SINGAPORE — The bodybuilder who died after fighting YouTube celebrity Steven Lim in a Muay Thai exhibition match had pre-existing heart conditions.
In findings made available on Tuesday (25 February), State Coroner Kamala Ponnampalam said that 32-year-old Pradip Subramaniam’s death had stemmed from cardiomegaly with cardiac channelopathy.
Cardiomegaly is an abnormal enlargement of the heart while cardiac channelopathy is a type of genetic abnormality that can cause heart rhythm disturbances.
“In the circumstances, I find Mr Pradip's death to be from a natural cause,” said Kamala in the findings dated 11 February.
Cleared medical screening before fight
Pradip, who was the president of the World Bodybuilding & Physique Sports Federation and a freelance gym instructor, died of cardiac arrest at the Singapore General Hospital after a bout at Marina Bay Sands on 23 September 2017. The fight was part of the inaugural card for the Asia Fighting Championship (AFC).
During hearings into Pradip’s death, a forensic pathologist commented that the genetic screening for inheritable cardiac conditions showed the deceased had cardiac channelopathy.
The two conditions he suffered from may have predisposed him to acute abnormal heart rhythms, resulting in sudden cardiac death, said the expert at the time.
Before the match, Pradip had undergone a medical screening examination and was certified fit to participate. He did not report any previous history of syncope, or temporary loss of consciousness due to insufficient blood flow to the brain.
During the match, Pradip became increasingly sluggish, likely due to the strenuous activity he was engaged in. Just over a minute into the bout’s second round, the match was called off after Pradip failed to respond to the referee's directions to move to the centre of the ring.
During the subsequent prize presentation ceremony, Pradip was seen standing near the ropes and resting against them. He again failed to respond to directions to move to the centre of the stage.
When the AFC general manager went over and placed the medal on Pradip, he slumped to the ground.
Pradip was immediately attended to and was observed to be unable to provide verbal responses. He was taken to SGH and became pulseless en route. Resuscitation efforts were carried out and continued even as Pradip arrived at the hospital. He died at 9.51pm.
Two independent medical experts testified during the hearing that the pre-match medical screening was adequate, and that the on-site doctor would not have been able to detect Pradip's medical conditions as it would have required an electrocardiogram (ECG) to have been conducted.
Both independent medical experts noted that Pradip had not reported any symptoms related to cardiomegaly to the on-site doctor during the pre-match medical screening. The second independent medical expert also stated that the medical attention provided on-site was adequate and timely.
On individuals performing in sporting events, SC Kamala noted that Sport Singapore (SportSG) recommendations state that those participating in sporting events involving high cardiovascular risk ought to undergo annual screening which includes the resting ECG.
“This can be arranged by the event organiser or undertaken by the participant himself. It was emphasised that adequate and appropriate training with a gradual build up in volume and intensity is essential for minimising the risk of sudden cardiac arrest,” said SC Kamala.
“(SportSG) also warned that being fit in one sport does not necessarily mean that the individual is fit for another sport. There must be self-awareness of one's fitness level and medical conditions,” she added.