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Dewi Evans
Dr Dewi Evans
Medical career
ProfessionRetired Consultant Paediatrician
FieldPaediatrics
InstitutionsSingleton Hospital, Swansea

Dewi Richard Evans (born July 1949) is a retired British consultant paediatrician and professional expert witness. He is a fellow of both the Royal College of Physicians and the Royal College of Paediatrics & Child Health. During the 1980s-90s, he helped develop the maternity unit in Singleton Hospital, Swansea.

Beginning in 2022 he rose to prominence as lead expert witness for the prosecution in the Lucy Letby trial.

Career

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Evans was born in Wales in July 1949 and attended Carmarthen Gammar School. He graduated from Cardiff Medical School in 1971 with a bachelor's degree (MB,BCh) and in 1973 was awarded a diploma by the Royal College of Obstetrics & Gynaecology. He graduated from Cardiff with a postgraduate degree (MRCP) in 1975, having previously worked in a paediatric post from 1 February 1973. He later worked in Alder Hey Children's Hospital in Liverpool as registrar 1974-1976 and as senior registrar in Cardiff 1977-1979.[1][2]

After moving to Swansea, Evans was appointed as a full-time clinical consultant paediatrician at Singleton Hospital in 1980 and became involved in the development of newborn intensive care and maternity services.[3] In 1990, the Swansea Bay Health Board built a new children's department and neonatal unit that Evans helped to design; between 1992–1997 and 2004–2008 he then served as clinical director of paediatrics and neonatology. During the Lucy Letby trial, Evans stated that from 1980 onwards all of the "tiny babies who required intensive care" within the large catchment area of southwest Wales "were under [his] care and the care of [his] colleagues".[1] Despite helping develop Swansea's neonatal services, Evans never worked exclusively in the speciality of neonatology; he was registered as a general paediatrician and he conducted his neonatology duties alongside his paediatric role.

In 1990, speaking in his capacity as West Glamorgan County councillor, Evans is reported to support an argument to decriminalise sexual offences against children. He sets that "people's lack of guilt and ignorance of wrong-doing after sexually abusing children supported an argument for 'decriminalising' the offence."[4]

In 2002, whilst Evans was a consultant in paediatric diabetes at Swansea Hospital,[5] he opposed the development of a planned national children's hospital for Wales, citing potential neglect of other parts of the country.[6] Evans was a cosignatory with 17 other medical professionals of a 2002 letter entitled "GMC must recognise and deal with vexatious complaints fast".[7] In 2004, he was an expert witness for the inquest into a baby girl's death in Fermanagh Hospital. She had been treated with the wrong fluids according to Evans after dehydration.[8] He was working at the Department of Child Health in Swansea at the time.[9] In 2005, Evans was cited as in support of a plan to merge Swansea's Singleton & Morriston Hospitals.[10] He was involved with the development of the Sapphire Suite for child victims of physical or sexual assault in 2006.[11]

Evans retired from practice in 2009 after over 30 years in practice and in the following year set up a company, Dewi Evans Paediatric Consulting Ltd, to handle his growing work as an independent medical witness.[12]

In 2013 Evans called for systematic vaccination of school children against measles.[13][14] He was an expert witness in the case of an inquest into the death of a four-year-old girl from salt poisoning; Evans identified broken ribs as a comorbity suggestive of potential abuse.[15] As town councillor for Carmarthen, he supported scrapping of child burial fees in 2017.[16] In 2018, he was quoted as calling for a centralised register for victims of child abuse in the UK. He was described as "a specialist witness ... in cases of babies who are abused".[17] He was expert witness in the murder and neglect trial of a 6 week old baby boy.[18] Evans unsuccessfully ran as a candidate for chair of Plaid Cymru[19] after having been a member of the party his whole adult life.[20][21]

