Loved ones of rising Manly Sea Eagles star Keith Titmuss have finally received answers about his death, more than three years after he collapsed during pre-season training.
Keith Titmuss immediately lost consciousness after a 139-minute training session at the team’s headquarters on Sydney’s Northern Beaches on November 23, 2020.
On Friday, State Coroner Derek Lee concluded that the 20-year-old had died of heat stroke after an inappropriately difficult workout.
He had trained for more than two hours during the first pre-season session of the year, which included both an outdoor session and an indoor session in a ‘hot and stuffy’ gym.
Keith Titmuss (pictured) died after collapsing during pre-season training with Manly in November 2020
The Sea Eagles forward was just 20 years old when he died after what a corner branded an ‘inappropriate’ level of exercise.
The inquest heard that Mr Titmuss had gained four stone in the off-season and that his fitness test scores indicated he was ‘the least fit member of the squad’.
Counsel assisting the coroner, Adam Casselden SC, said the ‘unnecessarily and inappropriately strenuous’ session highlighted the need for individualized training programs tailored to each player’s physique and fitness level.
Experts told the inquest that Titmuss’ higher body mass and lower aerobic fitness were risk factors that contributed to him overheating from exertion on the ‘mild’ day of 24 degrees Celsius.
Coroner Lee found that the combined risk factors made the training session more difficult for Mr Titmuss, who was then ‘at greater risk of heat illness’.
The evidence showed that the young attacker was likely suffering from involuntary dehydration by the time he entered the “very hot, very humid” indoor gym.
One of the paramedics who treated the 20-year-old as he fell ill measured his temperature at almost 42 degrees Celsius, the highest they had ever seen.
Titmuss (pictured playing for Hunters Hill rugby club as a teenager) recorded a temperature of 42 degrees before he died – with paramedics saying it was the highest they had ever seen
The promising striker had trained for more than two hours – with part of the program carried out in a ‘hot and stuffy gym’ – before suffering heatstroke
Coroner Lee found that Manly staff and paramedics had both responded appropriately in treating Mr Titmuss’ alarming collapse and subsequent attacks.
“There is no evidence that more could have been done by those immediately present,” he said.
He found that applying ice packs to the collapsed player “would not have resulted in a significant reduction in Keith’s temperature” but could have posed a risk of injury.
The inquest into Mr Titmuss’ collapse came just two years after Manly star Lloyd Perrett survived a ‘near miss’ when he collapsed from heat exertion during training.
In his closing address, Mr Casselden suggested Coroner Lee should recommend that Manly and the NRL use Mr Titmuss’ tragic death as a case study for education and awareness of heat illness.
He made a number of recommendations on improving the NRL heat policy, which are linked to an ongoing independent review by two heat disease experts commissioned by the NRL.
Titmuss’ shattered father Paul and mother Lafo (pictured) hope his death will lead to big changes from the NRL
Mr Casselden suggested clarifying heat guidelines that apply to indoor and outdoor training, and adapting training sessions based on environmental factors.
He also approved a mandatory two-week acclimatization period after players return to training after the offseason, and a requirement that a medical officer sign off on training programs.
Another key focus should be implementing screening to determine which players are at risk of heat illness and classifying them to ensure tailored training sessions, Mr Casselden said.
Mr Titmuss’ family asked the NRL to enforce mandatory reporting of all heat-related injuries to gain a comprehensive understanding of the prevalence of the problem.
Titmuss’ family and supporters wore shirts in his honor as the case was heard by the coroner (pictured)
His mother Lafo previously said she hoped the inquest could lead to changes in the sport her son loved.
“We are encouraged by the NRL’s internal review and its commitments to increasing its knowledge and understanding across all clubs, staff and players,” she said.
“We hope the findings of this research will be educational not only for the NRL, but also for the sport across Australia and globally.”
At the time of his death, Mr Titmuss was on the cusp of his big break after being elevated into the club’s top 30.
He was described at the inquest as ‘kind’, ‘gentle’ and ‘genuine guy’ who was ‘hardworking’ and loved by his teammates and friends.