Investigation Identifies Issues Over How Mum’s Blood Glucose And Blood Pressure Were Monitored
Baby Pronounced Stillborn Two Days After Official Report Finds She Should Have Been Delivered
A grieving husband has called for lessons to be learned after a Hospital Trust apologised for “unacceptable errors” that led to the stillbirth of his first child.
Fozia Hanif was deemed to be a high risk patient because of a history of asthma and Type-II diabetes and was placed under consultant led care at Birmingham Women’s Hospital.
Fozia and her husband Wajid Ali’s child, Anaya Hanif, was pronounced dead at 38 weeks on 12 May, 2019.
In the two weeks leading up to Anaya’s death Fozia had complained of feeling unwell. On 1 May, 2019, staff failed to keep Fozia in hospital to monitor her elevated blood glucose levels as well as her baby’s accelerated growth, the Trust which runs the hospital admitted. “Further errors” were made on 7 May, 2019, when staff did not act on Fozia’s increased blood pressure and protein markers by arranging a caesarean, placing her instead on an elective waiting list, it added.
Anaya was pronounced stillborn on 12 May – the day before Fozia was due to undergo a caesarean. An internal hospital investigation report found that the planned caesarean date was three days after Anaya should have been delivered.
The couple, of Sparkbrook, Birmingham, instructed specialist lawyers at Irwin Mitchell to help secure answers as whether more could have been done to prevent Anaya’s death.
Tragically, Fozia died aged 29 in April this year just days after giving birth to the couple’s second child Ayaan Hanif Ali. During her admission to hospital for delivery, Fozia tested positive for Covid-19. An inquest to establish her cause of death and why she died is still ongoing. Because of her condition, Fozia did not get to see or hold her baby.
Birmingham Women’s and Children’s NHS Foundation Trust, has admitted liability for Anaya’s stillbirth and has apologised to Wajid. The Trust was not involved in the care of Fozia when she gave birth in April 2020.
In a letter, David Melbourne, acting chief executive of Birmingham Women’s and Children’s NHS Foundation Trust, offered “sincere and heartfelt apologies on behalf of the Trust” adding Fozia did not “receive the level of care and treatment….she had every right to expect.”
He added that when Fozia’s elevated blood glucose levels were identified it was “absolutely clear” that she should have been admitted to hospital for observation. “Further errors” were also made when the Trust did not act on Fozia’s elevated blood pressure and protein markers.
Mr Melbourne said: “I am also conscious that any apology after such serious failings will be of limited comfort to you and your family, however I do hope that you can take some assurance from the fact that we are doing all we can to learn from these mistakes, by reviewing our practice and policies to minimise the potential of these unacceptable errors recurring for other women, babies and families in the future. We are committed to taking steps to prevent what happened to you happening again.”
Shay Williams, specialist lawyer at Irwin Mitchell supporting Wajid, said: “What was meant to be such a joyous occasion for Fozia and Wajid turned to sheer heartbreak.
“When a pregnant woman with diabetes has high blood glucose levels her baby will store this as body fat, making the baby larger than normal. Therefore, close monitoring and tight control of blood glucose levels is key to ensuring a safe pregnancy and delivery
“We believe that if Fozia had been admitted to hospital her condition could have been monitored, and if required, an appropriate care plan put in place and ultimately, Fozia would have delivered a healthy baby girl. Sadly this didn’t happen with devastating consequences for the family.
“Understandably the last 15 months have been incredibly difficult for Wajid. While nothing can make up for what has happened we welcome the Trust’s apology and acknowledgment to learn lessons from Anaya’s death. It’s now vital that the highest standards of care are upheld at all times.”
Fozia, who worked for the Probation Service, died on 8 April this year six days after giving birth to the couple’s second child, Ayaan Hanif Ali, at 31 weeks. She had tested positive for Covid-19. Ayaan tested negative for the virus.
Because of Fozia’s condition she was not able to see her baby and only saw photos of him.
Wajid, 30, said: “We were overjoyed when Fozia fell pregnant with Anaya. It was always our dream to start a family.
“For most part the pregnancy ran relatively smoothly. We were advised at Fozia’s 20 week scan that the baby was measuring big and that there would be extra monitoring of the baby’s growth. Towards the end of April Fozia started feeling unwell. We were concerned about what was happening but put our trust in those looking after us.
“To be told that Anaya had died was absolutely heart-breaking. Nothing can prepare you for those words and returning home to see a nursery full of toys that Anaya never got to play with.”
Wajid added: “Starting trying to come to terms with losing Anaya was hard enough and while Fozia’s death is not connected to what happened to Anaya, to be now left without my wife and daughter in the space of less than a year is something I’m not sure I’ll ever be able to get over.
“Having to say goodbye to Fozia was the hardest decision our family will ever make.
“Fozia was a wonderful, loving and caring person who wouldn’t think twice of helping others. She would have been an amazing mum.
“Ayaan will grow up knowing all about his mum and his big sister and they will always be a part of our family. While nothing can undo what has happened all I can hope for now is that the Trust learns lessons over Anaya’s death so others don’t have to face the pain of losing a child in such circumstances.”
Background
Due to her diabetes Fozia underwent regular baby growth scans during her pregnancy with her insulin requirements increasing. Discussions took place with a view to her undergoing a caesarean at around 38 or 39 weeks.
On 22 April, 2019, Fozia attended an ante-natal clinic expressing concerns about reduced movement of her baby. A scan showed her baby was expected to be big. The possibility of being induced at 38 or 39 weeks because there were risks Fozia’s child could suffer a serious birth injury be becoming stuck in delivery because of the baby’s size.
Eight days later Fozia was admitted to Birmingham Women’s Hospital complaining of sickness. Due to her blood sugar levels and sickness she was monitored overnight before being discharged on 1 May.
On 7 May Fozia attended another appointment. A scan showed continued fetal growth and tests highlighted she had increased blood pressure and protein markers. Further talks regarding a caesarean were held because of the risk of Anaya suffering
a birth injury during a natural delivery due to her size.
Staff decided Fozia did not require a category three caesarean and could be placed on the elective caesarean list. The Royal College of Obstetricians and Gynaecologists class a category three caesarean as where a baby requires early delivery and an elective procedure as where there is “no maternal or fetal compromise”.
She was booked in for the procedure on 13 May. The day before Fozia attended hospital concerned that Anaya had reduced movement. An ultrasound confirmed Anaya had died.
A Root Cause Analysis Report by Birmingham Women’s and Children’s NHS Foundation Trust found that following Fozia’s tests on 7 May blood tests for preeclampsia should have been carried out. The possibility of admitting her to hospital should also have been explored. Anaya should have been delivered by 10 May, it added.
The report made five recommendations including the possibility of creating an alert on electronic patient records to highlight abnormal observations, new guidelines on managing diabetes in pregnancy and finalising standard procedures for the booking of elective caesareans.
