Schoolgirl died from TB after nine trips to see a GP

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Neglect contributed to the death of a teenage schoolgirl from tuberculosis despite her making nine visits to her GPs’ surgery in the preceding months, a coroner has ruled.

Birmingham Coroner Aidan Cotter said 15-year-old Alina Sarag should have been sent for tests to diagnose active tuberculosis before her death at the city’s Children’s Hospital on January 6 last year.

Recording a verdict at Sutton Coldfield Town Hall that Alina died from natural causes and that neglect contributed to her death, Mr Cotter said: “A diagnosis should have been made and treatment should have been started.

“I am satisfied that the failure to take action did have a direct causal connection to Alina’s death.”

An inquest held last month heard that Alina, of Sparkbrook, Birmingham, made nine visits to her GPs’ surgery, three visits to a community health centre, and attended three different hospitals on four occasions in the months before her death.

In his summing-up of the inquest, Mr Cotter said: “In my view, it was a gross failure that the GP did not refer Alina either to the Birmingham Chest Clinic or to another hospital so that tests could be carried out in order to establish whether she had active tuberculosis.

“At the very latest that referral should have been made on the 8th of December 2010. He should have ensured tests were carried out.”

After the verdict, solicitor Thomas Riis-Bristow confirmed that her parents now intended to take legal action.

Mr Cotter, who described the death as tragic, was told that Alina was treated for latent TB in 2009 after an outbreak at her school.

The teenager appeared to recover from the condition and was discharged from a chest clinic in October 2009 after telling medics she felt fine.

But the normally “outgoing and bubbly” schoolgirl became unwell after a holiday to Pakistan in the summer of 2010 and was seen by two different GPs in the following months.

She also visited four different hospitals between August and October of 2010 as she lost weight and suffered from repeated vomiting.

Although Mr Cotter cleared Birmingham Chest Clinic, a community health facility in the city, and the hospitals involved in the case of any gross failure in their care of Alina, he said it was more likely than not that Alina would have tested positive for TB by December 8 2010.

The coroner said: “Treatment could and should have been started at that time.”

Mr Cotter said the court had heard no convincing evidence that Alina’s family thought she had active TB prior to her death.

He is to write to medical training organisations to voice concern that some of the doctors did not seem to be fully aware that latent TB can be made active by a subsequent and different illness.

GP Sharad Pandit told the inquest that Alina’s symptoms did not suggest she had TB in late October 2010, around 11 weeks before her death. Dr Pandit, one of two GPs then working at Birmingham’s Highgate Medical Centre, told Mr Cotter he could find nothing clinically to indicate serious illness when he assessed her on October 22.

Another GP at the Highgate surgery, Dr Khalid Iqbal, told the court he believed Alina did not have active TB when he saw her on four dates in September and October 2010.

The inquest heard Dr Iqbal eventually referred Alina to Birmingham Children’s Hospital but did not pass on details of her previous history of latent TB in his referral letter.