The nurse was sentenced to 15 life sentences in prison, but experts are now questioning the evidence

The case built by the prosecution was based on circumstantial evidence. No one saw her commit the crimes and there is no forensic evidence

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Photo: BBC
Photo: BBC
Disclaimer: The translations are mostly done through AI translator and might not be 100% accurate.

Former nurse Lucy Letby has become Britain's deadliest serial babysitter since she was convicted of killing seven newborn babies and attempting to kill another seven at a hospital in the north of England in 2015 and 2016.

Her murder trial was one of the longest in British history, and the media closely followed every twist and turn.

She was sentenced to 15 life sentences, which means that she is one of only four British women sentenced to die in prison.

But since the trial ended, many experts have come forward to express concerns about key evidence presented to the jury.

A BBC investigation spoke to some of them at the very top of their fields - statistics, neonatal medicine and science, who are questioning the way courts deal with cases of such medical complexity.

They accept that it must be difficult for families to hear their doubts about the trials raised, but they say they are so convinced of their arguments that they have to come forward.

Letbi was convicted of murdering and attempting to kill the babies by various methods - injecting air into their veins, poisoning them with insulin, inflicting injuries and injecting air or liquid into their stomachs.

Before the first suspicions were expressed, she seemed like a diligent and conscientious nurse.

Even during the trial, there were very few signs that there was anything psychologically wrong with her.

The case built by the prosecution was based on circumstantial evidence.

No one saw her commit the crimes and there is no forensic evidence.

Instead, the case relied heavily on the interpretation of clinical notes by six experts who testified for the prosecution.

Some of these evidences are those with which other experts - who did not participate in the trial - do not agree.

The defense did not call any expert to testify, the reason for this is unknown.

The senior statistician was among the first to speak up.

The prosecution's case was built around the fact that Lucy was "always there" when bad things happened.

In the years before 2015, the neonatal unit at the Countess of Chester Hospital where Letby worked had between one and three baby deaths per year.

But between June 2015 and June 2016, at least 13 babies died.

In early 2016, a small group of the hospital's top doctors began to suspect Letba because she was often on shift when these deaths occurred.

They alerted the hospital administration and eventually the police were called.

At the trial, the police presented a chart of their arguments.

It showed every death and collapse that Letbi was accused of, along with a list of other nurses from the unit.

She was the only sister present when each of these incidents occurred.

But statisticians, such as Professor Jane Hutton, argue that the chart is based on incomplete calculations.

She says the chart didn't include all the reasons why one nurse might have been present at more baby deaths than other nurses — she might have worked more shifts or been in charge of sicker babies because she was more skilled, for example.

And the chart only showed some deaths and some collapses that happened that year.

Professor Hutton believes that the police did not fully consider all the potential causes of death before assuming that a crime had been committed.

"The police will only get involved if they are told that we think there is a killer. In other words, they must assume that a crime has occurred.

"It's very easy for confirmation bias to occur. It's very easy to see things that aren't there otherwise," she says.

Insulin evidence

Letby was found guilty of attempting to kill two babies by adding insulin to their IV bags.

These babies were referred to as Baby F and Baby L - each baby was given a letter of the alphabet to protect its identity.

Prosecutors say a very small amount of insulin was enough to poison the babies, but the BBC spoke to a team of engineers who disagree.

Professor Jeff Chase, from the University of Canterbury in New Zealand, has been modeling how insulin works in premature babies for more than 15 years.

He collaborated with chemical engineer Helen Shannon on a mathematical model that calculated that significantly higher amounts of insulin would be needed to harm babies F and L, and to generate the levels seen in their test results.

In the case of baby L, it was 20-80 times more.

No evidence was presented at trial to indicate that a significant amount of insulin had disappeared from the ward.

Speaking to the BBC, another expert raised further concerns about the use of blood tests in the trial - something others have questioned in the media.

Dr Adel Ismail - a retired doctor who has published more than 30 studies on the immunosorbent assay - told the BBC he believed it could produce misleading results.

"In my research, I found that the error rate is one in 200 cases," said Dr. Ismail.

In his opinion, a second confirmatory test in such cases is of "absolute vital importance".

In the case of baby F and baby L, no additional tests were performed in the laboratory.

The hospital did not request further tests because both babies recovered soon after.

There are experts who believe that these tests are good enough to rely on just one round of results.


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Baby C's x-ray and collapse

Baby C was born in June 2015 at 30 weeks and weighed 800 grams.

He was being cared for in the intensive care unit room of the neonatal unit when, on the night of June 13, his condition suddenly worsened.

