Inquest opens into death of “beautiful” and “outgoing” Chesterfield woman suffering rare syndrome who died after childbirth

Assistant coroner Matthew Kewley opened the inquest into the death of Jess Hodgkinson at Chesterfield Coroners Court.

Jess, of 66 Nelson Street, Chesterfield, was born on August 9, 1994, and sadly passed away after giving birth to her daughter, Phoebe, at Chesterfield Royal Hospital on May 14, 2021.

Grant Finney is Jess’ uncle – although there is only a year’s age difference between the two – and he spoke on behalf of Jess’ family. He said that he and Jess were “best friends” and she was “deeply adored” by her loved ones. She grew up in Chesterfield and was an “outgoing, supportive person” who loved to dance – adding that he “couldn’t drag her home” when they went out together.

He said that Phoebe, although born very prematurely, was doing very well, and that she was a “little light for all of us” and had “kept us all going” in the aftermath of Jess’ death.

Grant said that Jess’ mum, Donna, described her as “beautiful inside and out.” He added that the pair had a “special bond” and were “more like sisters than mother and daughter” – and that Jess is “going to be missed by all of us so much.”

He also read a tribute from Jack, Jess’ partner, who said that from the “first moment she stood out as so special – she made me the man that I am today.” Jack added that “everyone who met Jess just loved her instantly”, and that their relationship was “supposed to be for the rest of our lives.”

Grant raised concerns surrounding Jess’ treatment during her pregnancy – especially in relation to her Klippel-Trenaunay Syndrome (KTS). This is a rare disorder that Professor Suvarna, who completed Jess’ post-mortem examination, said can lead to vascular malformation, organ abnormalities and an enhanced risk of deep-vein thrombosis in serious cases.

Grant said that Jess was “let down and did not receive the care she deserved.” Specific issues raised by the family included seeing staff googling KTS during Jess’ labour, and the lack of a specialist plan during her pregnancy. Grant added that they hope Jess’ death would lead to “more research into KTS and its effects on pregnant women – it would be comforting to know that she did not die in vain.”

Jess was first seen at Chesterfield Royal Hospital in December 2020 by Dr. Oskeira – a consultant and kidney specialist. He told the court that KTS was “certainly not something that we commonly see”, having seen perhaps just one patient with the disease before meeting Jess – and he looked the condition up after their encounter.

Her blood pressure had risen after changes to her medication – with the drugs she was previously prescribed to regulate her blood pressure being unsafe for pregnant women.

Jess’ prescription was changed and Dr Oskeira referred her to Dr Creswell – a consultant in Obstetrics and Gynaecology with expertise in the field of maternal medicine and complex pregnancies.

Dr Creswell echoed her colleague’s view that KTS was “really, really unusual” – before researching the condition as “standard practice”. She added that Jess’ case was “fairly complex”, and in January 2021, became responsible for the package of care that Jess received throughout her pregnancy.

By February 2021, the court heard that Jess was taking three different medications in an effort to lower her blood pressure. Dr Cresswell noted that there was an increased risk of blood clots across other expectant mothers using this combination of drugs, and changed her course of medication again.

On April 21 2021, Jess was admitted to Chesterfield Royal Hospital. Dr Creswell told the court that she still had high blood pressure, as well as significant protein in her urine, and noticed that the baby’s growth rate had slowed – signs that Jess was developing preeclampsia.

Dr Creswell said that this condition would put both Jess and her baby at risk – with concerns that she would need to be delivered very early. She told the court that Chesterfield Royal Hospital did not have the neonatal cots needed to treat babies after such a premature birth, and Jess was transferred to the Jessop Wing maternity unit in Sheffield the following day.

On April 21, Jess had also been prescribed Tinzaparin by Dr Creswell – a drug that helps to reduce the risk of deep vein thrombosis and pulmonary embolism. She said that Jess would have been given this drug during her pregnancy even if she did not suffer from KTS.

When Jess was discharged from the Jessop Wing on April 26 after undergoing tests, however, the team there opted to stop giving her Tinzaparin – a change that Dr Creswell confirmed was not communicated to her.

The court heard that when Dr Creswell saw Jess again on April 30, she had no access to the records concerning her time on the Jessop Wing. She said that she was not aware that Jess was no longer taking Tinzaparin, and that if she had been, she would have continued to prescribe the drug.

Dr Creswell said that now, the decision to end this course of medication surprised and concerned her – adding that she felt Jess should have continued taking this drug until the end of her antenatal period. She said that she “couldn’t say” whether the discontinuation of Jess’ Tinzaparin medication had made more than a minimal difference in terms of her eventual death.

Dr Creswell also stated that Jess’ “overriding condition” was high blood pressure and preeclampsia, and that she would have been prescribed Tinzaparin whether she did or did not suffer from KTS.

Professor Suvarna said that his post-mortem examination of Jess was “one of the most complicated cases I have seen” – with “none of the common maternal death features” present.

He said that KTS is a “rare syndrome” that presents “enhanced risks” during pregnancy – including deep vein thrombosis and pulmonary embolism. Professor Suvarna added, however, that you would “not necessarily expect junior doctors to have come across it”, and that it is “difficult to predict exactly how it is going to play out.”

Professor Suvarna said that he could not identify a single cause of death for Jess – stating that she was “more unwell than perhaps was appreciated”, and that this was complicated by her pregnancy. He also told the court that her risk of deep vein thrombosis was enhanced by both pregnancy and KTS.

The court heard that Professor Suvarna felt it was important to list pulmonary embolism as part of Jess’ cause of death, despite the absence of evidence for this in the post-mortem exam – which was highlighted by the coroner.

He said that, after resuscitation, fragments of the blood clots that cause pulmonary embolism are often difficult to spot, and that this was not surprising in Jess’ case.

He added, however, that he also felt that acute anaphylaxis had played a part in Jess’ death. He said that drugs administered to Jess were the most likely source of this condition – but stressed that he felt there was no indication these medications should not have been administered. Professor Suvarna said that this had caused her death along with pulmonary embolism – being unable to “weigh one more than the other.”

The inquest into Jess’ death continues today (Tuesday, January 17).