A 20-year-old Manly Sea Eagles player was subjected to an ‘unnecessarily and inappropriately tough’ training session before his sudden collapse, a court has heard.
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.
A coronial inquest into his sudden death heard several experts conclude that the attacker suffered from exertional heatstroke when he suffered a seizure at an indoor facility.
On Friday, barrister assisting coroner Adam Casselden SC said the evidence before the coroner showed the training session had been “objectively hard”.
“It was unnecessarily and inappropriately harsh as it was the first extended training session of the new season,” he told the NSW State Coroners Court.
‘With the benefit of hindsight, (it was) an inappropriately high level of intensity and not of a safe level or environment.’
Brothers Jesse (left) and Keith Titmuss (right) before the tragic death, which is now the subject of a judicial investigation
The court heard the training lasted more than two hours and included both an outdoor session and indoor session in a “hot and stuffy” gym.
Casselden noted that the indoor session was short but intense, its difficulty compounded by the fact that it followed a grueling outdoor session.
Titmuss’ teammate and childhood friend Josh Schuster told the inquest that the workout was ‘one of the hardest training sessions I’ve ever done’.
However, former Manly Sea Eagles coach Des Hasler rated it a ‘six or seven’ out of ten and said the team had been encouraged to take breaks if they were struggling.
Sir. Titmuss had put on four kilos during the off-season and his fitness test results suggested he was ‘the least fit member of the squad’, Mr Casselden said.
He said the training had been ‘inappropriate’ for one of Mr. Titmuss’ fitness level after an off-season layoff, pointing to the need for individualized training programs.
His higher body mass and lower aerobic fitness levels were risk factors that contributed to Mr Titmuss overheating from exertion on the ‘mild’ 24C day, experts told the inquest.
Lafo Titmuss, mother of Keith Titmuss, speaks to the media outside Lidcombe Coroners Court in Sydney
Paul Titmuss, father of Keith Titmuss, is seen outside Lidcombe Coroners Court during the coronial inquest
He was described as ‘screaming’ and thrashing around the indoor gym when he suffered a seizure after complaining of cramps.
A paramedic who treated the rising NRL star said his temperature was almost 42C, the highest they had ever seen.
Casselden said that none of Mr. Titmuss’ teammates, Manly staff or paramedics could be criticized for failing to recognize the ‘unusual signs’ of Mr Titmuss’ heat exertion.
However, he noted it was ‘regrettable’ that the death had come just two years after Manly star Lloyd Perrett survived a ‘near miss’ when he collapsed from heat exertion during training.
Casselden suggested the coroner recommend Manly and the NRL use Mr Titmuss’ tragic death as a case study for heat illness education and awareness.
The consultant assisting the coroner made a number of recommendations to improve the NRL heat policy amid an ongoing independent review by two heat illness experts.
In light of the humid conditions inside the gymnasium, Mr Casselden suggested the policy clarify guidelines that apply to indoor and outdoor training sessions as well as games.
Consideration should also be given to whether the NRL should enforce changes to training sessions based on environmental factors such as heat, he told Deputy Chief Medical Officer Derek Lee.
It was also recommended to mandate a two-week acclimatization period when players return to training from an off-season and ensure a doctor signs off on training programmes.
Another key focus should be implementing screening for players at risk of heat illness and classifying them to ensure tailored training sessions, Mr Casselden said.
Sir. Titmuss’ family called on the NRL to enforce mandatory reporting of all heat-related injuries to create a comprehensive understanding of the extent of the problem.
Former Manly Sea Eagles coach Des Hasler has also given a statement to the coronial inquest
Family and friends wear t-shirts in memory of Keith Titmuss outside Lidcombe Coroners Court
Titmuss was a rising star and was on the verge of being promoted to Manly’s senior squad before his death
In his closing remarks, Casselden praised the NRL and Manly for acting “timely” following the death of a “loved and admired man”.
“Both Manly and the NRL have already taken positive, proactive and immediate steps towards awareness and education about strenuous heat stroke,” he said.
Both the code and its club said they would welcome the results of the investigation into Mr. Death of Titmuss.
Manly Sea Eagles lawyer Peggy Dwyer SC said she hoped the heat illness findings would extend to “all teams in the NRL and hopeful codes beyond the NRL”.
At the time of his death, Mr Titmuss was considered to be on the verge of his breakthrough after being promoted to the club’s top-30 squad.
“His extraordinary skills and personality will never be forgotten by Manly,” Ms Dwyer said.
‘His legacy as a player and person will forever live on.’