Developments in the Ereck Plancher death

So what happens next?
UCF football player Ereck Plancher, a 19-year-old freshman receiver from Naples, collapsed after an offseason workout supervised by Knights Coach George O'Leary and his staff on March 18. He was taken to a nearby hospital and died about an hour later. On Friday, attorneys for the Plancher family notified the university they intend to pursue a wrongful death claim against the school. The following summary of Plancher's final workout and recent developments in the case was compiled from interviews with multiple UCF officials, public documents and the accounts of four UCF football players who spoke to the Sentinel on condition of anonymity because they said they feared reprisals.

Under Florida statute, the Planchers cannot file a lawsuit until UCF either denies the negligence claim or six months have passed. The Planchers can seek or be awarded any amount of money, but any award from UCF in excess of $200,000 would require approval by the legislature. Unclear is whether the statute applies to separate direct-support organizations, non-profit agencies of schools such as foundations, booster clubs and, in this case, the UCF Athletics Association.

What was the cause of death?

The Orange County medical examiner's autopsy report released July 17 stated Plancher collapsed and died as a result of "dysrhythmia brought on by exertional rhabdomyolysis with sickle-cell trait." That trait can hamper the ability of cells to carry oxygen and has been cited as the contributor to the deaths of 10 athletes between ages 12-19 since 2000. In simple terms, Plancher's heart stopped when his red blood cells became malformed during a workout. This "sickling" of his cells in the heart, lungs, liver, spleen, pancreas, kidneys, adrenal glands and thymus caused his body to shut down.

Did UCF know about the sickle-cell trait?

Yes. On the day the autopsy report was released, UCF spokesman Grant Heston told the Sentinel the school learned Plancher had the trait during a team physical exam in January 2007. Heston said Plancher was told he carried the trait and informed of precautions he should take. Heston said all coaches and training staff were aware Plancher carried the trait. Athletic Director Keith Tribble said the school's training staff "monitored his physical condition at every practice and workout." In earlier interviews, including an April 1 session at UCF, multiple UCF officials disclosed to the Sentinel they did not know of anything in Plancher's medical history that could cause a problem. "We look at the medical history of every athlete that arrives at our school," said Mary Vander Heiden, head football athletic trainer. "We talk to each athlete individually. If there is anything questionable, we follow up quickly."

Why was Plancher allowed to play?

Plancher had passed two NCAA standard physicals at UCF. NCAA and National Athletic Trainers' Association recommendations say athletes with the sickle-cell trait, which is "generally benign and consistent with a long and healthy life," can participate in sports and training activities if monitored closely.

What precautions are recommended?

The 2008-09 NCAA Sports Medicine Handbook urges trainers to exercise caution when supervising athletes with the blood disorder. "The harder and faster athletes go, the earlier and greater the sickling," the handbook states. "Sickling can begin in only two to three minutes of sprinting, or in any other all-out exertion of sustained effort, thus quickly increasing the risk of collapse. Athletes with sickle-cell trait cannot be conditioned out of the trait and coaches pushing these athletes beyond their normal physiological response to stop and recover place these athletes at an increased risk of collapse."

The NCAA suggests an athlete with sickle-cell trait not be urged to perform all-out exertion of any kind beyond 2-3 minutes without rest, be excused from performance tests such as serial sprints and mile runs, and immediately pulled from activity if warning signs occur. They also recommend rest and recovery between repetitions, especially during "gassers" and intense station or "mat" drills.
The NCAA and NATA note warning signs for a sickling collapse include muscle pain, abnormal weakness, undue fatigue or shortness of breath. The NATA wrote: "As the player rests, sickle red cells regain oxygen in the lungs and most then revert to normal shape, and the athlete soon feels good again and ready to continue."

How should sickling be treated?

Both the NATA and NCAA say a sickling collapse should be treated as an immediate medical emergency. The NATA sickling collapse protocol suggests checking vital signs, administering high-flow oxygen with a non-rebreather face mask; cooling the athlete, if necessary; as vital signs decline, calling 9-1-1, attaching an AED [defibrillator], starting an IV and getting to the hospital fast; telling the doctors to expect explosive rhabdomyolysis and grave metabolic complications; having an emergency action plan and appropriate emergency equipment for all practices and competitions.

