It's time for this Lucy Letby is innocent madness to stop: I sat through almost every day of her two trials. Here's the evidence I believe proves her guilt, writes LIZ HULL

• e-mail

Just over a fortnight has passed since Lucy Letby was handed a 15th whole-life sentence for trying to murder another premature baby girl entrusted to her care.

Baby K was the former neo-natal nurse's 14th victim — a tiny, defenceless infant, born 15 weeks early — who a second jury took a little over three hours to decide had been deliberately harmed at her hand.

I wrote in these pages soon afterwards about the strange band of misfits and ghouls who — convinced Letby is innocent and emboldened by conspiracy theorists online — travelled daily to Manchester Crown Court to see the woman in the dock who, they insist, is the real 'victim' in this case.

She's a scapegoat, they claim, for a failing NHS hospital; condemned to die in jail by a flawed and biased justice system.

Alarmingly, within days this group of dissenting voices began to grow and quickly moved into the mainstream, with articles in respected newspapers questioning whether both juries had 'got it wrong'.

Just over a fortnight ago, convicted killer nurse Lucy Letby was handed a 15th whole-life sentence for trying to murder another premature baby girl entrusted to her care

Was Letby — who desperately protested 'I'm innocent' as she was led away for the final time — really guilty of the cold-blooded murder of seven babies and the attempted murder of seven more?

The reports quoted medical professionals expressing doubts over the efficacy of tests to trace insulin in the babies, whose drips of feed and medicine had been contaminated with the drug, and the science of air embolism, the injection of air bubbles into the babies' bloodstreams. They also cited the concerns of statisticians, who claim the Prosecution relied on flawed hospital shift data.

Even in this newspaper, my colleague Peter Hitchens added reason and weight to the hysteria, writing how he felt 'baffled' by the Court of Appeal's 'swift' rejection of Letby's bid to contest her guilty verdicts. He also highlighted the 13,000-word dissection of her case by Rachel Aviv in The New Yorker magazine as evidence it should go before the Criminal Cases Review Commission.

I was one of four journalists who sat in court for almost every day of both of Letby's trials — around 160 days in total — and was also present for all three days of her Court of Appeal hearing.

I'm happy to say I'm not 'baffled' by the decision at all.

As I have stated previously, in the early stages, I — like many — doubted that this dedicated young nurse could have been responsible for some of the most heinous crimes in modern times.

Much of the evidence against her was circumstantial and all but one of the babies was born early and fragile. But — after listening to dozens of consultants, junior doctors and nurses from the Countess of Chester Hospital plus the evidence of eight expert doctors — I, like both juries, became convinced these children had been deliberately murdered or harmed.

A lot of this complex testimony — involving pages of medical records, nursing charts and documentation — was reported by myself and my colleague Caroline Cheetham via our award-winning podcast on Letby's trial.

Supporters of Letby demonstrate outside the High court in London during her appeal hearing. The campaigners claim she is a victim of a miscarriage of justice

But such evidence, by its very nature, is difficult to assimilate, which meant much of it did not make it in to the pages of newspapers — including those now questioning Letby's guilt.

Now, however, I believe the time is right to return to some of that evidence, to point out how important elements of the Prosecution case have been overlooked.

None of the doubters spent any time listening to the original case against Letby and have, at best, misunderstood and, at worst, simply ignored compelling and cumulative testimony in favour of cherry-picking evidence to suit their own misplaced narrative.

It is time for some serious sense to be delivered.

Here is the evidence that I believe proves Lucy Letby's guilt beyond all doubt.

The star witness

Of all the experts involved, Dr Dewi Evans, the Prosecution's lead medical witness, has come under the greatest scrutiny from doubters. Several have pointed out that Letby's defence KC, Ben Myers, twice tried – but crucially failed – to have his testimony thrown out for being biased.

Dr Evans worked as a paediatrician in hospitals in South Wales for 30 years and led the development of neonatal intensive care services before retiring in 2009.

He has produced hundreds of expert reports for the criminal and family courts and examined the medical notes of around 90 babies treated at the neonatal unit of the Countess of Chester Hospital.

He told me this week that he strongly refutes the allegations made in the articles and points out that he gave his testimony under oath. He says 'denial is a natural and understandable instinct' from people struggling to come to terms with events 'too awful to comprehend'.

Those protesting Letby's innocence want to 'shoot the messenger' but he insists his explanations for what happened to the babies were backed up by eight experienced specialist doctors during the trial.

Significantly, none of the (mainly anonymous) doctors and specialists now calling out his theories had access to any of the babies' medical notes that he spent months examining.

