Cornell lax player collapses

[RichH]

A similar event happened to Chris Pronger in the 1998 NHL playoffs.  He was struck in the chest with a puck, and was unconcious for several minutes.  Apparently he went into cardiac arrhythmia, and was kept in the hospital, but recovered and played in the next game.

http://www.canoe.ca/NHLPlayoffsGallery98/may10_2.html

I remember that as being a very freightening episode.  It's an absolute tragedy that Boiardi didn't recover.  My thoughts go out to everyone who knew George.

[Chris 02]

[Q]Beeeej Wrote:

 Ribbon?  What am I missing?

What a godawful thing to happen.  I'm just horrified.

Beeeej

[/Q]

See the front page of the forum.

[ugarte]

[Q]Beeeej Wrote:

 Ribbon?  What am I missing?

What a godawful thing to happen.  I'm just horrified.
[/Q]Look on the forum message list page, in place of the prior championships.

[Pete Godenschwager]

Tony Kornheiser is talking about the subject on his radio show right now

[Erica]

The Post has an article. I think you have to register to read the link.

http://www.washingtonpost.com/wp-dyn/articles/A6171-2004Mar18.html

[DeltaOne81]

I hate to spread rumors, but I've read from a few sources, including a Newsday article, that the cause of death may not have been commotio cordis, but rather internal bleeding caused by a shot to the abdomen, not chest. I wouldn't share it if it was just forum speculation, but Newsday carries enough weight to at least be worth a mention.

We'll have to wait for more official releases, obviously, but the, well, I hate to call it an 'upside', is that this is easier to protect against. While commotio cordis can't be easily protected, even by kevlar vests, . RIP George. Perhaps your memory can help make the game safer for others.

http://www.newsday.com/sports/lacrosse/ny-spdeath0319,0,3452756.story?coll=ny-sports-headlines

[Al DeFlorio]

[Q]DeltaOne81 Wrote:

 I hate to spread rumors, but I've read from a few sources, including a Newsday article, that the cause of death may not have been commotio cordis, but rather internal bleeding caused by a shot to the abdomen, not chest. I wouldn't share it if it was just forum speculation, but Newsday carries enough weight to at least be worth a mention.

We'll have to wait for more official releases, obviously, but the, well, I hate to call it an 'upside', is that this is easier to protect against. While commotio cordis can't be easily protected, even by kevlar vests, . RIP George. Perhaps your memory can help make the game safer for others.

http://www.newsday.com/sports/lacrosse/ny-spdeath0319,0,3452756.story?coll=ny-sports-headlines



Edited 1 times. Last edit at 03/19/04 05:33PM by . [/Q]

Similar report from the Daily Pennsylvanian:http://www.dailypennsylvanian.com/vnews/display.v/ART/406d0d940dd73

[Jim Hyla]

Firstly, I don't know how they could have gotten away without an autopsy. Most cases of unexplained death are medical examiner cases where he can order an autopsy without needing family permission. I can't imagine a medical examiner not doing a post, but does Ithaca have a pathologist as ME, or some less qualified person. It should be on the death certificate which I think is an open record, isn't it?

Secondly. the quote "Sources originally speculated that Boiardi died of commotio cordis, but if that were the case, he likely would have been revived with defibrillation." is not true. I've spoken with some very knowledgeable cardiologists, specializing in electrophysiology, who say there is something very special about this form of cardiac arrhythmia which makes it especially resistant to defibrillation.

[DeltaOne81]

Yeah, Jim's right that the second part doesn't hold up, but it's just the Daily Pennsylvanian. The first part appears to make sense, though a Sun article a few days ago had quotes from the university that, while not officially commenting on the cause of death, said that there could be other causes for bleeding, such as his fall.

Nonetheless, it really is a shame that they family decided not to get an official cause of death, IMHO. I believe the law on needing one varies by state and perhaps by conditions. For religious reasons or whatever, I generally think the family should have a choice, I just wish in this case they had made a different one.

