Dr Jarayram’s testimony clearly shows CYA (an American term for covering your a ss (aka as arse in UK english).
Clearly Dr. JARAYRAM and Dr. Smith had no idea how to care for sickly premie babies and this kept torturing the poor baby with several intubation attempts, some with wrong size intubation tube: "Dr Smith took three attempts to successfully intubate Baby K, twice with what he acknowledged may have been the wrong (too large) breathing tube..."
Can there be a relation between the repeated incubation attempts and the baby dislodging the breathing tube shortly afterwards ? (Lucy is accused of trying to murder the baby two hours after it was born.)
A neonatologist here. A 24 or 25 week infant just born and requiring intubation in the DR is not stable. So many questions...about the medical care, not the nursing care. Infection is always a consideration in any preterm birth. Fever is rarely a sign of infection in a preterm infant, can't believe anyone even mentions this. It is very possible for such a baby to have been intubated, or never intubated properly, and be able for a short period to sustain herself briefly, breathing on her own, then have her tire out and decompensate. The tube being dislodged or never in is one reason a large leak may occur. Incredible and bizarre is the inability of these docs to understand the leak. They should be fired based on their testimony alone and self-admittance of incompetency. Last, decompensations and low blood pressures like this can occur for other non-stated reasons...pulmonary hemorrhage after surfactant requiring an increase in vent support or bleeding in the brain ,intraventricular hemorrhage or IVH. Neither is specifically mentioned by there is reference to blood in the ETT and mouth, this raises the possibility of pulmonary hemorrhage which the docs did not recognize.
Hi Martin. Thank you for your professional input - it's nice to see that someone with the chops can look at the same information and ask many of the same questions. I have to say that one of the biggest realisations I have had looking at the babies I have investigated thus far is that this small group of paediatricians moonlighting as neonatologists at Chester lived in a strange bubble universe where all their premature neonates were stable, happy, doing well... even as proper neonatologists from the Level 3 NICUs in the surrounding areas who were receiving the most critical neonates from Chester were finding them to be poorly, infected, severely unwell and unavoidably dying. This happened in so many cases - including cases that didn't end up at Letby's feet (like the baby boy I reported on who got sepsis in Chester, was sent out to (I think) Liverpool and they found the infection and treated him with ABs, then he was sent back to Chester only to end up severely ill with sepsis again a week later. There is a severe and striking lack of competence at Chester, but worse than that, there is this reality distortion field around these doctors whereby they believe they are the best paediatric doctors to ever walk gods earth and that all their even most poorly neonates are going to survive to be rocket scientists while anyone not affected by the distortion field sees the truth and knowns that the lack of competence is surely what has killed these children.
The more I think about it the worse it seems. Do we know if any of the paediatricians had specialist training for neonates? This goes beyond the Lucy Letby case. How do we know that competent medics will treat us in hospital?
We don't. We can only hope. About 25-30% of all medical issues are iatrogenic.
I had surgery about ten years ago. It did not end as intended. I discovered the MD performing the procedure had lied on the ops report, giving a completely different reason for the operation.
Yes ! So many questions. Like: why did not more doctors, specialists, speak up for her ? Why did nurse's organizations not come to her defense ?
Also, I keep reading "but the jury knew so much more !" Apparently they had hundreds of pages of additional information ? What was in those reports ? Did Lucy's defense have acces to this material ?
I'm a retired engineer. One of the classic sources of error arises when a person carrying out a task is being watched by a supervisor who is more senior. If neither knows how to competently carry out the task, the person carrying out the task may think to themselves ... 'I don't really know how to do this, but I don't want to admit that I don't, and thank goodness the supervisor who is watching me does know how to do it. They would surely intervene if I get it wrong'. And meanwhile the supervisor is thinking, 'I don't really know how to do this, but I don't want to admit that I don't, and thank goodness the technician who is carrying out the work does know how to do it.'
"he did not build the ventilator and therefore did not know what the builders meant by that reading". If I get caught for speeding can I try - I did not build the car so not sure what the speedometer reading means? If infection or surfactant can show a similar appearance on X-ray the prudent decision would be a start with what would be worse; be prepared as in the Scouts moto. "I do wonder why the supposedly illustrious ‘tv’ paediatric doctor stood aside and watched as a locum/trainee first performed multiple cycles of resuscitation and then failed on the first two attempts to intubate Baby K" - painful to read; totally unprofessional.
