A baby who died after being exposed to heroin and cocaine was found to have dirt under her fingernails and armpits after being taken to hospital.

Nurses had concerns about Phoebe-Rose Douglas' 'unkempt and smelly' condition after she was rushed to the Royal Stoke University Hospital, an inquest has heard.

Paramedics had been called to an address on Meaford Drive, Blurton, to a report the 10-week-old was in cardiac arrest on the morning of October 25, 2019.

She was taken to the hospital's paediatric intensive care unit, but died four days later on October 29.

A urine sample carried out on October 29 showed a level of cocaine, the inquest heard. Tests carried out on hair samples indicated she had been exposed to cocaine, heroin and cannabis.

Parents Rachel Bourne and John Douglas both admitted child cruelty at Stoke-on-Trent Crown Court in 2024. Bourne was jailed for 31 months and Douglas sentenced to 10 months' custody, suspended for two years.

Now an inquest into Phoebe-Rose's death is being held this week at Swann House, Stoke.

The inquest heard Phoebe-Rose was born in Halifax in August 2019, where her father lived. She returned to Stoke-on-Trent a month later with her mother.

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Phoebe-Rose's parents were both drug users, the inquest was told. A number of referrals had previously been made to social services before she was born, due to concerns raised about the family, including in July 2019 in relation to their housing conditions.

They were evicted from the property and drug paraphernalia was later found there.

Phoebe-Rose missed her first set of routine immunisations and routine developmental check by a GP, which would usually take place at six to eight weeks old.

Phoebe-Rose's mother woke at around 5am on October 25, picked her up, and found her to be floppy. West Midlands Ambulance Service was alerted.

Phoebe-Rose was resuscitated, the inquest heard. But scans carried out at hospital revealed she had suffered severe brain damage due to a lack of oxygen, and on October 29 the decision was made to remove life support.

Paediatrician Dr Deborah Stalker told the inquest hospital discharge notes from Phoebe-Rose's birth indicated no signs of neonatal abstinence syndrome – withdrawal symptoms newborn babies may experience if they have been exposed to opiates while still in their mother's womb.

"But she was a bit of a struggle to feed, reading between the lines of notes", Dr Stalker added. "There was also evidence that feeding bottles were not sterilised prior to use – that had been observed in hospital."

When Phoebe-Rose was in hospital in October 2019, "she was unkempt and she was unclean", Dr Stalker said. She added: "She was smelly and she had dirty fingernails and feet and creases under arms and neck."

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Dr Roger Malcolmson, a consultant paediatric and perinatal pathologist, was involved in post-mortem investigations carried out after Phoebe-Rose's death. He told the inquest she was "relatively small".

"There was no evidence of external injuries of any significance that would suggest a pattern of physical abuse", he said.

"Her brain was swollen, which correlates with injury to brain cells and hypoxia (reduced oxygen to the brain). There was no obvious underlying cause. I think the biggest risk factor for this death we can identify from the history is maternal drug use and smoking."

The inquest continues.