TWO former Cumbrian health chiefs are among a 16-strong panel of experts who have issued a fresh challenge to the murder convictions of Lucy Letby.
Published just days before the release of a controversial Netflix documentary about the case, the panel’s "Briefing Paper" is a detailed, clinical rebuttal of the case against Letby, convicted of seven murders and seven attempted murders.
The 36-year-old is serving 15 whole-life prison terms.
Prosecutors said she killed or attempted to kill the babies while working as a nurse at the hospital's neonatal unit in the year up to June 2016.
She continues to deny wrongdoing.
The expert panel (below) includes Cumbria’s former director of public health, Professor John Ashton, and Dr Mike Bewick, a former medical director of Cumbria Primary Care Trust who also served as a national deputy medical director of NHS England.
The two doctors, who co-chaired the initial investigation into maternity unit failures at Furness General Hospital more than a decade ago, say there is compelling evidence to show Letby is the victim of a miscarriage of justice.
In a summary of Letby’s convictions, the panel provides an assessment of how each of the babies involved died or became seriously ill. The conclusions claim:
- Letby was convicted without direct eyewitness evidence of wrongdoing.
- The statistical analysis linking her presence to infant deaths was flawed and a product of confirmation bias.
- Medical and scientific evidence was misrepresented, cherry-picked, or unreliable.
- Expert witnesses lacked credibility, with key prosecution witnesses offering unscientific or misleading testimony.
- And alternative medical explanations for the deaths were ignored.
In every case, concludes the panel, the experts attribute deaths to either natural causes or medical errors, not criminality.
The briefing paper offers alternative non-criminal explanations for the death of medical collapse of every baby Letby was convicted of harming, in several cases focusing on the prosecution claim that she maliciously injected air in to the infants.
One “murdered” baby died in June 2015.
Prosecutors attributed the tragedy to Letby injecting air into the child’s nasogastric tube. The panel concludes: “[The baby] died due to decision to discontinue respiratory support in the face of poor response to active resuscitation.”
The panel suggests that “clear prior signs of intermittent bowel obstruction” warranting urgent surgical investigation went “unrecognised.”
In another case, again said by prosecutors to feature Letby injecting air into the victim’s body, the panel concludes that the death was linked to an injection – not administered by Letby – which punctured the baby’s liver.
Another child suffered fatal “systemic sepsis” after an alleged delay in medics recognising the infant was in “respiratory distress,” say the experts.
Yet another baby which prosecutors say was given a fatal air injection in the stomach was “extremely” premature and born with chronic lung disease and “multiple health complications.
There was no evidence, say the experts, that air was injected into the child.
In two cases, the panel rejects the prosecution case that Letby interfered with the airway of the child, including by intentionally dislodging a breathing tube.
'Urgent review'
Dr Bewick, who has extensive professional experience in overseeing investigations into excess deaths in NHS hospitals – including in neonatal and maternity settings - said Letby’s conviction is unsafe and should be subject to “urgent review.”
He said: “The weight of evidence grows by the day questioning that presented at Lucy’s trial which essentially convicted her on circumstantial evidence.
“The recent clinical review of the deaths, under the leadership of Dr Timothy Ho, and our own work, questions the scientific evidence presented at the trial. Lucy had a very poor defence and the evidence for the prosecution case was, in our view, flawed.
“While the families will be justifiably upset by the reopening of Letby’s case - and one can have nothing but sympathy with them - in my and many others’ view, a probable injustice against an individual has to be put under further detailed scrutiny.
“The Criminal Cases Review Commission pathway is a slow one, unfit for this specific case.
“To enable a rapid review, which is imperative in our view, political leadership by government ministers is required to re-examine Letby's conviction urgently.”
'What has happened here?'
Professor Ashton says he is now convinced that Letby is innocent and has become the victim of a “perfect storm in a dysfunctional organisation.”
He told The Cumberland News: “At the beginning of this sorry affair, I held the view that the evidence against Lucy Letby was wholly circumstantial and that it was not possible to say whether she was guilty.
“Having been immersed in the detail of the evidence with dozens of international experts… for the past two years, I can now say I have every reason to believe Lucy Letby is innocent of the charges against her and that the true culprits lie elsewhere and with a failed system of medical care and justice.”
Veteran MP Sir David Davis (above) last year delivered a House of Commons speech about the Letby case, telling fellow MPs he initially accepted the tabloid characterisation of Letby as "an evil monster."
"But then I was approached by many experts, including leading statisticians, neonatal specialists, forensic scientists, legal experts, and those who had served at the Chester hospital and are afraid to come forward," he said.
"The experts included a past president of the Royal Statistical Society and a past president of the Royal College of Paediatrics and Child Health - people who were more knowledgeable than the purported experts whose evidence convicted Lucy Letby.
"They were all concerned by what they perceived as the false analyses and diagnoses used to persuade a lay jury to convict Letby....
"So what has happened here?
"The Countess of Chester hospital neonatal unit suffered a sharp increase in deaths, from a typical two to four a year to 17 in one 13-month period.
"When hospital senior management became aware of the elevated mortality in June 2016, they were alarmed and commissioned some investigations.
"The most notable was carried out in November 2016 by the Royal College of Paediatrics and Child Health, whose report noted many failings on the unit, all of which—at least in part, if not in total—could have been the cause of the deaths.
"The report highlighted inadequate staffing levels, delayed escalation of concerns to tertiary units and 'disconnection between the neonatal leadership and the trust’s government and risk management processes....'
"In essence, because of a mixture of inadequate resources and poor medical management, the hospital was not capable of keeping those very fragile babies alive.
"That fact was recognised by the hospital when the neonatal unit was downgraded in July 2016 and stopped taking babies of less than 32 weeks’ gestation."
The 'incriminating' Post-it notes found at Letby's home, say her defence team, were messages she was encouraged to write while under pressure as a part of occupational therapy provided by her employer.
The Thirwall inquiry into the case produced clear evidence of how officials had exonerated Letby following an internal review of neonatal deaths at the County of Chester Hospital when she was employed there as a nurse .
Letby's barrister Mark McDonald, who says he is 100 per cent convinced she is innocent, pointed out that the 16 independent experts who analysed the case against her carried out a close analysis of the medical notes for each of the babies involved.
This was not done at the trial.
The prosecution case against Letby was based on "low grade" circumstantial evidence which was "incredibly weak" and not evidenced, said Mr McDonald. He questioned the quality of evidence from the prosecution expert, a retired paediatrician.
There was also evidence that "contaminated water" may be linked to a lung infection that affected one of the babies, he added.
'The jury heard all the detailed evidence'
After Letby was convicted, senior crown prosecutor Nicola Wyn Williams, of CPS Mersey-Cheshire’s Complex Casework Unit, said: “Lucy Letby has continually denied that she tried to kill this baby or any of the babies that she has been convicted of murdering or attempting to murder.
"The jury has heard all of the detailed evidence including from her in her own defence and formed its own view.
“Our case included direct evidence from a doctor who walked into the nursery to find a very premature baby desaturating with Letby standing by, taking no action to help or to raise the alarm.
"She had deliberately dislodged the breathing tube in an attempt to kill her.
"Staff at the unit had to think the unthinkable – that one of their own was deliberately harming and killing babies in their care."
The Criminal Cases Review Commission is currently assessing the expert panel's findings but there is as yet no decision on whether to refer Letby's case to the Court of Appeal.
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