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Ava suffered from Down syndrome, which can make children more vulnerable to infections
An investigation panel revealed that a series of hospital failures had contributed to the death of a five-year-old girl who died of toxic shock syndrome.
Ava Macfarlane passed away on December 15, 2017 after being treated at Queen's Medical Center in Nottingham.
The prescription of antibiotics earlier could have "given him chances of survival," said the Nottingham Coroner's Court.
Returning to a narrative conclusion, the jury stated that there had been "missed opportunities" to diagnose sepsis.
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Irwin Mitchell
Ava's family said his death was a "brutal reminder" of the dangers of sepsis
Ava, who was suffering from Down's Syndrome, was "seriously ill" when she returned to the hospital two days after being discharged from A & E on December 13th, the investigation had been heard.
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His mother, Lesley Gearing, said that her daughter had vomited, had difficulty breathing, had a high temperature and had a rash.
The jury concluded that there were missed opportunities to diagnose Ava on Dec. 13 and stated that she had been "improperly discharged".
Ava's mother, Lesley Gearing and her daughter Mia were under investigation
He concluded with failures that day "probably more than contributed to his death".
The family should also have had a "complete record of sepsis" in light of his Down syndrome and his risk of infection, he added.
Deputy coroner, Laurinda Bower, said the case had raised "significant concerns" that led her to convene a meeting with the medical director of the trust to discuss what was being done to diagnose sepsis.
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Irwin Mitchell
The NHS Trust of Nottingham University Hospitals Apologized for "Significant Gaps" in its Care of Ava
Following the hearing, family lawyer Tania Harrison, of Irwin Mitchell, said: "The pain felt by the Ava family as a result of the loss of life. Ava is as strong today as she was almost two years ago. "
She added, "Unfortunately, the investigation has highlighted a number of areas in which Ava has been abandoned."
Dr. Keith Girling, medical director of the NHS Trust at Nottingham University Hospital, apologizes for the "serious inconvenience" of his care.
He added that a number of changes had been made after Ava's death and that a greater awareness of sepsis in children with complex health problems had been raised.
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Irwin Mitchell
The investigation revealed that the family of Ava should have received more information during his illness
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