When Dr. Shoo Lee, one among Canada’s most famous neonatologists, wrote an academic paper in 1989, he by no means imagined it might in the future assist convict a British nurse of homicide.
However greater than three a long time after his paper was printed, 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 right now.
The case rocked Britain, seeming to reveal a remorseless serial killer who, prosecutors stated, used a weird vary of strategies to kill her tiny, usually 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 prices, 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 downside? 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, due to this fact 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 assessment Ms. Letby’s case. Working professional bono, he gathered 14 specialists from all over the world to evaluate the medical proof. Final month, he revealed their explosive findings — that “there was no medical proof to help malfeasance inflicting demise or harm” 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 attraction within the courts. Her solely hope now lies with a small, impartial physique, the Felony Instances Overview Fee, which is answerable 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 virtually nothing about Ms. Letby’s case till an electronic mail landed in his inbox in October 2023.
Ms. Letby had at all times maintained her innocence, and her lawyer wished Dr. Lee to assessment the medical proof. “I believed it was spam at first, as a result of how usually do you get an electronic mail like that?” Dr. Lee stated. After a second electronic mail, he realized the request was actual.
Dr. Lee had spent his whole profession targeted on the youngest sufferers. After finishing medical college in his native Singapore, he moved to Canada and skilled in pediatrics earlier than endeavor a neonatal fellowship at Boston Kids’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 remembers. “However no matter whether or not you’re harmless or responsible, you can’t be convicted on fallacious proof. That’s simply fallacious.”
He agreed to assist with Ms. Letby’s request for an attraction, writing to England’s Court docket 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 group 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 top of neonatology at Kids’s Hospital of Philadelphia, a former president of Britain’s Royal Faculty of Pediatrics and the previous director of the neonatal intensive care unit of Boston Kids’s Hospital.
The important thing caveat Dr. Lee insisted on was that the panel’s assessment 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 demise or deterioration for every of the 17 infants whom Ms. Letby was initially charged with murdering or trying 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 closing outcomes have been clear, Dr. Lee stated. “In all instances, demise or harm have been resulting from pure causes or simply dangerous medical care,” he advised the information convention final month.
Within the case of 1 child, as an example, 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 impartial assessment discovered, based mostly on her medical information, that she had died of sepsis and pneumonia, and that the mom, who went into labor prematurely, had not been given antibiotics to forestall an infection.
In one other case, a child born at 25 weeks was intubated utilizing the fallacious measurement of endotracheal tube. Whereas the prosecution alleged that Ms. Letby tried to homicide the toddler by dislodging the tube, the consultants discovered the child’s situation deteriorated due to harm brought on by intubation with a tube that was too giant, and since a health care provider didn’t perceive “the fundamentals of resuscitation, air leak, mechanical air flow, and the way tools 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 should you do this, then you definately’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 in regards to 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 happened, 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 research 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 assessment, however the choose refused, saying that the inquiry was by no means targeted on analyzing 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 Felony Instances Overview Fee, which might refer instances again to the Court docket of Enchantment. The fee stated in a statement final month that it had “obtained 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 trying 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 one among his central issues as he analyzed the instances, after spending 4 a long time caring for infants.
“I can let you know one factor: Households wish to know the reality,” he stated. “They wish to know the reality, no matter whether or not it’s painful or not painful. They wish to know what actually occurred.”
