U.K. Hospital Fined $1 Million After Baby Death

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An English hospital at the center of a maternity inquiry has been ordered to pay more than $1 million (£814,000 including fees) over the death of a baby in its care.

Friday’s seven-figure sum is the largest-ever fine issued to an English hospital over maternity care. It follows a hearing into the 2019 death of Wynter Sophia Andrews, who passed away just 23 minutes after she was born at Queens Medical Center in Nottingham.

A previous inquest found the newborn died after experiencing a loss of oxygen flow to the brain that could have been spotted sooner. Back in 2020, a local coroner said Andrews likely would have survived with an earlier cesaerean section.

Laurinda Bower wrote at the time that short staffing and poor decision-making contributed to a “clear and obvious case of neglect.”

On the day of Andrew’s death, Bower said, the unit “operated in a fundamentally unsafe manner.”

Friday’s fine follows a hearing into the case instigated by England’s Care Quality Commission: a regulator that inspects safety standards at hospitals.

Speaking at the sentencing, district judge Grace Leong said that a “a catalogue of failings” at the unit operated by Nottingham University Hospitals Trust put both Wynter and her mother, Sarah, at “significant risk” of avoidable harm.

She added: “There were systems in place, but there were so many procedures and practices where guidance was not followed or adhered to or implemented.”

A string of scandals in maternity care

The Andrews case, while shocking, is one piece of a much larger picture concerning maternity care in England. In recent years, failures at several trusts have exposed “longstanding” and “deep-rooted” problems.

Back in 2015, an investigation into maternity care at University Hospitals of Morecambe Bay NHS Foundation Trust over the previous decade blamed “serious clinical failings” for avoidable harm and “tragic and unnecessary” deaths.

The damning report published by obsetrician and patient safety expert Dr Bill Kirkup described a “dysfunctional” maternity department with “extremely poor”, factionalised staff relations and an unsafe emphasis on pursuing “normal childbirth ‘at any cost.’”

Although his report sparked a raft of policy changes intended to make maternity care safer, Dr Kirkup found himself investigating failings at a major hospital trust several years later.

A failure to listen to families

Last October, he published an investigation into maternity services at East Kent Hospitals Trust between 2009 and 2020. The report found poor decision making, poor working relations between midwives and obstetricians and a general failure to listen to families.

If the trust had adhered to national clinical standards, Kirkup and his team estimated, 97 cases of harm and death — 48% of the 202 they investigated — could have had a different outcome. Some 45 of 65 deaths over this period, they suspected, could have been avoided.

On its publication, he said: “I did not imagine that I would be back reporting on a similar set of circumstances seven years later.”

Inside the document itself, he wrote: “It is too late to pretend that this is just another one-off, isolated failure, a freak event that ‘will never happen again’.”

When senior midwife Donna Ockendon published a similarly damning, but much larger, investigation into maternity care at a hospital trust in central England last March, she commented:

“There should never again be a review of this scale, in both numbers, and the length of years across which these concerns remained hidden.”

Her investigation into nearly 1,500 family cases at Shrewsbury and Telford Hospitals Trust — which unearthed major problems in the department’s working culture, a failure to listen to families, short staffing and a failure to learn from mistakes — was at the time unprecendented.

But, like Kirkup, Ockendon is also now chairing a second investigation of a similar magnitude to her first. This time, she is likely to probe more than 1,500 family cases at Nottingham University Hospitals Trust — the organisation where baby Andrews tragically died.

In his East Kent report, Kirkup wrote that maternity services across the NHS need to take urgent action to tackle “longstanding issues [that have] become deeply embedded and difficult to change”.

Improving outcomes monitoring was necessary to prevent these kinds of maternity scandals, he added, writing: “The NHS could be much better at identifying poorly performing units, at giving care with compassion and kindness, at teamworking with a common purpose, and at responding to challenge with honesty.”

“Unless these difficult areas are tackled,” he continued, “we will surely see the same failures arise somewhere else, sooner rather than later.”

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