The grieving parents of Aishwarya Aswath say Perth hospital staff showed little urgency to treat the girl as her condition deteriorated before her death.
A Perth doctor who saw Aishwarya Aswath on the night of her death did not have access to the girl's triage notes and misunderstood why she had been brought to hospital, an inquest has heard.
Seven-year-old Aishwarya died of sepsis in April last year, hours after presenting to the Perth Children's Hospital emergency department with a fever and unusually cold hands.
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She was left in a waiting room for more than 90 minutes, despite her parents pleading with staff to escalate her care as her condition deteriorated.
Counsel assisting the coroner Sarah Tyler on Wednesday said the inquest would examine how trained professionals could have missed the warning signs of such a serious illness.
It will also look at why the concerns of Aishwarya's parents were not listened to and acted upon earlier.
Aishwarya was triaged in the second-least serious category by a nurse who did not take any physical observations when she arrived at the hospital around 5.30pm on Easter Saturday with her father Aswath Chavittupara and mother Prasitha Sasidharan.
Soon after, a doctor inspected Aishwarya after Sasidharan told a clerk she was concerned about white spots in the girl's eyes.
Tyler said the inquest would hear evidence the doctor believed Ms Sasidharan was solely concerned about Aishwarya's eyes, was not aware of her other symptoms and did not have access to the triage notes.
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The doctor viewed Aishwarya's eyes briefly and decided she did not require urgent medical attention.
A registered nurse who subsequently examined Aishwarya recorded family concern as zero, which Tyler said "does not appear to reflect the reality".
Her observation chart indicated staff should consider implementing sepsis protocols if a child's temperature exceeded 38.5C.
Aishwarya's temperature was recorded at 38.8C but the nurse "did not find it unusually concerning" and didn't trigger sepsis protocols.
Another registered nurse arrived just after 7pm to give Aishwarya ibuprofen.
"It is clear from the CCTV footage that Aishwarya was struggling to sit in an upright position and she was too weak to lift her head and take the medicine," Ms Tyler said.
In a statement read by Tyler on his behalf, Chavittupara described the nurse as "the rudest nurse that I've ever come across".
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He said she had appeared frustrated with Aishwarya and urged her to take the medicine.
The nurse sought an emergency department consultant who inspected the girl, and Aishwarya was carried by her father to an assessment bed before being stretchered to a resuscitation area.
She was pronounced dead around 9pm despite aggressive resuscitation efforts, having succumbed to an infection related to group A streptococcus.
Aishwarya's father said the family's pleas to escalate her care earlier had fallen on deaf ears and one doctor who inspected the girl "barely made eye contact with us".
Even when she was moved to an assessment bay, staff appeared initially to show no urgency, he said.
"We were getting more and more anxious about her but we were also mindful that we needed to wait our turn," Chavittupara said in his statement.
"We were worried about being kicked out of the hospital for being rude but we were worried about Aishwarya."
Former Perth Children's Hospital boss Aresh Anwar is among more than 20 witnesses scheduled to give evidence, along with a number of staff who treated Aishwarya.
The inquest continues.
