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panorama.s2014e46.the.innocent.serial.killer
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00:00Tonight on Panorama, the story of the nurse convicted of murdering four patients and attempting
00:08to murder a fifth.
00:10He has been found with a quantity that much insulin in it.
00:15A convicted hospital serial killer Colin Norris was branded the angel of death but he's always
00:22protested his innocence.
00:23There has been a miscarriage of justice here and he is not guilty.
00:28Tonight the new evidence which casts serious doubt on each of his convictions.
00:34I think the forensic evidence stops there because it's invalid.
00:38Was Doris Ludlam murdered?
00:40No.
00:41Was Bridget Burke murdered?
00:43No.
00:44Irene Cooks?
00:45No.
00:46And we hear from the people who decided his fate.
00:49I was juror number eight and I think I got the decision wrong.
00:58It was November 20th, 2002, the night shift at Leeds General Infirmary.
01:13An 86-year-old woman called Ethel Hall had been recovering from a hip operation.
01:19At 5am nurses heard a noise and went to her bedside.
01:23She was unresponsive.
01:25They soon discovered what was wrong and called the doctors.
01:30Her blood sugar level was dangerously low causing her to fall into a hypoglycemic coma
01:36from which she would never recover.
01:39Ethel Hall was thought to be the victim of a murder.
01:52But this was only the start.
01:55After her, another three recent deaths were reclassified as murder, along with one attempted
02:01murder.
02:02It seemed a serial killer was on the loose.
02:05Colin Norris, a nurse at the hospital, stood trial and in March 2008 was convicted of one
02:12of the worst medical crimes in history.
02:15A thoroughly evil and dangerous man.
02:18A killer who appeared to have no motive other than being irritated by the frail and elderly
02:23women.
02:24This man, Colin Norris, was stopped in his tracks after he'd killed four and attempted
02:28to kill another person.
02:30Harold Shipman went on to kill two, three hundred people.
02:33He wasn't stopped in his tracks.
02:36There to hear the verdict in the public gallery was Colin Norris' mother, June.
02:40I felt as if my world was just closing in.
02:43It was horrible.
02:44I couldn't believe what I'd heard.
02:47It was horrendous.
02:49I thought, my world had ended, I'm sorry, I'm sorry.
03:03Colin Norris was sentenced to life in prison with a minimum of 30 years.
03:13June makes the 10 hour round trip to the Category A prison in Durham, which holds her son every
03:19month.
03:20She has always believed in his innocence.
03:24Have you ever doubted for a second, even for a split second, that Colin might have done
03:30these things?
03:31Never.
03:32Never.
03:33Because I know my son.
03:36I've just got to keep going and keep going until we eventually let people know that there
03:42has been a miscarriage of justice here and he is not guilty.
03:46He is innocent.
03:49She isn't the only person who thinks an innocent man is in prison.
03:54I truly believe that he hasn't done anything wrong and I'll always believe that.
04:02I love Colin with all my heart.
04:05He's one of my best friends.
04:08He always has been and, as far as I'm concerned, always will be.
04:13And I miss him.
04:18I've investigated claims of innocence before, but there has never been a serial killer who
04:23is innocent on all counts.
04:25So what was the case against him?
04:29Ethel Hall's hypoglycemic coma was thought to be suspicious because she was not diabetic,
04:35a condition where the body can't control sugar and insulin levels.
04:40Insulin can cause hypoglycemia, or low blood sugar, and a blood test revealed Ethel Hall
04:46had huge levels of insulin in her system.
04:50Doctors quickly ruled out a number of naturally occurring conditions and that seemed to leave
04:56just one possible scenario, that Ethel Hall had been poisoned with a massive dose of insulin.
05:04West Yorkshire police were called in.
05:07Colin Norris quickly came to police attention during their interviews because he had apparently
05:12predicted Ethel Hall's collapse and had told colleagues that whenever he was on shift someone
05:18always died.
05:20It was the lead they needed.
05:22He was arrested and taken in for questioning.
05:25What was your full name please Colin, and your date of birth?
05:27Colin Campbell Norris, 12th of the 2nd, 1976.
05:30Colin Norris would answer all questions put to him in a series of interviews.
05:34Colin there, and these, this is your movements on the wall.
05:37It was clear from the outset he was the prime suspect.
