By Charles Huddleston and Megan Kreitner Ouzts
Over the last several years, we have seen several stories in the news where coaches and athletic directors find themselves at the centers of lawsuits after injuries and deaths occur on the athletic field. While most have resulted from tough practices that turned dangerous due to extraneous conditions like heat and dehydration, there are simple steps that coaches and athletic departments can consider to increase safety and minimize liability should an incident occur.
This trend reached new and dangerous heights recently when the Louisville district attorney filed a felony charge against a high school football coach for “reckless homicide” after a 15-year-old football player died following a session of “gassers” in the August heat. That event was followed by news of a recent settlement reached by the NCAA and Rice University with the parents of an athlete who died after practice. The student had not been tested for the sickle cell trait, which ultimately led to his death, and questions arose about the school’s liability when it comes to pre-participation physical exams.
It is a truism of all competitive sports: No player reaches his or her full potential without a great coach – a coach who can convince and motivate athletes to keep pushing themselves, even after the athletes are convinced that there is no more energy left in their tank. However, how do coaches know when they are pushing their players too hard? When does pushing players past the point of exhaustion cease to be the mark of a dedicated and tough coach and, instead, become a risky undertaking for coach and athlete alike; the potential cause of something unintended and horrific – like the death of a young athlete during, or as a result of, a “tough” practice?
Mandatory testing for sickle cell trait
The family of Aaron O’Neal was awarded $2 million dollars to settle a lawsuit filed on O’Neal’s behalf after he died following a preseason workout at the University of Missouri. The suit alleged that several of the school’s employees, including the coach, failed to take proper medical precautions required by O’Neal’s sickle cell condition. Sickle cell has been linked to heatstroke and exercise-induced collapse. The most frequent cause of death in those instances was rhabdomyolysis, which is a release of muscle fibers into the bloodstream, often brought on by heatstroke.
On June 28, the NCAA also announced that it and Rice University had settled a civil lawsuit with the family of freshman football player Dale Lloyd, II, who died after conditioning workouts in 2006. Lloyd’s death was also related to the sickle cell trait, but Rice did not test its athletes for the sickle cell trait that year. (After his death, the school began such testing for all of its athletes.) As a part of the settlement, the NCAA agreed to recommend such testing for all athletes in the future, and Rice agreed to propose NCAA legislation making such testing mandatory.
These two cases underscore the importance of requiring pre-participation physicals that include a test for sickle cell and of making sure that the coaching staff and trainers are fully aware of any health-related issues revealed in the athletes’ physical exams.
Louisville football coach acquitted on felony reckless homicide, but still facing civil suit
In a highly publicized incident, a high school coach was charged with a felony and the parents of Max Gilpin filed a civil lawsuit against their deceased son’s coach for Gilpin’s heat-related death. The lawsuit alleges that Gilpin collapsed after completing a sprint workout in August for two to three hours in 94 degree heat, and that the coach refused to let the players drink water and had admonished the team that they would keep running the “gassers” until somebody quit. When he was taken to the hospital, the sophomore’s internal body temperature was 107 degrees, and he died three days later of complications from heatstroke. Another teammate also collapsed and was released from the hospital two days later.
Although the civil lawsuit is still pending, the coach was acquitted on the felony reckless homicide charge September 17. If he had been convicted, he faced up to five years in prison. However, in returning the not guilty verdict, the jury relied heavily on testimony that Gilpin was taking creatine and Adderall for his Attention-Deficit Hyperactivity Disorder, which defense experts alleged, contributed to his death. The defense also presented evidence from teammates, who testified that they had run only a few more sprints than they normally did on the day of Gilpin’s death, and that Gilpin had been complaining of not feeling well all day long prior to practice.
This is the first case where a coach has been criminally charged as a result of a player’s death, and it underscores the importance of making water available to athletes at all times and being aware of players’ health and whether they are taking performance-enhancing supplements.
