Date of Award
Summer 2025
Document Type
Open Access Dissertation
Department
Exercise Science
First Advisor
Susan W. Yeargin
Abstract
Background: Sport participation among youth and collegiates remains high, elevating concerns regarding player safety. Particularly in emerging women’s and non-football sports, where catastrophic injuries, though rare, can have devastating/fatal consequences. A critical need exists to enhance understanding of the role of sport-related safety policies, injury trends, and litigation in informing effective prevention strategies. Purpose: This dissertation aimed to (1) assess the impact of safety rules and policy changes on injury outcomes in women’s lacrosse, (2) describe the epidemiology of catastrophic head and neck injuries (CHNI) in non-football sports, and (3) characterize the frequency of litigation evidence following sport-related athlete fatalities. Methods: Three retrospective investigations were conducted. A scoping review adhering to Joanna Briggs Institute and PRISMA-Scoping Review guidelines summarized 11 sources on safety policies in women’s lacrosse. A secondary analysis of 470 CHNI cases reported to the National Center for Catastrophic Sport Injury Research (NCCSIR) between 1982-2022 examined epidemiologic characteristics and rates. A review of 1,222 sport-related fatalities from NCCSIR (1982–2021) assessed athlete demographics, cause of death, and evidence of litigation. Results: (1) Protective eyewear mandates in women’s lacrosse led to significant reductions in eye/face injuries across three studies, while headgear interventions yielded mixed results, with reductions in concussion rates in some and increased head-impact frequencies in others. (2) The eligible CHNI events captured 17 unique sports. Most injuries transpired in those who were male (69.4%, n= 326), an average age of 17 ± 2, and competed at the high school level (76.1%, n=358). Permanent-disability (38.7%, n=182), and fatality (12.6%, n=59) represented over 50% of outcomes. Of CHNI, Traumatic brain (33.5%, n=107/326) and spine fractures (34.1%, n=111/326) were most frequent in males, and traumatic brain (34.0%, n=49/144) and other traumatic injuries (i.e., nerve injury, facial fractures, etc. [33.3%, n=23/144]) were most frequently in females. (3) Evidence of litigation was discovered in 9% (n=112) of sport-related fatalities, predominantly involving sudden cardiac arrest (32%) and heat related injury (31%), with football accounting for 64.3% of litigated cases. Conclusions: These results highlight the impact of protective equipment mandates and underscore the importance of ongoing injury surveillance, emergency action planning, and the development/implementation of policies and procedures to enhance athlete safety and mitigate catastrophic injuries and litigation risks.
Rights
© 2025, Courtney M Meyer
Recommended Citation
Meyer, C. M.(2025). Catastrophic Injury and Sudden Death in Sport: The Intersection of Injury, Policy, and Law. (Doctoral dissertation). Retrieved from https://scholarcommons.sc.edu/etd/8539