A Queensland nurse knew her sick nephew needed medical help but she didn't get it for fear of exposing the signs on his body of years of her abuse.
Jodie Maree Powell didn't call paramedics when Curtis died struggling to swallow a bite of a sandwich and she couldn't revive him.
Powell, 46, has now been sentenced to nine years in jail over her failure to provide care for Curtis Powell, 10, before he died of bronchopneumonia on July 15, 2015.
Curtis had been living with his aunt since he was three because his mother had drug issues.
Powell made what she accepts were violent, irrational and unjustified attempts to discipline her foster son.
They included banging his head against a wall, throwing a knife at his leg and striking Curtis with a carving fork, power cord and belt.
More than 200 injuries were found on Curtis' body during the autopsy.
Some of the injuries were due to his' issues with spatial awareness, which meant he often fell over. He also had difficulty eating.
Brisbane Supreme Court Justice Martin Burns said on Wednesday that Powell was a nurse who would have known the child was unwell days before his death.
But she did not seek medical help for Curtis because it would have given away the injuries he sustained from her attempts to discipline him.
Curtis had died after he struggled to swallow a bite of a sandwich.
Powell tried to remove the food but Curtis lost consciousness in the process and she could not revive him.
Powell sent unusual Facebook messages to family members - who called paramedics.
When the paramedics arrived and started to perform CPR on Curtis they realised rigor mortis had already set in.
Justice Burns said Powell's culpability should be distinguished from crimes of violence but her failure to seek medical treatment was "gross and irresponsible".
He said her crime was an act of omission.
Powell had pleaded guilty to manslaughter and assault occasioning bodily harm at a court hearing earlier this year.
She was sentenced to nine years' imprisonment with a parole eligibility date of June 14, 2020.
Outside court, Curtis' mother Kristie Anne Powell said she missed her son.
"I'm in shock still, that was my sister, that was someone I grew up with my whole younger life," Ms Powell said.
"To believe someone could hurt a child so much, especially a family member, is unforgivable in so many ways."
"I am happy with the outcome and I hope it will deter such a thing from happening again."
Australian Associated Press