In a statement issued after the inquest, Antonio’s mother Milena Galisi said her son had gone into hospital as a “healthy, happy boy for a planned procedure that was supposed to make his life better”.

“Instead, I watched him suffer for days as he became more and more unwell, and my concerns were not listened to,” she said.

“No family should ever have to see their child die in such a traumatic and avoidable way.”

Beatrice Morgan, a human rights solicitor at Leigh Day, who represented Antonio’s family, said his death had been “preventable” and he “should have recovered” after the surgery.

“Instead, he was kept on a drug that his clinicians knew carried serious risks when used for prolonged sedation,” she said.

“Rather than consider alternative sedatives, Propofol was continued for six days. The expert evidence is unequivocal.

“Antonio died from Propofol Infusion Syndrome, and his death was preventable.”

The BBC has contacted Leeds Teaching Hospitals NHS Trust and NICE for a comment.