A few weeks have passed since Lady Justice Thirlwall delivered her devastating report into the failures made by Countess of Chester Hospital while Lucy Letby was murdering babies.
asserted
Letby → pass → babies
The senior Appeal Court judge was unequivocal that 'dysfunctional management' and a 'complete failure' to understand safeguarding meant vulnerable infants were not protected from harm.
asserted
infants → understand → harm
Up to three children murdered by the 36-year-old former neonatal nurse should not and would not have died had hospital managers acted sooner to remove her from the ward, she said.
asserted
she → murder → ward
Lady Justice Thirlwall insisted it was not her job to re-examine the evidence called at Letby's lengthy trial or to pre-empt the work of the Criminal Cases Review Commission (CCRC) – the body charged with examining miscarriages of justice.
asserted
it → insist → justice
The CCRC is currently considering Letby's case and is her final hope of freedom after two failed appeals.
But, despite this, the contents of the judge's 822-page public inquiry report did not make good reading for those who continue to insist on Letby's innocence.
asserted
who → consider → innocence
Although it was not in her remit, the judge dismissed many of the arguments of Letby's supporters, who claim that no murders took place at the hospital and insist Letby was a scapegoat for a failing, understaffed and dirty ward.
uncertain
Letby → dismiss → ward
As we release a special podcast episode of The Trial on the subject, the time has come to explain precisely why Letby's supporters are not only wrong but continue to cling to indefensible misconceptions about the case – only harming the parents of Letby's victims further.
asserted
supporters → release → victims
Lucy Letby: The Facts, a special episode of The Trial UK, is available now wherever you get your podcasts
On a special episode of the Trial podcast, Caroline Cheetham and Liz Hull are joined by reporter Kim Pilling to 'draw a line' under the speculation still surrounding Lucy Letby's convictions
Many of Letby's supporters point to staffing shortfalls on the ward but, as Lady Justice Thirlwall said, 'none of the deaths could be attributed to staff shortages... [because] the nursing staffing levels at the Countess were slightly better than in all other comparable hospital neonatal units in the region'.
uncertain
levels → get → region
On sewage and the deadly pseudomonas bacteria in the neonatal unit's taps, which Letby fans repeatedly trot out to explain why several infants died, the judge was similarly forthright: 'There had been two periods of concern about infections on the unit.
asserted
judge → trot → unit
In 2012 and 2015, pseudomonas was found on the taps, and was dealt with and had no consequences for babies...
asserted
pseudomonas → find → babies
There was no evidence that pseudomonas played any part in any of the deaths.
asserted
pseudomonas → be → deaths
And on Letby's 'I AM EVIL I DID THIS' 'confession' note, which supporters claim she wrote under extreme stress on the advice of her occupational health mentor Kathryn De Berger, Lady Justice Thirlwall had this to say: 'Contrary to some reporting, Ms De Berger was not a counsellor and there is no evidence that counselling or any form of therapy was provided to Letby.
uncertain
counselling → do → Letby
And finally, on whether the downgrading of the neonatal unit to no longer take babies of less than 32 weeks' gestation explained the drop in deaths to zero – rather than that being due to Letby's removal from the ward – the judge concluded: '[This] was not an explanation for the absence of deaths and unexpected collapses.'
Lady Justice's Thirlwall's report made news around the world last month, but it took just a few days for the PR machine now powering Letby's 'innocence' campaign to fire up again.
asserted
machine → take → campaign
Westminster-based Maltin PR has confirmed they are working pro-bono for her bid.
asserted
they → base → bid
Timed to push the unfavourable inquiry coverage off the front pages, the latest in a series of documentaries questioning the guilty verdicts was aired on Channel 5, accompanied by more newspaper stories highlighting failings at the 'filthy' hospital or calling for a retrial of the serial killer.
asserted
latest → time → killer
Both the film and articles revisited theories debated at length in the mainstream media and online.
asserted
film → revisit → media
Lady Justice's Thirlwall's report made news around the world last month, but it took just a few days for the PR machine now powering Letby's 'innocence' campaign to fire up again
Documentaries examining the guilty verdicts have been aired, including shows on Netflix and Channel 5
asserted
Documentaries → make → Netflix
They also featured the usual contributors, including a statistician whose services Cheshire Police declined to use, a nurse made redundant from the unit eight years before Letby was operating and a disgraced coroner's officer forced out of her job for alleged misconduct.
