A GP missed a "unique opportunity" to save Baby P's life eight days before his death, the General Medical Council heard.
Dr Jerome Ikwueke observed that the little boy was withdrawn and had changed from his usual happy self when he saw him at his north London surgery on July 26 2007.
But the doctor failed to carry out an adequate examination or make an urgent referral for further checks despite knowing that the toddler - now named as Peter Connelly - was on the at-risk register, a GMC Fitness to Practise Panel heard.
If he had done so, it is likely Peter would have been removed from his family and escaped the final abuse that caused his death on August 3 2007 aged just 17 months, the hearing in London was told.
Jeremy Donne QC, counsel for the GMC, said: "The GMC allege many failings against Dr Ikwueke relating to his care of Baby Peter but by far the most serious is his failure to fully and properly examine him on July 26.
"If he had, we say he would almost certainly have made an immediate referral to hospital and it is likely that Baby Peter would have been removed from his family to a place of safety.
"In short, Dr Ikwueke had a unique opportunity to prevent the appalling abuse that was to occur in the following days, culminating in that unfortunate child's death."
Peter had head lice, a bleeding ear and healing scabs on his scalp when his mother, Tracey Connelly, took him to see the GP that day: a post-mortem examination found Peter would have been in great pain at this time, having already suffered eight broken ribs and serious injuries to his toes and fingers.
Dr Ikwueke should also have taken into account Peter being admitted to hospital on June 1 with suspected non-accidental injuries, the GMC heard.
Dr Ikwueke, who denies misconduct, is the second doctor to face GMC allegations over Peter's care.
