In 1973, Evans began working as a paediatrician in Cardiff. He then worked in Alder Hey Children's Hospital as a registrar (1974–1976). From 1977 to 1979, he worked as a senior registrar in Cardiff.[2][3]
Beginning in 1980, he held the post of consultant paediatrician at Morriston Hospital. From 1991 until his retirement, he held the post of full-time clinical consultantpaediatrician at Singleton Hospital, where he became involved in the development of newborn intensive care and maternity services.[4] In 1990, the Swansea Bay University Health Board built a new children's and neonatal department that Evans helped to design.[citation needed] Between 1992–1997 and 2004–2008 he then served as clinical director of paediatrics and neonatology. His areas of special interest included paediatric endocrinology and childhood diabetes. His clinical practice provided a wide experience of hospital-based management of acute illnesses in children.[1]
Evans retired from practice in 2009 after over 30 years in practice. In September 2010 he formed the company, Dewi Evans Paediatric Consulting Ltd, to handle his growing work as an independent medical witness, in the areas of child abuse and clinical negligence.[5][1]
Expert witness
Baby murder trial
Evans was an expert witness in the murder and neglect trial in 2018 of a 6 week old baby boy.[6][bettersourceneeded]
Appeal in the removal of children from parental care
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.[7][non-primary source needed]
Death of a five month old baby
Evans was an expert witness in the 2021 murder trial of a man later convicted of killing his 5 month old daughter,[8] being able to rule out pneumonia as a potential cause of death in favour of a blunt force brain injury.[9]
Comments by Lord Justice Jackson
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".[10][11] In a November 2024 podcast interview with John Sweeney, Evans criticised Lord Justice Jackson's comments.[12][13]
Evans has stated that the Letby case was his most difficult as expert witness. He stopped taking on new cases in February 2023.[3] He was still a councillor for Carmarthen in September 2023.[14]
Robbie (Robert Darren Powell), a nine year old boy, was admitted to Morriston Hospital in December 1989 with excesive weight loss, abdominal pain, vomiting but no diarrhoea, dehydrated, and dark pigmentation of the skin. At that time, Dr Dewi Evans, Dr William Forbes and Dr Narendra Agarwal were the three senior paediatric consultants at Morriston Hospital; Dr Evans's expertise was in endocrinology. Dr Forbes suspected Addison's disease, which is life threatening but treatable disease, and ordered an ACTH test, but this was never done. This crucial information was withheld from Robbie's parents, who were told instead that Robbie had gastroenteritis caused by a throat infection. Unknown to the family, their GP was informed of the suspicion of Addison's disease and the need for an ACTH test, and the GP was instructed to admit Robbie back to hospital if he became unwell.[15]
Robbie became unwell on 1 April 1990. In the final fifteen days of his life, he was seen by five different GPs, seven times. Robbie was finally admitted to hospital six days later. He died on 17 April 1990, aged ten. A subsequent investigation discovered cover ups by the medical professionals, the NHS, the Independent Police Complaints Commission, the General Medical Council, and other public bodies. Five GPs and their medical secretary were charged with 35 criminal charges, which included: gross negligence manslaughter; forgery; attempting to pervert the course of justice; and conspiracy to pervert the course of justice. The five GPs were: Dr Elwyn Hughes, Dr Nicola Flower, Dr Michael Williams, Dr Paul Boladz, Dr Keith Hughes, and the medical secretary, Mrs Linda Sims. Dr Evans said he had no involvement in Robbie's treatment. Dr Evans wrote a letter to the criminally charged GPs, stating: "One can but conclude that there are conditions in children that are virtually undiagnosable before it is too late. Certainly I cannot think of any steps that you could have taken as the GPs which could have anticipated such an event".[15][16]
Bonnie and Linda Lewis
