An investigation into the death of a two-year-old girl in Australia found that a hospital's failure to call her parents back was 'wholly inadequate'.
Sky News reports that Natalia Griffiths-I’Anson's daughter Callie had been admitted to hospital in December 2017 after ingesting cleaning liquid.
She had been in the care of her mother's colleagues at a hotel while her mum went to pay some bills, with the toddler gaining access to the bar area and drinking a caustic alkali liquid used to clean soda glasses.
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First taken to the Corowa District Hospital to be assessed for injuries after her lips started to bleed, the toddler was later air-lifted to the Royal Children's Hospital, Melbourne, where she was placed into intensive care.
Placed into a medically induced coma, the toddler received an esophagoscopy and dilatation procedure and an inquest into her death gave the verdict that she'd died of 'perforation of her esophagus during or as a result of the procedure that led to her death about 24 hours later'.
The child had returned home with her parents after the procedure, but by 10pm on 11 January, 2018 they found that their daughter couldn't keep her eyes open and Callie's mum Natalia called the hospital.
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Asking for urgent medical advice, she was told that the surgeon would call her right back, but she never received the call.
The Royal Children's Hospital said the toddler's family didn't receive a call back that night because the surgeon was busy in a major procedure and when they finished at 1am thought it was too late to call and decided they would follow up the next morning.
Callie's parents were exhausted and slept with their daughter between them, but were woken up at 6am on 12 January by the sound of their daughter gurgling, they found that she was limp and had stopped breathing.
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They and paramedics attempted to revive the two-year-old but were unable to do so and the toddler died at Corowa District Hospital.
Coroner Paresa Antoniadis Spano recommended that the RCH develop better protocols for these situations.
Among the recommendations made are that the hospital is able to re-route calls to a qualified medical professional who will be available to speak.
They also recommended that the vulnerability of children such as Callie who lived in rural areas 40 minutes drive from the nearest paramedics be taken into account.
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The Royal Children's Hospital told Tyla in a statement: "The Royal Children’s Hospital extends its deepest sympathies to Callie’s family.
"There can be no greater sadness than the loss of a child. We will review the findings and respond to the Coroner’s recommendation."
Joe Harker