Georgia Ray Tilmouth was born with her umbilical cord wrapped around her neck on August 22, 2006. She died at RDH 13 hours later from perinatal asphyxia.
In the NT Coroner's Court in Darwin on Friday, an inquest was told the baby may still be alive if medical staff had "picked up and acted upon" abnormalities in foetal monitoring during labour.
A lack of supervision and senior staff may also have played a part in the tragedy.
NT Coroner Greg Cavanagh, who will consider his findings over the next few weeks, on Friday commended the hospital for taking action following the death.
But, he said, it had come at the cost of a child's life.
"The systems that were in place in 2006 are not the systems that operate today ... and give some confidence to the general public."
Cavanagh also warned medical staff that not reporting an unexpected death to the coroner was illegal.
It took seven months for Georgia Ray's death to be reported, despite repeated requests to hospital staff by her mother, Juliana De Castro Matos.
She eventually took her concerns to the Health Department which prompted the investigation.
"It's a fairly blunt message that has to get out," Cavanagh said.
"Reporting a death is not optional, it's mandatory and it's a criminal offence not to do so.
"Is there anything confusing about that I ask myself and I don't think so."
RDH has been the subject of four damning coronial inquests during 2008, with yet another case to be heard before the end of the year.
RDH lawyer Kelvin Currie told Friday's inquest that hospitals were "a massive undertaking" and mistakes would always be made.
"Every now and again, even though over many years there have been various systems put in place, one does slip through," he said, adding that every unfortunate case became a learning tool.
"That doesn't mean that nobody at RDH will ever have problems ... but it does mean that a person in this same situation will be likely to have a different outcome."
