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's case relied on the tests that were done: the Roche Cobas insulin immunoassay, post-mortem macroscopic examination, and clinical observation. The jury was told these were sufficient to establish deliberate harm.
In every comparable case worldwide, forensic-standard exogenous-insulin cases proceed on confirmatory mass spectrometry from a validated forensic laboratory (in the UK, Guildford). The Letby samples were processed at the Royal Liverpool laboratory under a clinical — not forensic — protocol: gel tubes, delayed centrifugation, ambient-temperature storage. Confirmatory mass spectrometry was never performed. Nor was post-mortem imaging (CT or radiograph) that would show intravascular gas if air embolism had occurred. Nor were TPN bags retained for forensic testing. The absence of these tests is not an incidental gap — they are the tests that would actually answer the forensic question. Their absence is itself evidence.
You cannot convict on the tests that were done while ignoring the tests that were not done but should have been. The missing forensic chain of custody is part of the record.
The jury heard what the prosecution's witnesses reported from the tests that were actually done. The jury was not systematically walked through the tests that would have been required to reach a forensic standard.
The Panel concludes that the absence of mass spectrometry confirmation on the insulin samples, the absence of post-mortem imaging of the type that would show intravascular gas, and the absence of retained TPN bags for forensic chemistry, together mean the medical evidence does not meet a forensic standard for any of the charged mechanisms.