I think a jury cannot decide on complex matters of medicine myself. as lay person I do not think I could. there is a HUGE learning curve, years of training and analysis that laypeople unless they have these backgrounds cannot in my view fully appreciate. The consequences for a Lucy of that is really serious.
I also agree the media have done a great deal to paint a monster Lucy. That is what sells papers. the 'so called confession note was touted by many of them. This note with its I'm innocent, was wrongly and seriously taken out of context to totally alter its meaning. A jury member out of their depth with the science could easily have been swayed by the use of that note to a guilty verdict.
Very good detailed analysis of Baby K, I hope people are listening!
Just what I have been thinking. The jury are being asked to make probability judgements on matters where they may have no medical knowledge or proper grasp of statistics, which is notorious for fallacious reasoning.
Yes. A murder is a blessing for a newspaper. A serial killer is even better because that means many articles. A serial baby killer ? Jackpot ! It does not get better than that. And indeed we have seen how the media - print, television, radio, so-called social media all had a field day for the past few years. Journalism - critical thinking, investigating - is apparently not done anymore in the UK. Hang the wench and take the money !
I assume you are aware of Prof. Norman Fenton who is currently Professor Emeritus in Risk Management at Queen Mary’s College, University of London.
I mention Prof. Fenton because he was involved in a similar case to Ms Letby’s some years ago where a male NHS nurse was accused of serious crimes, but the Court was shown using Bayesian statistical analysis (Fenton’s speciality) that the events ascribed to the nurse could have just as easily happened by chance.
It’s a straw in a torrent but might have merit in an Appeal.
This whole saga hasn’t ‘felt’ right from the start.
I can only commend you for your honest diligence and hard work in reporting the facts as documented, and for voicing obvious concerns about the evidence for Ms Leroy’s guilt.
The prosecution opening (propensity statement that because she was already found guilty of something else, it's important - and therefore the jury should find her guilty here) is disturbing. It makes me wonder whether, at the start, the prosecution believed they couldn't have a successful case without smearing her first. Surely in a fair justice system and if they honestly believed their case to be strong, they should have had to present this case on its own merits before a Letby-naive jury?
Long before these sorry episodes reached public consciousness, it was well known in that region that CoCH had clinical management problems. Your reports highlight this terrible situation.
A bleak picture of the practice of medicine and law in England indeed.
A warning to anyone aspiring to positions in the NHS. And avoid having anything to do with the police and the law if at all possible.
Excellent summary and analysis of the trial. As many others have commented, I also believe Dr. Jayaram and co were not competent in neonatal care and they are using Lucy Letby as a scapegoat. My blood boils every time I think about the LL case and the terrible injustice I have witnessed. The headline from the Daily Mail thoroughly sickened me.
Honestly, it is like two new green airline pilots who have taken command of an Airbus A380 calling in the airline stewardess who just qualified to fly a Cessna 172 and getting her to take the left seat while the pilots fumble around for the flight manuals in the back of the cockpit - and then, when she undoubtably finds an A380 is nothing like a Cessna 172 and asks them to take over, and they do, and they crash because they still haven't found the flight manual that would tell them which buttons to push and how to fly the plane, blaming her for the inevitable death and destruction caused by their lack of competence that crashed the A380 into a shopping mall.
With the fact that it was Dr. J. who was clearly involved (and, as the senior specialist, ultimately responsible) for Baby K, it suddenly strikes me that the string of circumstances you've elucidated here lend a serious level of circumstantial evidence to the idea that this whole persecution of Lucy stems directly from Dr. J (another commenter mention 'covering your arse' - I totally agree). If it was up to me I would have him seriously interrogated and evaluated in great detail and, if necessary, not just struck off but potentially put on trial for, well, I'll think of something. Malicious prosecution, libel, perversion of the course of justice, perjury - and we haven't even gotten on to medical malpractice or manslaughter and such like.
I've always thought there was 'something about him' - it immediately triggered my primal, instinctive 'warning' thing. And that primal instinct has always been really prominent in me since I was an abused child...
