A Victorian coroner has been brought to tears while delivering findings into the death of eight-year-old Amrita Lanka, ruling that her death at Monash Children’s Hospital in Melbourne in 2022 was preventable.
As per 7News, Deputy State Coroner Paresa Spanos delivered the findings on Wednesday, concluding that shortcomings in Amrita’s clinical management and care contributed to her death from lymphocytic myocarditis, an inflammation of the heart muscle.
For Amrita’s parents, the findings follow years of grief and anguish over the loss of their daughter.
“They just left her to die,” her father, Chandra Sekhar told 7News.
Amrita initially presented to the hospital’s emergency department with nausea, vomiting and abdominal pain. Doctors suspected gastroenteritis, a condition involving inflammation of the stomach and intestines.
However, her symptoms worsened, and a registrar who reviewed her at around 3am suspected myocarditis. Further blood tests raised additional concerns, but the registrar reportedly considered the results potentially unreliable and did not believe Amrita appeared seriously unwell.
In her findings, Spanos acknowledged the pressures faced by emergency departments and the responsibilities carried by the relatively junior doctor, Dr Patrick Tan. However, she said the standard of care provided to Amrita was inadequate.
“While I accept (emergency departments) are busy places and Dr (Patrick) Tan was a relatively junior doctor with many responsibilities, the clinical management and care he provided to Amrita was wanting … and thereby contributed to the death.”
Amrita was later moved into acute care, where she suffered a brief cardiac arrest.
Before a proposed transfer to the Royal Children’s Hospital, she suffered a second cardiac arrest and could not be saved.
The emotional weight of the case became evident as the coroner read part of Amrita’s mother’s impact statement. Spanos paused for an extended period and was visibly emotional as she described the young girl through her mother’s words as the most precious, talented and beautiful child.
7News reports that Monash Health acknowledged the coroner’s findings and said it would carefully consider the conclusions.
The health service also said changes had been made since Amrita’s death, although further details of those changes were not provided in the information available.
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