Inquest finds Walthamstow woman was failed by GP after cancer went undiagnosed

A Walthamstow mother who suffered from undiagnosed cancer for at least six months before being referred to a cancer clinic was failed by her GP, a coroner has found.

Hadia Girshab, 61, visited The Firs Medical Clinic in Walthamstow 21 times complaining of persistent coughing with chest pain before dying of a rare asbestos-linked cancer in April this year.

The mother-of-three should have been urgently referred to a cancer clinic in September 2019 when it was clear her symptoms could have been cancer, according to coroner Nadia Persaud.

Mrs Girshab’s cause of death was given as both industrial disease and sarcomatoid mesothelioma, a rare cancer that is closely linked to asbestos exposure.

A statement by Mrs Girshab described being exposed to asbestos dust while working in a factory in Leeds making toys for a company called Storytime in 1979.

At the inquest heard on November 2 at Barking and Dagenham Town Hall, the coroner said: “I’m satisfied, on the evidence I’ve heard, that there was a failure to refer her to the urgent test clinic for urgent cancer referral.

“Whilst on balance it would not have prevented her death, I have heard it would have reduced the level of pain and (improved) her quality of life, and her family’s quality of life, between September 2019 and her final diagnosis in May 2020.

“I believe further training is required, I have heard there used to be a lot of training from secondary care, but in recent years this has not happened.”

Mrs Girshab’s medical notes from her GP surgery, The Firs, showed since January 2019 she had attended numerous times complaining of coughing and pain in her shoulder and chest.

Dr Terry John, partner at the surgery, told the court: “I accept that something more could have been done, looking at my notes it seems that my colleagues would have been reassured by various x-rays that were done.”

Other issues, such as fibromyalgia, were “incorporated” into their diagnoses of the pain she was experiencing, he added.

Dr John said there had been “lessons learned” from Hadia’s case, and agreed to write to his local NHS clinical commissioning group about the death.

The Firs, which serves almost 8,000 patients in the Walthamstow area, was inspected in August this year and rated as “inadequate” by health watchdog, the Care Quality Commission.

After the inquest concluded, daughter Waffa Girshab, 32, said: “Our concern is that she could have had a better quality of life, there would have been more pain management, it would have been before COVID and she would have seen her family that meant so much to her

“They should have referred her much earlier to a lung cancer clinic, there are other cancers that could have a much better outcome.”

Hadia’s husband added: “Why did they do this, was it a lack of training? Negligence? Or they didn’t care?”

A family statement read to the court said Mrs Girshab had moved to Leeds in the 1970s while her husband studied for his PhD.

It added: “Our mother lived life for her family, she did this with an open heart and did anything she could to make our lives easier and joyous.

“This experience not only gave her pain and took away life, it took away from those close to her a positive outlook on life.

“It’s hard not to be angry and trust in god’s plan when you feel your mother should have been protected as a worker from dangers of asbestos, it’s not an understatement to say it has ruined our lives.”

Peter Szlosarek, professor of medical oncology for Barts Health NHS Trust, said a lag time of between six and twelve months before diagnosis of this cancer is “not usual”.

Looking at her GP medical notes, he agreed that after several courses of antibiotics with no improvement there should have been a “concern that something else is going on” in September 2019.

He also agreed that after several months of chest pain, she should have had a more urgent referral.

Prof Szlosarek added: “Unfortunately this is a very aggressive cancer, so most studies show that the median survivability from a diagnosis is four to six months.

“An earlier diagnosis would have resulted in Mrs Girshab being made aware of palliative care earlier in her cancer journey, but it would not have made a difference.”

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Josh Mellor

Local Democracy Reporter