[Jerseygirl]

Why is it a shame that the family didn't get a cause of death?  Their son is dead.  Do you think why he died really matters to them?  An autopsy isn't going to change anything for them.  Should the get a cause of death to satisfy everyone's morbid curiosity about this horrible tragedy?  So we can all go, "Ah yes, that was it, I guess we can stop debating"?  Or are you saying it's a shame purely because you think science should have their answer?  Be honest with yourself.  
I'm one of those people who likes to know everything that happens and why, but God forbid, if I were a parent whose child died, there's no way I'd lay my kid out on a ceramic table and let someone cut him or her open so people could have answers.  It's not a shame, it's a totally legitimate choice.  I'd say the real shame is the questioning of the choice at all, but whatever, free speech...

[DeltaOne81]

I honestly wish they had made another choice because it could possibly help avoid future tragedies. If it was commotio cordis, well, there's unfortunately not to much to be done about it, it seems. But if it was something else, we could know so the NCAA and appropriate authorities could decide if there's anything to do to avoid tragedies like this from occurring again.

I agree that the family should have every right to decide based on their own values and decisions - perhaps except in the cases of a criminal investigation.

Anyhow, I'm sorry the misunderstanding, the last thing I want to do it cause an argument around this situation. I feel bad in a way everything I post to this thread, so this is all I'll say. But it's not just morbid curiousity or some phantom ideal about science... I would hope that we could get real answers so maybe something could be done to decrease the likelyhood of anyone having to experience what the lax community, Cornell community, and the Boiardi family have.

[Greenberg \'97]

As a former lacrosse player and future medical examiner, I've been meaning to chime in on this for a while.

Autopsy permission is a state-by-state decision.  However, I believe medical examiner jurisdiction varies by municipality.  In New York City (where I am most familiar), we follow New York State law for hospital autopsies (requiring permission from the next of kin), but the medical examiner has jurisdiction over all cases of "unnatural death."  In this case, as the death was caused by injury, it would have been a medical examiner's case, who would have certainly performed an autopsy.

The one exception to this is when a family strongly objects to autopsy, usually on religious grounds.  It is the ME's discretion as to whether or not to grant that objection, or to proceed with the autopsy.  The ME will take into account several factors, the most important of which is the implication on public health.  (In my opinion, learning about a sports injury to possibly make equipment safer in the future IS in the interest of public health).

Now, about commotio cordis... Whether or not this electrophysiological phenomenon actually happens is controversial.  Some cases that were thought to be commotio cordis, upon detailed dissection of the heart, turned out to show microscopic cardiac contusion, with actually injury to the cardiac muscle.

From a resuscitation point of view, asystole (the absence of electrical activity) does not respond to defibrillation.  Any movie or TV show where you see them shock a flatliner is just wrong.  If commotio cordis exists, and it results in asystole, it wouldn't respond to electric defibrillation.

Blunt trauma to the chest can cause death numerous other ways -- a fractured sternum, a lacerated aorta, cardiac contusion or rupture.  He also could have had one of several congenital heart diseases that happened to be aggravated by the injury (such as hypertrophic cardiomyopathy, the classic "young athlete with sudden death").  In this sense, it is a great disservice to his family to forego an autopsy.

The bottom line is that determining a true cause of death in such a case is much more than just "morbid curiosity."

All that aside, I continue to extend my deepest sympathy to Boiardi's on- and off-field families.

Michael J. Greenberg, M.D.
Resident, Department of Pathology, Mount Sinai Hospital
Fellow, Office of Chief Medical Examiner, City of New York (2005-06)

[Jim Hyla]

[Q]Greenberg '97 Wrote:

 As a former lacrosse player and future medical examiner, I've been meaning to chime in on this for a while.

Autopsy permission is a state-by-state decision.  However, I believe medical examiner jurisdiction varies by municipality.  In New York City (where I am most familiar), we follow New York State law for hospital autopsies (requiring permission from the next of kin), but the medical examiner has jurisdiction over all cases of "unnatural death."  In this case, as the death was caused by injury, it would have been a medical examiner's case, who would have certainly performed an autopsy.

The one exception to this is when a family strongly objects to autopsy, usually on religious grounds.  It is the ME's discretion as to whether or not to grant that objection, or to proceed with the autopsy.  The ME will take into account several factors, the most important of which is the implication on public health.  (In my opinion, learning about a sports injury to possibly make equipment safer in the future IS in the interest of public health).

