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Heart of the Game: Ekeng’s death is a reminder to take health matters seriously

Heart of the Game: Ekeng’s death is a reminder to take health matters seriously

Patrick Ekeng, a 26-year-old Cameroonian footballer who was playing in Romania, died after collapsing on the pitch at the weekend. Medical staff at the hospital say he arrived without having received proper first aid. An investigation is being launched to determine if that’s the case, but whatever the outcome, it is another reminder that sporting bodies must provide a higher duty of care to players and ensure frequent and adequate screening in order to prevent incidents such as these. By ANTOINETTE MULLER.

Almost exactly one month after James Taylor, the English cricketer, was forced to retire from the game at the age of 26 due to a heart condition, another sportsman suffered a far grimmer fate. On Friday, Cameroonian footballer Patrick Ekeng came on as a second-half substitute for his Romanian club side Dinamo Bucharest. Seven minutes later, he collapsed. Two hours later, he was dead. He was 26 years old.

The exact cause of his death is not yet known, but early suggestions are that he suffered a heart attack and arrived at the hospital in cardiopulmonary arrest, according to doctors who treated him.

The Romanian Football Federation (FRF) suspended all of the weekend’s matches following the incident and local media reported that an inquiry into his death is being launched. Medical staff at the hospital reported that he was transported in an ambulance without any resuscitation equipment.

He was brought to us in cardiopulmonary arrest at the emergency room, in an ambulance, without resuscitation measures as far as we know. We started resuscitation measures that lasted approximately one hour and 30 minutes. These measures were, unfortunately, without result,” said Dr Cristian Pandrea of the Floreasca emergency hospital.

“This is not the first such incident on the sports field, the causes can be multiple and they will be revealed by the necropsy to be performed later,” he added.

Fabrice Muamba is perhaps the most famous case of a player suffering a heart condition on the pitch. He survived largely thanks to the treatment he received on the spot and his near-death experience led to advances in precautions in matters of the heart in English football. It often takes a tragedy to shake sport into realising the importance of having emergency equipment on hand should the worst happen. which makes Ekeng’s death all the more shocking.

He was not the first Romanian or even Dinamo Bucharest player to suffer a heart condition on the pitch. In 2000, C?t?lin Hîldan, Dinamo’s captain at the time, suffered a cardiac arrest during a friendly and died. In 2012, Nigerian footballer Henry Chinonso Ihelewere died during a pre-season friendly in Romania after suffering a cardiac arrest. He was 21.

Back then, Fifpro, the world footballers’ union as well as Afan, its Romanian member, urged clubs and FRF to make it compulsory for clubs to have fully equipped ambulances at all official and friendly matches. Afan president Emilian Hulubei said that it would have cost as little as “400 Euros” per club per match to have all the necessary equipment, but that was not adopted.

The Department for Emergency Situations of the Ministry of Internal Affairs and the Health Ministry in Romania will now investigate several aspects of the incident including the ambulances and their equipment, as well as compliance with the regulations in force; compliance with the legislation on emergency medical aid and private medical transportation; the ambulance staffing and their qualifications, including documents proving the continuous training of the employees manning the ambulances.

Dinamo insist that the three ambulances that were contracted for the match were “properly equipped for emergency interventions” while the club doctor Liviu Paltinean said that he attended to Ekeng on the spot: “The first thing you do is to clear out the air passage and perform cardiac massage.”

The match footage (which is not for sensitive viewers) does indeed show the medical staff immediately rushing on to the pitch, without waiting for clearance from the referee. It does not show any attempt at CPR or the immediate use of a defibrillator. Since the first few minutes of such incidents are the most critical in saving a life, with most doctors believing resuscitation should happen within two minutes, an investigation into the matter will be critical.

An unnamed fan who was at the match posted on a forum: “I saw him collapse suddenly, no movement at all after, and once the players realised it was serious very quickly, the entire stadium, fans/managers/players were screaming belligerently at the medics and EMTs to get out there, it was absolutely chilling.

It seemed, in that moment, that the EMTs took ages to get out there, everyone was feeling a big sense of frustration, especially with how close the hospital is to the stadium. In my head I was telling myself it can’t be that bad otherwise they would’ve used a defibrillator from the mini ambulance right there on the spot, and they didn’t.”

The hospital to which Ekeng was taken is within two minutes of the stadium and it took seven minutes before he arrived in the emergency room. It is not impossible that the club might have viewed the ambulance as being “properly equipped” even without a defibrillator because of its close proximity to the hospital. If that does turn out to be the case, it will be gross negligence of the highest order and both Fifa and the FRF must take drastic action.

However, the immediate medical treatment is not the only thing that should come under the spotlight.

In 2005, following the death of Cameroonian international Marc-Vivien Foe, who collapsed during the Confederations Cup in 2003 and was later discovered to have been suffering from hypertrophic cardiomyopathy (the same condition as Muamba), Fifa proposed to have complete examinations of every player prior to competitions. This was applied in 2006 at the Fifa World Cup and in 2007 at the Fifa Women’s World Cup and all teams complied. After this, Fifa made it mandatory for all of its competitions.

Not all conditions can be detected, but frequent screening can eliminate the risk significantly and that is where Fifa needs to act strongly. While more and more member nations have started to adopt these screenings, they are still lacking in many professional leagues across the world and if it turns out that Ekeng was suffering from a pre-existing condition that could have been detected and possibly caused his heart attack, Fifa should take as much responsibility for his untimely death as the medical staff who failed to respond adequately. DM

Photo: An undated handout picture made available by Romanian soccer club Dinamo Bucharest of Cameroonian midfielder Patrick Claude Ekeng, who collapsed during the Romanian Premier Soccer League playoff match between Dinamo Bucharest and Victoria at National Arena Stadium in Bucharest, Romania, 06 May 2016. Ekeng fell unconsciously without being touched by any other player seven minutes after he entered the match. The 26-year-old Cameroonian player died at hospital hours later. EPA/DINAMO BUCHAREST

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