At the top of this article is a link to the previous article with the word "HERE" that takes you back to Part 21. For each article in the main series I have put a link to the previous article at the top of the page, and a link to the next article (once published) at the bottom. Thanks for reading!
Stable...you mst be joking or at least Dr J and his boy Robin were joking.
The ONLY way that the 94% number was due to the tube being displaced by Lucy...really....Did Dr J and his boy ever read the instruction manual and even consider if the right ET tube was in. It makes good reading to read those instructions and it is a pity that they were never read to the jury but like so many things in this trial a lot has been hidden and a lot is going to come out.
Yes all these poor babies died but not one was murdered, however that does not mean nobody was responsible and that will come out too in due course. How convenient to point the finger at 'the witch' when it will get a lot of powerful men out of the shit.
In fact if you look at this whole fiasco you have a man in fancy dress siting in judgement. You have another abhorrent man in slightly less fancy dress bullying a young woman day after day.
You have hysterical mendacious witnesses to come in for the kill and a baying mob in the street.
I have just described the Salem Witch Trials powerful men overcoming ironically and truly in this case, a defenceless woman....seems remarkably similar to what we have seen in Manchester in 2024.
Para starting 3.30. Dr Jayaram says his first instinct was to scan the monitors. Maybe Lucy was doing this when she was caught “virtually red handed” not doing anything.
Apparently (again) mainly based on testimony of Dr. Ravi Jayaram.
It was the only possible outcome of course. Because had she been exonerated for Baby K., or at least been given the benefit of doubt, it could have made the previous convictions questionable.
Dr Jarayram’s testimony clearly shows CYA (an American term for covering your a ss (aka as arse in UK english).
Clearly Dr. JARAYRAM and Dr. Smith had no idea how to care for sickly premie babies and this kept torturing the poor baby with several intubation attempts, some with wrong size intubation tube: "Dr Smith took three attempts to successfully intubate Baby K, twice with what he acknowledged may have been the wrong (too large) breathing tube..."
Lucy's coworkers are covering up by blaming Lucy.
I agree I think its very sad for this poor infant, I think the intubation attempts must have been hugely traumatic all by themselves.
Can there be a relation between the repeated incubation attempts and the baby dislodging the breathing tube shortly afterwards ? (Lucy is accused of trying to murder the baby two hours after it was born.)
P.S. The MD's name is Ravi Jayaram.
A neonatologist here. A 24 or 25 week infant just born and requiring intubation in the DR is not stable. So many questions...about the medical care, not the nursing care. Infection is always a consideration in any preterm birth. Fever is rarely a sign of infection in a preterm infant, can't believe anyone even mentions this. It is very possible for such a baby to have been intubated, or never intubated properly, and be able for a short period to sustain herself briefly, breathing on her own, then have her tire out and decompensate. The tube being dislodged or never in is one reason a large leak may occur. Incredible and bizarre is the inability of these docs to understand the leak. They should be fired based on their testimony alone and self-admittance of incompetency. Last, decompensations and low blood pressures like this can occur for other non-stated reasons...pulmonary hemorrhage after surfactant requiring an increase in vent support or bleeding in the brain ,intraventricular hemorrhage or IVH. Neither is specifically mentioned by there is reference to blood in the ETT and mouth, this raises the possibility of pulmonary hemorrhage which the docs did not recognize.
Hi Martin. Thank you for your professional input - it's nice to see that someone with the chops can look at the same information and ask many of the same questions. I have to say that one of the biggest realisations I have had looking at the babies I have investigated thus far is that this small group of paediatricians moonlighting as neonatologists at Chester lived in a strange bubble universe where all their premature neonates were stable, happy, doing well... even as proper neonatologists from the Level 3 NICUs in the surrounding areas who were receiving the most critical neonates from Chester were finding them to be poorly, infected, severely unwell and unavoidably dying. This happened in so many cases - including cases that didn't end up at Letby's feet (like the baby boy I reported on who got sepsis in Chester, was sent out to (I think) Liverpool and they found the infection and treated him with ABs, then he was sent back to Chester only to end up severely ill with sepsis again a week later. There is a severe and striking lack of competence at Chester, but worse than that, there is this reality distortion field around these doctors whereby they believe they are the best paediatric doctors to ever walk gods earth and that all their even most poorly neonates are going to survive to be rocket scientists while anyone not affected by the distortion field sees the truth and knowns that the lack of competence is surely what has killed these children.
