Five-year-old Rozalia Spadafora recorded an abnormally fast heart rate at a general practice clinic the day before she died at Canberra Hospital.
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Her death is subject to a coronial inquest, which started on Wednesday, and is expected to reveal a series of "missed opportunities" to save the little girl's life.
Kingston Foreshore Medical Centre general practitioner Dr Khaleda Yesmin saw Rozalia at about 5.30pm on July 4, 2022.
While Dr Yesmin did not record Rozalia's heart rate, she believed it was more than 120 beats per minute, indicating tachycardia.
"I didn't write [the heart rate] down, but definitely it concerned me at that time," she told the court on Wednesday.
Tachycardia is an increased heart rate.
It is believed that Rozalia eventually died from myocarditis, or inflammation of the heart muscle, as a result of an influenza A infection.
Rozalia's mother Katrina Spadafora told the court on Wednesday that her daughter could not walk on the day she saw the GP, and had to be carried out of bed.
However, Dr Yesmin said she did see Rozalia stand with support of her mother.
She did not consider Rozalia critically unwell enough to be sent to hospital in an ambulance.
"She was not critically unwell, she was still talking to me in a sentence, her breathing was normal, she was talking, she was standing beside her mother," Dr Yesmin said.
The doctor told the coroners court that she conducted a number of tests on Rozalia, including measuring her heart rate, but couldn't come to a diagnosis.
Dr Yesmin had seen Rozalia that same week, on June 28, and prescribed antibiotics for a suspected ear infection.
She didn't believe Rozalia's condition on July 4 was related to the ear infection.
As it was late in the day, any testing done at the GP clinic would have been processed by pathology the next morning, and then taken 24 hours to be sent back, Dr Yesmin said.
While suspecting the young girl may have a bacterial or viral illness, the GP said she could not come to a conclusion as to Rozalia's illness without further testing.
She told the mother and grandmother to take Rozalia to the Canberra Hospital emergency department.
Dr Yesmin was asked repeatedly why she did not give Rozalia's family clinical notes to take to Canberra Hospital.
"Retrospectively, now I can think yes [I should have], but at that moment, because I did not come to a conclusion ... I didn't think that it's going to make any change for the triage," Dr Yesmin said.
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"When a child [comes] to the hospital, they will do triage no matter what I do. [The condition] can change by that time."
When asked if she did not send clinical notes because she expected Rozalia would be seen at the Emergency Department in a timely and competent manner, Dr Yesmin said yes.
Dr Yesmin said she had not received any instruction from Canberra Hospital or Canberra Health Services as to whether general practitioners should or should not send patient clinical notes to the hospital.
A lawyer representing Canberra Health Services said Dr Yesmin could have sent notes via an email and fax number.
The inquest will continue on Thursday.
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