A Father’s Lament: Remus’ Dad Speaks Out

Mr. Rudy Fuentes is sharing the agonizing story of the death of his runner son, Remus, who collapsed and later died of multiple organ failures as a result of heat stroke 2 days after running the Milo Marathon eliminations. Here is his story:

REMUS FUENTES died of multiple organ failures as result of heatstroke two days
after he ran the 21K in the recent 34th Milo Marathon last Sunday, July 4, 2010.
His death was the result of fatal mistakes, sheer incompetence and gross
negligence in the event organized by the Organizing Team.
My son, 37-year-old Remus ran the 21K together with a running buddy when he
collapsed at 19.9 kilometer mark. There was none of organizer’s ambulance nor
marshalls to respond in the incident. Policemen hailed for a taxi and they,
together with his buddy, assisted in bringing him to the nearest hospital,
Ospital ng Maynila. At the ER, the diagnose was suspected heart attack. My wife
and me, upon being informed by his younger brother, Roy Fuentes, who also ran
the 21K, rushed to the hospital and saw that Remus in coma, had seizures and
struggled breathing in spite of hand-pumped oxygen and dextrose attached. His
body temperature was 40 degrees C and when asked, the medical attendant told
us he had fever. She introduced paracetamol intravenously twice at interval of
about 15 minutes. Remus continued having seizures even until the arrival of
Medical City doctor & ambulance attendants that we have arranged for his
transfer.
 
The Medical City doctor attending said his status was unstable,
contrary to the earlier advice to her by the Ospital ng Maynila ER doctor. They
rushed him with the ambulance to Medical City at about 11:30 AM. There, a
series of tests were done, including blood chemistry, CT scan, etc.
 
 
Cardiologist told us his heart was strong and no intervening medicine was
necessary. Blood Chemistry results showed positive findings on creatinin level,
an indication of kidney failure. They suspected liver failure too. To stop his
seizures, Remus was put on full sedation for 12 hours. Kidney functions further
deteriorated after 36 hours. Blood pressure and heart rate went erratic.
Doctors attending him in the ICU asked our permission to do dialysis and blood
transfusion to stabilize his blood pressure. Seven hours later, ICU nurse wake
us up and asked us to rush to the ICU. We saw 18 medical people around him,
several taking turn doing the CPR. Failing to revive him, the doctor asked our
consent to stop the CPR after 15 minutes. We begged them to continue hoping for
miracle. 30 minutes further, doctor told us again that all numbers in the
monitoring “were bad” and asked again the consent to stop the CPR. Finally, we
relented. Few minutes later, his heart rate monitor went flat. All these
happened in front of my wife and me. We lost Remus 48 hours after he collapsed
into coma which he has never recovered. His young wife and his eight-year old
son took the news very badly.
About Heatstroke:
It usually happen in extreme sports like basketball, football, boxing and
marathon.
Heat stroke is a life-threatening medical condition. The person’s cooling
system, which is controlled by the brain, stops working and the internal body
temperature rises to the point where brain damage or damage to other internal
organs may result. The body temperature, usually at normal 37 C, goes up during
the exertion of effort as result of the increased heart rate. When it reaches
40 C, the person is in danger of getting heatstroke. Above 40 C and mostly at
about 42 C, the person can collapse into unconsciousness. If nothing is done
within few minutes, he can slip into coma and brain damage may occur. The
proven first aid response for heatstroke is cooling the body rapidly in
whatever means to the level of below 40 C before bringing him to a hospital.
Ice and water is the best way to do this, the same way it is done for a child
having high fever who has convulsion.
 
Another way of understanding heatstroke is comparing it to the performance of
car engine. At idling, the engine temp is low and safe. At sustained high
speed, engine temperature increases rapidly but because of the cooling system,
the heat is continuously dissipated in the radiator and safe temperature level
is maintained. But when the water in the radiator is gone, Undissipated heat
will rack up the engine temperature and ultimately exceeds the safe limits. At
this condition, engine breakdown will occur in minutes starting with broken
piston rings, rods, pistons, etc.
Why Heatstroke is More Dangerous in Marathon than in other Extreme Sports? 
With the human body, perspiration cools down the body so hydration by drinking
water is essential. Without water, perspiration stops and body temperature goes
to critical level and into heatstroke and then organs and brain begin to fail.
Big obvious difference between human body and car engine is that you can always
overhaul the engine but you cannot do that on the human body.