asserted
Letby → feature → misconduct
All have long been cheerleaders for the convicted murderer.
asserted
All → convict → murderer
But retired vascular surgeon Colin Ferguson was a new voice to enter the fray.
asserted
Ferguson → enter → fray
He told the Channel 5 documentary that none of the murdered babies could have been killed by air embolism – in which air is injected into the bloodstream – because all the medical literature suggested gas would have been found in the hearts of the infants if they had died this way.
uncertain
they → tell → infants
'We've done a review of the cases in literature and there are only eight,' he says. '
asserted
he → do → literature
The real-world data says that in order to die from air embolus, you have to have those features.
asserted
you → say → features
'
But, if Dr Ferguson had done his research, he might have realised that this is exactly what happened with several of Letby's victims.
uncertain
what → do → victims
Although no air was detected in their hearts, Professor Owen Arthurs, a leading paediatric radiologist based at Great Ormond Street Hospital in London, told the jury at Letby's trial that air could indeed be seen in the major blood vessels of three of the infants, Babies A, D and O, when he studied X-rays taken shortly just after they died.
uncertain
they → detect → X
The court was shown a particularly striking X-ray which revealed a 'line of gas' in a blood vessel along Baby D's spine that, in the absence of a fracture or infection, Professor Arthurs said, must have been injected into her circulation.
asserted
Arthurs → show → circulation
Professor Andreas Marnerides, the expert pathologist who also testified at Letby's trial, said he too found gas in a blood vessel in Baby D's belly which could not be explained by infection or decomposition.
uncertain
which → testify → infection
He also described seeing bubbles of air within veins in tissue samples from Baby A's lungs and brain, and said haemorrhaging was 'highly suggestive' that the air had entered the brain while they were still alive.
asserted
they → describe → brain
In evidence to the public inquiry, pathologist Jo McPartland, who carried out some of the post-mortems on Letby's victims, also made it clear that air is very difficult to see in the hearts of neonates, even in scans after death.
asserted
air → carry → death
Other new claims attempt to cast fresh doubt on Letby's convictions for poisoning two baby boys with insulin – evidenced by the 'extremely high' levels of the hormone in their systems.
uncertain
claims → attempt → systems
The former nurse accepted during cross-examination that someone – just not her – must have poisoned Babies F and L, two boys from different sets of twins that were attacked eight months apart, in August 2015 and April 2016.
asserted
that → accept → August
But critics say the prosecution failed to explain to the jury that newborn babies can produce high levels of insulin naturally after birth.
asserted
babies → say → birth
They also contend that control tests used to detect insulin in the infants' blood were flawed, which meant they could have produced falsely high results.
uncertain
they → contend → results
The problem with that argument is it was discussed at the trial at length in front of the jury, who heard from Dr Anna Milan, a biochemist based at the laboratory at the Royal Liverpool Hospital.
asserted
who → discuss → Hospital
None of those doubting Letby's guilt were present during her lengthy ten-month trial – but they still claim to know better and confidently claim the jury got it wrong'
uncertain
it → doubt → trial
She told them she was 'very confident' in the veracity of the tests they carried out, while endocrinologist Professor Peter Hindmarsh also told the court that the blood readings could only be explained by someone having given insulin to the baby, not produced by the child themselves.
uncertain
someone → tell → child
Question marks have also been raised over a supposedly 'normal' blood test result from Baby F, five hours after Letby tampered with his drip, which was 'not consistent with insulin poisoning'.
However, the trial heard that Letby herself entered that test result into Baby F's medical notes and she was caught deliberately doctoring timings and entries in other infants' records to cover her tracks.
asserted
she → raise → tracks
The truth is that none of those doubting Letby's guilt were present during her lengthy ten-month trial – but they still claim to know better and confidently claim the jury got it wrong.
uncertain
it → doubt → trial
They cherry-pick flaws in the medical evidence, while paying scant regard to important testimony about Letby's odd behaviour after babies died, her bizarre searches on Facebook for parents of murdered infants she'd barely met and her hoarding of hundreds of confidential nursing handover sheets for patients at her home.
asserted
she → pick → home
In all the newspaper articles and documentaries that have been written and produced since Letby was found guilty, few pay any attention to key moments in the trial which, I believe, helped convince the jury she was responsible for the most heinous crimes.
asserted
she → write → crimes
…and 30 more, not listed.
The Aporia
