An NHS trust has admitted mistakes in the care of a six-year-old with a “radiant smile” who died just days after being sent home from A&E.

An inquest held at Maidstone’s Oakwood House today concluded that Maya Siek died with suspected sepsis at Margate’s QEQM.

But assistant coroner Catherine Wood said although medical mistakes were made there was still no “full understanding” of exactly what caused her death.

Maya, of Margate, was discharged with a tonsillitis diagnosis, despite collapsing twice and her mother insisting something was gravely wrong.

She was sent home with antibiotics and then readmitted to hospital after her condition deteriorated.

Maya then died after her heart failed due to an influenza infection, which is believed to have led to sepsis.

Giving evidence, head of nursing for children at QEQM, Sophia Lindsay admitted mistakes had been made in Maya’s care.

She acknowledged the trust should have considered transferring Maya to a London intensive care unit in the days before she died.

Ms Lindsay agreed Maya should not have been sent home from A&E on December 19, 2022.

She also affirmed the trust’s intention to make changes in response to this tragedy, promising to put in place improved training on sepsis and introduce changes to how information is passed between departments.

But Maya’s mother and step-father, Magdalena Wisniewska and Rajratan Bande, are not satisfied with the trust’s response to their daughter’s death.

Before the conclusion was announced, Magdalena stood and addressed the courtroom tearfully.

“We want to say how disappointed we are of our NHS trust. We trusted them but today we know that was our biggest mistake,” she said.

“We should have looked for help somewhere else or maybe pushed them more. We definitely should not have left the hospital on the 19th.

“We don’t know if somebody had reacted more quickly whether Maya could have been saved but we know that they didn’t try everything that they could.

“We have completely lost faith in the NHS. We trusted them by leaving Maya under their care. We didn’t have any idea how bad Maya’s condition was, who decided that it was not necessary to inform the mother that Maya is the most sick child with sepsis?”

She continued: “I wish that I’d known this at the time when Maya was here, that I could spend more time with her hugging her tightly. Or maybe I would go back and look for help at a different hospital? As I felt they just don’t really care there.

“Instead they comforted me and told me that she was fine when she wasn’t. They said that soon we would be ready to go home, why did the doctor tell me that? He shouldn’t have.

“Maya was at the end of her life and I didn’t know because nobody thought that her mother should know.

“I am angry and I don’t trust a word that they say. I just know that they missed opportunities to help Maya, especially on the 19th but also on Rainbow ward.

“Our life is ruined. We have lost all joy for life. Nathan has lost his sister and his childhood.

“The hospital has learned lessons, so I should be satisfied? No, I am not. I lost my Maya and nothing will give me her back.

“It is great if they can save other kids but does this really matter for me? Honestly, no.

“I lost my best friend because of them and I know we are not here today to blame anyone but I just want to say that I am angry, sad, disappointed and I blame and hate them all.”

On Monday the court heard that the day Maya was sent home from A&E with a diagnosis of tonsilitis was the most challenging of Dr Andrew Mortimer’s career.

Accident and emergency consultant Dr Mortimer, who has worked in A&E for nearly 20 years told the court: "It was a busy shift in the emergency department.”

“I've worked in emergency medicine for nearly 20 years and been a consultant for eight years and this shift stands out as the most challenging shift of my career.”

Dr Mortimer told how accident and emergency doctor Nizar Hassini escalated the case to his paediatric registrar who, following a review, “agreed it was appropriate to discharge” Maya.

Dr Hassini stressed the department was particularly busy that night and he himself had to treat an infant in cardiac arrest.

Last year, QEQM bosses publicly apologised for Maya being “inappropriately discharged due to a lack of senior clinical oversight” and vowed to learn lessons following an independent report into her death.

The hospital compiled a serious incident report, the results of which were sent to Maya’s mum Magdalena Wisniewska.

The report admitted Maya's case was not escalated to a consultant and there was a failure to acknowledge abnormal blood results.

It revealed a post-mortem examination concluded she died with sepsis caused by influenza A.

Maya’s mum Magdalena Wisniewska last year vowed to fight for justice.

A four-day inquest into her death, held at Oakwood House, also uncovered that a monitor meant to track Maya’s pulse (which had been concerningly high for days) and oxygen levels was wrongly removed by a nurse just hours before her heart failed.

Assistant coroner Catherine Wood was told medics working on Maya spent nearly 90 minutes trying to resuscitate her but were ultimately unsuccessful.

Before announcing her conclusion, the coroner addressed the court: “Sadly we know attempts were made to resuscitate Maya which were sadly unsuccessful.

