Sheffield twins died following ‘missed opportunities’ prior to emergency birth, inquest hears

A Sheffield mum's twins died following ‘missed opportunities’ to escalate her ‘rare’ health issues in the hours before she had an emergency birth, a coroner's court heard.
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Siobhan Weir underwent a category one C-section at the Jessop Wing maternity unit when she was 33 weeks pregnant after concerns were raised about the heart rates of her twin boys, Harry and Henry Jackson.

The 22-year-old, a care home worker, attended a number of appointments and scans after she found out she was expecting twins.

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On June 9, 2021, she was admitted to the Jessop Wing – part of the Sheffield Teaching Hospitals NHS Foundation Trust – complaining of vomiting and was sent home the following day.

Siobhan Weir underwent a category one caesarean at the Jessop Wing in Sheffield when 33 weeks pregnant after concerns were raised about the heart rates of her twin boys Harry and Henry Jackson. Siobhan, now aged 22, had been admitted to hospital three times in a week complaining of severe vomiting. Shortly before surgery she had been diagnosed with pancreatitis. Harry was delivered stillborn. Moments later Henry was born in a poor condition. He died aged six days.Siobhan Weir underwent a category one caesarean at the Jessop Wing in Sheffield when 33 weeks pregnant after concerns were raised about the heart rates of her twin boys Harry and Henry Jackson. Siobhan, now aged 22, had been admitted to hospital three times in a week complaining of severe vomiting. Shortly before surgery she had been diagnosed with pancreatitis. Harry was delivered stillborn. Moments later Henry was born in a poor condition. He died aged six days.
Siobhan Weir underwent a category one caesarean at the Jessop Wing in Sheffield when 33 weeks pregnant after concerns were raised about the heart rates of her twin boys Harry and Henry Jackson. Siobhan, now aged 22, had been admitted to hospital three times in a week complaining of severe vomiting. Shortly before surgery she had been diagnosed with pancreatitis. Harry was delivered stillborn. Moments later Henry was born in a poor condition. He died aged six days.

Two days later, she was re-admitted and allowed home in the early hours of June 12.

She was admitted to hospital for the third time June 16 and following tests, she was diagnosed with pancreatitis.

After concerns were raised about her babies’ heart rates she was sent for a Caesarean at about 10.30am on June 17.

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However Harry was delivered stillborn and Henry was born in a poor condition, before passing away six days later.

Harry and Henry passed away at Sheffield's Jessop wing maternity unit last yearHarry and Henry passed away at Sheffield's Jessop wing maternity unit last year
Harry and Henry passed away at Sheffield's Jessop wing maternity unit last year

Siobhan, speaking about her twins during the inquest in Sheffield today, said the brief period she and her partner, Luke Jackson, 24, shared with their boys was ‘amazing’.

She said: “We didn't get much time with them. But Harry was the spitting image of him (Luke), and Henry was the spitting image of me. We didn't have much time, but it was amazing.

“We've got some handprints and footprints. We've got loads and loads of photos. But we didn't get much time.”

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She also revealed that she was still ‘suffering’ from pancreatitis following her diagnosis just prior to the birth of her twins in June 2021.

Siobhan Weir holding Henry - who was not born still born - but died six days later. See SWNS story SWLEinquest; Grieving parents whose twins died following an emergency caesarean have spoken for the first time about their devastating loss. Siobhan Weir underwent a category one caesarean at the Jessop Wing in Sheffield when 33 weeks pregnant after concerns were raised about the heart rates of her twin boys Harry and Henry Jackson. Siobhan, now aged 22, had been admitted to hospital three times in a week complaining of severe vomiting. Shortly before surgery she had been diagnosed with pancreatitis. Harry was delivered stillborn. Moments later Henry was born in a poor condition. He died aged six days.Siobhan Weir holding Henry - who was not born still born - but died six days later. See SWNS story SWLEinquest; Grieving parents whose twins died following an emergency caesarean have spoken for the first time about their devastating loss. Siobhan Weir underwent a category one caesarean at the Jessop Wing in Sheffield when 33 weeks pregnant after concerns were raised about the heart rates of her twin boys Harry and Henry Jackson. Siobhan, now aged 22, had been admitted to hospital three times in a week complaining of severe vomiting. Shortly before surgery she had been diagnosed with pancreatitis. Harry was delivered stillborn. Moments later Henry was born in a poor condition. He died aged six days.
Siobhan Weir holding Henry - who was not born still born - but died six days later. See SWNS story SWLEinquest; Grieving parents whose twins died following an emergency caesarean have spoken for the first time about their devastating loss. Siobhan Weir underwent a category one caesarean at the Jessop Wing in Sheffield when 33 weeks pregnant after concerns were raised about the heart rates of her twin boys Harry and Henry Jackson. Siobhan, now aged 22, had been admitted to hospital three times in a week complaining of severe vomiting. Shortly before surgery she had been diagnosed with pancreatitis. Harry was delivered stillborn. Moments later Henry was born in a poor condition. He died aged six days.
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Assistant Coroner, Mrs Tanyka Rawden, described the twins as ‘absolutely beautiful boys’ when Siobhan then presented her with pictures of them.

Caroline Hallisey, representing the family, said one of the ‘real tragedies’ of the case was how Siobhan had felt personally responsible for their deaths.

She said: “One of the real tragedies in this case is how it's made Siobhan feel in terms of the monitoring.

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“We would like there to be some acceptance of the failings of the Trust, which I think have been constructively accepted for the most part by the Trust witnesses today, in particular, in relation to the failure to appreciate the deterioration of Siobhan's health.

“Clearly Siobhan wanted to do everything she could for her babies but wasn't put in a position where she was able to make the right decisions.”

Miss Ballard, representing the NHS Trust, said they had clearly ‘identified’ several failings and assured Siobhan that she wasn't responsible for the death of her babies.

She said: “It is right and it would only be proper, if you were going to go down the narrative [conclusion] root that marked and identified those failings that, please, lest it be not be forgot, the Trust has identified themselves - and therefore has candidly accepted those.

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“It's our view that Siobhan herself is in no way responsible for the outcome with her two babies here.

“We totally accept that she was wanting to do everything she could for them but was very unwell herself at the time.”

The hearing continues.

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