Overview

• Jake Lawler, 15, died in November 2024 from a rare genetic heart condition, biventricular arrhythmogenic cardiomyopathy, misdiagnosed as exercise-induced asthma.
• A coroner’s inquest revealed that an abnormal ECG and a prior collapse during football were not recognized as red flags by clinicians.
• Coroner Alison Mutch ruled that proper referral and testing after his initial collapse could likely have prevented Jake’s death.
• The Prevention of Future Deaths report criticizes diagnostic gaps, insufficient clinician training, and a lack of national guidance for exercise-induced syncope in children.
• Healthcare organizations, including Manchester University NHS Foundation Trust, must respond to the coroner’s report by July 4, 2025, with action plans due by May 30.