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Lucia de BERK






Classification: Murderer
Characteristics: Rob
Number of victims: 1
Date of murder: April
Date of arrest: Same
Date of birth: September 22, 1961
Victim profile: Dec
Method of murder: Shooting
Location: Ohio, USA
Status: Executed by lethal injection in


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Lucia de Berk, often called Lucia de B. or Lucy de B (born September 22, 1961 in The Hague, Netherlands) is a Dutch licenced paediatric nurse, who was subject to a miscarriage of justice. She was sentenced to life imprisonment in 2003 for four murders and three attempted murders of patients in her care. After an appeal, she was convicted in 2004 of seven murders and three attempts. Her conviction was controversial in the media and amongst scientists, and was questioned by investigative reporter Peter R. de Vries. In October 2008, the case was reopened by the Dutch supreme court, as new facts had been uncovered that undermined the previous verdicts. De Berk was freed, and her case was re-tried; she was exonerated in April 2010.


As a result of an unexpected death of a baby (Amber) in the Juliana Kinderziekenhuis (English: Juliana Children's Hospital, JKZ) in The Hague on 4 September 2001, earlier deaths and cardiopulmonary resuscitations were scrutinised. Between September 2000 and September 2001 there appeared to have been nine incidents, which earlier had all been thought unremarkable but now were considered medically suspicious. Lucia de Berk had been on duty at the time of those incidents, responsible for patient care and delivery of medication. The hospital decided to press charges against her.

Life sentence

On 24 March 2003, De Berk was sentenced by the court in The Hague to life imprisonment for the murder of four patients and the attempted murder of three others. The verdict depended in part on a statistical calculation, according to which the probability was allegedly only 1 in 342 million that a nurse's shifts would coincide with so many of the deaths and resuscitations purely by chance. De Berk was however only sentenced in cases where, according to a medical expert, other evidence was present or in which, again according to a medical expert, no natural causes could explain the incident.

In the appeal on 18 June 2004, De Berk's conviction for the seven murders and three attempted murders was upheld. The crimes were supposed to have taken place in three hospitals in The Hague: the Juliana Child Hospital (JKZ), the Red Cross Hospital (RKZ) and the Leyenburg Hospital, where De Berk had worked earlier. In two cases the court concluded that there was proof that De Berk had poisoned the patients. Concerning the other cases the judges considered that they could not be explained medically, and that they must have been caused by De Berk, who was present on all those occasions. The idea that only weaker evidence is needed for the subsequent murders after two have been proven beyond reasonable doubt has been dubbed chain-link proof by the prosecution and adopted by the court. At the 2004 trial, besides a life sentence, De Berk also received detention with coerced psychiatric treatment, though the state criminal psychological observation unit did not find any evidence of mental illness.

Important evidence at the appeal was to be the statement of a detainee in the Pieter Baan Center, a criminal psychological observation unit, at the same time as Lucia de Berk, that she had said during outdoor exercise: "I released these 13 people from their suffering". However, during the appeal, the man withdrew his statement, saying that he had made it up. The news service of the Dutch Broadcasting Foundation (NOS) and other media that followed the process considered the withdrawal of this evidence to be a huge setback for Public Prosecution Service (OM). A series of articles appeared over the following years in several newspapers, including Vrij Nederland and the Volkskrant, raising doubts about the conviction.

The case was next brought to the Netherlands Supreme Court, which ruled on 14 March 2006 that it was incorrect to combine life imprisonment with subsequent psychiatric detention. Other complaints were not taken into consideration, and the evidence from a re-analysis by a Strasbourg laboratory was not considered relevant. The Supreme Court gave the matter back to the Court in Amsterdam to pass judgement again, on the basis of the same factual conclusions as had been made before. Some days after the ruling of the Supreme Court, De Berk suffered a stroke and was admitted to the hospital of Scheveningen prison. On July 13, 2006, De Berk was sentenced by the Court of Appeal in Amsterdam to life imprisonment, with no subsequent detention in psychiatric care.


A committee of support for Lucia de Berk was formed that continued to express doubts about her conviction. Philosopher of science Ton Derksen, aided by his sister, geriatrician Metta de Noo-Derksen, wrote the Dutch language book Lucia de B: Reconstruction of a Miscarriage of Justice. They doubted the reasoning used by the court and the medical and statistical evidence that was presented. See also the English-language article Derksen and Meijsing (2009).

