A teenager suffered a cardiac arrest after he was accidentally struck in the chest by a team-mate during a hurling match at the exact moment his heart was vulnerable to electrical spasm, an inquest was told yesterday.
Kevin Quinn (18), an apprentice electrician, received the blow which triggered ventricular arrhythmia and led to cardiac arrest when he was playing for Harbour Rovers, from Glanworth in north Cork on August 13th, 2004.
Pathologist Margaret Bolster told the inquest that Mr Quinn, from Boherash, Glanworth, had suffered what is known in medical literature as commotio cordis which occurs when somebody receives a blunt force trauma during sporting activity.
Dr Bolster explained that the heart goes through a normal cycle while pumping blood around the body, but there was a particular moment, just a fraction of a second, when it is vulnerable to blunt force trauma sending it into electrical spasm.
She examined the medical literature and found that such blunt force during sporting activity did not have to be excessive to prove fatal. Dr Bolster cited the example of a child dying after his father threw a ball to him while playing in their garden.
"It is important to note that in each incident, the impact was not judged extraordinary . . . it is accepted that the force does not have to be excessive if it happens at that particular moment to cause the heart to go into this electrical spasm," said Dr Bolster.
The inquest heard how Mr Quinn, who was playing right half forward for Harbour Rovers in their Division 3 Junior League Final against Newtownshandrum, at Shanballymore, on the evening in question, had been very involved in the early action in the game.
Harbour Rovers right corner forward, Pat O'Brien (25) from Ballindangan, Mitchelstown told the inquest that the game was just four minutes old when he and his Newtownshandrum marker both raced out to meet a ball and they both pulled high over their heads.
"I felt that I hit Kevin as he came in from my right, I had seen someone coming from my right out of the corner of my eye, I knew the hurley had connected with Kevin as I swung for the ball, but the impact didn't stop the hurley from following through.
"The hurley would have been about four feet (off the ground) at the time of the impact, I heard Kevin let out a shout," said Mr O'Brien, adding that he raced back to Kevin after the ball went out of play and he saw him on his knees complaining about the pain in his chest.
Glanworth selector Paul O'Dwyer told how he raced in to help Mr Quinn who was saying: "My chest, my chest is killing me."Mr O'Dwyer said he noticed a graze on his chest and seconds later he rolled over on his left side and went out of consciousness and his eyes were rolling.
Nurse Nell Sheehan, who was attending the game, assisted and gave Mr Quinn CPR until Dr Catherine Kelleher arrived some 10 minutes later and together with an ambulance crew, they administered electric shock treatment to try and revive Mr Quinn.
Dr Kelleher said she had used an Automatic External Defibrillator which advised electric shocking the patient, and she inserted an intravenous line and gave him adrenaline and six shocks, but there was no response and she pronounced Mr Quinn dead at 7.55pm. Dr Bolster said she found no evidence that Mr Quinn had taken any alcohol, prescribed drugs or prohibited drugs. She also found no evidence of any heart disease or any heart condition and he appeared to have been healthy.
She found a graze about six centimetres long by 0.4cms wide on his chest and this was surrounded by bruising approximately eight centimetres long by two centimetres wide, consistent with a blow of a hurley to the chest.
She reviewed the medical literature on commotio cordis and found there was a very low rate of rescue in such cases, with the highest reported rate being just 16 per cent. "The only chance is to have a defibrillator at the scene, but even then, there is a very low rate of rescue."
The jury was shown a video of the clash in which Mr Quinn was injured and it supported Mr O'Brien's assertion that his pull on the ball which hit Mr Quinn was a typical pull in a hurling match, and "wasn't anything out of the ordinary".
North Cork coroner Dr Michael Kennedy said he had forwarded details of the tragedy to Dr Mick Molloy, of the Royal College of Surgeons in Ireland and the Royal College of Physicians of Ireland, who is conducting a review of sporting deaths and plans to publish a series of recommendations later this year.
The jury returned a verdict of accidental death.