Lucy Letby has been found guilty of the attempted murder of an additional baby, following a retrial in Manchester Crown Court. The reasons for dismissing her appeal against her previous convictions have now been published.

Letby, a former neo-natal nurse, had been accused of killing or attempting to kill 17 newborn babies.  Following a trial, she was convicted 14 counts of murder or attempted murder, and acquitted on two additional counts of attempted murder. On six counts, the jury was unable to reach a decision.

One of these charges has been retried. She was accused of intentionally dislodging ‘Baby K’s’ breathing tube, with the intent to cause serious harm. A consultant paediatrician provided witness evidence, stating that he already had concerns about Letby, and found her standing by the child as their blood oxygen levels dropped. There was ‘no evidence’ that she had done anything to help. Letby denied any such event took place.

The jury, after 3.5 hours of deliberation, found her guilty.

In the interim, Letby had appealed her previous convictions. Her appeal was rejected. The reasons for this rejection have now been made public.

Letby advanced multiple grounds of appeal. All were rejected. The court noted that the case was a “circumstantial one”, but that the medical evidence was sufficiently reliable to render the conviction safe.

Firstly, she stated that the expert evidence of Dr Evans was not independent, as he had been part of the investigation; further, his cross-examination responses showed bias. She noted that, in a separate case, Dr Evans evidence had been described as ‘partisan’, with ‘no effort to provide a balanced opinion’. The Court of Appeal found that his earlier involvement in the investigation did not amount to a lack of independence, and alleged biased responses were the result of frustration in cross-examination, rather than a matter of substance.

Secondly, Letby advanced that a submission of no case to answer had been wrongly rejected. The scientific basis for cause of death was weak, and the experts had insufficient expertise to provide evidence on it. Whilst accepting ‘the force of the argument that the limits of scientific knowledge would not permit a reliable diagnosis’, the Court found that there was a distinction between a diagnostic test and evidence consistent with diagnosis. The latter was admissible, and could potentially suffice for conviction.

Thirdly, Letby argued that the judge had misdirected the jury by telling them that they did not need to ‘be sure of the precise harmful act’ which Letby had done to convict for murder. The Court, considering previous case law, found that in some cases ascertaining the precise act is necessary, where it could allow for different defences to be advanced. In this case, however, ascertaining the precise act was not required, as long as the jury were sure that an act had been done, with intent.

Letby additionally applied to admit fresh evidence from a further witness. The court found there was no reasonable explanation for it not already having been called, and further it did not provide the substance for an additional ground of appeal.

Finally, Letby advanced a claim regarding jury irregularity. The court had received an email, which accused a juror of telling others in a café that they were working on the Letby trial, and that the jury had predetermined their verdict from the start. On investigation, the trial judge found that this email had been motivated by antagonism to that juror, and after questioning the juror was satisfied the accusations were not substantiated. The Court of Appeal upheld this decision.

The safety of Letby’s conviction has also been questioned by an article in the New Yorker, which questioned the statistical evidence, the possibility of other causes of death, and the vilification