Chain-link proof

Of the seven murders and three attempted murders finally attributed to De Berk by the court, the court considered two proven by medical evidence. According to the court, De Berk had poisoned these two patients. The court then applied a so-called chaining-evidence argument. This means that if the several attempted or actual murders have already been established beyond reasonable doubt, then much weaker evidence than normal is sufficient to establish that a subsequent eight “suspicious incidents” are murders or attempted murders carried out by the same defendant.

For the two murders found proven by the court in The Hague, many experts do not exclude a natural cause of death. In the case where digoxin poisoning was alleged, and supposedly detected by independent measurements in two Dutch laboratories, the method used in those laboratories did not exclude that the substance found was actually a related substance naturally produced in the human body. The Strasbourg laboratory used a new method, a test of high specificity and sensitivity, and did not support the digoxin overdose hypothesis. In the second case, the intoxication could have been an overdose caused by a faulty prescription. For both children, it was not clear how and when De Berk was able to administer the poison. Regarding the digoxin case, the prosecution gave a detailed reconstruction of the timing. However, other parts of the evidence discarded by the prosecution showed by the time-stamp on a certain monitor that at the alleged moment of poisoning De Berk was not with the patient at all, and that the specialist and his assistant were with the patient at that time.

The prosecution initially charged De Berk of causing thirteen deaths or medical emergencies. In court, the defence was able to show definitively that De Berk could not have been involved at all in several of these cases. For instance, she had been away for several days; the idea that she was there was due to administrative errors. Furthermore, all deaths had been registered as natural, with the exception of the last event. Even that last event was initially thought to be a death by natural causes by the doctors responsible for the child, but within a day, on being connected by other hospital authorities with De Berk and her repeated presence at recent incidents, it became classified as an unnatural death.

Statistical arguments

The court made heavy use of statistical calculations to achieve its conviction. In a 2003 TV special of NOVA, Dutch professor of Criminal Law Theo de Roos stated: "In the Lucia de B. case statistical evidence has been of enormous importance. I do not see how one could have come to a conviction without it". The law psychologist Henk Elffers, who was used by the courts as expert witness on statistics both in the original case and on appeal, was also interviewed on the programme and stated that the chance of a nurse working at the three hospitals being present at the scene of so many unexplained deaths and resuscitations is one in 342 million.

This value was wrongly calculated. If one wishes to combine p-values (right tail probabilities) of the statistical tests based on data from three separate wards, one must introduce a correction according to the number of tests, as a result of which the chance becomes one in a million.

Biased reporting meant that this lower figure was invalid. Events were attributed to De Berk once suspicions began to fall on her, which could not have had anything to do with her in reality. The statisticians Richard D. Gill and Piet Groeneboom calculated a chance of one in twenty-five that a nurse could experience a sequence of events of the same type as Lucia de Berk.

Philip Dawid, Professor of Statistics at the University of Cambridge (UK), stated that Elffers “made very big mistakes. He was not sufficiently professional to ask where the data came from and how accurate the data were. Even granted the data were accurate, he did some statistical calculations of a very simplistic nature, based on very simple and unrealistic assumptions. Even granted these assumptions, he had no idea how to interpret the numbers he got”. Professor DasGupta, a toxicologist from the University of Houston, (Texas, US) commented on the complete lack of toxicological evidence with regard to the claimed digoxin intoxication.

The use of probability arguments in the De Berk case was discussed in a 2007 Nature article by Mark Buchanan. He wrote:

The court needs to weigh up two different explanations: murder or coincidence. The argument that the deaths were unlikely to have occurred by chance (whether 1 in 48 or 1 in 342 million) is not that meaningful on its own - for instance, the probability that ten murders would occur in the same hospital might be even more unlikely. What matters is the relative likelihood of the two explanations. However, the court was given an estimate for only the first scenario.

At the initiative of Richard D. Gill, a petition for a reopening of the Lucia de Berk case was started. On 2 November 2007 the signatures were presented to the Minister of Justice, Ernst Hirsch Ballin, and the State Secretary of Justice, Nebahat Albayrak. Over 1300 people signed the petition.