What was the workout?

According to a timeline of the day provided by O'Leary to the Sentinel during the group interview with UCF officials on April 1, the workout at the Knights' indoor practice facility consisted of 75 minutes of weightlifting; 10 minutes of stretching; an agility course lasting "exactly 10 minutes, 26 seconds;" two 18-second sprints; a team huddle and some calisthenics that O'Leary said began at about 10:31 a.m. and concluded at about 10:45 a.m.

Did the workouts include mat drills?

Mat drills are considered to be among the most challenging of all football conditioning drills. O'Leary described the workout as "conditioning drills" in the April interview with the Sentinel and called them "agility" drills in a "My Turn" column published July 27 in the Sentinel. The four UCF players described the workout as including mat drills in multiple, separate interviews with the Sentinel in March and April. In an article published in the Sentinel on May 18, Florida State strength and conditioning coach Todd Stroud said "mat drills" generally refer to high-intensity, short-burst agility drills that may -- or may not -- be done on mats.

How difficult was the workout?

O'Leary, a 40-year coaching veteran, described it as a routine drill that was not very taxing. "I always look at the kids, at their sweat," he told the Sentinel in the April interview. "They had little rings of sweat around their neck and a little under their armpits. That's how I just know whether it was a taxing workout." The four players described the workout as being very tough, saying multiple players vomited. One of the players, a veteran, told the Sentinel: "It was the toughest workout since I've been here."

Did Plancher show signs of distress?

O'Leary told the Sentinel he saw Plancher get up after falling during the final sprints. UCF running backs coach and offensive coordinator Tim Salem said he saw no signs that Plancher was struggling. "When he was coming through my station, he actually was passing people," Salem said. The four players, however, said Plancher was woozy and staggering during the final portion of the drills, and that they alerted UCF staff to this before the workout was finished. The four players said Plancher fell during the final sprint, and members of the UCF coaching staff yelled at him to finish the drill. The players said O'Leary singled out Plancher and cursed at him for lack of effort. "That's some [expletive] from you, son," all four players said they recall the coach saying. O'Leary has denied those claims, but he did tell the Sentinel through a spokesman in April that he recalled telling people around him, "He's better than that."

When did Plancher collapse?

Plancher fell to one knee as the team broke its final huddle, O'Leary said. He said he did not see Plancher collapse but turned to see trainer Robert Jackson talking to the fallen player. "I asked him if he had eaten breakfast," O'Leary said. By then, the UCF players said, Plancher was not responding to a trainer, and David Kelly, UCF's receivers coach, attempted to give him water. Players said they carried Plancher outside and laid him on a bench.

Where were the trainers?

In their interviews with the Sentinel, the four players criticized UCF's reaction time and said teammates called trainers to respond. UCF officials repeatedly have said Plancher received appropriate, immediate attention. On June 5, Heston told the Sentinel the trainers attended to Plancher as soon as it "became clear he was in distress." "Where the players were having their workout, that's where [the trainers] were. . . . Ereck received professional care from our trainers, police responders and emergency personnel," Heston said.

What was the treatment?

According to the UCF Police Department's incident report, the timeline provided to the Sentinel by O'Leary and the statements to the Sentinel by the four players, Plancher was in distress on campus at least 18 minutes. The police report states a 9-1-1 call was made at 10:48 a.m., about 3 minutes after O'Leary said the workout ended; on the call, a school official says, "We have a kid who is in sheer exhaustion, going into possible cardiac arrest, so we need somebody over here ASAP." The caller also confirms that rescue breathing and CPR were being administered. Officers arrived at 10:49 and 10:52 to find Plancher unconscious on the bench. A defibrillator already was attached to Plancher. A trainer and officer performed compressions and rescue breaths; fire and rescue performed CPR. Plancher was placed in an ambulance at 11:06. He was pronounced dead at the hospital at 11:51.

Sources: Sentinel interviews and research, UCFAA Sports Medicine Department handbook, NCAA, National Athletic Trainers' Association

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