Mum-of-six, 45, died after losing more than half her body’s blood following botched caesarean carried out by trainee surgeon

A mum died after losing more than half her blood following a caesarean carried out by a trainee surgeon, an inquest heard.

Rosida Etwaree, 45, lost more than 6.5 pints of blood after successfully giving birth to twins at Mayday Hospital in Croydon, south London, in June 2010, the hearing was told.

Mrs Etwaree was one of five mums to die in childbirth at the hospital, now called Croydon University Hospital, in the same year.

The caesarean was recommended by Mrs Etwaree’s consultant because she was suffering from potentially fatal pre-eclampsia and one of the twins had a heart condition, the inquest heard.

But during the operation on June 23 2010, trainee surgeon Dr Latika Narang struggled to close the mum-of-six’s uterus due to a heavy bleed on a placental bed.

Consultant Obstetrician and gynaecologist Britt Clausson stepped in to finish the operation but then left the operating theatre, the hearing was told.

The operating team calculated that Mrs Etwaree had lost around two litres of blood (3.5 pints) and was given two units before she was stabilised and moved to a recovery ward.

Dr Narang later found the amount she had lost to be 3.75 litres (6.5 pints) and claims to have left the details in her handover notes.

The inquest heard that because Dr Narang had to attend a hearing, she left before the handover doctor, Dr Sajitha Nalini, had arrived, and gave her patient notes with Dr Ebrahim Foroughi to pass on.

She also claims to have told Dr Neelam Chitkara during the hearing, but consultant anaesthetist told the court she had no memory of being told that Mrs Etwaree blood loss was so high.

She said: “I do not remember that conversation, if I was told that it was nearly four litres I would have done something.

“I would have gone back or at least told a doctor, if someone had told me that in theatre perhaps going out was out of the question.

“Unfortunately, nothing like that happened.”

Later that day Mrs Etwaree, who was also diabetic, suffered two cardiac arrests triggered by the continuing internal bleeding, the inquest heard.

After the first she was resuscitated but the second proved fatal.

Dr Narang, who began working in Britain since 2003 and claims to have carried out around 400 caesareans, said: “There was bleeding.

“I could not see the lower segment, it seemed to have retracted down.

“Rosida had had four children and the lower segment was quite stretched, it loses its elasticity with each pregnancy.

“I knew I should call for help and I did not want to waste any more time looking for it.

“Ms Clausson arrived pretty quickly.

“We managed to identify the lower segment pretty much straight away and she put a couple of stitches in the placenta bed before we started closing the uterus.

“Ms Clausson started repairing the first layer and after the first layer was done the bleeding seemed to have stopped. Then we closed the second layer.”

Before Rosida was transferred out of the operating theatre she was given two units of blood and appeared to be stable in the recovery room, the inquest heard.

On the witness stand, Dr Narang was accused by Ben Rich of not telling senior staff directly about the loss of blood.

He said: “The difficulty is that you did not in fact refer the blood loss to anyone senior at all.

“My suggestion is that you are struggling about when you told Dr Chitkara because you did not tell her.

“You should have told someone more senior both on the surgeon side and the anaesthetic side.”

The inquest heard that hospital policy meant that senior clinicians should have been told about the blood loss, which amounted to a major obstetric haemorrhage.

But the call was not made until roughly 4.30pm, more than three hours after Mrs Etwaree was transferred into a recovery ward.

Giving evidence Temilola Doherty, an obstetric theatre nurse, said: “Sister Lucille Shooter was being questioned in the corridor as to why they did not make the MOH call.

“She asked what my opinion was and I said go and put it out, put it out now.”

The family suffered further tragedy in 2012 when one of the twins, Nabilah, died from a heart defect.

In 2014 Croydon Health Services NHS Trust admitted liability for Mrs Etwaree’s death after solicitors found a catalogue of “atrocious” failures, and agreed to pay her husband Ahamud an undisclosed settlement to help care for the couple’s children.

The hospital will not face criminal charges in connection with her death, the Crown Prosecution Service announced last September.

Mr Etwaree, from Croydon, was present with other relatives for the opening of the inquest which is expected to take three weeks to complete.

The hearing continues.

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