Kind of difficult to tell actually, but the upper left corner, and the EMS guy in the vest look blurred, while the BP cuff and the fellow on the right look adequately sharp. Perhaps it is just that the EMS fellow and the firefighter behind him are simply not within the DOF band? The lens compression makes the EMS guy and the patient appear close to one another in terms of distance, but the long focal length is compressing the scene, and it's clear that the EMS guy in the vest is the closest subject. FOCUS appears to be on the blood pressure cuff, and that looks sharp, while the EMS guy's right arm is clearly out of focus.
Also--this is a significantly down-sized image; I think the down-rezzing and the sharpening applied might not be quite optimal for this image.
There are other possibilities besides a shallow DOF band: decentered lens element, or perhaps a problem with VC being enabled at that fast a shutter speed, or perhaps even a lens mount alignment issue. Let's hope this is just a DOF issue!
Having VR or IS or VC engaged at speeds in the 1/500 and faster range CAN cause softening issues! I know this from very regrettable personal experiences from the early 2000's era.