Letby was convicted of causing the boy's collapse by deliberately injecting a lethal amount of air into his stomach through his nasogastric tube.

The key to the case was the X-ray taken on June 12, which the prosecution persistently referred to during the trial.

In pre-trial reports, two prosecution witnesses said he showed how the baby's stomach was swollen "most likely due to intentional" air being injected into the feeding tube.

However, Dr Michael Hall, a neonatologist who advised the defence, told the BBC that he did not think the X-ray showed that anyone had harmed the baby.

Lucy Letby's defense never called him to the witness stand to testify.

"There are a number of possible explanations for the presence of excess gas," he says.

He believes that it is likely that it was at least partially caused by the respiratory support that the baby was receiving and that the X-ray strongly indicates that there was a blockage of the intestines.

Letby was not working the day the X-ray was taken and had not been on shift since before the baby was born - information the jury heard at trial.

During the appeals process, the prosecution argued that Letbi could have visited the hospital while she was off shift, but did not provide any evidence that this actually happened.

The jury heard that Baby C was stable and that his collapse at almost four days old was unexpected.

But the BBC spoke to five senior clinicians who reviewed the baby's medical records which were presented to the public at the trial.

They all pointed out that the baby was extremely high risk due to premature birth and should have been in a higher level unit, where she would have been seen by the doctor on call at least twice a day.

"I think they failed to establish that the baby had a bowel obstruction which was causing problems and which required an urgent surgeon's opinion and possibly surgery to save the baby's life," says Professor Colin Morley, retired professor of neonatology at the University of Cambridge. .

He told the BBC he was "very sure" that Baby C had died of natural causes.

"I see no reason to come up with the very strange hypothesis that someone forcibly injected gas into his stomach through a nasogastric tube, enough to kill the baby," he adds.

The X-ray was by no means the only evidence used to convict Letba on this charge.

The prosecution argued that a series of text messages Letby sent showed she was desperate to get into the room where Baby C was being treated even though she was not the nurse in charge of him.

Another nurse said she found Letby standing over the baby's crib when it collapsed.

The court was given the impression that her behavior after his death was very strange and that she was looking for his parents on Facebook.

Liver damage

Baby O was one of triplets born in June 2016.

He was stable, Letba's trial was told, until the afternoon of June 23 when he experienced an "unbelievable deterioration" and later died.

The pathologist who testified for the prosecution, who reviewed the case, said he believed Baby O had suffered a "blunt injury" to the liver very similar to a collision in a car accident.

But a leading senior perinatal pathologist told the BBC she had serious objections to the way the pathology was presented at the trial.

She agrees with the original autopsy finding that the baby's liver damage and death were natural.

The pathologist - who asked to remain anonymous due to the controversial nature of the case - said she had seen this type of liver damage at least three times during her career.

Again, there was other evidence used to convict Letba.

She objected to moving baby O to another part of the unit where her condition would be monitored more closely.

She was accused of falsifying medical notes, and there was also a rash that prosecution witnesses said was consistent with the symptoms of air injected into the baby's veins.

They leaked the document

The BBC has also seen a document which sheds light on how many problems the neonatal unit at the hospital where Lucy Letby worked in 2015 and 2016 had.

The document is called a "risk register" and contains reports submitted by staff on a range of security issues.

It outlines the kinds of problems that any British hospital could face.

But some things stand out.

In March 2015, three months before the first murder, the head of nursing reported that the department was understaffed and understaffed.

She stated that plans have been initiated to change that.

But a year later, very little has changed.

There were problems with the transport team, which transports sick babies to more specialized hospitals.

In November 2015 and again the following March, they were not available when they were needed.

And in July 2015, there was an epidemic of antibiotic-resistant bacteria called pseudomonas in the ward.

This dangerous bacteria caused the death of three babies in a non-natal unit in Belfast in 2012.

According to this document, the unit tried to eradicate the bacteria from the taps - but eight months later it was still present.

The BBC can't directly link any of these problems to the injuries or deaths of the babies, but it does paint a picture that the unit had some serious problems.

The jury heard nothing about those problems.

None of the experts who spoke to the BBC made an assessment of Lucy Letby's guilt or innocence, but expressed concern about the credibility of Letby's verdict.

The Crown Prosecution Service told the BBC that "two juries and three appeal court judges reviewed the evidence against Lucy Letby and she was convicted on 15 different counts after two separate trials".

It said in May that the Court of Appeal had dismissed Letba's appeal on all grounds - rejecting her argument that the prosecution's expert evidence was flawed.


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