The Disturbing Murder Spree Of British Nurse Lucy Letby

The following article contains disturbing descriptions of murder and child abuse.

The human body produces insulin naturally, but in 2018, Dr. Stephen Brearey noticed there was not nearly enough C-peptide — an amino acid — accompanying the extremely high levels of insulin reported in Child F's bloodwork. Brearey, a consulting pediatrician, was part of an internal investigation into a sudden and alarming uptick in premature infant mortality in the neonatal ward at Countess of Chester Hospital in England from June 2015 to June 2016. Child F nearly died, and its twin, Child E didn't make it. With the insulin-C-peptide connection, Brearey's mind was made up: Child F was poisoned with insulin, but why, and by whom?

According to The Guardian, young nurse Lucy Letby was on duty when both Child E died and Child F was injured — and, for that matter, when four other recent premature babies unexplainably died or entered a medical emergency. Brearey and others involved in the investigation pointed this out before, but their entreaties to hospital upper management to investigate Letby were reportedly met with apathy. One former Letby colleague, Dr. John Gibbs, told The Guardian, "My initial feeling towards [Letby] was that I felt sorry for her. She happened to be around when some of these babies were collapsing and dying and perhaps it was purely coincidental. When it kept on happening, it began to look like this cannot be just pure coincidence."

By 2018, Cheshire police were involved, and Letby could no longer be ignored. In August 2023, Letby was convicted of murdering seven newborns, as well as seven counts of attempted murder related to six children — one she tried to kill twice, The New York Times reported.

Letby killed via air embolism, insulin, and trauma

According to The Guardian, Lucy Letby's methods of killing ranged from insulin overdose to feeding milk into the premature child's nasogastric tube. Other infants showed signs of trauma or had air inserted into their stomachs or blood (the latter caused embolisms). Some murders or attempted murders happened shortly after Letby arrived for work, while others occurred as soon as she was alone with the child. Some of the infants killed were already ill or born very premature, offering a plausible explanation for their deaths. Not all of Letby's victims died, but some who survived were injured. In one instance, someone interrupted her in the middle of an attack, per The Guardian.

It was difficult to determine how each child died, or what caused their injuries. Former chief prosecutor Nazir Afzal told The Washington Post that at first, law enforcement "didn't even know if there had been a murder in the first place." Notably, investigators suspect Letby might be linked to more child injuries and deaths across her career (via The Guardian).

As much as hospital consultants pointed the finger at Letby, though, her potential link to the child deaths and injuries was declared a "coincidence" by the hospital administration in May 2016. One consultant, Dr. Ravi Jayaram, later said (via Sky News), "We were getting a reasonable amount of pressure from senior management at the hospital not to make a fuss."

She was transferred in 2016, and the deaths stopped

BBC News says that in June 2016, the hospital's head of corporate affairs and legal services, Stephen Cross, seemed more concerned with "[turning] the neonatal unit into a crime scene." There was, after all, still no definitive evidence any of the children involved were intentionally harmed. Still, Dr. Dewi Evans, who testified at Letby's trial, told "BBC North West Tonight," "A number of red flags available to the medical team and management [were] overlooked. I think there were concerns raised by the consultants after the first three deaths. And no one acted at that time." 

Consultants and hospital administration continued to investigate the pattern of premature infant death at Countess of Chester Hospital until Lucy Letby was finally removed from the neonatal unit in July 2016 amid growing concern from senior doctors and staff, and the deaths stopped. But she was transferred to the hospital's risk and patient safety office — the very department where similar incidents were investigated and reported to the national NHS system. The outlet reported that baby deaths at Countess of Chester "were not reported appropriately," and the hospital board was not alerted to the matter until more than a year after the first child died.

The police got involved in 2017

In January 2017, accusing doctors and consultants were asked to apologize, and mediation was suggested. So in May 2017, stymied by hospital administration, Dr. Stephen Brearey and others involved in the internal investigation turned to Cheshire Police. At that time, Lucy Letby was still employed at the hospital. Stephen Brearey and Dr. Ravi Jayaram told Detective Superintendent Paul Hughes that there was always an explanation when a premature child collapsed, but none had been found for the suspicious incidents at Countess of Chester. So began Operation Hummingbird.

Though the deaths stopped once Letby left the ward could have been coincidental, in-depth reports from outside experts and pathologists affirmed what was long suspected: These deaths and injuries could only have been intentional. To determine who may be to blame, Cheshire police turned to the one piece of evidence earlier reports had pointed to: Letby was the only nurse on duty when each child died or went into crisis, and she was often alone with the newborn when it happened. 

Letby was finally arrested on July 4, 2018. Once in custody, among other evidence recovered from her home was a handwritten note seeming to admit her guilt. "I killed them on purpose because I'm not good enough to care for them ... I AM EVIL I DID THIS," it read. Letby pleaded not guilty to all charges against her. (In a contradiction, the handwritten note recovered also mentioned innocence, as Letby pointed out at her trial.)

Letby's trial, sentencing, and possible motive

Arrested in 2018, Lucy Letby finally faced charges in 2020 — a pandemic-related delay — and her trial started in October, 2022. In court, Letby admitted the insulin could have only been inserted on purpose, but said she didn't do it. She reportedly showed little emotion at her trial and refused to be present in court while her sentence was read, according to BBC News.

During her trial, it was suggested she may have been having an affair with a married doctor and committed the crimes to get his attention, per The Guardian. Otherwise, prosecutors suggested she may have done it for the thrill, out of boredom, or insecurity. Stating the obvious, The Guardian says psychopathology may have been what motivated the murders.

On the note discovered in her home, Letby reportedly wrote, "I will never have children or marry. I will never know what it's like to have a family." But as prosecutor Nick Johnson said in court (via The Guardian), "[Letby] knew what was going to happen. She was controlling things. She was enjoying what was going on. She was predicting things that she knew was going to happen. She, in effect, was playing God."

Letby is now the most prolific child serial killer in modern British history, as Reuters and The New York Times report. She is also only the fourth woman in Britain to ever receive a life sentence — or a "whole life order," in British legal terms. The jury failed to deliver a verdict on six other attempted murder charges, and she was declared not guilty on two attempted murder charges.

Aftermath

In the aftermath, many have called for a government inquiry into the matter — specifically, into why the Countess of Chester Hospital administration seemed to delay so long before taking action, BBC News reported. According to consultant Dr. Stephen Brearey (via BBC News), "There was no credibility given to our opinions. And from January 2017, it was intimidating, and bullying to a certain extent. It just all struck me as the opposite of a hospital you'd expect to be working in, where there's a safe culture and people feel confident in speaking out." 

Former Countess of Chester CEO Tony Chambers said in a statement (via BBC News), "The crimes that have been committed are appalling and I am deeply saddened by what has come to light. As chief executive, my focus was on the safety of the baby unit and the well-being of patients and staff. I was open and inclusive as I responded to information and guidance. ... I will cooperate fully and openly with any post-trial inquiry." Meanwhile, retired pediatrician Dr. Dewi Evans called for an investigation into what he saw as a "gross dereliction of duty" on the part of executives (via BBC News).

If you or someone you know may be the victim of child abuse, please contact the Childhelp National Child Abuse Hotline at 1-800-4-A-Child (1-800-422-4453) or contact their live chat services.