A hospital worker died after failing to wake the mother for “potentially life-saving observations” before the baby was born, an investigation has found.
Sonny Taylor was left in “considerable amounts of pain” at Ysbyty Gwynedd, Bangor, before an emergency caesarean section was delayed and he died three days later from severe brain damage caused by sepsis and lack of oxygen.
His parents, Eve and Thomas, said he was “terribly disappointed when he needed help the most”.
Betsi Cadwalladr University Health Board accepted the report’s findings and apologized “unreservedly” for the treatment failures.
Sonny’s mother Eve, 29, was hospitalized after her water broke at 36 weeks.
Later that afternoon, she was taken to the maternity ward after signs of possible infection were identified.
At 18:00 GMT, her observations and Sonny’s heart rate were successfully recorded.
While Eve was sleeping at 10pm, midwifery staff did not wake her to perform further observations or listen to Sonny’s heartbeat, despite it being necessary, an internal investigation report found.
“When I woke up, Sonny wasn’t moving much, so I knew right away that something was wrong,” she said.
“What happened next was frantic, chaotic and terrifying.”
Although the registrar confirmed that the fetal heart rate was abnormal, Eve was mistakenly transferred to the delivery room, causing further delays until Sonny delivered the baby via emergency caesarean section at 2:03 am.
“During the emergency C-section, I went to sleep not knowing if I would wake up or if my baby would be delivered safely,” Eve said.
“He was very disappointed.”
Later tests revealed that Sonny had been in “suffering for a significant amount of time” and should have been delivered sooner.
He was transferred to a specialized neonatal intensive care unit, but after discussions with clinicians, Eve and Thomas agreed to move him into palliative care.
He passed away shortly after 7pm on October 3, 2022, and his death was recorded as brain damage due to lack of oxygen and sepsis.
Investigators said that if Sonny’s heart rate abnormalities had been discovered earlier, “it is highly likely that the outcome would have been different.”
Eve said: “We will forever cherish the precious but all-too-little time we had with Sonny. However, it broke our hearts to have to say goodbye to him.
“Unfortunately, what happened to us was not an isolated incident.
“The very least families deserve is to have their voices heard so that care for others can be improved.”
“I don’t think I’ll ever get over being discharged from the hospital and not taking Sonny with me to start a new chapter as a family together,” Thomas said.
“Sony will always be a part of our family.
“We will always believe that he was badly let down when he needed help the most.”
Sonny’s parents hope lessons are learned from the tragedy [Family photo]
The family received an undisclosed settlement from Betsy Cadwalladr University Health Board (BCUHB).
Sarah Burns, a medical negligence lawyer at Irwin Mitchell who is representing the family, said: “No amount of compensation can compensate for what the family has gone through.”
The health board said the changes were made to reduce the risk of similar incidents occurring in the future.
He added: “While we know that no action can undo what happened, we are determined to learn from this incident and continue to improve the safety and quality of maternity care for all families across North Wales.”