In 2015, the High Court of Appeal, Northern Ireland heard an appeal relating to the Family Court where two children had been judged to have been the subject of non-accidental injury in Care Proceedings and removed from the care of their parents. Evans had been one of the expert witnesses. The appeal was upheld. Justice O'Hara stated in his reasoning that:

In his judgment the trial judge was critical of Dr Evans, suggesting that his evidence should have been more considered and structured than in fact it was. I accept that there is some justification for that criticism but, however frustrating changes in opinions are, this is a case in which both experts were clearly unsure about expressing an opinion about whether the injuries were non-accidental but both did so because they had been asked to and were expected to do so. That approach is entirely wrong and must be avoided in future. It is definitively not the role of expert witnesses to tell the court whether they believe injuries are accidental or non-accidental. That is especially so in cases such as the present and lawyers should be far more alert to avoid drafting letters of instruction to doctors inviting them to express their opinion on that issue.[22]

Evans was an expert witness in the 2021 murder trial of a man later convicted of killing his 5 month old daughter,[23] being able to rule out pneumonia as a potential cause of death in favour of a blunt force brain injury.[24] In 2022, Evans had written a report used in an application for permission to appeal to the Civil Division of the Court of Appeal in care proceedings. The Court of Appeal judge Lord Justice Jackson rejected the appeal on grounds that Evans's report was "worthless" and that he made "no effort to provide a balanced opinion".[25][26][27] Jackson is quoted as saying:

Finally, and of greatest concern, Dr Evans makes no effort to provide a balanced opinion. He either knows what his professional colleagues have concluded and disregards it, or he has not taken steps to inform himself of their views. Either approach amounts to a breach of proper professional conduct. No attempt has been made to engage with the full-range of medical information or the powerful contradictory indicators. Instead the report has the hallmarks of an exercise 'working out an explanation' that exculpates the applicants. It ends with tendentious and partisan expressions of opinion that are outside Dr Evans' professional competence and have no place in a reputable expert report.[1]

In a November 2024 podcast interview with John Sweeney, Evans criticised Lord Justice Jackson's comments.[28][29]

Evans has stated that the Letby case was his most difficult as expert witness. He stopped taking on new cases in February 2023.[2] He was still a councillor for Carmarthen in September 2023.[30]

Dr Evans at Manchester Crown Court

Lucy Letby trial

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Main article: Lucy Letby

Between 2015–2016 there was a rise in deaths at the neonatal unit of the Countess of Chester Hospital, placing it as the highest fatality rate in the UK. Letby was suspended from all clinical duties by the ward's senior consultants who subsequently met with police in April and May 2017, precipitating the police investigation.[31][32][33] Reading about the investigation in the news, Evans contacted the National Crime Agency in May 2017[27] via email; he is quoted as writing "Incidentally I've read about the high rate of babies in Chester and that the police are investigating. ... Do they have a paediatric/neonatal contact? I was involved in neonatal medicine for 30 years including leading the intensive care set-up in Swansea. I've also prepared numerous neonatal cases where clinical negligence was alleged. ... If the Chester police had no-one in mind I'd be interested to help. Sounds like my kind of case."[25][1]

During the police investigation which followed, Evans was instructed to review clinical records of the babies in the unit who had died or collapsed suddenly, in total 61 cases. Evans produced a large number of reports for Cheshire Police including a general statement dated 17 April 2019, a review of published literature regarding air embolus in newborn infants dated 3 July 2019 and a series of reports "considering" the events surrounding the deaths or collapses of babies.[1] Letby's trial opened on 10 October 2022 and Evans remained lead expert witness during the trial.[34] Evan's conclusions were peer reviewed by Dr Sandie Bohin a practising consultant neonatologist from Guernsey. Evans advised the police on the instruction of experts from specific specialisations, including:

Relying upon its medical advice, the prosecution asserted the babies had died by the following mechanisms:

