Deaths of young athletes raise questions over tests

March 14, 1994|By William C. Rhoden | William C. Rhoden,New York Times News Service

Susie Gary sat in her North Chicago home and recalled how her grandson, Devon Mills, would transform the living room into a basketball arena.

With imaginary fans cheering, Devon would do his own play-by-play as he hit the winning shot on a makeshift goal. Devon told his grandmother that he was going to be a star one day and predicted that television crews and reporters would flock to their home.

As she told the story, Mrs. Gary was torn by the irony of how Devon's predictions had been fulfilled. The home had in fact been swamped by camera crews and reporters, but, she said, "He never thought it would be because of something like this."

Devon, 16, had just finished getting a drink of water when he collapsed and died after playing in a game for the North Chicago High School freshman team on Feb. 12. The cause of death was an undetected heart problem.

"Sometimes I wish I could just wake up and have it not happen," Mrs. Gary said. "You just don't know how badly something like this hurts."

The sudden deaths of young people like Devon Mills do not receive the attention that was paid to Hank Gathers, the Loyola Marymount basketball star who died during a game four years ago this month, or Reggie Lewis, the Baltimore native and Boston Celtics' captain who collapsed and died last summer.

But for medical professionals and school administrators, the deaths have produced difficult questions: Can more be done to detect potentially fatal heart conditions? What will it cost? When is a condition threatening enough to cause someone to be declared unfit for athletic competition? Who should make that decision?

Many physicians and athletic officials say the routine tests that schools require for participation in sports have failed to keep pace with the intense levels of competition and stress on young athletes. The focus of their concern is hypertrophic cardiomyopathy, a thickening of the heart muscle that is difficult to detect and is the most common cause of sudden death among otherwise healthy individuals under age 30.

Undiagnosed illness

"It's a lot more common than people think because so many of these symptomatic patients go undiagnosed," said Dr. Laneh Fananapazir, director of the inherited cardiac disease section of the National Institutes of Health. "I think for every one diagnosis there is probably another athlete who has not been diagnosed. It's not a problem that can be ignored."

Sudden death affects 200,000 to 400,000 Americans each year, accounting for up to 20 percent of deaths of people between the ages of 1 and 20, according to an article by Dr. Elias H. Botvinick, Dr. Michael W. Dae, Dr. Rajagopal Krihnan and Dr. Stanford Ewing in the Journal of the American College of Cardiology.

There are no statistics on how many of these deaths occur as a result of athletics, but heart problems are the most common cause of death among high school athletes, said Dr. Fred Mueller, a professor in physical education at the University of North Carolina and the director of the National Center for Catastrophic Sports Injury Research there.

Dr. Mueller, who has been tracking the deaths of high school athletes since the 1981-1982 school year, said that in the 10 years for which he has statistics, 133 deaths were "non-injury related," mostly the result of heart problems, compared with 67 that resulted from injuries.

Considering that 3 million to 4 million athletes participate in high school sports, those numbers are relatively small. But they reflect only the deaths that have occurred in high school-related activities and only those that have been reported to Dr. Mueller. No one knows how many might have died on playgrounds or in gyms or while jogging in the streets.

Because the medical profession issues precautionary and controversial recommendations for many people -- the timing of mammographies to detect breast cancer in women and the use of blood testing to screen for high cholesterol levels or to detect prostate cancer -- some doctors wonder whether there should be guidelines for people who want to participate in a high-stress sport.

The issue is difficult for many reasons, including the fact that in high school, college and professional sports, health screening is unregulated, with no binding standards.

"We're still sort of flying by the seat of our pants," said Dr. Jack Kramer, an internist who works with the Charlotte Hornets basketball team. "The people who are clearly abnormal are easy to detect. But everybody knows that there are some folks out there at risk and we're having a problem identifying them or you wouldn't have as many who seem to die unexpectedly."

The death of Devon Mills prompted the principal of North Chicago High School, Jimmy Dew, to suggest tougher guidelines for screening, with a focus on heart examinations.

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