The more I think about it the worse it seems. Do we know if any of the paediatricians had specialist training for neonates? This goes beyond the Lucy Letby case. How do we know that competent medics will treat us in hospital?
We don't. We can only hope. About 25-30% of all medical issues are iatrogenic.
I had surgery about ten years ago. It did not end as intended. I discovered the MD performing the procedure had lied on the ops report, giving a completely different reason for the operation.
Yes ! So many questions. Like: why did not more doctors, specialists, speak up for her ? Why did nurse's organizations not come to her defense ?
Also, I keep reading "but the jury knew so much more !" Apparently they had hundreds of pages of additional information ? What was in those reports ? Did Lucy's defense have acces to this material ?
Anyone ?
I'm a retired engineer. One of the classic sources of error arises when a person carrying out a task is being watched by a supervisor who is more senior. If neither knows how to competently carry out the task, the person carrying out the task may think to themselves ... 'I don't really know how to do this, but I don't want to admit that I don't, and thank goodness the supervisor who is watching me does know how to do it. They would surely intervene if I get it wrong'. And meanwhile the supervisor is thinking, 'I don't really know how to do this, but I don't want to admit that I don't, and thank goodness the technician who is carrying out the work does know how to do it.'
"he did not build the ventilator and therefore did not know what the builders meant by that reading". If I get caught for speeding can I try - I did not build the car so not sure what the speedometer reading means? If infection or surfactant can show a similar appearance on X-ray the prudent decision would be a start with what would be worse; be prepared as in the Scouts moto. "I do wonder why the supposedly illustrious ‘tv’ paediatric doctor stood aside and watched as a locum/trainee first performed multiple cycles of resuscitation and then failed on the first two attempts to intubate Baby K" - painful to read; totally unprofessional.
I think a jury cannot decide on complex matters of medicine myself. as lay person I do not think I could. there is a HUGE learning curve, years of training and analysis that laypeople unless they have these backgrounds cannot in my view fully appreciate. The consequences for a Lucy of that is really serious.
I also agree the media have done a great deal to paint a monster Lucy. That is what sells papers. the 'so called confession note was touted by many of them. This note with its I'm innocent, was wrongly and seriously taken out of context to totally alter its meaning. A jury member out of their depth with the science could easily have been swayed by the use of that note to a guilty verdict.
Very good detailed analysis of Baby K, I hope people are listening!
Just what I have been thinking. The jury are being asked to make probability judgements on matters where they may have no medical knowledge or proper grasp of statistics, which is notorious for fallacious reasoning.
Yes. A murder is a blessing for a newspaper. A serial killer is even better because that means many articles. A serial baby killer ? Jackpot ! It does not get better than that. And indeed we have seen how the media - print, television, radio, so-called social media all had a field day for the past few years. Journalism - critical thinking, investigating - is apparently not done anymore in the UK. Hang the wench and take the money !
Just a thought.
I assume you are aware of Prof. Norman Fenton who is currently Professor Emeritus in Risk Management at Queen Mary’s College, University of London.
I mention Prof. Fenton because he was involved in a similar case to Ms Letby’s some years ago where a male NHS nurse was accused of serious crimes, but the Court was shown using Bayesian statistical analysis (Fenton’s speciality) that the events ascribed to the nurse could have just as easily happened by chance.
It’s a straw in a torrent but might have merit in an Appeal.
The author of the article has worked with the excellent Prof Fenton.
Yes, I did
But while Norman is a genius I am just... well... me :-)
Yes, an excellent MAN who has shown he puts Truth, honesty, and integrity before credentials, position, money, and even his own personal tragedies.
I hope history judges him well.
I found in Facebook discussion several people who stated they knew for sure Lucy Letby was guilty, as it had been proven by Bayesian statistics !
This whole saga hasn’t ‘felt’ right from the start.
I can only commend you for your honest diligence and hard work in reporting the facts as documented, and for voicing obvious concerns about the evidence for Ms Leroy’s guilt.