Letby pictured during her police interview on the July 3 2018

The defence expert

There has been much speculation online and in recent reports about why Letby's defence team failed to call their own expert, paediatrician Dr Mike Hall, to give evidence.

I've seen Dr Hall's report in relation to Baby A, the baby boy who was the first of Letby's victims. Dr Hall concludes that his cause of death was 'unascertained' but does not rule out air embolism or that a member of staff deliberately injected air to cause harm.

'If air embolism was the cause of Baby A's death it could have come about as a result of either inadvertent or deliberate actions taken by staff caring for him,' his report states.

Letby's defence team have never commented publicly on why Dr Hall wasn't called, but the only assumption must be that they did not believe his evidence would be helpful to Letby's case.

Sewage and insulin

Defence witness Lorenzo Mansutti, the estates manager at the Countess of Chester Hospital, told the jury that plumbers were called out five times to drainage problems at the unit in 2015 and 2016. It has been suggested online — and hinted at in The New Yorker article — that sewage back-ups in sinks on the unit could be behind the babies' deaths. However, no evidence was presented to show any of the infants contracted bacterial or parasitic infections linked to dirty water.

Similarly, although Letby's KC Mr Myers challenged the quality of blood samples which belatedly revealed two of the babies had been poisoned by insulin, the barrister never questioned whether the tests were suitable for use in a criminal prosecution, as some journalists have done.

But it was Letby herself, from the witness box, who said that 'somebody' added insulin to their drips, insisting: 'It wasn't me'.

The liver injury

Conveniently disregarded by The New Yorker and others, arguably the most important piece of evidence against Letby was the serious liver injury and internal bleeding suffered by Baby O, the first of two triplet brothers murdered on consecutive shifts, in June 2016.

His original post-mortem said the bleed was due to vigorous CPR. But Dr Andreas Marnerides, expert forensic pathologist from Guy's and St Thomas' Hospital in London, told the jury he'd only ever seen this type of 'extensive internal injury and haemorrhaging' in children involved in road accidents, or who'd fallen from trampolines or bicycles, or who'd been deliberately assaulted.

Letby herself, who was Baby O's designated nurse, accepted when she gave evidence that the injury took place 'on her watch'.

A court artist sketch of the convicted former nurse as she gives evidence during her trial at Manchester Crown Court earlier this month

Air in stomachs

The Guardian reported that seven neonatologists, who refused to give their names, have called Dr Evans' theory about how Letby injected air into the stomachs of several babies via their nasal feeding tubes, 'implausible' and 'ridiculous'.

Dr Evans admitted to me that injecting air in a nasogastric tube is 'utterly bizarre' and something he'd never heard of before. But he added: 'That doesn't mean it can't exist.

'Without access to the clinical records, I don't think these individuals are in a position to comment objectively.' He points out that all his reports were peer reviewed by Dr Sandie Bohin, the Prosecution's second expert witness, who also had access to the babies' medical notes and largely agreed with his findings.

Today the Mail can reveal that a third experienced neonatal paediatrician, Dr Martin Ward Platt, who was instrumental in setting up the first neonatal network in northern England, also assessed Dr Evans' initial reports. He too agreed that Babies G, I, O and Q all likely had air injected into their naso-gastric tubes (The jury failed to reach a verdict in Baby Q's case).

His report, which the Mail has seen, arguably goes further than those of Dr Evans because he identifies another baby boy, whose case was not part of either trial, who was likely hurt this way. Dr Ward Platt's report was never presented to the jury because he developed a terminal illness and died in 2019 before the trial began.

The shift rota data

A graph shown to the jury, which has Letby present at 25 collapses and deaths relating to all 17 alleged victims in the first trial, has been widely discredited by statisticians, according to The New Yorker and others. They say it is flawed because it excludes events relating to babies not on the indictment and covers too narrow a time frame.

But Dr Evans insists this is a misinterpretation of why and how the chart was created. He says all the cases he evaluated — apart from that of Baby L, the second child poisoned with insulin — were looked at 'blind,' months before the name 'Lucy Letby' was disclosed to him around the time of her first arrest in July 2018.

Crucially, Dr Evans says Cheshire police did not put together the shift graph until he had identified cases of suspected 'inflicted harm.' Only when officers cross-checked those events with staff on duty did the striking pattern of Letby's presence at every one emerge. Other deaths on the unit were not part of the Prosecution case because they were not suspicious, Dr Evans says, and not because Letby wasn't present.

Dr Dewi Evans, the Prosecution's lead medical witness, has come under the greatest scrutiny from doubters

The rash

Great focus has also been placed on the research, or lack of it, surrounding air embolus — air bubbles injected into the bloodstream — which block blood flow to the heart. Those who doubt Letby's guilt cite the trial's reliance on a single journal from 1989, co-authored by Dr Shoo Lee, an eminent neonatologist from Canada, which detailed a strange rash associated with the condition.

