Fatalities continue -- and so does ignorance of sickle cell trait
If Polie Poitier wanted to get away to play football, he didn't check the rearview mirror. The Coral Gables (Fla.) High School quarterback traded the ocean for The Flatirons when he traveled the 2,000 miles to play for Colorado in 1973.
By all accounts, he was popular. One former high school classmate recently blogged that Polie would tell people Sidney Poitier was his uncle. If not a genealogist, Poitier was at least playful.
"I heard something to that effect," Coral Gables guidance counselor Daniel Finora said, "but I wouldn't go on TV and say it."
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Those were the days when South Florida prep stars didn't necessarily migrate to nearby Miami. Florida State and Florida took their share of prospects. The ACC made recruiting raids. Howard Schnellenberger and the beginning of a dynasty was still a few years away.
So Polie traveled to Colorado, lured by coaching great Eddie Crowder. When Crowder retired, Bill Mallory inherited Poitier.
"He figured to be right in our lineup," Mallory said.
A year after collapsing on the opening day of practice in 1973, Poitier, by then a defensive back, collapsed again, this time under Mallory's watch in late August 1974.
On that day Poitier, 19, became Patient Zero, the NCAA's first documented case of a death due to complications resulting from sickle cell trait, a gene abnormality than can cause athletes to die during strenuous exercise.
Coaches, and players, didn't know any better back then.
"You've got to understand, we were ignorant," said Mallory, who is still haunted by the death.
• Non-traumatic deaths in college football
Some might say the ignorance prevails to this day. According to research obtained by CBSSports.com, "exertional sickling," a complication of sickle cell trait, is now the leading cause of death of NCAA football players this decade.
Five of the 10 deaths in Division I-A have been attributed to the condition. There have been seven deaths (out of 19 non-traumatic deaths total) due to sickle cell trait at all divisions since 2000. That means almost half of such deaths in college football (15 since Poitier died 35 years ago) have come this decade.
Anecdotal evidence over the years suggests that total could be higher. Athletic trainers, team doctors and NCAA personnel were responsible for assembling the data which had not been previously released.
Sickle cell trait is an inherited condition that occurs in approximately eight percent (one in 12) of the country's African-American population. Caucasians can have the trait but those at high risk have ancestors from Africa, South America, Central America, India, Saudi Arabia and the Mediterranean.
The list suggests that 35 years later, there is still a lack of knowledge about dealing with sickle cell trait. In a game known for its violence, it is not blows to the head, not paralysis, not heart conditions, not heatstroke that have killed the most players, but a simple physical anomaly.
Sickle cell trait is not a disease, it is merely a condition. While tremendous gains have been made in other areas of player safety, the NCAA calls precautions made for sickle cell trait "inconsistent." In 2006, only 64 percent of I-A team physicians surveyed by the NCAA indicated their school screened for the sickle cell trait. Screening is relatively inexpensive ($5-$10 per athlete, another $30 test to confirm).
All 50 states screen for the condition at birth, but in many cases families aren't told the results, or they forget or ignore them. Screening is recommended by some professional organizations. The NCAA says screening remains an institutional decision.
The deaths follow a familiar pattern: They occur in conditioning instead of practice or a game, and involve overexertion. That produces the sickling of red blood cells that can jam blood vessels.
"No player in this division [I-A] in this time period died playing the game, no player in this division in this time died practicing the game," Oklahoma head athletic trainer Scott Anderson said. "They died in preparation for the game. There is something about that that doesn't ring right."
Mallory actually lost two players due to the condition. In 1987, Indiana walk-on Parnell Sylvio collapsed and died during an August training run. The only small difference: Sylvio made it 1,200 meters. Poitier collapsed after 800 meters.
"People just aren't aware," Mallory said. "Coaches and ... doctors and trainers are a whole lot better ... [but] the way we're conducting conditioning at this time is putting some people at risk."
The lack of knowledge in treating the trait showed in two recent, highly publicized cases at Missouri and Central Florida.
At Central Florida, two players have collapsed since March 2008. Ereck Plancher, who had sickle cell trait, died that month during offseason conditioning drills. The school eventually spent $60,000 on what was described as an "independent, third-party review" of its football training policies.
Nowhere in the 24 pages of the report are the words "sickle cell." Upon the release of the review in March, school officials offered president John Hitt to the media for interviews. When contacted by CBSSsports.com for this story, however, Hitt declined to comment through a spokesman.
The report made sure to state it was "not intended to address every aspect of the football training and sports medicine programs at UCF," and "It was not part of the president's charge to investigate or to reach conclusions about specific past events."
