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Copyright 2003 The Atlanta Journal-Constitution
The Atlanta Journal and Constitution
September 7, 2003 Sunday Home Edition
SECTION: News; Pg. 1A
LENGTH: 3362 words
SERIES: PLAYING WITH DANGER
HEADLINE: PLAYING WITH DANGER: Athlete deaths test high school policy
BYLINE: CARLOS FRIAS
SOURCE: AJC
BODY:
Five high school athletes died on the playing fields of Georgia schools or
while traveling to competitions during the 2002-03 school year, prompting
concerned officials and grieving families to push for changes.
Changes that would provide thorough health screening, better on-site medical
care and supervised transportation.
Changes that some say cost too much money.
Changes that might have saved four of those lives.
* When Shai Owens collapsed at a cross-country meet in August of last year,
coaches and athletes frantically raced across the field to find a spectator who
could perform CPR because there were no medical personnel at the 18-team meet.
Shai, an outgoing 16-year-old honor student at DeKalb County's Cedar Grove High,
died two hours later. The cause: a heart problem undetected since birth.
A more thorough preseason physical might have detected the problem. And a
defibrillator --- a machine used to restart a stopped heart --- might have kept
her alive. Her mother has pushed for changes that would require both in the
aftermath of losing a daughter she called "my buddy."
"When I laugh about things, I can hear her laughing or talking," said
Nicolette Owens. "I keep her alive like that. And that's important, or otherwise
you become sad. You have to keep the person alive in your thoughts and in your
heart, and that's how they stay with you."
* Derrick Plankenhorn was coasting through a cool-down lap, jogging alongside a
friend during a track workout in February, when he dropped to the ground so
suddenly he couldn't break his fall. His coaches at Southeast Bulloch High, near
Statesboro, sprinted to his side, started CPR and called 911. An ambulance
arrived in eight minutes and paramedics shocked Derrick's heart with
defibrillator paddles. It was too late. Doctors later determined that no exam
would have detected the heart defect that caused his death.
"You can't blame anybody for something like that," said his father, Don
Plankenhorn. "You can't blame God. God knows what's right."
* Fourteen hours after Plankenhorn's death, Ryan Boslet was working out with his
football teammates at Chattahoochee High in Alpharetta. The 17-year-old had
received his first recruiting letter from a college the previous day and was
going all-out in the offseason workout in the school gym. When he collapsed near
the end of a running drill, school officials ran to get a nearby defibrillator
--- but no one knew how to use it. Like Shai, he had a heart problem that had
gone undetected since birth --- the kind doctors say can sometimes be detected
with proper screening.
His mother, Sandy Boslet, agonizes that she didn't know about the tests ---
and that she'll never know how to answer when she's asked, "How many children do
you have?"
"How do you explain that one is 17, and will always be 17?" she asked. "It's
extremely sad. To get through life, I hope to see him again one day. That's all
you can live on."
* Shane Williams and Daniel Hall III rode together to Greenbrier High in Evans,
outside of Augusta, every day. In April they died together when Williams' Ford
Explorer rolled over as they were driving to a school golf match. Williams, 17,
was driving the 16-year-old Daniel and two other teammates because Columbia
County school system officials, like most in the state, say they cannot afford
to provide buses and drivers for teams with small rosters.
Travel would be safer if they did, according to the National Highway Traffic
Safety Administration. Statistics show that car crashes are the biggest killers
of drivers aged 15 to 20. Moreover, teenagers are disproportionately at risk of
being involved in fatal car crashes when they are driving other teenagers,
according to the Insurance Institute of Highway Safety.
Daniel Hall's parents drove him to matches and practices for two years so he
wouldn't have to ride with teammates.
"It feels like someone has ripped open your chest, pulled out your heart and
left you open," said his mother, Angela Hall. "It's the worst **** on earth."
Debate heated
Georgia's three on-field deaths in 2002-03 far exceed the national average.
There were 33 high school sports-related deaths in the United States in
2001-02, the last year for which statistics are available from the National
Center for Catastrophic Sport Injury Research at the University of North
Carolina in Chapel Hill. No organization keeps statistics on how many athletes
are injured driving to events.
But these five deaths have sparked heated discussion about what changes
should be made --- and how to pay for them.
"The great block here is that you're talking about tons of money," said Herb
Garrett, executive director of the Georgia School Superintendents Association.
"State funds are being cut back, and the last thing anybody wants to do is raise
local taxes," Garrett said.
And some wonder how much of this is the schools' responsibility at all.
Ralph Swearngin, executive director of the Georgia High School Association,
said he wasn't sure he favored forcing schools to require more extensive health
screening, for instance.
"Here is my philosophical issue: At what point did the schools become
responsible for the primary health care of students?" he said. "Maybe this is a
symptom of another thing that has been going on for 30 or 40 years. There has
been a move that there are surrogate parents in various parts of our society.
