For three days, two sisters argued over who should take a seriously ill girl to hospital as she suffered headaches and vomiting.

On the fourth day, she was found unconscious on her aunt’s couch and could not be revived.

Experts have concluded the girl would not have died had she received prompt medical attention.

Today, her mother and aunt were in the High Court at Wellington for sentencing on manslaughter charges after failing to act.

The girl had complex medical needs and relied on a shunt inserted into her brain to drain fluid into her abdomen.

Her mother knew headaches, fevers and seizures could signal a medical emergency and that her daughter needed prompt medical attention.

But as the girl deteriorated, her mother was broke, dealing with car trouble and struggling with suicidal thoughts.

Meanwhile, the girl’s aunt continued texting her sister to come and collect her daughter.

“[The girl] has been having a head ache (sic) since lastnight (sic) she spewed up heaps she might need to go to hospital,” she messaged.

But neither woman sought medical help.

A medical emergency unfolding

The court heard the girl’s shunt often got infected, causing prolonged febrile seizures and lengthy hospital stays while it was replaced.

A team of specialists had repeatedly reminded the mother to be vigilant for headaches, fevers or seizures, which could indicate the shunt was failing.

If any occurred, she was to take her daughter to a GP or emergency department within four hours.

Despite this, the mother repeatedly missed specialist appointments and was not engaged with a GP.

When the girl became unwell, she was at her aunt’s.

The sisters exchanged text messages over three days. During that time, the mother repeatedly refused to travel from her home in the Wellington region to her sister’s house, citing car trouble and suicidal thoughts.

At one point, she told her sister she needed “time to sort out my head ’cause its s***”.

An expert psychiatrist later determined the mother was suffering from a depressive illness, which affected her response to what was unfolding over those days.

The mother’s sister also refused to seek help, later telling police she’d exaggerated the symptoms to try to get her sister to pick up the girl, and she “did not know what to say to doctors”.

As the two argued over who should help the girl, the vomiting and headaches continued and her condition worsened.

Early on the fourth day, the girl was found unconscious on the couch. An ambulance was called but paramedics could not revive her.

An autopsy revealed the girl likely died from a febrile seizure or brain swelling, but the pathologist confirmed the shunt had not failed.

‘All you needed to do was call 111′

In July, both women accepted sentencing indications and pleaded guilty to charges of manslaughter.

At the mother’s sentencing indication, Justice Victoria Heine said there was no suggestion the girl was abused and, having watched the mother’s police evidential interview, it was clear she not only loved her daughter but was skilled at looking after her.

“But it was up to you as her mother to make sure that she was okay. I accept that you were one step removed at the time, but you were still her mum and knew best how to manage her health.”

Justice Heine also acknowledged that despite knowing her daughter wasn’t okay, the mother had been struggling to look after herself in the week before the girl’s death, with no money, no car and no way of getting into Wellington.

“You had conscious knowledge of the risks to her for a period of days and did nothing about it.

“I accept that you had car troubles, but [your sister’s] address was very close to the hospital.

“All you needed to do was call 111.”

At the sister’s sentencing indication, the judge referred to her police interview and accepted that she appeared to know less about her niece’s condition than the mother.

The sister claimed to be “getting kind of paranoid” about the headaches because she did not know what they meant and said the girl “seemed fine” when she had last seen her.

“There is no evidence that you knew the seriousness of her symptoms, or as your lawyer Phil Mitchell put it, that you knew the girl was ‘in grave life-threatening danger’,” Justice Heine said.

Justice Heine accepted the aunt was looking after other family members and had repeatedly asked her sister to take the girl to hospital.

“But your address was heartbreakingly close to it. All you needed to do was call 111.”

‘You will have to live with your actions’

At their sentencing today, Sarah Saunderson-Warner, who represented the mother, said there were several mitigating factors, including her client’s remorse.

“This case is a tragedy; it involves a high needs child and a mother ill-equipped to cope with the demands of that as well as the other struggles she was having,” Saunderson-Warner said.

“She’s suffered significant loss, grief, stigma and shame but she has taken responsibility for her actions.”

Justice Heine said the case differed from one of child neglect.

“This was serious offending, however, it was context-specific, and both women are assessed as being at a low risk of reoffending.”

Justice Heine said there was a clear link between the mother’s deteriorating mental health and her behaviour.

The judge said that at the time, the mother was also using and selling drugs to pay her debts.

Taking into account the mother’s guilty plea, her background, her inability to cope at the time, her remorse and the rehabilitative steps she had taken, the judge imposed an end sentence of 23 months in prison.

Because the sentence was less than two years, it could be converted to home detention.

The Crown, represented by Claire Hislop, did not oppose home detention for either defendant.

In granting home detention, the judge noted this wasn’t a case of child neglect, but one involving a failure to seek medical attention for a severely disabled child, making it unusual.

She said the most persuasive reason for granting home detention was that prison would disproportionately affect the mother’s other children, depriving them of contact with her.

“You will have to live with your actions and your manslaughter conviction for the rest of your life.”

Turning to the sister, the judge referred to the pressure she was under as a parent and caregiver at the time of the girl’s death.

A report writer noted her limited educational background and lack of understanding of her niece’s needs had contributed to her lack of assertiveness with her sister as the girl’s condition deteriorated.

Mitchell sought a community-based sentence and name suppression for the woman.

After adopting a starting point of four years in prison for the sister and taking into account the impact on her children, her remorse and upbringing, the judge arrived at an end sentence of one year and nine months in prison, which she also agreed to convert to home detention.

Again, the judge noted society’s interests would be best served by the sister remaining with her children.

The mother was sentenced to 12 months’ home detention, while the sister received 10 months.

Their names were permanently suppressed with the judge citing the impact publication would have on their children.