A FIVE-YEAR-OLD boy who survived a two-metre fall from a wall died after doctors at Queen Mary Hospital failed to detect he had fractured his skull, the Coroner's Court heard yesterday. It is the second time in less than a week that allegations have been made against doctors at the hospital for missing vital information about a patient when studying X-rays. Yu Ka-hung fell from the wall as he played with other children at the Chai Wan Estate on April 22. He was first taken to the Pamela Youde clinic, Eastern Hospital, where X-rays showed a fracture of the skull, said Dr Wong Chi-tat. The boy was then transferred to Queen Mary Hospital. Dr Wong said his notes on the patient were sent to the hospital. But when doctors there studied the X-rays and took further X-rays of their own, they could find no trace of the fracture, the court heard. 'The fracture was definitely not seen,' a medical officer at the hospital, Dr Tsang Tat-chi, said. He said further X-rays were taken because the boy was vomiting. The X-rays were reassessed by two other doctors but still the fracture was not detected. The child was kept under observation, but his condition deteriorated and he died the following day. Dr Tsang said no scan was carried out as he did not feel it was necessary in this case. The observation of the patient was more important, he said. Dr Tsang told the court the detection of a fracture would have indicated a higher chance of brain damage, but the treatment of the boy would have been the same. Pathologist Dr S. P. Poon said she found fractures of the skull when conducting a postmortem examination on the boy. The longest fracture was 12 centimetres, she said. The skull fractures were the primary cause of death, the court was told. The child's mother, Chumyen Sukanya, a cleaner, said she had left her son playing on a bench at the playground, outside the building where she worked. 'I attended to him occasionally,' she said. Coroner Ian Carlson said the only verdict which could be returned was one of accidental death. 'This young boy died as the direct result of a combination of misfortunes,' he said. The first misfortune was that the boy was not supervised while playing, and fell from the wall. The second was that the fracture of his skull was not detected at Queen Mary Hospital, Mr Carlson said. He made it clear that this was not a criticism of the doctors concerned. 'I have heard evidence that sometimes it is extremely difficult to detect this,' he said. The coroner recommended that parents should ensure their children are not left alone. 'Parents should be sensitive to the risks involved in leaving young children playing in a playground unsupervised by a responsible adult,' he added. Last week, an inquest before the same coroner heard how a man died at Queen Mary Hospital after a psychiatrist failed to spot signs on X-rays that he had swallowed his false teeth. The man later died as a result of the teeth perforating his oesophagus. A verdict of accidental death was returned.