HIGH SCHOOL STATE TOURNAMENTS : A matter of life and death
Posted on Wednesday, February 27, 2008
URL: http://www.nwanews.com/adg/Sports/218059/
When Jimmy Tucker looked at Antony Hobbs III, he saw his own child.
“He was just an awesome kid,” said Tucker, an orthopedic surgeon at Arkansas Specialty Orthopedics who had treated Hobbs for an ankle injury. “He always had a smile. He was one of those kids that had a sparkle in his eye. He reminds me of my daughter.”
Tucker can’t stop thinking of the nightmare Marcia and Antony Hobbs Jr. have been living since Jan. 2, when their son’s heart stopped beating.
Antony Hobbs III, a 17-year-old junior basketball player at Little Rock Parkview High School, collapsed with 4: 16 left in the first quarter of a home game against Lake Hamilton. He was taken by paramedics to nearby Baptist Health Medical Center in Little Rock, where he was pronounced dead.
The cause of death was hypertrophic cardiomyopathy (HCM ), better known as an enlarged heart.
Now Tucker and Hobbs’ parents are working through one inescapable fact.
The device that could have saved Antony Hobbs III’s life was nowhere to be found.
Hobbs died because his heart essentially short-circuited.
State medical examiner Charles Kokes, who produced the final report on Hobbs’ death, said that while all areas of Hobbs’ heart were abnormally large, the thickest section was the ventricular septum — a wall that helps separate the heart’s four chambers.
Abnormally thick heart muscle can restrict the heart’s pumping mechanism, sometimes limiting the flow of blood.
In Hobbs’ case, running up and down the court exacerbated his condition, and the thickness of his already-stressed heart disrupted the electrical impulses that regulate heartbeat.
“It’s like having the wire pulled out,” Kokes said.
Immediate defibrillation — essentially an electric shock sent to the heart in an attempt to restart normal cardiac rhythm — would have increased Hobbs’ chance for survival.
The technology to provide that shock, even before paramedics arrive, exists in automated external defibrillators (AEDs ), portable devices applied outside the body that automatically analyze the heart and deliver a shock if needed.
AEDs can be found in office buildings, airports, fitness centers and assisted living communities. But one was not available at Parkview High School.
An AED is not a cure-all, said Stuart Berger, cardiologist and professor of pediatrics at the Medical College of Wisconsin in Milwaukee and the medical director of Project Adam, a nationwide effort to promote placing AEDs in schools. But it can be a life-saver.
“Put it this way,” Berger said. “If you don’t intervene in a timely fashion, you’re not going to have survival. With every minute of delay, there’s a 5 to 10 percent increased risk of not surviving.”
Witness accounts vary, but the general consensus is that Hobbs was down for at least five minutes before paramedics arrived, though CPR was applied.
The circumstances of Hobbs ’ condition are sobering. In 2007, a task force sponsored by the National Athletic Trainers Association found that sudden cardiac arrest is the leading cause of death in young athletes, with about 110 sudden deaths involving young competitive athletes occurring each year.
The fact that Hobbs’ condition was unknown to him and his family makes for a textbook case, Berger said. Though the medical community has not produced an exact percentage, Berger said a condition like HCM often manifests itself only in the form of cardiac arrest.
“If you’re lucky, you’re going to have a warning sign,” Berger said, indicating that a “warning sign” could be anything from a fainting spell to a minor heart flutter.
Hobbs’ aunt, Carolyn Hobbs, said the only incident in Antony Hobbs III’s medical history that could qualify as a symptom occurred two summers ago, when he fainted during a church service. Marcia and Antony Hobbs Jr. said there is no history of heart defects on either side of the family.
A condition like HCM cannot be detected through a regular athletic physical and can only be detected through a chest X-ray if the condition is especially drastic. An electrocardiogram (EKG ) can detect HCM, but the procedure can cost between $ 90 and $ 100, according to St. Vincent Health System spokesman Margaret Preston. For now, the onus is not on detection but reaction. “Kids and adults who can intervene immediately and having an AED nearby, I think, is the best bet in saving lives,” Berger said.
