Nurse dubbed the ‘Angel of Death’ after murdering patients with insulin in a strikingly

From its imposing perimeter wall to its forbidding entrance gates, everything about HMP Frankland appears designed to extinguish hope. 

Only convicts facing a long stretch come to this maximum-security facility, dubbed ‘Monster Mansion’, because of the high number of notorious offenders incarcerated here.

Soham murderer Ian Huntley, serial killer Levi Bellfield and former police constable Wayne Couzens – who kidnapped, raped and murdered Sarah Everard – form part of the prison’s infamous roll call. The shocking brutality of their crimes means none is ever likely to be freed.

Another prisoner at Frankland is Scottish nurse Colin Norris, the so-called ‘Angel of Death’ who was sentenced to life imprisonment for killing four elderly patients in his care and trying to murder a fifth by injecting them with insulin.

Just a stone’s throw from Frankland in the Durham countryside is its Category A sister prison, HMP Low Newton, where another serial killer nurse, Lucy Letby, is serving 15 whole life sentences for murdering seven babies and attempting to murder seven others between 2015 and 2016.

Both are equally reviled for their crimes, for repeatedly attacking the most vulnerable in society: the very young and the very old.

Norris’s victims were inpatients on orthopaedic wards in Leeds, where he worked. All were found to be suffering from hypoglycaemia, or extremely low blood sugar, which causes the brain and other organs to shut down.

Prosecutors claimed hypoglycaemia in non-diabetic patients is so rare that a cluster of five cases within six months must mean murder. Jailed for a minimum of 30 years in 2008, Norris was described by a judge as ‘a thoroughly evil and dangerous man’.

A hand-wringing NHS report followed, detailing the ‘organisational, systems and cultural’ failures which allowed Norris to go freely about his murderous plan.

‘A determined killer like Colin Norris would be difficult to spot in any NHS organisation,’ said Dr Peter Belfield, medical director of Leeds Teaching Hospitals, adding: ‘This is a highly unusual case. We employ 13,500 staff. This was one nurse who was a criminal.’

Then came Letby – another highly unusual case, and another NHS horror story.

But the deeply troubling nature of both cases has now taken on a new twist. For compelling expert evidence has emerged which casts serious doubt on the safety of the verdicts against Colin Norris and Lucy Letby.

Earlier this month, a panel of 14 international paediatric and neonatal experts caused a sensation when they published a paper claiming Letby did not murder any babies in her care. Her lawyers are preparing an appeal in a bid to secure her freedom. 

Similarly, Norris’s supporters insist the largely circumstantial case on which he was convicted 17 years ago was based on flawed science and that not only is Norris innocent of any crime but that his ‘victims’ were not actually murdered.

His case has now reached a crucial milestone, with a hearing set for May at the Court of Appeal in London, which is due to last up to four weeks. Progress has been glacial – it is four years since the case was first referred to the appeal courts by the chronically under-resourced and overworked Criminal Cases Review Commission (CCRC) which, in turn, took eight years to decide whether the case met its high threshold.

It does not take such steps lightly. Since its creation in 1997, the CCRC has referred just three per cent of the applications it has received to the appeal courts.

In referring Norris’s case, the CCRC concluded ‘that there is a real possibility that the Court of Appeal will decide that Mr Norris’s conviction for the murder/attempted murder of one or more of the patients is unsafe’.

It concluded that new research suggested hypoglycaemia in four of the patients may have be down to natural causes and the assertion that the fifth was killed by Norris was fatally weakened if there was no longer a cluster of suspicious deaths linked to him.

If appeal judges agree and quash his convictions, it would recast Norris – who has always protested his innocence – as the victim of one of the worst miscarriages of justice of modern times, having spent almost two decades behind bars for crimes that simply never happened.

Last week, one of the experts backing Norris’s case claimed the similarities with Letby are glaring and said he believes their convictions could both be overturned.

Professor Alan Wayne Jones, a retired expert in forensic toxicology, told the Mail: ‘I see close parallels between the two cases, absolutely. It’s absolutely possible Colin Norris and Lucy Letby could be cleared of these crimes on appeal, given the weight of evidence that might be gathered to undermine the methodology applied in the trials.’

If so, it would signal an astonishing turnaround. But how could evidence considered by a jury to be as unbreachable as the concrete walls of HMP Frankland suddenly crumble to dust?

After all, Justice Griffith Williams was in no doubt about Norris’s murderous intent when sentencing him in 2008 at Newcastle Crown Court.

‘You are an arrogant and manipulative man with a real dislike of elderly patients,’ he told him. ‘Only you know why that dislike was so much that you decided to kill. Despite months of evidence, I am no wiser as to your motive.’

For Norris, now 49, and his supporters there was no motive because there were no murders.

Born in Glasgow in 1976 and raised in the city’s Partick area, Colin Norris decided to train as a nurse after completing a first aid course while working as a travel agent. ‘He just seemed to have an aptitude for it,’ his mother, June Morrison, once recalled.

‘He had always been a very caring person. When he was a teenager, he used to take kids in wheelchairs to watch the football.

‘This image of him as a callous, heartless person who hated the elderly – it bears no relation to the truth.’ After obtaining both a nursing degree and a higher diploma at Dundee University, Norris moved to Leeds to work.

There, Mrs Morrison said, senior staff soon grew to trust him and were happy to leave him in charge. He bought a house and began to take extra agency shifts to help pay his mortgage.

But in late 2002 his nursing career effectively ended when Ethel Hall, 86, a patient recovering from an operation to repair a broken hip on ward 36 at Leeds General Infirmary, was found unconscious early on the morning of November 20.

