GUY ADAMS: Evidence towards Lucy Letby and what might present her innocence

Lucy Letby’s murder trial at Manchester Crown Court was one of the longest in British legal history, lasting ten months and culminating in 110 hours of deliberation by a jury of eight men and four women who eventually ­convicted her of murdering seven newborn babies and attempting to murder six more.

There has followed a second trial, in which she was found guilty on another attempted murder charge, along with two unsuccessful appeals which failed to overturn those verdicts, for which the 34-year-old nurse is now serving the rest of her life behind bars.

The entire process, which spanned almost two years, saw two different juries and four of the most senior judges in the land conclude that Letby was one of the most prolific serial killers of modern times – a view shared by police, prosecutors and many of Letby’s colleagues at the Countess of Chester Hospital.

Yet its aftermath has seen a small but growing army of sceptics – ranging from tin-hatted conspiracy theorists to respectable statisticians and medical experts – decide that much of the evidence against her is deeply flawed. Some now argue she’s the victim of a grotesque miscarriage of justice.

Here, as the chorus of divisive scepticism grows, is a forensic dissection of the crucial areas of evidence the case hinged on – presenting the arguments for guilt and innocence for each one.

Today, in Part One of his ­compelling analysis, Guy Adams covers Letby’s ‘suspicious’ searches on Facebook for the parents of children she was accused of harming, the ­‘confessional’ jottings she made on notepaper, the ‘suspicious’ alterations to medical records and much else besides to help you make up your own mind about the verdict.

Controversial statistics

Case for guilt

A chart presented twice to the jury detailed all 25 ‘suspicious events’, including seven deaths and a number of sudden ­‘collapses’, involving newborn infants on the Countess of ­Chester Hospital’s neonatal unit over a 13-month period starting in June 2015.

They were plotted against the shift patterns of all 39 nurses employed there.

The table revealed that Letby was on duty every single time one occurred. No other colleague was around on more than seven occasions.

Prosecution barrister Nick Johnson KC argued she was the ‘one constant presence’ when babies were taken ill. And after Letby was taken off the ward, he noted, deaths reduced sharply.

The table doesn’t contain information about a further nine babies who had died between the start of 2015 and the end of the period covered by the chart.

However, the chart’s creator, expert witness and former ­paediatrician Dr Dewi Evans, says that’s because those deaths were not suspicious. Instead, they involved four children born with a congenital problem, one who was asphyxiated at birth, and four who died from infection.

Thanks to evidence shared at the Thirlwall Inquiry, which started this week, we now know a little more about the deaths not on the chart.

It seems Letby was present at four of the five that occurred prior to May 2016 (there was no data shared about the later ones). In other words, adding them to the table might not have helped her much at all.

Case for innocence

Critics strongly disagree. They argue that because the chart covers a relatively short period and omits several deaths and collapses that occurred ­during the relevant timeframe, it is statistically invalid and potentially very misleading.

Recent history certainly offers a warning about the dangers of relying on such data in court.

Shortly before Letby’s trial, a paediatric nurse from the Netherlands, Lucia de Berk, was freed from jail after it emerged her 2004 conviction on seven murder and three attempted murder charges had been based on erroneous analysis of statistics.

This case prompted the Royal Statistical Society to issue a paper titled ‘Healthcare Serial Killer or Coincidence’ which warned that ‘unexpected ­clusters’ of deaths ‘generally should not be taken as definitive evidence of misconduct’ in ­criminal cases.

One of its authors, Richard Gill, emeritus professor of ­statistics at Leiden University in the Netherlands, now believes Letby has been a victim of a ­similar miscarriage of justice to that of de Berk.

‘If you want my odds, I think there is less than a one in a hundred thousand chance she’s guilty,’ he claims.

John O’Quigley, a professor of statistical science at University College London, has told ­reporters: ‘In my opinion there was nothing out of the ordinary statistically in the spike in deaths, and all that the shift chart shows is that when Letby was on duty, Letby was on duty.’

Such concerns prompted 24 experts to write to ministers voicing concerns about Letby’s conviction.

Their letter read: ‘Possible negligent deaths that were ­presumed to be murders could result in an incomplete investigation of the management response to the crisis.’

A signatory, Professor Jane Hutton of Warwick University, told the BBC: ‘The work behind the stats presented to the jury appears not to have been done in the way that it should be.’

Her suspicious Facebook searches

Case for guilt

Letby repeatedly trawled Facebook looking for the ­parents of babies she was accused of harming.

Data obtained by police revealed that she’d made such searches at least 31 times, often late at night.

Frequently, she would attempt to view profiles on the anniversary of a child’s death.