Lucia de Berk's diary also played a role in her conviction. On the day of death of one of her patients (an elderly lady in a terminal stage of cancer) she wrote that she had 'given in to her compulsion'. She wrote on other occasions that she had a 'very great secret' and that she was concerned about 'her tendency to give in to her compulsion'. De Berk has stated that these were references to her passion for reading tarot cards, which she explains she did secretly because she did not believe it appropriate to the clinical setting of a hospital. However, the court decided they were evidence that she had euthanised the patients. According to the court, the reading of cards does not accord with a 'compulsion' nor with 'perhaps an expression of fatigue', as she described it at the time. De Berk's daughter Fabiënne stated in an interview on the television program Pauw & Witteman that some of her mother's notes in the diaries are 'pure fiction' which she intended to use in writing a thriller.

Dutch Forensic Institute Report

After the appeal proceedings were closed, but before the judges delivered their verdict, the Public Prosecution Service received, via the Netherlands Forensic Institute (NFI), a report from a forensic laboratory in Strasbourg on the evidence for digoxin poisoning. The report subsequently lay in a drawer of the NFI for two years, but it did turn up in time for the final evaluation of the case before the Supreme Court. According to the Public Prosecution, the report contained no new facts, but according to De Berk's defence the report proved that there was not a lethal concentration of digoxin in the first case. The Supreme Court accepts the facts reported by the judges at the appeal court, and is concerned only with jurisprudence and correctness of the sentence, given those facts. The report therefore was not admitted into the final considerations of the sentence given to De Berk.

Posthumus II Commission

In general, in the Dutch legal system, cases are not re-opened unless a new fact, called a novum, is found. New interpretations by experts of old facts and data are generally not considered a novum.

In spite of this, Ton Derksen submitted his and Metta de Noo's research on the case to the Posthumus II Commission. This ad hoc, non-permanent commission examines selected closed cases and looks for evidence of errors in the police investigation indicating "tunnel vision" and misunderstanding of scientific evidence. Derksen pointed out that the medical experts who had ruled out the possibility of death by natural causes had not been given all relevant information, that the hypothesis of digoxin poisoning was disproven, in particular by the Strasbourg analysis, and that the statistical data were biased and the analysis incorrect, and the conclusions drawn from it invalid. The commission announced on 19 October 2006 that this was one of the few cases it would consider in detail. Three men, recruited by the Public Prosecution service from the full Posthumus II committee, considered the following matters, having been instructed to focus on possible blemishes in the criminal investigation:

  • Whether there were also unexplained deaths when Lucia de Berk was not present, unknown to the public prosecutor.

  • Whether the expert witnesses were given all relevant available information.

  • Whether scientific knowledge now threw a different light on the digoxin question.

In October 2007, the commission released its report and recommended that the case be re-opened. They concluded that the case had been seriously marred from the start by tunnel vision. In particular, the same persons, chosen from close circles of the hospital authorities rather than on the basis of recognised relevant expertise, had first helped the hospital in its internal investigations, then had advised the police, and finally had appeared before the courts as independent scientific experts. They noted that there was strong disagreement concerning whether or not baby Amber had died of digoxin poisoning. On 2 April 2008, De Berk was released for three months because after re-examination of the death of the last "victim", a natural death could no longer be ruled out.

Case reopened

On 17 June 2008, the Advocate-General of the Supreme Court, G. Knigge, made a request for the Supreme Court to reopen the case. On 7 October 2008 the court acceded to his request, acknowledging that new facts uncovered by Knigge substantially undermined earlier evidence. In particular, an independent team of medical researchers with access to all available medical information had reported to Advocate-General Knigge that the death which sparked the case appears to have been a natural death. The key toxicologist of the earlier trials had agreed with the new medical findings, pointing out that at the time of the trial, the court had only given him partial information about the medical state of the child. De Berk's statements about her doings on the night of that child's death had also been shown to be correct; indeed, during the period in which the courts had earlier concluded that she must have administered poison, the baby was actually being treated by a medical specialist and his assistant.