It was Norris, covering the night shift, who discovered she was suffering from severe hypoglycaemia, and she was given glucose injections. Her blood sugar level returned to normal, but she never regained consciousness and died three weeks later.

When a lab in Guildford, Surrey, found inexplicable levels of insulin in her blood, the police were called in. Operation Bevel was led by Detective Chief Superintendent Chris Gregg, who had recently reviewed the 22 West Yorkshire deaths associated with Dr Harold Shipman, thought to have killed some 250 patients in his care by giving them overdoses of heroin.

The Shipman case had made police sensitive to possible murders by medical personnel and they seized on remarks Norris made to colleagues on the night Mrs Hall fell ill, such as, ‘I don’t think Ethel looks right,’ and that he had a ‘funny feeling’ about her. None of his colleagues told police they believed he had contributed to her death.

On December 11, Norris was arrested, questioned and held for 29 hours. He denied giving Mrs Hall an insulin injection or doing anything else to harm her.

The Guildford lab test was to be a mainstay of the case against Norris. In some people, high insulin levels can happen naturally, but there is normally a high level of another substance too, an enzyme called C-peptide – which was not present in the sample from Mrs Hall.

That implied she had been injected with synthetic insulin. Crucially, however, the lab breached its own protocols by failing to carry out a second confirmatory test on a separate sample. Moreover, the single test was conducted on a sample taken from Mrs Hall after she had been given glucose – which, say experts, can distort the results.

Some experts argue a less sinister explanation for the blood result is a rare condition called insulin auto immune syndrome (IAS), which causes insulin levels to spike without C-peptide. A chemical test is available to establish the presence of IAS, but it was not carried out.

Norris’s defence was told about IAS after the trial began, by which time they had already accepted the argument that the blood test was proof Mrs Hall had been poisoned. Their strategy was to argue that someone other than Norris had carried out the fatal injection.

Operation Bevel turned up four other cases of non-diabetic patients with hypoglycaemia, including three who died – Bridget Bourke, 89, Doris Ludlam, 80, Irene Crookes, 78, and Vera Wilby, 90, who had suffered an episode but recovered. Yet, all that could be said was that the patients had the condition – their insulin levels were never tested.

Campaigners have since discovered at least six women who were never looked after by Norris and who died from hypoglycaemia in the hospitals where he worked in the same period. Yet Operation Bevel took no account of these other deaths. 

Insulin injections featured in the Letby case, too, and tests on samples from two babies she was accused of attempting to murder were also checked at a clinical lab, not a forensic one.

Without forensic involvement, according to an NHS guidance note, such testing cannot usually be used to infer whether insulin has been administered artificially, but merely to indicate what level it is at in a patient’s blood. Professor Jones believes this renders these two convictions unreliable, saying the tests are ‘not proof of foul play in a criminal prosecution for murder’.

Letby’s trial at Manchester Crown Court also heard about suspicious clusters of babies falling ill on her watch. At first, the cluster evidence appeared damning in both cases.

But statistics, as Paul May, the veteran campaigner against miscarriages of justice who has taken up Norris’s case, pointed out, are notoriously unreliable.

‘Any hypothesis is only as valid as the most recent data,’ he said. ‘This sits uneasily within the adversarial English criminal trial system. Judges, lawyers and jurors routinely demand unambiguous certainty from expert witnesses, who may feel tempted to provide dogmatic and inflexible evidence.’

Norris and Letby’s cases were both affected by this rigid framework, says Professor Jones.

He told the Mail: ‘All the victims in the Norris case were allegedly given insulin although there was only any laboratory evidence in one case [Ethel Hall], which was the ‘trigger case’ and when Norris was already a suspect.

‘The other cases were ‘cherry picked’ by a trawl through hospital records to find cases of terminal hypoglycaemia when Norris was on duty.’

He points out that expert research since Norris’s conviction has concluded that spontaneous hypoglycaemia is far more common than first thought, affecting up to 10 per cent of non-diabetic elderly patients with serious risk factors like the women Norris was accused of attacking.

If the number of deaths fell within expected levels, any sign of a cluster vanishes. In the same way, Professor Jones says the panel of experts that reviewed the case notes of all Letby’s victims found ‘no evidence of foul play’, while several other deaths and collapses that occurred around the same time were not included in the prosecution case.

Letby’s trial prompted the Royal Statistical Society to issue a paper titled Healthcare Serial Killer Or Coincidence? which warned that ‘unexpected clusters’ of deaths ‘generally should not be taken as definitive evidence of misconduct’ in criminal cases.

Professor Jones argues Norris’s demeanour throughout the trial seemed to count against him, an observation also levelled at Letby.

‘He came across as rather cold and unfeeling and was described as that in the evidence,’ he says.

‘And it would not play well for him if a jury was perceiving him in that way.’

The prosecution alleged Norris was motivated by animosity towards elderly patients, pointing to a police interview in which he said he found bathing older female patients difficult while on student placement.

He’d made clear he only had problems ‘at first’ and ‘soon got over it’. At trial, he denied any dislike of older patients saying: ‘If you don’t like elderly patients you shouldn’t be in nursing.’

Yet, behaviour, however odd, is likely to carry much less weight with Appeal Court judges than cold, hard facts. As far as the CCRC is concerned, the facts now appear to speak in Norris’s favour.

But if he walks free in a few weeks without a blemish on his character, it will surely not be the end of things.

After all, if it’s possible to unpick the case against Colin Norris, others will watch their cell doors with renewed hope.