If you wanted to become a serial killer, where might you go to do it? It seems there are few places better than a hospital. The latest example is Lucy Letby, a British neonatal ICU nurse recently convicted of murdering seven babies and attempting to kill six others by a variety of means including deliberately injecting some with air, force feeding others milk, and poisoning others with insulin. She has been sentenced to life in prison.

What was particularly tragic in this case was that after several doctors reported their suspicions about Letby, she persuaded hospital managers that she was the victim of a witch-hunt. Hospital management forced the doctors to write an apology to her, and managers also threatened their careers.

Meanwhile, Letby was offered career advancement and temporarily reassigned to the risk and patient safety office, where she had access to sensitive documents from the neonatal unit and could monitor the investigation. She was then placed back in the neonatal intensive care unit before being arrested. Had police and the hospital bureaucracy acted more expeditiously at least some of these babies would have been saved.

Letby is Great Britain’s most prolific female serial killer and joins the rogue’s gallery of hospital killers that includes Beverly Gail Allitt, who was convicted of murdering four babies in 1991 in the UK, and Dr. Harold Shipman, Great Britain’s most notorious serial killer, suspected of killing between 200 and 500 patients in the UK (although many of those were outpatients.) The US has its own members of the gallery including nurses Orville Lee Majors and Charles Cullen, both of whom probably killed dozens of hospital patients; hospital orderly Donald Harvey, who killed scores of patients primarily with cyanide injections; and Genene Jones, a pediatric nurse in Texas, convicted of killing several infants and suspected of killing more than 20 by lethal injection in the early 1980s. The story of Genene Jones is the subject of The Death Shift, a gripping book by Peter Elkind about the murders, whose title refers to the name her fellow nurses gave her shifts in the pediatric intensive care unit.