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Post by wannabee on Sept 16, 2024 8:34:45 GMT
I'm following this exchange with interest. Rick - Wannabee says that "Many if not all of the babies at Countess of Chester during that period whether attended to or not by Letby suffered from Sepsis". Is that a fact ?? and is it normal for most babies in hospital to have it ? None of the babies that Letby is accused of harming had sepsis. Fact. From memory one of the babies had an infection but it wasn’t sepsis. This is not necessarily a Fact This is about Baby D Dr Arthurs, professor of radiology at London's Great Ormond Street Hospital, had been instructed to review X-rays taken of the baby, known as Child D, when alive and after death, as well as other babies in the investigation. Dr Arthurs said the amount of gas present in Child D's X-rays was consistent with babies that had died of sepsis, complications with a breathing support system, a severe trauma such as a road traffic collision or the direct administration of air into the body. So Dr Arthurs in his testimony didn't rule out sepsis A pathologist's report into the death of Child D deemed the cause of death was pneumonia. www.bbc.com/news/uk-england-merseyside-63599076x.com/LucyLetbyTrials/status/1834917745231618525On a more generic point from a report this week England’s health ombudsman, Rebecca Hilsenrath, voiced concern about the NHS’s “defensive culture” over the condition (Sepsis), which kills an estimated 48,000 people a year in the UK. She spoke of her acute anxiety that patients receiving NHS care are still dying avoidably with sepsis –better known as blood poisoning – despite hospitals and GPs being warned repeatedly over many years to get better at spotting and treating it quickly. www.theguardian.com/society/2024/sep/14/nhs-failing-to-learn-from-fatal-sepsis-mistakes-watchdog-warns?CMP=share_btn_urlIn the reporting of evidence of Child C at 3.20 p.m. It is noted that Child C was suspected of Sepsis www.chesterstandard.co.uk/news/23081233.recap-lucy-letby-trial-thursday-october-27/At the same time Babies A C and D were in the CoC Neonatal Unit Another Baby James developed Sepsis and was transferred to Liverpool where he recovered after 4 days transfered back to CoC and became I'll again The Article also outline evidence given at Trial that unlike other nurses she would report Doctors who she believed made mistakes, this made her very unpopular with Senior Doctors at CoC mephitis.co/sepsis-and-scapegoating-in-lucy-letby-case/I have already linked the BBC Panorama Program on CoC which highlighted CoC inability to deal with Sepsis This is an Article from Nursing Times commenting www.nursingtimes.net/news/hospital/trusts-efforts-to-tackle-sepsis-featured-in-bbc-programme-12-09-2017/We also have the RCPCH Report showing the chronic understaffing and dysfunctional medical practice at CoC
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Post by wannabee on Sept 16, 2024 8:49:06 GMT
Without getting into the Letby case specifically (I'm not as well read on it as Rick clearly is - so I'll leave that to him) - I queried this because I'm seeing quoted figures of the incidents of sepsis in newborns as being 1 in a 1000. So I'll be awaiting with interest to see what you can "dig out" The way I see it - If "most but not all" of babies at CofC contracted sepsis back then in the hospital as you intimated, that would have been massive news in its own right, and surely led to ward closures. Therefore i'm currently thinking you've made that up, which would be disingenuous at best, and would seriously hurt your credibility on this. Spouting unsubstantiated or completely made up "facts" like Trump does - just to eke out your argument and to heap unjustified additional criticism on the hospital would be piss poor, wouldn't it ? There are 25,000 cases of infant sepsis each year in UK The babies at CoC were premature and even more susceptible to infection sepsisresearch.org.uk/sepsis-in-children/For other answers see my reply to Rick
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Post by Rick Grimes on Sept 16, 2024 9:01:46 GMT
I’ve dealt the points you’re raising already, you either haven’t read the post properly or you’re not capable of basic comprehension. The ratio of c-peptide to insulin determines if it is exogenous or not. High insulin and low c-peptide means the insulin was exogenous. The specialist centre you think it should have been sent to confirmed that it didn’t need to be. Also when you say ‘Professor Jones pointed out that the test used measures the body’s reaction to insulin rather than the substance itself’ That doesn’t even make sense, it doesn’t measure the body’s reaction to it. I can tell that’s just the way you’ve interpreted it because you’re not very bright. You won’t be able to quote him saying that ‘it measures the body’s reaction to insulin’ because that’s not what he said. What the test does do is identify the level of insulin and c-peptide and from those readings you can calculate the ratio of insulin to c-peptide and therefore determine whether it’s exogenous or not. You really are humiliating yourself time after time at this point. It is you my friend who is displaying Gross Stupidity by not understanding basic facts I'll repeat again what Professor Alan Wayne Jones has said and I underline it above, AGAIN "The problem is that the method of analysis used [in these two cases] was probably perfectly good from a clinical point of view, but not a forensic toxicology point of view," he said. " That test cannot differentiate between synthetic insulin and insulin produced by the pancreas."
