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Image caption, Natalie Needham's son Kouper died in 2019 By Anna Whittaker Nottingham Published 7 minutes ago Warning: Some of the details in this story may be distressing to readers For many of the hundreds of families involved in the largest maternity scandal in NHS history, the suffering did not end with the loss of a baby or loved one. A key element of Donna Ockenden's review into Nottingham University Hospitals (NUH) NHS Trust, published last month, not only found that mothers and babies suffered potentially avoidable harm - but also revealed a litany of failures in its mortuary service. The review found mothers and babies "lost dignity" in a series of cases highlighted, including one baby who was disposed of as clinical waste and another who was placed in a mortuary space already occupied by a deceased adult. In a third case, the wrong baby was released to funeral directors. This poor care is far from historic. In March, eight bodies were found in a state of "advanced deterioration" in the mortuary at the trust after hospitals ran out of freezer space . So what do we know about the failings in post-death care and the mortuary service? Bereaved parents Natalie and David Needham's trauma of losing their baby Kouper was compounded when a disc containing graphic colour photos of their son's post-mortem examination was sent to the family home, accompanied with a letter outlining the costings involved with his death. "I'd always wanted my last image of Kouper to be when I was holding him in hospital while he was still breathing," Natalie said. "That was taken away from me - because my last image of him now is those mortuary pictures." So serious were Ockenden's concerns about mortuary care at NUH that she launched a full review into post-death care at the trust, which included 17 babies and one adult. "Many incidents involving poor post-death care share striking similarities, showing a marked lack of learning," Ockenden concluded. The report also highlighted a "siloed way of working" described by some families between the bereavement service, mortuary and funeral directors. The review also found some clinicians had used "dehumanising" language about people's babies, such as "fetus", a "sample" or "specimen". The 381-page report into NUH - which runs two main hospitals, the Queen's Medical Centre (QMC) and City Hospital - outlined harrowing details of care in the mortuaries spanning from 2008 to 2025. What the report said about mortuary failings One baby was kept in the mortuary for 772 days. The report said: "Their condition was checked 31 days post-death and deterioration was found; however, the baby was not moved into freezer storage until 151 days post-death." One mother was told after the neonatal death of her early gestation baby that the baby was a boy, but five months later, she found out the baby was a girl, having already buried the baby as a boy in a blue coffin. "The mother had also given the baby a boy's name, which she had tattooed o
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