Lucy Letby may have harmed more babies in her care, new evidence suggests

New evidence seen by the BBC suggests more babies in Lucy Letby’s care had been harmed – and in one case poisoned with insulin.

The former nurse was discovered responsible of murdering seven babies and making an attempt to homicide seven others – together with making an attempt to kill two with insulin on the Countess of Chester Hospital neonatal unit between June 2015 and June 2016.

BBC One’s Panorama has seen paperwork which counsel a 3rd child may have additionally been poisoned inside hours of Letby taking up the boy’s care.

Medical data reveal the toddler’s blood sugar degree plummeted and lab outcomes indicated he had suspiciously excessive ranges of insulin.

Panorama has additionally found that probably life-threatening incidents involving infants occurred on nearly a 3rd of Letby’s 33 shifts whereas she was coaching at Liverpool Women’s Hospital in 2012 and 2015.

The programme’s revelations comply with months of criticism of the prosecution’s case in her first trial. Various consultants have challenged the medical evidence used to convict Letby, in addition to the way in which statistics had been put ahead in court docket.

In August 2023, the 33-year-old was sentenced to life in jail, with no probability of parole. Letby was then discovered responsible of making an attempt to homicide a seventh child at a second trial in July this 12 months, and sentenced to a fifteenth whole-life jail time period.

The nurse has been refused depart to attraction in opposition to the convictions from her first trial.

Panorama has examined mounting questions from main statisticians and medical consultants concerning the security of her convictions.

But as a part of the programme, new evidence has additionally emerged of different sick and untimely babies probably being harmed whereas in Letby’s care.

When the physique produces insulin naturally, it additionally produces a substance referred to as C-peptide. Typically, the extent of C-peptide will likely be 5 to 10 instances increased than the extent of pure insulin.

Letby’s first trial heard blood exams from the 2 babies confirmed they’d excessive ranges of insulin and really low ranges of C-peptide.

The prosecution argued the insulin should have been given to them slightly than naturally produced.

Letby’s attorneys didn’t settle for the insulin evidence used in court docket, however neither did they argue it was improper. When she was cross-examined Letby herself accepted the 2 babies should have been poisoned, however denied it was completed by her.

The new evidence seen by Panorama exhibits a blood check from a 3rd child being cared for by Letby in November 2015 additionally recorded very excessive ranges of insulin and low ranges of C-peptide.

Lab outcomes indicated the insulin degree was in extra of 6,945 picomoles per litre – a really excessive studying. Had the insulin been pure, the C-peptide degree would have been between 35,000 and 70,000, however the blood check confirmed it was simply 220.

At the time, consultants on the neonatal unit assumed the insulin have to be pure. Tests later revealed the infant had congenital hyperinsulinism (CHI) – a situation the place the physique naturally produces an excessive amount of insulin.

But 4 consultants have informed Panorama that CHI couldn’t clarify such an exceptionally excessive insulin studying for the toddler – partly due to the low C-peptide degree, but additionally as a result of a child with CHI would by no means produce that a lot insulin.

Medical data seen by Panorama present how shortly the boy turned poorly after Letby got here on responsibility. A blood check taken at 06:56 confirmed the toddler had a traditional blood sugar degree of three millimoles per litre (mmol/L).

Letby began her shift at 08:00, and by 13:54 his blood sugar degree had plummeted to 1 mmol/L – a dangerously low degree, and a powerful indication the infant had an excessive amount of insulin.

The boy’s blood sugar degree remained low all through the nurse’s shift and he solely recovered after she went off responsibility at 20:00.

Letby’s new lawyer, Mark McDonald, famous that the infant had a selected downside with regulating his personal insulin. He additionally disputed the declare that the infant’s situation couldn’t clarify the extraordinarily excessive insulin ranges recorded by the lab.

“It may be said by one expert, but I have other experts that have a completely contradictory view,” Mr McDonald mentioned. “I’m working night and day on this case. If I thought for a moment that [Lucy Letby] was guilty, I wouldn’t be doing this.”

Some consultants have additionally questioned the accuracy of the easy check used to measure insulin in all three of the instances, generally known as the immunoassay methodology.

They level out there’s one other, more exact check and that solely the more superior check can definitively decide ranges of insulin in the blood.

There are circumstances in which the immunoassay methodology may give flawed or deceptive outcomes, however the check is extensively used and is often correct.

Panorama has spoken to main consultants on all sides of this debate. The programme discovered circumstances in which interference may happen are most unlikely in the context of the babies in the Letby case. It is even more unlikely that three lab exams carried out inside months of one another would all be improper.

It’s some extent that Letby’s lawyer, Mr McDonald, disputes: “It is accepted by all sides that there’s an error rating [with the test], but it’s the percentage of the error rating that’s not accepted.”

Panorama has additionally found that probably life-threatening incidents occurred on nearly a 3rd of Letby’s 33 shifts whereas coaching at Liverpool Women’s Hospital in 2012 and 2015.

In one case, from November 2012, a child boy collapsed and water was subsequently found in his respiratory tube – a extremely irregular incidence. The scientific notes affirm that the nurse taking care of him was Letby.

In addition, a retrospective evaluation confirmed that babies’ respiratory tubes turned dislodged on 40% of Letby’s shifts. The norm per nurse per child was 1%.

Cheshire Police is constant to research different instances the power believes the nurse may have been concerned in, together with the Liverpool incidents.

Mr McDonald plans to take Letby’s case to the Criminal Cases Review Commission (CCRC) to use for it to be despatched again to the Court of Appeal.

Reporter Judith Moritz, who has coated the case from the beginning, investigates the questions that have been raised about Lucy Letby’s conviction.

Watch Lucy Letby: Unanswered Questions on BBC iPlayer, or on BBC One on Monday 21 October at 20:00 (20:30 in Wales and Northern Ireland).