NFL Player Dies during Practice - Autopsy Unable to pinpoint

[Lynn Perry]

Autopsy unable to pinpoint cause of death
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Associated Press
Posted: 5 hours ago



DENVER (AP) - As he walked off the field on a relatively cool Colorado evening, Thomas Herrion was huffing and puffing. Still, he didn't look much different from his 49ers teammates who played alongside him during the fast-moving final seconds.

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49ers deal with tragedy
Hear from 49ers head coach Mike Nolan on the tragic passing of offensive lineman Thomas Herrion. Minutes after Saturday night's preseason loss to the Broncos, the 23-year-old collapsed in the team's locker room.


A few minutes later, the San Francisco offensive lineman collapsed near his locker. He was rushed to the hospital, pronounced dead at age 23.
The coroner's office in Denver performed an autopsy Sunday, but said no cause of death could be determined until toxicology tests were performed. The tests usually take about three to six weeks.

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O'CONNOR: A total tragedy

Herrion collapses, dies after game

Niners mourn loss of Herrion

Family, friends remember Herrion



"Our thoughts are with the Herrion family and the 49ers," NFL spokesman Greg Aiello said. "We will be in contact with the 49ers to learn the details of what happened."

The 49ers returned to San Francisco on Sunday still in shock, and coach Mike Nolan was deciding what to do next, with the start of the regular season three weeks away.

"We lost a teammate and a very good friend as well," Nolan said.

The death came a little more than four years after offensive lineman Korey Stringer of the Minnesota Vikings died of heatstroke following a practice in steamy 90-degree weather.

It was in the mid-60s with 50 percent humidity in Denver on Saturday night, and while heatstroke is still possible under such mild conditions, the notion that Herrion, or any football player, is in good enough shape to handle game conditions simply because he's a professional athlete is being questioned all over again.

The first-year guard, a long shot to make the final roster, was listed at 6-foot-3, 310 pounds, about average for an NFL lineman. But when measured on the body-mass index scale, which is a commonly accepted standard of fitness in the medical community, Herrion would be considered "severely obese."

And though obesity can't necessarily be blamed for the death - at least not at this point - one expert says it surely could have been a contributor.

"Obesity is associated with sudden death," said Dr. Joyce Harp, a University of North Carolina endocrinologist who recently did a study calculating the BMIs of all NFL players and found that almost all players qualified as overweight or obese.

"Yes, it could be totally unrelated to his weight, but the fact remains that he was 6-3 and he weighed 310 pounds and probably should have been 210 pounds," Harp said.


Niners offensive lineman Thomas Herrion collapsed and died shortly after playing in San Francisco's preseason game Saturday night against Denver. (Rocky Mountain News, Joe Mahoney / Associated Press)

Harp's study has its critics, including those in the NFL who say it doesn't take into account the fact that BMI doesn't consider the ratio of muscle to fat. Indeed, many musclebound football players who aren't fat would be deemed in the obese range on the BMI scale.

Before starting training camp last month, Herrion passed the broad range of physicals the NFL demands from all its players.

One of his former coaches at Kilgore College in Texas, Travis Fox, said he roomed with Herrion this summer after Herrion moved back to get in shape for 49ers training camp.

Fox said Herrion never struggled during intense drills in 97-degree heat and also said the lineman had no injuries or health problems while playing at Kilgore.

"The young man was in shape," Fox said.

Herrion played his college ball at Utah, and so was accustomed to playing in high altitude such as Denver's, which can intensify dehydration.

He was running down the field with the third- and fourth-team players during a frantic, 14-play, 91-yard drive that ended with 2 seconds left in San Francisco's 26-21 loss. While taxing, it certainly wasn't anything out of the ordinary for a professional football player.

"We didn't see anything happen," 49ers defensive lineman Marques Douglas said after the game. "I sat by my locker and prayed for him."

Stringer's death prompted the NFL to increase efforts to teach players about managing the heat and dehydration. Many teams moved practices out of the hottest hours of the day and began better monitoring of how much liquid players were drinking.

Others have started using devices to measure players' core body temperatures - a good preventive measure, but almost certainly not something that could have saved Herrion on Saturday.

