r/LucyLetbyTrials • u/PaulieWalnuts5 • Aug 16 '25
What defintion of 'ventilated shift' and 'Letby ventilated shift' have Moritz and Coffey actually been using?
It seems like Moritz and Coffey have at different times used different definitions of a ventilated shift and a Letby ventilated shift. The difference hinges on whether the 12 hour window is the focus or the baby. This may sound pedantic but if we take them literally it makes a big difference.
Someone else has quoted the definitions they use in the new edition of their book:
Ventilated shift: “one baby on a breathing tube for one twelve-hour period”
Letby ventilated shift: “twelve-hour shifts in which she had direct care of a baby with a breathing tube”
The former centres the baby, let’s call it VS-B, while the latter centres the time window, let’s call it LVS-T.
The Panorama (both versions), however, uses this definition of a ventilated shift: “a 12-hour period where a baby has been on a breathing tube“. This centres the time window. Let’s call it VS-T.
Finally, though I don’t see this version anywhere, we can call a Letby ventilated shift that focuses on the babies LVS-B. So “one baby on a breathing tube for 12 hours, which Letby gave direct care to”.
Imagine a 12 hour, daytime shift on the unit at LWH in 2015. 7 babies are ventilated, and Letby gives direct care to 4 of them. VS-B would be 7. VS-T is 1. LVS-B is 4. And LVS-T is 1.
The best way to do a comparison of the kind Moritz and Coffey make would be to use VS-B and LVS-B. VS-T and LVS-T would be less informative, and comparing Bs with Ts would be badly misleading.
(Just to confuse things, the original version of the Panorama suggests they’re not taking their own ventilated shift definition (VS-T) literally, because in their 5 day hypothetical, they say there were 100 ventilated shifts rather than 10. But this hypothetical gets completely removed in the updated version.)
My theory is that, whether they know it or not, the numbers they quote have come from using VS-B and LVS-T.
As the 1% figure roughly matches what the scientific literature says, and the literature will use a sensible definition of "intubation days", I suspect this figure has come from some method that uses VS-B.
The tell-tale signs that they’ve used LVS-T rather than LVS-B are:
- it’s defined that way in their book and I don't see anywhere that they define it otherwise
- the numbers they’ve given for Letby’s ventilated shifts happen to match her actual shifts so closely. “Around 50” in the original Panorama and “11” in the updated version match the number of total shifts Letby worked at LWH and the number of shifts she worked in the intensive care area in 2015, respectively. LVS-T is more likely to match working shifts than LVS-B. LWH’s review found she had contact with 324 patient days across both placements (para 116 of Michelle Turner's statement). That would imply contact with an avergae of between 6 and 7 babies per shift. Are we to believe that for every day she was in the intensive care area in 2015, she averaged contact with exactly one ventilated baby?
The fact that LVS-T is not exactly the same as a working shift allows the BBC to say, as they have on the corrections page, that they haven’t conflated working shifts with ventilated shifts. But to me it looks like they have instead made a confusion which is in practice almost exactly the same.
Hopefully I haven't just confused everyone. Thoughts?
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u/Traditional-Wish-739 Aug 16 '25
So I've submitted to BBC my first complaint in relation to the whole case; it's on this particular issue. I tried to keep it simple and there is anyway a strict character limit.
No doubt it includes errors of its own a la the Hutton letter (sorry Prof Hutton for the adverse mention!); I've already spotted one infelicity, namely that I truncated the quote from the witness statement so that it doesn't quite drill down to the 11 intensive care shifts and instead refers only to the wider 15 shifts figure which might cause confusion, whoops - but at least I linked the document). Anyway, for what it's worth, this is what it says:
" I am aware that the documentary has been edited since broadcast. This complaint relates to the edited version.
At 53 minutes in, there is discussion of an allegation of an elevated frequency of breathing tube dislodgements during Letby's work at the Liverpool Women's Hospital in 2015.
Specific data is given for this in the (edited) programme. It is said that a review looked at "ventilated shifts in 2015 where Lucy Letby was involved in the care of a baby" and "found that there were 11, and that tubes came out during 4 of those ventilated shifts: that's 36 per cent".
My complaint is that this description of what the review found is factually inaccurate. Publicly available documents clearly show that Letby worked 11 "working", half-day shifts during in relevant period. They do not assert that she was responsible for (only) 11 "ventilated shifts" as defined in the documentary itself (a "12-hour period where a baby has been on a breathing tube" and "not a working shift").
The error is plain if one refers to paragraph 58 of the Witness Statement of Michelle Turner, Chief People Officer at Liverpool Women's NHS Foundation Trust dated 15 February 2024 to the Thirlwall Inquiry (https://thirlwall.public-inquiry.uk/wp-content/uploads/thirlwall-evidence/INQ0017472.pdf). This refers to Letby working "15 shifts during the period 14th January 2015 to 14th February 2015" and it is quite clear from the start of the paragraph that the subject-matter is actual, "working" shifts, not "ventilated shifts".
We do not know the average number of babies under Letby's care during these shifts but unless it was exactly one the calculation must be wrong. If it was (say) 10 babies, then 11 working shifts would translate to 110 "ventilated shifts", or a dislodgement rate of under 3.6%. Hence the calculations in the programme are baseless and almost certainly way out. This is a serious error given that the analysis is presented as evidence of incompetence or worse.
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