De Berk was allowed to remain free while awaiting a retrial at the Court of Arnhem, which first adjourned while further investigations were made. The public prosecution had asked for extensive new forensic investigations, but this request was turned down by the court. Instead it commissioned further independent medical investigations into the cases of two more of the children, again allowing a multidisciplinary medical team access to all possible medical data concerning the children. At a session on 9 December 2009, the court stated that new integral medical investigations of the last nine months had confirmed that the cases of Amber, Achmed and Achraf were all natural deaths/incidents. These were the only cases where there was previously claimed proof of De Berk's culpability.)

The appeal hearing ended on 17 March 2010. Witnesses heard on the final day stated that the deaths at the Juliana Children's hospital were natural, sometimes caused by wrong treatment or bad hospital management, and sometimes unexpected because of faulty medical diagnosis. The behaviour of the nurses, including De Berk, during a couple of medical crises turned out to have been swift and effective, saving lives on several occasions. The Public Prosecution capitulated, formally requesting the court to deliver a not guilty verdict. On 14 April 2010, the court delivered the not guilty verdict.


On 12 November 2010, it was revealed that De Berk had received an undisclosed amount of compensation from the Ministry of Justice. The news was first broadcast by a local TV station in the West of the Netherlands. It was later confirmed by the ministry to the Dutch news agency ANP.

Nurse Lucia de Berk not guilty of murdering seven patients

April 14, 2010

Nurse Lucia de Berk has been formally found not guilty of murdering seven patients and attempting to murder three more, ending one of the biggest miscarriages of justice in Dutch legal history.

De Berk, who always maintained her innocence, was jailed for life in 2004.

The case against her was largely based on statistical evidence and claims that a baby had been poisoned.

That supposed murder, later disputed by toxicologists, led prosecutors to state that other patients had also been killed by her.


Following campaigns by doctors and statisticians, De Berk was released from jail in 2008 pending a review of the case and eventual retrial. In March, the public prosecution department urged judges to find her not guilty.

The way is now clear for De Berk, once described as the Netherlands' most notorious serial killer, to make a substantial claim for damages.

Justice minister Ernst Hirsch Ballin told reporters he has sent De Berk a letter apologising for her incarceration. 'What has been done to her is dreadful,' he said.


The former nurse is entitled to 'generous' financial compensation, he said. De Berk spent over six years in jail.

Public prosecution department chief Harm Brouwer has already apologised to De Berk in a private meeting last week, Nos tv reports.

The public prosecution department has also apologised to families of the people deemed to be De Berk's victims.


The alleged murders and attempted murders took place at three hospitals between 1997 and 2001. They came to light after police began investigating the death of a baby girl named Amber.

De Berk's eventual conviction was based on two deaths, including that of baby Amber, which toxicology reports said could have been caused by digoxin poisoning.

All the other patients were either very old or very sick and died as a result of 'medically unexplained' causes. In these cases, De Berk was on duty 'noticeably often' when someone died, the prosecution department had claimed.

The statistical probability of her being present at so many deaths was central to the prosecution's case. None of the alleged victims underwent post mortem examinations.

Dutch nurse gets life for murdering four patients

By Andrew Osborn -

March 25, 2003

A Dutch nurse thought to be one of the most prolific serial killers in the Netherlands was yesterday jailed for life after a court found her guilty of the murder of four of her patients and the attempted murder of three others.

Lucy Isabella Quirina de Berk, 41, has repeatedly protested her innocence but a court in the Hague yesterday concluded that she had killed three babies and one elderly woman by lethal injection.

It also found her guilty of trying to murder two other babies and another pensioner.

The case has captured the public imagination because of the large number of people who died under suspicious circumstances in De Berk's care - she was initially accused of killing 13 and of attempting to murder five others.

It has also raised fears that the Netherlands' ground-breaking decision to legalise euthanasia may allow doctors and nurses to get away with murder.

The presiding judge, Jeanne Kalk, said: "[De Berk] went about her work in a refined and calculating way when the chance of discovery was small. Apparently she believed she was qualified to hold the power of life and death over these people."

The murders happened between 1997 and 2001 at three hospitals in the Hague. In each case the patient died of an overdose of either potassium or morphine and De Berk was the last person to be at the bedside.

During her trial statisticians testified that the chances of her being present coincidentally at each death were one in 342m.

