Jade Hart, 33, has left behind her son Hugo and her husband Richard (Pictures: BPM Media)

A ‘kind and caring’ mum died just hours after giving birth because a doctor neglected her and made ‘truly exceptionally bad’ decisions, an inquest concluded.

Jade Hart, 33, had a ‘perfect life and marriage’ and was ‘full of excitement and anticipation’ for the birth of her son Hugo on July 8, 2018.

She was induced into labour at Bassetlaw Hospital, in the town of Worksop, Nottinghamshire, and died in the early hours of July 9.

This is, in part, because the doctor pulled Mr Hart’s umbilical cord at least four times before her placenta had separated, Nottingham Coroner’s Court ruled.

This would have resulted in a ‘serious risk of death’ and was ‘a very serious omission of care,’ assistant coroner Dr Elizabeth Didcock said.

Indeed, Jade suffered a uterine inversion – where her uterus turned inside out – and this complication was ultimately what caused her death.

On top of this, Jade was struggling with an ongoing hemorrhage and lost 5.5 litres of blood.

But this issue was neglected by her doctor and midwife and eventually, Jade experienced organ failure, brain damage and multiple cardiac arrests before dying.

Jade Hart was described as a ‘kind and caring mum’ who had a ‘perfect life and marriage’ (Picture: BPM Media)

Jade’s husband Richard said ‘it’s time to find peace and joy and enjoy the gift that Jade gave to us, our beautiful son’ (Picture: BPM Media)

The Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust (DBTH) looked into the tragedy but it left out criticisms and analysis made by independent investigators.

Dr Didcock told the inquest: ‘Serious omissions has led to insufficient learning and no acceptance that this had caused serious distress to the family.

‘This poses a risk of similar deaths occurring in the future. I am not reassured the necessary actions are in place.’

However, the inquest stressed that the trust could not have foreseen the individual mistakes made my staff at the hospital.

Jade’s mum Julie Hazelgrave said: ‘Jade was wonderfully kind and caring with a great zest for life.

‘When their son was born, I saw that Jade was the happiest she had ever been.

‘Cruelly, all happiness was short-lived when, within one hour of birth, Jade collapsed and died in the immediate hours thereafter.

‘We remain devastated at the loss of Jade. Her death has cast a long shadow over our lives and our world has irrevocably changed. We miss Jade every single day and always will.’

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Similarly, Jade’s husband Richard said: ‘Being independent and thorough, Jade’s inquest has been invaluable to our understanding of what happened to Jade, that turned what should have been a wholly wonderful day into one with tragedy.

‘Ascertaining the facts is important, not least for our son who now has to live his life without his mummy.

‘It is time to find some peace and time to grieve the gift that was Jade, while concentrating on the joy and gift that Jade gave to us, our beautiful son.’

Dr Didcock told the family: ‘I’m so sorry for your loss. It’s also my hope that lessons will be learned that will lead to improvements in care going forward.’

Jade Hart’s cause of death was given as brain injury, multiple cardiac arrests and uterine inversion from inappropriate management during third stage labour.

The DBTH’s executive medical director Dr Tim Noble said: ‘On behalf of the Trust, I want to again share my sincere apologies and sympathies with Jade’s husband Richard and her family and friends.

‘As was highlighted during the inquest, this was a truly tragic case and we are grateful for the Coroner’s time and careful deliberation in reaching a conclusion.

‘We will review carefully the Coroner’s findings and take any actions needed to further improve the safety of the Trust’s Maternity services.’

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