Coroner sounds alarm on impact of radiologist shortage after teen's death
A coroner in England is questioning how the availability of radiologists in the region could be impacting patient outcomes.
David Heming, senior coroner for the Cambridgeshire and Peterborough area, recently published a report that was inspired by his assessment of the events surrounding the untimely death of a 17-year-old amateur boxer—Christian Hobbs—in 2017. In the report, Heming highlights several factors that led to the young man’s death, including a potential misread of imaging and a failure to communicate findings to the individual’s care team during his hospitalization.
Hobbs passed away unexpectedly due to an undiagnosed heart condition, resulting in cardiac arrest. The athlete presented to Peterborough City Hospital in a "tenuous" state of consciousness, with a weak pulse, chest pain, nausea and obvious pallor after previously being asymptomatic.
As part of his workup, Hobbs received two chest X-rays—one shortly after his arrival and one after his condition began to deteriorate a couple hours later. However, according to Heming’s report, the exam’s findings were not documented when the images were acquired. The ICU consultant who reviewed the imaging at the time later reported that he observed soft ground glass opacification, mild upper lobe diversion and some fluid in the horizontal fissure—all subtle, though not specific, signs that could be linked to heart failure.
In a retrospective review of the images, a forensic radiologist noted mild pleural fluid in the horizontal fissure and the “clear” presence of cardiomegaly. Combined with some of the other details of the case, these findings led Heming to suggest that an echocardiogram also could have helped answer some of the questions pertaining to Hobbs’ heart function.
Heming described the move to forego echocardiography as “concerning.” What’s more, he communicated worries with patterns he and other coroners had observed numerous times related to issues with communication among radiologists and referrers within the trust.
“In the case of Christian, nothing is recorded in the notes on assessment of the X-Rays undertaken. There have also been a number of instances in our coroner investigations where there is an issue surrounding radiology,” Heming wrote.
Staffing has been a growing problem in the UK. The United Kingdom's National Health Service is grappling with a significant radiologist shortage, with some reports indicating that they need a 30% increase in consultants to meet demand. These issues could hinder the utilization of imaging, as there are not currently enough readers to keep up with the studies being completed.
“I have a concern over whether there are sufficient numbers of radiologists to cover the ever-increasing expansion of imaging as a key diagnostic tool,” Heming said.
The North West Anglia Foundation Trust (NWAFT) and the Cambridgeshire and Peterborough Integrated Care Board (CPICB) have both indicated they will review and respond to the report and suggestions Heming made in it.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.