Lucy Letby: Difference between revisions
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==Evidence== | ==Evidence== | ||
===Insulin “smoking gun”=== | ===Insulin “smoking gun”=== | ||
In two cases (Child F and Child L) lab tests indicating high levels of insulin without accompanying c-peptide, which is prime facie evidence of administered insulin (naturally occurring insulin is accompanied by c-peptides; artificially administered insulin is not). Insulin was not prescribed for either infant. | In two cases (Child F and Child L) lab tests indicating high levels of insulin without accompanying c-peptide, which is prime facie evidence of administered insulin (naturally occurring insulin is accompanied by c-peptides; artificially administered insulin is not). Insulin was not prescribed for either infant. If it was true that insulin was added without prescription this is evidence of actual human agency in these two episodes. | ||
If it was true that insulin was added without prescription this is evidence of actual human agency in these two episodes. | |||
The defence team accepted the prosecution’s claim that insulin was added to parenteral nutrition bags and it was presented to the court as an agreed fact.<ref>{{plainlink|https://www.scienceontrial.com/post/criminal-justice-in-england-disagreeable-facts|Science on Trial}}</ref> | The defence team accepted the prosecution’s claim that insulin was added to parenteral nutrition bags and it was presented to the court as an agreed fact.<ref>{{plainlink|https://www.scienceontrial.com/post/criminal-justice-in-england-disagreeable-facts|Science on Trial}}</ref> | ||
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“Please note that the insulin assay performed at RLUH is not suitable for the investigation of factitious hypoglycaemia. If exogenous insulin administration is suspected as the cause of hypoglycaemia, please inform the laboratory so that the sample can be referred externally for analysis.”}} | “Please note that the insulin assay performed at RLUH is not suitable for the investigation of factitious hypoglycaemia. If exogenous insulin administration is suspected as the cause of hypoglycaemia, please inform the laboratory so that the sample can be referred externally for analysis.”}} | ||
*'''The test results seem to indicate very high levels of insulin''': 4657 pmol/L is about four times a dangerously high level in an adult.<ref>There is plenty of online angst about whether the level recorded was abnormally high or ''absurdly'' high, such that such a level had never been witnessed in medical history: let’s go with abnormally high.</ref> While, yes, this is what you might expect a murderer to try to do — | *'''The test results seem to indicate very high levels of insulin''': 4657 pmol/L is about four times a dangerously high level in an adult.<ref>There is plenty of online angst about whether the level recorded was abnormally high or ''absurdly'' high, such that such a level had never been witnessed in medical history: let’s go with abnormally high.</ref> While, yes, this is what you might expect a murderer to try to do — | ||
*'''Both babies recovered''': You might expect premature babies registering such high insulin levels — | *'''Both babies recovered''': You might expect premature babies registering such high insulin levels — four times a critical level for an adult<ref>See: ''Very Well Health: Hyperinsulinema (High Insulin Levels)''[https://www.verywellhealth.com/hyperinsulinemia-is-associated-with-type-2-diabetes-1087717#:~:text=Your%20insulin%20levels%20are%20considered,could%20be%20diagnosed%20with%20hyperinsulinemia. .]</ref> — might have at least caused a fuss at the hospital. But not only did the babies make a full recovery, with no record of hypoglycemic coma, but — | ||
*'''No-one even noticed the high insulin in their tests until 2018''': That is, three years ''after'' the babies made a full recovery. If you are looking for a [[res ipsa loquitur]] about these events, can we suggest that this is as indicative of negligence in the clinical staff administering the test, or the self-professed unreliability of the tests for detecting factitious insulin. | *'''No-one even noticed the high insulin in their tests until 2018''': That is, three years ''after'' the babies made a full recovery. If you are looking for a [[res ipsa loquitur]] about these events, can we suggest that this is as indicative of negligence in the clinical staff administering the test, or the self-professed unreliability of the tests for detecting factitious insulin. | ||