An in-depth investigation is questioning the verdict in the case of a British neonatal nurse who was found guilty of murdering babies in her care.
Lucy Letby, 34, was convicted last year of the murders of seven babies and sentenced to life imprisonment. She failed at an initial attempt to overturn her convictions earlier this year.
But now, a 13,000-word article in the New Yorker by writer Rachel Aviv raises serious questions about her conviction and the lack of evidence pointing to her guilt, while highlighting chronic understaffing in her hospital unit.
The article has been blocked in the United Kingdom due to contempt-of-court rules as Letby faces a retrial in June on a single attempted murder count.
Much of the initial suspicion around Letby's role in the deaths was based on the supposed statistical unlikelihood that she could have been present for all the fatalities but not have played a part.
A month before Letby's 2022 trial, the Royal Statistical Society published a report which looked at the cases of two nurses in The Netherlands and Italy who were wrongly convicted of murder. The link between shift patterns and the deaths was the main piece evidence in the cases.
The society sent the report, which detailed the dangers of drawing causal conclusions from improbable clusters of events, to both Letby's lawyers and the prosecution team.
In the trial of Dutch nurse Lucia de Berk, a criminologist calculated there was a one in 342 million chance the deaths were coincidental. But statisticians looked into the data and found the chances were closer to one in 50. De Berk has since been exonerated and her case is now considered one of the worst miscarriages of justice in Dutch history.
In the case of Letby, colleagues spoke highly of her and she had no red flags in her background.
Because of chronic understaffing, she was often taking on unsafe amounts of work, Aviv uncovered. When a mother gave birth to triplets, each baby was supposed to have its own nurse but Letby was assigned two while also caring for a baby from another family and training a student nurse. One of the triplet's oxygen levels dropped seven hours into her shift and he developed a rash on his chest. Letby called for help but the baby died after two rounds of CPR.
After seeing a newspaper article on a criminal investigation into the spike of deaths at Letby's hospital, retired Welsh pediatrician Dewi Evans offered to help. The information he gave to police on the clinical methods Letby may have used to kill the babies led police to arrest her in July 2018.
In another case, a judge called a medical report written by Evans "worthless" and said: "No court would have accepted a report of this quality." Letby's team called for Evans' evidence to be struck but the request was turned down.
For one baby's death, Evans' determination that it was suspicious came down to how to define projectile vomiting. Letby's team pointed to other incidents that met the same criteria of suspiciousness that happened when she wasn't working. In another case, Evans proposed a baby died of excessive air in her stomach from her nasogastric tube. He then suggested she may have been smothered when it emerged that she might not have had a tube.
Following Letby's arrest, police found a note with the heading "NOT GOOD ENOUGH" in Letby's house. There were several phrases written across the page, including: "Slander Discrimination"; "I'll never have children or marry I'll never know what it's like to have a family"; "WHY ME?"; "I haven't done anything wrong"; "I killed them on purpose because I'm not good enough to care for them"; "I AM EVIL I DID THIS."
Another piece of paper had the note: "I just want life to be as it was. I want to be happy in the job that I loved with a team who I felt a part of. Really, I don't belong anywhere. I'm a problem to those who do know me." On another piece of paper she had written, "I can't do this any more. I want someone to help me but they can't." She also wrote, "We tried our best and it wasn't enough."
Police asked Letby about the "I killed them on purpose" note.
"I didn't kill them on purpose," she said.
Letby said she was being made to feel like she killed the babies on purpose.
"If my practice hadn't been good enough and I was linked with these deaths, then it was my fault."
Letby was eventually found guilty of 14 charges of murder and attempted murder after the judge told the jury they could find her guilty even if they weren't "sure of the precise harmful act" she'd committed.
Blocked from view
The New Yorker article, and it's being blocked from view, has sparked a strong reaction in the UK.
Former Conservative minister David Davis called on the Government to review the court order preventing Britons from accessing the article.
"Yesterday the New Yorker magazine published a 13,000-word inquiry into the Lucy Letby trial, which raised enormous concerns about both the logic and competence of the statistical evidence that was a central part of that trial.
"That article was blocked from publication on the UK internet, I understand because of a court order. Now, I'm sure that court order was well intended but it seems to me in defiance of open justice.
"Will the Lord Chancellor look into this matter and report back to the House?"
Justice Secretary Alex Chalk replied: "Court orders must be obeyed and court orders can be displaced by someone applying to court for them to be removed. So that will need to take place in the normal course of events.
"I will just simply make a point on the Lucy Letby case - that jury's verdict must be respected. If there are grounds for an appeal, that should take place in the normal way."
