Deputy State Coroner Paresa Spanos on Wednesday handed down her findings into the death of eight-year-old Amrita Varshini Lanka, who died from lymphocytic myocarditis at Monash Children's Hospital on April 30, 2022. The coroner found that the girl could have been saved if emergency department doctor Patrick Tan had recognised the urgency of escalating her care to intensive care clinicians.
The coroner accepted that emergency departments are busy places and Dr Tan was a relatively junior doctor with many responsibilities. However, she said his clinical management of Amrita was inadequate and caused or contributed to her death. 'While I accept that EDs are busy places and Dr Tan was a relatively junior doctor with many responsibilities, the clinical management and care he provided to Amrita was wanting … and thereby caused or contributed to her death,' Magistrate Spanos said.
Amrita was referred to the emergency department on April 29 after two days of stomach pain, nausea and vomiting. Doctors initially diagnosed gastroenteritis. She was placed in a cubicle that did not have an allocated nurse. During the night, Amrita told her mother Satya Tarapureddi she was having 'hard breathing'. Ms Tarapureddi pressed the staff assistance button but no one came. Dr Tan conducted a review at about 3:20am on April 30, but Amrita died later that day.
Outside court, Ms Tarapureddi said: 'If they had put more attention to her, maybe today my Amrita could be sitting next to me.'
The coroner choked up and paused as she described how Amrita was deeply missed by her father Chandra Sekhar Lanka, her mother and her brother. 'Satya described her daughter as the most precious, talented and beautiful child who loved art and animals, especially birds. Amrita played the piano, was very smart and was the centre of their universe,' Magistrate Spanos said.