Nottingham's Queen's Medical Centre failings led to girl's sepsis death

Ava had Down's syndrome which can make children more susceptible to infections

A series of hospital failings contributed to the death of a five-year-old girl who died from toxic shock syndrome, an inquest jury has found.

Ava Macfarlane died on 15 December 2017 after being treated at Nottingham's Queen's Medical Centre.

Prescribing antibiotics earlier could have "given her chances of survival", Nottingham Coroner's Court heard.

Returning a narrative conclusion the jury said there had been "missed opportunities" to diagnose sepsis.

Ava's family said her death was a "stark reminder" of the dangers of sepsis

Ava, who had Down's syndrome, was "critically ill" when she returned to hospital two days after being discharged from A&E on 13 December, the inquest had heard.

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Her mother Lesley Gearing said her daughter had been vomiting, struggling to breathe, had a high temperature and a rash.

The jury found there were missed opportunities to diagnose Ava on 13 December and said she was "inappropriately discharged".

Ava's mother Lesley Gearing and her daughter Mia were at the inquest

It concluded failures on that day "probably more than contributed to her death".

The family should also have had a "comprehensive brief on sepsis" in light of her Down's syndrome and risk of infection, it added.

Assistant coroner Laurinda Bower said the case had raised "significant concerns" which had led her to call a meeting with the trust's medical director to discuss what was being done to diagnose sepsis.

Nottingham University Hospitals NHS Trust apologised for the "significant shortcomings" in its care of Ava

After the hearing, the family's lawyer Tania Harrison, of Irwin Mitchell, said: "The pain that Ava's family feel over the loss of Ava is as strong now as it was nearly two years ago."

She added: "Sadly the inquest has highlighted a number of areas where Ava was let down."

Dr Keith Girling, medical director at Nottingham University Hospitals NHS Trust, apologised for the "significant shortcomings" in its care.

He said a number of changes had been made following Ava's death and greater awareness of sepsis, in relation to children with complex medical conditions, had been raised.

The inquest heard Ava's family should have been given more information during her illness