Babies O, P and Q — three different Panel findings, not one pattern

What the jury heard

The triplet pregnancy was acknowledged. The obstetric history of Child O's delivery, the management of Child P's pneumothorax, and the fact that Child Q had been bagged before air was aspirated from the nasogastric tube were not developed as competing explanations.

What the Panel says

The Panel reaches a different conclusion for each triplet: Child O — a subcapsular liver haematoma caused by a traumatic, extremely rapid delivery, with the blind needle aspiration during resuscitation possibly adding further injury but not causing the death; Child P — a pneumothorax that was suboptimally managed, with no evidence of air injection into the stomach or an IV line; Child Q — early NEC or sepsis, with the aspirated air most likely introduced by the preceding bagging.

What independent experts add

• Child O: a subcapsular liver haematoma from an extremely rapid delivery; blunt inflicted trauma is implausible on the Panel's reading, and CPR is not the cause.
• Child P: a pneumothorax suboptimally managed — a failure of care, with no evidence of air injected into the stomach or an IV line.
• Child Q: early NEC or sepsis; the '++ air' aspirated from the nasogastric tube was most likely introduced by the bagging that preceded it.
• The jury reached no verdict on Child Q, which already sat awkwardly with the Crown's unified triplet-pattern argument.
• BAPM Triplet Pregnancy Standards set out the evidence-based mortality and morbidity baseline for triplet pregnancies.