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Why experts continue to question the 'Killer nurse' Lucy Letby case

LAUREN FRAYER, HOST:

We turn now to a true crime case that's captivated Britain, where I live. Lucy Letby was a neonatal nurse convicted of murdering babies in her care - one by one, quietly, often at night, at the hospital where she works. The tabloids called her an angel of death.

(SOUNDBITE OF MONTAGE)

UNIDENTIFIED REPORTER #1: Party girl, graduate, bright young nurse.

UNIDENTIFIED REPORTER #2: Lucy Letby seemed like an ordinary woman.

UNIDENTIFIED REPORTER #1: For evil, hiding in plain sight.

FRAYER: Coverages focused on her appearance, young and blonde, how she doodled the words - I am evil; I did this - in her journal. But while Letby serves a life sentence, some forensics experts are now asking, did she actually do this? Or, at least, did she get a fair trial? And to probe that question, I'm joined here in our London studio by the BBC's Stephanie Hegarty, who reported a podcast called "Lucy Letby: The Killer Questions." Welcome.

STEPHANIE HEGARTY: Hi. Thanks for having me.

FRAYER: Thank you so much for coming. So let's just dive into the evidence. On what basis was Letby convicted?

HEGARTY: So this was one of the longest trials in English criminal history. It went on for 10 months, and she was eventually convicted on 15 separate charges for seven murders and eight attempted murders. And there was a huge amount of evidence. The police investigation went on for about six years - I think - from 2017 up until the main trial last year. So the backbone of the case - the prosecution's case was that Letby was the only nurse who was always there when babies collapsed and some of them then died, when it was unexplained or unexpected.

FRAYER: So she was in the room. Were her fingerprints on - was there a murder weapon?

HEGARTY: So this is a big problem with this trial. There was no forensic evidence and no eyewitnesses. No one ever saw Letby commit a crime. And instead of forensic evidence, what the prosecution really relied on was medical evidence. So the notes of the baby's conditions, nursing notes, medical notes. There were various different methods that she was convicted of hurting these babies by. One was injecting air into their veins. One was injecting air into their stomachs via their feeding tubes. Another was administering insulin when they didn't need it. And again, no one ever saw these things happening.

FRAYER: Some of those notes - there were also some journals. I mentioned these doodles of, I did this - I mean, seemingly really damning evidence. But later on, we found out that's not quite as it appeared.

HEGARTY: This was a Post-it note, and the image of it was shared really widely in the media. They...

FRAYER: Front page of papers.

HEGARTY: Yeah. And there was lots of scrawl and scribble on this Post-it note. But there was one part where she said, I'm evil; I did this. And that on the face of it, it's very damning.

FRAYER: It's chilling.

HEGARTY: There was other things, many other things written on that Post-it note. One of them was - why me? One of them was something like - I didn't do anything wrong. That wasn't reported as widely in the media. This was written in response to a prompt from one of her counselors to, you know, get everything off her chest - I suppose a therapeutic kind of process.

FRAYER: And then that was used against her at trial.

HEGARTY: The prosecution did refer to it repeatedly.

FRAYER: So what concerns are being raised now and by whom? She's already in jail - 15 charges...

HEGARTY: Fifteen whole life sentences.

FRAYER: Yeah. Charges...

HEGARTY: Yeah. She's only one of four British women who has been sentenced to spend her whole life in prison. The backbone of the case is really based on statistics, proving that one nurse is the only person who's always there when these things happened. You know, is it possible that one just happens to be on the ward more often? Is it possible that one nurse is working with sicker babies and therefore might be more likely to be there when a baby dies?

FRAYER: At trial, the names of the babies who died in Letby's care were given pseudonyms, so they were Baby A, Baby B, and so on. I think it went up to Baby P or Q. That's a lot of babies, a lot of grieving families for whom the coverage of this, and us even having this conversation, is painful. Can you talk about the sensitivity that you had to bring to your reporting on something like this?

HEGARTY: These families have been through - you know, the first of these cases was in 2015. Having an answer at the end of it was so important. And the fact that these questions now rock the - any sort of sense of closure they were able to have, I think has been devastating, as anyone can understand.

FRAYER: These murders coincided with a spike in infant mortality in Britain. Austerity measures have left hospitals short-staffed. Maternal outcomes are now worse in Britain than in much of Europe. Tell me about the systemic problems that are the backdrop.

HEGARTY: So what we found in our reporting and through a number of leaked documents from the Countess of Chester Hospital, where all of this happened, was that it was really struggling. It was facing a number of really serious challenges. Staff were understaffed and under skilled. There was also an issue with the transport service. So these hospitals operate in a network where really sick babies will be transferred to a hospital that can deal with more complex issues. And there were serious issues with that service, that it wasn't available when they needed it.

And then there was a bacteria outbreak in a ward. It's called pseudomonas. And it's not that harmful to healthy people, but for - in an ICU, especially a neonatal ICU, it can be really dangerous. We couldn't directly link any of these issues to the deaths or the collapses that happened that were the subject of this trial. But they certainly created a picture of a unit that wasn't operating at its best.

FRAYER: The U.K. law differs from the U.S. when it comes to reporting on litigation that's ongoing. But some of the reporting on Letby has been censored in this country. There was a story in The New Yorker magazine that wasn't allowed to be published in the U.K. And so when it was published online, friends here were sharing PDFs because the website was blocked in the U.K. Tell me about how those legal restrictions have complicated your own reporting.

HEGARTY: The reason for that is the U.K. has really strong contempt of court laws. The media is only allowed to report what happens on a day-to-day basis in that trial. And people aren't allowed to speculate about guilt or innocence or what the outcome of the trial might be. It was really hard to get people to speak, even off the record, which was - or, you know, a private phone call, which is perfectly legal. People were really reluctant because they were scared.

FRAYER: In America, there's been series and obsession with missing girl cases, and the victims are frequently young, white women. Lucy Letby is a young, white woman. Has race and gender affected the way this case has either been prosecuted or the media coverage of it?

HEGARTY: There is a fascination, I think, with women murderers, so gender definitely. There is also a fascination with women who can harm children. So I think it's the nature of the crimes, really. But over the course of the trial, very little was exposed about who this woman is beyond painting a picture of someone who is just very ordinary. So often in these cases where women harm children, there is a history of psychiatric disorder. There was nothing like that in Lucy Letby's history. Also, she was well-liked on the ward. She was thought to be a competent nurse. The judge even said that in his sentencing remarks. Like I said, she was nothing but if not ordinary. And I think that did create a kind of fascination with who she was and why these crimes occurred.

FRAYER: That's BBC correspondent Stephanie Hegarty. Her podcast is called "Lucy Letby: The Killer Questions." Thank you so much.

HEGARTY: Thank you. Transcript provided by NPR, Copyright NPR.

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Lauren Frayer covers India for NPR News. In June 2018, she opened a new NPR bureau in India's biggest city, its financial center, and the heart of Bollywood—Mumbai.