Prevention of Future Deaths reports · 2022

Millie-Rae Needham

Regulation 28 report to prevent future deaths, reference 2022-0122, written 25 Apr 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report25 Apr 2022
Reference2022-0122
DeceasedMillie-Rae Needham
CoronerAbigail Combes
Coroner areaSouth Yorkshire (West District)
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Child Death (from 2015)
Organisation namedSheffield Teaching Hospitals NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1. Sheffield Teaching Hospitals NHS Foundation Trust

1  CORONER 

I am Abigail Combes, assistant coroner, for the coroner area of South Yorkshire (West 
District) 

2  CORONER’S LEGAL POWERS 

I 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 22 January 2021 I commenced an investigation into the death of Millie Rae-
Needham born on 6 August 2020. The investigation concluded at the end of the inquest 
on 17 February 2022. The conclusion of the inquest was:-  

Millie-Rae Needham was born at the Jessop’s Wing of Sheffield Teaching Hospitals on 6 
August 2020. As a result of clinical decisions there was a 23-minute delay in her delivery 
and during that time her condition was not adequately monitored. She died in the 
neonatal unit at the hospital on 9 August 2020. Her death was contributed to by neglect.  

The medical cause of death was: 

1a:  Hypoxic-ischaemic encephalopathy 
1b:  Intra-uterine hypoxia 

4  CIRCUMSTANCES OF THE DEATH 

Millie-Rae Needham was born at the Jessop's Wing of Sheffield Teaching Hospitals on 6 
August 2020. Her mother (Skinna) had been categorised as a high-risk pregnancy 
throughout her pregnancy as a result of a previous baby with a very low birth weight.  

On the last scan 
with no consultation and as a result Millie-Rae was born on the midwife led unit at the 
Jessops.  

was switched to midwife led care rather than consultant led care 

 was given very high pain relief early in her labour journey with 

Throughout labour 
minimal effect. Millie-Rae's heart rate was listened to periodically using auscultation. 
Once it became apparent that 
 labour was not progressing as it had been hoped 
the midwife determined that an episiotomy would be needed. She did not feel confident 
in doing this without support and so requested assistance. The midwife that then came 
into the room encouraged further position changes and this resulted in a 23-minute 
delay in Millie-Rae being born. During that time there was no adequate monitoring of her 
heart rate resulting in her being born in a very poor condition and dying on 9 August 
2020.  

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 could occur unless action is taken. In the 
circumstances it is my statutory duty to report to you. 

1 

 The MATTERS OF CONCERN are as follows: –  

1.  A decision was made by the midwife who had been with 

 throughout her 

delivery to move to an episiotomy. Instead, the midwife that came to support 
encouraged further position changes leading to delay in delivery and inadequate 
monitoring of the foetal heart rate. Whilst the decision seek support for the 
episiotomy is not one which I would criticise, people should always be able to 
ask f or help when needed, the fact that the midwife who was with 
 was 
talked out of this so readily resulting in avoidable delay is concerning. 

2.  The decision to move 

 from consultant to midwife led care without 

consultation, although not contributory to Millie-Rae's death is concerning. 

3.  The lack of discussion with 

 about birthing options prior to labour and 

4. 

theref ore the lack of engagement with the pregnant woman is concerning. 
I have had sight of the new documentation around 'Born in Sheffield' and I am 
concerned by reference to 'normal birth' on the checklist. Again, this appears as 
though it is encouraging expectant mothers to be influenced into a natural birth 
when they may prefer to explore options such as caesarean section. Language 
is hugely important in terms of the experience individuals have when vulnerable. 

5.  Evidence was given about fresh eyes on continuous heart rate monitoring but 

there appear to be no safeguards in place for those not on continuous heart rate 
monitoring.  

6  ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe your 
organisation have the power to take such action. I would ask that your responses 
specifically consider the following:- 

1.  Engagement with families and especially expectant mothers about their 

pref erences for birth. The real pros and cons of consultant led and midwife led 
care. 

2.  How the unit will work on culture to ensure that those who have the most 

knowledge are supported to lead decision making and not be talked out of that 
decision upon the arrival of someone more senior or more experienced.  

3.  Guidance for how to make safe decisions. 
4.  The equivalent safeguard for expectant parents and babies of fresh eyes when 

they are not on continuous heart rate monitoring  

5.  How expectant parents know exactly what to expect from a labour and what 

level of  service they should expect. Make the NICE guidelines accessible so that 
parents are true partners in their care. 

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by 21st June 2022.  I, 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. 

8  COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to the following Interested 
 and Sheffield Teaching Hospitals 
Persons: 
NHS Foundation Trust. 

 and 

I am also under a duty to send a copy of your response to the Chief Coroner and all 
interested persons who in my opinion should receive it.   

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 I may also send a copy of your response to any other person who I believe may find it 
usef ul or of interest. In this case I have sent a copy of this report to NHS England and to 
NHS Shef field CCG and the South Yorkshire and Bassetlaw ICS as the legacy 
organisation for CCGs. 

The Chief  Coroner may publish either or both in a complete or redacted or summary 
f orm. 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. 

9 

25th April 2022    

Abigail Combes 
Assistant Coroner 

3

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