As always, medical staffers were on hand. Paramedics were performing CPR on Herrion within moments of his collapse.

Herrion adds to a very short list of NFL deaths that also includes St. Louis Cardinals tight end J.V. Cain, who died of a heart attack during training camp in 1979, and Detroit Lions receiver Chuck Hughes, who died of a heart attack during a game in 1971.

Herrion was a first-year player with the 49ers, and spent part of last season on the San Francisco and Dallas practice squads. He also played this season with the Hamburg Sea Devils of NFL Europe.

Fox said Herrion always talked about his niece, and family was a big motivation for playing.

"When he got here," Fox recalled, "the first thing he told me was, 'I'm going to make this team and buy my mom a nice house."'

A former Cowboys teammate, lineman Stephen Peterman, remembered Herrion as "a really fun, nice guy."

"It's sad to see that happen," Peterman said. "All you can do is pray for his family and for his soul."

[Lisa Salberg]

Copyright 2005 The Chronicle Publishing Co.
The San Francisco Chronicle

AUGUST 22, 2005, MONDAY, FINAL EDITION

SECTION: NEWS; Pg. A1

LENGTH: 1243 words

HEADLINE: 49ERS SAD DAY;

Lineman who died mysteriously after Saturdays game recalled as great human being gregarious, competitive and musical ;

CAUSE: Preliminary autopsy inconclusive, but heart defects are top killer of young athletes

SOURCE: Chronicle Science Writer

BYLINE: Carl T. Hall

BODY:
It may take weeks for the doctors to determine what killed Thomas Herrion, a first-year reserve lineman for the San Francisco 49ers who collapsed in the locker room Saturday after playing in his team's final drive during an exhibition game against the Denver Broncos.

*** Heart defects are by far the No. 1 cause of sudden death in young athletes, but no one is sure yet if that caused Herrion's death. Preliminary results of an autopsy Sunday in Denver were inconclusive, and officials said they plan more detailed examinations and toxicology tests.

*** Team officials said they had seen no evidence of cardiac anomalies in the 23-year-old's medical record. He was 6-foot-3, and 49ers coach Mike Nolan put his weight at about 330 pounds or a little above.

*** By all accounts, Herrion was in good health before the 7 p.m. game in Denver, where the temperature was in the mid-60s by the time he came on the field.

*** "With that kind of history, there's no real way to know," said Dr. Barry Maron, a nationally known expert on cardiac-related sudden death at the Minneapolis Heart Institute Foundation. "A long list of cardiac abnormalities could be responsible. There's a possibility that his heart was structurally normal but had an electrical problem that would not be apparent at autopsy."

*** One of the most common causes of such tragedies is an irregular thickening of the wall of the left ventricle, a condition known as hypertrophic cardiomyopathy. That is the most common inherited heart defect, occurring in an estimated 1 in 500 people, and it accounts for about a third of all sudden cardiovascular deaths in young athletes.

*** The vast majority of people with enlarged hearts never experience any symptoms, and evidence of an abnormality can be subtle even when the heart is examined at autopsy. Often, doctors have to look for disarray at the cellular level, a sign that the heart muscle tried to grow its way out of trouble.

*** Even if they find a flaw in the architecture of Herrion's heart, doctors may not be able to tell if it caused his death, particularly since he appears to have been at the top of his game and had no prior symptoms. That's because fatal problems typically arise from the mysterious interaction of the heart and nervous system, which controls how the blood system responds to stress and exertion.

*** Potential problems may be detected by a standard heart test known as an electrocardiogram, or EKG. Dangerous heart-rhythm disturbances also tend to show up in EKGs and other exams. Doctors may also resort to magnetic resonance imaging, or MRI, to get a detailed picture of the living heart.

*** But medical experts debate the value of widespread use of EKGs or other sophisticated heart tests as a screening tool for sports programs. Unless an athlete has had fainting spells, chest pains or other medical problems, or comes from a family with a history of cardiac disease, the cost of the tests may outweigh the advantages, particularly when the expense of inevitable false positive results is factored in.

