Jabbey (Letby case is a miscarriage of justice)

I haven’t been on x for a year but I’ve come back to say this: Lucy Letby is a victim of the worst miscarriage of justice of the century. Utter garbage expert analysis w/ fantastical causes of death, consultants who had a vested interest in her guilt & BS stats. Appeal NOW

Dr Jayaram never saw any pink flitting rash with Baby A because by the time he arrived (8 minutes after Baby A's collapse) there was no audible heart-beat. Therefore, there could be nothing driving an air embolus around the circulation to cause this flitting. And according to Doctor Lee it only lasts a very short period of time anyway - a minute or two. Plus no one else saw what he claims to have seen. He didn't see a pink flitting rash with Baby M because there were a number of other people there and none of them saw the same thing. Dr Ukoh was first to arrive and he just described Baby M as looking pale and lifeless - no flitting rash. I think Dr Jayaram has got an overactive imagination.

@GarrickKingston He also was given these details, which is why he was able to do his own statistical analysis of Letby being on duty for all the “suspicious” deaths. He said too much during his victory lap, before he realised how controversial it was. The way this was handled is very damning

@Jabbey20 Those were questions that Evans was advising the police to ask.

This is astonishingly unprofessional. Dewi Evans wasn’t employed as a detective, and it wasn’t his job to assemble inculpatory evidence. He was supposed to be a neutral clinical expert. The answers to these questions were entirely irrelevant to his medical opinions. #Letby

@GarrickKingston He isn’t an investigator with expertise in health care deaths. He was paid purely to assess the medical events, and should not have received any info to bias his assessments. The fact that he zeroed in on these questions shows he was committed to foul play early.

Drs. Evans & Bohin had no images, descriptions nor, in most cases, even a contemporary written record: yet from descriptions recalled years—not days, weeks or even months—later they categorically diagnosed a condition neither had ever encountered in practice. This is just nuts.

