CQC warning as Royal Free apologises to family of woman who died after maternity ward failings

A view of the Royal Free Hospital teaching hospital in the Hampstead area of the London Borough of Camden. The hospital is...

A view of the Royal Free Hospital teaching hospital in the Hampstead area of the London Borough of Camden. The hospital is part of the Royal Free London NHS Foundation Trust. PA Photo. Picture date: Thursday February 6, 2020. Photo credit should read: Jonathan Brady/PA Wire - Credit: PA

After a mum died during childbirth, the Royal Free Hospital has received a warning from the Care Quality Commission (CQC) which said it was forced to take “enforcement action”.

Senior coroner Mary Hassell outside Camden Town Hall. Picture: Polly Hancock

Senior coroner Mary Hassell outside Camden Town Hall. Picture: Polly Hancock - Credit: Polly Hancock

On February 20 this year, Malyun Karama, 34, died at the Royal Free after she was given an excessive amount of the drug misoprostol, which was used to induce labour while she was suffering a miscarriage.

The CQC warning comes after senior coroner for inner north London Mary Hassell wrote to the trust in November calling on it to make changes to prevent similar deaths.

READ MORE: Concerns over Royal Free’s relationship with controversial parking firmShe wrote that the misoprostol “was administered at doses in excess” of national guidelines, and that when a midwife observed something was going wrong and told a senior registrar, the doctor failed to attend to the patient.

Ms Hassell said that had the doctor visited Ms Karama, “the likelihood is that Ms Karama’s life would have been saved”.

In response to the coroner’s letter, the CQC conducted an unannounced inspection of the maternity department on October 28.


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Nicola Wise, the CQC’s lead hospital inspector in London, said: “As a result we have taken enforcement action to ensure improvements are made. We are unable to give further details at this time but will report on our findings shortly. All CQC’s action is open to appeal.”

In a report to the Royal Free London NHS Trust’s board on November 25, the trust’s group chair, Dominic Dodd, and chief executive Caroline Clarke wrote that “the Royal Free London maternity service was issued with a section 29a warning notice which detailed two specific areas of improvement to keep women safe”.

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The trust was told that the CQC “was not assured” that maternity services at the Royal Free were learning from incidents – and it was given a deadline of December 11 to make improvements.

It was also told to improve access to information for expectant mums in languages other than English.

A spokesperson for the Royal Free said: “We would like to offer our deepest condolences to Malyun Karama’s family and to apologise for mistakes made in the care that was provided to her.”

The spokesperson said there are now “plans in place” to improve on the two points raised by the CQC – and assured Ms Karama’s family that “lessons will be learnt going forwards”.

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