A soccer league game in Romania’s top division on Friday (May 6) took a tragic turn after Patrick Ekeng, a 26-year-old Cameroonian player, collapsed after seven minutes in the game as a substitute for his club, Dinamo Bucharest. Ekeng’s collapse, which happened without contact with any other player, prompted treatment on the pitch, and when it became clear he required more medical attention, he was wheeled into an ambulance to be taken to a nearby hospital.

Ekeng was pronounced dead less than two hours later, and an inquiry into his death has released some shocking findings. Romania’s interior ministry has suspended the license of a private ambulance company that transported Ekeng after finding the ambulance had defibrillators with expired batteries and expired medicine. The ambulance company has also been fined $6,000.

Hasan Anil Eken, Ekeng’s agent, told Reuters that even though there were ambulances at the stadium, none of them were properly equipped to give Ekeng adequate medical care en-route the hospital. “There were three ambulances around the stadium but none of them had a defibrillator,” Eken told Reuters.

FIFPRO, the global union for soccer players, said it had “concerns” and “expects answers” as to whether Ekeng’s death could have been avoided. It also criticized the levels of emergency medical care at Romanian soccer clubs, which the organization said have a history of “skimping on medical facilities.”

Collapses are not so rare in soccer. Most such incidents are attributed to heart conditions, so clubs and the global bodies that oversee them have taken measures to try to protect players. The world soccer governing body, FIFA, introduced mandatory cardiac testing for players and the Asian Football Confederation made it compulsory for defibrillators to be present at all official matches on the continent.

In Romania, AFAN, the soccer players’ union, has tried to take similar steps. After the 2012 death of the Nigerian soccer player Henry Chinonso Ihelewere (also after a collapse during a Romanian soccer league match), the union asked the country’s football federation to adopt plans to have ambulances with state-of-the-art equipment at all official and friendly matches. Emilian Hulubei, AFAN president, says the plan would have cost “as little as 400 euros per club per match” but it was not taken up.

Adequate and prompt medical care can prove the difference between life and death. In 2012, during a Premier League soccer game in the UK, Fabrice Muamba collapsed after a cardiac arrest. Even though Muamba’s heart stopped beating for all of 78 minutes, he survived thanks to the high-quality medical care available at the stadium and on the way to a hospital. Muamba has since retired and now enjoys a career in punditry.