A six-year-old boy who visited a West Australian hospital three times in as many days before he died was initially assessed "off the books", an inquest has heard.
Sebastian Keith Parman was thought to have scarlet fever but died at Geraldton Regional Hospital in September 2010 from pneumonia complicating a swine flu infection.
The WA Coroner's Court is now investigating whether the care provided to Sebastian was appropriate and if his death could have been prevented.
In her opening address, counsel assisting the coroner Kate Ellson said Sebastian's mother, who was a nurse, gave him Panadol and Nurofen on September 10 and continued the treatment over the weekend as his temperature increased.
On the Monday, he went to stay with his father, who was also a nurse, and he took the boy to the emergency department the following day.
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Dr Lesley Cupitt saw Sebastian "off the books", noting he was covered in a bright red rash and his tonsils were a little large but there was no pus, Ms Ellson said.
The doctor considered Sebastian might have scarlet fever, tonsillitis or a virus, and wrote a prescription for penicillin.
Sebastian's mother called the hospital on the Wednesday for more information but was told it was an "unofficial presentation" and Dr Cupitt had not made any notes.
She took her son back to the hospital where Dr Sunil Reddy recorded a plan to have urine testing and a chest X-ray done, and for paracetamol and an anti-convulsive to be given.
When his shift ended, Dr Reddy had a handover with Dr Cupitt, who later checked the X-ray and sent Sebastian home, the inquest heard.
On the Thursday, the boy's mother took him to see general practitioner Wesam Abujala, who suspected the child had scarlet fever and referred him to the hospital for admission.
The hospital's consultant pediatrician Dr Lewis Ingram diagnosed the boy with scarlet fever, ordering intravenous fluids and antibiotics.
Doctors came to redo Sebastian's intravenous cannula on the Friday, and although he appeared to be alert and responsive, within five minutes he arrested and efforts to resuscitate him failed.
Sebastian's mother was dissatisfied with last year's coronial findings, so they were put aside in favour of an inquest, which is being held in Geraldton.
KEY ISSUES TO BE INVESTIGATED BY THE CORONER:
* Whether and why the first consultation with Dr Cupitt was unofficial?
* Are informal consultations ever appropriate in an emergency department?
* On what basis were the antibiotics prescribed on the Tuesday?
* Was a discharge plan created for Sebastian on the Wednesday?
* Was the fluid regime on the Thursday sufficient to manage Sebastian's illness?
