fine, let me paste the most relevant bits although I really think you should read the whole thing.

One possible good reason for there not being expert evidence put in by the defence has been identified by the experienced criminal barrister Adam King in a strong piece setting out why there may be a miscarriage of justice in this case:

“One reason the defence might have chosen not to call Dr Hall (and I am speculating here) is if they felt they had so thoroughly undermined Dr Evans that they were better off leaving it at that. That would be a big tactical call, but covering your own back is not always consistent with protecting your client’s interests.

“So, for example: if your own expert would contradict much, but not all, of the Crown’s expert’s conclusions, and you believe the credibility of the Crown’s expert has been totally destroyed, you might judge it prudent not to put your own expert in the witness box. Avoiding the potential for future criticism and hindsight regret by putting your client in what you believe will be a worse position — by calling your own expert — is not a boss move. This is all speculation, but I guarantee that careful thought went into the decision not to call Dr Hall. None of this, though, would mean the conviction is safe.”

*

Another possible reason not to call expert evidence is that your client’s case is that the relevant area of knowledge is such that no actual expertise is possible. This may be because of the lack of reliable data, or because it is a novel or developing area.

If so, calling an expert on that point would contradict that position.

We do know that Letby’s defence lawyers put in a detailed submission at the end of the prosecution case in the first trial that the prosecution had shown no case to answer and that prosecution expert evidence should be ruled inadmissible. It may have been that calling expert evidence would have undermined the prospects of what may have been a successful application.

We don’t know.


 
Posted : 04/09/2024 1:15 pm
slackboy, cheers_drive, slackboy and 1 people reacted
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Oh, I read it, but you said "many" - again, dangerous to presume but I presumed you had more than the two you outlined above.

But again, I'll leave you to it.


 
Posted : 04/09/2024 1:21 pm
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Well, just let us know when you come up with a number you would find acceptable.

Anyway, the piece linked in the original piece which is also worth a read:

https://unherd.com/2024/07/the-questions-haunting-the-lucy-letby-trial/


 
Posted : 04/09/2024 1:25 pm
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Ok, cool.


 
Posted : 04/09/2024 1:32 pm
 poly
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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.”

That’s one interpretation, but another interpretation would be that US “experts” are much more willing to say what the defence want to hear in return for cash, and UK experts understand their responsibility is to the court and not directly to the party that pays them so will give more nuanced (and less “useful”) evidence!

Only if they were prepared to testify on her behalf. If not then once summons they would just no comment everything.

that’s not how being a witness works in court - you can’t say “no comment” when you are in the witness box.  And expert witnesses don’t give evidence on behalf of the defence or the prosecution, they may be instructed or called by one party but they are not (supposed to) have any allegiance to that party or miss out / gloss over details to help that side.  In a perfect world all experts would agree so you only need one (on each topic).  In many cases that IS the way it works.   Of course a defence team are very unlikely to call/summons an expert who they have not had lots of discussion with before hand - rule 1 is never ask a witness a question you don’t already know the answer to!  But I think it is very unlikely that any esteemed expert would be unwilling to engage because the alleged crime is heinous, most experts completely understand the implications of being falsely accused of such a crime.

So, one of the issues for the defence is they have their own expert report.  It agrees with the prosecution expert report on a lot of content - but differs on some key facts.  Do you call your witness and have him say “yes most of what the prosecution witness said is true BUT…” and risk the jury remembering the bits where they agreed.  Or do you try through robust cross examination to get the prosecution expert to admit that there are some holes in their version.  It does not follow that if there are holes that the person is not guilty - only if together with all the other evidence there is reasonable doubt.   The defence don’t have to decide that until after they’ve examined the prosecution witnesses so a calculated decision will have been taken that it was at least no worse for their case not to call a witness.

as a passive observer of the media stories, the “post it notes” probably had more weight on my impression than the “stats”.  If it is true that they were from counselling I don’t think that was explained in court.  Presumably she could even have called the counsellor and waived any rights to confidentiality - but of course that is not without risks either!

the jury did see her give evidence in her defence, they would have been told that if they found her to be a credible witness she should be acquitted, so not only did they believe enough of the crown case, they didn’t believe her.  That doesn’t mean there were no mistakes in the crown case - but did they result in a miscarriage of justice is a different question.  It’s one of the problems with our jury system - there’s no record of what weight they put on any individual aspect and therefore we second guess what might have happened if slightly different evidence was presented.


 
Posted : 05/09/2024 12:18 pm
pondo and pondo reacted
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That’s one interpretation, but another interpretation would be that US “experts” are much more willing to say what the defence want to hear in return for cash, and UK experts understand their responsibility is to the court and not directly to the party that pays them so will give more nuanced (and less “useful”) evidence!

From the link I posted above:

Also very unusual is the fact that Dr Evans “pitched” his services to the police, when he heard about the investigation in the media. This is not the way experts are normally selected. The defence argued it indicated pro-prosecution bias. The Court of Appeal disagreed.

