INQ0000844 – Blood Test Results of Child F shows blood glucose of 999mmol/l thirlwall inquiry
Executive summary
The document INQ0000844 is an exhibit in the Thirlwall Inquiry containing blood-test results for “Child F” produced for R v Letby (the source document is indexed in the Inquiry’s evidence pages) [1]. The reported figure — “blood glucose of 999 mmol/L” — sits massively outside standard clinical thresholds for hyperglycaemia used in paediatric medicine, and the most plausible immediate explanations are measurement or transcription error rather than a survivable physiological blood-glucose level; verification of the laboratory method, units and repeat testing are therefore essential [2] [3].
1. The report exists and contains a highly anomalous value
The Thirlwall Inquiry’s evidence list includes a file titled “INQ0000844 – Blood Test Results of Child F,” which was produced in the criminal proceedings of R v Letby and is available through the Inquiry’s evidence pages [1]; that file is the source of the cited glucose figure. The raw value as stated — 999 mmol/L — is presented in the context of that evidence, prompting scrutiny because it is far beyond routinely described paediatric measures for glucose and diabetes thresholds [2].
2. How usual paediatric glucose values compare to the reported number
Clinical guidance and reference ranges used in paediatric diabetes workups show that diagnostic thresholds are orders of magnitude lower than 999 mmol/L: a fasting whole-blood glucose higher than about 6.7 mmol/L or a 2‑hour value above about 11 mmol/L indicate diabetes in children in standard protocols [2], and typical “normal” pediatric blood-glucose ranges discussed by expert paediatric centres and patient education resources are expressed in tens rather than hundreds of mmol/L [4] [5]. That gap is not a small discrepancy but a categorical mismatch between routine clinical reality and the reported figure [2] [4].
3. Measurement, units and transcription are common sources of anomalous results
Authoritative sources emphasise that blood-glucose measurement methods vary in accuracy — venous blood tests are more accurate than fingerstick meters or continuous glucose monitors — and that incorrect readings can and do occur, particularly with point-of-care devices or in transcription from lab instruments to reports [3] [4]. Given those established vulnerabilities, a single extraordinary numeric entry in an evidence file should trigger verification of the assay method, the sample type (venous vs capillary), and whether the units were mis‑stated or a decimal point / digit was misplaced; the publicly available sources warn clinicians to treat anomalous readings with caution pending confirmation [3] [4].
4. Clinical implications and immediate actions that the literature supports
Clinical practice guidance for children with high measured glucose highlights specific follow-up steps: repeat testing using an accurate venous sample, assessment for ketones when blood sugar is high, and involvement of the specialist diabetes team to interpret unexpected values — actions meant to distinguish true severe hyperglycaemia and diabetic ketoacidosis from artefact or device error [6] [3]. None of the sources supplies a clinical precedent or plausibility for a sustained physiologic glucose concentration on the order of hundreds or thousands of mmol/L, and established paediatric diabetes literature frames urgent investigation and repeat measurement as the correct next steps [2] [6].
5. What the available sources do and do not say about this specific entry
The Thirlwall Inquiry entry confirms the document’s existence but the public excerpted evidence pages do not, by themselves, explain how the 999 mmol/L figure was derived, whether it reflects a unit error, transcription mistake, or laboratory instrument output, nor whether a repeat or confirmatory venous test was performed after the entry [1]. The medical and patient‑education sources consulted outline expected ranges, diagnostic cutoffs and recommended verification practices, but they do not provide direct forensic commentary on the provenance of this particular anomalous value [2] [3] [6].
6. Bottom line: a figure that demands forensic verification, not an immediate clinical diagnosis
Taken together, the published medical standards and testing guidance make clear that a solitary, extremely high glucose number in an evidence document should be treated as an outlier until the laboratory methodology, sample type, units and data transcription have been audited and a repeat—or an alternative venous laboratory assay—has been performed [3] [2] [6]. The Inquiry document confirms the value’s presence in the case record [1], but available sources do not supply the laboratory audit trail needed to explain whether 999 mmol/L reflects true physiology or error.