Staff at a Kent school have faced difficult questions following the death of a severely disabled pupil.

Ridge View School employees appeared before North West Kent Coroner's court today on the second day of an inquest into the death of Isabel Pearce.

The 13-year-old choked on a meatball while eating her lunch at the Tonbridge school in January, but despite desperate efforts made to save her life, she died the following day.

A police investigation was launched but Det Insp Dom Kilbride told the court there was insufficient evidence to bring criminal charges.

Isabel, who was a former pupil at Oakley School in Tunbridge Wells, suffered from a rare genetic condition - Sotos syndrome - and autism.

Yesterday the inquest, held at Gravesend Old Town Hall, heard she was eating lunch on a table with five pupils and two members of staff on January 16 when the tragic incident unfolded.

Moments after refusing to let teaching assistant, Jennifer Seymour, cut up her food she began choking and gagging.

Staff began carrying out back slaps and the Heimlich manoeuvre.

School nurse, Deborah Marsden, was called to help.

She told the court: "I saw my colleague Anita with Isabel who was on the floor and in some distress. Her face was pale, her lips were slightly blue."

Lead nurse, Anita Beebee, carried out further back slaps and abdominal thrusts.

"I was coughing to try and get Isabel to cough. I was removing anything that came out of her mouth.

"Some small bits of food and saliva came out, she seemed much better and her colour became pinker," Miss Marsden added.

Isabel stood up and was led towards a sensory room by Miss Beebee, but on the way she collapsed in the school's reception area.

Her face, lips and tip of her nose turned blue and her breathing became laboured.

Staff carried out further back slaps and abdominal thrusts. After three minutes an ambulance was called.

Jane Clements, the Pearce family's barrister, asked Miss Marsden why an ambulance wasn't called when Isabel initially began choking.

The court heard after a child receives abdominal thrusts they should be taken to A&E to check for internal damage.

Mrs Clements also questioned why an ambulance was not called for this reason.

Miss Marsden said: "We were carrying out first aid and two minutes later the blockage had been cleared.

"From Isabel's appearance getting better and her becoming pink and wanting to stand up she made a recovery definitely. We didn't feel she needed an ambulance."

"She had blue lips signs of a lack of oxygen. Why you did not consider that an ambulance should be called even if just for a precaution so something was being activated?" - Jane Clements, barrister

Paramedic Robert Paris told the court choking incidents are treated as highest priority for ambulance crews.

"They have the potential to cause cardiac arrest and are immediately life threatening.

"It is very time critical for an ambulance to be called in such circumstances," he added.

Headteacher, Jacqueline Tovey, was asked if she was concerned an ambulance was not called sooner.

She told the court: "I don't have a judgement on that; it is the medical judgement of the nurses when to call an ambulance."

Mrs Celements asked Mrs Tovey: "If Isabel could not cut up her food and did not want it cut up, but the staff thought it was a risk to let her eat it, would you expect the staff to override her?"

"The staff made a professional judgement about the food, I did not see it," Mrs Tovey said.

After two minutes of being on scene paramedics removed a whole, round meatball from Isabel's throat.

Mrs Tovey said meatballs have now been removed from the school dinner menu.

The court heard there had been a dispute between the parents and the school as to whether Isabel could eat independently.

In a care plan drafted by the school it reads "Isabel has school dinners and can independently feed herself."

These plans are sent home to parents, and Jane Pearce said she struck through the points she did not agree with, including the independent eating, and sent this back to the school.

However, this document is missing and the school, which was rated outstanding by Ofsted following an inspection in June, claims it never received the amendments.

Mrs Pearce said: "I chose food for Isabel and she had suitable food prepared for her in terms of the size and shape of it.

"It always needed to be cut up like I was cutting it up for an 18-month-old so the risk was minimal.

"She didn't know the concept of it being too much on the fork especially if she was hungry."

One of Isabel's respite carers, Lucy-Ann Petto, told the court today: "Isabel is most definitely not an independent eater.

"I do not believe she had the motor skills or dexterity to cut up and eat a meat ball herself."

The inquest continues.