The grandson of football manager and Manchester United legend Steve Bruce died after being placed in an “unsafe sleeping position” in his cot by an unregulated maternity nurse, an inquest has heard.
Four-month-old Madison Bruce Smith was found unresponsive by his father, former Leeds United and Fulham striker Matt Smith, on the morning of October 18 2024.
He could not be resuscitated at the family home in Trafford, Greater Manchester and was taken to Wythenshawe Hospital.
He was pronounced dead there by paramedics.
Eva Clements had been employed by Mr Smith and his wife, Bruce’s daughter Amy, through a company named Ruthie Maternity Services after their son had difficulties sleeping in the afternoons.
They believed Ms Clements was skilled, fully trained and vetted and that the company was a well-established maternity and sleep support service but Stockport Coroner’s Court heard that neither was regulated.
Ruth Asare, head of Ruthie Maternity Services, said she had no medical qualifications and had only a first aid certificate and a Level 2 diploma in post-natal care gained from from a three-day course and a six-month coursework project.
Ms Clements said she had a degree in early years education but admitted she had no medical qualifications.
The inquest heard Madison’s parents would “never have dreamed” of putting their son asleep in the prone position but for the advice of the maternity nurse who was said to have informed them that all four of her own babies had slept on their stomachs with no problems.
Such advice was contrary to recognised safe sleeping guidance from the NHS and health professionals for young babies who cannot turn themselves over and therefore should be placed to sleep on their backs to reduce risk of a sudden and unexpected death.
In a short, narrative conclusion, senior coroner for south Manchester, Alison Mutch, said: “Madison died in circumstances where his death could not be ascertained while asleep in his cot having been placed in a prone and unsafe sleeping position.”
She said the “purported expertise” of untrained people posed a risk to all children where those unregulated services were used.
Issuing a prevention of future deaths report to the Secretary of State for Health, she said: “I hope the services can be regulated and, going forward, parents are not left in a situation where they believe they are employing someone who is qualified to advise them when they are clearly unqualified.”
She went on: “We have been told that in effect any of of us could leave the building today and call ourselves a maternity nurse as while the term registered nurse is strictly controlled, the term nurse is not.
“It gives an illusion of someone who is highly trained and able to support parents.”
She said Ms Clements slept in a different room and had responsibility for checking on Madison but although he was heard through a baby monitor to stir a number of times during the night and had cried she had not gone into his nursery.
Madison’s parents, together with Bruce and his son, ex-footballer Alex, attended Monday’s hearing.
Former Manchester United player Bruce was managing Blackpool FC at the time of the incident and missed the club’s following game and in a message posted on the club’s official X account said: “It’s been the worst time of my family’s entire lives and is something no family should have to endure.”
In a statement read to the court on Monday, Mr Smith said the couple’s son was their “precious, perfect little boy”.
He said: “Losing Madison has been utterly excruciating. The pain is indescribable and often too much to bear. It has totally shattered our entire family.
“We believe that Madison died in a complete regulatory vacuum. Without regulation this will happen again and other parents will place trust in individuals who should not be in the care of infants.”
The website of Ruthie Maternity Services invites visitors to ‘Hire a Ruthie Maternity Nurse’ and ‘Become a Ruthie Maternity Nurse”.
It states: “Ruthie Maternity Services believe having the right maternity nurse who understands all the elements in caring for your baby – like feeding and sleep training whilst incorporating the right activities – will achieve the perfect routine for your family.”
The company trained individuals on one-day courses for a fee of £450, the inquest heard.
Ms Asare told the coroner that those she trained were given the safe sleeping advice to put babies on their backs.
However, Ms Clements said she had been taught by Ms Asare to put babies on their tummies.
She denied telling Madison’s mother she was a nurse and also denied suggestions she had “convinced her” that the prone position was appropriate.
Lisa Judge, representing the boy’s parents, said: “Do you remember mum’s last words to you that night? That if there was any problem whatsoever to come and wake her up.”
Ms Clements replied: “No, I don’t remember that.”
The court heard police conducted an investigation and arrested Ms Clement on suspicion of neglect.
Senior investigating officer Det Ch Insp Matthew Dixon, of Greater Manchester Police, said the Crown Prosecution Service was approached for directions and guidance, and it was identified that the criminal threshold had not been met.
He said this was mainly because of the unregulation of such maternity services and that it was not illegal to place a baby on its front.
He added it could not be determined that Ms Clements set out to wilfully harm Madison.
