A four-year-old boy was "happy, smiling and giggling" the night before he died from sepsis, an inquest jury heard.
The second day of the inquest into the death of Ronaldo Iosif heard from the medical staff who initially assessed him when he was brought in to Alder Hey Children's Hospital with a fever by his worried parents.
Ronaldo's dad David, 30, had previously told the jury he had just brought his wife home after giving birth to their sixth child, in June 2019, when they became concerned about Ronaldo's condition.
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They took him to Alder Hey's A&E department and Ronaldo was subject to a "triage" assessment, which helped staff prioritise patients according to their medical needs.
The routine examination placed Ronaldo in the least urgent "green" category, meaning he faced a wait of up to three hours before being seen by a doctor for a full examination.
After a discussion with medics, his parents chose not to wait and instead returned to their home in Bligh Street, Wavertree, with their child.
Kiri Barrett, who at the time was a staff nurse at Alder Hey's emergency department, told the jury: "It was a busy shift on the night Ronaldo arrived.
"I carried out the initial triage assessment after the family arrived at A&E. Despite their being of Romanian descent, I could understand what the father was saying and he was able to understand me. He said that Ronaldo had a temperature that evening.
"The boy was really active, clapping his hands and seemed interested in his surroundings. The tests performed on him came back normal, although his heart rate and temperature were slightly elevated.
"We always consider sepsis in every unwell child who presents with a fever, but I was comfortable that it didn't need to be escalated.
"Despite what happened thereafter, I was satisfied that green was the right category based on that presentation. The dad asked how long it would be to see a doctor, and I told him the wait time could be something like two-and-a-half to three hours.
"I asked the parents to take a seat in the waiting room, but the dad indicated he didn't want to wait. I explained to him why Ronaldo was not the kind of emergency I'd need to prioritise, but he seemed unhappy to wait that amount of time.
"His wife had had a baby two days prior to this, and that was another reason they didn't want to wait to be seen. It was ultimately their choice, but they were more than welcome to wait for a doctor."
Ms Barrett added that she had never discharged a patient, regardless of how minor the complaint was, without their being seen by a doctor first.
Lauren Graham, a trainee nurse at the time of the incident, was also called to give evidence to the inquest. She said that when Ronaldo was brought in to A&E the first time, he was "clapping, happy, smiling and giggling."
However, Ronaldo's condition deteriorated overnight and when he was brought back to Alder Hey A&E the next morning by his frantic parents, he was rushed to a resuscitation unit.
Tragically, despite desperate efforts to save him, the four-year-old was pronounced dead within a few hours of his arrival at the hospital. A post-mortem examination later revealed he had died of sepsis following a meningococcal infection.
Assistant Liverpool and Wirral coroner Kate Ainge dismissed the jury this afternoon after all the evidence had been heard. She will begin her summing-up tomorrow (Wednesday), after which the jury will begin their deliberations.
(Proceeding)
