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StanChart Marathon runner died of heart attack: Coroner

SINGAPORE — A 28-year-old man who collapsed during the Standard Chartered Marathon last December suffered sudden cardiac death from the onset of arrhythmia, and his death was due to a natural cause, a Coroner’s Court found on Thursday (May 4).

Runners passing Marina Barrage during Standard Chartered Marathon Singapore 2016 on Dec 4, 2016. Photo: Wee Teck Hian/TODAY

Runners passing Marina Barrage during Standard Chartered Marathon Singapore 2016 on Dec 4, 2016. Photo: Wee Teck Hian/TODAY

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SINGAPORE — A 28-year-old man who collapsed during the Standard Chartered Marathon last December suffered sudden cardiac death from the onset of arrhythmia, and his death was due to a natural cause, a Coroner’s Court found on Thursday (May 4).

Pathologist Marian Wang said John Gibson likely suffered lethal cardiac arrhythmia — an irregular heartbeat — which could result in sudden unexpected death. There could also be a correlation between exertion and arrhythmia, she added. 

Gibson, a British national from Hong Kong, came to Singapore for a conference on Nov 29 and stayed on until Dec 4 to take part in a half-marathon. He started running at around 4.30am, and about two hours later, when he was less than 1km from the finishing line, a runner saw him staggering and sped up to find Gibson pale and unresponsive. His eyes had rolled backwards and his mouth gaped. 

A volunteer photographer rushed over to administer cardiopulmonary resuscitation (CPR). He could not feel any pulse, and Gibson’s skin was cold.

Two minutes after Gibson collapsed, someone alerted a security personnel, who immediately informed the supervisor. A roving first-aider on duty was notified around the same time and arrived at the scene at about 6.30am to administer CPR.

The security supervisor instructed the command post to send for an ambulance, and later ran towards the nearest ambulance, but it had been sent out for another case. He then ran farther to get another ambulance, which reached Gibson’s spot at around 6.35am. 

The ambulance got to Singapore General Hospital at 6.45am. Upon arrival, there was no electrical activity in Gibson’s heart. Despite resuscitation efforts, he was pronounced dead at 8.50am.

During the Coroner’s Inquiry, the deceased’s father pointed out that there was a duration of 10 minutes between his son’s collapse and the ambulance’s arrival. “(The security supervisor) didn’t know that the nearest ambulance had been sent away, so he ran to that one first. If the command centre had been notified immediately, it might have known (this),” Mr Robert Gibson, 64, told the court. He suggested that the chain of command for future races be reviewed.

The event’s medical operations plan showed that there was a medical tent 700m away from the location of the incident. Ten roving first-aiders, four nurses and two ambulances were within a 1km radius. 

A handbook with information and tips was given to participants before the race, and health and other running tips were available on the event’s website. Organisers also offered training clinics and training plans to runners. 

Gibson’s father, however, said that the information provided was rather general. “It doesn’t remind people of the particular circumstances of the race in Singapore ... My son had never run in a climate like this. I don’t think he thought carefully about the fact that he would have to get out of bed at 2.30 in the morning for the run. Talking about this now will not bring him back, but one of the things the court could consider is the extent to which the organisers could give advice (to 
participants).

“Young people. He was 28 years old. They think they’re going to live forever ... If he had understood the possible risks better, maybe he would have done things differently,” he added.
State Coroner Marvin Bay said it was incumbent for organisers to see if they could improve the standard operating procedures for medical response in the wake of an adverse event, particularly in getting help quickly to any runner who suffers a cardiopulmonary collapse. 

Organisers should also provide more in-depth practical advice, especially to less experienced runners, or runners arriving from abroad specifically to take part in the event. “Overseas runners may not adapt readily to our local hot and humid climate, and may benefit from additional preventive measures to ensure their own safety during the race,” he said.

Mr Bay suggested that runners ensure they are in optimum health before embarking on endurance events. Pre-race health screenings, optimal hydration before and during a race, and the absence of ailments are necessary, he said.

In a statement on Thursday, the marathon organiser, Ironman, extended its “deepest condolences” to the Gibson family.  

Mr Geoff Meyer, managing director of Ironman Asia, said: “The safety of our runners is our utmost priority, and the team regularly reviews safety and medical response plans with our partners and relevant authorities.”

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