Babies A and B — the Panel finds thrombosis, not air embolism
The prosecution’s claim: The Crown alleged Babies A and B, monochorionic twins, deteriorated as a direct result of deliberate harm by Lucy Letby acting on consecutive shifts.
Prosecution claim
The Crown alleged Babies A and B, monochorionic twins, deteriorated as a direct result of deliberate harm by Lucy Letby acting on consecutive shifts.
Counter-evidence
The Panel's findings for these twins are specific, and neither is air embolism. Child A, it concludes, died from thrombosis: the mother had anti-phospholipid syndrome, a recent non-occluding liver thrombus was found at post-mortem, and catheters had been left unperfused for up to four hours. Child B collapsed from thrombotic emboli arising from a central intravenous catheter that was kinked and had not been heparinised, potentially aggravated by the same maternal anti-phospholipid syndrome; her D-dimer was 6219 and her platelets 103. There is, in other words, a shared explanation for two consecutive collapses in twins — the mother's clotting disorder, plus the lines in the babies' veins — and it is not a nurse working consecutive shifts. Monochorionic twins are in general at elevated risk of shared placental pathology, and sequential deterioration in twins who share a placenta and a maternal exposure is not anomalous.
Key point: Sequential deterioration in twins whose mother has anti-phospholipid syndrome, and who both have central lines, is not the signature of deliberate harm. The Panel's finding is thrombosis in Child A, and catheter-related thrombotic emboli in Child B.
What the jury heard
The twin pregnancy was acknowledged, but the maternal anti-phospholipid syndrome, the catheters left unperfused, and the kinked, non-heparinised central line were not developed as a unifying natural-cause explanation for two sequential collapses.
What the Panel says
The Panel concludes that Child A died from thrombosis and that Child B collapsed from thrombotic emboli from a kinked, non-heparinised central catheter — both potentially aggravated by maternal anti-phospholipid syndrome. It found no evidence of air embolism in either baby.
What independent experts add
- Maternal anti-phospholipid syndrome is a shared exposure: it affects both twins of the same pregnancy, which is precisely why two consecutive collapses need not have a common human cause.
- Child A's post-mortem showed a recent non-occluding liver thrombus, and catheters had been left unperfused for up to four hours.
- Child B's D-dimer of 6219 and platelet count of 103 are the laboratory picture of a clotting problem, not of injected air.
- Dr Martyn Pitman has published case-by-case obstetric analysis of Babies A and B including the antenatal Doppler trajectory.