A young boy with special needs died after he choked on a nectarine after he was left alone in a classroom in Australia.
The incident happened in 2017, but Lucas Latouche Mazzei's parents have slammed the Department for Education over the way it handled the investigation and aftermath of their son’s death.
South Australia (SA) Deputy Coroner Ian White handed down his final report on Friday and found the five-year-old death was preventable.
Lucas Latouche Mazzei was watching cartoons in a classroom at Adelaide’s Henley Beach Primary School when he died.
He was separated from his classmates because his teachers were concerned he would be at risk of swallowing objects used in their science class.
He was supervised by his teacher who left the classroom briefly and an education support officer.
The officer, who had a restricted view of the area where the TV was playing, did not realise he was choking on a nectarine he had found in the classroom.
It wasn't until they asked Lucas if he needed to use the bathroom, that the teacher realised something was wrong because his eyes were glassy.
Emergency services rushed to the scene but they were unable to save him.
Lucas was one of 350 people in the world with a very rare genetic condition known as succinic semialdehyde dehydrogenase deficiency, which leads to developmental delays.
After they released he was choking, a number of attempts were made to save his life but they failed.
Teachers apparently banged on his back and at one point, he was lifted up by his legs so he was upside down as staff slapped his back.
In his criticism of the school, White said the staff did not have adequate first-aid training at the time.
The school released a newsletter statement about a week after Luca’s died, saying he died "after an isolated medical episode related to his condition."
White said the statement was "misleading."
Outside court, Lucas’s parents Daniela Mazzei and Miguel Latouche delivered an emotional statement and slammed the department.
Daniela said: "It was clear the education department did not know or want to know how a young boy died in their care.
"They were not interested in learning from his death to ensure that this never happened again.
"The very first communication on his death from the school was disingenuous, and our approaches to the then chief executive were effectively ignored.
"We were left misled and made to believe that there was an ongoing investigation.
"Adding to our grief was what could only be described as organisational abuse to protect the reputation of the department.
"We have been looking for answers since the day Lucas died. The journey has been extremely hurtful, even cruel.
"We ask the Department for Education to acknowledge that Lucas died because something went wrong in one of their special needs classrooms where he was left alone unsupervised."
White made several recommendations to the education department, including all teaching staff being required to hold up-to-date qualifications in providing first aid.
He also recommended the department review its policy and procedures around the storage and consumption of food and drinks at school.
