Lucy Letby bombshell as new memo from sole medical witness threatens to blow prosecution's case wide open

13 April 2025, 08:33

A new bombshell looks set to blow holes in Lucy Letby's prosecution following the release of a new memo from the trial's sole medical witness.

The revelatory email, which emerged on Saturday, appears to cast doubt over events surrounding the nurse's actions in the lead up to one baby's death.

Dr Ravi Jayaram - the only medical witness to give evidence across both of Letby's trials - testified that the nurse was seen standing over Baby K's cot as the infant's condition deteriorated.

Taking the stand, the doctor said Letby failed to call for help as the newborn's condition continued to deteriorate, insisting the nurse had virtually been caught 'red handed'.

The new email, sent on May 4, 2017, to colleagues at the Countess of Chester Hospital, appears to cast significant doubts over that order of events.

Letby, 35, from Hereford, is serving 15 whole-life orders after she was convicted across two trials at Manchester Crown Court of murdering seven infants and attempting to murder seven others, with two attempts on one of her victims, between June 2015 and June 2016.

The moment Lucy Letby was arrested over baby deaths

Prior to the start of the police investigation, Dr Jayaram wrote: "At time of deterioration ... Staff nurse Letby at incubator and called Dr Jayaram to inform of low saturations."

The revelatory memo appears to contradict previous testimony, with the evidence not making it into documents handed to police prior to the start of the investigation.

In the newly released email, Dr Jayaram also suggested Baby K's fragile premature condition was instead the cause of death, saying: "Baby subsequently deteriorated and eventually died, but events around this would fit with explainable events associated with extreme prematurity."

The note sees him suggest that the baby's death was explained by issues associated with extreme prematurity.

Appearing at the 2024 trial, the doctor framed her behaviour as suspicious, telling the court: "Lucy Letby was stood next to the incubator.

"She wasn't looking at me. She didn't have her hands in the incubator.

Asked by prosecutor Nick Johnson KC whether he had "any call for help from Lucy Letby?", he replied: "No, not at all.

"I was surprised that the alarm was not going off, although my priority was (Baby K) and I didn't question it at the time.'In retrospect, I was surprised that help was not called, given (Baby K) was a 25-week gestation baby and her saturations were dropping."

However, at the recent Thirlwall Inquiry, the doctor expressed regret at not raising the alarm over the nurse's behaviour sooner

He explained: "I lie awake thinking about this ... I should have been braver."

It follows a panel of medical experts has concluded that "no criminal offences had been committed" in the case of child killer Lucy Letby.

The 14-strong panel has provided alternative causes of death.

An international panel of medical experts has provided case summaries on all 17 babies who featured in the 10-month trial of Lucy Letby.

The 14-strong panel concluded that no criminal offences had been committed at the Countess of Chester Hospital in 2015 and 2016 and instead provided alternative causes of death:

• Baby 1 - (known as Child A in the trial): The prosecution said the boy was murdered by an injection of air into the bloodstream which caused an air embolism where bubbles form and block the blood supply. The panel found no evidence of air embolism and said the child had died from thrombosis, where a blood clot forms in a vessel.
• Baby 2 - (Child B): The prosecution said Letby attempted to murder Child A's twin sister by also injecting air into her bloodstream. The panel found no evidence of air embolism and said the child had collapsed from thrombosis.
• Baby 3 - (Child C): The prosecution said the boy was murdered with air forced down his feeding tube and into his stomach. The panel said the child died following ineffective resuscitation from a collapse after an "acute small bowel obstruction" that went unrecognised.
• Baby 4 - (Child D): The prosecution said the girl was murdered by an injection of air into the bloodstream. The panel found no evidence of air embolism and ruled the child died of systemic sepsis, pneumonia and disseminated intravascular coagulation (blood clotting). Issues with failures to give relevant antibiotics were also identified.
• Baby 5 - (Child E): The Crown said Letby murdered the twin boy with an injection of air into the bloodstream and she also deliberately caused bleeding to the infant. The panel said there was no evidence of air embolism and bleeding was caused either by a lack of oxygen pre-birth or a congenital blood vessel condition.
• Baby 6 - (Child F): The prosecution said Letby attempted to murder Child E's twin brother by administering insulin. The panel ruled that the child's insulin levels and insulin/C-peptide ratio did not prove that exogenous insulin was used and were within the norm for pre-term infants. It added that there was poor medical management of the child's prolonged hypoglycaemia.
• Baby 7 - (Child G): The prosecution said Letby attempted to murder the girl by overfeeding her with milk and forcing air down her feeding tube. The panel said there was no evidence to support air injection into the stomach or overfeeding. The infant's vomiting and clinical deterioration was due to infection, it found.
• Baby 8 - (Child H): Jurors cleared Letby of one count of attempted murder and failed to reach a verdict on a second count. Prosecutors said the nurse sabotaged the girl's care in some way which led to two profound oxygen desaturations. The panel said the deteriorations were due to medical mismanagement of a tension pneumothorax where air is trapped between the lung and chest wall.
• Baby 9 - (Child I): The prosecution said Letby murdered the infant by injecting air into her bloodstream and stomach. The panel said it found no evidence of air injections and that the baby died of breathing complications caused by respiratory distress syndrome and chronic lung disease.
• Baby 10 - (Child J): Jurors could not reach a verdict on an allegation of attempted murder. No specific form of harm was identified by the prosecution but they said Letby did something to cause the collapse of the girl. The panel said the deterioration was caused by sepsis and there was no evidence to support malicious airway obstruction.
• Baby 11 - (Child K): The prosecution said Letby attempted to murder the girl by deliberately dislodging her breathing tube. Among its findings the panel said there was no evidence to support a dislodged endotracheal tube (ETT) and the clinical deterioration was caused by use of an undersized ETT.
• Baby 12 - (Child L): The Crown said the nurse poisoned the boy with insulin. The panel said the infant's insulin-related levels were within the norm for pre-term infants and there was no evidence of deliberate administration.
• Baby 13 - (Child M): Prosecutors said Letby attempted to murder Child L's twin brother by injecting air into his bloodstream. The panel said there was no evidence of air embolism and his collapse was caused by sepsis or a heart problem.
• Baby 14 - (Child N): The Crown said the boy was the victim of attempted murder by inflicted trauma in his throat and an air injection into his bloodstream. The panel said there was no air embolism and it was likely his blood oxygen levels dropped due to his haemophilia condition or routine cares, which was "exacerbated" by repeated attempts to insert a breathing tube.
• Baby 15 - (Child O): The prosecution said Letby murdered the triplet boy by injecting air into his bloodstream and inflicting trauma to his liver. The panel said he died from liver damage caused by traumatic delivery, resulting in bleeding in the abdomen and profound shock.
• Baby 16 - (Child P): Prosecutors said Letby murdered Child O's brother by injecting him with air. The panel said there was no evidence to support that mechanism and that he died from a collapsed lung that was "suboptimally managed".
• Baby 17 - (Child Q): Jurors could not reach a verdict on an allegation of attempted murder.

The Crown said Letby attempted to murder the boy by injecting liquid, and possibly air, down his feeding tube.

The panel said there was no evidence to support air injection into the stomach and the child deteriorated because he had early symptoms of a serious gastrointestinal problem, or sepsis.