05:40I've been on the scene all night, because I've been at work since quarter to nine the
05:43previous night.
05:44Absolutely.
05:45But we've got you there.
05:48Heading up the investigation was Detective Chief Superintendent Chris Gregg, the man
05:53who'd just led the review into the mass murderer Dr Harold Shipman.
06:00Detecting they had another medical serial killer on their hands, they began trawling
06:04through patient records.
06:07They were looking for cases of low blood sugar or hypoglycemia, just like Ethel Hall.
06:1381 were originally identified, even though they'd all been classed as natural deaths
06:20at the time.
06:21This was narrowed down to 18, which were classed as high priority.
06:27In addition to Ethel Hall, police finally charged him with another four cases.
06:32The murders of Doris Ludlam, Bridget Burke, Irene Crooks, and the attempted murder of
06:37Vera Wilby.
06:39The only common denominator was Colin Norris.
06:42There was no direct forensic evidence tying Colin Norris to these deaths, and no obvious
06:48motive.
06:49So the prosecution case rests entirely on two things.
06:53The cluster of four patients were the only evidences they became hypoglycemic whilst
06:59Colin Norris was on shift.
07:01And a blood test from a fifth patient, Ethel Hall, which sparked the whole thing off.
07:06So the first thing to re-examine is this cluster of hypoglycemic patients.
07:14Hypoglycemia is not a disease, but a warning.
07:17When we eat, the body converts food into glucose, and that provides us with energy
07:23to function.
07:25Glucose levels in the blood are controlled by a hormone called insulin, which is produced
07:29in the pancreas.
07:32If there's too much insulin, glucose levels will be driven down too low, causing dizziness,
07:37and in extreme cases, coma and brain damage, even death.
07:43Part of the case against Colin is that a cluster of four non-diabetic patients with
07:49hypoglycemia is so rare that there must have been foul play.
07:54Remember, each of these women was thought originally to have died from natural causes.
08:00So just how rare is it to have a cluster like this?
08:08To find out, I've come to meet the leading authority on insulin poisoning, Professor
08:12Vincent Marks.
08:15He's conducted a review of scientific studies published since the trial.
08:20So is it true that unexplained hypoglycemia in the elderly is extremely rare?
08:26No, it's not true, and that was the main thrust of my report that I submitted.
08:34It wasn't as well known at the time of the trial as it is now that in the, particularly
08:43the elderly, frail, sick person, hypoglycemia is far from rare.
08:50Some people assess it at 2%, others at 7%, 8% even.
08:56It was a phenomenon of their illnesses.
09:00It was not the cause of their illnesses, it was caused by their illnesses, their general
09:06debility, their frailty, their general state of health.
09:10This is now a well-recognised phenomenon.
09:16So according to Professor Marks, the accepted science on hypoglycemia has moved on significantly
09:21since the trial.
09:23Perhaps then a cluster of four cases in six months isn't so significant after all, especially
09:29if you're looking for them.
09:31And we found a police memo which shows that's exactly what they were doing.
09:36They decided a key criteria was all the deaths in which the suspect, Norris, had attended
09:42at the time of death or at the time leading up to the death.
09:47There was no evidence of insulin in any of these deaths.
09:51Remember, they'd all been originally classified as natural causes.
09:56But suddenly Colin Norris was being blamed.
09:59And from that police troll, we uncovered a case the jury never got to hear about.
10:06Lucy Rowell was 82 and just like the others had died after falling into a hypoglycemic
10:12coma.
10:14But after her funeral, the police arrived at the family's door to tell them they suspected
10:19Lucy had been murdered by Colin Norris.
10:24He was looking at a male nurse that had been working every evening when grandma had slipped
10:31into a coma, along with the other patients that had died.
10:35Believing Lucy had simply died of old age, the family was shocked.
10:40But months later, the police returned.
10:43This particular male nurse that they'd been pursuing wasn't working the night that grandma
10:48slipped into the coma.
10:50So she went from being suspicious to non-suspicious.
10:55Just because he wasn't working?
10:57Yes.
10:59The Lucy Rowell story suggests that some cases had been cherry-picked to create a cluster
11:04around Colin Norris.
11:08I put it to Professor Marks, did any of these four cases belong in a criminal court?
