23 Comments
User's avatar
⭠ Return to thread
jojoZ's avatar

Again. across all the hospitals everywhere across a reasonable stretch of time it virtually is guaranteed to happen to some poor nurse. This time it was Letby.

Expand full comment
Theodric's avatar

All I’m saying is you’ve got to do the math. “It’s bound to happen sometimes” may or may not be a reasonable defense.

Expand full comment
jojoZ's avatar

That’s my point. They did do the math, and the people who did the math showed it was like a 1/20 chance this could happen by chance. Which is pretty dang likely. Unfortunately the jury was not shown the correct stats, but cherry picked ones only.

I recommend reading the New Yorker article if you haven’t. It really is very good.

Expand full comment
Theodric's avatar

Where are you getting the “1/20” stat? It’s not in the New Yorker article.

Expand full comment
jojoZ's avatar

I misremembered it is 1/50. The quote is about the other nurse falsely convicted, but the statistical reasons are identical:

“In the trial of the Dutch nurse, Lucia de Berk, a criminologist had calculated that there was a one-in-three-hundred-and-forty-two-million chance that the deaths were coincidental. But his methodology was faulty; when statisticians looked at the data, they found that the chances were closer to one in fifty”

Expand full comment
Theodric's avatar

I’m sorry but I don’t agree you can call that “identical”. Presumably the exact circumstances and confounders are different, which can affect the probability a lot, often orders of magnitude.

You’ve claimed that it’s a near certainty that a circumstance like Letby’s would occur by pure chance somewhere in the UK, but we simply don’t have the information to conclude that, at least in the New Yorker article. Only a reference to somewhere between 3 and 25 additional events (it’s not clear exactly how many) could potentially have been included in the chart, some number of which Letby may not have been present for. Without knowing exactly how many, it’s hard to say how likely that makes it.

Honestly the other evidence (or rather questioning of prosecution evidence) in the New Yorker article is more compelling.

Expand full comment
Athanasius's avatar

There were 61 potentially concerning events originally identified during this timeframe in the neonatal ward, as I understand it. (Deaths and infants in the ward with sudden issues, etc.) They somehow narrowed that down to 25, all of which Letby was present for. It's unclear how the investigators made that determination to specifically focus only on those 25, and some statisticians have been making the argument that Letby's presence was one determining factor. If she wasn't, it's unclear what the criteria were, as some have stated that other cases bore similarity to the 25.

Expand full comment
Theodric's avatar

Interesting. From the binomial math in my other comment, there would be a 1 in 7500 chance of a nurse being present for at least 25 out of 61 random events (something you’d probably expect to happen at least once a year across the UK!).

Expand full comment
jojoZ's avatar

Not even just the UK - but in the world.

Expand full comment
Theodric's avatar

Well, if we’re including the whole world for all of time, then there have been a lot of medical murderers too. What’s relevant is the probability this occurred by purely random chance vs. the probability Letby did it vs. the probability of malpractice by someone else.

Expand full comment
jojoZ's avatar

Worldwide There are a few of these clusters a year which is an expected number given the number of hospitals / providers / rates of adverse outcomes. Most don’t go to trial because people realize their statistical error before ruining anyone’s life

Expand full comment
Theodric's avatar

Show me. It seems like you’re extrapolating from a one liner in the New Yorker article about a totally different case with different circumstances - you didn’t note that it was from a different case at first, which is dishonest.

Again, there are also clusters of homicides frequently if we’re looking globally. So how do we determine whether a given cluster of deaths is more or less likely to be suspicious?

Expand full comment
jojoZ's avatar

It wasn’t dishonest - I genuinely misremembered which case the figure was about. But my point is this happens, as it did with deburk.

The proper way to think about these stats is simply not “how likely is this to have happened to Lucy letby” but rather “how likely is this to have happened to SOME NURSE SOMEWHERE”.

We notice the outliers because That’s how we’re built. Yea it’s useful to surviving in the Savannah because we didn’t live in a world with 9 billion people.

Expand full comment
jojoZ's avatar

Addressing the second part;

Since you can’t logically/statistically tell between the two, investigators should not use clustering in a medical setting as an indicator to investigate and try to dig up wrongdoing. Instead You use evidence of wrongdoing as the starting place for investigation.

Expand full comment
Ms No's avatar

I did read the article. It left out reams of compelling evidence against Letby. It would only be considered good by someone who has no knowledge of the actual case or trial. It's that old chestnut again - articles often seem well-researched and compelling to people who don't know the subject, but seem wildly inaccurate to people who do.

Expand full comment
Greg Chavez's avatar

What did it leave out?