A verdict had been expected last October, but De Berk was ordered to undergo psychiatric tests.

Her conviction was secured with the aid of apparently damning entries in her personal diary.

"I gave in to my compulsions ... I don't even know why I am doing it ... I will take this secret with me to the grave ... still I hope I am helping people by this," read one such entry.

De Berk's lawyer said yesterday he would appeal against the ruling, which he alleged was based solely on circumstantial evidence.

Nurse accused of killing 13 patients insists she's innocent as trial ends

Canadian Press

Tuesday, September 24, 2002

THE HAGUE (AP) - A Dutch nurse accused of murdering 13 patients with drug overdoses insisted she is innocent Tuesday, saying her love for life is so vast she could never kill another person.

Lucy Quirina de Berk's comments brought to a close the five-day trial and judges went into deliberations. They will issue their verdict Oct. 8 and sentence de Berk if she is found guilty. In a final appeal to the court, de Berk, who spent her teenage years in Canada, said prosecutors had unfairly portrayed her as a calculating killer and that she isn't the evil person they made her out to be. "It is true that I often questioned my own life," de Berk told the panel of three judges. "But I never questioned that of another."

"My mother always said I was a difficult and she was right, but to say I killed people just isn't true."

De Berk, who has a history of depression and worked as a prostitute in Vancouver and the Netherlands, has been described by prosecutors as a sociopath who skilfully killed her patients with lethal overdoses of medication for 4˝ years.

"We cannot predict what the court will rule," said prosecution spokeswoman Astrid Rijsdorp. "But we are coinvinced she took their lives," she said.

De Berk has admitted lying under oath about her credentials and stealing copies of patient records. Her lawyer Ton Visser argued Tuesday that those offences can't be accepted by the court as proof of an intent to kill.

Visser called for the dismissal of charges, arguing that the prosecution's case was sloppy and inconclusive.

The 41-year-old suspect has been charged with 18 counts of murder and attempted murder at four hospitals in the Hague area. She is a suspect in several other cases, but prosecutors said they didn't have enough evidence to prove her involvement.

De Berk's alleged victims, ranging from infant children to a 91-year-old Chinese judge at the United Nations war crimes tribunal, died between 1997 and 2001 in varying circumstances that puzzled medical experts who testified in her trial.

The defendant's brother, who gave a statement to investigators, called his sister a good liar and said he believed she was capable of killing. Several colleagues were quoted as saying de Berk had an unhealthy attachment to terminally ill patients.

Prosecutors called an FBI expert on serial killers to sketch a profile of the "typical" culprit in multiple murder cases and a toxicologist to explain how her alleged victims had died.

In nearly all cases, chronically ill patients turned blue and died suddenly and unexpectedly while de Berk was on duty. A number of them, including a six-month-old girl successfully operated for heart trouble, had been expected to return home soon.

But the fact that people died while in de Berk's care isn't enough to implicate her in murder, Visser argued. "Coincidence exists," he said.

"If people are ill and are deprived of oxygen they discolour, that doesn't have to mean it was Lucy's fault," he said.

None of the witnesses directly linked de Berk to the deaths or said they were sure she had committed the crimes in her indictment.

Further countering prosecution allegations, Visser cited witness statements describing de Berk as a caring, competent and involved member of her hospital team. Her performance, he said, had not been doubted until prosecutors opened a criminal investigation in Sept. 2001.

De Berk described her difficult youth with alcoholic parents who she said were unable to give her attention. After dropping out of high school and breaking from her family, she was tricked into prostitution and later robbed and beaten by customers.

On Monday, prosecutors requested that she be sentenced to life imprisonment, saying she is a danger to society.

"They have portrayed me as a bad person and I'm just not like that," de Berk told the court in her final plea.

"I love life and would never take that away from anyone," she said.

Dutch nurse 'killed 13 by lethal injection'

Hague court hears woman deny hospital murders

By Andrew Osborn -

September 18, 2002

A Dutch nurse accused of carrying out a killing spree on patients in her care went on trial yesterday for the murder of 13 people, including four babies.

Lucy Isabella Quirina de Berk, 40, allegedly administered lethal injections of morphine or some other drug to at least 13 patients. She is charged with the attempted murder of five others.

