Two child placement agencies have agreed to pay a combined $5 million to settle a wrongful death lawsuit over the death of a 10-year-old boy whose caregivers failed to get him medical attention for an intestinal blockage.

The settlement was reached between defendants NorthEast Treatment Centers and NET Treatment Centers and the estate of Ethan Okula, who died in February 2016, a death that his lawyer claims was “entirely preventable.”

According to the plaintiffs' court papers, Okula complained of severe stomach pain and began vomiting shortly after arriving at school. The school nurse called his foster mother to pick him up at 9:30 in the morning. The foster mother who had been housing Okula for six months, Denise Alston, sent her friend to the school at 1 p.m. The friend took Okula home, where he laid on the couch.

By the time Alston found Okula unresponsive and called 911 at 6 p.m. that evening, the child had died of a bowel obstruction, according to a Department of Human Services fatality report.

Criminal charges were subsequently filed against Alston and her wife, Carol Fletcher. The couple is currently out on bail. Their attorney, Edward Meehan, did not return a call seeking comment.

“It hurts my heart to think about how Ethan spent his last few hours in pain before he died alone,” said Okula's lawyer, Nadeem Bezar of Kline & Specter. “I pray that the tragedy of Ethan's death continues to inspire those who work in child welfare to continue to protect this vulnerable population.”

In court papers, Bezar argued that the child placement agencies were on notice about Okula's pre-existng health conditions and special needs stemming from his premature birth and should have more carefully chosen his foster home.

“But for the acts and/or admissions of defendants NorthEast Treatment Centers and/or NET Treatment Services, Ethan Okula would not have died at 10 years old after defendants placed Ethan, a special needs child, in the foster home of an untrained, unlicensed individual, in reckless disregard for Ethan's safety and well-being,” the plaintiffs' court papers said.

The defendants' lawyer, Francis Deasey of Deasey, Mahoney & Valentini, did not return a call seeking comment.

In the defendants' objections to the Okula estate's lawsuit, the treatment centers argued that there was no link between their placement of Okula in the Alston home and his subsequent death.

The agencies argued that the plaintiffs failed to show how there was any liability on NorthEast or NET's part.

“The symptoms exhibited by the decedent on the date of his death, starting at his school, i.e. vomiting, defecating, weakness requiring a wheelchair, were observed by school personnel,” court papers said. “There is no allegation that the foster parent's friend or the foster parent were aware of these symptoms.”

“However,” the defendants continued, “even if they were, that still does not sufficiently causally link their actions to the allegations” against the agencies.

Okula came from a broken home, Bezar said: “Ethan was horribly physically abused by his father, had a struggling mother … then he goes into foster care. He's initially placed in a series of foster homes where they're not equipped to handle him.”

Bezar said Okula's negligent treatment began in 2015, when doctor's appointments were missed and no follow-up visits were sought. He also said that the agencies failed to regularly check up on the child.

“There's some effort made, but it's inadequate,” Bezar said.