Family seeks accountability after GP misdiagnosis ends in tragedy

An inquest found a missed opportunity to send a seriously ill man to emergency care after a GP misdiagnosed him, raising questions about primary care escalation.

Family seeks accountability after GP misdiagnosis ends in tragedy

Michael Reynolds, 29, from Boston in Lincolnshire, visited his GP with a sore and swollen throat and a persistent cough. He was told to rest, given a steroid nasal spray, and referred for a chest x-ray, but his condition worsened the next day. He reported that he could not swallow, had a high fever, and feared his throat was closing. He was offered an urgent in‑person appointment, yet he was again diagnosed with tonsillitis and given antibiotics.

An inquest at Lincolnshire Coroner's Court concluded there was a missed opportunity to send Michael to A&E for urgent treatment. Post mortem findings linked his death to a hypoxic cardiac arrest caused by upper airway obstruction from epiglottitis. His wife, Charlotte Reynolds, spoke of the pain of losing him, while the family has instructed medical negligence solicitors. The coroner noted that staff might have recognized epiglottitis symptoms sooner and that an earlier transfer to resus could have been possible.

This tragedy lays bare the fragile line between routine primary care and life‑threatening airway emergencies. When symptoms are ambiguous, clinicians must balance safe reassessment with timely escalation. A single missed escalation can transform a treatable condition into a fatal outcome, particularly with illnesses like epiglottitis that can worsen quickly.

The case also tests public trust in the healthcare system. The inquest’s finding of a missed opportunity adds pressure on training, triage rules, and access to urgent care. While the focus is local, the questions it raises about patient safety, staffing, and decision making echo across many NHS settings and invite policymakers to review how primary care handles airway emergencies.

Highlights

Care is only as strong as its ability to act in the moment when every second counts.