11:14My conclusion was that no reliance should be placed upon the fact that there were four
11:22people identified who had low blood glucose levels.
11:29And on that basis, your opinion was, the convictions...
11:33The verdict was unsafe.
11:35Was Doris Ludlam murdered?
11:36No.
11:37Was Bridget Burke murdered?
11:39No.
11:40Irene Cookes?
11:41No.
11:42Vera Willoughby?
11:43No.
11:47As a result of his convictions in relation to these four women, along with Ethel Hall,
11:53Colin Norris remains in prison, approaching his seventh year in high security.
12:01Back in Leeds, where the evidence began, the so-called prediction of Ethel Hall's death.
12:07I want to find out what a former colleague thought when she'd heard what Colin Norris
12:11had said.
12:12If you listened in on any ward anywhere, it's just such normal nursing lingo that it wouldn't
12:17set any alarm bells ringing if anyone said that to me in handover, or if I said it to
12:21anyone.
12:22It is just such a normal thing.
12:23Like, what would worry you is if someone was uncaring or snappy with patients, or you heard
12:31through a curtain and, you know, there's other things that set alarm bells, but saying flippant
12:38comments about someone being unwell or going off, or the potential of someone dying, isn't
12:45a worrying thing to hear.
12:47It's normal.
12:48And there were those other alarm bells that you mentioned there, or you never heard any
12:52of those with Colin?
12:53No.
12:54No.
12:55Not at all.
12:56He was a really good nurse.
13:01The thing that put Norris right in the frame, this so-called prediction of Ethel Hall's
13:06collapse, well, so says Emily, that's the kind of thing that's said in hospitals and
13:11wards up and down the country every single day.
13:16But it was a single blood test from Ethel Hall showing insulin, which was enough to
13:21get this case to court.
13:23Professor Marks believes an insulin injection fitted her clinical picture.
13:28But just how reliable are these blood tests?
13:34When Ethel Hall collapsed at 5am, a blood sample was taken which showed she was hypoglycemic
13:40and glucose was given.
13:43Later, doctors discovered that sample hadn't been stored properly for insulin analysis.
13:51Seven hours later, another was taken and sent to the lab.
13:59I've come to meet an expert to ask if the result of that blood test is evidence of murder.
14:05The crime scene, if crime scene it was, was seriously disturbed by the infusion of glucose.
14:13Now clinically, that was absolutely the right decision, goodness me, the patient was hypoglycemic
14:18to try and restore the patient, glucose was going to be needed.
14:21The glucose meant that Ethel Hall's blood sugar had returned to normal by the time the
14:26sample that suggested poisoning was taken.
14:30The gold standard of diagnosing an insulin injection case has three requirements.
14:36High levels of insulin, low levels of a molecule called C-peptide, and crucially, these need
14:42to be found in a hypoglycemic sample.
14:45Ethel Hall had high insulin and low C-peptide, but when the sample was taken, she was no
14:50longer hypoglycemic.
14:52According to Professor Wilkin, this drives a fatal blow through the prosecution case.
14:57If a test is done when the patient is not hypoglycemic, what, you can't rely on it?
15:03It's useless?
15:05It's not a valid test, that would be my view, it's not a valid test, and I think it would
15:09be the view of biochemists the world over.
15:12If you disconnect these three tests in any way, over time or through samples, different
15:18samples, then you do not have a valid test.
15:22I think the forensic evidence stops there, because it's invalid.
15:28I found a scientific paper which was written by the same laboratory that carried out the
15:33work in the Ethel Hall blood test.
15:35It was written months before they did that work.
15:38And in it, they say the crucial, not to say mandatory, requirement is the establishment
15:44of hypoglycemia in the sample submitted for analysis.
15:49Which in the Ethel Hall case is precisely what they didn't do.
15:53And mandatory means must, there is no qualification of the word mandatory, it means must.
15:59And that's for a clinical laboratory.
16:03Now this is now forensic evidence, this is determining a man's future in terms of guilty
16:09or not guilty.
16:10And I do find it difficult that this mandatory requirement was laid to one side in order
16:17to come to a different conclusion.
16:20But the jury didn't get to hear that.
16:23Dr Derek Teal, who was in charge of the lab at the time, told us that after treatment
16:29with glucose, there was still an abnormally large amount of insulin in the circulation
16:34together with a correspondingly low C-peptide.
