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.
Bowel-gas findings on imaging and post-mortem in several indicted infants were treated as evidence of deliberate air injection rather than as evidence of natural disease.
Necrotising enterocolitis (NEC) affects approximately 7-10% of infants born under 1500g birthweight and carries 20-30% mortality. NEC is the leading cause of gastrointestinal emergency in preterm neonates and is independently associated with hepatic portal venous gas — the imaging finding the prosecution treated as proof of deliberate air injection. Several of the indicted Letby cases had post-mortem or imaging features consistent with NEC. The Crown's mechanism required that bowel gas had been deliberately introduced; NEC explains the same findings without any deliberate act and is the diagnosis of first choice for any extremely preterm infant with the imaging picture in question.
Hepatic portal venous gas in an extremely preterm infant is the textbook radiological signature of necrotising enterocolitis. Reaching for a deliberate-injection mechanism without first excluding NEC inverts the diagnostic hierarchy.
Bowel-gas findings were presented as corroborative of the prosecution's air-injection mechanism. The NEC base rate and its independent association with the same imaging findings were not given equal weight as a competing diagnosis.
The Panel's NG-tube physiology analysis explicitly identifies NEC and other natural-cause mechanisms as fully accounting for the imaging findings without any deliberate act. See our /analysis/ng-tube-physiology page.