MONEY MATTERS Why wasn’t an AED available that night at Parkview High School ? The answer lies in the price tag. In 2007, Rep. Sandra Prater, DJacksonville, worked to push the state Legislature to earmark funds to place AEDs in the state’s public schools. What became known as Act 1598 was approved on the condition that the necessary funds were available. Prater’s aim was to place two AEDs in each school district, at an estimated cost of $ 500, 000.
The money couldn’t be found.
“We have got to take a closer look at our budget,” Prater said. “$ 500, 000 to $ 1 million dollars ? It is there, especially if we have a surplus for next session.”
Tucker isn’t waiting. Spurred by his memories of working with Hobbs, Tucker has spearheaded The Antony Hobbs Project, a grass-roots initiative to drum up funds for AEDs involving medical professionals, school administrators and the Arkansas Activities Association.
“This is something I wish I did last year,” Tucker said. “I mean, my daughter [Jae ] plays basketball. I can’t tell you how much we should have done this last year.”
Tucker estimates a single AED can cost $ 1, 500 or more, but purchasing in bulk can lower the price to as little as $ 900 each.
Grant money is available for smaller, rural school districts such as Pottsville, which received three AEDs in 2005. But a larger, cashstrapped district such as Little Rock can find itself on its own.
Tucker and Arkansas Specialty Orthopedics have footed the bill for five AEDs, one for each LRSD high school. But take into account the number of sports offered — some of them going on simultaneously — multiply that not just by the number of high schools but by the number of junior high feeder programs in a large metro area, and five AEDs might be just a drop in the ocean.
“It doesn’t stop with just getting a defibrillator,” LRSD Athletic Director Johnny Johnson said.
Despite the costs, a statewide mandate for AEDs might not be a pipe dream.
In March 2007, the 80 th Texas Legislature passed Senate Bill 7, which among other things requires at least one AED to be on every school campus and readily available for athletic events.
As they’re finding out in Texas, state pressure can make a world of difference.
“The fact that it was in violation of state law not to have one was great incentive,” said William Farney, president of the University Interscholastic League, which regulates high school sports in Texas.
Farney said donations and partnerships with nearby fire departments and hospitals have enabled even smaller, poorer districts to stay in compliance with the law.
But what worked for Texas might not click in Arkansas. Farney said that while concerned parties like Tucker should push for legislative action, they also should be willing to call attention to districts without AEDs.
“It’s just like putting money in an offering plate, whether the giver does it begrudgingly or not,” Farney said.
PREVENTING TRAGEDY Expect the state Legislature to have another go at AEDs in the near future. State senators Shane Broadway, D-Bryant, and Tracy Steele, D-North Little Rock, said last week they hope to have the necessary funds for statewide AEDs earmarked in 2009. Both plan to hit up members of the public and private sectors for the money that couldn’t be found in 2007. “If the state’s going to mandate something, we’ve got to provide the money for it,” Broadway said.
Arkansas Activities Association Executive Director Lance Taylor said there have been discussions with Broadway and Tucker on how districts without AEDs can be pinpointed and assisted in getting the necessary funds.
Tucker said he plans on continuing the work that already has netted five AEDs for the LRSD. If nothing else, awareness seems to be spreading. Six of this week’s seven state basketball tournament hosts will have an AED on site, with the other, Dumas, mandating that paramedics be present at every game.
But if so much has been done in the nearly two months since Antony Hobbs’ death, why did it take that to spark a reaction ?
Marcia Hobbs hasn’t found that answer.
“We feel like if the machine had been there when Antony collapsed, then perhaps there could have been a chance,” Marcia Hobbs said. “We will never know, but the fact that it wasn’t there didn’t give him an opportunity.”
It’s that lost opportunity that continues to eat at those who knew Antony Hobbs.
“It’s very important, because once it happens, it’s too late,” Antony Hobbs Jr. said. “It’s just a nightmare [parents ] would have to live with for the rest of their life.”