16:37A situation which is unarguably consistent with an injection of insulin.
16:46Colin Norris' case is currently being considered by the Criminal Cases Review Commission,
16:51or CCRC, which will decide if the case should go back to appeal.
16:59The CCRC has consulted Dr Matthew Joel on another insulin homicide case.
17:05What does he think about the standard of evidence in the Norris trial?
17:10It's, I think, unconscionable to put a person on trial for murder with a presumptive test,
17:23one sample partially analyzed.
17:28That's really what we're sitting at.
17:30With no supporting evidence, no injection marks, no signs of an insulin depot, there's
17:38no witnesses, there's no empty syringe, there's no empty vial, there's nothing else connecting
17:47him to this case.
17:52But Ethel Hall did have a huge amount of insulin in her blood.
17:56Poisoning is one explanation.
17:59But could there be another, less sinister diagnosis that was missed?
18:04Insulin scientists thought there might be, and he contacted the defence team back in 2008.
18:10There is a condition, there is a disease, a syndrome called insulin autoimmune hypoglycemia
18:18because it can cause low blood glucose.
18:21It was a spanner in the work because it was completely new to the defence side, this particular fact.
18:29What Colin Norris' defence did was that they accepted that the Ethel Hall blood test was correct
18:37and that she had been given a malicious dose of insulin, but that their case was that it
18:44wasn't Colin, it must have been someone else.
18:47Yeah, I didn't know that.
18:49I didn't know this line of defence.
18:52You explained to them that there might be another cause.
18:58They were completely unaware of this.
19:00So I was talking about things which they never heard, they never thought, they never investigated.
19:08And this was three weeks after the trial had started.
19:15So it was really quite a very hard work to come at that point in time and start raising
19:23a completely new issue.
19:28So what is insulin autoimmune syndrome and could it have caused Ethel's condition?
19:35The immune system, usually the body's first line defence mechanism against infection,
19:41can sometimes turn on itself, creating antibodies that misfire and attack a healthy body.
19:50Antibodies can wreak havoc with normal insulin levels and, like an injection of insulin,
19:55can cause hypoglycemia and, if left unchecked, coma.
20:00So did doctors even consider this condition before they diagnosed insulin poisoning?
20:07We've been through more than 40 boxes of trial documents and we can find no evidence that
20:14at the time of Ethel Hall's collapse, doctors and scientists even considered insulin autoimmune
20:20syndrome and we know that they didn't conduct crucial tests.
20:25But six years later, at trial, they were confident enough to rule the syndrome out.
20:32You can't absolutely exclude it until you've done the one thing by which the syndrome is
20:37defined, which is measure antibodies to insulin in the sample.
20:45The lab tested for one type of antibody but failed to check for all.
20:51It can't be ruled out with certainty.
20:53These tests will cost a few pounds.
20:56You have the test available.
20:58You know it can be tested for.
21:00You know the test can give you categorical confirmation or refuting the presence of the
21:07disease.
21:08No ifs and no buts.
21:12I wanted to speak to someone who'd actually seen this condition.
21:16Professor Wilkin had worked on a case in the 80s which was correctly diagnosed as insulin
21:21autoimmune syndrome before anyone suspected poisoning.
21:25I think that, but for the grace of God, nobody was suspected of giving exogenous insulin
21:32because if somebody had raised their finger and said, well, could this be malicious?
21:38Everyone, of course, did point the finger at Colin Norris and at trial.
21:42When insulin autoimmune was raised as a last-minute alternative, no fewer than seven experts dismissed
21:48it as too rare and inconsistent with Ethel Hall's blood test results.
21:54Were they right?
21:58Is the blood test and the symptoms of Ethel Hall and her coma and eventual death, are
22:04all those things consistent with insulin autoimmune?
22:07The data that has come from the analysis that was done on the samples that were given
22:11to the laboratory is perfectly consistent with insulin autoimmune syndrome.
22:18So if you're asking the question, does insulin autoimmune syndrome fit with the facts of
22:26the case as reported, then yes it does.
22:31Another reason cited by the trial experts for ruling out the syndrome in Ethel Hall's
22:35case is that it principally affected Japanese people who have a genetic predisposition to
22:41it.
