Babies O, P and Q — three different Panel findings, not one pattern
The prosecution’s claim: The Crown alleged Babies O, P and Q (triplets) deteriorated and Babies O and P died as a result of deliberate harm by Lucy Letby.
Prosecution claim
The Crown alleged Babies O, P and Q (triplets) deteriorated and Babies O and P died as a result of deliberate harm by Lucy Letby.
Counter-evidence
The Crown's triplet narrative required a single mechanism operating across three siblings. The Panel's review produces three different findings, and none of them is deliberate harm. Child O died from a subcapsular liver haematoma caused by a traumatic, extremely rapid delivery — a birth injury, bleeding into the peritoneal cavity, which the Panel does not attribute to CPR and does not regard as plausibly inflicted. Child P died from a pneumothorax that was suboptimally managed; the Panel found no evidence of air injected into the stomach or into an IV line. Child Q's picture is early NEC or sepsis, with the air aspirated from the nasogastric tube most likely introduced by the bagging that preceded the aspiration. Triplet pregnancies also carry substantially higher perinatal mortality than singletons before any allegation is added — but the Panel's case does not rest on statistics. It rests on three specific, unrelated causes.
Key point: The prosecution needed one mechanism across three triplets. The Panel found three different things: a birth injury, a mismanaged pneumothorax, and early NEC or sepsis.
What the jury heard
The triplet pregnancy was acknowledged. The obstetric history of Child O's delivery, the management of Child P's pneumothorax, and the fact that Child Q had been bagged before air was aspirated from the nasogastric tube were not developed as competing explanations.
What the Panel says
The Panel reaches a different conclusion for each triplet: Child O — a subcapsular liver haematoma caused by a traumatic, extremely rapid delivery, with the blind needle aspiration during resuscitation possibly adding further injury but not causing the death; Child P — a pneumothorax that was suboptimally managed, with no evidence of air injection into the stomach or an IV line; Child Q — early NEC or sepsis, with the aspirated air most likely introduced by the preceding bagging.
What independent experts add
- Child O: a subcapsular liver haematoma from an extremely rapid delivery; blunt inflicted trauma is implausible on the Panel's reading, and CPR is not the cause.
- Child P: a pneumothorax suboptimally managed — a failure of care, with no evidence of air injected into the stomach or an IV line.
- Child Q: early NEC or sepsis; the '++ air' aspirated from the nasogastric tube was most likely introduced by the bagging that preceded it.
- The jury reached no verdict on Child Q, which already sat awkwardly with the Crown's unified triplet-pattern argument.
- BAPM Triplet Pregnancy Standards set out the evidence-based mortality and morbidity baseline for triplet pregnancies.