Manly player Keith Titmuss’ NRL dream before tragic death is revealed

Keith Titmuss had always dreamed of becoming a professional NRL player, but he never made it to his first game after collapsing during his first training session.

The Manly Sea Eagles player, 20, had just completed his first training session of the pre-season in late-2020 when he started suffering cramps and seizures.

The young forward from southwest Sydney was quickly whisked away from the club’s Narrabeen base to hospital, but later died following a heart attack.

An inquest at the NSW Coroners Court was told Mr Titmuss likely died as a result of exertional heat exhaustion, a rare and “under reported” medical condition.

Mr Titmuss’ mother, Lafo Titmuss, told the court on Wednesday her son had been more committed than ever to his training and was excited to realise his goals.

“Keith loved Manly. He loved his brothers in arms on and off the field. He loved the and respected the training staff,” she said.

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

Ms Titmuss described her “cherished” son as the “paragon of virtue”, and said he had left the prestigious Newington College in order to pursue the NRL over other codes.

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

“To share collectively your memories … I am very much grateful for that because it reminds us more about Keith the footballer – the son, the brother, the partner,” he said.

The court was told the training session on November 23, 2020 lasted for about two hours, under what a clinician described as a “mild” 24C degree day in Sydney’s north.

The rugby league team then entered Manly’s “tin shed dojo” for a 10-minute intense workout after which Mr Titmuss’ condition quickly deteriorated into full-body seizures.

Paramedics, who attended what they described as a “chaotic” and “extremely challenging” scene, said the dojo was “hot and humid”, and caused them to sweat.

In evidence, they defended not using ice to cool Mr Titmuss down before transporting him to an ambulance, stating the “sole focus” was to control his seizures.

NSW Ambulance paramedic Grant told the court it was crucial they protect Mr Titmuss’ airways according to procedure, despite him having a temperature of 41.9C.

The week-long inquest heard evidence from a range of experts about how Mr Titmuss came to suffer from exertional heat exhaustion on such a mild day.

Giving evidence on Thursday, Dr Simon Quilty put greater weight than others on a coronary stenosis, or thickening of the arteries, which Titmuss was diagnosed with after his 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 said.

The court was also told Mr Titmuss had put on about 4.6kg over the off-season, and had scored poorly in comparison to his teammates on aerobic fitness tests.

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)”.

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”.

The inquest was attended also by representatives from NSW Ambulance and the Manly Sea Eagles and will resume for oral submissions later this year.