TWO midwives are accused of providing inadequate care that led to the death of a newborn baby.

Joshua Titcombe was born on October 27 2008 at Furness General Hospital but died nine days later after suffering pneumococcal septicaemia and a lung haemorrhage.

Midwives Lindsey Biggs and Holly Parkinson face claims they failed to make adequate care records for Joshua and his mother, did not tell a paediatrician he had a low temperature and did not check up on him properly.

Opening the case at a hearing of the Nursing and Midwifery Council (NMC) in London, Amanda Hamilton said the pair's alleged failures could have contributed to his death or caused him to lose a significant chance of survival, and said their actions amounted to misconduct.

Misconduct accusation

Joshua's mother, Hoa Titcombe, and her husband James, from Dalton, have claimed they repeatedly told hospital staff she felt unwell the day before giving birth and was concerned about catching an infection from her young daughter who had been sent home ill from nursery.

Mrs Titcombe was due to have Joshua, her second baby, on November 14 but her waters broke three weeks early.

She was examined on October 25 and sent home with a thermometer and paracetamol, and the following day had a high temperature.

On October 27 she went into labour and gave birth to Joshua at around 7.30am.

He was given oxygen as he was breathing slowly, and Mrs Titcombe was prescribed antibiotics after her husband told staff she felt unwell and was cold.

'Very long, busy day'

Ms Hamilton told the hearing Ms Parkinson, who qualified as a midwife in 2003, started a "very long, busy day" at 7.45am and administered Mrs Titcombe the antibiotics.

Joshua's parents became worried her condition might be affecting him, and Ms Parkinson told a paediatrician Mrs Titcombe had high temperatures and was feeling unwell. 

He advised her to carry out three-hourly observations, and Joshua was later put in a post-natal ward.

At one point he was placed in a warming cot to maintain his temperature and at 2am on October 28 Ms Biggs, on the night shift, was called because he was breathing rapidly.

She undressed him but failed to find anything wrong, but at 6.50am found his temperature was low.

A lack of notes meant she did not know what it had fallen from, and he was placed back into a warming cot.

But at 7.45am Joshua collapsed and an emergency team tried to resuscitate him.

He was placed on a ventilator and transferred to another hospital before being taken to the Royal Victoria Infirmary in Newcastle, where he died on November 5.

Missing chart

Ms Hamilton outlined a series of alleged failings in Joshua's care, including the disappearance of an observation chart and records not being kept properly.

She said: "It is the NMC's case that during the day shift of October 27 Holly Parkinson failed to record the advice given to her by the paediatrician that the baby required three-hourly observations, but further, that she failed to escalate a finding of the baby's low temperature between 4pm and 9pm.

"Also, that Lindsey Biggs failed to ensure that three-hour observations were maintained accordingly between 3am and 6.50am, and that Ms Biggs failed to escalate findings of low temperature to a paediatrician so the baby could be examined further and failed to record them in the maternal or baby notes."

Ms Parkinson admitted one allegation of failing to document a paediatrician's advice that Joshua needed three-hourly observations but denied the others, while Ms Biggs denied all the allegations.

Earlier hearings cleared two other midwives, Gretta Dixon and Catherine McCullough, of any wrongdoing around Joshua's death.

2011 inquest

An inquest in 2011 heard midwives repeatedly missed chances to spot and treat a serious infection which led to Joshua's death.

Stuart Gray, the hearing panel's chairman, said he would consider a request from the NMC that the findings of the inquest should be admitted as evidence.

An inquiry into the University Hospitals of Morecambe Bay NHS Trust found last year that a "lethal mix" of failures led to the unnecessary deaths of 11 babies and one mother.

The hearing continues at 11am on Thursday.