'Missed opportunities' before death of teenager

A 17-year-old died in hospital after there were "missed opportunities" and the "urgency" of his situation "was underappreciated", an inquest heard.

Keen amateur boxer Christian Hobbs was taken to Peterborough City Hospital on 26 December 2017 at 17:42 - he was pronounced dead just over six hours later.

A post-mortem examination revealed he had arrhythmogenic cardiomyopathy, which was diagnosed after his death. It resulted in cardiogenic shock and multi organ failure.

A coroner recorded a narrative verdict into his death as a result of an underlying health condition.

North West Anglia NHS Foundation Trust said "cardiomyopathy is a rare and difficult diagnosis to make in a patient of this age".

Christian's parents, Louise and Caspar Hobbs, and his sister Isobel were joined by his grandparents at Huntingdon Coroner's Court.

The family had spent Christmas together and the inquest was told his grandfather James Christie recalled the teenager was "conscious, alert and well" during lunch and while playing a quiz after.

His family said the teenager "didn't eat junk food or smoke" and after he "fell in love with boxing" he had attended the Heart of England Community boxing club in Hinkley, Leicestershire.

But as Christmas Day continued, he began to feel unwell.

Cambridgeshire senior coroner David Heming told the inquest he took ibuprofen and paracetamol and Ms Hobbs asked his grandfather, a retired consultant surgeon in orthopaedic trauma, to take a look at him.

Christian complained of his "heart going fast" and Mr Christie said he looked "morbidly white".

Cambridgeshire Coroner's Court  - a red-brick 18th Century looking building, with a porch in its middle. It is is two-storey and has white-framed windows. There are trees in leaf to its left and right
Senior coroner David Heming said was an underappreciation of the situation" and that there had been "missed opportunities" after Christian was admitted [John M/Geograph]

His parents took him to Peterborough City Hospital on Boxing Day, arriving at 17:42 GMT, complaining of "chest tightness and vomiting". He was initially treated for sepsis.

Just after 20:00, Christian went into cardiac arrest and CPR was started. A call was made to the heart specialist Royal Papworth Hospital in Cambridge to "explore the possibility of "mechanical cardiac support", the inquest was told

At 23:45, with the family agreeing treatment should stop, Christian died.

In a report for the inquest, Dr Andrew Johnstone, a consultant in intensive care medicine at Addenbrooke's Hospital in Cambridge said the "urgency of the situation was underappreciated by the team".

He also said "the fact Christian was sitting up resulted in a false sense of security".

Mr Heming said he was not sure "if earlier intervention would have made much difference to the outcome", but there had been "missed opportunities" in the first two hours after Christian was admitted.

"Christian was a fit and healthy young man who deteriorated rapidly", but the "underlying condition was the cause of death", he said.

Peterborough City Hospital, a multi-storey modern building with large windows. In front of it is a bed of multi-coloured roses
Chief medical officer Callum Gardner said the trust was sorry it had not been able to "make the diagnosis and transfer Christian to a cardiothoracic unit before he deteriorated" [NHS]

Dr Callum Gardner, chief medical officer of the trust which runs the Peterborough hospital, said the teenager was immediately admitted to the resuscitation area on arrival at the hospital.

"Unfortunately, his condition did not improve, and he suffered a cardiac arrest just over two hours later," he said, adding he was intubated and intensive treatment was started.

Dr Gardner said: "Sadly, cardiomyopathy is a rare and difficult diagnosis to make in a patient of this age.

"We are sorry it was not possible to make the diagnosis and transfer Christian to a cardiothoracic unit before he deteriorated.”

He added "the trust and staff who cared for Christian wish to offer their sincere condolences to Christian’s family".

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