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5 months ago
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The loved ones of rising Manly Sea Eagles star Keith Titmuss have finally received answers about his death more than three years after he collapsed during pre-season training.
Keith Titmuss lost consciousness immediately after a 139-minute training session at the team's headquarters on Sydney's northern beaches on November 23, 2020.
On Friday, deputy state coroner Derek Lee concluded the 20-year-old had died of exertional heat stroke after an inappropriately difficult training session.
He had been training for more than two hours in the first pre-season session of the year, which encompassed both an outdoor session and indoor session in a 'hot and stuffy' gym.
Keith Titmuss (pictured) died after collapsing during a pre-season training session with Manly in November 2020
The Sea Eagles forward was just 20 years old when he died after what a corner has branded an 'inappropriate' level of exercise
The inquest heard Mr Titmuss had gained four kilos during the off season and his fitness test scores suggested he was 'the least fit member of the squad'.
Counsel assisting the coroner, Adam Casselden SC, said the 'unnecessarily and inappropriately tough' session highlighted the need for individualised training programs tailored to each player's build and fitness level.
Experts told the inquest Mr Titmuss' higher body mass and lower aerobic fitness levels were risk factors that contributed to him overheating from exertion on the 'mild' 24C day.
Coroner Lee found the combined risk factors meant the training session was more difficult for Mr Titmuss, who was then 'at greater risk of heat illness'.
The evidence showed the young forward was likely experiencing involuntary dehydration by the time he entered the 'very hot, very humid' indoor gym.
One of the paramedics who treated the 20-year-old while he was seizing measured his temperature at nearly 42C, which was the highest they'd ever seen.
Titmuss (pictured playing for Hunters Hill rugby union club as a teen) recorded a temperature of 42 degrees before he died - with paramedics saying it was the highest they'd ever seen
The promising forward had been training for more than two hours - with part of the program conducted in a 'hot and stuffy gym' - before suffering heat stroke
Coroner Lee found Manly staff and paramedics had both reacted appropriately when treating Mr Titmuss' alarming collapse and subsequent seizures.
'There is no evidence to suggest anything more could have been done by those immediately present,' he said.
He determined the application of ice packs to the collapsed player 'would not have resulted in any significant reduction in Keith's temperature' but could have presented a risk of injury.
The inquest heard Mr Titmuss' collapse came just two years after Manly star Lloyd Perrett survived a 'near miss' when he collapsed from heat exertion during training.
In his closing submissions, Mr Casselden suggested Coroner Lee should recommend that Manly and the NRL use Mr Titmuss' tragic death as a case study for education and awareness around heat illnesses.
He made a number of recommendations about improving the NRL heat policy which are tied to an ongoing independent review by two heat illness experts who were commissioned by the NRL.
Titmuss's shattered father Paul and mother Lafo (pictured) are hoping his death results in major changes being made by the NRL
Mr Casselden suggested clarifying heat guidelines applicable to indoor and outdoor training sessions, as well as altering training sessions based on environmental factors.
He also endorsed a mandated two-week acclimatisation period after players return to training from an off-season and requirement for a medical officer to sign off on training programs.
Another key focus should be implementing screening to determine which players are at risk of heat illness and classifying them to ensure tailored training sessions, Mr Casselden said.
Mr Titmuss' family asked the NRL be made to enforce mandatory reporting of all heat related injuries in order to create a comprehensive understanding of the pervasiveness of the issue.
Titmuss's family and supporters wore shirts honouring him as the case was heard by the coroner (pictured)
His mother Lafo previously said she hoped the inquest could lead to changes for the sport her son loved so much.
'We are encouraged (by) the NRL's internal review and its commitments to enhancing its knowledge and understanding across all clubs, staff and players,' she said.
'We hope the findings from this inquest will be instructive not just to the NRL, but to sport across Australia and worldwide.'
At the time of his death, Mr Titmuss was on the cusp of his big break after being elevated to the club's top-30 squad.
He was described throughout the inquest as 'kind', 'gentle' and 'genuine bloke' who was 'hard working' and beloved by his teammates and friends.
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