And as a large part of it, they turn [that responsibility] over to our schools."
Areas of concern
Some experts say the risk to athletes could be reduced by making changes in
three major areas:
* Preseason physicals.
All high school athletes in Georgia must present proof of a physical
examination by a physician before being allowed to compete, but critics say the
exams often are not thorough enough to detect potential problems. Proponents are
pushing for an exam that requires three components: a personal and family
medical history plus a thorough physical exam, both of which are recommended by
the American Heart Association, and an echocardiogram, a screening procedure
that can detect certain heart problems.
Emory cardiologist Dr. Randy Martin, president of the American Society of
Echocardiography, said a family history and an echocardiogram would have
detected Shai Owens' abnormal valve and led to further screening.
"If you do all those things, then you've gone a long way, a very long way,"
said Martin.
He said an echocardiogram also would have detected Boslet's condition.
"If my kid could have been tested, he might be alive today," said Sandy
Boslet, Ryan's mother. "Gosh, if nothing else, this is a benefit that could save
someone else's life."
* On-site medical care.
A survey of 111 metro Atlanta high schools conducted by the
Journal-Constitution found that athletes often practice and compete without the
supervision of trained medical personnel and without adequate medical equipment
to deal with emergencies. Most schools have certified athletic trainers present
for contact sports, but not all sports. And only now are schools starting to add
defibrillators. Ambulances, once a staple at football games, are unavailable or
unaffordable.
Dr. Charles Wilmer, a cardiologist at Piedmont Hospital, cited national
statistics that show using an external defibrillator within the first minute
provides the victim a 90 percent chance of survival.
Nicolette Owens, Shai's mother, says her doctor told her there was a good
chance Shai might have been saved if a defibrillator had been on hand.
"If there had been someone there with a defibrillator, you never know what
could have happened with Shai," she said. "The bottom line is, I want our
children to have a chance, and one way to do that is to have medical personnel
right there at every event."
* Transportation to events.
It is common practice for athletes, primarily golfers and tennis players, to
drive themselves and teammates to competition. Many schools say they don't have
the money to provide buses and drivers for every team.
"Almost every member of the school board came to our home" after the crash,
said Daniel's father, Dan Hall II. "They did their obligatory visit, saying they
're sorry for this tragedy and all, but I told every one of them the same thing:
We need this changed. Kids should not have the responsibility of having to drive
other kids to a school athletic event again."
Hall's message was heard. On Aug. 12 the Columbia County school board
tentatively approved a measure that would bar athletes from driving other
athletes to events.
At other schools, the policies that put the teenagers in harm's way result
from financial priorities and limited school budgets, officials say. And it is
only after the recent deaths that remedies --- and resources --- are being found
to prevent other tragedies.
"There have been a lot of conversations about each one of those incidents,"
Brunswick High athletic director Charlie Jordan said. "Unfortunately, it takes
tragedies sometimes for folks to examine how they do things."
Screenings detect risks
Thorough screenings, such as the echocardiogram, have been labeled too costly
to provide for all athletes, and critics point out that they are far from
foolproof. But many doctors agree that such screenings can be successful in
detecting athletes at risk.
In Georgia, a form of the echocardiogram test is being made available to some
schools, but parents must pay $58 per student. A few other states have similar
programs. One in California, called A Heart for Sports, has screened a small
fraction of the state's athletes at no cost.
The parents of more than 500 athletes at Chattahoochee, Northview, Milton and
Marist high schools recently paid for their children to be tested through Heart
Screens for Teens, and 40 other schools are scheduled in upcoming months,
including Cedar Grove and Southeast Bulloch. The process is a joint venture
between Georgia Pediatric Cardiology, Ultrascan Inc. and Tom Vardase, a producer
of "Prep Sports +" on Georgia Public Television, who champions the cause.
Ultrascan, the largest provider in the Southeast of the machines that perform
echocardiograms, hopes to expand the program to other states.
The test "would have caught Ryan's condition, and it would have kept [Shai]
out of sports and treatments could have been offered to her," said Dr. Eduardo
Montana, a cardiologist who is supervising the screening and making $20 per
exam. "There are all sorts of treatments that could have been offered to her and
her family."
The echocardiogram uses sound waves to create dynamic moving pictures of the
heart, its valves, chambers and blood vessels, and is one of the most widely
used diagnostic tests for cardiovascular conditions, according to Emory's Heart
Center. It can detect the heart abnormality called hypertrophic cardiomyopathy,
which led to Boslet's death. A thickening of the walls of the heart, the
condition kills about one in 200,000 people.
Doctors say the $58 exams already have identified three at-risk athletes, who
will undergo additional testing.