The deaths occurred between 1997 and 2001 at three different hospitals in the Hague.

The victims were aged between two months and 91 years and prosecutors claim that Ms De Berk deliberately preyed on the very young and the very old so as not to arouse suspicion. She was, they say, "obsessed with death" and a psychopath.

One of the victims was a 91-year-old Chinese judge at the Yugoslav war crimes tribunal.

Rene Elkerbout, a spokesman for the Hague district court, where the case is being heard, says it is the most serious murder trial the city has ever seen: "Thirteen victims is a record for us. We've never had anything like this before."

Ms De Berk denies the charges and yesterday, on the opening day of her trial, she tried to pin the blame on negligent doctors whom she claimed had failed to realise how seriously ill the patients in her care were.

One of the 13 people who died under her supervision was a physically and mentally handicapped six-year-old Afghan boy, Ahmad Noory, who died as a result of a lethal overdose of sleeping medication. Yesterday Ms De Berk denied she had killed the boy.

"I have a clear conscience. I didn't do a thing," she told the presiding judge, Jeanne Kalk. "Of course it [his death] is strange but I don't know how it happened.

"I warned the doctor that the child was very ill and nothing was done. Nobody did anything when I told them Ahmad had stopped responding and couldn't be woken up."

It was the first time that Ms De Berk had broken her silence on the case since her arrest last December.

Her lawyers say there is little real evidence against her and not a single witness: much of the prosecution case is based on the premise that she appeared to be the only person present when the patients died.

The fact that many of those who died were children born with physical abnormalities or elderly people suffering from terminal illnesses also complicates the prosecution's task.

However, in March investigators exhumed the bodies of three children initially believed to have died of terminal illnesses and discovered traces of toxins in their blood.

Ms De Berk is also accused of forging her professional qualifications and prosecutors claim that her reading matter indicates she has an unhealthy interest in murder. Searches of her home unearthed books such as Inside the Home of a Serial Killer.

In a country where euthanasia has just become legal - though it has been informally tolerated for decades - the case has touched a raw nerve.

The new law lays out strict criteria for mercy killing but the De Berk case has revived fears that medical staff could get away with murder more easily.

The indictment against Ms De Berk shows she had a troubled childhood. Her alcoholic parents moved to Canada when she was a teenager and she worked as a prostitute in Vancouver.

The trial, which is expected to last until Monday, will hear from a toxicologist and an FBI expert on serial killers. A verdict is not expected for a fortnight. Ms De Berk could face life imprisonment.

Dutch nurse 'killed' war crimes judge

BBC News

June 19, 2002

A judge with the war crimes tribunal for the former Yugoslavia has been identified by Dutch prosecutors as one of the alleged victims of a nurse charged with murdering 13 people over a four-year period.

Chinese judge Haopei Li died in November 1997 at the age of 91. No details on the cause of his death were released at the time.

The nurse, Lucy Isabella Quirina de Berk, is accused of killing both children and elderly people in her care by giving them a lethal dose of morphine and potassium.

The killings are alleged to have taken place between February 1997 and September 2001.

Ms De Berk, 40, has been in custody for six months and is due to go on trial in The Hague in September.


"The judge was one of her victims," Evert Boerstra, spokesman for the Hague prosecutors office told BBC News Online.

Mr Boerstra said was no indication that Li's position at the UN court had anything to do with his alleged murder.

A founding member of the 11-member war crimes tribunal in The Hague, the judge was due to retire the same month as his death.

Ms De Berk got into medical training using a fake high school diploma, her indictment says.

Prosecutors described her as a classic psychopath "obsessed with death".

Ms De Berk spent her teenage years in Canada after moving to Winnipeg from the Netherlands with her alcoholic parents, and later worked as a prostitute in Vancouver, prosecutors say.

Dutch nurse accused of 14 murders

BBC News

May 8, 2002

A Dutch nurse has been accused of murdering 14 people, according to public prosecutors.

Her victims are said to include babies, young children and elderly patients at four hospitals in The Hague.

Prosecutors have described the woman as a "classic psychopath".

The killings are alleged to have taken place over a four-year period between February 1997 and September 2001.

