WA hospital twice sent boy home: inquest

A two-year-old boy with Kawasaki disease was twice sent home from Perth's Princess Margaret Hospital before suffering a heart attack, an inquest has heard.

Christopher Ling Tao had a cardiac arrest on September 10, 2010, one week after he woke up crying with a temperature of 39C.

His parents gave him Panadol, but his fever persisted.

When he had a headache the next day, they took him to Princess Margaret Hospital.

They noticed the lymph nodes on his neck were swollen, but the doctor didn't believe that required a blood test, mother Claudia Ling told the West Australian Coroner's Court on Monday.

Christopher was sent home with Nurofen and antibiotics, and told to drink lots of water.

After he developed a rash and had diarrhoea, his parents took him to a GP, who said the rash could have been caused by the medication, advising Ms Ling to take her son off them.

But Christopher's condition worsened and his parents again took him to hospital.

He was panting and when his heart rate of more than 170 beats per minute set off an alarm, a nurse said that was normal for a child with a fever and turned the sound off, Ms Ling said.

Again, the boy was sent home instead of being admitted.

"I was very disappointed," Ms Ling said.

Worried but not wanting to overreact, they went home and took him to the GP again the next day.

By then, he was coughing and had a white spot in his mouth, which the doctor said could indicate measles or whooping cough, instructing the parents not to take him to hospital in case he was infectious.

Christopher's father found him unconscious the following evening and he was pronounced dead within an hour.

"We're so stupid - everyone was wrong," Ms Ling said.

"We just pushed him to the death."

Consultant pediatrician David Roberts said he believed the boy had succumbed to myocarditis - an inflammation of the heart muscle - associated with Kawasaki disease, which affects heart arteries.

Dr Roberts said Christopher had displayed the hallmarks of Kawasaki disease, including swollen lymph nodes and changes to mouth condition. It was also an illness that affected young Asian males.

Dr Roberts said he believed a GP would generally not expect to see cases of the mysterious disease, but it was not unusual in an emergency department.

Christopher should have been admitted to hospital the second time he presented, Dr Roberts said.

"I'm afraid I don't think it was managed appropriately on that occasion," he said.

The inquest continues.