The Lab Results detected High Levels of Insulin but that Lab was unable to detect THE SOURCE whether it was Exogenous (Administered Externally) or Endogenous (Naturally occurring e.g. via Sepsis) because the Lab where it was Tested are unable to perform this Test. Their Website says so. Please do catch up. It's like clubbing a baby seal at this point .... Alan Wayne Jones is technically correct, if you look at the results of the test it provides a reading for the amount of insulin in the body. It doesn't specify if it's exogenous (unnatural) or endogenous (natural). What the test does do is provide readings for the amount of insulin and c-peptide that was detected in the body at the time. pathlabs.rlbuht.nhs.uk/seafrm.htmIf click on the link from the lab that did the test you'll see ' Normal C-peptide/insulin ratio: 5.0 - 10.0'The reading for insulin detected by the test was 4,657The reading for c-peptide detected was ' less than 169'. Using the ratio it can be determined that the level of c-peptide that would normally be expected to be in the body should be between 20,000-40,000. Obviously there is quite a substantial difference between ' less than 169' and 20,000-40,000. Let's go back to lab document link that I've included above and you'll see there is a section for ' Interpretation' and it says the following; ' Low C-peptide, raised insulin: Insulin administration, insulin receptor antibodies (IR-A).' For the avoidance of doubt ' insulin administration' means the insulin is endogenous (unnatural). So it is perfectly reasonable to interpret from the results of the test that the insulin has been given to the babies when it shouldn't have been, providing other pathologies have been ruled out. Which they were. Insulin Autoimmune Syndrome is rare, and even more so in children. As of 2017, only 25 cases in paediatric patients were known worldwide. What are the chances that two babies in the same hospital, in the space of a few months, have such a rare physiological condition. www.ncbi.nlm.nih.gove/pmc/articles/PMC6174196/Not only is it incredibly rare, the syndrome does not resolve within a few days, so it is not consistent with the babies recoveries, which was within a few days. The other possible explanation for the test results is the 'hook effect' which I've already gone through, in order definitely conclude that the babies were poisoned you need an expert to check the results thoroughly, which is what Professor Hindmarsh did. So, we are now left with the possibility that the tests themselves were unreliable, except I've already covered this. The test results are not in doubt. During the trial Dr Anna Milan, the person who tested the results, made it clear that the referral to the Guildford lab (the specialist one) is optional and that the immunoassay used was confirmatory. In addition there was a lab representative from the Guildford lab, Dr Gwen Wark, who is an expert on insulin and she spoke about the assessments that Guildford lab performs on a 4-6 week basis to ensure that the results produced by the Liverpool Royal Hospital are accurate. TLDR: There are two separate ways of identifying unnatural insulin, one is the ratio method used for the trial. The other is sending the sample to the specialist lab. In an ideal world it would have been confirmed both ways but the ratio is sufficient. You can do either, you don't need to do both. The test results are reliable and other potential reasons were ruled out.
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Post by redstriper on Sept 16, 2024 9:49:42 GMT
Without getting into the Letby case specifically (I'm not as well read on it as Rick clearly is - so I'll leave that to him) - I queried this because I'm seeing quoted figures of the incidents of sepsis in newborns as being 1 in a 1000. So I'll be awaiting with interest to see what you can "dig out" The way I see it - If "most but not all" of babies at CofC contracted sepsis back then in the hospital as you intimated, that would have been massive news in its own right, and surely led to ward closures. Therefore i'm currently thinking you've made that up, which would be disingenuous at best, and would seriously hurt your credibility on this. Spouting unsubstantiated or completely made up "facts" like Trump does - just to eke out your argument and to heap unjustified additional criticism on the hospital would be piss poor, wouldn't it ? There are 25,000 cases of infant sepsis each year in UK The babies at CoC were premature and even more susceptible to infection sepsisresearch.org.uk/sepsis-in-children/For other answers see my reply to Rick You said - " Many if not all of the babies at Countess of Chester during that period whether attended to or not by Letby suffered from Sepsis"There is absolutely nothing in your response to corroborate that statement. So I suggest you accept it was bullshit and stop embarrassing yourself further. It's this kind of crap which perpetuates conspiracy theories, which are then repeated as "fact" by the ignorant/gullible. People like Trump & Musk do this all the time as you well know, and they similarly double down by deflection or arrogantly insisting black is white. Given how much effort you normally put into your posts I doubt you want to be cast alongside them.
