Amber Milnes, a five-year-old girl from St Just in Roseland, Cornwall, passed away days after she had undergone tonsil removal surgery at the Royal Cornwall Hospital in Truro on 5 April 2023.

The little girl suffered from sleep apnoea, a condition where your breathing stops and starts while you sleep.

However, while most children who undergo this type of surgery are discharged from the hospital the same day, Amber suffered from yet another condition known as cyclical vomiting syndrome (CVS). It is a condition when you experience cycles of severe nausea, vomiting and exhaustion that can last from a few hours up to a few days.

According to My Cleveland Clinic, CVS can continue for months, years, or even decades, but symptoms don’t appear daily. Most people experience episodes a few times a year, though in some cases they can happen as often as once or twice a month.

For each individual, the symptoms, timing, frequency, severity, and duration of episodes are usually consistent. However, these factors can differ from one person to another.

As Amber suffered from this condition, it left her dehydrated and in need of medical help over the years.

Because of this, her parents believed the girl should stay at the hospital over night following her tonsils removal surgery, but despite their request, she was discharged the same day.

In the morning of April 6, she started vomiting. When her parents called the hospital, they were told to monitor their daughter and only call back if symptoms won’t improve. At around 10 p.m. that same day, they took Amber back to the hospital after she vomited around 20 times.

Amber was given intravenous (IV) fluids and medications, including pain relief, treatment for vomiting, and antibiotics because she was found to have a chest infection. However, complications arose that severely limited her treatment.

On April 9, the little girl suffered a fatal haemorrhage, which was likely caused by an infection in the part of her throat where her tonsils had been removed. Sadly, she passed away that same day.

In November 2025, a two-day inquest into Amber’s death was held at Cornwall Coroner’s Court.

During the hearing, Amber’s parents, Lewis and Sereta Milnes, described how their daughter was the “happiest little girl” who bravely dealt with medical treatment. They said: “Amber was and always will be our magical little princess. She lit up our home with her singing, her dancing, her laughter and her heart of gold,” Metro reported.

“Bam, as everyone would call her, was the girliest of girls who loved doing girly stuff, like playing with princesses and babies. She absolutely loved music and singing. She filled our family home with love and fun as she sang and pranced around and when we were out on the road in the car the music didn’t stop.”

They described Amber as “cuddly, affectionate, and very, very caring,” always looking out for family members by holding their hands and gently stroking their heads when they weren’t feeling well. “Amber was the happiest little girl, and almost always smiling, but she was also a very brave person, and those qualities came to the fore when she first started getting poorly at the age of two,” they said.

“Once she had started vomiting, she was in and out of hospital on a regular basis, which was tough on her, tough on us all, but she took it all in her stride. Amber was so strong and when she felt sick she just got on with it.

“When she had to go into hospital, it was her choice because she was ready to go in, with no fuss and because she knew the  doctors and nurses wanted to make her feel better.”

Senior Coroner Andrew Cox provided a narrative conclusion, giving a detailed account of the circumstances surrounding Amber’s death. He determined that she died from a “known but very rare complication: catastrophic haemorrhage caused by infection after a surgical procedure (adenotonsillectomy).”

He said there was nothing unusual about the surgery itself, but serious questions were raised about what happened afterward. Specifically, he questioned whether doctors fully understood how Amber’s cyclical vomiting syndrome (CVS) could affect her recovery when they decided to send her home just hours after surgery instead of keeping her in hospital overnight.

He also pointed out that the surgeon and the anaesthetist did not fully know about Amber’s CVS before the operation, even though her parents had shared that information. The coroner said this could have made a difference when it came to assessing risks and deciding how closely she should have been monitored afterward.

According to Metro, the doctor who performed the surgery, Kel Anyanwu, said he had never witnessed anyone dying from a tonsillectomy before.

He also mentioned that the consent form Amber’s parents signed did not mention the risk of death and described her situation as “unique.”

As of the decision to discharge the girl mere hours following the surgery, Anyanwu said, “The conversation was let’s see how she’s managing three, four, five hours after.

“The assumption was that if she was fine, she will probably be ok. The decision was made later when we saw her, that she is fine, she can go.”

In a statement issued after the inquest, Dr Merry Kane, the chief medical officer at Royal Cornwall Hospitals NHS Trust, expressed sympathy with Amber’s parents.

“Our hearts go out to Amber’s family; the death of a child is utterly devastating.

“We have all learned from Amber’s tragic death. We remain committed to learning and ensuring that every child and family receives the highest standard of care.

“Since Amber’s death, we have introduced new guidelines on caring for children with obstructive sleep apnoea following adenotonsillectomy. We will continue to do everything we can to increase awareness of CVS.”

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