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 alleged Child M's collapse was caused by deliberate air embolism injected by Lucy Letby.
Child M was managed with positive-pressure ventilation and a rebreathing bag during the resuscitation period. Both routes can introduce air into the gastrointestinal and venous systems via well-recognised mechanisms — incompetent oesophageal sphincter under positive pressure, and inadvertent air-entrainment via line connections during emergency management. The skin discolouration cited at trial as diagnostic of air embolism does not match the criteria in the 1989 Lee & Tanswell paper relied on by the prosecution, as Dr Shoo Lee himself has stated. Equipment-mediated air entry during resuscitation is a recognised alternative explanation that does not require deliberate harm.
Positive-pressure ventilation and rebreathing-bag use during resuscitation can themselves introduce air into the gastrointestinal tract and, via documented mechanisms, into the vascular system — producing the imaging and clinical appearance the prosecution treated as evidence of deliberate air injection.
The skin discolouration on Child M was described as diagnostic of air embolism. The jury was told this, combined with Letby's presence, was proof of the deliberate-injection mechanism.
The Panel found no medical evidence of air embolism in Child M's case and identified resuscitation-associated mechanisms fully consistent with the recorded clinical and imaging findings.