“Medicine doesn’t always have all the answers either clinically or pathologically and I know that as lawyers and of course the family, we want to know everything but sometimes it's just not possible to know the full picture.

“I don’t think there's any doubt that nobody wanted for this to happen to Maya. I know the family are devastated but I’m also aware that all the clinicians who treated her were also affected.

“If there’s anything we can do, although it sadly won’t bring Maya back, to protect future patients, we ought to do it. I have a duty to ensure the safety of future patients.”

During Thursday’s hearing, the coroner concluded when Maya first attended A&E doctor Nizar Hassini diagnosed her with tonsillitis, treated her with antibiotics and discharged her.

The coroner told the court that when Maya left the hospital doors she passed out and was returned to A&E.

Here, the same doctor undertook an ECG and blood test then, having consulted with the registrar they agreed to discharge her.

The coroner added: "There is no objective evidence that discharging Maya more than trivially impacted her death.

"There was a number of failures in the communication of the diagnosis between departments and failures in their documentation.

“The nurses failed to document her initial admission at all but that is not deemed by me to be causative."

The coroner also highlighted Maya was placed in a cubicle furthest from the nurses station where they must avoid putting the sickest children.

She stressed concerns over the failure of clinicians to acknowledge the seriousness of Maya's heart rate being persistently high for days before her death.

Despite Maya's suspected sepsis being recognised in A&E on the 20th - and her being placed on the sepsis pathway - at no point in her time at QEQM did staff fill out the designated sepsis form on her behalf.

The coroner added: "There is not a paediatric intensive care service in Margate or even in Kent at all.

“They would have had to come from London to transfer her which would have taken at least an hour and a half."

She said Dr Jan Stanek, a consultant pediatrician on the Rainbow Ward who saw Maya on the 20th, was “very honest in his evidence”.

The coroner said Dr Stanek “regretted not prioritising Maya and he said that would stay with him for the rest of his life.

“He was regretful he did not go straight to see Maya that morning,” the coroner added.

"We know that from the pathologist’s evidence that the myocardial necrosis that killed Maya was present at least 12 hours before her death,” she said.

"Unfortunately the sepsis diagnosis was never discussed with Maya's parents but both the consultants on the ward were aware of it.

"We know there were a number of failures by the trust.

“There were failures in recognising the significance of the tachycardia.

“She shouldn't have been discharged on the 19th and her condition was repeatedly not escalated as it should have been."

The court heard Maya suffered chronic conditions her clinicians were not aware of; fatty liver disease and thickening of the walls in her heart.

Both likely a result of obesity.

Evidence from pathologist Dr Liina Palm said damage caused to Maya’s heart may have been due to sepsis but there is “not direct evidence to prove that”.

Ms Wood said there were “clearly things that should have been done differently but there was still no “full understanding” of why Maya died.

"I really struggled throughout with causation but I've noted a number of failings,” she told the court.

“These include failing to keep Maya in hospital and to consider starting the sepsis pathway at that time, failure to communicate the diagnosis to both clinicians and the parents, failure to recognise significance of the tachycardia, failure to notice her not responding to fluid treatment, failure to take an additional blood gas test.

“There were clearly things that should have been done differently but I have no evidence that anything done by the trust or not done by the trust could definitively have avoided Maya's death.

“We apologise unreservedly to Maya’s family for the mistakes we made in her care…”

“The evidence does not go as far as to suggest that the failures were probably causative in Maya's death.

“I still do not have the evidence to have a full understanding of what caused Maya's death.

“This may be a case where future medicine will uncover what caused the death. Despite the evidence we've heard we still don't have a full understanding of why Maya died."

Delivering her narrative conclusion, Ms Wood said Maya died as a consequence of myocardial necrosis, with a background of fatty liver disease and influenza A.

The cause of the myocardial necrosis could not be established but it had been present for at least 12 hours.

She concluded by addressing Maya's parents and passing on her condolences as well as apologising for not being able to completely explain the cause of Maya's death.

Following the inquest, Dr Des Holden, chief medical officer for East Kent Hospitals, said the trust is “truly sorry for the devastating loss of Maya”.

“We apologise unreservedly to Maya’s family for the mistakes we made in her care,” he said.

“We fully accept the coroner’s findings. We recognise, with great sadness, that we failed Maya and her family, and we are deeply sorry.

“We undertook a thorough investigation, facilitated by an experienced independent paediatrician, into Maya’s care following her death and we have made changes to our children’s service as a result, including improving staff training and the importance of listening to families’ concerns when a child is unwell.

“We have also strengthened handover between teams and our clinical guidelines for doctors who are looking after deteriorating children.”