Authorities were so concerned for a girl who was allegedly repeatedly raped at a Sydney care facility that she was removed from her home before her first birthday, an inquest has heard.
The 15-year-old, dubbed 'Girl X', died at Westmead Children's Hospital on April 21, 2014, following an overdose after years of being "used and abused" by those who should have been caring for her, counsel assisting the inquest Donna Ward told the Glebe Coroner's Court on Monday.
"She was not always treated with the kindness, dignity and respect that she deserved," Ms Ward said, telling the packed courtroom the girl was removed from her family home before her first birthday.
"(Her) death raises important questions about the ways that families, the community and 'the system' can fail children and young people."
The girl was placed into several homes, with the court hearing she had lived with friends, family and foster carers for much of her life.
While there were moments of brightness throughout her 15 years, many of those supposed to protect the girl had exploited and abused her, Ms Ward said.
"(She had been) tragically used and abused by many of the people she should have been able to rely on for comfort and care," Ms Ward said.
"She never really found any significant stability."
Instead, the girl had been dragged into criminal activity, probably prostituted and had been injecting hard drugs during her mid teens.
Her death was the result of a hypoxic brain injury, which Ms Ward said meant not enough to oxygen was going to the girl's brain.
The night before her death, it's believed she injected a "speed ball" - a dangerous combination of heroin and speed, while living at a residential care home.
When these drugs are taken together a fatal dose of heroin can be consumed without immediate effect, Ms Ward said.
There were also traces of meth and cannabis in her system, according to a toxicology report, which is expected to come before the inquest.
Evidence from a clinical psychologist is expected to show Girl X "was traumatised and severely damaged by her early childhood experiences."
In April 2014 she cut "I hate feelings" into her leg, the court heard.
"By 2014, and probably earlier, she operated in survivor mode with high levels of distrust and frequent disengagement from support services," Ms Ward said.
The state opposition is calling for the immediate suspension of a the facility where the girl was allegedly repeatedly raped.
Family and Community Services Minister Brad Hazzard confirmed he has written to Royal Commission into Child Sex Abuse to look into the alleged historical abuse from 2012 to 2014 at the Sydney foster care refuge centre.
The inquest is due to run for a week.
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