Asif Ali moved his family to Australia so that his daughter Dua, who lived with disability, would receive better treatment and have more opportunities than in Pakistan.
He said that was always the case, until a trip to Blacktown Hospital in Sydney's west in January, during which she was violently coughing and vomiting, and died less than two days later.
"Here in Australia, one thing which I cannot forget is that they gave us the right attitude towards special needs," he said.
"She was treated special all her life in any hospital she went to, any doctor she went to, she was treated very VIP."
Dua lived with Turner's syndrome, a chromosomal disorder, autism and intellectual disability.
Her father remembers her as a loving child and said they had a special relationship.
"All she had was love for us," he said.
On January 31, Dua started violently coughing and vomiting late at night, and her mother and brother took her to the emergency department at Blacktown Hospital.
Dr Ali was travelling overseas for work at the time.
He claims they waited outside for about two hours while Dua was tested for COVID-19.
Because of COVID restrictions, Dua's brother was not allowed into the hospital, despite their mother's limited English and that Dua was non-verbal.
Dua, 21, and her mother were in the emergency department for several hours.
Medical documents show Dua's oxygen, blood pressure and respiratory rate were checked, but the family want to know why no other tests appear to have been done.
Dua was given anti-nausea medication, but the records say that had no effect.
She was diagnosed with food poisoning and was discharged in the early hours of the next morning.
"Dua had food poisoning before and it was absolutely unusual this time that she was coughing and these are the symptoms not for food poisoning," Dr Ali said.
"That hurts us so much today ... the hospital is equipped with everything, every scan, and every test — why they didn't do that, on our non-verbal child who is in pain constantly."
In a statement, the Western Sydney Local Health District (WSLHD), which includes both Blacktown and Westmead hospitals, said: "At the peak of the COVID-19 Omicron outbreak in February 2022, restrictions on visitor access to hospitals were in place to minimise the risk of transmission of COVID-19.
"Visitor exemptions were available through an application process and were carefully assessed to balance compassion, patient need and safety.
"The district apologises that these restrictions were not adequately explained to the family."
'She was in a terrible condition'
Later in the morning after she left the hospital, on February 1, Dua's condition deteriorated, and her family took her to the GP.
Dr Ali said she received an injection for food poisoning there, but her condition continued to worsen back at home and the family called an ambulance when Dua lost consciousness.
The ambulance took her to Blacktown Hospital again, and her family followed.
"By the time family reached there, they knew everything ... one doctor told my wife that there is an unexplained fluid in the lungs," Dr Ali said.
She was transferred to Westmead Hospital where she was operated on for an aortic dissection, but she died early the next morning.
It was less than 48 hours after she first left Blacktown Hospital.
International research has found that the risk of aortic dissection is up to 12 times higher in women with Turner syndrome than the general public.
While Dua had never been to Blacktown Hospital before, she had been treated for most of her life at The Children's Hospital at Westmead, and records are accessible across those facilities.
Dr Ali is angry that more wasn't done to test and diagnose Dua during that initial visit to the emergency department considering her history of Turner syndrome and the fact she was non-verbal.
"My family, they were all relying on the system and on the doctors," he said.
In a statement, the WSLHD said: "Patients in emergency departments were, and continue to be, triaged according to the urgency of their presenting condition.
"The District also has an established process to access medical records from all NSW Health facilities, including Westmead Children's Hospital."
Further adding to the family's distress, when Dua's body was sent to the funeral home, there was medical equipment still attached to her.
This was the last time Dr Ali, who had rushed home from overseas, saw his daughter.
"I went to the funeral director's place, this was our last chance to see her and touch her and kiss her — she was in a terrible condition," he said.
"I never expected my daughter would be in that situation, she had so much of equipment on her.
"They told me even the urine bags were on her when they received her, it's absolutely unacceptable."
Family considers legal action
Dr Ali has complained to the Health Care Complaints Commission about Dua's death and the state in which her body was left, including statements from two people at the funeral home.
The investigation by the WSLHD has progressed to a serious adverse event review.
According to NSW Health Policy, this type of review aims to identify any factors that caused or contributed to a clinical incident.
Dr Ali is also considering legal action and has engaged Shine Lawyers.
"We will be investigating whether or not negligence is to blame for Dua's passing," lawyer Brielle Straney said.
"That includes whether or not earlier surgery, whether it be in a matter of hours, 10, 12, 14 hours difference would have made a difference to the outcome.
"We are a first-world country and our residents should be able to implicitly trust the healthcare system. And in this situation, it has failed her."
Dr Ali and his family are devastated that their daughter and sister died in such terrible circumstances.
"I want everybody to know in this beautiful country, wonderful people, that this happened with a child who trusted them ... and this health system just disappointed her towards the last week of the life," he said.
"She might [have] been thinking 'my parents, they didn't understand what I'm going through' — this will stay with me for my life."
The NSW Premier offered his condolences to the family, and defended the government's record on investment in the health system.
"There are always difficulties and there are always going to be incredibly tragic stories that come through and I said my heart goes out to the family," Dominic Perrottet said.
"I'll get some information in relation to it.
"But what I do know is I've been part of a government that's been able to invest record amounts in our health system, to provide people with the best health care when they need it."
