By Adam Pengilly
Former Manly player Keith Titmuss died after a training session which was “more likely than not inappropriate”, a coroner has found.
Deputy state coroner Derek Lee presented his findings on Friday into the death of the rising rugby league star after almost two weeks of evidence from Manly officials, former teammates and expert witnesses.
Lee told the NSW Coroners Court that Titmuss was “most likely suffering involuntary dehydration” when he entered a dojo, or wrestling gym, for a short and intense cardio workout at the end of Manly’s first field session of pre-season training in November 2020.
The coroner said a number of factors caused Titmuss to suffer from exertional heatstroke– in which a paramedic described his body temperature of 41.9 degrees as the “hottest they’d ever seen” – including his high body-mass index and lack of aerobic capacity compared to teammates.
His recommendations included that the NRL consider a graduated 14-day return-to-training program for players after extended breaks such as the off-season, individual programs for players given their characteristics, and medical personnel on standby for sessions in which heat illness is a greater risk.
Lee denied a 70-per-cent narrowing of one of Titmuss’ arteries was a factor in his death and described Manly’s legal team raising the issue, while highlighting the caring nature of the club at length during the inquest, as “incongruous with the themes described”.
Keith Titmuss died in November 2020.Credit: NRL Photos
“Agitation of this issue was a source of distress to Keith’s family,” Lee said. “The degree to which this issue was raised by Manly was surprising and rarely seen.”
The court heard Manly’s immediate response to Titmuss’ medical episode and the treatment by paramedics was appropriate.
Speaking on behalf of the family outside court, Titmuss’ mother, Lafo, said they hoped the NRL and Manly would implement all the coroner’s recommendations.
“It’s been years in the making understanding the cause of death – and we now do,” she said.
Titmuss’ parents arrive at Lidcombe Coroners Court on Friday.Credit: Nikki Short
“Keithy was unique. Keith loved life, and he loved rugby league. He had so much belief in himself, and he was so looking forward to making a mark in the rugby league world.
“Listening to the details of his last moments, that was heartbreaking.”
The Sea Eagles honoured Titmuss by posthumously naming him their 623rd first-grade player. He was yet to make his NRL debut when he died at the age of 20.
‘Incredibly distressing’
Titmuss collapsed inside the club’s Narrabeen gym and suffered a seizure. Evidence given to the court described his involuntary howls as he moved around the dojo. He was taken to hospital where he later suffered a cardiac arrest.
Former teammates including Josh Schuster (far left) gave evidence to the inquest.Credit: Nikki Short
“It’s been an incredibly distressing time for all of us, but particularly the family,” Manly chief executive Tony Mestrov said.
“We want to make sure we’re thinking of them today and how tough that was. Obviously, we’ve willingly participated in this inquiry and inquest. His Honour has handed down the findings today, and we intend to take the recommendations up.
“This can’t happen again in the game. We all understand that. We don’t want it to happen under Manly’s watch ever again.”
Former Manly coach Des Hasler gave evidence alongside several Sea Eagles officials and Titmuss’ former teammates Josh Schuster, Moses Suli, and Ben Trbojevic.
Titmuss was found to record the lowest score of Manly’s players during a yo-yo screening test days earlier, and had put on more than four kilograms during his off-season break.
Hasler previously told the court he rated the training session a “six or seven out of 10” as GPS data found Titmuss only covered an average of 47 metres per minute over the course of the session.
Counsel assisting the coroner, Adam Casselden, SC, told the inquest in March that the training session was “unnecessarily and inappropriately tough” for a player of Titmuss’ aerobic capacity.
Lee described Titmuss’ death as a “tragic and devastating loss” and urged it to be used as a case study for education and awareness about heat illness.
“Keith was doing what he loved and sharing the love with his close friends,” Lee said.
An NRL spokesperson said: “We express our deepest condolences to Keith’s family and friends. The NRL has already commenced work on the coroner’s recommendations and will commission experts to further review our policies and update them to ensure best practice.”
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