22:42Again, science has moved on since the trial and we found more than 60 cases in peer-reviewed
22:49academic journals and all of those are Caucasian.
22:53Now, you know, it's no longer a very rare condition, 60 cases is not insubstantial.
23:04The advances in science are no surprise for Colin Norris or his mother.
23:10It's taken us nearly seven years to get to where we are just now and a lot of the research
23:15and everything that we've got has just came, it wasn't available at the time of the trial.
23:20So there might be more stuff that will come in the future.
23:26Just as we were finishing our investigation, I was contacted again by Professor Wilkin
23:31who had collaborated on more research with a mathematician.
23:38I knew police claimed Ethel Hall had been injected with 10 mils of insulin, about 2
23:43teaspoons, but were their calculations correct?
23:47If the dose required is really large, that would seriously question whether poisoning
23:52by injection was even possible.
23:58The new calculation combines the absorption rate of insulin with the time it takes to
24:04leave the bloodstream.
24:06The amount of insulin that would have been required, the amount of insulin injection,
24:11was just over a litre.
24:13Now that is a 20 millilitre syringe, if I draw that up to 20 millilitres, I would have
24:21to inject that much 50 times to have injected a litre.
24:28So I think that's unrealistic.
24:29These calculations are based on the most likely insulin absorption rates, but every human
24:35is different, so they are recalculated using a far more conservative scale, just in case.
24:41We doubled it.
24:43The requirement would have been something like 35 millilitres of insulin.
24:51But again, that seems quite unrealistic, because that's three and a half, 10 millilitre
24:58syringes, whereas a normal insulin injection is just a millilitre or two.
25:06Are you saying that the data suggests that the amount of insulin found in Ethel Hall's
25:12blood is unlikely to have been caused by an injection of insulin?
25:19It seems unlikely.
25:20On the balance of probabilities, it seems unlikely, because the dose of insulin required
25:25to have produced them seems to be much higher than could realistically have been given.
25:34So if those calculations are correct, and an insulin injection is unlikely, with a prosecution
25:41case so heavily based on one blood sample, where does that leave the evidence against
25:48Colin Norris?
25:53None of the relevant trial experts we contacted answered our questions about insulin autoimmune
25:59syndrome or insulin levels.
26:02We invited West Yorkshire Police to an interview to discuss the new evidence.
26:06They gave a statement.
26:08The case is currently under review by the Criminal Cases Review Commission, and we will
26:12consider their findings when they are presented to us.
26:20The BBC will be making all of the new evidence in Colin Norris's case available to the Commission.
26:26What began as a mother's plea to investigate her son's convictions has caused me to question
26:32not only whether a completely innocent man is in prison, but also whether anyone was
26:38murdered in this case at all.
26:41If a jury today saw the evidence revealed in this programme, would they have come to
26:46the same decision?
26:49There are only 12 people who could answer that question.
26:54Jurors' names are read out in open court, and so I contacted people by the same name
26:59to try and track them down.
27:01Jurors are not allowed to talk about their deliberations, but they can talk about some
27:06things.
27:07Finally, one man contacted me.
27:11He's a juror number eight, and he was prepared to look at our evidence.
27:14Well, it was funny.
27:16After the trial, I got home, and I had a bit of a cry to myself, thinking, have I did the
27:27right thing here?
27:28Have I made the right decision?
27:31Did you think Colin Norris was guilty?
27:36On the evidence I was shown, yeah.
27:40On the evidence I'd seen, yeah, he was guilty.
27:43You're the first juror to have looked at this new evidence.
27:47What's your reaction to it?
27:51It just throws a new light to it.
27:57I mean, I could...
28:01If that evidence was sort of the new evidence now, I mean, if that was available at the
28:07time, I mean, I think they would have thrown the case out, to be honest.
28:13Do you still think Colin Norris is guilty?
28:15I have to say the new evidence, no.
28:18How do you feel now about the verdict?
28:23Very doubtful.
28:24That we've come to the right conclusion.
28:34Very doubtful.
28:37Getting inside some wild weather next, Richard Hammond experiences extreme temperatures here
28:45on BBC1.
28:46Over on BBC3 now, Russell Brand challenges the idea that the government's drugs policy
28:52is a success, a very personal debate in End the Drugs War.