The Prosecution said eight of the babies, including five who died, displayed this rash.

Dr Lee didn't give evidence at the trial but told Letby's appeal he believed the rashes clincians saw at the Countess of Chester Hospital were not diagnostic of the condition.

Like other experts now questioning Letby's guilt, Dr Lee did not have access to the babies' medical notes or doctors' witness statements when making this assessment.

The appeal court ruled Dr Lee's evidence as inadmissible and, significantly, said the experts did not rely on the rash alone when they diagnosed air embolism in the babies.

The screams 

The suddenness of the babies' collapses, and their failure to respond to standard resuscitation, was also a feature of an injection of air, according to expert paediatricians. There was also harrowing testimony of parents, doctors and nurses, who described uncharacteristic 'screaming' from several of the premature babies, who likely suffered extreme pain.

Baby E's mother described walking into the unit to find Letby alone with her newborn twin boy 'screaming... like nothing I had heard before'.

Letby, the Prosecution said, had rammed a medical instrument down the boy's throat moments earlier, causing internal bleeding. She later injected him with air to kill him.

Then there was Baby N, the premature boy with haemophilia, who 'screamed' and couldn't be consoled for around half an hour when his designated nurse went on his break.

Dr Bohin told the court that it was 'absolutely extraordinary' for a premature baby to cry like that and Dr Evans said it was his view an injection of air had caused him to suffer a heart attack.

Letby's supporters conveniently ignore these features and also fail to mention that both Dr Marnerides and Professor Owen Arthurs, the eminent Cambridge-educated radiologist based at London's Great Ormond Street Hospital who also gave evidence for the Prosecution, backed up the theory that the babies had been harmed this way.

Professor Arthurs found unusual 'columns' of air in the major blood vessels of Babies A, D, and O. The jury was also shown a striking X-ray of a 'line of gas' in a blood vessel along Baby D's spine which, in the absence of a fracture or infection, Professor Arthurs said, must have been injected into her circulation. Dr Marnerides also found a bubble of air in Baby A's brain and lung at post-mortem, while Baby D also had gas in a blood vessel in her belly which could not be explained by infection or death.

Letby's behaviour

Those who doubt Letby's guilt regularly point out that nobody saw her injecting a baby or inflicting any harm.

That is true but, while the Prosecution insist she was 'hiding in plain sight', they also pointed to plenty of examples — conveniently ignored by her supporters — of when her behaviour gave her away.

There was the 'I am evil' confession note and the 257 nursing handover sheets recovered from addresses linked to Letby after her first arrest — 21 relating to babies she is alleged to have harmed.

Then there was the occasion when Letby told a colleague a baby 'looked pale,' when no lights were on in the nursery, and her face was obscured by a canopy.

That child, Baby I, had stopped breathing because Letby had attacked her, the Prosecution said. She was resuscitated, but Letby murdered her by injecting her with air the following evening.

After Baby I's death, her mother recalled Letby 'smiling' and making inappropriate comments. 'She kept going on about how she was present at the first bath and how [Baby I] had loved it,' the mother said. 'I wished she would just stop talking.'

She also sent Baby I's parents a condolence card and kept a picture of it on her phone for two and a half years.

Similarly, after Letby murdered Baby C, the shift leader told the jury she had to tell her to leave his parents alone.

And a senior consultant said that after the death of triplet Baby P, Letby — who had murdered his brother the day before — appeared 'excited'.

'She [Letby] was almost, sort of very animated [saying], 'Do you want me to make you a memory box for him, you know, like I did for Baby O yesterday?' I remember thinking, 'This is not a new baby, this is a dead baby, why are you so excited about this?'

Then there was the deliberate and cunning meddling of medical notes to place her elsewhere when children collapsed and the way she suggested false reasons for the deaths of babies in text messages to colleagues.

I have no doubt the jury took their job extremely seriously. They spent weeks mulling over each of the 22 charges in the original trial and let's not forget that they didn't convict her across the board. They cleared her of two attempted murders and were also undecided on another six.

Of course everyone is entitled to their opinion and, in the age of social media, armchair detectives have a vehicle to voice it. But only those 13 women and ten men of the jury sat through all the evidence in both trials.

And what must the families of the babies be thinking now? It must be almost impossible for them to bear.

For their sakes, and for faith in the jury system as the bedrock of our civilised democracy to endure, this parallel narrative must stop.

Justice has been done. It's time for the madness to stop.