Sudden Cardiac Arrest in Athletes: Lindsay’s Law & Liability in Ohio

SCA is the most common cause of death among young athletes, and as its name implies, it strikes quickly with little or no warning.

According to Boston Scientific, young athletes are more than twice as likely to experience sudden cardiac arrest as non-athletes. The overwhelming majority of sudden cardiac arrest cases occur in male basketball and football players.

Regardless of age or participation in sports, sudden cardiac arrest is survivable with prompt recognition and early treatment through CPR and / or use of an Automated External Defibrillator (AED). Even if a person survives cardiac arrest, however, he or she may sustain permanent brain injuries if there was a delay in treatment.

What is Sudden Cardiac Arrest?

SCA occurs when the electrical and mechanical activity of the heart stops working, resulting in almost immediate loss of consciousness and collapse. It happens when the heart suddenly (and unexpectedly) stops pumping blood, stopping the flow of oxygenated blood to the brain and vital organs.  

What Causes Sudden Cardiac Arrest?

In student-athletes, the most common causes of SCA stem from the following heart or cardiovascular conditions: 

• Hypertrophic cardiomyopathy (HCM): Generally a hereditary condition in which the walls of the heart thicken and disrupt the heart’s electrical system, which can lead to fast or irregular heartbeats (arrhythmias), and SCA.
• Arrhythmogenic right ventricular cardiomyopathy: A heart disease that usually starts in the right ventricle of the heart and causes irregular heart rhythms.
• Congenital coronary anomalies: People with congenital coronary anomalies are born with heart arteries that are connected abnormally and become compressed during exercise, which can lead to insufficient blood flow to the heart.
• Commotio cordis: A rare phenomenon that occurs as the result of a sudden, blunt-force blow to the chest (e.g., being hit by a hockey puck or another player) that can trigger ventricular fibrillation if it strikes at exactly the wrong time in the heart’s electrical cycle.
• Myocarditis: Inflammation of the heart muscle that can enlarge and weaken the heart, create scar tissue, and force the heart to work harder to circulate blood and oxygen in the body.

How to Recognize Sudden Cardiac Arrest

Early recognition of sudden cardiac arrest is key to saving the athlete’s life. Seizure-like activity, such as involuntary arm and leg movements, occurs in more than half of sudden cardiac arrests, which may lead bystanders and responders to mistakenly assume the victim is having a seizure, or that they fainted. But anytime  an athlete collapses, is not breathing normally or is only gasping, and is unresponsive, on-site responders need to assume sudden cardiac arrest.

How to Prepare for Sudden Cardiac Arrest in Student Athletes

State legislatures, sports leagues, and athletic organizations recognize the serious risks associated with sudden cardiac arrest in athletes, as well as the efficacy of quickly treating athletes who experience SCA. The result has been greater awareness about the potentially fatal condition and implementation of preventative and responsive measures designed to protect athletes.

Ohio, the National Athletic Trainers’ Association, and organizations like the NCAA, for example, have developed guidelines for how to prepare for and respond to SCA in young athletes. These and other efforts have led to accepted practices on the cardiovascular care of young athletes.

First, athletes should have a pre-participation physical evaluation by a doctor, including a thorough family health history. Second, sports organizations and facilities should have a written emergency action plan in place that requires:

• AEDs to be placed near or in high-risk areas, such as weight rooms, indoor arenas/courts, practice facilities, stadiums and fields;
• Clearly visible signage to show the location of an AED;
• Regular checks of AED to ensure proper battery charge and functional electrode pads;
• All athletic trainers, team physicians, and coaches to be trained in CPR and AED use;
• A communication system that ensures a rapid and coordinated response to cardiac arrest, both internally and for emergency medical services.

Ohio’s Lindsay’s Law

In March 2017, Ohio passed Lindsay’s Law (Ohio Revised Code 3313.5310, 3707.58 and 3707.59), to promote the protection of athletes from SCA in sports activities at the youth, middle school, and high school levels.

Lindsay’s Law applies to all public and private youth sports organizations for athletes 19 or younger, and it requires sports teams to educate students, young athletes, parents, and coaches about the warning signs of SCA and how to respond.

Under Lindsay’s Law, coaches have specific responsibilities, including requirements for:

• Completing an annual required SCA training course approved by the Ohio Department of Health;
• Preventing certain students (i.e. young athletes with parents, siblings, or a child who has experienced SCA, and any young athlete who experiences syncope or fainting before, during, or after a practice or game) from athletic participation until they receive written clearance from a licensed health professional.

Liability for Sudden Cardiac Arrest

Depending on the circumstances surrounding SCA, there may be parties who can be held liable for failures to protect student athletes. This may include:

• Youth organizations or coaches who do not comply with requirements to educate parents / players or implement and follow safety protocol under Lindsay’s Law;
• Sports organizations, universities, and schools that fail to adopt or follow emergency action plans or meet other requirements under applicable rules;
• Medical professionals who fail to diagnose heart or cardiovascular conditions that pose risks of sudden cardiac arrest;
• Sports organizations, universities, individuals, or health care providers who fail to promptly and appropriately respond to SCA warning signs. 

The Becker Law Firm has fought for injured victims and families across Ohio and the nation for decades, and has extensive experience handling personal injury and wrongful death lawsuits involving complex medical issues, medical malpractice, and negligence committed by individuals and entities with legal responsibilities for the safety of others. This includes cases involving athletes who’ve experienced sudden cardiac arrest.

If you have a potential case, please call or contact us online for a free consultation.