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.
Blood samples from two infants — Children F and L — returned results suggesting raised insulin with low C-peptide. Normally insulin and C-peptide are released together by the pancreas. A high-insulin-low-C-peptide pattern, the prosecution argued, is only explicable by insulin administered from outside the body. The jury was told this was proof of deliberate poisoning.
The Roche Cobas immunoassay used is a screening test. Its own manufacturer's guidance requires confirmation by mass spectrometry before a result can be treated as diagnostic of exogenous insulin. That confirmation was never done. Independent endocrinologists (including Adel Ismail and contributors to science4justice.nl) have shown the assay is prone to false positives in neonates because of interfering antibodies and cross-reactivity. The Panel concluded the insulin evidence cannot bear the weight placed on it in a criminal trial.
A screening immunoassay was never designed for forensic use. In every other British criminal case involving insulin, confirmatory mass spectrometry is performed. That did not happen here.
Biochemists from the Royal Liverpool laboratory described the Roche immunoassay results as showing an insulin level inconsistent with endogenous pancreatic release. The Crown's witnesses told the jury the pattern left no explanation other than exogenous insulin in the TPN bag.
The Panel notes the screening result was never confirmed by the confirmatory mass spectrometry that the assay manufacturer itself recommends for forensic use. Without that second test the result cannot discriminate reliably between exogenous insulin, interference from auto-antibodies, and certain cross-reacting compounds that are elevated in sick neonates. The Panel considers the evidence falls below the standard required for a murder or attempted-murder conviction.