"If I had known about it, [Ryan] would be here today," said Sandy Boslet, his
mother. "If I had even known that a $58 test would tell me, I would have done it
in a second. I spend that on a dinner. That's why we're trying to create this
awareness."
But some officials say the exam is too costly for some students.
"It's not a lot of money for [many of us], but when you're talking about
kids, immigrants from another country, that is a lot of money," said Charlie
Henderson, athletics director for DeKalb County schools. "The $58 . . . we have
got to figure out a way to have insurance pay for it."
It would cost about $8.7 million this year to test every high school athlete
in Georgia.
Other signs
Doctors say personal and family histories, which examine the health of
parents and other relatives, can reveal inherited conditions and provide warning
signs.
In Ryan's case, family history would have revealed that his grandfather
survived a heart attack in his early 60s and that his brother Chase was
diagnosed with a heart murmur at birth that prevents him from playing football.
Although one physician cleared Ryan to play, Wilmer, the cardiologist at
Piedmont Hospital, said he thought Ryan's condition could have been detected.
"If a brother has a heart problem, I'd be more inclined to look more
diligently at that patient," Wilmer said.
Two doctors from Children's Healthcare of Atlanta at Scottish Rite pressed
the Georgia High School Association to provide a more thorough physical
examination form recommended by the American Heart Association to help detect
athletes who might be at risk. Only 24 schools out of 301, polled by the doctors
in late 2001 and early 2002, had been asking the questions the AHA suggested.
"The most important thing is talking to the kid and making sure you have a
good family history," said Dr. Gerald Fletcher, AHA national spokesman and head
of preventive cardiology at the Mayo Clinic in Jacksonville. "Did dad have a
heart attack at age 40? And No. 2, the physical examination, testing for heart
murmurs and irregular heartbeat."
The high school association can only recommend using the new form. But an
Alpharetta lawmaker says he will introduce the "Ryan Boslet Bill" in the 2004
Legislature. Rep. Mark Burkhalter's bill would create a comprehensive physical
form that schools would be required to use. The bill also would create an
educational program designed to instruct students, parents, teachers, coaches
and administrators on emergency procedures. Burkhalter teaches an advanced
government class at Chattahoochee High.
On-site help is rare
It was pure chance that Shai Owens made it from the DeKalb County
cross-country field to the hospital.
Since no medical personnel were assigned to the meet, a Dunwoody High runner
's mother who is a nurse had to perform CPR on Shai, restoring her heartbeat and
stabilizing her heart rate before paramedics arrived.
In DeKalb, Gwinnett and City of Atlanta public schools, it's rare to find a
full-time certified athletic trainer, a profession recognized by the American
Heart Association.
South Gwinnett football coach T. McFerrin said Gwinnett's school board had
turned down requests by the county's athletics directors for a salary supplement
to hire full-time trainers each year since 1998.
"That needs to be done, because it's a big job and a full-time job," McFerrin
said. "It would make coaches feel a whole lot better about assessing any
situation by having a professional there at all times."
North Carolina requires that professional medical personnel be present at all
high school athletic events. Hawaii, the District of Columbia and the school
districts of Orlando and Fairfax County, Va., require their high schools to have
full-time certified athletic trainers. In North Carolina, the state's Department
of Public Instruction compels high schools to have a certified trainer or first
responder at every football practice or game.
While some of Georgia's 180 school systems do hire full-time trainers --- and
others, such as DeKalb, contract them for certain events --- 72 of the largest
metro schools have no full-time trainer.
Scottish Rite-based physician Dr. David Marshall, who specializes in sports
medicine and is a proponent of the new physical forms, said he would like to see
the situation improved.
"I'd like to see the state --- I'm not sure who that is --- regulate some
kind of athletic trainer coverage," he said. And not just for competitions.
"What about the 3,000 hours these kids practice?" he asked. "But it is
expensive."
The cost to keep a certified trainer on staff is about $35,000 per year,
which would add up to about $12 million per year for about 340 public high
schools in Georgia.
Few buy defibrillators
Schools and county school boards also are trying to raise money to acquire
defibrillators. New York law mandates the devices at all athletic events. In
Georgia, few schools have them.
DeKalb's Henderson vowed, after Shai Owens' death, that all of the county's
high schools, and eventually the middle schools, would have defibrillators at
all athletic events.
Wilmer, the Piedmont cardiologist, said there was "a good chance" a
defibrillator would have saved Ryan Boslet. "Those were events where you'd have
a high success rate, 60 to 80 percent," he said.
Every Fulton County high school purchased at least one of the machines after
Ryan's death. Chattahoochee has three that cost $3,000 each. One is in the main
office, one at the next-door middle school, where several of the teams practice,
and one is near the locker rooms in the gym.
The school also bought a $325 machine that trains people to use
defibrillators by simulating lifesaving scenarios.