1/3 Baby L And The Flawed Case of Alleged Insulin Poisoning Following on from my previous post, here I will debunk the "sticky insulin" theory proposed by Professor Hindmarsh, which was endorsed by Nick Johnson KC as the sole explanation for Baby L’s persistent hypoglycaemia after Lucy Letby had gone off shift. I will also argue that this undermines the allegation of insulin poisoning at any point in the case of Baby L. See the attached chart for a visual representation of Baby L’s blood glucose readings over the relevant period, set against the timing of dextrose bag changes and other key events. The prosecution alleged that Lucy Letby injected insulin into multiple bags of dextrose solution on 9th April, resulting in a 53-hour hypoglycaemic episode. But there was a major problem with this allegation. The hypoglycaemic episode, which Professor Hindmarsh attributed to exogenous insulin, continued for nearly two days after Lucy Letby had gone off duty. During that period, two new dextrose bags were hung which she could not have poisoned. The only insulin blood test done was on 9th April. How, then, could the prosecution attribute the continuing hypoglycaemia to alleged insulin poisoning by Lucy Letby? Nick Johnson KC relied on Professor Hindmarsh’s sticky insulin theory. According to Hindmarsh, insulin from a spiked dextrose bag, which had stuck to the plastic inner surface of the giving set, could later be released into the dextrose infusion after a new, uncontaminated bag was connected. (A giving set is the sterile tubing that connects an infusion bag to a cannula or long line; trial testimony indicated that it isn't necessarily changed when a dextrose bag is replaced.) No calculations — in fact, no figures of any kind — were provided to support this suggested mechanism. Aside from the obvious flaws in the theory itself, it also depended on the giving set not being changed through two bag changes - something that was never established. Here, I will show that not only is the sticky insulin theory scientifically invalid, it’s also inapplicable, because the giving set definitely was changed when a new dextrose bag was hung after Lucy Letby had gone home. Firstly, a quick run-through of the key events: 9th April 2016 (See chart for the timings of the dextrose bags and blood glucose readings.) Lucy Letby was accused of spiking 3 bags with insulin on 9th April, though she was not Baby L’s designated nurse; there was no evidence that she actually did so. Baby L (and his twin Baby M) had been born on the morning of the previous day, 8th April, and he was receiving dextrose to bring his blood glucose levels up. By midnight, a normal reading of 3.6 was recorded. The allegation was that Lucy Letby spiked this dextrose bag the next day, 9th April, at some point between starting shift at 7.30am and 9.30am. This would have been while it was hanging, which is implausible in itself, especially as Letby wasn't his designated nurse on that day. This was Bag #1. At 10am Baby L’s blood glucose reading was low at 1.9, and this is where the 53-hour hypoglycaemic episode identified by Professor Hindmarsh began. Bag #1 was replaced at midday on 9th April, after having been in use for the standard 24 hours. The replacement bag was hung by Lucy Letby and Mary Griffith, Baby L's designated nurse. This was Bag #2. The prosecution alleged that Lucy Letby also poisoned this bag, though no explanation was given as to how or when. At some point before 3.45pm (the exact timing was uncertain), a blood sample was taken and sent to Liverpool for insulin testing. Several days later, the results came back showing a high insulin level alongside low C-peptide — findings associated with the presence of exogenous insulin. This formed the basis of the allegation that Lucy Letby had poisoned Baby L with artificial insulin. At 4.30pm that same day, the dextrose bag was changed again, this time to a more concentrated 12.5% dextrose solution. This bag was hung by Belinda Williamson (Simcock) and Ashleigh Hudson. This was Bag #3. The prosecution alleged that Lucy Letby also poisoned this bag with insulin after it had been hung, though again no explanation was provided as to how or when. Throughout this period, Baby L continued to record abnormally low blood glucose readings. Lucy Letby finished her shift on 9th April at 8pm, remaining for another hour or so to complete her nursing notes. This was her fourth consecutive day of work following which she was then off duty for several days. 10th – 11th April 2016 In the early hours of 10th April, at around 2.30am, the dextrose bag was changed again, this time to a 15% dextrose solution. This was Bag #4. The prosecution did not allege that Lucy Letby poisoned this bag as she had already been off shift for several hours by then. Nevertheless, low blood glucose levels continued at roughly the same level throughout the night and into the following morning. From this point onwards the only explanation given for the continuing hypoglycaemia was the sticky insulin theory: that insulin from the previous bag, Bag #3, had stuck to the inner surface of the giving set and was now being released into the infusion. There was a further bag – Bag #5 – hung up 24 hours later on 11th April; the low blood glucose readings persisted but later in the day spontaneously returned to a normal level. To summarise: 1.We have a 53-hour hypoglycaemic episode, identified by Professor Hindmarsh, running from 10am on 9th April 2016 until 3pm on 11th April. 2.Professor Hindmarsh had no explanation for this episode other than the presence of exogenous insulin throughout the entire period. 3.Lucy Letby was only on shift during the first day, 9th April, until 8pm. 4.On 9th April there were three different dextrose bags in use, all of which the prosecution alleged Lucy Letby had poisoned. 5.Two further bags were hung in the early hours of 10th and 11th April, producing no marked change in glucose levels until the afternoon of 11th April. 6.Since Lucy Letby could not physically have poisoned those last two bags, Professor Hindmarsh relied on the sticky insulin theory to explain the continuing hypoglycaemia. Evidence that the giving Set WAS changed If it could be proven that the giving set was changed with Bag #4 then that would nullify the sticky insulin theory, wouldn't it? Well, it can be proven, because prior to Bag #4 being hung there was a long line put in by Dr A specifically to be used with the next dextrose bag. And when a long line is connected up a new, sterile giving set is always used to prevent infection! This is well known and there's no doubt about it. There was even trial testimony confirming this practice from two nurses, in relation to the stock bag used for Baby F. Dr Sandie Bohin also confirmed it. Dr A’s reason for inserting the long line was that he was intending to increase the dextrose concentration to 15%, which is above the maximum level of 12.5% which can be infused through a catheter, which is what had been used up to then. The long line was put in at around 1am on 10th April, and following this Bag #4 was hung at 2.30am. (See chart – the timing of the long line insertion is shown as blue line.) Therefore, the sticky insulin theory — that "stuck" insulin was being released from the giving set after Bag #4 was hung — cannot possibly account for the continuation of hypoglycaemia after this bag-change event, because the giving set previously used was no longer in place! The prosecution’s case that this mechanism explained the continuing hypoglycaemia is completely invalid. References: Dr A’s medical notes from that night which refer to the long line can be seen here at page 2 (he was cyphered as Dr U at Thirlwall): thirlwall.public-inquiry.uk/wp-content/upl… The long line insertion was also brought up in his Thirlwall Inquiry oral testimony (see pages 223–226): thirlwall.public-inquiry.uk/wp-content/upl… And it was also reported by the Chester Standard’s live trial reporting at the time (see entry at 12.13pm): chesterstandard.co.uk/news/23322508.…

Asking for nurse presence & cot locations goes beyond clinical expertise & into police-style suspect construction. Sequence matters; Cheshire PD should’ve kept this info well away from Dewi, purely to avoid reverse reasoning shaping his conclusions.