Medical histories are important
Although it may seem from the above cases that only football coaches need to worry about lawsuits related to players’ deaths, such is not the case. A case eerily similar to Gilpin’s has been filed by the parents of a deceased 13-year-old basketball player, who died during practice in late 2008. The parents have sued the boy’s two basketball coaches, alleging that they “acted with reckless disregard” for the safety of their 13-year-old son. These charges come despite the fact that an autopsy ruled the cause of death as sudden cardiac death, which occurred while the boy was engaged in a simple three-on-two drill. Notably, heat was not a factor in the death, yet it is unclear whether the boy’s medical history may have played a factor in his death. This case underscores, again, the importance of requiring pre-participation physicals and knowing an athlete’s medical history.
Guidelines
In addition to ensuring that pre-participation physicals include a test for sickle cell, and that all coaching staff are aware of players’ medical conditions (and how to deal with them), coaches can also reduce their risk of liability by doing the following:
• Develop an emergency action plan that is shared with staff, athletes and parents. If everyone understands his or her role in an emergency, the chances of permanent disability or death may be reduced.
• Never refuse athletes water. Two to three water breaks per hour are needed during vigorous exercise, particularly when the weather is hot or athletes are in a warm environment, even a non-airconditioned gym.
• Lobby for and install automated external defibrillators (AEDs), and become certified in their usage. Early defibrillation can and has saved the lives of athletes – and spectators and coaches – who suffer from sudden cardiac arrest, and some states are even passing laws to make access to these tools mandatory.
• Become certified in CPR.
• Have a Certified Athletic Trainer on staff who attends all practices and games. If possible, try to get a team physician to attend all games and contests.
• Require your athletes to have pre-participation physicals and periodic physicals thereafter, including sickle cell testing. A coach should know if an athlete has a history of heat-related illness because this player will be more susceptible to heat stroke. It is also important to understand that overweight players are at higher risk for heat-related injuries.
• Emphasize proper, gradual and complete physical conditioning to avoid injuries, especially when athletes are recovering from an injury or returning from time off.
• Know the signs of potential heatstroke: Rapid pulse, muscle cramps, dizziness, high temperature (above 103), confusion and nausea.
• If heatstroke is suspected, immediately cool the body while waiting for emergency services to arrive. Remove the player’s clothing and immerse their body in cold or ice water. On very hot days, a plastic baby pool can and should be made available in the case of an emergency. If a method of immersion is not available, place icepacks on the neck, groin and armpits of the player until emergency services arrive.
• Seek medical attention immediately if a player vomits during a hot practice or game.
• Provide shaded rest areas with circulating air for any long outdoor sessions, and provide a fan in any non-air-conditioned buildings that get warm.
• Foster an environment where players are not afraid to complain about feeling ill during practices or games. Certain athletes will not complain about heat-related injuries because they fear letting down their team or coach. A coach should explain to players that even though he or she may be pushing them to work harder, any and all complaints of dehydration or heat exhaustion should always be voiced. Remind athletes that the body’s thirst mechanism is not a good gauge for when they should hydrate during workouts, as it usually lags 30 minutes behind the body’s need for hydration.
• Consider weighing athletes before and after heat-intensive workouts. Weight loss of more than two or three percent could be dangerous and will indicate that the player may not be drinking enough water.
• Be cautious and get a physician involved when an athlete suffers a blow to the head. Concussions often go undiagnosed, because coaches simply reply on an athlete’s assurances that he or she is “all right.” Trained medical personnel should evaluate for a concussion and its severity, and the athlete should be released by a physician before engaging in strenuous activity after a concussion. Coaches and athletes risk serious brain damage, and even death, by not getting a physician’s evaluation of a head injury.
Although it is impossible for a coach to prepare for every possible emergency, following the above suggestions should reduce the risk of death or serious injury. It is imperative that all coaches educate themselves on the risks associated with dehydration and heatstroke. Doing so will help protect their players, and, in turn, also help protect themselves from the heartache and unnecessary legal headache that can result from the unfortunate injury or death of a young athlete.
NOTE: This column is not an attempt to provide either legal or medical advice, but merely represents a summary report of some issues brought out in recent court cases.
Charles Huddleston and Megan Kreitner Ouzts are attorneys in the Atlanta office of Baker, Donelson, Bearman, Caldwell & Berkowitz, PC. Mr. Huddleston, a shareholder, can be reached at chuddleston@bakerdonelson.com or (404) 221-6536. Ms. Ouzts, an associate, can be reached at mouzts@bakerdonelson.com or (678) 406-8736.