Table of cases in the Letby Trial[1]
Count Baby Charge Date of death/collapse Mechanism
1 A Murder 8 June 2015 Air embolus
2 B Attempted Murder 9/10 June 2015 Air embolus
3 C Murder 14 June 2015 Air via nasogastric tube[35]
4 D Murder 22 June 2015 Air embolus
5 E Murder 4 August 2015 Acute bleeding/air embolus
6 F Attempted Murder 5 August 2015 Insulin poisoning
7 G Attempted Murder 7 September 2015 Overfeeding with milk
8 G Attempted Murder 21 September 2015 Overfeeding with milk
12 I Murder 23 October 2015 Air via nasogastric tube/air embolus
15 L Attempted Murder 9/11 April 2016 Insulin poisoning
16 M Attempted Murder 9 April 2016 Air embolus
17 N Attempted Murder 3 June 2016 Throat trauma
20 O Murder 23 June 2016 Injury to liver/air embolus
21 P Murder 24 June 2016 Air via nasogastric tube

Evans is stated to have later changed his mind about the mechanism of death for Baby C from pumping air into his stomach to an intravenus air embolism. This was following it demonstrated that Letby was not actually present in the ward at the time the original incident was alledged to have been committed.[36] Evans previously told a BBC reporter[37] that Baby C had died due to "a combination of air and milk" pumped via the nasogastric tube into the stomach, which differed from what he had said in court when he only mentioned air. Evans was also stated to have changed his mind about this mechanism for babies I & P.[38][39]

Air embolism was implicated to have allegedly been involved in 5 of the 7 murders. Evans frequently cited[40] a 1989 paper by Dr Shoo Lee and A K Tanswell of the Department of Paediatrics, University of Western Ontario, published in Archives of Childhood Disease entitled "Pulmonary vascular air embolism in the newborn" to support their case that skin discolouration was diagnositic of air embolism.[41][1]

Lord Justice Jackson is said to have taken the unprecedented step of writing to Mr Justice Goss in December 2022 to warn him of the unreliability of Evans in a previous case, and that his evidence had then been "worthless".[36][27]

Letby was found guilty of the 7 counts of murder and 6 counts attempted murder and sentenced to life imprisonment with a whole life order on 21st August 2023.[42][43]

After the trial, upon reviewing the descriptions of the infants' skin discolourations, Dr Shoo Lee, author of the 1989 paper used by the prosecution, disagreed that they are suggestive of air embolism. Lee also described any attempt to diagnose air embolism just by ruling out other possibilities as "a fundamental mistake of medicine".[44][45] The defence applied to use Lee as a witness for an appeal, but the Court of Appeal ruled that his testimony was not admissible since he could have been called at the trial and the prosecution's case did not solely rely on skin discolouration to indicate the condition.[46][1][27]

Following Letby's failed appeal, Dr Lee and a group of 14 international neonatology experts conducted a private review of the deaths. During their 3 February 2025 press conference he stated "We did not find any murders. In all cases, death or injury were due to natural causes or just bad medical care" and "In our opinion, the medical opinion, the medical evidence doesn't support murder in any of these babies."[47][48] In parallel, Letby's legal team applied to the Criminal Cases Review Commission which deals with miscarriages of justice to review the case.[49] The Royal Statistical Society criticised the prosecution's evidence, citing similaries to the medical miscarriage of justice cases of Lucia de Berk and Daniela Poggiali.[50] Evans was in turn critical of The Royal Statistical Society's suggestions, as well as the Cheshire Coroner and other expert neonatologists during his November 2024 interview with Sweeney.[28]

During the November 2024 interview by John Sweeney, Evans acknowledged the known presence of pseudomonas aeruginosa in the neonatal unit's water supplies, leading to several cases of pneumonia.[51][52]

