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Hospital inspectors are investigating an NHS trust over the deaths of three babies.
Nottingham University Hospitals trust could be prosecuted over the deaths of the infants in 2021 by the Care Quality Commission (CQC).
A police investigation has already been announced into the trust’s maternity services.
The trust said it was cooperating with the CQC.
The investigation is examining whether the trust failed to provide safe care and treatment during the delivery of the three babies, who died within 14 weeks of each other.
The Nottingham University Hospitals trust is currently at the centre of the largest maternity inquiry in the history of the NHS, with around 1800 cases being examined by a review headed by the senior midwife, Donna Ockenden.
On Thursday, Nottinghamshire police also said they were opening a criminal investigation into the trust’s maternity services.
The deaths the CQC are investigating occurred at the trust’s City Hospital in April, June and July of 2021.
BBC News understands that one common theme that the CQC is investigating is whether staff could have spotted that the three mothers all had placental abruptions and delivered the babies sooner. Such a complication, which often presents as heavy bleeding in the mother, can deprive a baby of oxygen.
In a statement, CQC director of operations Lorraine Tedeschini said: “We are currently in the process of making enquiries to establish whether there is reasonable suspicion that a criminal offence has been committed. Those enquiries are ongoing and we will report further as soon as we are able to do so.”
An inquest into the death of Quinn Lias Parker, who died at just two days old in July 2021, found that a series of errors by the hospital had contributed to his death.
The coroner said that “earlier delivery would have been achieved… if the significance of the bleeding and pain had been clearly identified as an abruption.”
It is understood that the CQC are also looking into whether the trust breached its duty of candour to Quinn’s family, a legal obligation to be open and honest with patients and their families.
The BBC understands the other cases being examined by the CQC are the deaths of Adele O’Sullivan and Kahlani Rawson.
Adele was just 26 minutes old when she died in April 2021. An inquest found a series of missed opportunities in her mother’s treatment including a delay in diagnosing the cause of her vaginal bleeding, a common symptom of placental abruption.
Kahlani died aged four days in June 2021. An inquest found there had been a delay in conducting a Caesarean section. Without that delay, the coroner concluded that Kahlani would not have died.
She also found that a placental abruption was likely to have occurred hours earlier but that CTG scans had been “misinterpreted” by staff, which led to “reassurance” about the baby.
In January, the trust was fined £800,000 – a record for a maternity incident – after being found guilty of failing to provide safe care and treatment to Wynter Andrews and her mother Sarah in 2019. Wynter died aged 23 minutes.
Commenting on the new CQC investigation, Michelle Rhodes, chief nurse for the Nottingham University Hospitals trust, said: “The trust is currently providing information to the CQC to support their investigation of those serious incidents which occurred in 2021.
“We are cooperating fully and will await confirmation from the CQC as to whether they intend to pursue a formal prosecution.”
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