An eight-year-old girl died after she was hit by a boy running at speed in a playground game and then fell onto a recycled railway sleeper, an inquest has heard.
Freya James was playing a game called Jails when one boy chasing another in the game Bulldog ran into her, a jury at West London Coroner's Court was told.
She then fell onto one of the wooden sleepers that were in the playground at Trafalgar Junior School in Twickenham, south west London.
A teaching assistant noticed her sitting on the floor surrounded by other girls. "She approached her and she said she had hurt her tummy."
Freya walked to a room used for first aid, and an ambulance was called. The first paramedic arrived at 1.30pm, and an ambulance 10 minutes later.
Oxygen was given, and observations made, and she left in the ambulance at 1.50pm, arriving at 2pm at West Middlesex University Hospital.
Despite efforts by hospital staff she died just before 4pm.