Seized maternity notes not given to Letby defence for trial

Maternity notes for the babies Lucy Letby has been convicted of murdering were not made available to her defence ahead of her trial, the BBC has learned.

The neonatal nurse was convicted of murdering and attempting to murder 14 babies at the Countess of Chester Hospital in 2015 and 2016.

File on 4 Investigates has discovered that maternity notes for the babies in the case - which include details of the mother's pregnancy, labour and birth - were seized by Cheshire Police. But they were not reviewed by the prosecution's chief medical expert or disclosed to Letby's defence.

The Crown Prosecution Service said Letby was convicted following two jury trials and that the Court of Appeal dismissed her argument that prosecution evidence was flawed.

Letby, originally of Hereford, is currently serving 15 whole life terms.

Since her trial, and subsequent retrial on one case, there have been concerns raised about some of the evidence presented to the jury.

One concern is that the maternity history of the babies in the case was not adequately considered.

Experts told the BBC that it is critical to fully assess the pregnancy, labour and delivery of a baby when determining why they collapsed and died.

Dr Dewi Evans, the chief medical witness for the prosecution, said the full maternity notes were not relevant to the case.

"I never saw any obstetric notes and I have no idea what happened to them," he said.

"I don't think that maternity care was a particular issue in the Letby case. I think most of the babies I dealt with were born in acceptable condition."

Evans said he did see brief maternity summaries - "usually a couple of paragraphs" - attached to each baby's neonatal notes.

File on 4 Investigates has also learned from several sources that the Crown Prosecution Service did not disclose the obstetrics records to the defence.

The CPS reasoned that because the prosecution did not use them to form its case against Letby, they were not relevant.

The BBC has also seen evidence the defence did request the maternity notes but they were not released.

Evans said the CPS should have disclosed the records, even if the prosecution was not using them.

He added: "With the benefit of hindsight, would that have made a difference to the outcome? I don't think so. The events that occurred to these babies were events that occurred after they were born."

However, Phil Bennett, professor of obstetrics and gynaecology at Imperial College London, disagreed.

"It's very surprising indeed to me that little or no attention was paid to the maternity care in these cases," he says.

He said that when investigating a baby's death in a hospital or as part of litigation, it is normal practice for maternity care and neonatal care to be considered together.

"These experts should know that to come to the right conclusion you need an integrated opinion," he added.

Bennett has reviewed one case, referred to in court as Baby O, in detail on behalf of her new defence.

The jury unanimously convicted Letby of murdering the triplet after the prosecution said she had injected air into his bloodstream, into his feeding tube and inflicted liver damage.

Bennett relied on Baby O's neonatal notes as well as testimony from a police interview with the baby's mother about the infant's birth.

The prosecution argued that Baby O was born in good condition and was stable for 48 hours before he suddenly collapsed. They said that indicated that Letby attacked him.

But Bennett's opinion is that the baby died from a liver condition caused by an injury to his liver during, what he believed was, a difficult Caesarean section to deliver him.

He says though this is quite rare, there was substantial medical literature on it.

In these medical reports the injury usually happened during delivery and the baby seemed to be well for an average of 48 hours until suddenly collapsing and often dying.

Bennett said he would like to see the obstetrics notes to get a better understanding of the delivery.

In response, Evans said Baby O was born in good condition.

He added: "I don't think that anything in the obstetric notes would have improved my understanding or the understanding of all of us who became involved with this investigation."

File on 4 Investigates spoke to various families who alleged failings of care on the maternity and neonatal units at the Countess of Chester, before during and after Letby's time at the hospital.

None of them encountered Letby.

They said doctors, nurses or midwives repeatedly ignored their concerns about the progress of their labour or the health of their baby. In several of these cases their babies died.

Sue Pemberton, the deputy chief executive of the Countess of Chester, said they "apologise unreservedly to the families who have had poor experience in our care".

She said she noted that the cases being discussed relate to maternity care between 2015 and 2020 and that if families felt their concerns had not been addressed she would urge them to contact the trust.

She said: "The Trust has made significant improvements and it is now nationally accredited for its family-integrated care approach."

The Crown Prosecution Service said: "Lucy Letby was convicted of 15 separate counts following two jury trials.

"In May 2024, the Court of Appeal dismissed Letby's leave to appeal on all grounds – rejecting her argument that expert prosecution evidence was flawed."

Cheshire Constabulary said it would not be commenting.

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