*** By most accounts, just 1 or 2 in every 100,000 athletes dies each year, and not all those cases can be blamed on the same kind of heart problem.

*** "It's very hard to say that all athletes should have this sort of stress test," said Dr. Steven Polevoi, an emergency-room physician at UCSF. "The problem is the rarity of these events. That makes it very hard to do mass screening to the point you can say with absolute certainty that you are getting a real benefit."

*** He said Herrion's case should encourage authorities to re-examine how they screen athletes at all levels of play. Studies have pointed to defects in the questions athletes are asked about their medical background.

*** And experts argue whether a warning sign found in a test of a young athlete should be grounds for ineligibility by itself.

*** One recent study, based on a large sampling of French civil servants who were tracked for as long as 23 years, found that oddities in the heart rate during exercise and cool-down might be a strong predictor of sudden death in people without known risk factors.

*** That evidence, published in May by the New England Journal of Medicine, suggests the possibility of designing an easy-to-give stress test to find the prospective athletes who are most at risk.

*** A congenital heart condition, of course, isn't the only possible cause of sudden death on a playing field. Other potential factors include drug use, heat exposure or trauma, particularly blows to the chest.

*** Herrion, a native of Fort Worth, Texas, who played at the college level in Utah, was conditioned to hot weather and high altitudes. Videotape from Saturday shows him walking tiredly off the field after the game but in no obvious distress.

*** Polevoi said it's pointless to speculate how Herrion died. Even a heat-related cause shouldn't be ruled out, he said, despite the relatively cool temperatures at game time in Colorado.

*** "Whenever you have guys that big pounding into each other, with these tremendous energy bursts, that's going to generate a lot of heat even if the ambient temperature is not that high," he said.

***----------------------------------------------------

*** Football deaths

*** Before Thomas Herrion's death Saturday, these four professional players died from activities on the football field:

*** -- 1971: Chuck Hughes, a Detroit Lions wide receiver, died of a heart attack during a game against the Chicago Bears.

*** -- 1979: St. Louis Cardinals tight end J.V. Cain died of a heart attack in training camp.

*** -- 2001: Korey Stringer, a Minnesota Vikings offensive lineman, died of heatstroke during a training camp practice when the heat index soared to 110.

*** -- April: Arena Football League player Al Lucas of the Los Angeles Avengers died of a spinal-cord injury after making a tackle.

***-------------------------------------------

*** Other sports deaths

*** -- 1920: Cleveland Indians batter Ray Chapman is hit in the head by a pitch and dies the next day, the only major-league baseball player to die from injuries sustained during a game.

*** -- 1986: College basketball All-American Len Bias, 22, dies of cocaine-induced cardiac arrest less than 48 hours after he was chosen by the Boston Celtics as the No. 2 overall pick in the NBA Draft.

*** -- 1986: U.S. Olympic volleyball captain Flo Hyman, 31, dies of a heart attack during a game. The cause was Marfan syndrome, a heart disorder often found in tall, slender people, like the 6-foot-5 Hyman.

*** -- 1990: College basketball's leading rebounder and scorer in 1989, Loyola Marymount senior Hank Gathers, 23, falls to the floor in the middle of a game and dies. He had collapsed in a game earlier in the season and was diagnosed as having an abnormal heartbeat.

*** -- 1993: Boston Celtics all-star Reggie Lewis, 27, dies of a heart attack while practicing. He had earlier in the year collapsed during a game, and later continued playing in defiance of a team of doctors that told him he should give up his career.

*** -- 2002: St. Louis Cardinals pitcher Darryl Kile, 33, is found dead in his hotel room after the Cardinals became concerned when he was late for a game. A condition of narrowed arteries was the cause of death.

*** -- Aug. 18: Former UC Berkeley and USF basketball player Kenyon Jones, 27, dies at his home in Atlanta, reportedly of a heart attack. He played on the Denver Nuggets' NBA Summer League team this year.

[Lisa Salberg]

I will not go into great detail - yet. Thomas Herrion will be a name we all come to know in the future - may his untimely death not be ignored. May he rest in peace.

Sincerely,
Lisa