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Post by Rick Grimes on Sept 16, 2024 9:52:38 GMT
None of the babies that Letby is accused of harming had sepsis. Fact. From memory one of the babies had an infection but it wasn’t sepsis. This is not necessarily a Fact This is about Baby D Dr Arthurs, professor of radiology at London's Great Ormond Street Hospital, had been instructed to review X-rays taken of the baby, known as Child D, when alive and after death, as well as other babies in the investigation. Dr Arthurs said the amount of gas present in Child D's X-rays was consistent with babies that had died of sepsis, complications with a breathing support system, a severe trauma such as a road traffic collision or the direct administration of air into the body. So Dr Arthurs in his testimony didn't rule out sepsisIn the reporting of evidence of Child C at 3.20 p.m. It is noted that Child C was suspected of Sepsis I'm just going to address the above, the other stuff I've deleted in your response isn't relevant. What is relevant is context, something that seems to completely elude you. None of the babies were diagnosed with sepsis by the staff in the hospital at the time they were there, in the autopsies, or by Dr Evans when he's reviewed the cases. Let's take your claim in bold and then look at the appeal judgement with regards to Baby D. www.judiciary.uk/wp-content/uploads/2024/07/R-v-Letby-Final-Judgment-20240702.pdfPoint 63 Professor Arthurs identified a striking black line from left to right in front of the spine which was either gas in the aorta or the inferior vena cava. He said that he had never seen this quantity of gas in one of the main great vessels where no reason (for example, sepsis or trauma) could be found. It was also present in Baby A. He said that one of the explanations for this finding was that someone was injecting air into the child. In the absence of any evidence that suggested that Baby D had died of overwhelming sepsis or any of the other explanations that had been put forward he concluded that the radiographs were consistent with air embolus. You're so clueless that you've actually bought up the wrong baby because for Baby D sepsis was clearly ruled out. Have another go at identifying the right baby Dr Arthurs is referring to and we'll go from there. For your point about Child C it just goes without saying that being suspected of having sepsis isn't the same as actually being diagnosed with it.
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Post by gawa on Sept 16, 2024 10:13:23 GMT
It is you my friend who is displaying Gross Stupidity by not understanding basic facts I'll repeat again what Professor Alan Wayne Jones has said and I underline it above, AGAIN "The problem is that the method of analysis used [in these two cases] was probably perfectly good from a clinical point of view, but not a forensic toxicology point of view," he said. " That test cannot differentiate between synthetic insulin and insulin produced by the pancreas."
The Lab Results detected High Levels of Insulin but that Lab was unable to detect THE SOURCE whether it was Exogenous (Administered Externally) or Endogenous (Naturally occurring e.g. via Sepsis) because the Lab where it was Tested are unable to perform this Test. Their Website says so. Please do catch up. It's like clubbing a baby seal at this point .... Alan Wayne Jones is technically correct, if you look at the results of the test it provides a reading for the amount of insulin in the body. It doesn't specify if it's exogenous (unnatural) or endogenous (natural). What the test does do is provide readings for the amount of insulin and c-peptide that was detected in the body at the time. pathlabs.rlbuht.nhs.uk/seafrm.htmIf click on the link from the lab that did the test you'll see ' Normal C-peptide/insulin ratio: 5.0 - 10.0'The reading for insulin detected by the test was 4,657The reading for c-peptide detected was ' less than 169'. Using the ratio it can be determined that the level of c-peptide that would normally be expected to be in the body should be between 20,000-40,000. Obviously there is quite a substantial difference between ' less than 169' and 20,000-40,000. Let's go back to lab document link that I've included above and you'll see there is a section for ' Interpretation' and it says the following; ' Low C-peptide, raised insulin: Insulin administration, insulin receptor antibodies (IR-A).' For the avoidance of doubt ' insulin administration' means the insulin is endogenous (unnatural). So it is perfectly reasonable to interpret from the results of the test that the insulin has been given to the babies when it shouldn't have been, providing other pathologies have been ruled out. Which they were. Insulin Autoimmune Syndrome is rare, and even more so in children. As of 2017, only 25 cases in paediatric patients were known worldwide. What are the chances that two babies in the same hospital, in the space of a few months, have such a rare physiological condition. www.ncbi.nlm.nih.gove/pmc/articles/PMC6174196/Not only is it incredibly rare, the syndrome does not resolve within a few days, so it is not consistent with the babies recoveries, which was within a few days. The other possible explanation for the test results is the 'hook effect' which I've already gone through, in order definitely conclude that the babies were poisoned you need an expert to check the results thoroughly, which is what Professor Hindmarsh did. So, we are now left with the possibility that the tests themselves were unreliable, except I've already covered this. The test results are not in doubt. During the trial Dr Anna Milan, the person who tested the results, made it clear that the referral to the Guildford lab (the specialist one) is optional and that the immunoassay used was confirmatory. In addition there was a lab representative from the Guildford lab, Dr Gwen Wark, who is an expert on insulin and she spoke about the assessments that Guildford lab performs on a 4-6 week basis to ensure that the results produced by the Liverpool Royal Hospital are accurate. TLDR: There are two separate ways of identifying unnatural insulin, one is the ratio method used for the trial. The other is sending the sample to the specialist lab. In an ideal world it would have been confirmed both ways but the ratio is sufficient. You can do either, you don't need to do both. The test results are reliable and other potential reasons were ruled out. Low c peptide and high insulin can be indictive of exogenous insulin administration. But is that not why they need to go to a lab to follow standardised testing protocol? The American Association for Clinical Chemistry (AACC) has highlighted that hemolysis (damage to red blood cells during collection) and improper centrifugation or transportation can cause interference in assay measurements, affecting both insulin and C-peptide levels. So how can we be confident the samples were handled correctly if not tested through the standardised protocols? How do we know they were stored at the correct temperature to prevent c peptide levels dropping? Is the reason to send to the lab not to remove all this doubt? And by not following the protocol on multiple occasions it has allowed this doubt?
