Keith Titmuss’ family’s touching act as coronial inquest nears conclusion

The mother of Manly Sea Eagles player Keith Titmuss told a court her son loved the club and his “brothers in arms”, before he died after his first pre-season session.

The young forward died in hospital after suffering seizures following a cardio workout at the club’s base at Narrabeen, on Sydney’s northern beaches, on November 23, 2020.

A coronial inquiry into the incident was told the 20-year-old suffered a heart attack in hospital, with his death determined to have been the result of exertional heat exhaustion.

Titmuss’ mother and father, Lafo and Paul Titmuss, as well as sister, Zara, and brother, Jesse, wore shirts with Titmuss’ face as they entered the NSW Coroners Court.

Addressing the court, Titmuss’ mother described her son as having been “cherished” from birth and as a “paragon of virtue”, who lived his life to “completeness”.

“Keith loved Manly. He loved his brothers in arms on and off the field. He loved the and respected the training staff,” Mrs Titmuss said, flanked by a photo of her son.

“After signing the contract he had an extra bounce in his step. He finally realised his commitment and hard work to become an NRL was about to happen. 2020 was going to be his year.”

Ms Titmuss expressed her gratitude for the “clarity and understanding of the events that lead to his death”, and said the inquiry could lead to changes for paramedics and the NRL.

“We are encouraged of the NRL’s internal review and its commitments to enhancing its knowledge and understanding across all clubs, staff and players,” Ms Titmuss said.

“Specifically, they seek to prioritise heat related injuries ... We hope the findings form this inquest will be instructive not just to the NRL, but sport across Australia and worldwide.”

Deputy State Coroner Magistrate Derek Lee, who became emotional after the statement, thanked Mr Titmuss’ family for reminding court about “Keith the son, brother, and partner”.

“From these learnings something might be done to prevent a similar tragic events happening again ... but we cannot forget the reason that has happened in the first palace,” he said.

“To be so generous to share collectively your memories ... I am very much grateful for that because it again reminds us more about Keith the footballer - the son, the brother, the partner.”

The weeks-long inquiry has canvassed a range of factors that may have influenced Titmuss’ sudden deterioration from complaining of cramps to suffering from seizures.

Giving evidence on Thursday, Dr Simon Quilty put greater weight than previous experts on a coronary stenosis, or thickening of the arteries, diagnosed after Titmuss’ death.

“There is a 20-year-old who is very fit and well and died on a relatively mild day of heat stroke. There has to be a predisposition somewhere,” Dr Quilty told the court.

Asked if the Manly Sea Eagles could have tailored a shorter workout for Titmuss, Dr Quilty said the “unfortunate thing” was at the time his coronary condition was unknown.

“My understanding is it was 24C. Football teams have been doing training sessions like this since my childhood days. It was a classic type of session,” Dr Quilty told the court.

Evidence also focused on Mr Titmuss’ fitness at the start of the preseason, with the court being told he had scored low on a number of aerobic fitness tests by Manly.

University of Technology Sydney professor in sport and exercise science, Aaron Coutts, said the results were a “red flag” when it came to his ability to deal with heat.

“The data showed Keith has the lowest aerobic fitness score tested in the Manly Sea Eagles at the time, much lower than generally reported scores,” he said.

He later added that: “He (Mr Titmuss) was at greater risk of not tolerating the fitness sessions and as a consequence increased his risk (of heat related illness)”.

The court was told Titmuss had put on 4.6kg in the off-season, which Prof Coutts opined was most likely fat, and that the session was long for the first in pre-season.

Questioned as to whether he applied any blame, he said: “It was a very complicated situation and it is impossible to predict exertional heat stress ... only the risk factors”.

Two ambulance paramedics gave evidence on Tuesday about the conditions in the Manly “tin shed dojo”, which they said was hot and humid, and caused them to sweat.

Critically, the duo – as well as a NSW Ambulance director – backed the decision to not call on players, staff, and allied health professionals present to help in the response.

NSW Ambulance paramedic Grant said it would have been difficult to keep ice packs in place amid the “chaotic” scene, and that he had focused on addressing the seizures.