@sergeantdixie And how were management supposed to act on these concerns appropriately if they didn’t bother sharing them? They didn’t share info about Baby K, they didn’t tell them shit about the unique rashes (not recorded in contemporaneous clinical notes). Are they supposed to mind read?

@sergeantdixie What are you talking about? You guys are so focused on court, of course they said shit yrs later! Why didn’t they share this information with management contemporaneously? It makes zero sense. RJ didn’t mention the incident with baby K for over a yr even to his colleagues

Anyone remember Breary’s “draw of doom”? Did he accidentally forget to give all its contents to the hospital attempting to investigate the accusations? AND Ravi forgot to mention the fact that he walked in on her trying to kill a baby? Did police ever bother to interrogate WHY?

@sergeantdixie Are you not bothered by such a blatant contradiction in RJ’s contemporaneous notes? “Letby called me to the incubator” is VERY different from “I had a gut feeling & caught her doing nothing”. Those aren’t just slightly different, they are the complete opposite of each other!

@Jabbey20 They all gave statements & gave evidence at court. What lie about baby K?

@sergeantdixie Like what did you expect management to do? “Oh, some deaths occurred when this nurse was on duty, and this doctor has a gut feeling she’s a murderer. Let’s march her to the police station”. Why would they refuse to share their evidence & lie about their theories on air embolism?

@sergeantdixie And “I don’t have to prove anything”, yes of course, just say whatever you want then! Maybe, do you think, that the HR investigation would’ve been less of a farce if Breary and Jayaram had bothered to explicate all their concerns to management?

@sergeantdixie “The reason managers have been arrested”, they weren’t charged, they’ve been arrested for questioning by the same police force that ran this absolutely disastrous and biased investigation. Meanwhile RJ didn’t mention the baby K incident for a year plus and he’s not arrested

@sergeantdixie point out the lie. Am I mistaken, did Ravi actually notify the investigator that he walked in on Letby trying to kill a baby? Did Breary give his evidence to this HR investigator? If you have evidence that they did, provide it. Otherwise take your ad hominem attacks elsewhere

@sergeantdixie Oh, so now you guys are downplaying that the significance of Letby “doing nothing” whilst a baby desaturated, I thought that was portrayed as her being caught ”virtually red handed”and clinched the baby K prosecution. And was she doing nothing, or did she call or help?

@MySweetLandlord @gill1109 @markjurgenmayes @MartynPitman @cheshirepolice This is extremely disturbing. He is not an investigator or detective, a true expert should merely be providing reviews of medical evidence, not helping police get around Letby not being the designated nurse to increase the indictments.

@markjurgenmayes @MartynPitman @cheshirepolice And this is from September 2016. Dewi Evans giving Cheshire Police advice on how to run their investigation.

On what date did @cheshirepolice supply Evans with #LucyLetby's rota data? Who, precisely, supplied it? Why did they do so? Had Evans asked for it? If so, why? Evans subsequently shared this data. #FreeLucyLetby

@sergeantdixie Failing to provide such monumental info and evidence to this investigator, whilst these two ring leaders sat on their hands, is impeachment evidence that undermines their credibility. As an RN, it defies logic that RJ sat on this for over a year. It is not a spurious point.

@Jabbey20 Another clown editing evidence to make a spurious point then lying about what he saw. If Letby’s had a valid defence you wouldn’t need to lie.

@AlexCutter86 @merchant47 I just don’t trust anything Breary, Jayaram or Evans say anymore.

An excellent point made here by @merchant47 Also, the document states "The concept of air embolism also appears to have originated from the consultant body although this is denied." Brearey & Jayaram are both liars.

@AlexCutter86 @merchant47 Does Evans claim he came up air embolism on his own? If this idea was established within the consultant body, with the Lee paper being shared, it is highly probable that Evans got the idea from the police. This investigation was one big mess of circular reasoning.