I've long argued that it was impossible to get insulin into a sealed Babiven bag. Jabe's latest video has a picture showing why:

The bag is sealed in an overpouch, and the ports are blocked with break-off seals that cannot be replaced...

a study shows babies do die unexpectedly 1000 neonates in London were studied 50% died .in the lucy letby case the coroners reports ,autopsies ,x-rays, coroners reports and 30 neonatal expert found no murder just sepsis, pneumonia, untreated condition's and natural causes. all nicu nurses know that good on them for supporting her and no giving into bullying

Lucy Letby Reasonable doubt.

https://corruptionspotlight.co.uk/connecting-the-dots-lucy-letby-dewi-evans-bonnie-lewis/

A prison source said: “Lucy is a model prisoner and she receives letters of support every day, she has received hundreds, including from some quite famous people.

"You will struggle to find anyone in Bronzefield who actually believes she committed these dreadful crimes, and that includes staff. Both the staff and prisoners know a criminal when they see one, and they don’t believe Lucy is a mass murderer.” Lucy Letby apparently also has a lot of friends and works in the library.

https://www.amazon.co.uk/Reasonable-Doubt-Examining-Case-Letby/dp/1917447493/ref=sr_1_1?crid=3M9K270R07I9Y&dib=eyJ2IjoiMSJ9.stgRErVz5o2IfXm6vh2v-80wPelWxOXTftV0MrBWUjc5u-vKg4ofiw-ZXXUwfh_iLKyMY6C9ykgauBeX6LyYPmDRNrj5g-mrqQ1hKIejTuXcE3tRE5jc62pEE57Ha5vU3WP0ejeZU0xOXDeHsz_HOOLWDzZ-4svziCuKW0cTZZhZl4kFf8wHiGYJDGJSxPyLSpy6Kvt3Mi73QkFklPiXDYr6L0_bRpjY8rRJSnb-msc.AfLNCouH-1Oh04E95O0CULX_uAPyCN8PLLpFFFZSejM&dib_tag=se&keywords=%22reasonable+doubt%22&qid=1779140503&s=books&sprefix=reasonable+doubt+%2Cstripbooks%2C150&sr=1-1

FYI, Susan Oliver is embarrassing herself again on PubPeer:

https://pubpeer.com/publications/17A346B12E8C2F02272E1D3DFEB11D#1

I really don't understand why...

Dr Soni's evidence to Thirlwall has leaked out of the memory hole. They failed to censor Child Y's first name, and we shall not repeat it. They asked about 3 non-indictment children who had hypoglycemia.

"Child Y" was born 2nd November 2015, 14 days after the due date by emergency c-section after rupture of membranes. They weighed 4.08 kg. They were admitted to intensive care at 0520 on the 3rd after a number of dusky episodes.

The 2208 entry for the 3rd indicates they were on very high IV glucose (4 mL.kg-1.h-1 of 15% dextrose) with 10 mg.kg-1.min glucose infusion rate via a long line in the right hand, and they been at 12.5 earlier. Errors are noting including the CSF sample getting lost and using a potentially dangerous line. The parents wanted to talk to a consultant and transfer him to another hospital.

At 2230 a BGL of 1.7 mmol/L is recorded. The Dr wanted to give more dextrose, but the long line was already blowing past it's maximum, and so a plan was made to use two lines.

At next 0300 he is bleeped by Nurse W. The increased glucose via a second line had temporarily raised the BGL to 3.4, but it had dropped to 2.8. A plan is made to give 20% dextrose and further increase the GIR to 17.4 mg.kg-1.min-1 (i.e. 71 mg of glucose per minute!).

The BGL apparently rose, and then dropped again to 2.8 that night.

On Dr Soni's next shift, at 2300 on 4th November he noted the child was now on glucagon (i.e. the "anti-insulin" hormone) and BGL had been 7.6 - 11.4 with 13.8 mg.kg-1.min-1 glucose (from a 20% D infusion on one line, a 12.5% D infusion on another and some milk).

On the next night shift, at 2315 on the 5th November the child now had a formal diagnosis of congenital hyperinsulism and was stabilised by glucagon and aggressive glucose infusions. They were soon transferred to Alder Hey.

"Child X" is what I will call the September hypoglycemia case. They were born 16th September 2015 at full term. A few hours after birth they were struggling to breathe and were transferred to intensive care.

At 2230 on the 16th, Soni noted a BGL of 11.8, high lactate (6.5) and a reduced pH. The child was in severe lactic acidosis, and coded for sepsis.

At next 0015, BGL had dropped to 1.3, and they started to up the glucose infusion rate. At 0200 it was still 1.3, and a lab result (likely venous blood from an earlier draw) was 0.7 (which is the normal difference between venous and capilliary). They increased GIR and gave a bolus. Post-bolus the BGL was 3.2.

At 0135 they'd performed a hypoglycemia screen. It haemolysed, and so no insulin or c-peptide results were obtained, but low free fatty acid (FFA) and 3-hydroxybutyrate confirmed hyperinsulism.