A shocking miscarriage of justice!
Seems to me Lucy Letby has been found guilty in this case because she is Lucy Letby.
The prosecution opening (propensity statement that because she was already found guilty of something else, it's important - and therefore the jury should find her guilty here) is disturbing. It makes me wonder whether, at the start, the prosecution believed they couldn't have a successful case without smearing her first. Surely in a fair justice system and if they honestly believed their case to be strong, they should have had to present this case on its own merits before a Letby-naive jury?
Long before these sorry episodes reached public consciousness, it was well known in that region that CoCH had clinical management problems. Your reports highlight this terrible situation.
A bleak picture of the practice of medicine and law in England indeed.
A warning to anyone aspiring to positions in the NHS. And avoid having anything to do with the police and the law if at all possible.
Excellent summary and analysis of the trial. As many others have commented, I also believe Dr. Jayaram and co were not competent in neonatal care and they are using Lucy Letby as a scapegoat. My blood boils every time I think about the LL case and the terrible injustice I have witnessed. The headline from the Daily Mail thoroughly sickened me.
Honestly, it is like two new green airline pilots who have taken command of an Airbus A380 calling in the airline stewardess who just qualified to fly a Cessna 172 and getting her to take the left seat while the pilots fumble around for the flight manuals in the back of the cockpit - and then, when she undoubtably finds an A380 is nothing like a Cessna 172 and asks them to take over, and they do, and they crash because they still haven't found the flight manual that would tell them which buttons to push and how to fly the plane, blaming her for the inevitable death and destruction caused by their lack of competence that crashed the A380 into a shopping mall.
With the fact that it was Dr. J. who was clearly involved (and, as the senior specialist, ultimately responsible) for Baby K, it suddenly strikes me that the string of circumstances you've elucidated here lend a serious level of circumstantial evidence to the idea that this whole persecution of Lucy stems directly from Dr. J (another commenter mention 'covering your arse' - I totally agree). If it was up to me I would have him seriously interrogated and evaluated in great detail and, if necessary, not just struck off but potentially put on trial for, well, I'll think of something. Malicious prosecution, libel, perversion of the course of justice, perjury - and we haven't even gotten on to medical malpractice or manslaughter and such like.
I've always thought there was 'something about him' - it immediately triggered my primal, instinctive 'warning' thing. And that primal instinct has always been really prominent in me since I was an abused child...
He is good-looking, does well on tv. In the original home country, India, he is hailed as a hero.
Please, Mr. HLandT, How do I access the other 21 (?) parts of LL, please ?!
At the top of this article is a link to the previous article with the word "HERE" that takes you back to Part 21. For each article in the main series I have put a link to the previous article at the top of the page, and a link to the next article (once published) at the bottom. Thanks for reading!
Not seeing HERE. But I think I found another way to acces previous articles.
Stable...you mst be joking or at least Dr J and his boy Robin were joking.
The ONLY way that the 94% number was due to the tube being displaced by Lucy...really....Did Dr J and his boy ever read the instruction manual and even consider if the right ET tube was in. It makes good reading to read those instructions and it is a pity that they were never read to the jury but like so many things in this trial a lot has been hidden and a lot is going to come out.
Yes all these poor babies died but not one was murdered, however that does not mean nobody was responsible and that will come out too in due course. How convenient to point the finger at 'the witch' when it will get a lot of powerful men out of the shit.
In fact if you look at this whole fiasco you have a man in fancy dress siting in judgement. You have another abhorrent man in slightly less fancy dress bullying a young woman day after day.
You have hysterical mendacious witnesses to come in for the kill and a baying mob in the street.
I have just described the Salem Witch Trials powerful men overcoming ironically and truly in this case, a defenceless woman....seems remarkably similar to what we have seen in Manchester in 2024.
Para starting 3.30. Dr Jayaram says his first instinct was to scan the monitors. Maybe Lucy was doing this when she was caught “virtually red handed” not doing anything.
LUCY IS FOUND GUILTY - AGAIN !
Apparently (again) mainly based on testimony of Dr. Ravi Jayaram.
It was the only possible outcome of course. Because had she been exonerated for Baby K., or at least been given the benefit of doubt, it could have made the previous convictions questionable.