Doctor orders the the death of a 6year old by error.

Nottingham Crown Court heard that Bawa-Garba had confused Jack for another patient she had treated earlier in the day, in what prosecutor Andrew Thomas QC called a 'remarkable error'.

He added that while Jack, of Glen Parva, Leicester, was 'beyond the point of no return' and that resuscitation was 'futile', it suggests Bawa-Garba had not given the youngster 'sufficient care'.

The doctor along with nurses Theresa Taylor, 55, and Isabel Amaro, 47, who all worked on the Children's Assessment Unit, have been charged with manslaughter through gross negligence.

Mr Thomas said Jack, who lived with his parents Victor and Nicola, and younger sister Ruby, had suffered from associated problems including a hole in the heart, for which he took daily medication.

The court heard despite a 'tricky start' he was a 'lively and energetic' boy who was 'thriving', attending a mainstream primary school where he was receiving one-on-one support.

But Jack fell ill with diarrhoea, sickness and breathlessness the evening before he was admitted to hospital.  

Mr Thomas told the jury: 'We say that Jack's death was caused wholly or in part by serious neglect on the part of the team on the Children's Assessment Unit.'

The court heard that Jack was admitted on the morning of February 18, 2011, after falling ill during the night.

His GP said he should go to hospital, where medical staff 'failed to act on obvious symptoms of serious illness', said Mr Thomas.

It is alleged that staff did not monitor Jack's condition effectively, and failed to recognise high levels of blood gas and lactate as concerning.

Jack collapsed at 7.45pm, with prosecutors saying his lips had started to turn blue, and a paediatric arrest team were summoned.

Mr Thomas said: 'During this critical period an event occurred which you may think is powerful evidence of Dr Bawa-Garba's performance that day.

'When she came into the bay, almost immediately she called the resuscitation off.

'She told the other doctors Jack had been marked down as Do Not Resuscitate earlier in the day.'

A first-year doctor then re-read the notes and said she could not see a DNR entry.

Mr Thomas said: 'It was a remarkable error for a doctor to make. Dr Bawa-Garba was later to explain she had mixed Jack up with another child she had been treating on the Children's Assessment Unit.'

The court also heard that nurses Amaro, an agency nurse, and Taylor gave Jack a Paediatric Observation Priority Score (Pops) of four when he was admitted.

Mr Taylor suggested a score of seven or eight would have been more accurate, which would have suggested Jack was in a critical condition.

He said: 'We say that the failings of each of the defendants contributed significantly to Jack's death.

'There was of course an underlying natural illness - the lung infection - which had led to sepsis and septic shock. But the lack of care contributed to Jack's death.

'It was a needless death.'

All three deny the charge and the trial is expected to last up to five weeks.