Mpozi: cause of death

Dateline: Thu 05 Oct 2006

Marion County Chief Deputy Coroner Alfarena Ballew said Wednesday that the autopsy on Mpozi Tolbert, 34, shows he experienced sudden cardiac death as a result of arrhythmogenic right ventricular cardiomyopathy.

The latter condition is genetic or is caused by environmental factors. It can be diagnosed with electrocardiograms and treated with drugs and/or an implant and/or surgery. Symptoms include shortness of breath, light-headedness, fatigue, racing heart and cardiac collapse.

According to the Cardiomyopathy Association website:

"Anyone may develop ARVC. The first clinical presentation is usually in the teens to early 20s. It is uncommon for it to first present after the age of 40. Similarly, it is unusual for it to cause problems in childhood, though a few cases are known. It appears that men and women of any ethnic origin can be affected.

"As more is known about the disease, it is realised that it may be more common than first thought. It is very difficult to gauge how many people are affected though a reasonable estimate in the light of current knowledge may put it at between 1:3,000 to 1:10,000 people affected.

"Although it is thought that sport does not cause ARVC the condition is reported more frequently among athletes as compared to some other groups of people."

The American Heart Association website puts great emphasis on a speedy response to cardiac arrest caused by ARVC or any other underlying factor. That response is what saves a life.

"Sudden death from cardiac arrest is a major health problem that's received much less publicity than heart attack. The American Heart Association supports implementing the "chain of survival" to rescue people who suffer a cardiac arrest in the community. The adult chain consists of:

"Early Access to Medical Care (calling 9-1-1 immediately)

Early CPR

Early Defibrillation

Early Advanced Care

"What is sudden cardiac death?

"Sudden cardiac death is death resulting from an abrupt loss of heart function (cardiac arrest). The victim may or may not have diagnosed heart disease. The time and mode of death are unexpected. It occurs within minutes after symptoms appear."

"Can the cardiac arrest that causes sudden death be reversed?

"Brain death and permanent death start to occur in just four to six minutes after someone experiences cardiac arrest. Cardiac arrest is reversible in most victims if it's treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation. A victim's chances of survival are reduced by 7 to 10 percent with every minute that passes without defibrillation. Few attempts at resuscitation succeed after 10 minutes. If someone becomes unconscious, call 9-1-1 immediately. They may be suffering from sudden cardiac arrest."

Sudden cardiac arrest has garnered quite a few newspaper headlines because it so often happens on the athletic field -- everyone knows the stories of seemingly healthy runners, football and basketball players and other young jocks who suddenly collapse.

Physicians in the National Athletic Trainers' Association in 2001 produced a paper, "Sudden Cardiac Arrest in Athletes."

Among their observatsions:

"The effective treatment of an athlete experiencing sudden cardiac arrest depends on a sequence of responses by well-prepared providers, so that the steps, when linked together, form a "chain of survival" for the successful management of sudden cardiac arrest.

"The chain of survival includes the following: (1) prompt emergency medical system (EMS) activation; (2) early cardiopulmonary resuscitation (CPR) by a first or target responder (less than 2 minutes); (3) early defibrillation (2 to 4 minutes); (4) early advanced life support (less than 8 minutes); and (5) late advanced life support.17 The first 4 links must have as short a time delay as possible to significantly increase survival rates.

"The second and third links in the chain of survival are inseparable from the first. Early CPR, which is a capability of a first responder trained in BLS, can enable the heart to survive longer when it is in fibrillation....

"However, CPR alone cannot reinstitute the normal cardiac output or normal electric activity for a heart in ventricular fibrillation.

"The quality of CPR is important; authors of one study have suggested that when CPR is administered by bystanders, it is administered effectively less than half the time. However, at best, CPR delivers 60 to 80 mm Hg of pressure to the heart, only generating approximately 30% of the cardiac output.1,17 As a consequence of these factors, the American Heart Association has included early defibrillation training as a necessary addition to CPR in BLS certification."

The Star's Barbara Henry and Dennis Ryerson promised CPR training for employees after Mpozi died. The Gannett headquarters has defibs available for its employees -- a fact reported by the National Association of Black Journalists' Jennifer Jiggetts. So far, the Star has nothing.

Chief Deputy Coroner also reported that her office was able to locate Mpozi's medical records which showed he received treatment for "junk in the lungs" after 9/11. She said the pathologist's conclusion was that there was no connection between that and his death.

Case closed? Not hardly. This blog had documented problems that occurred in the newsroom that night, from confusion over phones and whom to call to improper directions to the paper to a blocked elevator.

The Star needs to get its act together. As somebody noted, Mpozi would have had a better chance had he collapsed at a Starbucks or a Target, where people are trained to respond and defibs are available.

Other companies take care of their workers. Not Gannett.

comments: ruth@ruthholladay.com

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