"It shows how sometimes it takes tragedies like this before people wake up
and realize there was something more that could be done," said Ray Broadaway,
executive secretary of the Georgia Athletic Coaches Association.
Alabama high school officials think it's worth the cost. In February, Ashley
Sheppard, a basketball player at Hoover High near Birmingham, was saved by a
defibrillator after collapsing during a team practice. One of Hoover's three
full-time athletic trainers used the defibrillator to restore her heartbeat,
then performed CPR to get her breathing again. Sheppard was found to have a
heart defect and has given up sports.
The defibrillator used to save Sheppard was donated by an alumnus only eight
months earlier. Hoover has added three more defibrillators, and most high
schools around Birmingham have at least one, Hoover athletics director Ron Swann
said. Defibrillators cost $1,500 to $3,000.
"Now they're everywhere because that made big-time news," Swann said. "They
cost us about $2,000 [apiece], but to save a child's life is priceless."
Putting a defibrillator in every Georgia school, and training personnel to
use it, would cost about $1 million.
Money woes
Money is the major reason Shane Williams was driving three Greenbrier High
teammates to a school-sanctioned golf match.
The Columbia County school system, like many in the state, says it doesn't
have money to buy buses and pay trained drivers to take athletes to all
competitions, especially during spring, the busiest sports season. But officials
now are trying to decide how many buses are needed to transport all athletes.
Federal highway safety statistics make a strong case that buses are safer. An
average 10 teenagers are killed every day while driving, but only about two
teenagers a year are killed riding school buses.
Columbia County spends 4.2 percent of its $115 million budget on
transportation, and Superintendent Thomas Price called the transportation
process "poorly funded."
A bus that seats between 14 and 34 students --- large enough for every team
but football --- costs $38,000.
Dan Hall, whose son was killed in the Augusta wreck, believes golf gets
shortchanged because it doesn't generate revenue.
"We think that determines how things are done on the transportation level and
other levels: the weight of the revenue," said Hall. "Revenue from football is
big. Revenue from golf is zip."
Schools also have different policies on student participation in other
extracurricular activities. Some metro schools do not allow students involved in
debate, drama and play competitions to drive themselves. Others use a waiver
system.
Some school systems, such as Burke County near Augusta, Fulton County and
Henry County, have strict rules that forbid athletes to drive themselves or
other teens to events.
It means more money is spent on buses and drivers, but, said Burke County
Superintendent Doug Day, when children's safety is at play, "You have to find a
way to do it."
Staff writers Curtis Bunn, Michelle Hiskey, Todd Holcomb, Al Levine, John
Manasso and David Markiewicz and researcher Joni Zeccola contributed to this
article.
GRAPHIC: Photo: A collector's case in the Halls' living room holds Daniel's team
golf shirt, letters he earned, his Beta Club card, a Masters money clip and
other things important to him. / JOEY IVANSCO / Staff; Photo: > No exam would
have found Derrick Plankenhorn's heart problem.; Photo: Nick Williams of Evans
appears lost in thought in a room where awards and other sports memorabilia pay
tribute to his son Shane. Shane and another Greenbrier High student were killed
in a car crash on their way to play in a golf match. / JOEY IVANSCO / Staff;
Photo: > An undetected heart problem felled Shai Owens.; Photo: Memorabilia of
Ryan's football days adorn the Boslet family's fireplace. / JOEY IVANSCO /
Staff; Photo: A memorial at Chattahoochee High School pays tribute to Ryan
Boslet, near the football field where he died during practice. / JOEY IVANSCO /
Staff; Photo: > Ryan Boslet had a previously undetected heart problem.; Photo: >
Shane Williams died in the same car crash as Hall.; Graphic: SPORTS DEATHS
Fatalities in high school sports for 1999-00 through 2001-02, as compiled by the
National Center for Catastrophic Sport Injury Research at the University of
North Carolina at Chapel Hill.
1999-00
Football....15...44%
Basketball.. 4...12%
Other..... 15...44%
2000-01
Football....14...58%
Basketball.. 2... 8%
Other........8...33%
2001-02
Football....18.. 55%
Basketball.. 6.. 18%
Other........9.. 27%
Note: The percentages may not add up to 100 percent.
/ ROB SMOAK / Staff; Photo: Sharon Williams sits beside a backyard pond that her
husband, Nick, constructed in memory of their son Shane. / JOEY IVANSCO / Staff;
Photo: > Daniel Hall III died in a car crash going to a golf match.; Graphic:
ATHLETES AT RISK
In a survey of 111 metro schools, the Journal-Constitution found:
* Only 11 percent said they had medical personnel on hand for offseason
workouts.
* Only 43 percent have a full-time certified athletic trainer or provide one
five days per week.
* 57.6 percent allow athletes to drive themselves to events.
ME: Part 1 of a 3-part series about the dangers that high school athletes risk.
