The mother of a six-year-old boy, who died while he was in respite care for a weekend, has said she hopes his death means other families will not have to suffer.
St John of God Community Services apologised to Angela and Andrew Neiland for the death of their son Tristan in January 2013.
The boy, who was one month away from his seventh birthday, had a number of medical conditions, but was happy and in good health at the time of his death.
The court heard equipment which should have been used to monitor his oxygen levels at night was not used and he was not checked for up to an hour-and-a-half before his body was found.
Tristan, from Cabinteely in Co Dublin, had a number of medical conditions, including autism, asthma and epilepsy.
His epilepsy meant he had to have an oxygen monitor attached at night.
He attended the Carmona Special National School run by the St John of God Community Services in Dún Laoghaire, Co Dublin.
In October 2012, he had begun attending the Carmona Respite Service for overnight stays and had stayed overnight on three or four occasions.
In January 2013, he was to attend the respite service for two nights.
He was described as being happy, laughing, running and in good health before he went in.
His mother provided the medical staff with a detailed care plan which outlined that Tristan was to have an oxygen saturation monitor attached to his big toe as if he suffered a serious epileptic seizure he would require oxygen very quickly.
The court heard that on the night of his death, the monitor was not used.
He was also to be checked every 15 minutes but an internal inquiry by St John Of God showed he had not been checked for an hour and possibly up to 88 minutes before his body was discovered.
Senior Counsel Bruce Antoniotti for the family said there were certain disturbing aspects in relation to the case.
These included the falsification of the care plan, and the falsification of the time of death.
The family also said the defendants initially alleged that Mrs Neiland had told them it was acceptable not to use the oxygen monitor.
She said this had greatly added to her distress.
In an apology read to the court, St John of God Community Services said it apologised for shortcomings in the care of Tristan at the time of his death.
It acknowledged the great stress and anguish caused to his family. It said the organisation also acknowledged Tristan's mother did nothing to cause or contribute to his death.
In a statement read to the court, Mrs Neiland said their son was a very happy boy who loved life.
She said they had had a long four-and-a-half-year battle since he died in the care of St John Of God services.
She said he entered the service as a happy six-year-old boy on a Friday afternoon and returned to their home in a white coffin on the Monday.
Mrs Neiland said that after several long and tedious investigations, the terms neglect and abuse had been used to describe the care he received.
She said his death broke their hearts and the family were speaking so that families who seek respite were aware and vigilant of the care and lack of care provided by institutions.
An external investigation termed the case as being the worst case of the downfall and lack of governance within an institution that it had seen.
Mrs Neiland said Tristan died unnoticed, alone and had only an estimation as to his time of death.
He died with equipment and medication that was part of his medical protocol only feet away.
Attempts by staff to conceal the facts of what happened on the night and subsequently to deflect blame to the family was reprehensible as borne out by the independent investigation commissioned by St John of God, Mrs Neiland told the court.
She said she hoped Tristan's death had made St John of God Community Services a safer place.
They lived their lives without their precious Tristan but hoped and prayed no other family would suffer like they had.
She said Tristan would live through them as they loved and missed him all the days of their lives.
In a statement, St John of God Community Services said they apologised to Tristan's parents, sisters and brother for the shortcomings in the care provided to Tristan at the time of his death.
They also acknowledged that this was a cause of great anguish and stress for his family.
They said Tristan was remembered with great fondness by all who knew him and supported him in their service. and said their thoughts and prayers were with Tristan's family through these very difficult times.
In the earlier apology read to the court, they also added that they acknowledged that Tristan's mother did not cause or contribute to her son's death.
This was after staff had initially alleged, wrongly, that Mrs Neiland had said it was acceptable not to use the oxygen monitor.