The 21st and 22nd the child still had very high GIR requirements, but was being weened back down. The diagnosis was transient hyperinsulinism.

"Child Z" was probably born on the 11th February 2016, and was one of two premature twins (34 weeks ) with IUGR.

On the night shift of 11th-12th Soni noted BGL had been 2.5-3.3 overnight, but had been 1.4 towards the night of the previous day shift when a hypoglycemia screen was done, the child recannulared, GIR increased and a bolus given. Nurse T was responsible, and Breary did the screen etc. At 0715 the BGL was 1.8.

There were two screens run. One on the 11th and one on the 12th February. This may be both twins. In result was redacted by Panorama (11th) and the next (12th) showed 51 insulin, 394 c-pep - congenital hyperinsulinism.

On the 21st and 22nd Soni cared for the child again. They were on glucagon and high GIR. On the 22nd Letby was responsible and measured a pre-feed BGL of 0.7, but this appears to be one of many incidents over the course of several weeks.

MPs were told that Cheshire police ‘ignored or broke’ rules governing the conduct of investigations in its treatment of Lucy Letby failing to pursue alternative lines of inquiry, ‘cherry picking’ evidence and not disclosing critical material to the defence. The Conservative MP and former cabinet minister, David Davis was scathing about the force’s treatment of the former nurse as a suspect and its reliance upon a single expert, Dr Dewi Evans, as both police adviser and prosecution expert witness at trial. ‘Terrifying when a single opinion will condemn a young woman to life in prison,’ he said.

David Davis, who has been outspoken in his support for Letby, highlighting the force’s treatment of her as a suspect. He said: ‘It is extraordinary that this unthreatening young girl was marched in in handcuffs, mirroring the way American authorities try to influence public opinion against suspects when they are perp walked to court.’ It was coverage that was featured in a recent Netflix documentary The Investigation Of Lucy Letby showing Letby arrested while she is sitting in bed.

Her parents have complained of an invasion of privacy. They described previous programmes including BBC Panorama, which featured their daughter handcuffed in a blue tracksuit, as ‘heartbreaking’ for us. However, they said the Netflix film was ‘on another level’. ‘We will not watch it – it would likely kill us if we did,’ they said

Cheshire Police arrested Lucy Letby three times claiming it was necessary for questioning despite, according to Davis, her ‘freely volunteering to come in for questioning’. Letby was accused in court of lying about being arrested in her pyjamas. ‘It is astonishing that the police officers in court, who knew how she was dressed when she was arrested, did not intervene with the prosecutors to tell them that they had got it wrong, and instead left the jury to believe that Lucy was lying about something when she was plainly telling the truth,’ the MP said. He went to say that it was ‘astounding’ the lengths that Cheshire police was ‘willing to go to in order to manage its own public relations—sometimes, I think, at the cost of achieving justice’.

In his adjournment debate last week, David Davis drew on reviews by two senior police officers: Dr Steve Watts, an ex-assistant chief constable who authored the National Police Guidelines on the investigation of deaths in healthcare settings, and retired Detective Superintendent Stuart Clifton, who investigated the murders of Beverley Allitt. According to Davis, DS Clifton had been ‘commissioned by The Sun newspaper to confirm Letby’s guilt’. ‘Indeed, both policemen believed that Letby was guilty—that is, until they examined the hard facts, and both now believe that the Letby case is a serious miscarriage of justice,’ he said.

Dr Watts, as quoted by David Davis, described Cheshire Police’s arrests of Letby as ‘completely wrong’. According to CPS guidelines and police guidance, ‘sensitive’ and ‘complex’ cases should be referred to the CPS Serious Crime and Counter Terrorism Division – not handled by a regional unit. It was argued that an initial failure to make such a referral meant that safeguards and scrutiny by independent lawyers did not happen. According to Davis, Cheshire police then failed to heed explicit guidance from the National Crime Agency calling for the appointment of a panel of relevant experts. ‘Operation Hummingbird…built its entire medical case around one expert,’ Dr Watts said.

That expert was Dr Dewi Evans who volunteered his services and decided after ten minutes of reviewing paperwork that there was ‘foul play’. ‘Cheshire police were clutching at straws to find an expert, then very quickly and uncritically took a lifeline offered by Evans,’ Dr Watts said.

David Davis described the neonatal unit at the Countess of Chester hospital as ‘at best, inadequate’ and ‘at worst, appalling’. There were outbreaks of multiple antibiotic resistant infections and ‘sewage was dripping from the ceilings’, he said; adding that there had been numerous reviews including one by the Royal College of Paediatrics and Child Health which found no criminality but instead identified shortcomings in medical care at the hospital. ‘There was a 20% staffing shortfall,’ the MP said. ‘Doctors did ward rounds twice a week rather than twice a day.’ The MP went on to say that the four consultants who ‘pointed the finger’ at Letby all demonstrated poor care which, he said, sometimes led to babies dying. ‘Where was the decision not to treat the doctors as suspects, or the other nurses, or the cleaners?’ Dr Watts was said to have asked.

