5-Year-Old Girl Dies Days After Undergoing Tonsil Surgery

In April 2023, what was meant to be a routine and relatively common surgical procedure turned into a devastating tragedy for one family in the United Kingdom. Amber Milnes, a bright, loving five-year-old from St Just in Roseland, Cornwall, underwent elective surgery to treat obstructive sleep apnoea — a condition in which breathing repeatedly stops and starts during sleep.

What should have been a standard tonsil and adenoid removal ended in catastrophe, leaving her parents, Sereta and Lewis Milnes, bereft and searching for answers.

Amber was described by her family as their “magical little princess”, a joyful, musical child who lit up every room with her laughter, singing, and imagination. She adored playing with princesses and dolls, and was known for being affectionate, caring, and brave even from a young age.

A Common Operation for a Rare Child

On 5 April 2023, Amber underwent an adenotonsillectomy at Royal Cornwall Hospital in Truro, a surgical procedure that removes the tonsils and adenoids and is among the most commonly performed operations in children.

The aim was to relieve her sleep apnoea, a serious but treatable condition that interferes with healthy breathing during sleep, affecting energy, growth, and quality of life.

Yet unlike many children who have this surgery and go home the same day, Amber had another significant medical condition: cyclical vomiting syndrome (CVS) — a rare disorder that causes episodes of severe nausea and vomiting that can last for hours, recur unpredictably, and frequently require hospital support.

Those episodes often left her dehydrated and in need of medical care over the years.

Because of this, Amber’s parents had repeatedly told clinicians that she should ideally remain in hospital overnight after her surgery to minimise the risk of a CVS flare-up or complications afterwards.

Discharge and Rapid Decline

Despite these concerns, Amber was discharged from the hospital on the same day as her surgery, after a 38-minute operation that the surgeon described as uncomplicated and showing no immediate signs of infection or unusual bleeding.

The Milnes family was surprised by this decision. Amber had arrived at the hospital early in the day, and by around 9 p.m. she was back home.

At the time, her parents assumed that she would be watched overnight because of her underlying health needs — particularly her CVS.

In the early hours of 6 April 2023, Amber began to vomit. Initially, her parents called the hospital to ask for advice, and were told to monitor her closely and call back if symptoms did not improve.

Amber’s vomiting continued relentlessly — reportedly around 20 episodes throughout that day — and by about 10 p.m., her parents brought her back to the hospital for urgent care.

Hospital Readmission and Treatment Challenges

Once readmitted, 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.

According to evidence heard at the inquest in November 2025, the IV line Amber was relying on failed around midnight, leaving her without fluids, pain relief, antibiotics, or anti-nausea drugs for up to 14 hours, because she could not take medications by mouth due to ongoing vomiting. Intravenous treatment was not re-established until the afternoon of 8 April.

During this time, Amber remained in hospital but continued to struggle with her condition and associated symptoms.

A Sudden and Fatal Turn
At about 3 a.m. on 9 April 2023, Amber woke up in hospital and suffered a massive haemorrhage — a catastrophic bleed in her throat where the tonsils and adenoids had been removed during her surgery. Despite immediate medical efforts, she could not be resuscitated and was pronounced dead at 4 : 37 a.m..

A post-mortem examination conducted by a pathologist revealed that a surgical-site infection had developed at the location of the surgery.
That infection eroded an artery, leading to a fatal rupture — not an injury that occurred during the operation itself, but one that arose afterwards, as the tissue became inflamed and compromised.

The official cause of death was recorded as:

Massive haemorrhage with aspiration of bloo
Surgical site infection
Enlarged tonsils
Complications following adenotonsillectomy

This combination indicated that the infection — a known but very rare complication of tonsil surgery — led to the artery rupturing and the haemorrhage that ultimately claimed Amber’s life.

Inquest Findings and Coroner’s Conclusions

In November 2025, a two-day inquest into Amber’s death was held at Cornwall Coroner’s Court. Senior Coroner Andrew Cox delivered a narrative conclusion — a detailed explanation of the circumstances surrounding her death — and found that Amber’s passing was due to a “known but very rare complication:

catastrophic haemorrhage caused by infection after a surgical procedure (adenotonsillectomy).”

The coroner noted that while the surgical procedure itself was “unremarkable,” there were important questions about clinical decision-making — particularly whether the medical team fully recognised the implications of Amber’s cyclical vomiting syndrome (CVS) when determining whether she should be discharged or kept in hospital.

He emphasised that neither the surgeon who performed the operation nor the anaesthetist present were fully aware of the details of Amber’s CVS prior to her surgery — a condition that had been communicated by her parents and could have influenced post-operative care and risk assessment.

The surgeon, Kel Anyanwu, testified that he had worked at the hospital for 25 years and had never before seen a death resulting from a tonsillectomy. He described Amber’s procedure as “quiet in terms of blood loss” and said he saw no signs of infection at the time of surgery.

He also noted that the consent form Amber’s parents signed did not explicitly mention the risk of death, a point that the coroner considered significant in terms of informed consent.

The coroner also acknowledged expert evidence from an ENT surgeon who reviewed Amber’s case — concluding that there were no clear failings in care that would certainly have changed the outcome, but that a discussion about increased risk due to her CVS should have happened.

Parents’ Tribute and Message

Throughout the inquest and in statements shared publicly afterwards, Amber’s parents described their daughter with warmth, love, and deep heartbreak.

They highlighted her courage in coping with difficult medical treatments throughout her short life and urged other families to be vigilant, informed, and assertive when their children face surgery.

Sereta and Lewis emphasised: “If surgery is needed then do go ahead, but if you are worried, don’t be afraid to trust your instincts, ask questions, and work with the doctors. Remember that no operation is risk-free, however common it may be.”

They also expressed that, despite the rarity of complications like this, they still felt Amber’s condition wasn’t fully understood enough by the medical team, and that keeping her in hospital overnight or being readmitted sooner might have made a difference.

While the coroner could not confirm whether this would have changed the outcome, the family stated their belief that earlier readmission could have helped.

Response From the Hospital Trust

In the wake of the inquest, Royal Cornwall Hospitals NHS Trust issued a formal statement expressing deep condolences to Amber’s family, acknowledging that the death of a child is “utterly devastating.”

The Trust also stated that it fully accepted the coroner’s findings and was committed to improving care and learning from the tragedy.

The statement said the Trust had introduced new guidelines for caring for children with conditions like obstructive sleep apnoea following tonsil and adenoid removal, with increased awareness of associated risks and care needs.

Additionally, the Trust extended an invitation to Amber’s parents to meet with a paediatrician to discuss care and support.

A Rare Outcome With Lasting Lessons

Tonsillectomy is one of the most common operations performed on children in countries like the UK and the United States, typically with low rates of serious complications. However, any surgical procedure carries risk — and in extremely rare cases, post-operative infection and haemorrhage can occur, as was tragically the case with Amber Milnes.

Experts note that children with additional medical conditions — such as CVS or disorders that affect hydration, nutrition, or immune response — may require more personalised planning and post-operative care, including possibly extended monitoring in hospital. The awareness of these nuances in care remains an ongoing area for clinical improvement.

Amber’s story, and the thorough inquest that followed, has underscored the importance of:
Clear communication between medical teams and families
Detailed pre-operative assessment of underlying health issues
Trusting parents’ knowledge and concerns about their child
Recognising that even routine procedures may present unique risks