NORWALK, Conn.-- A Norwalk doctor wants to make sure that what happened to Nathan Crowell won t happen again.
The 22-year-old University of New Haven student died a week ago after he was struck in the chest with a puck during a hockey game at The Rinks of Shelton. An autopsy found the cause of death to be commotio cordis, which means commotion to the heart, according to the state Medical Examiner s Office.
"It's a bash to the chest," said Dr. Jonathan G. Greenwald, a cardiologist who practices in Norwalk. Commotio cordis occurs when someone is struck hard in the chest when the heart is between beats, Greenwald said.
"You can have a perfectly normal heart, but if you are struck at that exact moment between heartbeats it can cause cardiac standstill and trigger chaotic electrical activity," he said. "The heart shivers and no blood is pumped and the result is rapid death."
It's been known to happen in sports such as lacrosse, hockey and baseball, he said.
"If you have a defibrillator close by and can grab it within 60 seconds, it's conceivable that it could shock the heart back into beating," he said.
Greenwald said he is working with the American Heart Association to get legislation passed that would require defibrillators to be on hand at places such as The Rinks that could be accessed immediately in such situations, he said.
"There should be one anywhere a contact sport is played," he said, "and hockey is one heck of a contact sport."
Rinks owner Howard Saffan couldn t be reached for comment, but Echo Hose Ambulance chief Jason Perillo said there was no defibrillator at the sports complex the night Crowell died.
Since then, Rinks personnel have approached Perillo asking for assistance purchasing one, he said.
"We have done it for other organizations," he said. "We help determine how many they need and where they need them -- you can't just go out and buy them."
When someone suffers cardiac arrest, every minute that goes by without treatment decreases the chance of saving them by 10 percent, said Perillo, an alderman who was recently elected to the state House of Representatives.
"We try to defibrillate a patient within four minutes," he said. But it's better to have a defibrillator on site rather than wait for the EMTs to arrive to do it, he said.
Similar legislation failed to make it through the Legislature last year, Greenwald said, and he will be meeting soon with officials from the American Heart Association to discuss what will be submitted during the next session.
"What happened to this 22-year-old is right at the heart of what we are trying to do," he said.
The puck struck Crowell shortly before 11 p.m. Oct. 25 while he was playing in a Men's League game sponsored by the Rinks. Three seconds remained in the game when Crowell received the fatal blow.
An emergency room doctor playing in the game attended to him immediately, but Crowell died that night at Bridgeport Hospital.
Greenwald is working with state Sen. Robert Duff, D-25, on getting legislation passed to require the equipment in facilities where sporting events take place.
"The issue is liability, if it is used wrong," Duff said. "I don't think anyone disputes the advantages of having a defibrillator there, but in our litigious society, it's a question of liability."
The equipment itself is simple to use, he said. "It's not something that requires a lot of training -- it basically walks you through it as you use it," he said. "It's incredible that something that is so critical in saving a life can be used by anybody."Several bills have been discussed that would require defibrillators in schools and gyms, and, in Greenwald's case, at facilities that host sporting events, Duff said. "The concept is simple," he said, "but we have to work out the details."