A LATVIAN woman living in West Cork for 12 years had cancer treatment in her home country because the Irish waiting list was too long – but ended up dying on her return due to surgery complications.
Many foreign nationals are returning to their home countries for treatment for various illnesses and conditions because they have to wait so long to get an appointment with a specialist in Ireland, a leading oncologist said.
Prof Seamus O’Reilly, clinical director of Cancer Services and consultant medical oncologist at Cork University Hospital, said that he finds foreign nationals who are diagnosed with cancer and other conditions often opt to return home for their care and treatment.
‘We would often find that patients return to their home countries when they become unwell because of confidence in the system there and lack of a language barrier. Unfortunately our long waiting lists and concerns expressed about prompt access to do not help instil confidence.’
Prof O’Reilly’s came after the death of Latvian woman, Elena Shcherbakova (48) from Mariners View, Derryminihan West, Castletownbere, who had lived in West Cork for 12 years. When she began to feel unwell in early 2023 she went to see her local GP, Dr Jacqui Glisson.
Ms Shcherbakova’s son, Artjom (16), told he inquest how his mother was diagnosed with ovarian cysts. Dr Glisson told her would take a long time to see a specialist here in Ireland, so she decided to go to Latvia in September.
She went to Riga East University Hospital where she was diagnosed with Stage 2 stomach cancer and she underwent surgery on November 8th 2023. She had a hysterectomy before doctors removed part of her stomach, duodenum, and small bowel to treat the cancer.
Artjom told the inquest that his mother’s surgery went well, though she lost a lot of blood and subsequently lost a lot of weight. She stayed in hospital for about two weeks before she was discharged and she returned to Ireland on December 1st, 2023.
He said that on December 11th 2023, she met with cancer specialist Prof O’Reilly, to discuss a chemotherapy and radiation therapy course to prevent any return of the cancer and she was due to commence the treatment on January 2nd, 2024.
However, Ms Shcherbakova took ill and collapsed at home on December 14th. She was rushed to the Mercy University Hospital in Cork where she underwent a CT scan which showed that she had an infection in a blood vessel supplying blood to her gut.
Vascular surgeon at the Mercy Gavin O’Brien said the surgery that Ms Shcherbakova had undergone in Riga to have part of her stomach, duodenum and small bowel removed was high risk and the stitch line of the surgery had not healed properly and an infection had developed.
The infection had travelled to her superior mesenteric artery (SMA), which supplies blood to the gut but had become too fragile to allow them to intervene surgically.
Following consultation with colleagues, he decided to treat Ms Shcherbakova with an aggressive course of antibiotics.
The hope was that the antibiotics would allow Ms Shcherbakova’s artery to recover to a point where the tissue would be robust enough to allow doctors to operate and ensure that blood would get to her gut.
Mr O’Brien said that in addition to the SMA, another artery, the celiac artery also supplies blood to the gut, but surgeons in Riga had tied up this artery, which is a normal procedure, so everything depended on repairing the damage to Ms Shcherbakova’s SMA.
He told how he spoke to Ms Shcherbakova with the assistance of an interpreter about her condition and what they were planning to do, but her condition deteriorated suddenly around 8am on December 17th and she passed away later that day.
‘The crux of the issue is that if you operate on the gut, you are releasing bacteria. Infection is always a risk,’ said Mr O’Brien, adding Ms Shcherbakova’s condition was an exceptionally rare and complicated medical situation which was particularly difficult for her family to understand.
‘I am very sorry that there was nothing more I could do to save her life,’ said Mr O’Brien as he extended his sympathies and those of his team at the Mercy University Hospital to Ms Shcherbakova’s husband Alexander Shcherbakov and her son Artjom.
Assistant State pathologist Dr Margot Bolster told how she carried out a post-mortem on December 19th and concluded that Ms Shcherbakova died from haemorrhage due to a rupture of a mesenteric pseudoaneurysm, or where a blood vessel wall is injured.
The issue was complicated due to sepsis at the point where the two structures in her intestine had been joined, following a partial gastrectomy for cancer of the stomach associated with a swelling of the gall bladder, said Dr Bolster.
Coroner Philip Comyn said that it was clear that Ms Shcherbakova had a complex medical condition and the infection to her SMA was such that the tissue would not sustain a surgical intervention and doctors treated her as best they could.
Mr Comyn returned a narrative verdict of death due to a known complication of a medical procedure, on a background of a complex medical history, before extending his sympathies to her husband and her son, Artjom.
Sgt Fergus Twomey also extended his sympathies and those of gardaí to Ms Shcherbakova’s family and he paid tribute to Artjom for the dignified manner in which he had given his evidence in difficult circumstances, providing a voice for his mother at the inquest.
