Report shows missing physical, good on-field response

By ALEX STRICKLAND / Bigfork Eagle

The Bigfork School District released its report on the death of Jeffrey Bowman last Tuesday, prompting the late student's parents to deride it as "an insult."

The report, which details an investigation conducted by Missoula attorney Elizabeth Kavela, found that coaches on the field acted appropriately in response to Bowman's collapse and that the school's system for filing athletic physicals was flawed.

Kavela interviewed school administrators as well as coaches, players and parents who were on the field at the time of the accident. But Bob and Troy Bowman, Jeff's parents, issued a statement calling the document "biased and incomplete" and referring to Kavela only as the "school's hand-picked attorney" or the "school's attorney." Kavela was hired by the Bigfork School District.

Kavela found that there was no physical on file for Bowman or two other students who practiced on August 13, the day Bowman collapsed. The system was undergoing an overhaul that was designed to end the practice of coaches accepting physicals on the field, according to Activities Director Shannon Smith's statements in the report. Susie Hullet, Bigfork High's secretary, was working with Smith to ensure that all physicals were turned in at the school's office and the two had sent a letter out on May 4 to all fall sports participants to notify them of the changes.

Physicals were also discussed at a May 21 fall sports meeting, according to the agenda. Smith indicated in the report that he was unclear as to whether os not the Bowmans were present at that meeting.

An athletic physical relies on both a patient's self-reporting of any family or individual medical history, as well as a check for a variety of issues. Those include, but are not limited to, eyes, ears, cardiovascular, pulmonary, skin, skeletal and neurological conditions, according to an athletic physical form provided by Bigfork Medical Clinic.

An article in the American Family Physician journal on May 1, 2000, details the steps a physician should take when performing such a physical. It also notes that the rate of sudden death in males under the age of 35 is approximately .75 per 100,000 participants per year. "Congenital cardiac anomalies account for most sudden deaths," according to the article.

However the article also states that the cardiac conditions most likely to cause sudden death in young athletes are rarely detected. "When large groups of young athletes are evaluated, few are disqualified because these orders are suspected."

The family history, the articles states, is a more sensitive tool than the physical examination.

Bowman's official cause of death has not been announced.

While Bowman did not have a physical on file for the 2007 football season at Bigfork High, he had played football as a freshman for Bishop Machebeuf High School in Denver. The small, catholic school is a member of the Colorado High School Activities Association, according to that organization's assistant commissioner Bert Borgmann.

In order to participate in a high school sport at a member school, a physical must be on file and given in the last 12 months, Borgmann said.

The Bigfork School District was fined $50 last week by the Montana High School Association for violating its similar policy regarding physicals.

Machebeuf High School Athletic Director Hans Bihr confirmed that Bowman had played football there as a freshman, but did not play as a sophomore and did not attend that school as a junior.

The school district's investigation found discrepancies in the amount of time it took coaches to react to Bowman's collapse, though 19 people on scene who witnessed the event testified that staff reached bowman in 30 to 45 seconds, and only four - none of whom actually saw Bowman collapse - recalled the response time as excessive.

According to multiple witnesses, Bowman did not collapse at once, but rather slowed on the second lap of a conditioning exercise, put his hand on his knees, then dropped to one knee and then over onto his back. The investigation found more than one witness who initially mistook this action for a player simply trying to catch his breath.

What the investigation did not explore - to the chagrin of Bob and Troy Bowman - was the conditions in which the practice took place.

On August 13 there were two practices, one in the morning and in the evening. The evening practice was wrapping up around 8 p.m. when coaches were beginning conditioning drills for the players, according to the report.

Head Coach Bruce Corbett said he and the assistant coaches took the smoky conditions into account and modified the conditioning workout appropriately, the report stated.

According to the Montana Department of Environmental Quality's Kalispell air monitoring station, the particulate levels at 8 p.m. on August 13 were deep into the "unhealthy" category at 176 micrograms per cubic meter.

The station's report for that day shows that air quality was good to moderate most of the day, with a spike in particulate levels coming just before noon and then again in the early evening. The levels hit their peak for the day at the 8 p.m. reading.

John Coefield, the meteorologist at the Air Resource Management Office at the DEQ, said that smoke from forest fires can affect air conditions severely and quickly.

"You get clearing periods and then a huge wall of smoke will roll in and it will get terrible," he said.

Coefield also stressed that forest fires' influences on air quality can change drastically over a short distance, so a reading in Kalispell might not accurately reflect conditions in Bigfork.

The DEQ, however has no local authority about health, that's done on a county level. Flathead County has guidelines to rate conditions from "Good" to "Hazardous" based on the particulate levels in the air similar to the DEQ. The DEQ's one-hour level for "Unhealthy" is 88.6-201 micrograms per cubic meter, while Flathead County's "unhealthy" category is significantly higher at between 175.1-300 micrograms per cubic meter. Multiple calls to the Flathead City-County Health Department's Air Quality Services division for explanation were not returned.

Missoula County, by comparison, issues Stage I and Stage II air alerts in response to high levels of particulates. A Stage II alert, the more severe of the two, is issued at 150 micrograms per cubic meter, according to Missoula County air quality specialist Eric Englebert.

The Stage II warning advises "sensitive populations should stay indoors if possible. Everyone else should limit prolonged exertion," according to Englebert.

Coefield said DEQ research has shown expected consequences from exposure to bad air quality over the past six or seven years.

"Whether it's wood smoke or tobacco smoke, there are all these expected consequences," he said. "People with lung issues usually medicate themselves. The worst results are heart attacks from people who didn't know they had a condition."

Coefield said some people are incredibly tolerant of smoke while others suffer from even a hint of it. In between those extremes are most people.

"We tell people, 'Listen to your bodies and pay attention,'" he said.

Bob and Troy Bowman dismissed the report as a "charade" and an example of "the hired gun trying to protect her client."

Bigfork School District Superintendent Russ Kinzer released a statement along with the report that said "Out of respect for the family I'm not going to comment on the content of the report. The report speaks for itself and people are encouraged to read it for themselves."

Kinzer added last week that the policy for accepting and filing physicals was being looked at administratively.