One grieving mother was looked up on nine separate occasions, including late on Christmas Day. Another had her profile viewed the moment Letby woke up after the night shift on which a child she allegedly murdered had died.

Prosecution barrister Nick Johnson KC argued that the habit revealed ‘voyeuristic ­tendencies’, alleging she ‘took pleasure in her murderous ­handiwork’ and enjoyed ­observing the trauma it had caused families.

Case for innocence

Letby denied any sinister motive for her social media activity, saying she ‘regularly’ attempted to find Facebook pages of people she met during her daily life.

That much does seem to be true: the same police data shows that she made a total of 2,287 Facebook searches during the two-year period that was the focus of the case, looking up everyone from work colleagues to old school and university friends, to people she met at her Salsa class. A mere 1.3 per cent of those involved bereaved ­parents. Or at least the bereaved parents at the centre of her trials.

‘I was always on my phone,’ she testified, denying any ‘fascination’ with victims or their grief and instead claiming to be motivated by ‘general curiosity’.

Odd behaviour

Case for guilt

Witnesses also accused Letby of making strange and inappropriate efforts to spend time with grieving parents.

One, a shift leader, told the court how she had to repeatedly tell Letby to stop going into the ‘family room’ where the parents of a dying infant, Baby C, were cradling their son.

At the time, Letby was supposed to be caring for a different child in a separate nursery.

‘Lucy went into the family room a few times and I asked her to come out and leave that family,’ the shift leader testified.

Baby C’s parents said Letby at one point walked in carrying a ventilated basket and told them: ‘You’ve said your goodbyes, now do you want to put him in here?’

The father recalled: ‘This comment shocked us. My wife said: “He’s not dead yet.”’

Another witness, the mother of Baby I, said Letby was ‘smiling’ as she bathed her dead child, and at one point offered to take a commemorative photo of the infant’s corpse.

‘She kept going on about how she was present at the first bath and how [Baby I] had loved it,’ the mother said. ‘I wished she’d just stop talking.’

Then came Child P, a triplet who collapsed in June 2016.

Shortly before his death, Letby astonished colleagues (who thought he would make a full recovery) by predicting ‘he’s not leaving here alive, is he?’

She then dressed the body, took photographs for a ‘memory box’ routinely handed to bereaved families, and commiserated with the parents, who recalled: ‘She was in pieces, almost as upset as we were.’

Prosecutors alleged that such incidents show Letby ‘getting a thrill’ from the suffering of victims.

Case for innocence

Letby insisted her unusual and sometimes animated behaviour towards bereaved parents had been either wrongly interpreted or mis-­remembered by witnesses.

She did accept visiting the mother and father of Baby C ‘at some point’ but claimed ‘I don’t recall the shift leader having to pull me back.’

Letby further accused the parents of mis-remembering the incident with the ventilated basket, saying: ‘I don’t think I ever accepted definitely that’s what I said.’

As to the other interactions, the nurse did not accept that she behaved in an abnormal fashion in front of parents, but argued that she was instead attempting to help the couples process grief, saying at one point: ‘I was trying, in that awful situation, to [help them] have some positive memories.’

Hidden ‘trophies’

Case for guilt

When police raided Lucy Letby’s home, they found a treasure trove of documents that had been improperly removed from her workplace.

Under her bed was a carrier bag containing a printed blood gas reading for Child M, an infant she was later convicted of attempting to murder.

A colleague who took that reading testified it had been disposed of in the unit’s confidential wastepaper bin.

This bag also contained a paper towel on which a list of emergency drugs administered to Child M had been written, along with 31 shift ‘handover’ sheets.

Another bag held a further tranche of ‘handover’ sheets including four that covered dates in June 2016 when both Child O and Child P were killed.

There was a keepsake box with roses on it containing confidential paperwork from her first professional shift. Other medical records were found in a bin bag in her garage and in her childhood bedroom at the family home where she grew up.

In total, some 257 handover sheets were recovered, of which 21 included the names of babies she was alleged to have harmed. Some others are understood to include names of children now at the centre of further, ongoing police inquiries.

On her phone, detectives found a photo of a sympathy card she’d sent to the parents of Child I, plus an image of a thank you letter received from the parents of twins she was later accused of harming, Child E and Child F.

According to the prosecution, Letby hoarded such material because, like many serial killers, she got a ‘thrill’ from compiling a ‘little collection’ of souvenirs.

Case for innocence

Letby argued that all 257 documents found at her homes were merely items she had ‘inadvertently come home with in my uniform pocket’ at the end of a shift. She’d decided against disposing of them because that she had ‘difficulty throwing things away’.