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Post by Rick Grimes on Sept 16, 2024 10:33:37 GMT
It's like clubbing a baby seal at this point .... Alan Wayne Jones is technically correct, if you look at the results of the test it provides a reading for the amount of insulin in the body. It doesn't specify if it's exogenous (unnatural) or endogenous (natural). What the test does do is provide readings for the amount of insulin and c-peptide that was detected in the body at the time. pathlabs.rlbuht.nhs.uk/seafrm.htmIf click on the link from the lab that did the test you'll see ' Normal C-peptide/insulin ratio: 5.0 - 10.0'The reading for insulin detected by the test was 4,657The reading for c-peptide detected was ' less than 169'. Using the ratio it can be determined that the level of c-peptide that would normally be expected to be in the body should be between 20,000-40,000. Obviously there is quite a substantial difference between ' less than 169' and 20,000-40,000. Let's go back to lab document link that I've included above and you'll see there is a section for ' Interpretation' and it says the following; ' Low C-peptide, raised insulin: Insulin administration, insulin receptor antibodies (IR-A).' For the avoidance of doubt ' insulin administration' means the insulin is endogenous (unnatural). So it is perfectly reasonable to interpret from the results of the test that the insulin has been given to the babies when it shouldn't have been, providing other pathologies have been ruled out. Which they were. Insulin Autoimmune Syndrome is rare, and even more so in children. As of 2017, only 25 cases in paediatric patients were known worldwide. What are the chances that two babies in the same hospital, in the space of a few months, have such a rare physiological condition. www.ncbi.nlm.nih.gove/pmc/articles/PMC6174196/Not only is it incredibly rare, the syndrome does not resolve within a few days, so it is not consistent with the babies recoveries, which was within a few days. The other possible explanation for the test results is the 'hook effect' which I've already gone through, in order definitely conclude that the babies were poisoned you need an expert to check the results thoroughly, which is what Professor Hindmarsh did. So, we are now left with the possibility that the tests themselves were unreliable, except I've already covered this. The test results are not in doubt. During the trial Dr Anna Milan, the person who tested the results, made it clear that the referral to the Guildford lab (the specialist one) is optional and that the immunoassay used was confirmatory. In addition there was a lab representative from the Guildford lab, Dr Gwen Wark, who is an expert on insulin and she spoke about the assessments that Guildford lab performs on a 4-6 week basis to ensure that the results produced by the Liverpool Royal Hospital are accurate. TLDR: There are two separate ways of identifying unnatural insulin, one is the ratio method used for the trial. The other is sending the sample to the specialist lab. In an ideal world it would have been confirmed both ways but the ratio is sufficient. You can do either, you don't need to do both. The test results are reliable and other potential reasons were ruled out. Low c peptide and high insulin can be indictive of exogenous insulin administration. But is that not why they need to go to a lab to follow standardised testing protocol? The American Association for Clinical Chemistry (AACC) has highlighted that hemolysis (damage to red blood cells during collection) and improper centrifugation or transportation can cause interference in assay measurements, affecting both insulin and C-peptide levels. So how can we be confident the samples were handled correctly if not tested through the standardised protocols? How do we know they were stored at the correct temperature to prevent c peptide levels dropping? Is the reason to send to the lab not to remove all this doubt? And by not following the protocol on multiple occasions it has allowed this doubt? Sorry Gawa, I'm not sure you mean because the blood sample did go to a lab where standard testing protocol was followed. I do understand your concerns with regards to transportation and temperature etc though and the defence did query this sort of stuff in the trial. The testing lab confirmed everything was above board.
