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An NHS trust has been fined £800,000 in the highest ever penalty for maternity care after admitting to failings in the care of a woman and her baby, who died minutes after being born.

Wynter Sophia Andrews died on 15 September 2019, 23 minutes after being born by emergency caesarean section, in the arms of her parents, Sarah and Gary, at the Queen’s Medical Centre in Nottingham.

Nottingham university hospitals trust pleaded guilty to two counts relating to failures in the care of mother and child – the first time the trust has ever been criminally prosecuted – at a hearing on Wednesday.

Sentencing the trust on Friday at Nottingham magistrates court, the district judge Grace Leong said: “The catalogue of failings and errors exposed Mrs Andrews and her baby to a significant risk of harm which was avoidable, and such errors ultimately resulted in the death of Wynter and post-traumatic stress for Mrs Andrews and Mr Andrews.

“My assessment is that the level of culpability is high, where offences on Wynter and Mrs Andrews are concerned. There were systems in place, but there were so many procedures and practices where guidance was not followed or adhered to or implemented.”

Andrews thanked the judge for her decision, noting “the delicate balance that has to be made to impose this significant fine”, which she hoped would send “a clear message to trust managers that they must hold patient safety in the highest regard”.

“Sadly, we are not the only family harmed by the trust’s failings. We feel that this sentence isn’t just for Wynter, but for all the other babies that have gone before and after her,” she said.

The CQC said the trust had exposed Sarah and Wynter to “a significant risk of avoidable harm” by failing to identify and manage risks, despite knowing that Sarah, then aged 33, was deemed as having a high-risk pregnancy for health reasons. The regulator’s investigation found multiple failings and missed opportunities in Sarah’s care from when she attended the Queen’s Medical Centre during her pregnancy, right up to the birth of her baby at 40 weeks.

The trust admitted several failures from when Sarah presented as contracting and was found to be 4cm dilated. This included inducing labour on 7 September for insufficient and undocumented reasons; failing to acknowledge Sarah’s concerns; missing signs of hypertension in her blood pressure readings on 14 September, which would have led to continuous monitoring of the baby’s heart rate; administering diamorphine without proper process; and triggering an emergency caesarean section too late.

After the sentencing, the chief executive of Nottingham university hospital trust, Anthony May, said he was working hard to make necessary improvements, including investing in staff, digital systems and equipment, and that the trust accepted in full the court’s sentence.

He said: “I am truly sorry for the pain and grief that we caused Mr and Mrs Andrews due to failings in the maternity care we provided. These were serious failings that led to the worst possible outcome and we let them down at what should have been a joyous time in their lives.”

In addition to the fine, which was reduced from £1.2m due to early guilty pleas, the court ordered the trust to pay a £181 victim surcharge as well as £13,668.75 costs to the CQC, which prosecuted the criminal offences.

Lorraine Tedeschini, the CQC’s director of operations in the Midlands, said she hoped the prosecution would serve as a reminder to hospitals to prioritise patient safety, especially when inspections identify areas in need of improvement.

“The death of Wynter Andrews is an absolute tragedy and my thoughts are with her family and all those grieving their loss. Mothers have a right to safe care and treatment when having a baby, so it is unacceptable that their safety was not well managed by the trust,” she said.

The CQC said it was closely monitoring the trust and noted that following Wynter’s death it has been working to address failings.

The Andrews family’s solicitor, Georgina Peckett, of Switalskis Solicitors, said her firm was regularly instructed by families “on cases where incidents of unsafe maternity care have occurred since Wynter’s death”.

An independent review is being carried out by the healthcare leader Donna Ockenden into failings at the trust’s maternity services “in light of significant concerns raised regarding the quality and safety of maternity services” raised by families. It is currently asking families to submit evidence.

Ockenden will follow the same process as the review of maternity services at Shrewsbury and Telford hospital NHS trust, which uncovered a pattern of repeated serious harm to mothers and babies in 2020.

The CQC has warned of a “concerning decline” in women’s experiences with maternity services due to a shortage of frontline staff, noting that there had been a “deterioration” over the last five years in the ratings women gave their care, with many reporting feeling they did not always get the help they needed during labour and birth and feeling they were not listened to when they raised concerns.

#NHS #trust #receives #record #fine #death #newborn

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