Speaking in Hansard in January 2025, Sir David Davis MP, who chaired the February 2025 Dr Lee panel had already lead a debate in the House of Commons on Letby's trial, stating: "It is a clear miscarriage of justice by a judicial system that could not manage admittedly difficult statistical and medical scientific evidence."[53][54] In the same debate, Davis voiced his view that "technical problems" were responsible for failures in Letby's trial; namely that counter-indicative evidence of the murders was available at the time of the trial but that the defence failed to present this to the jury; therefore the grounds for appeal were nullified by the Court of Appeal. Davis was then quoted in Hansard as saying: "It is in essence saying, 'If your defence team weren't good enough to present this evidence, hard luck, you stay banged up for life.' That may be judicially convenient, but it is not justice. This has been a historic problem in Britain, delaying the resolution of a number of miscarriage of justice cases."[27]

References

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  1. ^ a b c d e f g h Letby v Rex [2024] EWCA Crim 748 archived from the original. Archive dated 5 July 2024
  2. ^ a b "'I'm not here for the prosecution. I'm not here for the defence. I'm here for the court'". www.expertwitness.co.uk. Archived from the original on 10 August 2024. Retrieved 2025-02-08.
  3. ^ Mansfield, Mark (2024-07-30). "Mothers at centre of failing maternity unit scandal say their concerns have been brushed aside". Nation.Cymru. Retrieved 2025-02-06.
  4. ^ "British Newspaper Archive". 1990-11-19.
  5. ^ "Doctors attack new hospital plan". 2002-04-29. Retrieved 2025-02-06.
  6. ^ Dobson, Roger (May 2002). "Children's hospital in Cardiff could drain resources from rest of Wales". BMJ : British Medical Journal. 324 (7345): 1056. doi:10.1136/bmj.324.7345.1056/d. PMC 1172148.
  7. ^ Marcovitch, Harvey (2002-01-19). "GMC must recognise and deal with vexatious complaints fast". BMJ. 324 (7330): 167a–167. doi:10.1136/bmj.324.7330.167a. ISSN 0959-8138. PMC 1122077. PMID 11799039.
  8. ^ "Baby's death inquest criticism". 2004-02-18. Retrieved 2025-02-06.
  9. ^ "Doctor slams care given to tot". BelfastTelegraph.co.uk. 2004-02-18. ISSN 0307-1235. Retrieved 2025-02-06.
  10. ^ "Super hospital 'more efficient'". 2005-10-05. Retrieved 2025-02-06.
  11. ^ "Health News: Assault - Child-friendly unit opens in Swansea". CYP Now. 2006-05-23. Retrieved 2025-02-06.
  12. ^ "Dewi Evans Paediatric Consulting Limited people - Find and update company information". find-and-update.company-information.service.gov.uk. Retrieved 2025-02-06.
  13. ^ "Measles vaccination for pupils call". BBC News. Retrieved 2025-02-06.
  14. ^ "Call to give measles MMR jab in mass school vaccination". BBC News. 2013-04-05. Retrieved 2025-02-06.
  15. ^ "Coroner halts inquest into salt poisoning death". BBC News. 2014-06-05. Retrieved 2025-02-06.
  16. ^ Lewis, Ian (2017-02-22). "Child burial fees in Carmarthen set to be scrapped". Wales Online. Retrieved 2025-02-08.
  17. ^ "Call for register for victims of child abuse in Wales". BBC News. 2018-02-20. Retrieved 2025-02-06.
  18. ^ "Doctor claims bite to baby before his death was 'intentional'". Daily Echo. 2018-12-01. Retrieved 2025-02-06.
  19. ^ "Conciliation is the only way to resolve Plaid Cymru's internal discord". Nation.Cymru. 2019-09-28. Retrieved 2025-02-06.
  20. ^ Shipton, Martin (Mar 20, 2020). "Call for resignation of Plaid Cymru's equality director over election bid".
  21. ^ "Dewi is Plaid's Man in Neath". South Wales Daily Post. 16 October 1990. p. 4.
