A baby died after being starved of oxygen during birth while midwives joked about how many sweets they’d eaten and how much money they earned, an inquest heard.

Theo Bradley had to be resuscitated following delays in his care at King’s Mill Hospital in Sutton-in-Ashfield, Nottingham, in September last year.

Mum Amelia Bradley, 26, said she called for help in agony several times but heard maternity staff chatting — including one saying: ‘I can’t believe how many Haribo’s I’ve had tonight.’

Numerous midwives were sat around the desk when Ms Bradley should have been assessed within 15 minutes of arriving at hospital, but this did not happen for 40 minutes, it was claimed. 

An obstetrician from the Trust advised the coroner if Ms Bradley had been seen promptly, it was more likely than not that Theo would have survived. 

Theo Bradley (pictured) had to be resuscitated following delays in his care at King’s Mill Hospital in Sutton-in-Ashfield, Nottingham, in September last year

Theo Bradley (pictured) had to be resuscitated following delays in his care at King’s Mill Hospital in Sutton-in-Ashfield, Nottingham, in September last year

Grieving parents Amelia Bradley, 26, and her partner Luke Sherwood, 26, (pictured centre) are now calling for lessons to be learned following the tragedy

Grieving parents Amelia Bradley, 26, and her partner Luke Sherwood, 26, (pictured centre) are now calling for lessons to be learned following the tragedy

When it was recognised she had not been seen to, one midwife admitted making a comment about a colleague earning more money than her.

Theo was found to have a slow heartrate and a decision was made to deliver by category one caesarean — when there is an immediate threat to the life of mother or baby. 

After he was born, resuscitation equipment on the unit was found to be missing and Theo was transferred to a specialist neonatal unit for treatment.

However, his condition continued to deteriorate and he died the following day in his parents’ arms surrounded by his family.

Theo was found to have a slow heartrate and a decision was made to deliver by category one caesarean — where there is an immediate threat to the life of mum or baby

Theo was found to have a slow heartrate and a decision was made to deliver by category one caesarean — where there is an immediate threat to the life of mum or baby

A post-mortem examination found he died after suffering a serious brain injury caused by a lack of oxygen.

An inquest at Nottingham Coroner’s Court reached a narrative conclusion this week.

Nottinghamshire assistant coroner, Elizabeth Didcock, found neglect contributed to Theo’s death.

She found that if Theo had been delivered earlier, on balance, he would have survived.

Grieving parents Ms Bradley and her partner Luke Sherwood, 26, of Kirkby-in-Ashfield, Nottingham, are now calling for lessons to be learned following the tragedy.

Ms Bradley, who has applied to start a midwifery degree starting in September, said: ‘Following Theo’s death, Luke and I discussed how we wouldn’t ever want another family to have to go through what we’re going through.

‘I want to honour Theo’s name and to use this awful experience to be an advocate for women and help deliver the best care and support that women should expect to receive.

‘To lose Theo so soon after he came into the world is something we’ll never get over.

‘We’d been looking forward to becoming a family and to have that ripped away from us in such a cruel way was nothing short of traumatic.

“To this day, I still wake up and hope it’s all been a nightmare and then it hits me and I’m completely floored by the grief.

‘Knowing that our baby boy will never even celebrate his first birthday is so difficult to come to terms with.

‘Hearing everything again at the inquest has been unbearable, but we’re grateful to have some answers now.

‘We would do anything to bring Theo back, but we know that’s not possible.

‘All we can hope for now is that no other families have to go through the heartbreak we have. I wouldn’t wish it on anyone.’

A post-mortem examination found he died after suffering a serious brain injury caused by a lack of oxygen. An inquest at Nottingham Coroner’s Court reached a narrative conclusion this week

A post-mortem examination found he died after suffering a serious brain injury caused by a lack of oxygen. An inquest at Nottingham Coroner’s Court reached a narrative conclusion this week

Ms Bradley and Mr Ashfield attended King’s Mill Hospital at around 9.30pm on September, 13 last year after her contractions started.

But the parents waited for over an hour to be seen before Ms Bradley was given pain relief and underwent a sweep and was allowed home at around 11.30pm.

Just after midnight she started passing blood and experiencing unbearable pain.

They returned to hospital and she was finally assessed at 1.42am before Theo was delivered at 2.02am.

A Healthcare Safety Investigation Branch (HSIB) report found there was no allocated lead in the maternity triage department, so nobody had responsibility for assigning roles and managing workload.

Both present triage midwives did not take responsibility on who would see Ms Bradley upon her return to hospital, causing unnecessary delays.

Evidence given by an obstetrician from the Trust at the inquest stated that Ms Bradley’s presenting symptoms should have prompted an immediate assessment.

The 29-minute delay in Theo receiving resuscitation medicines and blood products may also have impacted Theo’s outcome, the report added.

Evidence given by an obstetrician from the Trust at the inquest stated that Ms Bradley's presenting symptoms should have prompted an immediate assessment

Evidence given by an obstetrician from the Trust at the inquest stated that Ms Bradley’s presenting symptoms should have prompted an immediate assessment

An obstetrician from the Trust advised the coroner if an assessment was made promptly, it was more likely than not that Theo would have survived.

Laura Robinson, the specialist medical negligence lawyer at Irwin Mitchell representing the family, said after the hearing: ‘It’s less than a year since Theo died, and losing him so suddenly and in such traumatic circumstances continues to have a profound effect on Amelia and Luke.

‘The pain and grief they feel has been made worse by the questions they had around the events that unfolded in the lead up to their baby boy’s death.

‘While nothing will ever make up for what Amelia and Luke are going through, we’re pleased to have at least been able to provide them with some of the answers they deserve.

‘Sadly, however, the inquest has identified issues in the care prior to Theo’s death, especially around communication, training among maternity staff, and staff culture.

‘Every second counts when delivering a baby in distress. It’s now vital that lessons are learned to help improve maternity safety and prevent other mums and dads from suffering the way Amelia and Luke have.

‘We’ll continue to support them at this difficult time.’

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