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Post by gawa on Sept 16, 2024 11:27:05 GMT
Low c peptide and high insulin can be indictive of exogenous insulin administration. But is that not why they need to go to a lab to follow standardised testing protocol? The American Association for Clinical Chemistry (AACC) has highlighted that hemolysis (damage to red blood cells during collection) and improper centrifugation or transportation can cause interference in assay measurements, affecting both insulin and C-peptide levels. So how can we be confident the samples were handled correctly if not tested through the standardised protocols? How do we know they were stored at the correct temperature to prevent c peptide levels dropping? Is the reason to send to the lab not to remove all this doubt? And by not following the protocol on multiple occasions it has allowed this doubt? Sorry Gawa, I'm not sure you mean because the blood sample did go to a lab where standard testing protocol was followed. I do understand your concerns with regards to transportation and temperature etc though and the defence did query this sort of stuff in the trial. The testing lab confirmed everything was above board. My point is that while high insulin and low c peptide can be indictive of insulin administration. There are also a load of things relating to the collection, storage and transport of a blood sample which can also cause this. I presume the reason it suggests the tests should be sent to a lab for further testing is to confirm this as tests such as mass spectrometry would. The fact this wasn't done means there isn't conclusive evidence and reasonable doubt. An insulin metabolism expert, Stephen O'Rahilly, referenced an example from a recent case where parents were under investigation for exogenous administration of insulin in a child. In this instance the Mass Spectrometry test proved that it wasn't exogenously administrated and the cause of the high levels was proinsulin. There also seems to be a third baby, not involved in the criminal case, who had high insulin and low c peptide recorded at the same hospital but was given a diagnosis of hyperinsulinism. So I guess my question to you is. How can you be certain that these results are indictive of exogenous insulin administration? And if that was the assumption of the hospital at the time, why did they not follow procedure and get the tests down to confirm it? Is the point not to prove someone is guilty without doubt. But by not following the protocol to prove exogenous insulin administration it has added doubt. Especially when there are examples of other kids from the same hospital with similar test results get diagnosis which aren't indictive of exogenous administration? Surely if this was suspected at the time then further tests should have been done to prove it. As they weren't it adds needless doubt to the case, as protocols which could have been followed weren't. So how are you so certain it is indictive of this? And in the two examples I've provided with similar results - are you suggesting the diagnosis was wrong? Or are you happy to concede that without further testing (mass spectrometry) these tests don't prove exogenous administration and therefore cannot be relied on. What it does do is raise further questions about the operations of the practice. If these tests are indictive of possible poisoning, why wasn't this raised at the time or further tests done? Because again if this is crystal clear that insulin has been administered when it shouldn't have been on a child, then surely it should have been investigated? But it wasn't. So either the tests alone aren't as indictive as you are portraying. Or serious questions need to be asked about the management of the practice and why tests which show poisoning of children were ignored. Correct me if I'm wrong please.
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Post by Rick Grimes on Sept 16, 2024 13:13:00 GMT
Sorry Gawa, I'm not sure you mean because the blood sample did go to a lab where standard testing protocol was followed. I do understand your concerns with regards to transportation and temperature etc though and the defence did query this sort of stuff in the trial. The testing lab confirmed everything was above board. My point is that while high insulin and low c peptide can be indictive of insulin administration. There are also a load of things relating to the collection, storage and transport of a blood sample which can also cause this. I presume the reason it suggests the tests should be sent to a lab for further testing is to confirm this as tests such as mass spectrometry would. The fact this wasn't done means there isn't conclusive evidence and reasonable doubt. An insulin metabolism expert, Stephen O'Rahilly, referenced an example from a recent case where parents were under investigation for exogenous administration of insulin in a child. In this instance the Mass Spectrometry test proved that it wasn't exogenously administrated and the cause of the high levels was proinsulin. There also seems to be a third baby, not involved in the criminal case, who had high insulin and low c peptide recorded at the same hospital but was given a diagnosis of hyperinsulinism. So I guess my question to you is. How can you be certain that these results are indictive of exogenous insulin administration? And if that was the assumption of the hospital at the time, why did they not follow procedure and get the tests down to confirm it? Is the point not to prove someone is guilty without doubt. But by not following the protocol to prove exogenous insulin administration it has added doubt. Especially when there are examples of other kids from the same hospital with similar test results get diagnosis which aren't indictive of exogenous administration? Surely if this was suspected at the time then further tests should have been done to prove it. As they weren't it adds needless doubt to the case, as protocols which could have been followed weren't. So how are you so certain it is indictive of this? And in the two examples I've provided with similar results - are you suggesting the diagnosis was wrong? Or are you happy to concede that without further testing (mass spectrometry) these tests don't prove exogenous administration and therefore cannot be relied on. What it does do is raise further questions about the operations of the practice. If these tests are indictive of possible poisoning, why wasn't this raised at the time or further tests done? Because again if this is crystal clear that insulin has been administered when it shouldn't have been on a child, then surely it should have been investigated? But it wasn't. So either the tests alone aren't as indictive as you are portraying. Or serious questions need to be asked about the management of the practice and why tests which show poisoning of children were ignored. Correct me if I'm wrong please. You've indicated again that standard testing protocol wasn't followed, you've said the hospital haven't followed the 'procedure'. Correct me if I'm wrong but I'm going to presume you're referring to the fact that the blood sample could have been referred to the Guildford lab which then would have specifically determined the endogenous and exogenous insulin. So we need to look at the context. At the time the hospital sent the blood tests the babies were symptomatic with hypoglycaemia, and they didn't know why. The hospital staff did not suspect that the babies had been poisoned at the time because, why would they, they don't know about the low c-peptides at that point because the test hasn't yet been done. They're just trying to establish what is causing the hypoglycaemia so that they can treat it. It is possible, although rare, that an infant does have a pathology that could cause a high insulin and low c-peptide hypoglycaemia. I've already mentioned one myself, Insulin Autoimmune Syndrome and you've raised another case which I'm not familiar with. To establish those sorts of pathologies you would need further testing. It's also worth noting that these sort of tests don't involve quick turnarounds, it can take days. However, what happened concerning Letby is that the babies got better within a couple of days, therefore from the hospital's point of view there was no need to do the further testing as the hypoglycaemia had resolved itself through treatment. The only thing the hospital is interested in keeping people alive and once the issue has resolved they move on. They're not thinking someone has deliberately poisoned the babies so they had better get the other test done, just in case it ends up being useful in a criminal investigation, again, why would they? We only know with hindsight that this would have been ideal. Going back to the babies getting better within a couple of days, based on the information we currently have available the pathologies that would cause high insulin and low c-peptide are chronic conditions, they don't happen acutely and they're very rare in infants. In addition to this there is plenty of other circumstantial information, such as, the start of the decline of the babies coincides with when the bags were hung, they were able to establish opportunity etc. From memory I believe one of the babies recovered when Letby had a couple of days off. With the benefit of hindsight, once everything is put together the only logical conclusion is that the babies had been poisoned and this is what was presented to the jury.
