High school football player’s death caused by spleen injury

Warren Hills Regional High School quarterback Evan Murray in action Friday night before suffering an injury that resulted in his death. Larry Murphy/Lehighvalleylive.com via AP

The death of a high school football quarterback in New Jersey has been attributed to a lacerated spleen he suffered during a game Friday night.

Autopsy results released Monday afternoon offered an explanation into the death of 17-year-old Evan Murray, a three-sport athlete at Warren Hills Regional High School.

Murray took a hit during the second quarter of Friday night’s game and, according to reports, walked off under his own power before collapsing on the sideline. As he was placed on a stretcher to be taken to a local hospital, he told his teammates he would be fine and gave them the thumbs-up sign.

He was pronounced dead several hours later.

According to a statement released by the Morris County Coroner’s Office, the cause of death was a lacerated spleen that caused a massive intra-abdominal hemorrhage. Dr. Ronald Suarez found that Murray’s spleen was abnormally enlarged, making it more susceptible to injury.

Deaths due to spleen injuries are rare in football. Over a 20-year-period ending in 2010, 243 deaths occurring in high school and college football in the United States were reported to the National Center for Catastrophic Sports Injury Research. Cardiac failure accounted for 41 percent of the deaths. Brain injuries made up 25 percent, and heat illness comprised 15 percent. Only two players died from splenic rupture.

Many causes of death in the sport proved to be more common than what killed Murray. Asthma, sickle cell trait, blood clots, cervical spine fractures, infection and lightning all caused more football deaths over those 20 years. That’s right. You are more likely to be struck by lightning and die.

Spleen ruptures do occur, though. Last season, Tennessee Titans wide receiver Justin Hunter suffered a ruptured spleen after a big hit from a Houston Texans safety. He stayed in the game for two quarters before he was taken to the hospital.

In 2006, Tampa Bay Buccaneers quarterback Chris Simms had his spleen removed after rupturing it in a game against the Carolina Panthers. He left the game for two plays after several hard hits, but he returned and played into the fourth quarter.

The spleen is the most frequently injured abdominal organ in sports. A direct blow to the left side of the upper abdomen in contact or collision sports like football can injure the spleen in a healthy athlete. If the spleen is enlarged from an infection like mononucleosis, a blood disorder or other cause, it is more vulnerable to blunt trauma.

Recognition and prompt treatment of injured athletes is crucial. It is estimated that at any given moment, one unit of the body’s 12 units of blood is in the spleen. Laceration or rupture, then, can lead to massive bleeding into the abdomen that can be catastrophic.

Spleen injuries can be hard to diagnose at the time of injury. A player might have upper left abdominal pain after a hard tackle to the body. He might complain of left shoulder pain caused from blood irritating the diaphragm. A doctor or athletic trainer might find tenderness when feeling the abdomen or ribs over the spleen.

Unfortunately the exam is often unremarkable right after the trauma. Therefore it is vital for medical providers with the athlete, or parents if the athlete is at home, to assess the athlete many times in the ensuing minutes and hours. Evaluation of the athlete at a hospital is critical if there is any question of a serious injury.

Many athletes with ruptured spleens require surgery and sometimes removal of the spleen, like Chris Simms did. Others with stable vital signs can be treated without surgery, like Justin Hunter was. These athletes usually do well and lead healthy lives, often returning to sports.

Evan Murray’s death has devastated an entire community in Washington, New Jersey. Maybe one positive outcome will result from this tragedy. Parents, coaches and athletes can become more aware of these injuries so that no more athletes die from them in the future.

Dr. David Geier is an orthopaedic surgeon and sports medicine specialist in Charleston. For more information about football injuries and other sports medicine topics, go to drdavidgeier.com.