Boston College lightweight oarsman Scott Laio passed away immediately after crossing the finish line at the Dad Vail regatta in May 2005. The following document was provided to row2k this week by Boston College coach MJ Curry, Scott's parents DJ & Mary Laio, and Dr. Ali Loveys and Dr. Greg Ewert, whose professional bios appear at the bottom of the document, accompanied by the following comments: "Given the fact that there is still a lot of speculation about what happened to Scott we felt the truth needed to get out to the rowing public. Attached is a clear and concise explanation that has been reviewed and signed off on by two physicians."
The sudden death of Boston College rower Scott Laio at the Dad Vail regatta in May of 2005, prompted many questions in the rowing and medical communities as to why Scott died. The close knit rowing community wanted to examine how this could happen to one of their own and explore if there was anything they could do to safe guard others. Laio, a healthy oarsman who had been a competitive rower for seven years, three years with the BC Lightweights, suddenly collapsed and died at the end of his race. In search of an answer as to how this happened, the Laio family assembled a group of physicians to examine the autopsy results and attempt to find answers. The group consisted of Scott's family physician, Dr. Ali Loveys, and Dr. Greg Ewert, a renowned sports medicine physician from Chicago. Dr. Loveys has also been working directly with physicians from the US National Rowing Team. They presented the following results:
Scott's Past Medical History
Scott was a healthy young man with no current medical issues or medications. He had routine physicals as recommended for his age. He had a cardiac evaluation at age 16 for an innocent heart murmur. A cardiology evaluation at that time, including an electrocardiogram was completely normal.
Scott had a responsible and reasonable approach to weight management. Scott's weight loss was only 10-12 pounds off his normal off season weight of 170 lbs. It was much less than their "alarm" level of 15% which would have been 26 pounds, and only 5-6 pounds from his median weight that spring. According to his coach, parents, teammates and doctor, Scott's weight loss was gradual and began in January after he had a physical checkup in which he weighed 170. He slowly dropped from 170 to 165 between January and April, so that he was within five pounds of 160 lbs., the required lightweight cut-off and his weight for spring weigh-ins. Additionally, Scott weighed in and raced without incident as a lightweight five times that spring prior to the Dad Vail regatta, including the week before.
On the day of the race, Scott was with his teammates and his father between the 8am weigh-in and 3pm when his boat launched and provided a detailed history of Scott's intake during that time. By these accounts, one could presume adequate hydration. The only way to know for certain is to have a pre-race urine specific gravity. This was not available. He had no signs or symptoms of infection or other illness pre-race.
Immediately after his collapse his team mates performed CPR and when he was brought to shore, EMT's attempted cardiac defibrillation. On autopsy, Scott's body, major organs and blood vessels were in perfect condition. His heart's size, mass, and valve structure were normal with respect to his age and physical conditioning, with no blockages, abnormalities, blood clots, cardiomyopathy or signs of heart attack.
Blood tests showed electrolyte levels of potassium and sodium consistent with expected levels for an athlete at the end of a competitive race. There was no blood evidence of an acute or chronic infection.
Toxicology reports were directed and specific to rule out drug use. Specifically, there was no evidence of "phen-phen", other illegal substances, performance enhancing medications, or even over the counter medications.
In cases of sudden death in young athletes, the athlete loses consciousness first - believed to be the result of a sudden drop in blood pressure, with the body's normal reaction to a drop in blood pressure being to accelerate the heart rate. The problem is that what occurs after the point of passing out is simply speculation, as these rare cases have never been observed under controlled conditions. Rowers do occasionally pass out at the end of a race, but normally recover naturally on their own.
It's believed that the fatal series of events in cases of "sudden death" such as Scott's, occur within a matter of seconds. As a result, nothing more could have been done to resuscitate him. The real question in what led to his death is: What triggered the series of physical events? Dr. Ewert consulted with a number of colleagues to attempt to answer this and also to understand why it doesn't happen more often.
a. The answer to the question of the trigger is unknown because the results of the autopsy showed no presence of drugs, no cardiomyopathy, and no damage to the heart. The physicians' answer is that current testing methods and diagnosis capabilities haven't advanced to a point where the root cause can be determined. In other words, they are confident that there is an answer, but modern technology has simply not advanced enough to understand it yet.
b. "Why doesn't this happen more often?" Dr. Ewert commented that given the immense complexity of the human body, the probability of all the necessary conditions to be present at one time for this to occur makes it extremely rare.
Dr. Ewert and Dr. Loveys believe that there was absolutely NO reason for Scott not to participate in competitive rowing given the data from the autopsy, the results of the EKG performed on Scott 4 years earlier, and the results from a cardiology exam (electrocardiogram, stress test and echocardiogram) performed as a reference last June on Scott's 17 year old brother, Michael who is also a competitive rower. Scott was a model picture of good health and physical condition.
Ali A. Loveys, M.D.
Dr. Loveys is a practicing pediatrician in upstate New York. She did her training and went to medical school at the University of Rochester. She was chief resident at Rochester General Hospital before going into private practice in 1994. She is a member of the American Academy of Pediatrics and its Steering Committee on Clinical Information Technology. She lives in Pittsford, N.Y. Dr. Loveys served as Scott Laio's pediatrician for ten years from 1995-2005.
Greg D. Ewert, M.D.
Dr. Ewert has worked as the Medical Director of the LaSalle Bank Chicago Marathon since 1993. Since 1990 Dr. Ewert has been in practice at Northwestern Memorial Hospital and is an Assistant Professor of Medicine at the Northwestern University Feinberg School of Medicine. Dr. Ewert has an extensive background in sports medicine. He has been the team physician for the Chicago Blackhawks and the Chicago Cubs. He has also been a consultant to the Chicago Bulls and Chicago Bears. After graduating from the University of Illinois at Urbana-Champaign in 1982 with a B.S. in Biology, he attended the University of Illinois College of Medicine earning his M.D. in 1986. Next, he completed the Internal Medicine Residency Program at Northwestern University in 1989. He then completed a Primary Care Sports Medicine Fellowship at Northwestern, ending in June 1990. He is certified by the American Board of Internal Medicine with a Certificate of Added Qualification in Sports Medicine.