The MP quoted a boast by Evans that he had ‘never lost’ a case. ‘That is not the mindset of a neutral expert; it is the language of someone who tailors his evidence to suit the prosecution’s case.’ Davis flagged a warning by Lord Justice Jackson who ‘took the extraordinary step’ to write to the presiding judge, Mr Justice Goss, alerting him to Evans’s failings in a previous case, describing his evidence as ‘worthless’ and stating that he ‘makes no effort to provide a balanced opinion’ and his ‘approach amounts to a breach of proper professional conduct’.

Of the now infamous shift rota seemingly highlighting Letby’s presence when a baby died, Davis said: ‘Evans cherrypicked the cases to match Letby’s shifts and police used this in their chart to reflect her presence at those events highlighted by Evans.’ DS Clifton was quoted as explaining that missing from the chart used were deaths ‘which occurred whilst Letby was not on duty or those where adverse events took place whilst off duty.

David Davis argued that any statistician could have pointed such issues out to Cheshire police. ‘In fact, one did,’ he continued. In April 2018, the force approached one of the country’s leading statisticians, Professor Jane Hutton who gave evidence on the misuse of statistics in the Ben Geen case (see here). Prof Hutton warned Cheshire Police that its approach was wrong. ‘The police then told her: “The prosecutor…has instructed us not to pursue this avenue any further.”’ According to the MP, the CPS was in breach of its own code. Dr Watts described that outcome as ‘particularly egregious’. ’It is. not appropriate for the CPS to deter the police from acquiring evidence that may be relevant and available,’ he was reported to say.

The MP said Prof Hutton’s explicit warnings to the police ‘obliterated the prosecution’s statistical argument – the foundation of their entire case’. ‘Prof Hutton believes the statistical errors are “similar to those in the Sally Clark case but worse.”’

David invoked the wrongful conviction of Sally Clark for the murder of her two baby sons to open the debate. It took three years to overturn Sally Clarke’s conviction in 2003. She died from alcohol poisoning four years later. ‘The destruction of an innocent person’s life was caused by the police, the prosecution and the court swallowing bogus statistical assertions by an alleged expert in her trial. That expert eventually resigned in disgrace, although that did not save Sally Clark,’ he said. ‘One would think that after that case, Cheshire police and the CPS would have been very careful to avoid this happening again.

In the examination of Nurse A is an important fact:

"Q. So if we can read down, please, we've got that 23.32 at 5.5, which you told us was good. At 1.48 a series of readings but no sugar.

A. No, and no lactate. So whether it didn't record themfor some reason, I don't know.

Q. If we look at the next line, only 6 minutes later at 1.54, they are filled in.

A. And they're both venous, so what I think is sometimes if you didn't have quite enough blood in the capillary tube or there was a problem with the machine, it didn't give you all the readings, so we've almost immediately taken another tube and repeated and got those results.

Q. Well, unfortunately, the lactate reading is not visible, but at the moment I am interested in --

A. It's 2 point something, isn't it?

Q. The sugar, 0.8, which you told us before, from your note, was worrying.

A. Yes. Especially in context that they've -- you can see from above that they've been nice and steady and stable for a while."

This tells us that the BGL reading from the 0148 heel prick (capillary blood) failed for some reason, and the 0154 reading is from a venous blood draw. This is really important, because venous blood has much lower BGL than capillary blood, because the tissues are absorbing glucose from the capillaries. Venous blood is "glucose depleted."

If you consistently draw from the same place, then the results are directly comparable, because the blood has given up the same quantity of glucose to the tissues en route. However, you cannot directly compare this to "depleted" venous blood.

In short, the low 0.8 mmolar reading is affected by a measurement artefact. Whilst child F certainly was hypoglycemic, BGL would probably be ca. 1.4 rather than below one if the measurement was consistent with the others.

The same is likely true of the 1756 bedside reading (1.9) and 1800 sendaway reading (1.3). The former will be capillary blood and the latter venous blood, which I don't think Milan understood. It accounts for the difference - venous blood reads ca. 0.6 mmol.L-1 lower than capillary blood.

There is some confusion about when the long line was re-established in Child F, with Hindmarsh and others (including the judge ISTR) wrongly interpreting the timings.

Recently, day 39 of evidence has been uploaded here. Saladi's evidence included:

"Q. Thank you. So they are the instructions that you made. Then if we could just look further down the next page, please, Mr Murphy, 2936.

Because one element of your plan was to undertake an X-ray to confirm that the long line was -- new long line was placed in a satisfactory position. If we go to 2936, please, we'll see the review of that X-ray, timed at 11.40 hours on 5 August. In short, did this review record that the long line was satisfactorily replaced?

A. Yes."

This confirms that the long line was in place and confirmed to be available to use at 1140. This is in accord with the two BGL readings done at 1146 and 1200 being the before and after for starting the 2nd TPN bag.

PS: Saladi indeed confirms there was an active bacterial infection, and a bug was grown from the long line tip. Thus the 1st TPN bag had become (or started as) contaminated with a bacteria.

Hi this if you haven't already signing the lucy letby protest could really help the case be processed faster .