May 2026: Thirlwall Inquiry report delayed to at least September 2026 · six-baby inquests relisted to 2027 · CCRC review active · Shoo Lee Panel: no medical evidence of deliberate harm.
The Crown argued Child L's blood sample showed an insulin level inconsistent with C-peptide, a pattern said to be diagnostic of exogenous insulin and therefore proof of deliberate poisoning.
The Roche Cobas immunoassay used is a screening test. Its manufacturer requires confirmatory mass spectrometry before any forensic conclusion can be drawn. That confirmation was never performed for Child L. The dual-sample protocol that would allow assay-interference and sample-degradation to be ruled out (paired venous and arterial samples, immediate centrifugation, mass-spec confirmation, Guildford reference-laboratory handling) was not followed. C-peptide is also independently suppressed by repeated dextrose administration — which Child L received during management of hypoglycaemia — meaning the C-peptide reading does not reflect the infant's baseline. The Panel's Joint Insulin Report sets each of these problems out in technical detail.
Without the confirmatory mass spectrometry the assay manufacturer itself requires for forensic use, the screening result for Child L cannot discriminate reliably between exogenous insulin, assay interference and treatment-induced C-peptide suppression.
Royal Liverpool laboratory biochemists described the screening result as inconsistent with endogenous pancreatic release. The jury was not told that the manufacturer requires confirmatory mass spectrometry for forensic use, that the dual-sample protocol was not followed, or that dextrose treatment itself suppresses C-peptide.
The Panel's Joint Insulin Report concludes the Child L insulin evidence falls below the standard required for a criminal finding of exogenous insulin administration.