The Surprising Truths About Sudden Cardiac Arrest in Young Athletes

The image of a young, seemingly invincible athlete suddenly collapsing on the field is one of the most frightening in sports. These moments are deeply visceral, sparking immediate fear and concern. When such a tragedy occurs, it often leaves parents, coaches, and communities scrambling for answers, trying to understand how something so catastrophic could happen to someone in peak physical condition.

In recent years, the conversation around sudden cardiac arrest (SCA) in athletes has become clouded by a storm of misinformation. Widespread narratives, particularly online, have attempted to link these events to the COVID-19 pandemic and vaccinations, adding a layer of confusion and anxiety to an already emotional topic. The noise has made it difficult to separate fear from fact.

Now, two major studies, one a comprehensive review of malpractice lawsuits, the other a six-year analysis of cardiac arrest frequency, have cut through that noise, providing a data-driven look at the reality of these events. By analyzing decades of legal cases and comparing cardiac arrest rates before and during the pandemic, researchers have uncovered some startling truths.

There are four takeaways that every parent, coach, and sports administrator needs to understand:

1. Lawsuits for athlete cardiac events are rare.

According to a comprehensive review of U.S. malpractice lawsuits related to sports cardiology, litigation following these tragic events is exceedingly uncommon. From 1978 to 2022, 35 relevant cases have been identified in the U.S.. This averages out to less than one case per year (0.8 cases/year) over more than four decades. Even with a slight increase in recent years, the average over the last decade was still only 1.8 cases per year.

Considering the tens of millions of young athletes compete annually, this number is surprisingly low. When legal action is taken, the most common primary defendants were health care practitioners (43% of cases), followed by school districts. Data suggests that while these events are high-profile, widespread litigation is not a common outcome.

2. The #1 legal danger isn't misdiagnosis; it's a failed emergency response.

When lawsuits do occur, the primary allegation is often not what one might expect. The most common reason for legal action was not a failure to detect a hidden heart condition, but rather a negligent emergency medical response at the moment of crisis.

A negligent emergency response accounted for 37% of primary allegations, making it the leading cause for litigation. These weren't minor oversights; they were catastrophic failures. In one case, an AED was on-site but was never used on a 14-year-old baseball player who died. In another, an AED was available for a 15-year-old soccer player, but again, it was not used; the athlete survived but with a severe brain injury. Of the cases alleging a failed response, a detailed breakdown showed 18% involved an AED that was available but unused, another 18% had no AED available at all, and 35% involved delayed cardiopulmonary resuscitation (CPR) or AED use.

This finding powerfully shifts the focus from the complexities of advanced medical screening to the fundamentals of life-saving preparedness. It highlights a clear, actionable area for improvement for every school, club, and sports organization: having a well-rehearsed and properly equipped emergency action plan is the single most critical factor in both saving a life and preventing legal fallout.

3. The COVID-19 "spike" in athlete cardiac arrests is a myth.

Contrary to persistent online claims, a major study monitoring SCA cases in young athletes found no increase during the COVID-19 pandemic. The research, which tracked cases over six years, directly refutes the narrative that the pandemic, or related vaccinations, led to a surge in cardiac events on the field.

Researchers compared a 3-year pre-pandemic period (2017-2019) to a 3-year period during the pandemic (2020-2022). The numbers were not significantly different, with 203 cases of SCA identified before the pandemic versus 184 cases during it. Furthermore, the study looked specifically at myocarditis, a condition often cited in misinformation, and found that over the entire 6-year period, it was the confirmed cause of SCD in only 7 of the 139 fatalities where a specific cause could be determined.

The significance of this is profound. The researchers concluded that reports claiming a link between SCA/SCD and COVID-19 infection or vaccination overestimate the cardiovascular risk. It was also noted that many athlete cases shown in social media video montages, which claimed a pandemic-era link, actually depicted events that occurred before the pandemic began.

4. While the lawsuits are rare, the financial stakes are astronomical:

While the data shows that lawsuits are infrequent, the malpractice review found that the financial consequences for cases that do result in a settlement or a verdict favoring the plaintiff are enormous. The financial risk for institutions found to be negligent is exceptionally high.

Known settlements or awards in these cases ranged from $600,000 to 24,000,000** (or **893,198 to $29,655,000 when adjusted for inflation). This demonstrates the "low-frequency, high-severity" nature of the risk; though an institution is unlikely to face a lawsuit, the financial impact of a single failed response can be devastating. This underscores why having ironclad, well-practiced protocols for emergency response is not just a medical imperative but also a critical component of institutional risk management.

A Call for Preparedness

The latest research paints a clear and surprising picture of sudden cardiac arrest in young athletes. We now know that lawsuits are incredibly rare, and when they do happen, the true legal danger lies not in a missed diagnosis but in a fumbled emergency response. We also have definitive data showing the pandemic did not cause a spike in these events. Finally, while the risk of litigation is low, the financial stakes are massive for those unprepared.

These takeaways should re-focus our collective efforts away from misinformation and toward tangible action. The data points in a single direction: preparedness saves lives and protects organizations. This leads to a crucial question for all of us: Knowing that the single biggest factor in both saving a life and preventing legal action is a fast and effective emergency response, how prepared is your local school, team, or sporting venue? ThriveIn can help to support EAPs, training, and continued preparedness support!

 References:

Weller, S, Barat, M, Weller, Z. et al. Medical Malpractice Claims for Sports Cardiology Cases Among Young Athletes. JACC Adv. 2025 Aug, 4 (8) .https://doi.org/10.1016/j.jacadv.2025.101915

Astley C, Petek BJ, Delong RN, et al. Sudden Cardiac Arrest Among Young Competitive Athletes Before and During the COVID-19 Pandemic. JAMA Netw Open. 2025;8(2):e2461327. doi:10.1001/jamanetworkopen.2024.61327