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A ten-year-old schoolboy died from an infection which could have been caused by a circumcision carried out in Africa, an inquest heard today.

Stanley Chola had the procedure carried out in Zimbabwe during the school summer holidays

But nearly two months later the youngster - from Reading - went into septic shock and died in hospital.

An inquest heard today that officials looking into Stanley's death concluded it was possible that the circumcision could have been the start of the infection.

The day before Stanley died, he was due to see a doctor about his condition but his mother failed to take him to the appointment - a decision described as a "pivotal" moment.

"If they had been able to come down I think we could have admitted him to hospital and treated him," said Dr Jeremy Lade, director of the Westcall out-of-hours GP service in Berkshire, told the inquest.

Stanley, a pupil at New Christ Church School in Reading, went with his family to Zimbabwe during the summer holidays last year and was circumcised on August 23.

However, he was absent during the first week of the new term and his step-father, Malik Issa, told a member of school staff this was because he had developed an infection from the circumcision.

On October 7 his mother, Ellen Gomes, took Stanley to the Royal Berkshire Hospital in Reading, with her son complaining about a knee problem caused while playing football.

It was claimed later in the inquest that the injury may have been caused by another pupil hitting Stanley with a plastic hockey stick, with the 10 year old lying about it for fear of being beaten again. Nurse practitioner Roger Wood diagnosed him with having a soft tissue injury.

Ms Gomes took Stanley to a GP the next day, but there appeared to be no reason for major concern.

On October 11, his mother spoke to a doctor on the phone and told them Stanley had developed a chesty cough, abdominal pains and was not eating.

She also said he was suffering from vomiting and diarrhoea.

(Image: Rex)

Stanley was prescribed antibiotics, with the doctor saying the information his mother had given did not suggest he needed to be seen in person.

At around 4.40am on October 12 paramedics were called to the family's home in Whitley, after a call to say Stanley was unable to walk because of his knee pain.

The paramedics said he was able to walk but that his breathing and oxygen saturation level were unusual and Stanley also had a slight temperature.

It was arranged for the boy to see a doctor at 8am the next morning, but he did not attend the appointment.

Dr Lade said: "This was a pivotal moment in Stanley's case because, had he been seen by a doctor that Saturday morning and appropriate treatment and investigations taken place, he might have been saved."

When Stanley did not go to his appointment, the Westcall service would normally have contacted the family, but a systems failure that day and the fact they could not find a number for Ms Gomes, made this impossible.

The next day a paramedic was scrambled to the family home at around 7.40pm after Stanley started having breathing difficulties.

His right calf was very firm and swollen and the paramedic found marks on his thigh, which his mother said were healing boils.

On arrival at the Royal Berkshire Hospital, doctors diagnosed Stanley with septic shock and thought his chances of survival were slim.

His condition rapidly deteriorated and doctors twice performed CPR before Stanley was declared dead at 11.35pm.

Dr Lade told the inquest it was not uncommon for children with sepsis to die very quickly.

"They will walk into a ward and then suddenly pass away a short time afterwards," said Dr Lade.

It was thought the infection might also have been caused by an injury to his knee, either from being hit with a hockey stick by another pupil or while playing football.

However, a leading doctor said the two latter theories were "very unlikely" to be the case.

Asked if being hit by an object on his leg, such as a hockey stick, could have caused the septic infection, Dr Lade said: "That seems very unlikely."

The inquest heard that the boils on Stanley's thigh could have been caused by the circumcision infection and Dr Shabnam Iyer, a microbiologist who helped with the post-mortem examination, said the infection could have spread from the skin and into Stanley's leg.

The two-day inquest, before coroner Peter Bedford, continues.