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| Florida State linebacker Devaughn Darling died in 2000 due to exertional sickling. (Provided to CBSSports.com) |
"I really thought [the report] did a disservice to the safety in football," said one source familiar with the situation who did not want to be identified. "It's a headline around the country that UCF's program is within the norm. I can't dispute that, but from where I sit the norm needs to change.
"They had two players collapse in offseason workouts. One of them survived. One of them did not."
Plancher's family has sued Central Florida.
The family of Aaron O'Neal recently settled a lawsuit with the University of Missouri after O'Neal's death during offseason conditioning in 2005. Part of the reason more information hasn't been shared among medical professionals, Anderson said, is that the information in these types of lawsuits is frequently sealed.
However, the Associated Press uncovered damning evidence when it acquired depositions taken from parties during the lawsuit proceedings. The depositions show that Missouri personnel apparently knew little about how to deal with an athlete with sickle cell trait struggling for his life.
• Documents show Missouri missteps at time of player's deathAccording to AP, strength and conditioning director Pat Ivey testified that he "lacked the necessary professional certification to be hired." In a deposition, Ivey said he lacked certification by the National Strength and Conditioning Association. According the AP, that certification is listed by the school as a condition of hiring.
Ivey and others were involved in dealing with O'Neal's emergency after he collapsed.
NSCA president Lee Brown was not familiar with the details of the Missouri case but he did surmise, "I would say people aren't doing their due diligence. If that's the job description, these people are hiring unqualified people and there's no excuse for that. They're running a greater risk and in this case it came back to bite them."
Brown called the NSCA "the gold standard" in the industry with approximately 35,000 members worldwide.
Without the revelations by AP, there would be less definition to the final settlement. Missouri paid $2 million to O'Neal's family. In exchange it got the final language that states no blame be put on Ivey, sports medicine director Rex Sharp, AD Mike Alden and coach Gary Pinkel.
In 2007, the National Athletic Trainers' Association released a consensus statement to help peers reduce the risk of collapse due to the trait. Obviously, screening and notification are important. But simple acclimation during the first days of practice allows any sickle cell trait athlete to compete normally.
Sickling of blood cells can occur in as few as two minutes into a strenuous practice, according to Oklahoma team internist Dr. Randy Eichner. Adding to the confusion, once a player collapses or dies the condition can be mistaken for heatstroke.
That apparently is what happened in the case of one I-AA player who died in 2000. The official cause of death was listed as heatstroke. The coroner, according to a source, had refused to consider sickle cell trait as a cause of death. Because the circumstances were similar to sickle cell trait overexertion, a call was placed to the school's trainer by one of his peers who had done research on the condition.
The last vial of the deceased players' blood was about to be thrown out before it was saved and examined. Despite the medical examiner's claims of heatstroke, after the blood was tested the players' death is listed here as "exertional sickling."
"When you talk to the experts, many of these cases have been missed by medical examiners," said J.D. Dowell, an attorney representing the Plancher family. "If the leading cause of death for football players is sickle cell, it would make sense that they know how to handle those particular athletes."
Obvious questions, then: Are deaths increasing because more is known about categorizing victims, or is the trait more prevalent? Or are coaches just running kids into the ground with harder practices without the proper precautions?
Coaches are not allowed to be present during such "voluntary" offseason drills. However, that term is a joke within the sport. Those who don't participate in offseason drills won't find themselves on the field in the fall.
Oklahoma is a leader in sickle trait research and awareness. Anderson and Eichner co-chaired the task force that produced the consensus statement. Eichner, Anderson and Fred Mueller have done landmark research on the subject. Dr. Mueller, a professor at North Carolina, is the director for the National Center for Catastrophic Sports Injury Research.
Anderson is proud of saying that if coaches have any doubts about sickle cell trait athletes, send them to Norman.
"We've done quite well with them, thank you," he said. "There's been some pretty good players here who have carried the trait."
At places like Maryland, coach Ralph Friedgen can reach across his desk and hold up a list of his sickle cell trait players. At others, it's obvious coaches and trainers don't know or don't care about what has become the game's leading killer.
The family of Rice's Dale Lloyd, who died in 2006, also is suing the school. The lawsuit alleges that Lloyd's death could have been prevented had Rice tested for sickle cell trait and the NCAA mandated it.
"It is shameful that these athletes continue to die from something that is completely preventable," Eichner said in 2006.
It's easy to reach a conclusion of general negligence similar to that of the plight of minority coaches in college football. There is a lot of talk about the issue, but not enough action. At many schools, minority coaches can't get a fair shot at being hired. It's more serious for some of the young African-Americans they are coaching. Those players are still dying.
"It wouldn't be [an issue] if they had the situation I went through," said Floyd Keith, the executive director of the Black Coaches Association.
That day in August 1974, when Polie Poitier died, Keith was the running backs coach at Colorado.