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Post by gawa on Sept 16, 2024 15:25:08 GMT
My point is that while high insulin and low c peptide can be indictive of insulin administration. There are also a load of things relating to the collection, storage and transport of a blood sample which can also cause this. I presume the reason it suggests the tests should be sent to a lab for further testing is to confirm this as tests such as mass spectrometry would. The fact this wasn't done means there isn't conclusive evidence and reasonable doubt. An insulin metabolism expert, Stephen O'Rahilly, referenced an example from a recent case where parents were under investigation for exogenous administration of insulin in a child. In this instance the Mass Spectrometry test proved that it wasn't exogenously administrated and the cause of the high levels was proinsulin. There also seems to be a third baby, not involved in the criminal case, who had high insulin and low c peptide recorded at the same hospital but was given a diagnosis of hyperinsulinism. So I guess my question to you is. How can you be certain that these results are indictive of exogenous insulin administration? And if that was the assumption of the hospital at the time, why did they not follow procedure and get the tests down to confirm it? Is the point not to prove someone is guilty without doubt. But by not following the protocol to prove exogenous insulin administration it has added doubt. Especially when there are examples of other kids from the same hospital with similar test results get diagnosis which aren't indictive of exogenous administration? Surely if this was suspected at the time then further tests should have been done to prove it. As they weren't it adds needless doubt to the case, as protocols which could have been followed weren't. So how are you so certain it is indictive of this? And in the two examples I've provided with similar results - are you suggesting the diagnosis was wrong? Or are you happy to concede that without further testing (mass spectrometry) these tests don't prove exogenous administration and therefore cannot be relied on. What it does do is raise further questions about the operations of the practice. If these tests are indictive of possible poisoning, why wasn't this raised at the time or further tests done? Because again if this is crystal clear that insulin has been administered when it shouldn't have been on a child, then surely it should have been investigated? But it wasn't. So either the tests alone aren't as indictive as you are portraying. Or serious questions need to be asked about the management of the practice and why tests which show poisoning of children were ignored. Correct me if I'm wrong please. You've indicated again that standard testing protocol wasn't followed, you've said the hospital haven't followed the 'procedure'. Correct me if I'm wrong but I'm going to presume you're referring to the fact that the blood sample could have been referred to the Guildford lab which then would have specifically determined the endogenous and exogenous insulin. So we need to look at the context. At the time the hospital sent the blood tests the babies were symptomatic with hypoglycaemia, and they didn't know why. The hospital staff did not suspect that the babies had been poisoned at the time because, why would they, they don't know about the low c-peptides at that point because the test hasn't yet been done. They're just trying to establish what is causing the hypoglycaemia so that they can treat it. It is possible, although rare, that an infant does have a pathology that could cause a high insulin and low c-peptide hypoglycaemia. I've already mentioned one myself, Insulin Autoimmune Syndrome and you've raised another case which I'm not familiar with. To establish those sorts of pathologies you would need further testing. It's also worth noting that these sort of tests don't involve quick turnarounds, it can take days. However, what happened concerning Letby is that the babies got better within a couple of days, therefore from the hospital's point of view there was no need to do the further testing as the hypoglycaemia had resolved itself through treatment. The only thing the hospital is interested in keeping people alive and once the issue has resolved they move on. They're not thinking someone has deliberately poisoned the babies so they had better get the other test done, just in case it ends up being useful in a criminal investigation, again, why would they? We only know with hindsight that this would have been ideal. Going back to the babies getting better within a couple of days, based on the information we currently have available the pathologies that would cause high insulin and low c-peptide are chronic conditions, they don't happen acutely and they're very rare in infants. In addition to this there is plenty of other circumstantial information, such as, the start of the decline of the babies coincides with when the bags were hung, they were able to establish opportunity etc. From memory I believe one of the babies recovered when Letby had a couple of days off. With the benefit of hindsight, once everything is put together the only logical conclusion is that the babies had been poisoned and this is what was presented to the jury. I don't know if procedure was followed but I'm sort of insinuating two separate things: - Amongst other conditions potentially being a cause for the results. The handling, collection and storage of the blood samples can also result in low c peptide compared to high insulin. - Therefore to rule out any doubt, it is clearly labelled on the test that "If exogenous insulin administration is suspected...inform the lab so the sample can be referred externally for analysis" The results were never sent for analysis which would have involved different testing to rule out any sampling/handling errors and also to confirm without doubt if insulin was administrated exogenously. As this wasn't done then it means either a) Exogenous administration wasn't suspected. b) Protocol wasn't followed. And due to the above there is reasonable doubt to question the results. From what I gather you seem to continue to argue that because it was low c peptide and high insulin it means it was exogenously administered but the only way to prove this is to do the additional testing which wasn't done. It's