X-ray evidence made a significant contribution to the conviction of U.K. neonatal nurse Lucy Letby. On 21 August, she received a whole-life prison term, with no chance of parole, for the murder of seven babies and the attempted murder of six more.
During the 10-month court case, the defence argued there was no evidence to suggest Letby had inflicted harm on any baby, citing "suboptimal care" by the Countess of Chester Hospital, issues with poor hygiene, and a campaign of conspiracy against the defendant by several senior doctors as reasons for the deaths and nonfatal collapses, according to a statement by Cheshire Police.
After 110 hours of deliberating, the jury dismissed Letby's version of events and found her guilty. Letby refused to attend the sentencing at Manchester Crown Court, leading to demands to change the law to compel those convicted to attend sentencing.
Letby used a variety of methods to target the victims -- injecting the babies with air and poisoning them with insulin as well as overfeeding them with milk, noted the Cheshire Police statement.
Radiological body of evidence
An article posted on 18 August by the Guardian newspaper noted that in one case, "postmortem x-rays showed a higher than normal amount of gas in his body, causing police to believe Letby murdered him by injecting air into his nasogastric tube." The baby (called Child O) was one of two triplets killed by Letby a day after returning from a holiday to Ibiza in June 2016. Child O had been a "perfect" healthy baby and was due to go home before he collapsed unexpectedly, the article noted.
Prof. Owen Arthurs, a consultant pediatric radiologist at London's Great Ormond Street Hospital and professor of radiology at the UCL Great Ormond Street Institute for Child Health, acted as an expert witness in the case.
In a court session on 21 October 2022, he reviewed neonatal x-rays taken when the victims were alive and after death, as reported in AuntMinnieEurope.com.
On 3 February 2023, BBC News reported that Arthurs told the court that it "stands to reason" but cannot be proven that the "massive" stomach of a premature baby girl (Child A) was caused by a lethal air injection. Arthurs said he agreed that x-rays of the baby's enlarged stomach would be consistent with her having been "deliberately injected" with air.
"It's quite unusual to see babies with this degree of dilatation of the stomach," he said, adding that such an enlargement, through the presence of air, could cause "splinting in the diaphragm" and that could lead to "respiratory complications", according to the BBC report.
Asked how much air it would take to cause the stomach to expand to that degree, Arthurs said: "We don't know, I don't think anybody really knows ... Those experiments can't really be carried out; we can't experiment on babies giving them 50 or 100 ml of air and taking X-rays. But, I would guess more than 20 ml of air."
Further court appearance
Giving evidence again on 16 March, Arthurs said the x-ray of another baby (Child P) was "very similar in appearance" to one taken of Child O, according to an article posted by ITV News.
"This is gas throughout the gut. This degree of gas is quite unusual in a baby like this," he told the court, adding that potential causes were infection or necrotising enterocolitis, a bowel disorder in premature-born babies. An alternative explanation was the administration of air via a nasogastric tube, Arthurs pointed out. He agreed with defence lawyer Ben Myers that another possible explanation for Child P's dilation was an "unidentifiable cause."