A coroner in Surrey has raised concerns about the role of physician associates (PAs) in the NHS in response to the death of a woman with abdominal pain who was wrongly diagnosed as having a nosebleed.
Coroner Karen Henderson published a report1 asking agencies including the General Medical Council and NHS England to take action to prevent future deaths, warning that patient safety is at risk unless greater clarity is provided about PAs’ role and scope of practice.
Pamela Marking, who was 77, died in February 2024 because of complications of a strangulated femoral hernia. Four days before her death she experienced abdominal pain and vomited bloodstained fluid, and presented to the emergency department at East Surrey Hospital. She was reviewed by a PA who diagnosed her with epistaxis (nosebleed) and discharged her without a review by a doctor.
Marking re-presented to the hospital two days later and was found to have grossly dilated small bowel obstruction. She …
