Mystery still surrounds the death of a mum who died after waiting three hours to speak to a GP.
Helena Maffei was “fit and healthy”, an inquest heard, but was declared dead at home after suffering a seizure.
The 55-year-old had collapsed at 2am on September 23 last year but didn't let her family ring an ambulance, instead telling them that she would contact her GP in the morning.
At 8.30am she called Kidderminster's Church Street Surgery and waited for 30 minutes until her phone ran out of battery.
She called back and was in a queue for a further 59 minutes before she was informed that a doctor would ring her back within an hour and a half.
When her GP, Dr Khatim Niwa, called back just over 90 minutes later, Mrs Maffei's condition had deteriorated and she was having a seizure in front of her son Giuseppe, who called 999.
Birmingham Live reports that Mrs Maffei, who ran a bakery with her husband Tony, had been prescribed the antidepressant drug Sertraline for panic attacks by Dr Niwa two weeks before the tragedy.
The inquest heard how her health deteriorated after starting the medication on September 9 and she stopped taking them days before her death.
Tony Maffei said: “Helena was never ill, not even a cold. She was fit and healthy, walking every day and working 8am to 8pm in the bakery.
“She didn’t smoke or drink, wasn’t overweight and her diet was very good.
“After two weeks of taking these tablets she became very weak and fragile and had no strength. The side effects of the tablets were all symptoms Helena had during the last days of her life.”
Mrs Maffei suffered gradually increased weakness, heart palpitations, shortness of breath, confusion, sweating, shivering, vomiting and diarrhoea over a period of two weeks, the court heard.
A post-mortem including specialist tests on the brain and heart could not ascertain the cause of death.
No evidence was found of a heart attack or epilepsy and pathologist Dr Sarah Littleford ruled there were a couple of possibilities.
Dr Littleford said: “In my opinion, this is a difficult case. Sertraline can be associated with seizures in individuals developing Serotonin Syndrome.”
She said the rare syndrome is a recognised adverse drug reaction that typically develops within the first few hours and days of using a drug that affects Serotonin.
Sertraline is also known to speed up or change the rhythm of the heart and increase the risk of sudden death if a person is predisposed to cardiac problems or has Sudden Adult Death Syndrome, or SADS.
Dr Littleford said: “I cannot exclude the possibility that Sertraline caused Serotonin Syndrome and death in this case. Neither can I exclude that Mrs Maffei had SADS, which the Sertraline may or may not have exacerbated.”
NHS GP Khatim Niwa told the court there was "nothing she would have done differently", adding that she’d had a good relationship with Mrs Maffei since 2010.
The GP said she’d followed NICE guidelines in prescribing 50mg of Sertraline as the mum of two had been feeling overwhelmed and unhappy with anxiety.
Church Street Surgery investigated and ruled the death was not due to a delay in accessing care for its service.
It found that when Mrs Maffei got through to the call handler, they were professional and the GP had called back in around the 90-minute time expected.
The surgery added that Mrs Maffei had not mentioned collapsing during the night when booking a call with a GP that day.
Sarah Murphy, Worcestershire assistant coroner, recorded an open verdict and said she found no failure to provide basic medical attention or with the surgery’s call handling.
“There is nothing to say that if the time was reduced, it would have affected the outcome,” said Ms Murphy. “It’s possible but it may not have done.”
