A day-old baby suffered permanent brain damage when a blood transfusion for jaundice went disastrously wrong at London’s biggest NHS trust.
An investigation into Barts Health found the two doctors and nurse involved in the procedure took out far more blood than they put in.
This caused the girl, referred to only as Baby F, to suffer a collapse and for her heart to stop. She was left disabled and will need care for the rest of her life.
The incident happened in 2010 but only came to light today as one of many appalling NHS blunders highlighted by the Parliamentary and Health Service Ombudsman as it published details of 160 investigations completed between April and June.
The Ombusdman refused to say which of Barts’ three hospitals with maternity units – the Royal London, Newham and Whipps Cross – the case involved, claiming this would breach the child’s confidentiality.
Parliamentary and Health Service Ombudsman Julie Mellor said: “These investigations highlight the devastating impact failures in public services can have on the lives of individuals and their families.
“A shocking case that stood out was that of a one-day-old baby who suffered permanent brain damage at Barts Health NHS Trust in London because a nurse and two doctors made serious mistakes during a blood transfusion.”
A Barts Health NHS Trust spokesman said: “We have recently completed an investigation into the care received and the circumstances surrounding this incident, and intend to share this and its recommendations with the family shortly.
“As this case is currently the subject of on-going legal proceedings, it would be inappropriate for us to comment further at this time.”
Another of the 15 cases in London involved the death of a man two days after a liver biopsy at Barking, Havering and Redbridge NHS Trust (BHRUT), which runs Queen’s in Romford and King George in Ilford.
The man, who was not named, was admitted via the accident and emergency department and was given a biopsy. But consent for the biopsy – in which a small amount of the organ is removed for testing – was not properly obtained. He was not adequately cared for and monitored afterwards.
The ombudsman’s report said: “It is impossible to judge whether the biopsy was safe to proceed with, because of the missing records. We were unable to say if [his] death could have been avoided, but he was not given the best possible chance of surviving.”
BHRUT acting medical director Magda Smith said: “A comprehensive action plan was drawn up following the patient’s tragic death in 2010 and shared with his family. I hope that they are reassured that processes have now been put in place to protect patients who require a similar procedure.
“We have sincerely apologised to the family for the mistakes that were made.”
A third case saw the Royal Free hospital pay the daughter of a patient £1,500 compensation for failures in the last six weeks of his life.
She accused the hospital of giving her father too little help with eating and drinking and claimed he had unexplained wounds and injuries. The ombudsman said the experience worsened her bereavement.