Also interesting was the comments on Evans from a judge in an unrelated case:

One way of achieving this is to look at whether the experts have been wrong before. In the case of the lead expert in Letby’s case, Dr Evans, the defence discovered halfway through the trial that he had been utterly excoriated in a ruling by a Court of Appeal judge in a different case. “No effort to provide a balanced opinion… No attempt made to engage with the powerful contradictory indicators… The report has the hallmarks of an exercise ‘working out an explanation’ that exculpates the applicants… tendentious and partisan expressions of opinion that are outside [his] professional competence.” That level of criticism from a senior judge is not made lightly: they know it can be career-ending. And if the Crown had known of it in advance, I suspect they would have looked for a different expert.


 
Posted : 05/09/2024 12:39 pm
qwerty and qwerty reacted
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https://www.theguardian.com/uk-news/2025/jan/08/lucy-letby-retrial-needed-after-clear-miscarriage-of-justice-says-david-davis

David Davis has an interesting history of taking up unpopular causes. Of course he's also got a history of being spectacularly wrong on occasion too!


 
Posted : 09/01/2025 8:23 am
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Bristol - They looked at their cases of babies who died,

It wasn't just babies that were dying in Bristol, they used the data for babies to prove a point, Wisheart (the cardiac surgeon) had an appalling cardiac surgical record, nearby hospitals knew this and would send their patients to cardiac units further away.  I was on the ward back in the 70s, made friends with the other patients and watched them die, found one dead on the bathroom floor - quite something for a 13 year old......................


 
Posted : 09/01/2025 9:58 am
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Bit of an update here. Seems a panel of experts have found there was no evidence of murder being committed.

Reasons given appear to have been echoed in this thread.

https://www.theguardian.com/uk-news/2025/feb/04/no-medical-evidence-to-support-lucy-letby-conviction-expert-panel-finds


 
Posted : 04/02/2025 12:09 pm
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Saw that. I wonder if those poo-pooing my comments (and those of others) from a few weeks back have yet accepted that it has been terrible miscarriage of justice.


 
Posted : 04/02/2025 12:49 pm
dyna-ti, cinnamon_girl, cinnamon_girl and 1 people reacted
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Just saw this on the BBC too.

https://www.bbc.co.uk/news/articles/cvgl5yyg1x6o


 
Posted : 04/02/2025 4:15 pm
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There are some proper big hitters in that panel, people who do not have an agenda but do have serious credentials. It will be hard to ignore their voice, so long as judicial process allows for it to be heard.

I still can't get my head around how or why her defence team did not call any expert defence witnesses. If or when she appeals, I hope she has a new legal team that will do a better job of offering a fair defence.


 
Posted : 04/02/2025 4:24 pm
slackboy and slackboy reacted
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The expert witness has form and would be interested to know whether Mark McDonald has been made aware of it.  It's horrific by the way.


 
Posted : 04/02/2025 4:40 pm
 kilo
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The expert witness has form

Form for what?


 
Posted : 04/02/2025 4:43 pm
pondo and pondo reacted
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Form for what?

Ah, bad choice of words.  Not done a good job on an occasion much much earlier than this.


 
Posted : 04/02/2025 5:11 pm
 kilo
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Be jaysus it's hard work getting any intel out of you! Could you possibly give some details of this failing?


 
Posted : 04/02/2025 5:16 pm
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Could you possibly give some details of this failing?

Careful, STW don't want to be a respondent in a libel case.


 
Posted : 04/02/2025 6:15 pm
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Exactly Sandwich, am very mindful of that.


 
Posted : 04/02/2025 6:32 pm
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Makes you think.


 
Posted : 04/02/2025 6:42 pm
pondo, BoardinBob, pondo and 1 people reacted
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Lots of info in the Private Eye series. Not necessarily saying she's innocent, more questioning the process and some of the evidence.

Private Eye Online | The Lessons of the Lucy Letby Case


 
Posted : 04/02/2025 6:47 pm
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I still can’t get my head around how or why her defence team did not call any expert defence witnesses. If or when she appeals, I hope she has a new legal team that will do a better job of offering a fair defence.

Ironically was it not the research work by Dr Shoo Lee which the prosecution used as evidence?

My understanding is that her appeal failed and she can't appeal again and all that can be considered now is a miscarriage of justice.

Since the entire prosecution case rested on expert medical advice and nothing much else I cannot see how the unanimous decision of the an international panel of medical experts can possibly mean anything other than she is completely innocent.

My heart goes out to Lucy Letby and also the devastated parents for all the turmoil it will have caused them, compounded by the fact that the medical panel found that in some cases poor medical practices were a contributory factor.


 
Posted : 04/02/2025 6:57 pm
 poly
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Saw that. I wonder if those poo-pooing my comments (and those of others) from a few weeks back have yet accepted that it has been terrible miscarriage of justice.

of course it is entirely possible that even if the expert witness evidence was wrong that there has not in fact been a miscarriage of justice.

There are some proper big hitters in that panel, people who do not have an agenda but do have serious credentials. It will be hard to ignore their voice, so long as judicial process allows for it to be heard.

The conduct of the appeal(s) and the (re)trial by media does make the case rather odd.   I’m not sure if it’s just how the media reported it today - but I think their credibility as expert witnesses is undermined by both the manner of what has been said and where; the correct process is for the CCRC to look at the evidence not for a self appointed panel to make public statements that someone did not commit murder (when what they actually seem to mean, is the deaths may be explained by other causes).