LOAD-DATE: September 8, 2003
Copyright 2003 The Atlanta Journal-Constitution
The Atlanta Journal and Constitution
September 7, 2003 Sunday Home Edition
SECTION: News; Pg. 1A
LENGTH: 3362 words
SERIES: PLAYING WITH DANGER
HEADLINE: PLAYING WITH DANGER: Athlete deaths test high school policy
BYLINE: CARLOS FRIAS
SOURCE: AJC
BODY:
Five high school athletes died on the playing fields of Georgia schools or
while traveling to competitions during the 2002-03 school year, prompting
concerned officials and grieving families to push for changes.
Changes that would provide thorough health screening, better on-site medical
care and supervised transportation.
Changes that some say cost too much money.
Changes that might have saved four of those lives.
* When Shai Owens collapsed at a cross-country meet in August of last year,
coaches and athletes frantically raced across the field to find a spectator who
could perform CPR because there were no medical personnel at the 18-team meet.
Shai, an outgoing 16-year-old honor student at DeKalb County's Cedar Grove High,
died two hours later. The cause: a heart problem undetected since birth.
A more thorough preseason physical might have detected the problem. And a
defibrillator --- a machine used to restart a stopped heart --- might have kept
her alive. Her mother has pushed for changes that would require both in the
aftermath of losing a daughter she called "my buddy."
"When I laugh about things, I can hear her laughing or talking," said
Nicolette Owens. "I keep her alive like that. And that's important, or otherwise
you become sad. You have to keep the person alive in your thoughts and in your
heart, and that's how they stay with you."
* Derrick Plankenhorn was coasting through a cool-down lap, jogging alongside a
friend during a track workout in February, when he dropped to the ground so
suddenly he couldn't break his fall. His coaches at Southeast Bulloch High, near
Statesboro, sprinted to his side, started CPR and called 911. An ambulance
arrived in eight minutes and paramedics shocked Derrick's heart with
defibrillator paddles. It was too late. Doctors later determined that no exam
would have detected the heart defect that caused his death.
"You can't blame anybody for something like that," said his father, Don
Plankenhorn. "You can't blame God. God knows what's right."
* Fourteen hours after Plankenhorn's death, Ryan Boslet was working out with his
football teammates at Chattahoochee High in Alpharetta. The 17-year-old had
received his first recruiting letter from a college the previous day and was
going all-out in the offseason workout in the school gym. When he collapsed near
the end of a running drill, school officials ran to get a nearby defibrillator
--- but no one knew how to use it. Like Shai, he had a heart problem that had
gone undetected since birth --- the kind doctors say can sometimes be detected
with proper screening.
His mother, Sandy Boslet, agonizes that she didn't know about the tests ---
and that she'll never know how to answer when she's asked, "How many children do
you have?"
"How do you explain that one is 17, and will always be 17?" she asked. "It's
extremely sad. To get through life, I hope to see him again one day. That's all
you can live on."
* Shane Williams and Daniel Hall III rode together to Greenbrier High in Evans,
outside of Augusta, every day. In April they died together when Williams' Ford
Explorer rolled over as they were driving to a school golf match. Williams, 17,
was driving the 16-year-old Daniel and two other teammates because Columbia
County school system officials, like most in the state, say they cannot afford
to provide buses and drivers for teams with small rosters.
Travel would be safer if they did, according to the National Highway Traffic
Safety Administration. Statistics show that car crashes are the biggest killers
of drivers aged 15 to 20. Moreover, teenagers are disproportionately at risk of
being involved in fatal car crashes when they are driving other teenagers,
according to the Insurance Institute of Highway Safety.
Daniel Hall's parents drove him to matches and practices for two years so he
wouldn't have to ride with teammates.
"It feels like someone has ripped open your chest, pulled out your heart and
left you open," said his mother, Angela Hall. "It's the worst **** on earth."
Debate heated
Georgia's three on-field deaths in 2002-03 far exceed the national average.
There were 33 high school sports-related deaths in the United States in
2001-02, the last year for which statistics are available from the National
Center for Catastrophic Sport Injury Research at the University of North
Carolina in Chapel Hill. No organization keeps statistics on how many athletes
are injured driving to events.
But these five deaths have sparked heated discussion about what changes
should be made --- and how to pay for them.
"The great block here is that you're talking about tons of money," said Herb
Garrett, executive director of the Georgia School Superintendents Association.
"State funds are being cut back, and the last thing anybody wants to do is raise
local taxes," Garrett said.
And some wonder how much of this is the schools' responsibility at all.
Ralph Swearngin, executive director of the Georgia High School Association,
said he wasn't sure he favored forcing schools to require more extensive health
screening, for instance.
"Here is my philosophical issue: At what point did the schools become
responsible for the primary health care of students?" he said. "Maybe this is a
symptom of another thing that has been going on for 30 or 40 years. There has
been a move that there are surrogate parents in various parts of our society.
