Herpes deaths: Why did our daughters die after Caesareans?

In 2018, two new mothers died of herpes - a common, normally mild infection - just weeks apart, shortly after giving birth by Caesarean section at the same NHS Trust. Following an inquest into both deaths, their families say they will continue their fight to find out what happened.

Once a month for the past year and a half, Yvette Sampson and Nicola Foster have met up in a coffee shop in Canterbury, Kent. The first meeting, says Nicola, was "very tearful. They still are now, sometimes. Because we've both been in the same situation, we understand how the other's feeling."

At first glance, the two women are not natural companions. Their personalities are very different - Yvette, 54, is quiet and softly spoken while Nicola, 56, is louder and more forthright.

But their inner cores - an ironclad determination sustained by overwhelming grief - matters more than any superficial characteristics. "We have helped each other. No-one else can understand it unless you've been through it," says Nicola.

Despite not meeting until 2021, the two women have known of each other since the summer of 2018, when their daughters died seven weeks apart in extraordinary circumstances.

Yvette's daughter Kimberley died in May that year aged 29, three weeks after giving birth to her second child by Caesarean section. Then in early July, 32-year-old Samantha Mulcahy, Nicola's daughter, died 10 days after she gave birth to her first child, also by Caesarean section.

At the time, health officials insisted the two deaths were not linked. But a BBC investigation in 2021 established apparent links between the two deaths - both had been operated on by the same surgeon.

On 14 July a coroner concluded that it was "unlikely" that the surgeon was "the source of the infection", leaving unanswered questions for their families.

Both Samantha and Kimberley were treated in hospitals run by the East Kent Hospitals University NHS Foundation Trust. And on 26 July, the coroner ruled both had died following a "disseminated" herpes infection before or around the delivery of their babies that caused multi-organ failure.

It is estimated about 70% of adults have one of two types of the herpes simplex virus by the age of 25, but for the vast majority of people this will only cause occasional, mild symptoms at worst.

Deaths caused by HSV-1 - herpes simplex 1 - are almost unheard of in healthy people.

In a statement after the inquest into Kimberley and Samantha's deaths, the trust's chief executive Tracey Fletcher offered "sincere condolences" to their families, adding that it had made changes since 2018 "to ensure that if such a rare infection arising from this virus is suspected, it will be treated more quickly".

In mid-July 2018, Yvette attended a meeting with senior clinicians at the trust. By this point, she knew of the death of Nicola's daughter, Samantha. Yvette asked whether any of the same healthcare staff had treated Samantha and Yvette's own daughter, Kimberley.

"I was told, it was something they were still looking into," she says. "And then I said, but if you do find out there is a healthcare [link] you will let us know, won't you? And they said yes."

She now believes the trust was not being honest, however. Though Kimberley had been treated at the Queen Elizabeth the Queen Mother Hospital in Margate, and Samantha at the William Harvey Hospital in Ashford, the same surgeon had performed both Caesarean operations, an inquest into both women's deaths heard. And by the time of that meeting, the trust knew this. At the inquest, the trust did not deny that it withheld this information from the families.

Ms Fletcher, the trust's chief executive, apologised after the inquest for the "additional and unnecessary suffering the trust has caused these families through failing to answer their questions after Kimberley and Samantha's deaths and contributing to the delays in their inquests being heard". She said the trust was changing the way it responds when things go wrong, adding: "We are truly sorry."

Yvette says she was "definitely" lied to when it told her Samantha and Kimberley had not been treated by the same staff.

Despite the trust failing to acknowledge any link, the two mothers refused to accept the narrative that their daughters' deaths had been unfortunate, unlikely coincidences. "I couldn't let it go," says Yvette, who with her husband Louis is raising Kimberley's two children.

Both Nicola and Yvette knew of the other family affected but investigated each death alone.

Nicola did spend time on Facebook trying to find the Sampsons but couldn't locate them. Yvette isn't on social media, and while similarly keen to speak to Samantha's family, she wanted to "respect" the grief they were going through.

