Prevention of Future Deaths reports · 2019

Serena Nicholas

Regulation 28 report to prevent future deaths, reference 2019-0381, written 14 Nov 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report14 Nov 2019
Reference2019-0381
DeceasedSerena Nicholas
CoronerKevin McLoughlin
Coroner areaWest Yorkshire (East)
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Child Death (from 2015)
Organisation namedHull University Teaching Hospitals NHS Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

ANNEX A

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:
1. Hull University Teaching Hospitals NHS Trust, Hull Royal Infirmary, Anlaby

Road, Hull, HU3 2JZ, For the Attention of hier Medical
Officer, Trust Headquarters

CORONER

| am Kevin McLoughlin, Senior Coroner, for the Coroner area of West Yorkshire (East).

—|
CORONER’S LEGAL POWERS

| make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009
and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.

3

[INVESTIGATION and INQUEST

On 5'* September 2017 an investigation was commenced into the death of Serena Jane
Nicholas, a new born baby. The investigation concluded at the end of the Inquest on
Monday 11" November 2019. The conclusion of the Inquest was a narrative conclusion
based upon the cause of death: 1(a) Intrauterine hypoxia, 1(b) Infant of a diabetic
mother.

4

+—
CIRCUMSTANCES OF THE DEATH

Serena Jane Nicholas died on Wednesday 30' August 2017 at 0010 hours at Leeds
General Infirmary, shortly after she was born by a category 1 emergency Caesarean
section performed at 2224 hours on 29! August 2017.

The pregnancy was complicated by virtue of (1) the mother’s type 1 diabetic condition
which was poorly controlled and (2) a truncus arteriosus fetal heart abnormality identified
on a 20 week scan. When the mother attended the maternity unit at the tertiary centre
the evening before the planned C-section the following day, the fetal heart was found to
be bradycardic, necessitating an immediate C-section. The baby was born in poor
condition and died shortly afterwards.

[5

| CORONER’S CONCERNS

During the course of the Inquest the evidence revealed matters giving rise to concern. In
my opinion there is a risk that future deaths will occur unless action is taken. In the
circumstances it is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows. —

(1) The antenatal surveillance was largely carried out in Hull where the mother
lived. She was seen by a variety of clinicians and at a late stage by a community
midwife, despite the recognition that this was a pregnancy accompanied by
clear risk factors. The absence of identified consultants responsible for the
oversight of mother and baby’s care in relation to diabetic and gynaecological
aspects resulted in disjointed management.

=

(2) The tertiary centre where the C-section (and the subsequent open heart surgery
envisaged) were to take place, were not aware that the baby had been inactive
for some days before the planned C-section (because the mother had not
reported this and had not had contact with clinicians since the clinical
appointment with a community midwife on 24/08/4 7). In consequence, a serious
adverse development went unheeded until stumbled across on the eve of the C-
section. In view of the history of the pregnancy continuity of care and close
monitoring of a high risk pregnancy led to a situation in which the desirability of
advancing the C-section by say, a week, was not recognised.

[ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you and/or
your organisation have the power to take such action.

a:
YOUR RESPONSE

You are under a duty to respond to this report no later than 5pm on Friday 17% January
2019. |, the Coroner, may extend the period.

Your response must contain details of action taken or Proposed to be taken, setting out
the timetable for action. Otherwise you must explain why no action is proposed.

r 8 | COPIES and PUBLICATION

i have sent a copy of my report to the Chief Coroner and to the following Interested
Persons:

1) yap
2) linical Lead for Obstetrics, Leeds Teaching Hospitals;

and to the Local Safeguarding Board.
| have also sent it to:
1) eeds Teaching Hospitals;
2) Capsticks Solicitors;
3) Consultant in Obstetrics and Gynaecology — Hull;
4) Consultant in Diabetes and Endocrinology — Hull;
who may find it useful or of interest.
| am also under a duty to send the Chief Coroner a copy of your response.
The Chief Coroner may publish either or both ina complete or redacted or summary
form. He may send a copy of this report to any person who he believes may find it useful

or of interest. You may make representations to me, the coroner, at the time of your
response, about the release or the publication of your response by the Chief Coroner.

ol],

i
14" November 2019

Signed: Ken. Me (naiho~

Kevin McLoughlin
Senior Coroner
West Yorkshire (E)

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