Hospital 'failures' during caesarean caused death of young mother, coroner finds

The death of a young mother was caused by a series of failures at the hospital caring for her as she gave birth, a coroner has said.

Frances Cappuccini, 30, died at Tunbridge Wells Hospital in Pembury, Kent, just hours after her second son was born by caesarean section.

An inquest was told Mrs Cappuccini lost more than two litres of blood following the procedure and was operated on for a postpartum haemorrhage, but never woke up from the anaesthetic.

Coroner Roger Hatch blamed her death on "failures, inadequate diagnosis and treatment" and said the C-section was not carried out with enough care.

He said: "The result of this failure led directly to the subsequent series of events which tragically led to the death of Frances."

The inquest heard that a small piece of placenta was left inside Mrs Cappuccini’s uterus – a mistake that was described as a "fundamental failure of care".

Mr Hatch then criticised the management of Mrs Cappuccini's haemorrhage and said the premature removal of a breathing tube also contributed to the decline in her condition.

Speaking on behalf of Mrs Cappuccini’s family, solicitor Kate Rohde said the hospital's failures "cost Frankie her life".

She said: "Nothing can heal that pain. At least today, after over four years, the truth is acknowledged."

In a statement, Maidstone and Tunbridge Wells NHS Trust offered its "deepest sympathies" to the mother’s family and admitted it had "fallen short" in areas of her care.

It said: "Patient safety remains of paramount importance to the trust.

"The trust has however recognised from the start that there were aspects of Frances' care that fell short of the standards that the trust would expect and we wish to once again sincerely apologise to the family for this."

The trust added that it had made changes to improve patient safety and said it would "carefully consider all of the evidence heard at the inquest to ensure that any necessary changes which have not already been made are fully addressed".