 

In basketball, the player exerts extreme effort only in bursts, stopping or
slowing down intermittently which slows down heart rate and cools down the
body. At timeout, they drink to replenish lost body water hence you always have
the waterboy. Heart stroke is rare but ask any PBA player what they do when a
player collapse. They don’t move the body but cool them off with water or ice
before bringing him to the hospital.
The same is true in football and in many similar sports.
In boxing, in between rounds of three minutes, boxer rests and drinks water. We
can only wonder what will happen if the rule of the sport is drastically
changed and will only end when one is down and out.
In Marathon , the risk of heatstroke is much higher for the following reasons:
 
 

1. The long distance runner aims for shorter time as a goal and therefore
motivated to keep a sustained effort, not unlike cars at high speed in the
highway.
2. Furthermore, the target minimum time set by the organizer adds more to
the motivation to run faster. The cut-off time added more pressure to the
marginal marathon runner, meaning if you are used to run above the target
time, the tendency is to do better time, probably at pace unproven by your
body in practice. (Milo Marathon set the target for 21K medal at 2 ½ hours
or less. Remus collapsed at near 20th km. with time of 2 hours 10 minutes
when his previous record was 2 hours and 27 minutes. )

3. The more critical factor is that the hydration management is not in the
control of the runner. He has to rely on water availability at the water
stations provided and planned by the organizer along the route. ( In this
34th Milo Marathon, several runners including Remus brother, Roy and Remus
running buddy asserted that practically there was no water to drink in the
last 2~3 kilometers before the finish line, a fatal failure for Remus by
the organizer when they changed the route resulting in over-traffic near
the finish line. There were record 28,000 runners on that day and
obviously the organizers failed to anticipate the complexity of hydration.
Milo ’s last year marathon participant was well below 10,000 runners.)

4. The correct life-saving response for heatstroke depends on few
knowledgable people who may happen to be around the person. To mitigate
this, the organizer deploys ambulances with water & ice for cooling
heatstroke victims and is expected to respond within minutes. In addition,
marshalls are provided along the route to assess runner situations
continuously. (Obviously, the organizer failed again on this aspect
because Remus was helped by policemen and his buddy instead. By this time,
Remus is probably already brain damaged as evident by his seizure at the
hospital. No Milo people knew of Remus case on that day until Roy, his
brother, sent an email informing the organizer of the incident in the next
morning).
 
5. The Sun Factor adds to the danger in Marathon . Running under the heat
of the sun in tropical country like ours cannot be underestimated. To
minimize the effect of the sunheat, Marathon run is planned to finish in
the early morning avoiding the heat at later time. Organizers usually take
this into consideration. ( Milo organized the 21K to start at 5:30 AM , a
departure of common practice of other marathons which started at 5:00 AM.
Remus collapsed at about 7:57 AM. Roy who is a better runner than his
brother Remus, complained that it was unusually hot that morning even if
he was able to finish it earlier in 2 hours 45 minutes ).
Clearly, Marathon is an extreme and dangerous sport even to the young, healthy
and trained runners. This is not the “fun run” many people confused of.
The organizer has clear life-and-death responsibility to make sure that the
conditions the runner will run under item 3, 4 and 5 above are done properly.
Obviously they did not do their job properly in the 34th Milo Marathon. In my
opinion, being the father of Remus, Milo Marathon Organizers have failed my
son. It is their sheer incompetence and consequently the gross negligence in
their duty that results in the death of Remus …an unneccesary death.
 
About Remus:
At the time of his death, he was an IT project manager of Hewlett-Packard (HP)
responsible in computerizing big companies like Unilab, Coke, etc. including
installation of hardwares (servers, etc.) and software system. He used to
worked for Intel for 10 years before he moved to HP 3 years ago. He graduated
in Computer Engineering. He left a housewife, Takako and two children, Raphael,
8 years old and Therese, 4 years old. Raphael is enrolled at La Salle
Greenhills. He played basketball with his brothers regularly on weekends. He
has been running since his high school days in Lourdes School of Mandaluyong.
He has run many 10Ks and two 21Ks before these, the “Freedom Run” in June 13
and “ Nature Valley ” in May 20 only this year. He has no history nor complaint
of illness and he lived clean.
 
