Yes, you can do that, but it's always going to be far more cumbersome than native multi-value return would be. Even in the simplest case (stack allocation in the caller), you have to define a new struct that has no other purpose, in a place visible to both caller and callee. You also have to refer to the status and value as struct members rather than simple variables. That's already worse than using a return value for the status and a reference parameter for the value.

I guess you could say that multi-value return is just syntactic sugar for more reference parameters. That's mostly true at the source level, but at the object level not quite. Using a reference parameter requires an extra stack operation (or register allocation) to push the parameter's address, in addition to whatever was done to allocate the parameter itself. Then the callee has to access it via pointer dereferences. With true multi-value return neither is necessary. The exact details are left as an easy exercise for any reader who knows how function calls work at that level. (BTW yes, interprocedural optimization can make that overhead go away, but a lot of code is written in C specifically to avoid relying on super-smart compilers and runtimes.)

Multi-value return isn't a huge deal, though. I appreciate having it in Python, but in almost thirty years I rarely missed it in C. While I wouldn't necessarily oppose its addition, I think it's more in keeping with C's general spirit of simplicity to leave it out.

A interface devised just to unwind information from a two member struct is beyond 'cumbersome'.