In today’s @PrivateEyeNews, I reveal why Dr Svilena Dimitrova (@NeoDoc11), a consultant neonatologist and instructed expert for Letby, has referred the case of Baby O back the Cheshire police and asked them to investigate the possibility of gross negligence manslaughter.   Her detailed report, prepared with another neonatologist, was discussed at a press conference in December, which she did not attend as she was working on other reports. It focused on injury to the liver. However, a bigger error was that the ventilation pressures were set so high, the heart couldn’t function properly. In Dr Dimitova’s view, this would have led to the death of the baby irrespective of what happened to the liver. 

A chest x-ray clearly shows hyperinflated lungs and the liver pushed down into the region where one of the consultants stuck a needle and drew back blood. A haemoglobin measurement shortly afterwards shows a catastrophic halving, indicating a major bleed most likely from the needle breaching the capsule of the liver which was already under pressure because of a subcapsular haematoma. The significance of the haemoglobin drop before resuscitation was discontinued and the failure to correct the profound acute anaemia was not adequately examined by the prosecution experts, and neither were the high ventilation pressures even though they are clearly documented in the notes. 

Dr Dimitrova believes that if the ventilation pressures and loss of blood had been spotted and corrected, as they should have been,  the baby would have lived. She could find no evidence of deliberate harm to the liver and no evidence of venous air embolism. She has also reported her findings to the Cheshire coroner asking for an inquest into the death of Baby O, and to the GMC to assess any competency issues amongst the medical staff. 

Dr. Brearey and the Countess of Chester Hospital have declined to comment, and I am awaiting a comment back from prosecution pathologist Dr Marnerides, to see if this new information changes his views on the cause of death.