The nurse, who has also been charged with four attempted murders, is due to go on trial in The Hague in June.

Lethal overdose

The woman, aged 40, is accused of killing five babies and children and nine elderly people in her care, by giving them a lethal dose of drugs.

"The nurse is suspected of killing the victims by giving them substances such as potassium... and morphine," Hague prosecutors said in a statement.

"In certain cases, the nature of the deadly substance could not be determined."

Some of the deaths were said to have occurred in a children's ward and a prison infirmary, but the prosecutors' statement gave no indication of the illnesses suffered by the victims.

Babies less than a year old and patients as old as 91 were among the victims, prosecutors said.

The nurse, whose name has not been released, is also charged with four attempted murders and forging school certificates to enable her to qualify for medical training.

She was suspended from her last job at a hospital in The Hague in 2001 following the death of a baby. She has since been sacked.

According to the Associated Press news agency, the woman is a former resident of Winnipeg, Canada, who is obsessed with death and has attempted suicide seven times in the past decade.

The bodies of three children she allegedly killed were disinterred for examination in March, according to the news agency.

Synopsis/reconstruction of the Lucia de Berk case

* Supervisors at the hospital are suspicious because of a small cluster of deaths and the repeated presence of a particular and striking nurse in the shifts when the deaths occur; there has been some gossip among some colleague nurses, too, concerning her past.

Actually, an intensive care ward has just been closed for economization reasons and the cluster is probably due to a change in case-mix on the ward in question. There is also nervousness among the staff because of reorganization, merger, possible job losses.

* After a lull, a new event (Achraf) raises suspicion again to high levels. Gossip increases.

* Lucia is deliberately given heavy night shifts while Amber's situation is rapidly deteriorating though the responsible specialist is not aware of this and has told the parents that she can go home [to die?] soon.

* Amber dies on Lucia's shift, the hospital goes into Red Alert. Press release, newspaper items, letters written to parents of dead children. "Sorry, it seems we may have a serial killer here, but don't get angry, we are in full control of the situation". Some days later the police are also involved. 9-11.

The police come to law-psychologist and ex-statistician Henk Elffers with the story, thinking that it is probably much ado about nothing. He convinces them that it is NOT chance, something really is going on! It is indeed not chance as he understood it, his formulation of "chance" is the wrong one.  His analysis is inappropriate. Moreover the data he was given were biased, and moreover, (adding insult to injury) he blundered in his calculations. He ALSO resolved all possible data-analysis choices available to him, in the way most damning to Lucia, whether by luck or bad judgement, we shall never know.  Though repeatedly hearing the extensive scientific arguments against his methodology he never retracted them.

In the meantime the hospital authorities have come up with lots more deaths and incidents at other hospitals. We had a serial killer, now we also have the people she killed. It just remains to get the proof. How did she do it and why?

After a year, someone comes up with the digoxin theory and a (provably wrong) reconstruction is given of how Lucia poisoned Amber with digoxin. The situation right now is that there is good reason to believe she did not die of this at all [Dasgupta - top world authority on digoxin poisoning]. 

Uges: "the mystery is not what Amber died of, but how come she was still alive".  The available material was of "such bad quality that the actual cause of death is idle speculation".

De Wolff, alone, does still support the digoxin theory as cause of death, but he rules out that it was administered by Lucia.  There are still the mysteries of where did the piece of gauze come from, which was found at the second autopsy, but so far not claimed by anyone, and from which a sample of bloody fluid was squeezed out. And why was the last real blood sample taken of Amber, taken while she was still alive, get thrown away the week _after_ a murder investigation starts§?

At the first court hearing, Richard de Mulder [colleague and collabororator of Elffers, a lawyer with an MBA and a computer hobby] supports Elffers' analysis and conclusion, and convinces the court that "the coincidence needs explanation".

They understand this as follows: "Lucia needs to explain the coincidence". She is unable. Five possibilities offered her by Elffers "by way of example" do not give her any help. The fact that Lucia denies killing, and cannot explain her presence, shows she is a liar and a killer, and the fact that no evidence can be found of how she killed anyone else, shows how refined a killer she is. The fact that the times of death were unpredicted and that no common cause could be found provides a link between them (!). The diary provides a motive - a compulsion - because of a coincidence between a diary entry and a death of a terminally ill aged cancer patient on her ward. The non-coincidences are not reported. Lucia is convicted of only 4 of the murders and 2 of the attempted murders, with which she was originally charged.  She is given a life sentence.