like trying to diagnose pancreatic cancer solely based on a high ca-19 marker without doing further tests as per protocol. "The hospital staff did not suspect that the babies had been poisoned at the time because, why would they"Well because according to your posts a high insulin level and low c peptide is a sign of exogenous insulin administration. So they should have reason to suspect the baby was poisoned based on that and their knowledge on whether insulin should have been administered or not. The only reason I can see why the wouldn't suspect this is if the test results you're using as evidence of exogenous administration aren't as robust and clear cut as you've said. If they're enough to prove someone guilty of poisoning a child. Then surely they're enough for a nurse to suspect a child is poisoned? " ...they don't know about the low c-peptides at that point because the test hasn't yet been done."My bad I should have read past the comma. But the hospital staff did take the blood samples when the child was sick and get the results back. If someone attempts to murder someone, you don't stop investigating it because the person survived. So once again these results would have came back to someone in the hospital showing, what you consider conclusive proof of potential poisoning, and again nothing flagged and no further testing done. So it either points to a) hospital staff not following protocol and questions about the unit as a whole b) The tests maybe aren't as indictive as you think. Whichever it is, it doesn't look good on the hospital. As the tests weren't sent on that suggests to me exogenous administration wasn't suspected because had it been... the steps on the test would have been followed. "It is possible, although rare"And therefore for that reason the results cannot be trusted to prove guilt without doubt. "They're not thinking someone has deliberately poisoned the babies so they had better get the other test done, just in case it ends up being useful in a criminal investigation, again, why would they?"
Well according to you those results are indictive of exogenous insulin administration and it is rare it's caused by anything else by your own admission. So if three separate children have all had tests indicative of poisoning and if the test says "if you suspect this do this" and on three occasions it wasn't done, of course questions have to be asked about why it wasn't? This all points to a clear failing by the hospital itself and it is there in competence as to why this evidence can now no longer be trusted. "Going back to the babies getting better within a couple of days, based on the information we currently have available the pathologies that would cause high insulin and low c-peptide are chronic conditions, they don't happen acutely and they're very rare in infants."What pathologies do we have available? I read something about pregnant women with diabetes can cause high levels of a precusor to insulin, is this included. But again this is all ifs and buts. If we wanted to know for certain there is a simple test which could be performed and wasn't done on 3 occasions. Did someone say that the standards of the hospital or something were coming under investigation before the Lucy Letby link was found? Not getting any of those three tests sent for external examination or even flagging the possibility of exogeneous administration of insulin being a potential cause in any of the cases at the time would sort of back up that claim about the hospital not meeting standards. "...such as, the start of the decline of the babies coincides with when the bags were hung,"But when one of the bags were hung for a baby which did decline, there is no evidence of Letby even being in the hospital at the time. So are you implying that she was now leaving contaminated bags in the fridge to poison the babies and this again all went undetected? So does that not mean that there should be evidence of lots of kids who declined when Lucy Letby wasn't present because she was also contaminating all the bags of feed? How does one contaminate a bag of feed and ensure said feed is then used hours later on their target. Or was it just random bags for random targets do you think? Or did Lucy somehow evade being recording in the hospital by using a colleagues pass or something and this allowed her to poison the baby with insulin when she wasn't there? "With the benefit of hindsight, once everything is put together the only logical conclusion is that the babies had been poisoned and this is what was presented to the jury."
There are plenty of possible conclusions but I do find it rather convenient that the one test which could give conclusive proof wasn't done on three separate occasions and that points to further questions about the practice of this hospital. I'm not sold at all on this insulin evidence. Also side note. I can't remember who posted the source a few days back but I remember reading about one of the people involved in the investigation. And one really strange thing which grabbed me in the article was that they mentioned they got involved after "reading about an article in the local newspaper in relation to an investigation in the hospital" and they then contacted the police and asked if they could help. In 2024... reading a random story in a newspaper... and then contacting police about said story... and suddenly being involved in the investigation. Now I know this Drs credentials are disputed on whether or not he is an expert in the field he is investigating. Presuming he isn't an expert then of course questions would be asked of the police why they have got someone involved who isn't an expert, surely they should have sourced someone better qualified. So does this whole story of "Oh I just happened to read it in a newspaper and offered to help" sort of remove any line of questioning in relation to why the police selected this particular expert. I know the last two paragraphs probably sound a bit far fetched. But I just find it very weird in 2024 for someone who has been involved in past cases (I think I read) to then be involved in this one by chance after reading a newspaper. I'd be interested to know how common it is for this to occur as it just sounds a bit far fetched to me and a convenient way of making said person seem impartial rather than a trusted individual to carry out the investigation to someones liking.
