Source · Prevention of Future Deaths

Charlie Craig

Ref: 2018-0048 Date: 15 Feb 2018 Coroner: Chris Morris Area: Manchester (South) Responses identified: 1 / 1 View PDF

British Cycling does not conduct health assessments or medical screening for young riders on its World Class Programme, missing opportunities to identify potential cardiac abnormalities.

Date 15 Feb 2018
56-day deadline 3 Aug 2018 est.
Responses identified 1 of 1
Child Death (from 2015) Other related deaths

Coroner's concerns

AI summary
British Cycling does not conduct health assessments or medical screening for young riders on its World Class Programme, missing opportunities to identify potential cardiac abnormalities.
View full coroner's concerns
the any

, It was confirmed during the inquest that British Cycling does not currently undertake any health assessments or medical screening to accepting young riders onto the Apprenticeship stage of the World Class Programme_ The evidence before the court was that this approach differs from that of some other UK sporting bodies running comparable programmes for young athletes, who undertake medical screening as a matter of routine_ A consultant cardiologist gave evidence in the course of the inquest to the effect that medical screening can play an important role in identifying cardiac abnormalities in asymptomatic young people_

Responses

1 respondent
British Cycling Other
10 Apr 2018 PDF
Action Planned

British Cycling will implement new cardiac screening guidelines developed with Liverpool John Moores University for all athletes on the World Class Programme and apprentice level. Apprentice riders will not be allowed to participate until they have completed a health questionnaire, provided a fitness certificate from their GP, and provided evidence of cardiac screening. (AI summary)

View full response
Dear Mr Morrison REGULATION 28: REPORT TO PREVENT Future OEATH: CHARLIE BENJAMIN CRAIG (DECEASED) Thank you for your Report daled 15 February 2018 made under paragraph 7 , schedule 5, of the Coroners and Justice Act 2009 and regulalions 28 and 29 of the Coroners (Investigations) Regulatlons 2013 ("Report" ) which has been made following the inquest louching the dealh of Charlle Cralg which was heard at Slockport Coroner's Court on 13t and 14t February 2018. We have set out below our response to the Report addressing the malters of concem raised in (he Report, namely that British Cycling does not currently undertake health assessments or medlcal screening prior lo accepling young riders onlo the apprentice stage or (he World Class Programme ("WCP") Great Britain Cycling Team ("GBCT") WCP As you are aware Ihe GBCT operales & performance palhway which nurtures promising Ialent ultimately leading lo parlicipation on the WCP . performance palhway is broken dow into an apprentice slage for riders between the ages of 14 and 16, the Junior academy for riders between Ihe ages of 16 and 18, the senior academy for riders between the ages of 18 and 23 and the podium slage for riders aged 21 upwards In the apprentice slage the training Is regionalised and riders are not subject to a full lime training program and in fact only (rain wilh the GBCT for, on average, 15 (o 20 days per year As riders progress through (he various slages the training becomes more extensive ad Is centralised in Manchester GBCT medlcal assessment At presenl; on joining the apprentice slage, rders are required lo complele health questionnalre. As riders progress through the slages and Ihe training becomes more Intense, so does the medical ravlew whlch Includes a full medical screening including cardiac screening In the form of an ECG, followed by a echocardiogram where abnormalitles are detected on the ECG HSBC UK 58' Uk sport Gwg eh The Brluth Cyclint Fadarbbon Vading 48 'Brllhh Crallrt" I $ Oonpurq Itiled 6y Guuranter Mtblcred I Emlend NoJ90lt Kttuered Ollke: Bnuhth Gyctit Faderdoa Saurt Sucrl, Mnchatc? 49I 45q any The

HSBC @UK BritiSh 0 CYCLNG Britlsh Cycling Stuart Street Manchesler M11 40 T;+44 (0} 161 274 2000 F:+44 (0) 161 274 2001 brilishcycling uk Review of medical screening on the GBCT The type of lesting envlsaged as a possibility by Ihe Coroner has in fact been under research since last Seplember when a new Head of Medical Services was appointed and Brillsh Cycling believes that this lesling will meet what is envisaged by the Coroners report. Since his appolntment Ihe new Head of Medical Services has been working with some of Ihe UKs leading sports cardiology experts at Liverpool John Moores Unlversity to produce new GBCT cardiac screening guidelines ( Guldelines") covering all alhletes on the WCP logether with (hose at apprenlice level. The recommendalions for Guidellnes are due lo be submitted for review by Ihe GBCT Senior Leadership Team by 16 April 2018, following whlch lhe Guidelines will be Implemented across Ihe WCP and (hose at apprentice level. The screening of individuals below the age of 16 has previously been a contenlious area across al sports, as due lo the developmenlal changes in the heart which are slilI laking place at Ihis age ECG monitoring can produce false positive ECG findings. However; Ihe lalest prolessional consensus al the UK Cardiology in British Sport Symposlum (23 March 2018) is (hat screening al thls age can be slalistically relevant It Is proposed that under the Guidelines, as a minimum , apprentice riders will nol be allowed to parliclpate In Ihe performance pathway until Ihey have: satisfaclorily compleled a health questionnaire and any areas of concern have been addressed by the GBCT medical team , provided a fitness to participale certificale from thelr General Practitioner; and provlded evldence that cardiac screening has been underlaken In the fomm of an ECG, and where abnormalities are detected on the ECG, evidence has been oblained that a satisfaclory echocardiogram has been compleled: abnormalilies found at Ihe time of screening will trigger referral to sporls cardlologist for further aclion; Including decisions on further participation on Ihe performance palhway. We trust lhat the above addresses Ihe mallers of concern raised in Ihe Report; however, should further information be required please do not hesitale t0 contact us.

Report sections

Investigation and inquest
On 2gih March 2017 , Alison Mutch OBE, Senior Coroner for Manchester South opened an inquest into the death of Charlie Benjamin Craig, who was aged 15 when his death was confirmed at Stepping Hill Hospital, Stockport on 21st January 2017 The investigation concluded at the end of the inquest which heard on 13" and 14th February 2018. The conclusion of inquest was that Master Craig died as a consequence of damage to his heart resulting from a number of myocardial infarctions_ It is likely that these myocardial infarctions occurred as a result of an abnormal physiological response to adrenaline and noradrenaline produced by the body during intense exercise: At the end of the inquest, recorded a narrative conclusion to this effect.
Circumstances of the death
Charlie Craig was an elite cyclist; and a member of the Apprenticeship stage of British Cycling's World Class Programme: Master Craig appeared to be generally in excellent health; and in particular did not at stage report any signs or symptoms which would ordinarily be suggestive of any problems wilh his heart. Master Craig was found unresponsive in his bed on the morning of 21s January 2017 , having last been seen by his family apparently fit and well; the previous evening: A post mortem examination (part of which included examination of Master Craig's heart by a specialist cardiac pathologist) concluded that Charlie Craig died as a result of: 1a) Idiopathic myocardial infarction; II) Gastrointestinal bleeding
Action should be taken
In my opinion action should be taken to prevent future deaths ad believe you have the power to take such action:

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Report details

Reference
2018-0048
Date of report
15 February 2018
Coroner
Chris Morris
Coroner area
Manchester (South)

Responses identified

Responses identified 1 of 1
All listed responses identified

Organisations named in PFD reports are normally expected to respond within 56 days. Deadline: 3 Aug 2018 (estimated).

Sent to

British Cycling

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