Child Q
The prosecution’s theory: Air into stomach.
Outcome: Survived
Gestation: 31+3 weeks, 2.076 kg, male
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Prosecution theory
Air into stomach.
Method alleged: Air-in-stomach via NG tube.
Prosecution experts: Dr Dewi Evans; Dr Sandie Bohin.
Panel view (Feb 2025)
Panel: the deterioration with vomiting was because he was developing early necrotising enterocolitis or sepsis. No evidence to support air injection into the stomach.
Pathology
No fatal outcome — he recovered and was discharged home. Panel conclusion: Baby 17's deterioration with vomiting was because he was developing early necrotising enterocolitis (NEC) or sepsis; there was no evidence to support air injection into the stomach through the nasogastric tube. He was in fact treated for NEC at Alder Hey. The Panel addresses the central prosecution point directly: the nursing notes state that Neopuff and bagging were applied AFTER the vomiting, and the '++ air' was aspirated from the nasogastric tube after that bagging — so the air was most likely introduced by the bagging. Had enough air been pumped in to splint the diaphragm and cause collapse, the abdomen would have been tense and hard and the later X-rays would still show it; the notes record a soft, non-tender abdomen and the X-rays showed no gaseous distension.
Natural-cause alternatives identified
- Early necrotising enterocolitis or sepsis — the Panel's stated cause (he was later treated for NEC at Alder Hey)
- Air introduced by Neopuff and bagging applied after the vomiting, explaining the '++ air' aspirated from the NG tube
- Delays in escalating ventilation leaving him acidotic and poorly ventilated
What the jury did not hear
- The Panel's conclusion that the deterioration was early NEC or sepsis — he was subsequently treated for NEC at Alder Hey.
- That the nursing notes record bagging was applied BEFORE the '++ air' was aspirated from the NG tube — so the bagging most likely put it there.
- That the abdomen was recorded as soft and non-tender, and the later X-rays showed no gaseous distension — inconsistent with enough air to splint the diaphragm.
Key primary sources
- International Expert Panel — Additional 10 Cases report (June 2025), Panel Baby 17: https://lucyletbyinnocence.com/shoo-lee/International%20Expert%20Panel%20New%20Summary%20Report%20of%20additional%2010%20cases.pdf
- R v Letby sentencing remarks (August 2023)
Read the full long-form analysis →
Sources:
- Court of Appeal judgment (May 2024) and sentencing remarks — judiciary.uk
- Shoo Lee International Expert Panel Report (February 2025) — lucyletbyinnocence.com
- Per-baby trial evidence archive — lucyletbyinnocence.com
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