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A mother of three, Sarah Catherine Daniels, tragically passed away from cancer after experiencing a nine-month delay in receiving the results of her pathology tests. This delay prevented her from obtaining potentially life-extending treatment in time, an inquest revealed. Sarah’s husband described her as someone who “never gave up” in her fight against a rare and aggressive form of cancer. She died at her home in Porth, Rhondda Cynon Taf, at the age of 43 in April 2025.
During the inquest held at Pontypridd Coroners’ Court, Coroner Rachel Knight highlighted that the pathology department responsible for analyzing the mass removed from Sarah’s ovary was overwhelmed by demand. This strain was a consequence of the Covid-19 pandemic, which had vastly increased their workload. Knight described the nine-month delay in processing the pathology samples as “unacceptable,” emphasizing that it significantly lowered Sarah’s chances of benefiting from chemotherapy.
Sarah initially sought medical advice at 39 years old in October 2021, presenting with concerning gynaecological symptoms. Her GP promptly referred her for an ultrasound scan on 21 October 2021, which detected a mass on one of her ovaries. Subsequently, she was referred to the gynaecology team within the Cwm Taf Morgannwg University Health Board. Faced with the options of a full hysterectomy or a less invasive surgery, Sarah chose the latter to avoid early menopause and other effects. In February 2022, the mass was surgically removed; although the appearance was not typical of cancer, samples were submitted for pathological assessment.
Martin Ludlam, the cellular pathology and mortuary service manager for the health board, explained in his testimony that pathology services were under exceptional pressure toward the end of 2021 and into 2022. The backlog had grown substantially because many routine appointments had been delayed during the pandemic. With insufficient capacity, the pathology department struggled to manage ongoing demand alongside clearing the backlog. By the end of 2022, they began outsourcing some of the work, a practice that continues today. Ludlam reflected on the case, stating, “This case has highlighted the case that we can never go back to a position where we have a routine backlog again.”
Ben Daniels, Sarah’s husband, shared emotional written evidence describing the trajectory of her care. After finally receiving her diagnosis, Sarah was informed that the cancer was terminal, with a prognosis of roughly 12 months to live. Undeterred, she pursued private treatment at the Christie cancer treatment centre in Manchester, where her appendix was removed. Subsequently, Sarah underwent follow-up therapy at Velindre Cancer Centre in Cardiff, including ten rounds of chemotherapy and scans. Though she was given the all-clear at one point, later scans revealed the cancer had returned. Her ability to undergo chemotherapy regularly was compromised due to fluctuating blood markers, resulting in intermittent treatment. Ben said, “she never gave up” despite her condition worsening progressively by January 2025.
Consultant oncologist Dr. Kein Yim confirmed that by March 2025, Sarah’s health had deteriorated to the point where further chemotherapy was deemed unsuitable. Sarah passed away at home on 15 April 2025, surrounded by family. Consultant Mohamed Khalifa, who leads the gynaecological cancer multidisciplinary team for the health board, emphasized the impact of the delayed pathology results. He stated that the nine-month gap between surgery and histology testing caused a loss of valuable treatment time and described the Risk of Malignancy Index (RMI) as “incorrectly reassuring” to Sarah and her family. Khalifa remarked, “When she died might have been different if the chemotherapy or other treatment had been started sooner.”
Coroner Rachel Knight noted that initial stages of Sarah’s care proceeded in a timely manner. This included the prompt referral by her GP and the scheduling of an MRI scan on 10 November 2021. At that point, there was “low suspicion” of cancer, which she considered a reasonable conclusion by the medical team. The fact that the mass’s appearance did not suggest malignancy led to an “appropriate” decision to send samples to pathology. Despite attempts to address the backlog through early outsourcing measures, the pathology department remained “completely overwhelmed by demand” owing to staffing shortages and volume issues linked to Covid-19. Knight called the nine-month delay “unacceptable” and acknowledged that the health board recognized this failure. She concluded that Sarah had likely been living with stage four cancer since October 2021 and that the delay had adversely affected both her treatment chances and her quality of life.
The coroner officially recorded Sarah’s medical cause of death as “metastatic signet ring adenocarcinoma of the appendix.” While acknowledging that her death was “naturally occurring,” Knight chose a narrative conclusion to fully represent the circumstances surrounding her passing. Expressing sympathy to Ben and the children, she said, “I’m sorry you lost Sarah in the way you did. You have shown great dignity throughout the proceedings… What you went through must have been horrendous.” She also affirmed the deep love and profound loss felt for Sarah
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