• Prosecutors say trust failed to ensure two anaesthetists had the right qualifications
  • Maidstone and Tunbridge Wells Trust pleaded not guilty
  • Trial relates to death of Frances Cappuccini after she gave birth at Pembury Hospital
  • First case of an NHS trust being charged under Corporate Manslaughter and Corporate Homicide Act

PATIENT SAFETY: Prosecutors in the first corporate manslaughter prosecution against an NHS trust said it failed to ensure two anaesthetists had the right qualifications and training and for their roles.

Maidstone and Tunbridge Wells Trust has been charged with the offence under the Corporate Manslaughter and Corporate Homicide Act. It has pleaded not guilty.

As part of the same case, consultant anaesthetist Errol Cornish pleaded not guilty to gross negligence manslaughter.

Inner London Crown Court heard another anaesthetist doctor involved in the case, Nadeem Azeez, is in Pakistan and prosecutors are trying to ensure his return to the UK to face the same charge.

The trial follows the death of primary school teacher Frances Cappuccini, 30, after she gave birth by emergency caesarean section in October 2012 at the trust’s Pembury Hospital.

Prosecutor John Price said the birth was performed safely, but Ms Cappuccini required a general anaesthetic for a further procedure to remove residual tissue.

This procedure was performed successfully, but problems arose when the patient was taken off mechanical ventilation by Dr Azeez, the court heard.

Mr Price said Dr Azeez failed to restore mechanical ventilation despite it being clear the patient was not breathing properly, and for half an hour he was “hand ventilating” her.

When other staff called Dr Cornish from a neighbouring ward, he supported Dr Azeez as he continued to hand ventilate the patient with a face mask attached to the anaesthetic machine. But he also failed to ensure mechanical ventilation was restored, the court heard.

Mechanical ventilation was restored 80 minutes after it was first removed, after a senior anaesthetist was called from intensive care, but by this time it was too late for Ms Cappuccini, the court heard.

Mr Price said the doctors had failed to perform “elementary tasks” and Ms Cappuccini’s death was “wholly avoidable”.

If the jury accepts the charges against at least one of the doctors it will then be asked to decide whether the trust “knew or ought to have known” they were not suitably qualified or trained for their roles.

Dr Azeez initially worked for the trust as a locum, but was given a substantive role of staff grade doctor in 2007. About a year later he was given the role of specialty doctor, which the trust told police was an “automatic process”.

Mr Price said: “Dr Azeez was a doctor whose training did not match the requirements for the post. There was no evidence of formal assessment of competence either at the time he was appointed as locum, or permanently to the post of staff grade or subsequently when transferred to specialty doctor grade.”

He said the trust also failed to ensure he received adequate supervision, and failed to escalate concerns that were raised in appraisals.

In the case of Dr Cornish, the court heard he did not hold the relevant qualifications needed for a substantive anaesthetist consultant but was employed as a locum.

Mr Price added: “It is submitted that the trust failed to comply with this code of practice as it has failed to show that it made appropriate efforts to recruit a qualified consultant anaesthetist, failed to consider Dr Cornish’s continuing professional development or record of appraisal, and failed to give appropriate oversight to Dr Cornish as a person who did not meet the criteria for substantive appointment as a consultant.”

Some trust board members have been present in court, along with members of the Cappuccini family and national media.

The trial continues.

Maidstone trial: Patient’s death ‘wholly avoidable’, court hears