Staff at Perth Children's Hospital are being "thrown under the bus" by the West Australian government over the death of Aishwarya Aswath, the Australian Medical Association says.
A report by WA's Child and Adolescent Health Service has found emergency department staff missed a "cascade" of opportunities to escalate the seven-year-old's care as she succumbed to a fatal infection on Easter Saturday.
Aishwarya's parents, who have accused staff of lacking compassion, had sought help on five separate occasions while in the waiting room.
The McGowan government insists the hospital was adequately staffed.
But AMA WA president Andrew Miller has hit back, saying inexperienced staff had been left to run an "overheated" emergency department without adequate support.
"The AMA's not going to stand by and allow the most junior staff in the system, who do the most difficult job ... to be thrown under the bus by powerful managers, by the (director-general) or by the minister for health," he told reporters on Tuesday.
Dr Miller said staff had repeatedly called for more support and education and for the inclusion of a dedicated triage support nurse.
"To now try and blame these people for everything that's going on is completely unreasonable," he said.
Within 20 minutes of arriving, Aishwarya's hands were cold, her eyes were discoloured and her respiratory rate and heart rate were significantly elevated.
But the severity of her condition wasn't recognised until an hour and 17 minutes later, when a doctor noticed she had cold peripheries and slurred speech.
She entered a resuscitation bay but was pronounced dead within two hours.
The report highlights a 30-minute period where it was left to one nurse to watch over eight waiting room cubicles as Aishwarya continued to deteriorate.
In meetings with hospital executives dating back to October last year, emergency department staff raised concerns around the safety of children in the waiting room.
Plans for the new hospital to have a triage support nurse who would check patients' vital signs did not progress after it opened in 2018.
Opposition health spokeswoman Libby Mettam said Health Minister Roger Cook had overseen a "monumental failure" in the system.
"The health minister needs to stop deflecting the blame and explain how this has been allowed to happen on his watch," she said.
The report found that while the total staff-to-patient ratio on the night was adequate, the handovers between staff were incomplete and uncovered sick leave had impeded the capacity for nurses to escalate parental concerns.
Two of the nurses involved in Aishwarya's care have taken leave.
The CAHS panel raised concerns about a culture of staff "not engaging" with waiting families after interviewing staff and reviewing CCTV footage.
"(This is) most obviously evidenced on the footage by avoidance of eye contact with families and patients when walking through the waiting room," it said.
Premier Mark McGowan said the claim needed to be examined by a planned independent inquiry into the PCH emergency department.
"I think that concerns us all," he said.
The premier, who has rejected calls for Mr Cook's resignation, said a coronial inquest into Aishwarya's death would be held as soon as possible.
CAHS chair Debbie Karasinski resigned last week but chief executive Aresh Anwar was asked to remain.
Australian Nursing Federation secretary Mark Olson said the hospital's executives had ignored nurses' concerns and should be sacked.