Why did we trust NHS colleagues?
Couple want OWN hospital to be prosecuted after 13 blunders led to their baby’s ‘preventable’ death
A COUPLE whose baby died after a catalogue of NHS blunders are calling for hospital bosses to face criminal charges.
A report said the death of Jack and Sarah Hawkins’s healthy daughter was ‘almost certainly preventable’.
Harriet was stillborn at Nottingham City Hospital – which belongs to the same trust her parents work for – in April 2016 after Mrs Hawkins was transferred from one maternity unit to another due to understaffing.
Her baby was pronounced dead nine hours before she was delivered.
Mrs Hawkins had previously been seen by medical staff but remained in undiagnosed labour for six days beforehand.
The couple said the death of their daughter – their first child – caused psychological damage, flashbacks, nightmares and insomnia.
They are still to hold a funeral because their daughter’s body has been in the hospital mortuary for 20 months.
An independent investigation into the death by the National Patient Safety Agency, published in December, identi- fied 13 failings, including lack of midwifery leadership, poor safety culture and delays in administering the correct treatment. It also found there was a failure to record information properly, a failure to recognise a prolonged dysfunctional labour and a delay in applying appropriate foetal monitoring.
Speaking about the report, Mrs Hawkins said: ‘To have it officially acknowledged that I was in prolonged, undiagnosed labour and that her death was certainly preventable is a relief.
‘The report’s authors were open and honest, and listened to our story – but the trust has not yet heard it. We are not sure what the trust is thinking or what they have changed. More staff is good but what went wrong for us were clinical issues, not staffing concerns.
‘As staff members in that same trust, we trusted our colleagues and the NHS to deliver our perfectly healthy, full-term baby alive, and that got us a dead baby.
‘No one has listened to us. They have not been open and honest. It has taken 20 months to get this report out, when hours after she died we were raising concerns. We got the blame and Harriet got the blame.’
Nottingham University Hospitals NHS Trust, which manages the hospital, has ‘apologised unreservedly’ to the couple for the shortcomings. But Mr and Mrs Hawkins believe the trust has yet to accept responsibility for the death.
The couple are now taking the unusual step of referring their daughter’s death to the Crown Prosecution Service and Health and Safety Executive. They are also pursuing a civil case for damages against the trust and referring the doctors and midwives involved in Harriet and her mother’s care to professional bodies for further investigation.
Mrs Hawkins, 34, a senior physiotherapist, had been due to give birth at the Queen’s Medical Centre, but its maternity unit halted admissions because of staff shortages. She had already been sent home from hospital twice after staff failed to diagnose labour. When I was told Harriet was dead, when she was still inside me, what I felt was disbelief. I felt completely numb,’ she said.
‘Then I had to go through several hours of labour before I gave birth to her. It was total disbelief and numbness.’
The couple then had to fight for nearly two years for an investigation into their daughter’s death, and called for a change in the law to close a loophole that prevents coroners from investigating the deaths of babies who die during birth. At present, hospitals investigate themselves when babies die in labour.
The Hawkins accused the trust of lacking openness and candour after Harriet’s death when they were trying to find out why she died.
Mrs Hawkins said they were concerned there have been similar cases since Harriet’s death but those families and couples did not have the advantage of being from a clinical background.
Because of the lengthy inquiry, Harriet’s body remains in the hospital mortuary. Mrs Hawkins told Sky News: ‘We will also be able to have Harriet’s funeral, which will be an important emotional time for us. We have been so disturbed by the attitude of the NUH that we could not hold it.
‘We did the right thing, but having your daughter’s body in a mortuary for 20 months is tough.
‘We could have had it as soon as she died if the trust had been open and honest but this has compounded our mental and physical illness.’
Mr Hawkins, a 48-year-old consultant,
‘I felt disbelief and numbness’ ‘We let them down so badly’
added: ‘I would like to be believed and I would like our daughter’s death to be valued.’
The couple’s lawyer, Janet Baker, of Switalskis Solicitors, said it was one of the worst cases of medical negligence she has seen in 30 years.
Hospital trust chief executive Tracy Taylor said: ‘I profoundly apologise that we let them and Harriet down so badly. NUH has acknowledged that it is likely Harriet would have survived had it not been for several shortcomings in care. We accept the recommendations that have arisen from the external review and have worked to ensure appropriate further actions have been taken where needed.’
Mrs Taylor also apologised for not communicating as ‘effectively as we should have early in this process’ and said they have sought to ‘communicate openly and frequently’ with the couple since.