  22. ^ In the Matter of the Children (NI) Order 1995 Upon Appeal from the Family Care Centre in Belsfast [2015] NIFam 14 archived from the original
  23. ^ "Life sentence for Dudley man who murdered baby daughter". BBC News. 2021-02-26. Retrieved 2025-02-06.
  24. ^ Parkes, Thomas (2021-02-04). "Dudley baby death trial: Collapse of five-month-old Summer not due to pneumonia, expert tells court". www.expressandstar.com. Retrieved 2025-02-06.
  25. ^ a b "Bid to exclude evidence of prosecution medical expert was refused by judge". The Independent. 2023-08-18. Archived from the original on 15 May 2024. Retrieved 2025-02-06.
  26. ^ "Fresh doubts are raised over conviction of 'killer' nurse Lucy Letby - as unearthed papers show she was off duty for third of cases". Kmaupdates. 2025-02-05. Retrieved 2025-02-06.
  27. ^ a b c d e "Trial of Lucy Letby - Hansard - UK Parliament". hansard.parliament.uk. 8 January 2025. Retrieved 2025-02-10.
  28. ^ a b "Was There Ever A Crime? The Trials of Lucy Letby with John Sweeney - Podcast Episode". Global Player. Retrieved 2025-02-08.
  29. ^ Mansfield, Mark (2024-11-19). "Doctor whose evidence convicted Lucy Letby speaks out against statisticians who doubt her guilt". Nation.Cymru. Retrieved 2025-02-08.
  30. ^ "Agenda for County Council on Wednesday, 13th September, 2023, 10.00 am". democracy.carmarthenshire.gov.wales. 2023-09-13. Archived from the original on 6 September 2024. Retrieved 2025-02-08.
  31. ^ Gleeson, Bill (2017-06-25). "Death rate at Countess of Chester maternity unit among highest in country". Cheshire Live. Retrieved 2025-02-06.
  32. ^ "Chester hospital baby deaths to be investigated by police". BBC News. 2017-05-18. Retrieved 2025-02-06.
  33. ^ "Neonatal Update - Thursday 18 May". Countess of Chester Hospital (CoCH). 2017-06-17. Archived from the original on 17 June 2017. Retrieved 2025-02-07.
  34. ^ McIntyre, Alex (2022-09-30). "Lucy Letby trial to begin as nurse denies murdering babies at Chester Hospital". Cheshire Live. Retrieved 2025-02-06.
  35. ^ Knapton, Sarah (2024-10-01). "Lucy Letby prosecution witness changed his mind about baby death". The Telegraph. ISSN 0307-1235. Retrieved 2025-02-06.
  36. ^ a b "THE LESSONS OF THE LUCY LETBY CASE" (PDF). www.private-eye.co.uk.
  37. ^ "BBC Radio 4 - File on 4 Investigates". BBC. Retrieved 2025-02-06.
  38. ^ "Expert witness 'changed mind' over deaths, say Lucy Letby lawyers". BBC News. 2024-12-16. Retrieved 2025-02-06.
  39. ^ Knapton, Sarah (2024-10-01). "Lucy Letby prosecution witness changed his mind about baby death". The Telegraph. ISSN 0307-1235. Retrieved 2025-02-06.
  40. ^ "Trial of Lucy Letby - Hansard - UK Parliament". hansard.parliament.uk. 8 Jan 2025. Retrieved 2025-02-10. [David Davis:] Evans's assertion of murder by air embolism was entirely based on a research paper from 1989, and its relevance in these cases has been robustly challenged by the actual author of that paper. Evans changed his opinion on several key issues during the trial, and is now accused by Letby's lawyer of changing his opinion again since the end of the appeal process. Evans disputes this, but if Members are interested, I suggest that they compare his evidence recorded in the trial transcript of 1 November 2022 with his signed statement to Channel 5 on 3 August 2024 and decide for themselves. It is also the case that Evans has submitted a new report to the police. What is extraordinary, however, is that the Crown Prosecution Service has refused to provide a copy of that report to Letby's current defence counsel.
