College athlete died after collapsing at practice. How can these tragedies be prevented?

Calvin “CJ” Dickey Jr. was a university soccer participant who had many pursuits outdoors the sport.

He beloved to prepare dinner, journey and go to museums, stated his mother and father. In addition they stated their son beloved historical past and science and needed to be a pharmacist.

“He was extra than simply an athlete,’’ his mom, Nicole, instructed USA TODAY Sports activities.

Nonetheless, Dickey had a situation that has troubled different athletes over time. He was recognized in 2024 with the sickle cell trait, which has been linked to the deaths of 14 school soccer gamers since 2000, in response to the Nationwide Registry of Catastrophic Sports activities Accidents (NRCSI). The loss of life toll is 30 on a listing that dates to 1963.

Dickey was an 18-year-old freshman when he collapsed July 10, 2024, on the primary day of the Bucknell soccer workforce’s exercises. He died two days later in a hospital, and a health worker’s post-mortem and a non-public post-mortem each cited sickle cell trait as a trigger.

Questions on negligence and the best way to forestall comparable deaths amongst school athletes have emerged since then.

The genetic dysfunction is present in about one in all 12 Black Individuals and in about one in 500 white Individuals. Dickey was Black. On April 3, an lawyer representing Dickey’s mother and father filed a wrongful loss of life lawsuit in opposition to Bucknell. They allege the college knew Dickey had sickle cell trait however didn’t take motion that might have prevented his loss of life.

The dangers are biggest when gamers overexert themselves in excessive temperatures. However sickle cell consultants say that by following common precautions, equivalent to satisfactory hydration and relaxation, athletes who’ve the trait can nonetheless safely compete.

What’s sickle cell trait?

For these with sickle cell, pink blood cells can lose their pure form and turn into crescent-shaped sickles that block blood circulation. However sickle cell trait shouldn’t be confused with sickle cell illness.

Sickle cell illness is extra severe and might result in issues equivalent to organ harm, strokes and anemia. Against this, these with sickle cell trait “sometimes stay regular lives,’’ in response to the American Society of Hematology (ASH).

However for folks with sickle cell trait, ASH additionally studies, “Hardly ever, excessive situations equivalent to extreme dehydration and high-intensity bodily exercise can result in severe well being points, together with sudden loss of life …” Nonetheless, neither the NCAA nor ASH regard sickle cell trait as a situation that ought to disqualify athletes from competing.

“Based mostly on the information and the rigor that we see, we proceed to carry the place that common interventions to scale back exertion-related harm and loss of life is efficient in all athletes, together with these with sickle cell traits,’’ stated Chancellor Donald, an energetic member of ASH and an assistant professor on the Tulane College College of Medication.

Although ASH asserts sickle cell trait doesn’t result in exertional-related loss of life, it cites a examine that confirmed sickle cell trait was related to a 54-percent larger danger of rhabdomyolysis. Exertional rhabdomyolysis, triggered by bodily exercise, will be deadly, breaking down muscle tissue and inflicting harm to the kidneys, liver and coronary heart.

Dickey suffered from rhabdomyolysis, in response to his mother and father’ lawsuit, which stated he went into cardiac arrest no less than 5 occasions earlier than he died.

Defending a household’s ‘treasure’

On June 28, 2024, Dickey accomplished the NCAA-mandated sickle cell testing, in response to his mother and father’ lawsuit. The check revealed he had sickle cell trait, and his medical data have been uploaded electronically to Bucknell’s medical reporting platform, per the lawsuit.

Two weeks earlier than Dickey reported to Bucknell’s campus in Lewisburg, Pennsylvania, in response to the lawsuit, a faculty coach referred to as Dickey’s mom, Nicole, “to debate CJ’s optimistic sickle cell trait check. Nicole was assured that satisfactory precautions could be taken to accommodate this situation.”

Induced by warmth and overexertion, athlete deaths related to sickle cell trait have nearly at all times occurred at practices or exercises. However some coaches have discovered artistic methods to take precautions with gamers who’ve the trait.

Beneath former Kansas soccer coach David Beaty, gamers with sickle cell trait wore totally different coloured jerseys and helmets at apply in order that they might be simply recognized and shielded from overexertion.

In 2006, Beaty was an assistant coach at Rice when Dale Lloyd II, then a 19-year-old freshman defensive again, died from problems of sickle cell trait after he collapsed throughout a exercise.

“I vowed that if I ever was accountable for it, that I might take each measure attainable after which some from that time,” Beaty, who was the top coach at Kansas from 2015 to 2018, instructed USA TODAY Sports activities. “So there was no excuse for anyone, anyone, to not be taking nice care of someone else’s household treasure.”

At Miami, athletes with sickle cell trait put on pink armbands throughout apply to alert coaches and help employees, in response to Carter O’Toole, the college’s government affiliate athletic director for strategic communications/chief of employees. He stated these athletes are additionally listed on harm studies supplied to coaches throughout the season.

However in response to the Dickeys’ lawsuit, Bucknell didn’t take the mandatory precautions earlier than their son joined the offensive linemen on the primary day of exercises.

“The loss of life of a scholar is at all times a tragic loss,” Bucknell College stated in a press release supplied to USA TODAY the day the Dickeys’ lawsuit was filed. “…Whereas the College won’t touch upon pending litigation, we once more prolong heartfelt sympathies to CJ’s household, and we are going to proceed to deal with our most vital precedence — the well being and security of all Bucknell college students.”