Expand full comment
Ms No's avatar

ok, you asked for it, so here it is: Letby was not just convicted because of scribbled notes and statistical probability - the fact that in a hospital where 2-3 babies normally died per year, and then suddenly 4 babies collapsed and 3 died in a single month (June 2015) was rightly considered anomalous, and was therefore investigated by the hospital at the instigation of one of the doctors. The review brushed it off as coincidence, and it took over a year before the doctors went to the police with suspicions of a criminal case; thereupon the police slowly and carefully built a case against Letby, who had been by this time taken off ward duty, against the wishes of the nursing head and HR head, who fully supported her. The police were so anxious not to make any assumptions that each baby's case (both collapses and deaths) were investigated by separate teams that were forbidden to communicate until they had gathered and analysed every piece of evidence. When they finally met to compare results the similarities between cases were striking - the flitting, mottled purple/pink patches of skin discoloration (that were never seen in babies before or since, with Adams' theory about viruses found to be incorrect), the sudden collapses right after parents standing vigil went to get some sleep or food, the collapses of children who had seemed to be recovering, bizarre symptoms such as bleeding from the mouth, extreme projectile vomiting or a scream that sounded like "a noise that should not have come from a baby", anomalous air bubbles seen in the postmortem x-rays, and all collapses and deaths happening either when Letby had come on shift and was alone with a baby, or just after she had gone off shift. Letby was discovered standing over a baby with a bleeding mouth by its mother - she sent the mother away saying this was normal (it was not). One of the doctors who had suspicions about Letby was anxious upon seeing from the chart she was caring for a baby alone - he went to check that everything was alright. He found her standing motionless over the baby, watching it desaturate rapidly and not intervening. She only sprang into action after he asked her what was going on. In another incident, she told a colleague coming into the ward that one baby was pale and looked unwell, but the other nurse testified that it was too dark for Letby to have been able to see this as it was night time and the lights were off. Letby insinuated the other nurse was lying, but the court established that in fact it would have been too dark to see, so it is highly likely Letby knew the baby was pale/unwell because she had just attacked it.

Contrary to what Katie said, Letby was not normal. When she was qualifying for nursing, her assessor described her as "cold" and said she did not pick up on non-verbal signs of anxiety or distress in parents, suggesting a lack of empathy, which is unusual in paediatric nurses - warmth should be part of the job. Letby appeared animated after babies died, saying after the death of the second of two triplet babies to a colleague "you'll never guess what just happened!" you can read more about that here https://www.theguardian.com/uk-news/2024/oct/15/lucy-letby-discussed-babies-deaths-in-excited-way-inquiry-told . One set of parents told in court about how, after their baby died, she was in the room with them as they bathed the baby for the final time, and she talked excitedly about how she had bathed their baby for the first time when it was alive. This is not normal behaviour and upset the parents a great deal. Letby also took home hundreds of confidential handover sheets from the hospital including those of babies she killed, which is illegal, and stored them under her bed. When asked why she did not shred them in court, she said she didn't have a shredder, but a working shredder was found at her home. Sheets of babies she killed were stored in a separate bag. She wrote the initials of babies she killed in her diary on the days they died. She took a picture of a sympathy card she had written for the parents of a dead baby and stored it on her phone. She searched for the parents of dead babies on Facebook and looked at their profiles on the anniversaries of the children's deaths - this was morbid behaviour, very unusual in neonatal nurses and medical professionals, who normally will want to try to forget about babies who have died. My father was a GP - when a baby in his care died, he cried and lay in bed for 3 days, for context. Letby's nursing colleagues usually took time off work after babies in their care died - Letby did not, and said she found caring for less sick babies "boring". She had glib and callous reactions to the deaths, they did not seem to affect her the way they did everyone else. She once said to a doctor about a baby who had collapsed in her care, and was being transferred to another hospital, "he's not leaving here alive, is he?" - it is perhaps hard for us to fully understand how taboo it is among medical professionals, especially those working with babies and children, to make such morbid predictions, but the doctor was sickened by the comment. She also often took it upon herself to care for sick babies that were assigned to other colleagues when she felt the babies she was looking after were not sick (ie interesting) enough. This could also have been to cover her tracks - the court also established she falsified handover notes to make it look as though other colleagues had taken over care of babies she attacked earlier than they had, presumably in order to deflect responsibility for collapses/deaths. The evidence found in her home did not just amount to her scribbled confessions, as suggested by Katie.

Letby went on holiday to Ibiza and during this time there were no deaths - immediately after her return, there were 2 deaths in quick succession, the aforementioned triplet babies. Deaths/collapses on the unit then appeared to return to more normal levels after Letby was moved from night shifts to day shifts (day shifts mean there are far fewer opportunities to be alone with a baby, as parents are awake and more staff are on duty). After she was removed from duty altogether, the deaths stopped entirely - although it should be noted that at this point, the unit was downgraded meaning it took on less sick and premature babies.

Finally, it is also noteworthy that Letby's defence lawyer Ben Myers never called a single medical expert to testify for the defence. This tends to only be the case when one can find no good evidence in support of one's client. No plausible alternative explanations for the babies' collapses and deaths were ever given by Letby's defence. In one case, Letby's counsel even admitted a baby had been deliberately harmed, but just insisted it must have been someone else. Letby's counsel also called the plumber who fixed the sewage issues, attempting to link poor plumbing to the deaths, but if you actually compare the days when he was called out with the collapses and deaths, they never line up together, and were often weeks apart. Additionally, alternative handwashing facilities not connected to the hospital's old plumbing system were available for medical staff. Antibacterial/antiviral hand gel would also always have been used as a matter of medical protocol.

I've submitted this plus more to Jesse via email and I'm hoping it will be read out as a correction in the next show.

Expand full comment