A completely healthy teenager was killed in a freak accident after he was hit in the chest by a football when out playing with his friends, an inquest heard today.
Keelan MacKnight, who was 15, was struck by the football just below his ribs at the exact nanosecond that the heart’s system is vulnerable.
He collapsed onto the pitch after suffering a fatal heart arrhythmia.
The medical phenomenon, known as ‘concussion of the heart’, is incredibly rare and usually only happens in the US when youngsters are hit in the chest with a baseball or hockey puck.
Keelan MacKnight, who was 15, was struck by the football just below his ribs at the exact nanosecond that the heart’s system is vulnerable
A friend of Keelan’s, William Freeman, also aged 15 years at the time, said in a statement read by the coroner: ‘We arranged to meet on the Astro. He was just normal. We started a game of headers and volleys.
‘Keelan took his turn in goal. The ball came towards him and he put his hands in the keeper save position. The ball missed his hands, hitting him in the centre of the chest.
‘He looked like he had been winded. I knew something wasn’t right because his face had gone pale and blue,’ said William.
Keelan collapsed onto the ground while William supported him and called an ambulance.
Peter Brady, playing in the park with his two-year-old son, saw the commotion and used his first aid training to give CPR while the emergency services arrived.
Consultant pathologist Dr Lucie Winter told the inquest that the medical phenomenon that killed Keelan almost always resulted in death
Keelan was flown by air ambulance to the Stoke Mandeville hospital in Aylesbury, Buckinghamshire, and then transferred to the John Radcliffe Hospital in Oxford.
However, despite desperate attempts to save him, the boy died in the early hours of the morning.
Consultant pathologist Dr Lucie Winter, who carried out Keelan’s post mortem examination, told the inquest that the medical phenomenon that killed Keelan almost always resulted in death.
She carried out an examination of his completely healthy and normal heart with the help of national cardiac expert Professor Mary Sheppard.
Giving evidence to the Oxfordshire coroner Darren Salter, Dr Winter said: ‘There was no obvious cause of death at all. I liaised with Mary Sheppard who agreed to urgently assess the heart.’
Despite desperate attempts to save him, the boy died in the early hours of the morning.Keenan is pictured with his mother, Denise.
Mr Salter said: ‘The professor said the heart was normal weight. Given his history, this is in keeping with commotio cordis.’
Dr Winter described the phenomenon: ‘It just means concussion of the heart,’ she said.
‘It’s incredibly rare. It does occur in young athletes. We’re not sure why it happens. It causes a sudden cardiac arrest which is almost universally fatal.
‘There’s just a tiny fraction of a second, a window in the cardiac cycle where the heart is vulnerable. Thousands of times you can be hit in the chest with a ball and this would not happen. It was just in that nanosecond.’
Concluding, Coroner Mr Salter said: ‘Keelan was simply struck in the chest with a football. It is not apparent the football was even kicked very hard.
‘But with the way the heart works it is thought, but not fully understood, that there is a small window where if the chest is struck in that particular point it can, very rarely, result in what’s called an arrhythmia.
‘I think the cause of death is the ball striking Keelan in the chest accidentally. So I think the conclusion here is one of accidental death.’
Mr Salter recorded that Keelan MacKnight was killed by a football blow to the chest which caused commotio cordis, resulting in a fatal arrhythmia.
DEVASTATING PHENOMENON WILL STRIKE IN A FEW MILLISECONDS
Adolescents are more likely to sustain this injury because the thorax is less developed
Commotio cordis will usually occur in boys and in young men, with the average age of a sufferer being 15.
It is a form of Ventricular fibrillation – when the heart quivers instead of pumps due to disorganised electrical activity in the ventricles – and can happen in perfectly healthy hearts.
Sadly, the fatality rate for commotio cordis without prompt treatment is around 80 per cent. Even if the sufferer is promptly given CPR and defibrillation, just 35 per cent survive.
The phenomenon is usually caused by a projectile, but is also caused by an elbow blow or other body part.
Adolescents are more likely to sustain this injury because the thorax is less developed.
It is so rare because there is a tiny window of vulnerability – a 10 to 30 millisecond portion of the cardiac cycle during a heartbeat.