When Dr. Shoo Lee, considered one of Canada’s most famous neonatologists, wrote an academic paper in 1989, he by no means imagined it could someday assist convict a British nurse of homicide.
However greater than three a long time after his paper was revealed, that’s what occurred.
Lucy Letby, a former nurse in a neonatal unit in northern England, was found guilty in two trials in 2023 and 2024 of the homicide or tried homicide of 14 infants in her care, and sentenced to life in jail, the place she stays at present.
The case rocked Britain, seeming to reveal a remorseless serial killer who, prosecutors stated, used a weird vary of methods to kill her tiny, typically very untimely, victims: Injecting them with air, overfeeding them with milk or contaminating their feeds with insulin.
For seven of the homicide or tried homicide fees, the prosecution’s lead skilled witness relied on Dr. Lee’s 1989 paper on a uncommon complication in newborns — pulmonary vascular air embolism — to argue that Ms. Letby had deliberately injected air into their veins.
The one drawback? The skilled witness had misinterpreted his work, Dr. Lee says.
“What they have been claiming was that this child collapsed and had pores and skin discoloration, subsequently that equals air embolism,” stated Dr. Lee, 68, in an interview in London final month. However, he stated, “That isn’t what the analysis exhibits.”
That realization set Dr. Lee on an ethical mission to evaluate Ms. Letby’s case. Working professional bono, he gathered 14 specialists from all over the world to evaluate the scientific proof. Final month, he revealed their explosive findings — that “there was no medical proof to help malfeasance inflicting loss of life or damage” in any of the infants that Ms. Letby was charged with harming.
“If there’s no malfeasance, there’s no homicide. If there’s no homicide, there’s no assassin,” Dr. Lee stated, including, “And if there’s no assassin, what’s she doing in jail?”
Ms. Letby has exhausted her avenues to enchantment within the courts. Her solely hope now lies with a small, unbiased physique, the Legal Instances Overview Fee, which is liable for investigating attainable miscarriages of justice.
‘I didn’t know whether or not she was harmless or responsible’
Dr. Lee, who retired in 2021 to a farm in rural Alberta, knew nearly nothing about Ms. Letby’s case till an e mail landed in his inbox in October 2023.
Ms. Letby had all the time maintained her innocence, and her lawyer wished Dr. Lee to evaluate the medical proof. “I believed it was spam at first, as a result of how typically do you get an e mail like that?” Dr. Lee stated. After a second e mail, he realized the request was actual.
Dr. Lee had spent his whole profession targeted on the youngest sufferers. After finishing medical faculty in his native Singapore, he moved to Canada and educated in pediatrics earlier than endeavor a neonatal fellowship at Boston Youngsters’s Hospital and later a Ph.D. in well being coverage at Harvard.
In 1995, he created the Canadian Neonatal Community, connecting specialists from throughout the nation to enhance outcomes for newborns. He grew to become pediatrician-in-chief at Mount Sinai Hospital, Toronto, and in 2019, he received the Order of Canada for introducing finest practices that lowered toddler mortality.
As he studied Lucy Letby’s trial transcripts, Dr. Lee instantly knew his analysis had been misinterpreted. “I didn’t know whether or not she was harmless or responsible,” he recollects. “However no matter whether or not you’re harmless or responsible, you can’t be convicted on incorrect proof. That’s simply incorrect.”
He agreed to assist with Ms. Letby’s request for an enchantment, writing to England’s Courtroom of Enchantment and later offering reside video testimony. However the court docket finally denied her request, saying Dr. Lee’s testimony ought to have been launched at trial.
It was then that Dr. Lee determined to assemble a crew of neonatal specialists to look into the case.
“This panel, you’re not going to discover a higher group of individuals,” he stated, rattling off an inventory that included the pinnacle of neonatology at Youngsters’s Hospital of Philadelphia, a former president of Britain’s Royal School of Pediatrics and the previous director of the neonatal intensive care unit of Boston Youngsters’s Hospital.
The important thing caveat Dr. Lee insisted on was that the panel’s evaluate can be launched irrespective of their findings — even when they strengthened the case that Ms. Letby was responsible.
‘You’re going to get disasters’
The consultants, who all labored on a voluntary foundation, forensically assessed the reason for loss of life or deterioration for every of the 17 infants whom Ms. Letby was initially charged with murdering or making an attempt to homicide.
Two consultants individually examined the medical notes of every child. If their assessments differed, a 3rd skilled was introduced in. The method was painstaking and took 4 months. However the remaining outcomes have been clear, Dr. Lee stated. “In all instances, loss of life or damage have been as a result of pure causes or simply dangerous medical care,” he informed the information convention final month.
Within the case of 1 child, as an illustration, the prosecution argued at trial that she had been steady and had died from an injection of air into her IV line, inflicting an embolism. However the unbiased evaluate discovered, based mostly on her medical data, that she had died of sepsis and pneumonia, and that the mom, who went into labor prematurely, had not been given antibiotics to stop an infection.
In one other case, a child born at 25 weeks was intubated utilizing the incorrect dimension of endotracheal tube. Whereas the prosecution alleged that Ms. Letby tried to homicide the toddler by dislodging the tube, the consultants discovered the infant’s situation deteriorated due to damage attributable to intubation with a tube that was too giant, and since a physician didn’t perceive “the fundamentals of resuscitation, air leak, mechanical air flow, and the way gear that have been generally used within the unit work.”
A number of the hospital employees, the panel concluded, have been caring for probably the most critically in poor health or untimely infants in a unit that was solely meant to deal with infants with lesser wants.
“You’re asking medical doctors in locations with out the experience, with out the infrastructure, to take care of infants that they they’re not ready to do,” Dr. Lee stated. “And if you happen to do this, you then’re going to get disasters.”
No person ever noticed Ms. Letby harming a child, and main questions have been first raised about her guilt in a New Yorker article in Could 2024. Within the months since, dozens of experts in medicine and statistics have voiced issues concerning the proof.
Dr. Dewi Evans, the prosecution’s lead skilled witness, didn’t reply to requests for remark, however he has publicly criticized the panel’s work and said he stands by his testimony.
The Countess of Chester Hospital, the place the deaths befell, stated it was targeted on an ongoing police investigation and on a public inquiry that was arrange by the federal government final 12 months to analyze how a serial killer might get away with such crimes for therefore lengthy. Earlier this week, the hospital’s former managers requested a halt to that inquiry, within the wake of Dr. Lee’s evaluate, however the choose refused, saying that the inquiry was by no means targeted on inspecting Ms. Letby’s guilt.
Mark McDonald, Ms. Letby’s present lawyer, plans to incorporate Dr. Lee’s full skilled report in his software to the Legal Instances Overview Fee, which may refer instances again to the Courtroom of Enchantment. The fee stated in a statement final month that it had “acquired a preliminary software in relation to Ms. Letby’s case, and work has begun to evaluate the applying.”
The mother of a child whom Ms. Letby was convicted of making an attempt to homicide denounced the skilled panel’s evaluation, and a spokesman for the C.C.R.C. requested “that everybody remembers the households affected.”
Dr. Lee insisted that these households have been considered one of his central issues as he analyzed the instances, after spending 4 a long time caring for infants.
“I can inform you one factor: Households need to know the reality,” he stated. “They need to know the reality, no matter whether or not it’s painful or not painful. They need to know what actually occurred.”
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