I still can’t get my head around how or why her defence team did not call any expert defence witnesses.

certainly seems odd, but presumably the defence team knew what that expert was likely to say under cross examination - not only to their questions but to the questions the crown would almost certainly ask.  I don’t think any expert was suggesting to the defence pretrial that none of the cases could possibly be murder?

If or when she appeals, I hope she has a new legal team that will do a better job of offering a fair defence.

she already has a new legal team.  The jury are of course unable to explain how they reached their verdict, I only saw the edited media reporting of the evidence but some of the circumstantial evidence seemed to me like it would need a decent defence to explain, and didn’t come across well when giving her own evidence.   I have no idea if she’s guilty or not, or whether even if she is guilty if there really was enough of a case to secure a conviction but it does feel as though people on both sides have already made their mind up which is never good.


 
Posted : 04/02/2025 7:03 pm
pondo and pondo reacted
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and some of the evidence.

There was evidence ? I thought the whole case rested on theory and speculation.


 
Posted : 04/02/2025 7:12 pm
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If someone had misused or misinterpreted my past work, I'd want some redress in how that work was used. In this case, the lead author only went ahead to look at the data on the basis that ANY findings (for or against the defendant) would be made public. Naturally there were no financial incentives either. And to make things water tight, I would also want to assemble the best team possible of independent colleagues for review of interpretations using my work (which he has). It is naturally harder to blind the cases presented by merging them into a larger file of neonatal deaths and make a double-blind assessment of causation, but that would have been the next step to identify false positive assignment rate.


 
Posted : 04/02/2025 7:12 pm
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There is lots of evidence but its poor quality or outright wrong.  I believe that they knew the case was weakso went hunting for anything they could use.

I stll think she harmed some babies but i am sure the  conviction is unsafe


 
Posted : 04/02/2025 9:07 pm
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Since the entire prosecution case rested on expert medical advice and nothing much else I cannot see how the unanimous decision of the an international panel of medical experts can possibly mean anything other than she is completely innocent.

The what, now? That's one heck of a giant leap to make.


 
Posted : 04/02/2025 11:53 pm
poly and poly reacted
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It's such a desperately sad situation. As much for the families who now face the prospect of a version of events that gave them some closure being torn down and rewritten.

We still don't know if Letby is innocent of some or all of these murders and attempts, although it's hard to believe she would be convicted today if the prosecution evidence was put under proper scrutiny.

It's an indictment of how Ill equipped the justice system is to handle complex medicolegal cases that require nuanced evaluation of clinical evidence, rather than black and white opinions.


 
Posted : 05/02/2025 12:06 am
phil5556, pondo, poly and 3 people reacted
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"New evidence" under review.

https://www.bbc.co.uk/news/articles/cj0y9673rjno


When it comes to the Lucy Letby case, there are two parallel universes. In one, the question of her guilt is settled. She is a monster who murdered seven babies and attempted to murder seven more while she was a nurse at the Countess of Chester Hospital between 2015 and 2016.

In the other universe, Letby is the victim of a flawed criminal justice system in which unreliable medical evidence was used to condemn and imprison an innocent woman.

...

I have spent almost three years investigating the Letby case - in that time I have made three Panorama documentaries and cowritten a book on the subject with my colleague Judith Moritz. Yet, if true, the new evidence, presented by [Letby's barrister] Mark McDonald in a series of high-profile press conferences and media releases, is shocking.

According to his experts, the prosecution expert medical case is unreliable.

Mark McDonald has not released the panel's full reports, which are currently with the Criminal Cases Review Commission (CCRC), the body he needs to persuade to reopen Letby's case, but he has released summaries of the panel's findings.


 
Posted : 11/08/2025 12:32 pm
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It sounds like 'campaigners' on both sides need to stop trumpeting firm 'conclusions' in a complex case where there still seem to be a wide spectrum of possible causes and contributory factors for these deaths. 

If anything, it is an illustration that, if you run a crumbling, underfunded hospital with a culture of poor staffing, poor practice, and arse-covering, it potentially makes it quite easy for a serial killer to hide in plain sight, as their handiwork can be almost indistinguishable from your normal day-to-day tally of poor outcomes and avoidable harm to patients.


 
Posted : 11/08/2025 2:56 pm
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Devils advocate view - there were lots of deaths when she was working there.  Has the death rate dropped since she was removed? 


 
Posted : 11/08/2025 3:07 pm
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Devils advocate view - there were lots of deaths when she was working there. Has the death rate dropped since she was removed?

Unfortunately that doesn't prove anything. It is possible that the excess deaths dropped because staff were more aware of the problems in the unit & were taking steps to ensure it didn't happen again.


 
Posted : 11/08/2025 3:16 pm
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Posted by: grahamt1980

Has the death rate dropped since she was removed? 

 The unit was downgraded so that it could no longer look after very vulnerable and very sick babies, so yes, the rate of deaths decreased. 


 
Posted : 11/08/2025 4:36 pm
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