Football coaches and referees should undergo mandatory training to identify signs of sudden cardiac arrest, a coroner has urged, despite opposition from the Football Association (FA).
The recommendation follows an inquest that found a “missed opportunity” contributed to the death of teenager Adam Ankers, who suffered a cardiac arrest while playing for Wycombe Wanderers’ under-19s in January 2024.
Assistant coroner Valerie Charbit had previously ruled that a failure to recognise the 17-year-old was experiencing cardiac arrest “more than minimally” contributed to his passing. The inquest heard that a defibrillator was brought onto the pitch, but confusion over its safe use meant it was never deployed in an attempt to save Adam’s life.
Following this ruling, Ms Charbit, presiding at West London Coroner’s Court, recommended that the Football Association mandate a training course for all its accredited members, including grassroots football coaches and referees, to equip them with the ability to spot the signs of sudden cardiac arrest.
While the FA’s website currently offers a free, online module “designed to help recognise a sudden cardiac arrest and respond appropriately”, Ms Charbit’s report insisted this training should be compulsory and extend to all members.
The FA, however, argued against this move in its submissions to Ms Charbit. The organisation contended that making the training mandatory for all members, including children, would exclude younger individuals from refereeing roles, as it would require them to be “put in the position of having to deliver such basic life support as would be necessary.”
Ms Charbit firmly disagreed with the FA’s stance. “I disagree as to the fact that that shouldn’t be something that children should engage in,” she stated.
“Children are allowed to train in first aid… I consider it important that the responsibility for first aid lies with all ages within society and outweighs any concern that this would stop them becoming referees.”
She further dismissed the FA’s concern that the recommendation would necessitate training over 185,000 coaches, asserting that this logistical challenge was outweighed by the potential to save numerous young lives through wider training implementation.
The inquest had previously heard that Adam collapsed during the second half of a football match on 31 January 2024. He was subsequently taken to hospital, where he died on 4 February 2024, having suffered unsurvivable brain damage.
Adam’s family had urged Ms Charbit to broaden the recommendation to encompass all sports, but the assistant coroner deemed this an “overreach,” explaining it fell outside the scope of the evidence and issues considered during the inquest.
In her report, Ms Charbit highlighted the widespread “difficulty” faced by both ordinary individuals and ambulance call handlers in recognising symptoms of cardiac arrest and agonal breathing – sudden, irregular gasps of breath.
Adam had exhibited agonal breathing, a symptom that demands immediate CPR. Explaining her decision to issue the report, Ms Charbit expressed her belief that existing training provided by bodies such as NHS England and the South Central Ambulance Service, which handled Adam’s 999 call, was insufficient, despite arguments to the contrary.
Although NHS England has since implemented changes, meaning a sudden collapse during sport or exercise is now automatically treated as requiring immediate CPR, the assistant coroner noted that these changes took a “particularly long time” to come into force.
She observed: “Although there was training given, and some of those on the pitch were trained, there was still a misidentification of Adam’s agonal breathing by those on the pitch and those receiving the 999 call.”
Ms Charbit’s report also underscored the need for improved understanding of defibrillator use among both medically and non-medically trained individuals.
Furthermore, she pointed out that cardiac screening for those aged 14 and above, which can reduce the risk of sudden cardiac death, is not universally accessible to all young people or young football players.
The inquest also noted a failure to cascade a family history of arrhythmogenic right ventricular cardiomyopathy (ARVC), an inherited heart condition Adam was only identified to have had after his death.
Addressing the virtual hearing, attended by Adam’s father, Ms Charbit concluded: “I remember Adam Ankers. I remember everything I heard about him, and I do hope that this prevention of future deaths report that I have made allows us to prevent a similar death to that which Adam suffered.
“I express my sincere and deepest condolences, at the conclusion of these proceedings, to Adam’s family and friends.”