"Bonnie" (not her actual forename, owing to reporting restrictions) Lewis was the twelve year old daughter of Linda Lewis, living in Neath Port Talbot. In November 1996, Bonnie was in considerable pain and attended several hospitals in South Wales over a period of months. Doctors were initially unable to correctly diagnose her illness, but eventually settled on appendicitis. They removed her appendix but to no effect; in fact the operation caused an abscess that almost killed her. She was treated and the abscess healed but she was still in pain and without a diagnosis. Twice Bonnie was prescribed huge overdoses of drugs, which were refused by the pharmacist and her mother respectively. Bonnie was discharged from hospital without a diagnosis. Social Services became involved. Bonnie was still in pain but managing to attend school. In July 1997, Dr Dewi Evans from Singleton hospital attended a Social Services Case Conference and said there was nothing wrong with Bonnie but her mother "has problems". Evans said the mother suffered from the syndrome "attention seeking by proxy" – a diagnosis he was not qualified to make – and essentially blocked her from taking independent medical advice.[17][bettersourceneeded]
Social Services called Linda to the Family Court regarding Bonnie's education. In January 1998, Linda, her father and Bonnie flew to the USA for a diagnosis. Doctors diagnosed Zollinger–Ellison syndrome, however Social Services unlawfully[18] "kidnapped" and extradited Bonnie on the grounds that the mother suffered from the undiagnosed syndrome Munchausen by proxy. Dr Dewi Evans's clinic and Social Services ensured that Linda and Bonnie were permanently separated; Bonnie was distraught, as was Linda. Due to her parents' efforts, Bonnie's illness was treated. The case has been the subject of ongoing debates and discussions, particularly concerning the actions of social services and the medical professionals involved.[19][18][bettersourceneeded]
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.[20][21][22] Reading about the investigation in the news, Evans contacted the National Crime Agency in May 2017 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."[10][2]
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.[2] Letby's trial opened on 10 October 2022 and Evans remained lead expert witness during the trial.[23] Evans' 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:
Professor Sally Kinsey, consultant paediatric haematologist
Professor Peter Hindmarsh, consultant paediatric endocrinologist
Professor Stavros Stivaros, consultant paediatric neuroradiologist
Dr Simon Kenney, consultant paediatric surgeon.
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 intravenous air embolism. This was following it demonstrated that Letby was not actually present in the ward at the time the original incident was alleged to have been committed.[24][bettersourceneeded] Evans previously told a BBC reporter[25] 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 reported to have changed his mind about this mechanism for babies I & P.[26][27]
Air embolism was implicated to have allegedly been involved in 5 of the 7 murders. Evans frequently cited[28][non-primary source needed] 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 diagnostic of air embolism.[29][2]
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".[24]
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".[32][33] 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.[34][2]
Following Letby's failed appeal, Dr Lee and a group of 14 international neonatology experts conducted a private review of the deaths. During their press conference on 4 February 2025 Dr Lee 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." Dr Lee went on to say:
"When it comes to Dr Evans's testimony, and his opinions, I would ask you to ask three questions:
First of all, the first question would be: if our panel found so many problems with the medical care provided by this team at this Hospital, how is it that Dr Evans found none?, because in none of the 17 cases did he even identify one problem with the medical care provided at the hospital.
The second question I would ask is this: he seemed to be rather selective in his use of information, so if he wasn't selective, if all the information was used, in fact you would come to a very different conclusion than what he came to. Just take for example the case of the hypoglycemia, where he said there was no sugar for two hours and blood sugar grows therefore it must be insulin. In fact he missed the one important value, which was at 11:46, showing that the blood sugar in fact did not rise, so was he just careless, or was it deliberate?
The next question that I would ask is: even when there's an obvious cause of death, why did he go around looking for malfeasance?" [35][36]
The Royal Statistical Society criticised the prosecution's evidence, citing similarities to the medical miscarriage of justice cases of Lucia de Berk and Daniela Poggiali.[38] 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 John Sweeney.[12]
Speaking in the House of Commons in January 2025, Sir David DavisMP, stated: "It is a clear miscarriage of justice by a judicial system that could not manage admittedly difficult statistical and medical scientific evidence."[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.
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