Child K — an undersized breathing tube, not a dislodged one
The prosecution’s claim: At the Child K retrial (July 2024), Dr Ravi Jayaram testified that he walked into the nursery to find Letby standing over the infant, whose endotracheal tube had become dislodged and whose oxygen-saturation alarm had been silent. The jury convicted on this single count.
Prosecution claim
At the Child K retrial (July 2024), Dr Ravi Jayaram testified that he walked into the nursery to find Letby standing over the infant, whose endotracheal tube had become dislodged and whose oxygen-saturation alarm had been silent. The jury convicted on this single count.
Counter-evidence
The Panel reviewed Child K's medical notes and found no evidence that the endotracheal tube had been dislodged at all. On its reading the deterioration is explained by the tube itself: Child K had been intubated with a size 2 tube where a size 2.5 was needed, producing a 94% air leak — almost all of each delivered breath escaping around the tube instead of reaching the lungs. The Panel also found that the incubator alarms had not been turned off. Both physical premises of the count — a displaced tube and a silenced alarm — are, on the Panel's review of the records, not made out. Separately, analysts comparing Dr Jayaram's 2016 contemporaneous notes with his 2024 testimony have highlighted material differences in his account of where he was, what he saw and when the alarm was sounding.
Key point: A 94% air leak around an undersized tube will destabilise a 25-week infant on its own. The Panel found no evidence the tube was dislodged, and no evidence the alarms were turned off.
What the jury heard
The Child K retrial (June–July 2024) focused squarely on Dr Jayaram's eyewitness account. The jury was told his testimony was consistent with his 2016 contemporaneous notes.
What the Panel says
The Panel found no evidence that Child K's endotracheal tube had been dislodged. It attributes the deterioration to an undersized endotracheal tube — a size 2 where a size 2.5 was required — producing a 94% air leak, and it found that the incubator alarms were not turned off.
What independent experts add
- An undersized endotracheal tube leaks: the bigger the leak, the less of each breath reaches the lungs. A 94% leak is a mechanical explanation for instability that requires no third party.
- The Panel's finding that the incubator alarms were not turned off removes the second factual pillar of the eyewitness account.
- Independent analysts have highlighted differences between Dr Jayaram's 2016 notes and his 2024 oral testimony — location, sequence of alarms, and what was seen.
- lucyletbyinnocence.com has archived a side-by-side transcript of Jayaram's 2016 and 2024 accounts.