This is an archived article and the information in the article may be outdated. Please look at the time stamp on the story to see when it was last updated.

BIRMINGHAM, Ala. (WIAT) — By the time Kamiya Dufermeau got to the emergency room in Birmingham, she was fighting for her life.

Just weeks earlier, she’d undergone a routine appendectomy at Children’s of Alabama. Her family thought the surgery would be the end of Kamiya’s pain, but on May 5 of last year, as she entered the emergency department at Children’s, the 7-year-old girl — still in her pink pajamas — was unresponsive. She had only a “faint” pulse, the charge nurse said. Despite attempts to save her life, she did not make it. Kamiya was pronounced dead at 7:48 p.m.

A year later, her mother Sherry Robinson is still seeking answers. Late last year, Robinson filed a lawsuit accusing Children’s of Alabama and two doctors of negligence that led to her daughter’s death.

Now, an autopsy report obtained by CBS 42 is shedding more light on the circumstances of Kamiya’s death.

The report, prepared by the Jefferson County Coroner’s Office, concludes that the child’s death was caused by complications from her recent appendectomy.

The autopsy showed that the Kamiya’s intestines were twisted in two places, obstructing her bowel. Part of her bowel was “necrotic” near the site of the appendix removal.

“Volvulus (a twisting of the intestine) can occur in the postsurgical setting,” the report said.

Such twisting causes bowel obstruction, a lack of blood flow, and death of the intestinal wall, according to the report, signed by Associate Coroner Brandi McCleskey.

“Therefore, it is my opinion, based on the circumstances surrounding death and the findings at autopsy, that Kamiya Dufermeau died as a result of complications of a recent appendectomy due to appendicitis,” McCleskey concluded.

Complications after a laparoscopic appendix removal are rare, but not unheard of. Often, though, the complications are addressed with further exploratory surgery. A 2014 case report found five such cases in the medical literature and described another, in which a 30-year-old’s complications following an appendectomy were corrected after she was readmitted to the hospital for further examination of her symptoms.

“This case reminds us of the many pitfalls of surgery,” the case report by five Swiss doctors said. “The decision to readmit this patient in spite of reassuring laboratory findings and the swift performance of an exploratory laparotomy within hours of deterioration were crucial to her quick recovery.”

Kamiya Dufermeau was never readmitted to the hospital after her surgery. Because her daughter still felt tired and weak days after the appendectomy, her mother did bring Kamiya to Dr. Theresa Bolus, a physician at Midtown Pediatrics, a facility run by Children’s. Bolus diagnosed the child with pinworms and sent her home. She did not conduct a physical exam, according to Robinson’s suit. Kamiya would die the next day.

The coroner’s report will likely play an important role in Robinson’s wrongful death lawsuit against Children’s of Alabama. Last week, a judge ordered the pediatric hospital to hand over documents in the case it had not yet produced, including Kamiya’s medical records.

Children’s of Alabama and the two doctors named in the suit — Theresa Bolus and Colin Martin — have denied responsibility for Kamiya’s death and argued that Alabama’s wrongful death statute is unconstitutional.

A trial in Kamiya Dufermeau’s case has tentatively been set for 2023.