Lucy Letby’s barrister has told Nursing Times his team has “hope” that her conviction could be overturned, after a review found no medical evidence that the former neonatal nurse harmed babies.
Mark McDonald said the findings from the review were “uncontroversial, huge and compelling”.
“They have demolished the theory of air embolism, found no murders were committed and no deliberate harm and that Lucy Letby is innocent”
Mark McDonald
Earlier this month, a panel of 14 international paediatric and neonatal experts published a paper claiming that the convicted serial killer did not murder any babies.
In an interview with Nursing Times this week, Mr McDonald said the review had “demolished the theory of air embolism”, one of the methods Letby was said to have used to attack babies; found no deliberate harm; and had concluded that Letby was innocent.
Letby, 35, was convicted in August 2023 of murdering seven babies and attempting to murder six others at the Countess of Chester Hospital neonatal unit between 2015 and 2016.
She was then found guilty after a retrial in June 2024 of attempting to murder a seventh baby.
Letby is currently serving multiple life sentences for these crimes and has made unsuccessful attempts to appeal.
On 4 February, findings of a clinician-led investigation commissioned by Letby’s legal team were made public.
The panel that led the review – comprising 14 experts from the UK, US, Canada, Japan, Germany and Sweden – concluded there was “no medical evidence to support malfeasance” in any of the cases heard at Letby’s trial.
Instead, they claimed that death or injury of affected babies were due to natural causes or errors in medical care.
The report identified “problems related to the medical care of patients” and issues relating to teamwork and interdisciplinary collaboration at the Countess of Chester Hospital neonatal unit (see box below).
The international expert panel was instructed by Dr Shoo Lee, a retired neonatologist, professor emeritus at the University of Toronto and founder of the Canadian Neonatal Foundation.
Dr Lee’s research on pulmonary vascular air embolism in newborn babies, published in 1989, was used by the prosecution during Letby’s trial to help convict the former neonatal nurse.
The prosecution’s leading expert witness, retired consultant paediatrician Dr Dewi Evans, used Dr Lee’s paper to support the theory that Letby had injected air into the bloodstream of babies.
Dr Lee was not asked to give evidence during Letby’s original trial, and said he had only become aware that his paper had been used after the trial had concluded.
Importantly, Dr Lee said he believed his paper had been misinterpreted.
When Letby appealed in April 2024, Dr Lee testified and said he was concerned that there were problems with the medical evidence used during the original trial and current appeal.
Dr Lee then proposed to Letby’s legal team that he would convene an international expert panel to examine all of the medical evidence in detail, to produce an “impartial, evidence-based report” about the cases of death or injury of all the cases involved in the trial.
Lucy Letby
Mr McDonald, who has been Letby’s barrister since September 2024, told Nursing Times that the panel was given access to medical records and witness statements used during the trial.
“They have given an opinion on each one of those 14 babies, and none of them have identified any deliberate harm to any child,” he said.
“In essence, they have demolished the theory of air embolism, found no murders were committed and no deliberate harm and that Lucy Letby is innocent.
“Not just that, there’s no crime being committed here.”
Mr McDonald argued that the report’s findings of poor medical care, lack of training and lack of resources showed “a neonatal unit that was in crisis”.
He likened the state of the Countess of Chester Hospital neonatal unit during 2015 and 2016 to other obstetric and neonatal units across England “that have had severe problems”, some which have prompted public inquiries.
A spokesperson for the Countess of Chester Hospital NHS Foundation Trust said: “Due to the Thirlwall Inquiry and the ongoing police investigations, it would not be appropriate to comment further at this time.”
Mr McDonald – who has previously compared Letby’s case to the Birmingham Six and the Guildford Four, two famous examples of wrongful convictions – said he believed that Letby’s case was “the biggest miscarriage of justice in UK history”.
“This will turn the criminal justice system on its head, really, if she is found to be innocent, but more importantly that it’s found that no crime was ever committed,” he added.
Nursing Times asked Mr McDonald what impact the report findings had had on Letby.
He replied that she and her legal team “have hope”.
Mr McDonald said: “Put yourself in her position: you’re a nurse, you’ve dedicated your life to one single job which you love.
