Laura-Jane Seaman, a mother who begged for her life after giving birth, could have allegedly been saved, but hospital staff treated her for dehydration and gave her a biscuit as she suffered an internal bleed.
Seaman, 36, was known to be at high risk of post-partum hemorrhage, and a new investigation has concluded her death was "avoidable" and "contributed to by neglect" during her treatment at Broomfield Hospital in Essex.
The 36-year-old died days before Christmas in 2022 after giving birth to her fifth child.
"I have five babies at home. Please don't let me die," she pleaded to hospital workers.
Seaman's mother, Sarah, recalled her daughter's final hours, noting she was able to breastfeed her new baby boy and was looking forward to going home.
"We were going to have a McDonald's breakfast-that's what she did after the birth of every baby," Sarah told Sky News.
She started to feel unwell as the day progressed. Her mother stated, "She at times was quite distressed, but at other times was calm. She just kept saying, 'I'm not right. I feel like I'm gushing.'"
Despite being known to be at high risk of postpartum hemorrhage, her case was not escalated accordingly.
Her observations were handwritten on a cardiotocography printout rather than the chart, which would have flagged her many warning signs.
"She said, 'Mum, I'm dying', and she told [the staff] so many times, 'I'm dying. Help me.'"
Two days later, after multiple operations and cardiac arrests, Seaman died.
Area coroner Sonia Hayes declared her death was due to "basic failings to recognize a loss of consciousness as a maternal collapse."
Seaman's eldest daughter, Amie, commented:
"At the time, we really believed [the staff] were doing all they could."
Sarah added, "I thanked every member of staff that was in that room; I actually thanked them for giving us an extra two days with her."
For Seaman's family, the "basic" mistakes proved devastating.
A spokesperson from the hospital trust extended their "sincerest sympathies and condolences to the family of Laura-Jane," while adding that their focus since the tragedy has "been on improving training to prevent this from happening again."