Position of the NCAA in athlete security

Mike Caspino, an lawyer representing Dickey’s mother and father, stated they’re not suing the NCAA as a result of the group has “no responsibility of care” – that means no authorized obligation to guard athletes.

The NCAA, responding to a lawsuit filed by Lloyd’s mother and father after their son died at Rice in 2006, wrote, “The NCAA’s Structure confirms that member establishments expressly retained the accountability for the conduct of intercollegiate athletics…”

Nonetheless, that argument has not spared the NCAA from criticism for failing to police health-and-safety efficiency by its member faculties.

“Even in case you take a look at the NCAA Structure, well being and security would not fall beneath the realm of enforcement,’’ stated Brian Hainline, who served because the NCAA’s first chief medical officer from 2013 via Might 2024. “So there is a shortfall there, if you’ll. It is like, ‘OK, member faculties, that is what you are presupposed to do. Make sure that you simply do it.’ ’’

A authorized settlement between Rice and Lloyd’s mother and father after their son’s loss of life led the NCAA to require all athletes have their sickle cell trait standing confirmed. The hope was that faculties could be better-prepared to assist the athletes.

Legal professional Eugene Egdorf, who represented Lloyd’s mother and father, stated the case is the spotlight of his 35-year profession.

“As a result of it made that distinction,” Egdorf instructed USA TODAY Sports activities.

The NCAA-backed sickle cell testing started in August 2010. Within the prior decade, 10 soccer gamers died of problems from sickle cell trait. However within the decade after the testing was launched, and as educating athletic trainers and coaches concerning the dysfunction elevated, there have been solely two such deaths.

However Dickey’s loss of life is the second fatality associated to sickle cell trait in 4 years – even if it’s “100-percent preventable’’ when faculties know an athlete has it, as required by the NCAA, stated Scott Anderson, a number one researcher of sickle cell trait in school soccer deaths.

“My hope could be that everyone is simply incensed,” Anderson, a former athletic coach on the College of Oklahoma, instructed USA TODAY Sports activities of Dickey’s loss of life. “That everyone on the NCAA is incensed … That every one the stakeholders are simply incensed.’’

What will be executed?

James Borchers, chief medical officer for the Huge Ten, has began the U.S. Council of Athletes’ Well being (USCAH) in hopes of stopping deaths like Dickey’s.

“Traditionally in these conditions, I feel there’s often two sorts of failures,” Borchers instructed USA TODAY Sports activities. “One is a person failure, and it may be a person that is doing one thing that is inappropriate. However there’s additionally often a system failure someplace. It’s important to take a look at each of these.

“And I feel my guess is that you simply’d discover failures in each instances, in each the person and system method right here equally to traditionally the place you discover elsewhere.”

The plan, Borchers stated, is for USCAH to audit and accredit programs in place at faculties –designed to forestall deaths and in addition present training. The USCAH already companions with greater than 20 conferences and greater than 280 of the NCAA’s roughly 1,100 member faculties, in response to Borchers.

He has the backing of Hainline, the previous NCAA chief medical officer, who joined USCAH as a senior advisor. “I feel it will possibly turn into a 3rd arm that’s actually going to be helpful to the NCAA,’’ Hainline stated.

The NCAA has endorsed suggestions for faculties to forestall catastrophic harm and loss of life. However the group has drawn scrutiny for an absence of enforcement.

A key suggestion is for every sports activities venue to have an Emergency Motion Plan (EAP), a written doc outlining procedures for responding to an emergency.

“This stuff have to be rehearsed,” stated A.J. Duffy, the president of the Nationwide Athletic Trainers’ Affiliation.

Based on the Dickeys’ lawsuit, Bucknell didn’t have an EAP within the facility the place their son collapsed.

With an occasion like Dickey’s loss of life, Borchers stated, the USCAH tries to spotlight finest practices that additionally handle comparable deaths, equivalent to these ensuing from heatstroke and cardiac arrest. (Since 2000, along with 14 deaths related to sickle cell trait, 13 school soccer gamers have died from cardiac arrest and 7 have died from heatstroke, in response to the NRCSI.)

Anderson, who spent 26 years as an athletic coach at Oklahoma, didn’t handle the precise state of affairs at Bucknell however did say, “There needs to be a change in the way in which we practice and situation these people. There needs to be a change in teaching. We won’t emergency-treat our approach out of this.”

Remembering CJ

Not lengthy earlier than he died final summer season, Dickey boarded his household’s boat, becoming a member of his sister, Patrice, 20, and their mother and father close to the household’s residence in Land O’ Lakes, Florida, the Dickeys recalled of their interview with USA TODAY Sports activities.

“He helped me launch it and unload it,’’ Calvin Sr. stated.

“CJ actually knew the best way to do every little thing,’’ Nicole stated.

The identify of the boat: Simply 4 Us.

Now it’s simply the three of them as their authorized struggle ensues.

Throughout a latest interview, nonetheless, the Dickeys appeared much less within the authorized battle than in sharing recollections of their solely son.

“He beloved to eat,” Nicole Dickey stated, including that CJ deliberate a household trip to New Orleans. “We hit each joint for crabs and crawfish and lobster, and, yeah, that was CJ.”

She additionally stated CJ acquired the household to create accounts on LinkedIn.

“He was like, ‘Yeah, Mother, I’ll begin making my community,’ ” Nicole Dickey stated. “He was already considering past soccer.”

CJ’s LinkedIn account nonetheless reads, “Pupil Athlete at Bucknell College.” Together with 2024-2028, the time he deliberate to remain.