And as a large part of it, they turn [that responsibility] over to our schools."
Areas of concern
Some experts say the risk to athletes could be reduced by making changes in
three major areas:
* Preseason physicals.
All high school athletes in Georgia must present proof of a physical
examination by a physician before being allowed to compete, but critics say the
exams often are not thorough enough to detect potential problems. Proponents are
pushing for an exam that requires three components: a personal and family
medical history plus a thorough physical exam, both of which are recommended by
the American Heart Association, and an echocardiogram, a screening procedure
that can detect certain heart problems.
Emory cardiologist Dr. Randy Martin, president of the American Society of
Echocardiography, said a family history and an echocardiogram would have
detected Shai Owens' abnormal valve and led to further screening.
"If you do all those things, then you've gone a long way, a very long way,"
said Martin.
He said an echocardiogram also would have detected Boslet's condition.
"If my kid could have been tested, he might be alive today," said Sandy
Boslet, Ryan's mother. "Gosh, if nothing else, this is a benefit that could save
someone else's life."
* On-site medical care.
A survey of 111 metro Atlanta high schools conducted by the
Journal-Constitution found that athletes often practice and compete without the
supervision of trained medical personnel and without adequate medical equipment
to deal with emergencies. Most schools have certified athletic trainers present
for contact sports, but not all sports. And only now are schools starting to add
defibrillators. Ambulances, once a staple at football games, are unavailable or
unaffordable.
Dr. Charles Wilmer, a cardiologist at Piedmont Hospital, cited national
statistics that show using an external defibrillator within the first minute
provides the victim a 90 percent chance of survival.
Nicolette Owens, Shai's mother, says her doctor told her there was a good
chance Shai might have been saved if a defibrillator had been on hand.
"If there had been someone there with a defibrillator, you never know what
could have happened with Shai," she said. "The bottom line is, I want our
children to have a chance, and one way to do that is to have medical personnel
right there at every event."
* Transportation to events.
It is common practice for athletes, primarily golfers and tennis players, to
drive themselves and teammates to competition. Many schools say they don't have
the money to provide buses and drivers for every team.
"Almost every member of the school board came to our home" after the crash,
said Daniel's father, Dan Hall II. "They did their obligatory visit, saying they
're sorry for this tragedy and all, but I told every one of them the same thing:
We need this changed. Kids should not have the responsibility of having to drive
other kids to a school athletic event again."
Hall's message was heard. On Aug. 12 the Columbia County school board
tentatively approved a measure that would bar athletes from driving other
athletes to events.
At other schools, the policies that put the teenagers in harm's way result
from financial priorities and limited school budgets, officials say. And it is
only after the recent deaths that remedies --- and resources --- are being found
to prevent other tragedies.
"There have been a lot of conversations about each one of those incidents,"
Brunswick High athletic director Charlie Jordan said. "Unfortunately, it takes
tragedies sometimes for folks to examine how they do things."
Screenings detect risks
Thorough screenings, such as the echocardiogram, have been labeled too costly
to provide for all athletes, and critics point out that they are far from
foolproof. But many doctors agree that such screenings can be successful in
detecting athletes at risk.
In Georgia, a form of the echocardiogram test is being made available to some
schools, but parents must pay $58 per student. A few other states have similar
programs. One in California, called A Heart for Sports, has screened a small
fraction of the state's athletes at no cost.
The parents of more than 500 athletes at Chattahoochee, Northview, Milton and
Marist high schools recently paid for their children to be tested through Heart
Screens for Teens, and 40 other schools are scheduled in upcoming months,
including Cedar Grove and Southeast Bulloch. The process is a joint venture
between Georgia Pediatric Cardiology, Ultrascan Inc. and Tom Vardase, a producer
of "Prep Sports +" on Georgia Public Television, who champions the cause.
Ultrascan, the largest provider in the Southeast of the machines that perform
echocardiograms, hopes to expand the program to other states.
The test "would have caught Ryan's condition, and it would have kept [Shai]
out of sports and treatments could have been offered to her," said Dr. Eduardo
Montana, a cardiologist who is supervising the screening and making $20 per
exam. "There are all sorts of treatments that could have been offered to her and
her family."
The echocardiogram uses sound waves to create dynamic moving pictures of the
heart, its valves, chambers and blood vessels, and is one of the most widely
used diagnostic tests for cardiovascular conditions, according to Emory's Heart
Center. It can detect the heart abnormality called hypertrophic cardiomyopathy,
which led to Boslet's death. A thickening of the walls of the heart, the
condition kills about one in 200,000 people.
Doctors say the $58 exams already have identified three at-risk athletes, who
will undergo additional testing.
