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A coronial inquest has been told that Keith Titmuss, the 20-year-old Manly Sea Eagles prospect, was suffering from heatstroke when he died in November 2020.
The evidence, according to coroner Adam Casselden, “leaves no real doubt that Keith suffered exertional heatstroke”, with multiple independent medical staff coming to the same conclusion.
One, an ambulance worker, told the inquest that Titmuss’ temperature was so high that he retested him three times, thinking that a reading of 41.9 degrees Celsius must be false.
“I didn’t believe it. I’d never seen a temp like this before,” said the paramedic.
He collapsed at the club’s Narrabeen training base during pre-season ahead of the 2021 NRL campaign and was expected to make his first grade debut that year.
The day itself was measured at 24.9C, though some of the training had taken place indoors in a building without air conditioning.
Titmuss’ physical condition was also raised, with the coroner explaining that he had put on weight during the off-season and was not in the same shape as other Manly players.
“The fact is that Keith, relatively speaking, was less fit and less conditioned to the heat than he would have been other times,” he said.
He was seven kilos heavier than at the end of the 2020 season and weighed 119kgs at time of death.
“Without the education, it’s extremely difficult (to diagnose) even for a doctor,” said Luke Inman, who was chief medical officer at Manly in 2020.
“But if the defibrillator shows there’s no need for resuscitation, there’s a high chance it’s heat stroke.
“If it’s not detected or treated, they’re dead after 20 or 30 minutes. They’ll cook internally. It’s nearly impossible to get them back after that point.
The player had been experiencing cramps before collapsing, and experienced a seizure lasting ‘seven or eight minutes’ before being taken to hospital, where he died several hours later at Royal North Shore hospital.
The incident occurred in the Manly wrestling dojo and took place after a field session lasting over an hour and a half.
Then-boss Des Hasler described the trianing that day as “not an over-strenuous or taxing session” and Chad Randall, his assistant, rated it as “seven out of ten” in terms of intensity.
“They recommend a period of acclimatisation in the NRL, but there’s no exact way of guiding teams on what that entails,” said Inman.
“What it should mean is a graded increase in exposure to the heat so the body can adjust gradually and build a tolerance to it.
“But it wouldn’t be done at any NRL club – no one will comply to that in a performance setting. They would be feeling that they would be two weeks behind any other team if they put the brakes on.”
The inquest will continue for the next week, with the question of whether staff reacted adequately to be examined by the coroner.
NRL players Moses Suli, Josh Schuster and Sione Fainu, as well as Manly staff John Bonasera, Michael Monaghan and Don Singe are all expected to give evidence.