In short:

An independent review of two cases at Joondalup Health Campus found there was inadequate communication with parents, who described feeling "disempowered" regarding their child's care.

In one of the cases, 21-month-old Sandipan Dhar died after being sent home from the ED without a blood test being done.

Sandipan's father was not satisfied by the report's findings but welcomed the recommendation for a coronial inquest.

A Perth hospital has promised to improve its paediatric emergency services following an investigation into the death of a toddler and the misdiagnosis of a girl who was bitten by a deadly snake.

An independent review of the two cases found there was inadequate communication with parents, who described feeling "disempowered" in the decision-making around their child's diagnosis and care.

In March, Perth toddler Sandipan Dhar died in Joondalup Health Campus after being sent home two days earlier without a blood test being done. 

Sandipan was taken to the hospital's emergency department on March 22 after suffering a persistent fever for several weeks, but was sent home after an examination.

His parents said they made a clear request for blood tests, but this was denied.

Two days later, Sandipan's condition deteriorated further and the family returned him to the emergency department.

He died there later that evening, with a post-mortem revealing he had acute lymphoblastic leukaemia (ALL).

The independent review released on Tuesday found Sandipan's clinical care was acceptable and it was reasonable that clinical staff did not order blood tests during the toddler's first presentation.

But Sandipan's family remain unsatisfied with the healthcare approach and decision-making of clinicians.

Call for accountability

They would like to see a full and thorough investigation into the actions of individual clinicians involved in Sandipan's care and a review of the public-private partnership contract between the WA government and Ramsay Health Care, the operator of Joondalup Health Campus.

Sandipan's father Sanjoy Dhar was not satisfied by the report's findings but welcomed the recommendation for a coronial inquest.

He hoped the coronial inquest would examine the actions of all doctors involved in his son's care, including the general practice he attended multiple times before he attended hospital.

"If Sandipan had been diagnosed and treated properly, he should be with us today," Mr Dhar said.

"Justice delayed is not justice delivered.

"We just want accountability. I have trust that exactly what happened to my son will be revealed by an inquest."

Health Minister Amber-Jade Sanderson welcomed the report's findings.

"What comes through very strongly is the importance of listening to parents," she said.

"Sandipan was not old enough to describe his symptoms himself, but he did not need to because he had his parents by his side.

"I believe the Dhar family when they say they advocated strongly for their child."

Snakebite error

In May, a 10-year-old girl named Olivia presented at Joondalup Health Campus with a suspected snakebite.

Her mother felt certain, based on Olivia's symptoms, that she had been bitten by a tiger snake.

But after conducting a blood test, hospital staff incorrectly concluded she had not, diagnosed her with cellulitis and advised her to go home and take antihistamines.

But Olivia's mother did not accept the diagnosis, and instead took her daughter to Perth Children's Hospital, where staff looked at the same blood results and concluded she had indeed been bitten by a tiger snake.

By the time she was treated, it had been 17 hours since the snakebite and she was lucky to be alive.

Olivia spent three days in hospital recovering.

"There is unreserved acknowledgement of a series of errors that led to [Olivia's] mother leaving the ED and taking her directly to another hospital in order to be diagnosed and managed correctly," the report found.

Investigators found Olivia experienced ongoing side effects from her ordeal.

"After the incident [Olivia] initially felt like a superhero for surviving a snakebite and she was revered by her social circle," the report stated.

"However, she suffered episodes of health anxiety and regularly asked her mother to watch her sleep to ensure she continued to breathe."

Both Olivia and her mother expressed disappointment and frustration with Joondalup Health Campus, and said this was compounded by the fact they only received a response to their complaint after going to the media with their story.

Nine recommendations

The report found the clear theme in both children's cases was inadequate recognition and responses to parental concern.

It made nine recommendations relating to improving communication with parents, documentation, discharge summaries and processes, staffing, nursing education and the interface between hospitals and general practitioners.

Ramsay Health Care state manager Shane Kelly said the hospital would move quickly to implement the recommendations.

"We've made a number of improvements that are recognised in the independent report including the introduction of a new snakebite assessment tool and pathway," Dr Kelly said.

"We've updated our electronic discharge summary to include additional prompts relating to communication and parental concern, return to hospital advice, and more."

The report recommended further investigation of the care provided by general practitioners.