Both Lucia and the prosecution appeal. The prosecution wants more murders pinned on Lucia. This requires even stronger reliance on the statistics since other key parts of the evidence have significantly weakened in the meantime. However moral probabilist Meester and computer scientist and logician van Lambalgen insist that there is not a single well defined probability in such a case. The judges obligingly remove reference to any particular probability and any particular calculation-method from their summing up.  The fundamentally wrong argument of Elffers and de Mulder, based moreover on wrong data, remains in its entirety, but in verbal form and carefully avoiding use of the words "probability" or "statistics". The first page of the summing-up reports that indeed, no statistical probability calculation is used in the conviction. Exeunt statisticians. Lucia is convicted for 7 murders and 3 attempts (still less than she was charged with). The court increases the sentence to life, followed by detention in psychiatric care.

The evidence from Strasburg, further destroying the digoxin argument, arrives too late for the trial. It is lost in a drawer at the Netherlands Forensic Institute for two years. The Supreme Court removes detention in psychiatric ward after the life sentence, since Lucia has not pleaded that she was mentally disturbed when doing the crimes. (She still declares her innocence).

Committee Posthumus II ("Evaluation of closed cases") does take Lucia's case into consideration and passes the dossier to a committe of Three Wise Men, recruited from the larger committee. The "three wise men" are to report to the Public Prosecution Service and they have a Public Prosecutor as chairman, a professor of criminal law and part-time judge, and a retired policeman from the board of Rotterdam's Feyenoord football team, as advisory members. They are instructed by the "entrance committee" - i.e., by themselves - to see if errors have been made in the police investigation. They are not instructed to look at errors made by the prosecution. There can be no errors made by the judges, since the case has now been to the ultimate authority, the Supreme Court. They can in principle make a recommendation that the case be reopened. This advice would then be considered by the Supreme Court. The Supreme Court has the power to send the case to be reopened by a normal appeal court.

The Supreme Court will only request reopening of the case if "new evidence" is available, of such import, that had it been available to the judge during the trial, it would likely have impacted the judge's conclusion, or if new evidence shows that key evidence gathered by the police was not actually legal. The Three Wise Men have not instructed themselves to see if there is new evidence. Nor can they conclude that the wrong conclusions were drawn from existing evidence (this is legally speaking impossible, since the case is legally closed).

They are only to see if police procedures were imperfect. They might conclude that there were failings in police procedure but they could easily imagine that this did not impact the verdict significantly, if they are not to evaluate the judge's arguement anyway.

As said, the three wise men will report to the Chief of the Public Prosecution Service, not to the Supreme Court.

The Chief Public Prosecutor will consult with the Minister of Justice before acting in this situation. Both he and the Minister of Justice believe that the system in the Netherlands works perfectly. Moreover they believe that public faith in the system was already too badly shaken by the events which led to the installation of committee Posthumus II. That committee is part of an operation to restore public faith in our system, which is not subject to any of the faults which have beset the systems of other countries in recent years. They will be highly reluctant to allow public faith to be shaken by the reopening of yet another case.

Posthumus II only received requests to consider 25 cases, and only took up 3 of them. These small numbers are said to confirm that the system is indeed working very well, as was expected; the public's worries were unfounded and public faith in the system can be restored. (In the UK, the CCRC receives about 2000 cases per year, admitting about 25; almost all of these 25 finally lead to overturned convictions). The criteria for consideration by Posthumus II are however extremely stringent. It is only admitted that police investigators could err, by misinterpreting scientific evidence, thereby inadvertently leading public prosecutors astray. The only members of the "public" who were allowed to submit a case are established scientists who have done significant new research on it.

A recent survey shows that the Dutch public is actually highly satisfied by the justice system in the country (fourth European place). The scandals which led to installation of the Posthumum II committee have had no impact on this at all. I hope that the chief public prosecutor and the minister of justice will take this to mean that no harm whatsoever need be done to public faith in the system by reopening this case too.




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