"If I had known about it, [Ryan] would be here today," said Sandy Boslet, his
mother. "If I had even known that a $58 test would tell me, I would have done it
in a second. I spend that on a dinner. That's why we're trying to create this
awareness."
But some officials say the exam is too costly for some students.
"It's not a lot of money for [many of us], but when you're talking about
kids, immigrants from another country, that is a lot of money," said Charlie
Henderson, athletics director for DeKalb County schools. "The $58 . . . we have
got to figure out a way to have insurance pay for it."
It would cost about $8.7 million this year to test every high school athlete
in Georgia.
Other signs
Doctors say personal and family histories, which examine the health of
parents and other relatives, can reveal inherited conditions and provide warning
signs.
In Ryan's case, family history would have revealed that his grandfather
survived a heart attack in his early 60s and that his brother Chase was
diagnosed with a heart murmur at birth that prevents him from playing football.
Although one physician cleared Ryan to play, Wilmer, the cardiologist at
Piedmont Hospital, said he thought Ryan's condition could have been detected.
"If a brother has a heart problem, I'd be more inclined to look more
diligently at that patient," Wilmer said.
Two doctors from Children's Healthcare of Atlanta at Scottish Rite pressed
the Georgia High School Association to provide a more thorough physical
examination form recommended by the American Heart Association to help detect
athletes who might be at risk. Only 24 schools out of 301, polled by the doctors
in late 2001 and early 2002, had been asking the questions the AHA suggested.
"The most important thing is talking to the kid and making sure you have a
good family history," said Dr. Gerald Fletcher, AHA national spokesman and head
of preventive cardiology at the Mayo Clinic in Jacksonville. "Did dad have a
heart attack at age 40? And No. 2, the physical examination, testing for heart
murmurs and irregular heartbeat."
The high school association can only recommend using the new form. But an
Alpharetta lawmaker says he will introduce the "Ryan Boslet Bill" in the 2004
Legislature. Rep. Mark Burkhalter's bill would create a comprehensive physical
form that schools would be required to use. The bill also would create an
educational program designed to instruct students, parents, teachers, coaches
and administrators on emergency procedures. Burkhalter teaches an advanced
government class at Chattahoochee High.
On-site help is rare
It was pure chance that Shai Owens made it from the DeKalb County
cross-country field to the hospital.
Since no medical personnel were assigned to the meet, a Dunwoody High runner
's mother who is a nurse had to perform CPR on Shai, restoring her heartbeat and
stabilizing her heart rate before paramedics arrived.
In DeKalb, Gwinnett and City of Atlanta public schools, it's rare to find a
full-time certified athletic trainer, a profession recognized by the American
Heart Association.
South Gwinnett football coach T. McFerrin said Gwinnett's school board had
turned down requests by the county's athletics directors for a salary supplement
to hire full-time trainers each year since 1998.
"That needs to be done, because it's a big job and a full-time job," McFerrin
said. "It would make coaches feel a whole lot better about assessing any
situation by having a professional there at all times."
North Carolina requires that professional medical personnel be present at all
high school athletic events. Hawaii, the District of Columbia and the school
districts of Orlando and Fairfax County, Va., require their high schools to have
full-time certified athletic trainers. In North Carolina, the state's Department
of Public Instruction compels high schools to have a certified trainer or first
responder at every football practice or game.
While some of Georgia's 180 school systems do hire full-time trainers --- and
others, such as DeKalb, contract them for certain events --- 72 of the largest
metro schools have no full-time trainer.
Scottish Rite-based physician Dr. David Marshall, who specializes in sports
medicine and is a proponent of the new physical forms, said he would like to see
the situation improved.
"I'd like to see the state --- I'm not sure who that is --- regulate some
kind of athletic trainer coverage," he said. And not just for competitions.
"What about the 3,000 hours these kids practice?" he asked. "But it is
expensive."
The cost to keep a certified trainer on staff is about $35,000 per year,
which would add up to about $12 million per year for about 340 public high
schools in Georgia.
Few buy defibrillators
Schools and county school boards also are trying to raise money to acquire
defibrillators. New York law mandates the devices at all athletic events. In
Georgia, few schools have them.
DeKalb's Henderson vowed, after Shai Owens' death, that all of the county's
high schools, and eventually the middle schools, would have defibrillators at
all athletic events.
Wilmer, the Piedmont cardiologist, said there was "a good chance" a
defibrillator would have saved Ryan Boslet. "Those were events where you'd have
a high success rate, 60 to 80 percent," he said.
Every Fulton County high school purchased at least one of the machines after
Ryan's death. Chattahoochee has three that cost $3,000 each. One is in the main
office, one at the next-door middle school, where several of the teams practice,
and one is near the locker rooms in the gym.
The school also bought a $325 machine that trains people to use
defibrillators by simulating lifesaving scenarios.