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Post by gawa on Sept 16, 2024 15:30:55 GMT
PS: Not being a dick here Rick, I'm open minded on it all. Just stating my reasons for why I feel there is reasonable doubt over those tests.
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Post by Rick Grimes on Sept 16, 2024 18:42:57 GMT
PS: Not being a dick here Rick, I'm open minded on it all. Just stating my reasons for why I feel there is reasonable doubt over those tests. No issues from me, it’s clear you’re engaging in good faith. I’m not trying to be a dick either. Your first two points where you’re saying there should be reasonable doubt are just a non-issue. No one the hospital suspected it was down to exogenous insulin so it was sent to the right lab according to procedure at the time. Just as unfounded are the concerns over the storage etc, the entire process was explained in court and there is no doubt about the results. There would be no point in sending any insulin tests to that lab if we went by your logic. Once the insulin to c-peptide ratio was identified by the lab it’s arguable it could have been sent to the other lab to be retested but even at this point no one suspects poisoning and the babies got better so there was nothing further that needed to be established. It was only when Dr Evans was sifting through the reports for the investigation that the poisoning was first identified. The process was followed and there are no doubts about the accuracy of the result. So when the ratio and the fact that the expert Prof Hindmarsh has ruled out other pathologies/reasons, it is absolutely fair and right to point the finger at Letby because of the weight of the evidence as a whole. I don’t know the ins and out of pathologies because I’m not an expert is. Professor Hindmarsh is though and that’s her judgement. The speed of the recovery, the timing coinciding with bags being administered and other evidence are all crucial. Regarding the bags in the fridge, they have a shelf life and as such are dated so nurses getting bags out are always going to use the shortest dated ones so I don’t think it’s as difficult as you might think at it narrows down the potential bag that would have been used. You might not be convinced based on what I’ve said but the jury, who had a lot more information to go through than either of us saw fit to convict her.
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Post by mickeythemaestro on Sept 16, 2024 18:50:51 GMT
Is truth serum a real thing? Can't we just give her a dose of that and ask her if she done it or not 🤔
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Post by numpty40 on Sept 16, 2024 19:05:14 GMT
The conspiracy theorists seem to believe that the standard of proof in legal terms has changed from reasonable doubt to absolutely no doubt.
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Post by Rick Grimes on Sept 16, 2024 19:15:39 GMT
The conspiracy theorists seem to believe that the standard of proof in legal terms has changed from reasonable doubt to absolutely no doubt. I’m not putting gawa in this category but yeah you’re right a lot of people have a completely flawed understanding of how the justice system works. Social media is absolutely full of airheads making completely mental points and thinking they’re so smart that if they were on the jury, they wouldn’t have convicted her. The type of people that think if they were a German in Nazi Germamy they would have been dead against Hitler. It’s just bollocks.
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Post by redstriper on Sept 17, 2024 8:00:00 GMT
They're (truth serums) not reliable apparently, and not admissible either. Lie detector tests are supposed to be 98% accurate, if she is innocent as she says maybe she should have volunteered to take one.
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Post by Rick Grimes on Sept 17, 2024 13:34:49 GMT
Haven't seen it properly discussed in this thread but the testimony from the mother and father of babies E and F (twins), particularly in relation to child E is very compelling from a circumstantial evidence point of view. www.chesterstandard.co.uk/news/23122195.recap-lucy-letby-trial-monday-november-14/Child E's mum gave testimony that she went into the room where the baby was just before 9pm. Child E was making a horrendous sound which wasn't normal crying and there was blood around his mouth. She asked Letby what was wrong and Letby said the feeding tube was rubbing the back of the throat and that would have caused the blood. Child E's mum was concerned because the blood wasn't fresh and after getting back to the post-natal ward phoned her husband to tell him what had gone on because she felt something was wrong, the records show this call was made at 9:11pm and lasted 4 minutes and 25 seconds. When she returned to the ward later that evening Child E was being resuscitated, she called her husband again to tell him to get to the hospital. Unfortunately the attempts were unsuccessful and Child E died. Child E's father testified that during the phone call at 9:11pm the mother had told him about the bleeding from Child E's mouth. The defence put forward for Letby is that the mother and father are lying.Letby writes a note retrospectively at 4:43am to say that the mum was in the neo-natal ward at 8pm. The mum denies this, she was in the post-natal ward 7:00pm-8:30pm. Medical records show that Letby recorded 'fresh' blood at 10pm. There is no mention of any blood or the presence of the mother at all in a note written for 9pm. It was put forward by the defence that the mother came to the ward as late as 10pm, that Letby never mentioned the tube was 'irritating Child E' and that the screaming was "not as bad as that [horrendous]." In addition it is suggested the blood was only mentioned in the later call to the father, and was not mentioned in the 9:11pm call. I just don't believe that the mother and father were lying.
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