“You then have been accused of murder, you have then been tried and you’ve been convicted and you’ve been sentenced to your whole life [in prison].
“Every battle, every trial you’ve had, you’ve lost and now suddenly there’s a report to say that, in fact, you’re innocent. It will give you hope.
“That’s where we are, we have hope.”
Earlier this week, former head of nursing at the Countess of Chester Hospital, Karen Rees, said she thought Letby was innocent.
Ms Rees had made a public statement in August 2023, where she said Letby was “convincing”, “calculated” and that she had deceived her.
However, she told the Sunday Times at the weekend that she made this statement on the advice of her lawyers, and that she regretted doing so.
Nursing Times asked Mr McDonald whether he thought there could be other individuals who have been pushed to remain silent about their true opinions of Letby, due to fear of being reprimanded.
In response, he highlighted that senior Conservative MP Sir David Davis, who recently called for a retrial of Letby, had been contacted by nurses who worked with Letby who had been told not to give evidence on her behalf as “it would damage their career”.
Similarly, Mr McDonald noted that there were current neonatal nurses working across the country who were “frightened” that “the finger could easily be pointed at them”.
He said: “I’ve been contacted by a number of nurses who have said to me that, in their unit and on their ward, particularly neonatal wards, they’re frightened, they’re scared.
“They’re scared because the finger could easily be pointed at them.
“Because if the experts are correct, and no crime was committed and, in essence, they blamed someone for deaths that were part of systemic failings of the unit, then there but for the grace of God go any of us.”
So far, requests by Letby’s legal team to appeal her convictions have been denied by the courts.
However, the Criminal Cases Review Commission (CCRC) confirmed earlier this month that it had received an application from Mr McDonald.
The CCRC is an independent body responsible for reviewing suspected and alleged miscarriages of criminal justice in England, Wales and Northern Ireland, and can send cases back to the courts.
If a case is referred by the CCRC, it is for the appeal court to decide whether the conviction is unsafe.
The expert panel’s findings formed part of the application that has been made to the CCRC for Letby’s case to be investigated as a potential miscarriage of justice.
Mr McDonald said he hoped that the CCRC process would be “done within a year”.
“I’m saying that the evidence is now uncontroversial, huge, compelling and this matter needs to be sent back to the Court of Appeal immediately,” he told Nursing Times.
“[The CCRC] are already working on it, they’re already looking at it.
“I say they should get this done by the summer. It’s up to them to say how long it will take.”
A spokesperson for the CCRC confirmed to Nursing Times that it had received a preliminary application in relation to Letby’s case and that work had begun to assess the application.
It added that it could not provide a timescale for the review, as it would be depend on the complexity of the case and the submissions made.
What the international expert panel found about the Lucy Letby case
Findings based on the review of medical records
Medical histories were incomplete
Failure to consider the obstetric history
Disregard for surveillance warnings about infectious bacterial colonisation
Misdiagnosis of diseases
Caring for patients who were beyond the unit’s designated level of care
Unsafe delays in diagnosis and treatment of acutely ill patients
Poor skills at resuscitation and intubation
Poor supervision of junior doctors in procedures like intubation
Poor skills in basic medical procedures like insertion of chest tubes
Lack of understanding about respiratory physiology and basics of mechanical ventilation
Poor management of common neonatal conditions like hypoglycemia
Lack of knowledge about commonly used equipment in neonatal units
Failure to protect at risk patients (such as those with haemophilia) from trauma during intubation
Lack of teamwork and trust between health professions
Findings based on the review of witness statements
Inadequate numbers of appropriately trained personnel
Lack of training for assigned nursing roles
Inadequate staffing
Work overload
Poor plumbing and drainage, resulting in need for intensive cleaning; this was a potential factor in Stenotrophomonas maltophilia colonisation and infection
Poor environmental temperature control in the facility
Difficulty in finding a doctor when need arose
Congestion at medication cabinet and preparation trolley
Lack of appropriate facilities for sterile preparation, e.g. IV drugs prepared in corridor
Some high-risk infants who should have been born and cared for at higher level institutions were born and cared for in Countess of Chester Hospital because of a shortage of beds at higher level facilities
Delays in transfer of sick infants to higher level facilities when the need arose