As well as grieving for her daughter, Nicola - who owns a cleaning firm - also had to try to support her son-in-law, now on his own with a new baby.

Ryan Mulcahy's life had swung violently from the high of having his first child to losing his wife in a matter of days.

Samantha and Ryan were teenage sweethearts who married in September 2017. It wasn't too long before Samantha found out she was expecting a baby. Though there were complications during the pregnancy, their daughter was born healthy. "I felt like my world was complete," Ryan says.

But Samantha wasn't recovering as expected, and despite what had happened to Kimberley only a few weeks previously, doctors struggled to identify what was making Samantha ill.

"She just kept saying, 'It hurts. It hurts,'" remembers Ryan. "I told her… that I loved her and just to keep fighting."

But she died before she could be moved.

In the aftermath of her death, Ryan felt "complete numbness". He says he wanted to grieve but felt he couldn't because he needed to be there for their daughter, as Samantha would have wanted.

Ryan says of their child: "The one thing that terrifies me is that later on, she's going to blame herself." He worries she will think "'this wouldn't have happened to Sam if she wasn't there' - that's what I don't want.

"I want her to know that it's nothing to do with her."

Like Nicola, Ryan has spent the years since desperately trying to find out what happened to Samantha, both for himself and his daughter.

A breakthrough came in the summer of 2021, when Yvette was on holiday in Tenerife. She received an email - a batch of documents she had requested through Freedom of Information requests after being advised to do so by the BBC.

That is when she found out that the same surgeon, who cannot be named for legal reasons, had operated on both Kimberley and Samantha, and that the trust had been encouraged in the summer of 2018, by an external laboratory, to test the surgeon - to check if he could have infected them, something the trust never did.

"I was in total shock," she said in an emotional witness statement at the inquest. "I felt betrayed. I even felt foolish that I had let these people [from the trust] into my home. I had trusted and believed in what they told me."

Following the initial BBC story, Nicola and Yvette met up and have become firm friends since, a bond strengthened when both went through the gruelling inquest process.

The start of the inquest was delayed for several weeks when, the night before it was due to begin, the trust applied for reporting restrictions to prevent the same surgeon who carried out both procedures being named.

Then the families had to sit through nine days of aggressive questioning as the trust's barrister probed both mothers' enduring belief that their daughters had been infected, unwittingly, by the same surgeon.

"I know they have a job to do," says Nicola. "But sometimes I think they need to actually stop and think before they speak and maybe think if that was their daughter, and that had happened to them. How would they actually feel?"

Then on 14 July, after numerous delays, the coroner, Catherine Wood, outlined her conclusions.

Ms Wood found that "on the balance of probabilities, it was unlikely that the obstetrician in common was the common source of the infection", in part as the trust had never tested the surgeon back in 2018. Ms Wood was unable to come to a conclusion as to how the virus had been caught by the two women.

In Kimberley's case, the coroner found that doctors should have considered that she may have been suffering from a viral infection 48 hours earlier than they did - and that if they had, and treated her accordingly, she may have survived.

Ms Wood found that in Samantha's case, her symptoms were not so straightforward to spot, so "there was no clinical indications to commence" anti-viral drugs before it was likely already too late to make a difference.

As the rain started to pour outside Maidstone Town Hall, where the inquest was heard, both Nicola and Yvette reflected on the loss their families have suffered. Despite the coroner's conclusion, both remain convinced the surgeon did infect their daughters.

"Losing Sam has left a massive void in our lives and a little girl without her mummy," says Nicola.

"The last five years have felt like a real fight for answers. I've not been able to grieve properly because I've been so focused on getting answers about what happened to Kim, and why it happened. It's consumed my life. I'll always be angry and upset at everything I've had to go through to get to this stage," says Yvette.

"Whilst I have some answers as to how Kim came by her death - as a mother, there are still many questions I have about what happened, which remain outstanding."