My Questions for the Organizers:
1. How many died in the 34th Milo Marathon last July 4? Is it true that
there was another runner at 42K who collapsed at 33 km and later died?
2. How many runner collapsed in that marathon due to heatstroke who later
survived but now are no longer the same person as before due to partial
brain injury? At Ospital ng Maynila, we saw a 2nd runner brought in
unconscious and woke up later but he can no longer recognize his family.
Do the Organizers of knew this? What happened to him. Are their more?
3. Is it true that another 36 year-old runner, Fidel Camson, who ran the
42K 31st Milo Marathon in November 2007 collapsed near the finish line,
brought to the Ospital ng Maynila and died later of undetermined cause? If
true, what did they do avoid a repeat which apparently did not happen in
this 34th Milo Marathon? If true, why do they still keep Rudy Biscocho as their
Marathon organizer for 10 years until now?
4. Do they keep tally of deaths in the 34 years of Milo Marathon? Do they
study the statistics and establish how many died of heatstroke, the
preventable one?
5. What is the corporate culture of the Organizers regarding its respect
of the value of life? Upon knowing the death of my son Remus, A Senior
Vice President of one of the organizing team, who head its Beverages
Business Unit went to see me and among other things, he told me that the
Marathon is continuously improved and but sometimes “lapses occur and they
will learn from these lapses”. Lapse is defined as a ‘mistake’. People
learn from ‘error’, a deviation from being correct but a ‘mistake’ is
caused by a fault: the fault could be misjudgment or carelessness. We learn
from ‘error’ but we take action on ‘mistake’ and more drastic action when
people die of this ‘mistake’. So death in my son’s case is a mere
learning process for this person? Is this the culture that pervades in
their Organization? or only in him?
6. Is the measly “humanitarian” offer to help the family shoulder medical
& funeral expense to the family had become an SOP too often? Was it their
expectation that as appreciation of this help, the family will keep quiet
about the whole thing? Do they really think that the waiver signed by the
runners protect them from being liable? Do they know that this waiver
won’t apply if negligence of their duty as organizer can be established?
7. What did the Organizers do, if any, to keep the news of Remus death
from appearing in the media even after one week? Not one news item of his
death appeared in the newspaper, TV or radio. Could the news of “ HP Manager
Died of HeatStroke during the Milo Marathon” not interest the public? Were
they afraid that the bigger news is when the subline “Father charged Milo
Marathon Organizer of Incompetence and Negligence” which may damage the
public image of the company?

The answers to these questions will help enlightened the public whether Milo
Marathon is safe or not for the runner. To the runners, their parents, wives
and relatives…they all better asked these questions before the runners decide
to run in Milo Marathon.

Last Words from Remus Father:
I am not condemning the sport but the organizer who failed to make sure runners
will not die of heatstroke, when the risks can be grossly minimized with proper
route planning, hydration management and quick medical response. I am
condemning the contribution of the apparent culture of the sponsor of
diminished value of human life as indicative of its senior executive’s attitude
calling my son’s death a result of lapses. My hope is something good will come
out of his death and as result of improved organizing of the marathon run, few
lives will be saved from heatstroke. My other hope is to get justice and for
the Organizing team to answer for his untimely death. I am working on it.

Rudy Fuentes, Father of Remus

From: http://www.pinoyfitness.com/2010/07/remus-story-as-told-by-his-father/

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3 responses to “A Father’s Lament: Remus’ Dad Speaks Out

    • Mr. Fuentes,
      Thank you for sharing this.

      I am a runner also and I am starting to organize a fun run in my hometown. With your article, it opened my eyes on the risks of running and the precautionary measures that an organizer should plan about.

      Your son’s death definitely has purposes, that is to save the lives of many enthusiast runners like me and to put awareness on the organizers on avoiding fatal lapses during the race.

      Once again, thank you and may God bless you in your journey.

      John Apollo L. Bautista
      President
      Gensan Run Club

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