The tragic death of a helpless baby boy – murdered during a campaign of torture by his mother’s violent partner – might have been avoided if his background had been fully explored during an earlier visit to Airedale General Hospital, a serious case review has concluded.

Fifteen-month-old Charlie Hunt died at the Steeton hospital in November 2009 from injuries sustained in a series of vicious assaults by Darren Newton.

Newton, 32, of Earby, Lancashire, was jailed for life in December for Charlie’s murder. He had recorded video clips of himself abusing the screaming youngster in a catalogue of cruelty which he managed to hide from the baby’s mother, Laura Chapman.

The judge ordered that Newton must serve a minimum of 24 years before he is considered for release.

A report of the serious case review published yesterday states that Charlie had been admitted to Airedale Hospital suffering convulsions two months before he died but was discharged without abuse being considered as a cause for his condition.

The review, which refers to Charlie as Child AB, states although it was not possible to predict whether the baby would have been harmed in the way he had been “there were some possibilities that different interventions might have led to a different outcome”.

It describes the earlier hospital visit as a “missed opportunity for multi-professional child safeguarding work”. The serious case review also found evidence of gaps in information-sharing and planning between agencies and “a failure to recognise the potential for harm to Child AB”.

It continued: “There were some possibilities that different interventions might have led to a different outcome and the medical assessment of Child AB, when he was admitted to hospital in September 2009, is seen as a key point in this case.”

Responding to the report, Dr Andrew Catto, medical director for Airedale NHS Foundation Trust, expressed condolences to Charlie’s family.

He said the hospital had carried out an internal investigation since Charlie’s death. It has since increased the detail of information it takes when children are admitted, and how it considers the possibility of abuse when assessing symptoms.

Dr Catto said: “When the child came to us in September 2009, our doctors carefully examined him and were not aware of any concerns of abuse and the child was not on an ‘at risk’ register.

“A number of tests were carried out and he was kept overnight for observation and thoroughly assessed again the following day before being discharged with an ongoing care plan.

“We take the findings and recommendations of the report very seriously and as one of several agencies involved in the child’s care, we have implemented an action plan based on those recommendations and we will be reviewing these actions regularly to ensure that we have put them into practice.”

In a joint statement, the independent chairmen of Safeguarding Children Boards in Bradford and Lancashire, Nick Frost and Nigel Burke, said they and all the agencies involved with this family welcome the review panel’s recommendations and had developed “comprehensive action plans”.

NHS Bradford and Airedale’s director of nursing, Jo Coombs, said: “Using the lessons we have learned from this case, we are working closely with partners including Airedale NHS Foundation Trust and Yorkshire Ambulance Service to ensure we have robust evidence that standards are being met at all levels within organisations.”

A spokesman for West Yorkshire Police said the force had implemented changes and a Yorkshire Ambulance Service spokesman said it had also acted upon lessons learned.