Florida High School Athletic Assoc. draws medical rebuke, legislative attention for heat safety

Doctors, athletic trainers and others in sports medicine widely call for immediate access to ice tubs for athletes suffering from heat stroke.

But the Florida High School Athletic Association is planning to override its own medical advisers requiring access to ice tubs unless it is told to do so by the state Legislature.

The FHSAA also is disregarding its sports medicine advisory committee’s recommendation to apply its heat safety policies and guidelines to summer activities, which are mostly left to individual schools and districts to regulate.

Those positions in advance of Monday’s board meeting have rankled members of the 15-person sports medicine committee and the family of late Riverdale High School football player Zachary Martin-Polsenberg, who died from heat stroke last summer.

The death of Martin-Polsenberg, who was 16, was the second of a Florida high school football player from heat stroke since 2014.

Sebastian athlete

William Shogran Jr., 14, died after collapsing at an August 2014 practice with Sebastian River High School.

The family sued the Indian River County School District saying school officials were not forthcoming in a case that remains open.

William Shogran Sr. filed a wrongful-death lawsuit against the Indian River County School District in 2016, saying the coach ignored the health problems the teen was having that morning, according to Circuit Court documents.

William Shogran Jr. was 14 when he joined the Sebastian River High School football team. The lawsuit claims he had thrown up at least three times during and in between practices on Aug. 13, 2014, the day he died. The state Medical Examiner’s Office said the teen died from heatstroke.

“The (SRHS) issues an athletic handbook that requires head coaches to never allow a player to practice or participate in a contest if there is any doubt as to his or her ability, physical condition or eligibility,” the negligence claim said.

William Shogran Jr. had joined the team on a trip to Camp Blanding near Starke for five days of preseason practices.

His father and stepmother told officials that before joining the football team, the teen was a video “gamer” who did little physical activity outdoors.

The lawsuit claimed Sebastian River coach Kevin Pettis was not responsive to the player’s health needs. The lawsuit also said the team did not bring an athletic trainer or medical personnel on the trip.

Before breakfast on Aug. 13, William participated in an early-morning conditioning session that many referred to as “dawn patrol.” The lawsuit said he vomited during that session and when players returned to their barracks.

He joined the team for breakfast, then went to the 9 a.m. practice. William vomited again during one of the water breaks, according to the lawsuit. He returned to the sidelines later and passed out.

A coach called 911 at 10:47 a.m. William was pronounced dead at a hospital in Starke.

Temperatures in Starke on the day the teen died reached 85 degrees by 11 a.m. but felt like 94 degrees because of the humidity, according to The Weather Channel.

A problem

The issue also has gotten the attention of state Sen. Kathleen Passidomo, R-Naples, whose district covers large areas of Southwest Florida.

“It is problematic to our committee,” said Patrick Helma, a Cooper City chiropractor and chair of the sports medicine committee. “It doesn’t appear to be best practices for sports medicine.”

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“This does not protect student-athletes because there is no requirement to modify current practices,” Martin-Polsenberg’s mother, Laurie Martin Giordano, said through a foundation created in her son’s name to raise awareness to heat illness.

“The FHSAA is not fulfilling their own written purpose and responsibility by recommending policies that may or may not be implemented because no one is required to abide by them.”

Rather than requiring that cold-water immersion – an ice bath – be available within five to 10 minutes of an incident of heat stroke, as the committee unanimously voted in January, the language the board will vote on Monday has been changed to say it is “strongly recommended."

Such ice baths are routinely used at schools for sports training recovery purposes.

The sports medicine committee’s recommendation that wet-bulb globe thermometers – which measure heat stress – be mandatory also was downgraded for Monday's vote to “strongly recommended.”

Those items and others to be voted on do represent a strengthening of heat safety guidelines and in some cases requirements from previous FHSAA policies, as noted by the FHSAA in a statement to The News-Press.

“The FHSAA’s No. 1 priority is student-athlete safety,” FHSAA spokesman Kyle Niblett wrote in an email. “To that end, the Association has specifically bolstered its stance centered on Heat Acclimatization, Hydration, Rest and the availability and use of cold immersion tubs and environment monitoring devices such as the Wet Bulb Globe Thermometer.”

Required?

But without offering an explanation for the changes, the FHSAA said the sports medicine committee's recommendations may only become mandatory if the state Legislature requires them in the same fashion as it does automatic external defibrillators (AEDs).

“As with the State Statute and FHSAA Policy regarding AED’s (F.S. 1006.165),” Niblett wrote, “the FHSAA would mandate each school have and employ the use of heat monitoring and quick cooling devices, provided a similar state statute were in place mandating such.”

Helma said he still hopes the board changes Monday’s agenda to match the committee’s recommendations, which he said are based on extensive research by the committee and widespread adoption in sports medicine.

“We volunteer tons of hours to make sure student-athletes in our state can safely participate in sport,” Helma said. “We know that there’s going to be injury in sport. I just don’t want people to die."

Passidomo, whose district includes Collier and Hendry counties and the southeastern portion of Lee County, said she has taken notice of the number of heat stroke cases but wanted to wait until after Monday to see whether legislative involvement is needed.

“Whatever is in the best interest of the kids is what we need to support, obviously,” Passidomo said. “We don’t know what the board’s going to do. They know my position though. I am not uncomfortable filing legislation. I am very concerned about the issue.”

Heatstroke

Exertional heatstroke, as it is known, killed an average of three football players a year at all age levels from 1995-2015, according to the National Center for Catastrophic Sport Injury Research. That is despite medical professionals calling it “100 percent survivable” if responded to within 5-10 minutes.

Of 61 deaths in those years, 46 were in high school, 11 in college, two in youth football and two in professional football. Ninety percent of the deaths occurred during practice.

Those numbers also are for football only, and they don’t include include hospitalizations for heat illnesses that didn’t result in death or other heat events that didn’t result in hospitalizations.

Earlier this month, Texas A&M football player Koda Martin suffered temporary organ failure but survived an extreme case of heatstroke in a case similar to what killed Martin-Polsenberg last summer.

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Unlike Martin-Polsenberg, however, Koda Martin was immersed in an ice tub at practice and treated in the ambulance with chilled IV fluids to continue lowering his temperature, his father said.

“Things change. Things have to be updated,” Helma said of making ice tubs mandatory. “We now know things we didn’t know five years ago, two years ago. They have to be updated to the latest standards. We want it to be required because we don’t want any more kids to die.”

Martin-Polsenberg’s family earlier this month sent notice of intent to sue the Lee County School District, school board and Riverdale High for what it said was negligence leading up to and immediately after Polsenerg’s collapse.

Lee County School Board member Chris Patricca, who also is an FHSAA board member, declined comment.

“It’s ridiculous that they (the FHSAA) are the governing body but they don’t want to mandate what is considered best practices,” said Martin Giordano, Polsenberg's mother. “They should be in place year round.

“All sports and clubs practice in the summer time. These are students practicing on school grounds and being coached by school employees. Why wouldn’t they be covered by the same guidelines in the summer time? I haven’t gotten any kind of good answer.”