In court, Letby denied ‘fishing out’ Child M’s blood pressure reading from a workplace bin to take home (as alleged by a colleague) saying ‘I can’t recall’ when asked how it had ended up under her bed.

Apropos the images of cards on her phone, she told police: ‘I often take pictures of any cards I have sent, even birthday cards – anything like that.

‘I often take pictures of them. It was upsetting losing (Child I) and it was nice to remember the kind words that I hoped I’d shared with that family.’

‘Doctored’ medical records

Case for guilt

Letby was repeatedly accused of making ‘fraudulent’ nursing notes which were ‘false, misleading and designed to cover her tracks’.

On several occasions, the court heard claims that she had altered

timings of critical events to distance herself from an infant’s deterioration or death. In the case of Child H, for example, Letby was at one point seen by a registrar attempting to revive the critically ill baby using a ‘neopuff’ resuscitator. Yet notes she later filed suggested that she was instead carrying out observations on a different baby at the time.

Elsewhere, Letby twice claimed to be in a different room when another baby, Child D, suffered collapses. In fact, witnesses said, this child was in her care.

She also confessed in court that an unsigned blood gas reading related to Child D, who died from an air embolism, was in her handwriting.

Then came the case of Child E, who died in the early hours of August 4, 2015, after losing a third of its blood.

Child E’s mother recalled finding Child E in acute distress at 9pm, bleeding around the mouth and ­making a ‘horrendous’ sound while Letby was ‘faffing around, not doing anything’.

Concerned, the mother phoned her husband. Phone records put this call at 9.11pm. Letby later filed notes claiming the infant was first seen bleeding around 10pm, which could excuse the fact that emergency care wasn’t administered until it was too late.

The mother recalled feeling ‘fobbed off’ by Letby, who persuaded her to leave the ward by playing things down, saying ‘Trust me, I’m a nurse’.

Case for innocence

Letby argued that Child E’s mother was mistaken about the timing, saying, ‘I disagree with that,’ when asked whether the incident had actually unfolded an hour earlier than her notes claimed.

She also denied telling the mother to leave the ward, but said she might have advised her to get some rest.

Asked about Child H, Letby said she could not say ‘from memory exactly what I was doing when’ (the jury found her innocent of one charge and could not reach a verdict on others related to this infant).

The failure to sign Child D’s blood gas reading was meanwhile an ‘error that happens from time to time’.

When cross-examined about a host of other disputed incidents that appear to have been left unrecorded, or where paperwork distanced her from being responsible for a child who died or suffered a collapse, she either denied wrongdoing or said she couldn’t remember details so: ‘I can’t answer that’.

Her ‘confession’

Case for guilt

Police who searched Letby’s house found a handwritten sheet of paper headlined ‘NOT GOOD ENOUGH’ along with several densely written Post-it notes.

Covered by largely unpunctuated text, they contained such phrases as ‘I AM EVIL I DID THIS’ and ‘I killed them on purpose because I am not good enough to care for them and I am a horrible evil person’.

The sheets contained the names of triplets, two of whom had died in Letby’s care, along with such phrases as ‘There are no words. I am an awful person – I pay every day for that’, ‘I can’t breathe. I can’t focus. Kill myself right now’, ‘Overwhelming fear/panic’, ‘I’ll never have children or marry. I’ll never know what it’s like to have a family. NO HOPE’.

According to the prosecution, Letby’s notes amounted to a ­private confession, offering a window into the tortured soul of a serial killer who had realised that the net was closing in on her.

Case for innocence

The notes, seemingly written when Letby had been suspended from duty at the Countess of ­Chester amid fears about the ­number of deaths on her watch, also contained such phrases as ‘Why me?’, ‘I haven’t done ­anything wrong’, ‘Police ­investigation slander discrimination victimisation’.

Letby’s barrister, Ben Myers KC, argued they should be seen as the ‘anguished outpouring of a young woman in fear and despair when she realises the enormity of what’s being said about her’.

In court, Letby claimed that ­writing notes was her way of ‘processing emotions’, saying: ‘I felt at the time if I’d done something wrong and I didn’t know I’d done that I must be such an awful evil person, if I’d made mistakes I’d not known.’

Asked why she wrote ‘I did this’, she added: ‘I felt I must be responsible in some way.’

According to The Guardian newspaper ‘sources close to the case’ claim the notes were written on the advice of her GP and the Countess of Chester Hospital’s Head of Occupational Health, Kathryn de Beger, who believed that writing down feelings would be a good way to ‘cope with extreme stress’.

Yet Letby failed to mention this during hours of police interrogations, or while giving evidence, so it was never tested in court.