  41. ^ Lee, S. K.; Tanswell, A. K. (1989-04-01). "Pulmonary vascular air embolism in the newborn". Archives of Disease in Childhood. 64 (4 Spec No): 507–510. doi:10.1136/adc.64.4_Spec_No.507. ISSN 0003-9888. PMC 1592039. PMID 2658851.
  42. ^ "The King v Lucy Letby [2023]" (PDF). www.judiciary.uk.
  43. ^ "Lucy Letby sentencing live: Nurse to spend rest of life in prison". BBC News. Retrieved 2025-02-06.
  44. ^ Aviv, Rachel (2024-05-13). "A British Nurse Was Found Guilty of Killing Seven Babies. Did She Do It? | The New Yorker". The New Yorker. Archived from the original on 2024-05-13. Retrieved 2025-02-06.{{cite magazine}}: CS1 maint: bot: original URL status unknown (link)
  45. ^ Wheeler, Caroline (2025-02-01). "My research was misused to convict Lucy Letby — so I did my own inquiry". www.thetimes.com. Retrieved 2025-02-06.
  46. ^ Lawrence, Felicity (2024-07-09). "Lucy Letby: killer or coincidence? Why some experts question the evidence". The Guardian. ISSN 0261-3077. Retrieved 2025-02-06.
  47. ^ "Lucy Letby did not murder babies, claim medical experts". BBC News. 2025-02-04. Retrieved 2025-02-08.
  48. ^ Mahase, Elisabeth (2025-02-04). "Lucy Letby: No medical evidence to suggest murder, experts conclude". BMJ. 388: r250. doi:10.1136/bmj.r250. ISSN 1756-1833. PMID 39904517.
  49. ^ Knapton, Sarah; McArdle, Tom (2025-02-04). "Lucy Letby latest: Experts claim she didn't murder a single baby". The Telegraph. ISSN 0307-1235. Retrieved 2025-02-08.
  50. ^ Knapton, Sarah (2024-09-20). "Letby shift data was scientifically worthless, statisticians warn". The Telegraph. ISSN 0307-1235. Retrieved 2025-02-08.
  51. ^ "Was There Ever A Crime? The Trials of Lucy Letby with John Sweeney - Podcast Episode". Global Player. Retrieved 2025-02-08.
  52. ^ "Trial of Lucy Letby - Hansard - UK Parliament". hansard.parliament.uk. 8 January 2025. Retrieved 2025-02-10. [David Davis:] Around that time, the hospital was struggling with another problem—and possibly a more sensible explanation for this sudden increase in deaths. Leaked reports show that the hospital, and specifically the neonatal unit, battled a Pseudomonas aeruginosa infection for months. That antibiotic-resistant bug posed a serious risk to the babies. The child mortality rate for Pseudomonas aeruginosa ranges from 14.5% to 50%, and stands at over 55% for infants of extremely low birth weight, such as those in this case. It is hard to see how we can eliminate that as the cause of death or collapse for at least some of those babies. Again, the jury never knew about that contamination.
  53. ^ Knapton, Sarah (2025-01-08). "Lucy Letby deserves a retrial, senior Tory tells Parliament". The Telegraph. ISSN 0307-1235. Retrieved 2025-02-10.
  54. ^ "Trial of Lucy Letby - Hansard - UK Parliament". hansard.parliament.uk. 8 January 2025. Retrieved 2025-02-10. My central argument today, which comes back to what my right hon. Friend asked me, is about what to do about a trial which, in my view, is a clear miscarriage of justice by a judicial system that could not manage admittedly difficult statistical and medical scientific evidence. The only body available to correct this today is the Criminal Cases Review Commission. In my view, it should look at all the new diagnoses when they come out, and if necessary consult the leading neonatal and statistical authorities in the land—the most expert people, who are much more equipped to give proper assessment than the experts who were employed by the police at the time. As a result, in my view it should order a retrial, and it should do it quickly
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