British mother who died in childbirth 'did not receive all the blood doctors ordered for her'

A mother who suffered a massive haemorrhage and died hours after childbirth did not receive all the blood doctors had ordered for transfusion, an inquest has heard.

Gabriela Pintilie, 36, lost a total of six litres of blood after giving birth to her daughter via C-section at Basildon University Hospital last February.

The Romanian-born mother bled to death over several hours after a breakdown in communication meant that doctors conducting emergency surgery after the birth did not realise how much blood and blood clotting products were available.

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Mrs Pintilie, from Grays, Essex, had been due to give birth to her second child via C-section on February 28 2019, but arrived at the maternity unit three days earlier when her waters broke.

Gabriela Pintilie, 36, lost a total of six litres of blood after giving birth to her daughter via C-section at Basildon University Hospital last February.Gabriela Pintilie, 36, lost a total of six litres of blood after giving birth to her daughter via C-section at Basildon University Hospital last February.
Gabriela Pintilie, 36, lost a total of six litres of blood after giving birth to her daughter via C-section at Basildon University Hospital last February.
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After a series of delays, doctors decided to attempt an induced vaginal delivery, but when that was not successful, she was given a C-section the following evening.

The healthy baby was born at around 9:35pm on February 26.

Mrs Pintilie was rushed into surgery after haemorrhaging, and died seven hours later at 4:41am on February 27.

Dr Malcolm Griffiths, a consultant gynaecologist not affiliated with Basildon University Hospital and brought in as an expert witness, told Essex Coroners Court in Chelmsford that Mrs

Pintilie lost 600ml of blood - a usual amount for a C-section - by 10pm, however half an hour later, she had lost another two litres.

Blood and blood clotting products were requested and Mrs Pintilie was given two units of O negative universal blood, and six units of blood matched to her.

None of the clotting products were administered.

Dr Griffiths said: "Key people in theatre did not know blood products were available.

"Gabriela did not receive all of the blood and any of the blood products."

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According to a report by the blood transfusion service, referred to by Dr Griffiths, eight units were released over, but two were returned afterwards.

He said: "Appropriate blood products were provided, but due to confusion [...] they weren't administered."

When asked whether this was a breakdown in communication, he said "yes" and later added: "The top and bottom is more blood was available that wasn't used."

Dr Griffiths also said there had been a series of delays in Mrs Pintilie's care before the C-section.

He said: "There were delays in instigating the induction because of work load issues in the unit."

The later decision to abandon the vaginal delivery was also delayed by a "number of hours" Dr Griffiths told the hearing, as doctors in the maternity unit were dealing with complications in another patient.

Midwife, Grace Ladbrook, who looked after Mrs Pentilie after she was admitted on February 25, said she apologised for delays in her care on the "extremely busy" day.

She said: "I don't remember there being any spare rooms, theatre was open all day.

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"There was difficulty getting to see doctors because they were in theatre."

Ms Ladbrook spoke with an on-call registrar and consultant who advised Mrs Pentilie to swap from an elective C-section to vaginal delivery, which she agreed.

The midwife added: "When I left that evening she was sympathetic to the delay."

The maternity unit at Basildon University Hospital was given a "requires improvement" rating following a care and quality commission inspection in July last year.

In the same month, a coroner found the hospital's "neglect" contributed to the death of baby boy Ennis Pecaku, who died hours after his breech birth in 2018.

The hospital overall was rated as "good" in last year's report.

The inquest continues.