With the news that 26-year old Cameroon and Dinamo Bucharest player Patrick Ekeng had died during a Romanian League match on Friday night, painful memories of similar past instances were brought to mind. As well as in the case of Ekeng’s compatriot Marc-Vivien Foe, there have been numerous examples of players who have lost their lives in similar circumstances in the last 15 years alone while playing in Europe’s top leagues. Miklos Feher, Antonio Puerta, Daniel Jarque and Phil O’Donnell are just some of the names to have lost their lives due to previously undiagnosed heart conditions, as seems to be the case with Ekeng.
The senseless nature of any death prompts many questions. Two questions, however, remained unanswered in all of the previously mentioned cases and will again be asked in the wake of Ekeng’s passing – why did this happen and what can be done to prevent it happening again?
Prevention, they say, is always better than cure. Following the death of Foe in 2003, FIFA made it mandatory for all participating players to have full physical examinations prior to major tournaments and this ruling has been in place since 2006. However, following the collapse of Fabrice Muamba due to a suspected heart attack while playing for Bolton against Tottenham Hotspur in March 2012, which he thankfully survived, Professor Jiri Dvorak admitted in his role as Chief Medical Officer for FIFA that more could be done;
“You can always do more. For instance, we recommend that national team players should have assessments before games… In Central Europe, the standards are extremely high, but then we have to assist less affluent countries.”
Dvorak also said at the time that all national team doctors were encouraged by FIFA to report instances of sudden cardiac death to allow the building of a database that could be analysed to identify patterns or causes. The Scottish FA also stated at the time of the Muamba incident that they were working on the use of electronic chips in players’ shirts to communicate any potential issues to medical staff during games but, with current FIFA rules stating that electronic communication between players and sideline staff is banned, this is yet to be adopted.
So with prevention of such incidents appearing to be difficult to achieve, it would seem that optimum handling and treatment of sudden cardiac arrest when it occurs may be a more realistic and implementable way of saving lives. Yet again, however, Dvorak admitted FIFA were aware appropriate safety measures may not always be implemented saying that they “obviously can’t guarantee that there is a defibrillator at every single stadium all around the world,”. Questions are already being raised in the case of Ekeng, with Romanian journalist Emanuel Rosu stating that the first medical report of the incident is “shocking” and that it is his opinion that the handling of the young Cameroonian player in his hour of need displayed “a shocking case of Romanian ignorance and stupidity”, with the hospital spokesperson confirming that no cardiac massage was performed on Ekeng on the pitch and it was over 2 minutes before he was transferred to the ambulance.
What’s clear from initial reports in the case of Ekeng is that there appear to have been few well-defined protocols for his treatment or, at the very least, they were poorly implemented. A young man has died in circumstances where, in the case of Fabrice Muamba, it’s been proven that quick and effective treatment can save lives. Prevention of cardiac arrest in such circumstances seems something that will remain difficult for many years but what’s clear is that more can be done to clearly define the requirements in terms of equipment, staffing and procedures that should be in place at all competitive football matches being played under the FIFA banner. It simply isn’t good enough for the Chief Medical Officer to say that basic equipment such as a defibrillator can’t be guaranteed at every stadium around the world. Be it Bucharest or Berlin, Rotherham or Rio, all professional competitive matches being played on FIFA’s watch should have to stick to the same strict rules that will hopefully prevent deaths in future. If not, how many more times will we have to see these sad stories unfold before something is done? Sort it out FIFA – and do it now.