Coroner Records Neglect By GPs Contributed To Tragic TB Death Of Schoolgirl

Lawyer Describes Treatment As ‘An Appalling Example Of Systemic Failings’

15.06.2012

The devastated family of a 15-year-old school girl who died after doctors repeatedly failed to diagnose that she was suffering from tuberculosis today spoke of their heartache after an inquest heard that a catalogue of failings by numerous doctors meant her condition was missed.

Tragic Alina Sarag was seen by her two GPs and paediatric doctors at FOUR separate hospitals over a five-month period but all repeatedly failed to diagnose the Birmingham youngster as suffering with the disease, even though she had been treated for it a year earlier, and at one stage even claimed she had an eating disorder or was “lovesick for a boy” and needed psychiatric help.

Alina’s heartbroken family said her case showed the need for TB vaccinations to schoolchildren to be reintroduced, after they were stopped in 2005 as medical experts said they were pointless and cost ineffective.

Following today’s verdict by Birmingham Coroner Aidan Cotter, of natural causes, contributed to by neglect, by the GP’s responsible for Alina’s care, a medical law expert at Irwin Mitchell representing the family described her treatment as ‘an appalling example of systemic failings in patient health care’.
 
The firm has now called for the authorities involved to prove to the local community that improvements in TB management have been implemented and said it will be referring one of the doctors involved to the General Medical Council.

Tom Riis-Bristow,  a medical law specialist at Irwin Mitchell’s Birmingham office, said: “Today’s inquest conclusion has confirmed the worst fears of Alina’s family - that she was failed in some way by virtually every clinician she saw over the five-month period leading up to her death.

“Repeated opportunities to intervene were missed. Until she arrived at Birmingham Children’s Hospital on the morning of her death, not one single doctor had tested her for TB despite her medical history.

“This is an appalling example of systemic failings in patient healthcare and it is a real concern that Alina visited nearly every available hospital within the Birmingham area and they all failed to consider TB”.

Riis- Bristow added: “Alina’s unexpected death immediately prompted the Director of Health for Birmingham to order a full scale review by the local Primary Care Trust to ascertain the likely reasons for these failings and to try to learn lessons from her death. 

“Although nothing can turn back the clock for Alina’s family, we are now urging every authority, including the various hospital Trusts who had a duty of care to Alina, to reassure both them and the local community that improvements in TB management have been made.”

On her final admission to hospital, Alina’s weight had plummeted to under eight stones (50kgs), she was unable to walk, was suffering from bed sores and had become incontinent. Despite a desperate battle to save her, tragic Alina died just 20 hours later.

The pathologist who carried out Alina’s post-mortem told the coroner during the six-day inquest that Alina’s lungs “were the worst we have ever seen”.
Alina had first been diagnosed with latent (non-active) tuberculosis following an outbreak at her school in April 2009 but, after receiving treatment, doctors at the Birmingham Chest Clinic assumed she had recovered from the disease and discharged her without arranging a follow up appointment to check whether her TB had been cured – despite noting that Alina may have not taken a full course of medication.

But in August 2010, following a holiday to Pakistan, Alina fell ill again and over five months she was seen on numerous occasions by her two GPs, Dr Pandit and Dr Iqbal, and various doctors at Heartlands Hospital, Birmingham Children’s Hospital, City Hospital and Sandwell Hospital.

After repeated desperate pleas for help from her family both her GP and a paediatrician at Birmingham Children’s Hospital told the youngster that she might be suffering from an eating disorder and she required a psychiatric assessment, or that she might be ‘lovesick for a boy‘.

It was not until 6 January 2011, when she was rushed by ambulance to Birmingham Children’s Hospital after becoming seriously ill, that a diagnosis of TB was made but it was too late - despite receiving a quadruple dose of TB antibiotics and emergency treatment in intensive care, she died the same day.

Giving evidence, Alina’s father Sultan Sarag, said: “It was soul destroying for Alina as she knew she was not making herself unwell and it led to her losing all faith in the medical profession. She lost all hope of ever getting better.”
And speaking after the coroner’s ruling, he paid tribute to his daughter, saying: “Alina was such a fun-loving girl and I miss her so much. I still wait for her to come through the door after school.

“She had just started thinking about her future and we were going to discuss what she was going to do after she got her qualifications.

“I don’t know how I will ever trust medical professionals again after the heartache they have put me and my family through. Alina deserved far better. We went back time and again pleading with the doctors to help her but each one of them let her down.

“My beautiful, precious daughter was taken from us so needlessly. If only her illness had been diagnosed earlier she could have received the correct treatment and I firmly believe she would still be alive today.

“I feel very strongly that routine TB vaccinations should be reintroduced in this country and all doctors should be properly trained to spot the symptoms of this terrible disease so that hopefully no other family has to go through the hell that we have suffered.

“It is so painful to know that Alina’s life has been wasted and that she could have been cured of the disease and be with us today.”

Tom Riis Bristow continued: “During the hearing the Sarag family were shocked to hear during Dr Pandit’s evidence that, following an audit trail of the surgery’s computer records, the GP admitted to adding to Alina’s computer medical records for attendances in August 2010 and November 2010 just days after her death in January 2011, without making it clear that his comments were added after the event.

“Following the conclusion of today’s inquest, I can confirm that we will be pursuing civil action on behalf of the family and we will also be reporting Dr Pandit to the General Medical Council.”