When Dr. Shoo Lee, one of the most famous neonatologists in Canada, wrote an academic document in 1989, would never have imagined that one day he would help to condemn a British murder nurse.
But more than three decades after the publication of his document, this is what happened.
Lucy Letby, a former nurse in a neonatal unit in northern England, was judged guilty in two processes in 2023 and 2024 of the murder or attempted the murder of 14 children in her care and sentenced to life imprisonment, where she remains today.
The case shook Great Britain, seeming to exhibit a timeless serial killer who, said the ministries, used a bizarre range of techniques to kill its tiny, often premature, victims: by injecting them with air, enduring them with milk or contaminating their feed with insulin.
For seven of the murder accusations or murder attempt, the main witness of the accusation was based on the document of Dr. Lee of 1989 on a rare complication in infants – embolism pulmonary vascular air – to argue that Mrs. Letby had intentionally injected air into their veins.
The only problem? The expert witness had mistakenly interpreted his work, says dr. Lee.
“What they said was that this child collapsed and had an skin discoloring, therefore equivalent to plane absence,” said dr. Lee, 68, in an interview in London last month. But, he said, “it’s not what research shows.”
That realization put Dr. Lee on a moral mission to review the case of Mrs. Letby. Working Pro Bono, has collected 14 specialists from all over the world to evaluate clinical tests. Last month, he revealed their explosive discoveries: that “there were no medical tests in support of the criminal causing death or injuries” in none of the children that Mrs. Letby has been accused of damaging.
“If there is no malfunction, there is no murder. If there is no murder, there is no murderer,” said dr. Lee, adding, “And if there is no murderer, what is he doing in prison?”
Mrs. Letby has exhausted her roads to appeal to court. His only hope now lies with a small independent body, the Commission for reviewing criminal cases, which is responsible for the search for possible abortions of justice.
“I didn’t know if it was innocent or guilty”
Dr. Lee, who retired in 2021 to a farm in the rural areas of Alberta, knew almost nothing about the case of Mrs. Letby until an and -mailing has landed in his mailbox in October 2023.
Mrs. Letby had always maintained her innocence and her lawyer wanted Dr. Lee to meet the medical evidence. “At the beginning I thought it was a spam, why how much often do you receive such an e -mail?” Dr. Lee said. After a second and -mail, he realized that the request was real.
Dr. Lee had spent all his career concentrated on younger patients. After completing the School of Medicine in his native Singapore, he moved to Canada and trained in pediatrics before taking a neonatal scholarship at the Boston Children’s Hospital and later a doctorate of research. In Harvard health policy.
In 1995, he created the Canadian neonatal network, connecting specialists from all over the country to improve results for infants. He became pediatrician at the Mount Sinai hospital, Toronto, and in 2019 he received the order of Canada for introducing the best practices that reduced child mortality.
As he studied the transcriptions of the Lucy Letby process, Dr. Lee knew that his research had been misunderstood. “I didn’t know if he was innocent or guilty,” he recalls. “But regardless of whether you are innocent or guilty, you cannot be sentenced for wrong tests. It is simply wrong.”
He agreed to help with the request of Mrs. Letby of Appeal, writing to the Court of Appeal of England and subsequently providing live video testimonies. But in the end the court denied his request, saying that the testimony of Dr. Lee should have been introduced to the trial.
It was then that Dr. Lee decided to assemble a team of neonatal specialists to examine the case.
“This panel will not find a better group of people,” he said, touching a list that included the head of neonatology at the Pediatric Hospital in Filadelfia, a former president of the British Royal College of Pediatrics and the former director of the Neonatal Intensive Care Unit of the Boston Pediatric Hospital.
The key warning on which Dr. Lee insisted was that the revision of the panel would be released, regardless of their discoveries, even if they strengthened the case that Mrs. Letby was guilty.
‘You will have disasters’
The experts, who worked all on a voluntary basis, foreseely evaluated the cause of death or deterioration for each of the 17 children that Mrs. Letby was initially accused of murder or murder attempt.
Two experts examined the medical notes of each child separately. If their assessments differ, a third expert was introduced. The process was scrupulous and took four months. But the final results were clear, said dr. Lee. “In all cases, death or injuries were due to natural causes or simply bad medical care,” he told the press conference last month.
In the case of a child, for example, the accusation supported the process of being stable and had died of an air injection in his line IV, causing embolism. But the independent review discovered, based on her medical records, which had died of sepsis and pneumonia and that her mother, who had gone prematurely to Labor, had not received antibiotics to prevent infection.
In another case, a child born at 25 weeks was intubated using the wrong dimensions of the endotracheal tube. While the accusation said that Mrs. Letby tried to kill the child by removing the tube, the experts discovered that the child’s conditions deteriorated due to the injury caused by intubation with a too large tube and because a doctor did not understand “the basics of resuscitation, the loss of air, mechanical ventilation and how the equipment were commonly used in unit work”.
Part of the hospital staff, concluded the panel, took care of the most serious or premature children in a unit that only had to treat children with minor needs.
“You are asking doctors in places without the experience, without the infrastructure, to take care of children who are not ready to do,” said dr. Lee. “And if you do, then you will get disasters.”
Nobody has ever seen Mrs. Letby damage a child and important questions were raised for the first time on her fault in a New York article in May 2024. In the following months, dozens of medicine and statistical experts expressed concern about the tests.
Dr. Dewi Evans, the main witness of the accusation, did not respond to the requests for comment, but publicly criticized the work of the panel and said he was based on his testimony.
The countess of the Chester hospital, where the dead took place, said he was focused on an ongoing police investigation and on a public investigation that was established by the government last year to investigate how a serial killer could get away with these crimes for so long. At the beginning of this week, the former hospital manager asked for a stop at that investigation, in the wake of the review of Dr. Lee, but the judge refused, saying that the investigation never focused on the examination of Mrs. Letby’s fault.
Mark McDonald, current lawyer of Mrs. Letby, plans to include the complete report of Dr. Lee experts in his question to the Criminal Case Revision Commission, which can report the cases to the Court of Appeal. The Commission declared in a last month declaration that he had “received a preliminary question in relation to the case of Mrs. Letby and the work began to evaluate the question”.
The mother of a child that Mrs. Letby was sentenced for attempting to murder denounced the evaluation of the panel of experts and a spokesman for the CCRC asked “that everyone remembers the affected families”.
Dr. Lee insisted that those families were one of his central concerns while analyzing cases, after spending four decades to take care of children.
“I can tell you one thing: families want to know the truth,” he said. “They want to know the truth, regardless of whether it is painful or non -painful. They want to know what really happened.”