Now, about commotio cordis... Whether or not this electrophysiological phenomenon actually happens is controversial.  Some cases that were thought to be commotio cordis, upon detailed dissection of the heart, turned out to show microscopic cardiac contusion, with actually injury to the cardiac muscle.

From a resuscitation point of view, asystole (the absence of electrical activity) does not respond to defibrillation.  Any movie or TV show where you see them shock a flatliner is just wrong.  If commotio cordis exists, and it results in asystole, it wouldn't respond to electric defibrillation.

Blunt trauma to the chest can cause death numerous other ways -- a fractured sternum, a lacerated aorta, cardiac contusion or rupture.  He also could have had one of several congenital heart diseases that happened to be aggravated by the injury (such as hypertrophic cardiomyopathy, the classic "young athlete with sudden death").  In this sense, it is a great disservice to his family to forego an autopsy.

The bottom line is that determining a true cause of death in such a case is much more than just "morbid curiosity."

All that aside, I continue to extend my deepest sympathy to Boiardi's on- and off-field families.

Michael J. Greenberg, M.D.
Resident, Department of Pathology, Mount Sinai Hospital
Fellow, Office of Chief Medical Examiner, City of New York (2005-06)[/q]Thanks, that was the best discussion, about the process and reasons, yet posted. Autopsies do make a difference.

[Jerseygirl]

I am well aware of the many arguments in favor of autopsy in cases such as this, especially the argument of "if we did an autopsy and determined that this could be prevented  by wearing a chest guard, the sport would be made safer for everyone."  And I know autopsies make a difference.  In fact, one of the first thoughts I had after I heard the terrible news was, "I hope this makes them finally put chest guards on those kids."  
However, I also feel like in an age when information is more accessible than ever, people have developed a "right to know" mentality.  I work in news, and I see it all the time.  Sometimes we don't scoop everyone else by broadcasting the gory details of the latest attack in Iraq, but I rest easy at night knowing we broadcast our show with dignity and respect.  My friend was shot while serving in Iraq, and as they loaded him in the ambulance, a Fox News crew stuck a camera in his face and recorded the event.  He asked them to turn the camera off, saying, "I don't want my mom to see this, please."  Well, they didn't and she did.  If people didn't have a morbid curiosity to get every detail of every issue, my friend wouldn't have had to worry about his mother seeing him after he got shot, BEFORE she was notified by the army.  He's fine, by the way.
My sophomore year, I had a writing class with a very prominent member of the hockey team.  The fact that it was an amazing class aside, he turned in a damn good memoir about what else?  Playing hockey.  One of the lines stuck out and made me incredibly sad, partly because I knew I was guilty of what he was writing about.  He said, "People point and whisper in the library or on the arts quad when they see me.  I hear my name talked about like the weather.  They think I can't see them or hear them, but it's one thing I've never gotten used to."  
Do people have a right to talk about his glove side weakness?  Of course.  But in doing so, I think it's easy to lose sight of the fact that we're talking about people instead of commodities.  That's one thing that sometimes troubles me about this board, and why I reacted the way I did to DeltaOne81's post.  George was a great kid, and it would be really nice to not reduce a fine young man's life and death to a medical debate, as I interpreted this thread was turning into.  In fact, it would be really nice to keep in mind that for the most part we're talking about students who sacrifice a great deal to play the sport they love.  Maybe I have such strong feelings because while other people criticize someone's slipping goal production, I've seen him pop 4000 mgs of Ibuprofen at once because he just wants his arm to stop hurting.  When we make "objective" and sometimes downright cold assessments of someone's talent and/or effort, it would be nice to remember that he's not a seasoned professional getting paid millions of dollars to play for us.  I could go on, but I won't, because I have a lot of thoughts in my head and I'm having trouble getting them out.  A lot of things would be nice.  
So yeah, maybe I'm more upset about George's passing than I've been admitting to myself.  All I am saying is while I really do understand the many medical reasons beyond morbid curiosity (and there's no one who just wants to know what the cause of death was?  Come on.), I think that at this point we can do nothing but accept that we're not going to get a definitive answer, and it does nothing to question the family's decision.  
That said, between Eamon and George, Cornell Lacrosse has some damn fine guardian angels.  Here's hoping they're having a good old time playing catch up in heaven.  

[David Harding]

Thank you