"It shows how sometimes it takes tragedies like this before people wake up
and realize there was something more that could be done," said Ray Broadaway,
executive secretary of the Georgia Athletic Coaches Association.
Alabama high school officials think it's worth the cost. In February, Ashley
Sheppard, a basketball player at Hoover High near Birmingham, was saved by a
defibrillator after collapsing during a team practice. One of Hoover's three
full-time athletic trainers used the defibrillator to restore her heartbeat,
then performed CPR to get her breathing again. Sheppard was found to have a
heart defect and has given up sports.
The defibrillator used to save Sheppard was donated by an alumnus only eight
months earlier. Hoover has added three more defibrillators, and most high
schools around Birmingham have at least one, Hoover athletics director Ron Swann
said. Defibrillators cost $1,500 to $3,000.
"Now they're everywhere because that made big-time news," Swann said. "They
cost us about $2,000 [apiece], but to save a child's life is priceless."
Putting a defibrillator in every Georgia school, and training personnel to
use it, would cost about $1 million.
Money woes
Money is the major reason Shane Williams was driving three Greenbrier High
teammates to a school-sanctioned golf match.
The Columbia County school system, like many in the state, says it doesn't
have money to buy buses and pay trained drivers to take athletes to all
competitions, especially during spring, the busiest sports season. But officials
now are trying to decide how many buses are needed to transport all athletes.
Federal highway safety statistics make a strong case that buses are safer. An
average 10 teenagers are killed every day while driving, but only about two
teenagers a year are killed riding school buses.
Columbia County spends 4.2 percent of its $115 million budget on
transportation, and Superintendent Thomas Price called the transportation
process "poorly funded."
A bus that seats between 14 and 34 students --- large enough for every team
but football --- costs $38,000.
Dan Hall, whose son was killed in the Augusta wreck, believes golf gets
shortchanged because it doesn't generate revenue.
"We think that determines how things are done on the transportation level and
other levels: the weight of the revenue," said Hall. "Revenue from football is
big. Revenue from golf is zip."
Schools also have different policies on student participation in other
extracurricular activities. Some metro schools do not allow students involved in
debate, drama and play competitions to drive themselves. Others use a waiver
system.
Some school systems, such as Burke County near Augusta, Fulton County and
Henry County, have strict rules that forbid athletes to drive themselves or
other teens to events.
It means more money is spent on buses and drivers, but, said Burke County
Superintendent Doug Day, when children's safety is at play, "You have to find a
way to do it."
Staff writers Curtis Bunn, Michelle Hiskey, Todd Holcomb, Al Levine, John
Manasso and David Markiewicz and researcher Joni Zeccola contributed to this
article.
GRAPHIC: Photo: A collector's case in the Halls' living room holds Daniel's team
golf shirt, letters he earned, his Beta Club card, a Masters money clip and
other things important to him. / JOEY IVANSCO / Staff; Photo: > No exam would
have found Derrick Plankenhorn's heart problem.; Photo: Nick Williams of Evans
appears lost in thought in a room where awards and other sports memorabilia pay
tribute to his son Shane. Shane and another Greenbrier High student were killed
in a car crash on their way to play in a golf match. / JOEY IVANSCO / Staff;
Photo: > An undetected heart problem felled Shai Owens.; Photo: Memorabilia of
Ryan's football days adorn the Boslet family's fireplace. / JOEY IVANSCO /
Staff; Photo: A memorial at Chattahoochee High School pays tribute to Ryan
Boslet, near the football field where he died during practice. / JOEY IVANSCO /
Staff; Photo: > Ryan Boslet had a previously undetected heart problem.; Photo: >
Shane Williams died in the same car crash as Hall.; Graphic: SPORTS DEATHS
Fatalities in high school sports for 1999-00 through 2001-02, as compiled by the
National Center for Catastrophic Sport Injury Research at the University of
North Carolina at Chapel Hill.
1999-00
Football....15...44%
Basketball.. 4...12%
Other..... 15...44%
2000-01
Football....14...58%
Basketball.. 2... 8%
Other........8...33%
2001-02
Football....18.. 55%
Basketball.. 6.. 18%
Other........9.. 27%
Note: The percentages may not add up to 100 percent.
/ ROB SMOAK / Staff; Photo: Sharon Williams sits beside a backyard pond that her
husband, Nick, constructed in memory of their son Shane. / JOEY IVANSCO / Staff;
Photo: > Daniel Hall III died in a car crash going to a golf match.; Graphic:
ATHLETES AT RISK
In a survey of 111 metro schools, the Journal-Constitution found:
* Only 11 percent said they had medical personnel on hand for offseason
workouts.
* Only 43 percent have a full-time certified athletic trainer or provide one
five days per week.
* 57.6 percent allow athletes to drive themselves to events.
ME: Part 1 of a 3-part series about the dangers that high school athletes risk.
LOAD-DATE: September 8, 2003
