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GREENSBORO - Jospin "Andre" Milandu's death could have been prevented if N.C. A&T had followed NCAA rules for physicals, a physician who studies sickle cell trait said.
An autopsy report by the N.C. Medical Examiner's Office released Thursday showed that Milandu died from complications of the sickle cell trait and physical exertion.
"They were mandated to screen him," said Dr. Randy Eichner, professor emeritus of medicine at the University of Oklahoma Health Sciences Center . "If they had done that, then they would have known about the trait."
Eichner helped craft the NCAA's policy on sickle cell trait and has worked in college lawsuits on sickle-related deaths.
A&T Athletics Director Wheeler Brown, reached Thursday evening, did not speak to the autopsy findings.
"I have not had an opportunity to view what you're talking about right now," Brown said. "And I would not venture to make a comment."
The NCAA, the sanctioning body for intercollegiate athletics, requires students who participate or try out for sports to have a physical and a record - or signed release - for sickle cell trait testing.
That paperwork must be on file before any athletic participation.
Milandu, 20, of Knightdale died after collapsing at a track and field tryout Aug. 19. He did not have a current physical at the A&T athletics department and did not have a record of a sickle cell trait test.
Milandu was among 29 students at the tryout without a physical, according to Chancellor Harold Martin, who released that information Sept. 8.
That figure has since been disputed by track and field coach Roy Thompson , who has run the A&T program for 26 years. Thompson has said that only nine students lacked physicals on file at the tryout.
Thompson said recently that he plans to retire Dec. 1.
After Milandu's death, A&T filed a report saying that it did not follow NCAA policy on the collection of physicals.
Milandu's death is the second sickle-related at A&T since 2008 ; a football player died after he collapsed at practice.
Eichner said the conditions surrounding Milandu's death are similar to those of other athletes who had the sickle cell trait and died.
"This death scares me," he said. "This is their second in two years. ... They're going to be, I assume, in big trouble."
Eichner said lawsuits against a university often are filed by the surviving family.
Milandu's father, Fernand Milandu , did not return a phone message Thursday.
Milandu died during a workout called ins-and-outs. Runners go fast in straightaways and jog through curves.
Understanding how he died requires some basic knowledge of what blood does in a body.
Normal red blood cells, which deliver oxygen to the body, are round and flexible. Sickle cells are quarter-moon shaped. They are sticky and harder than normal red blood cells, Eichner said.
The trait is a genetic condition that anyone can have, but it is more prevalent in those of central and west African descent.
When the body works hard, it needs more oxygen, so demand is higher on red blood cells.
"Low blood oxygen causes cells to sickle," Eichner said, "and they will sickle with exertion."
At that point, Eichner said, the odd-shaped cells get stuck in blood vessels. The effect for a runner is like putting a tight tourniquet around each leg and going for a sprint.
"The muscles' cells are starting to die with no oxygen," he said.
The muscles then release chemicals that the body can't handle. In particular, potassium is released, which makes the blood acidic. And the possibility of kidney failure also exists.
The affected person remains aware for a while after collapse. That's different from most heart- , heat- or asthma-related collapses.
"It's a syndrome that occurs out in the field," Eichner said. "In police, military, basketball, football, firefighters and on the track. Even your average physician doesn't see it."
But Milandu's death could lead to new awareness of the sickle cell trait, Eichner said.
"This will be the first proven one in college track that I know of," he said.
Contact Gerald Witt at 373-7008 or gerald.witt@news-record.com
An NCAA-required physical could have protected the student, one doctor says.
