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Orlando SentinelOriginal Article »
December 20, 2007
The tourist who died this week on a roller coaster at Walt Disney World had a known heart condition and suffered from an enlarged heart, authorities said Wednesday.
Only three of the 500 portable heart defibrillators on Disney World property were in Disney's Animal Kingdom theme park when the death occurred Tuesday, and none was close to the Expedition Everest ride, where the man died. But Disney said its strategy for dealing with medical emergencies was sound.
"Our strategy is to put them [defibrillators] in a consistent place where guests and cast members can find them," Disney spokeswoman Andrea Finger said. "We rely on professional paramedics to respond to emergency situations."
The Orange County Medical Examiner's Office said Wednesday that Jeffery C. Reeb died of dilated cardiomyopathy, or an enlargement of the heart, that had no known cause. The report said Reeb, 44, had a history of cardiac arrhythmia -- an irregular heartbeat -- and died of natural causes.
Local medical specialists were unsure Wednesday whether quick use of a defibrillator would have helped Reeb because of his condition, though they agreed quick action could benefit someone in cardiac arrest without Reeb's problems.
Reeb, who was visiting Animal Kingdom with his family from the Panhandle town of Navarre, collapsed during the 3-minute Expedition Everest ride shortly before 11:30 a.m. He was unconscious and unresponsive when the ride pulled into the unloading station, though a camera inside the attraction showed he was conscious less than a minute before the ride ended.
He received immediate cardiopulmonary resuscitation from a Disney employee and a registered nurse visiting the park. Paramedics responded within four minutes of the 911 call but could not revive him, according to Reedy Creek Emergency Services.
"Everything we do is based on set protocol," Reedy Creek Deputy Fire Chief Bo Jones said. "He was unresponsive when we got there. We were wondering why what we did didn't work, but we didn't know about the underlying condition."
When a woman called 911 to first report a collapsed man at the Everest ride, an emergency dispatcher asked her about a defibrillator.
"Is there a defibrillator available?" the dispatcher asked.
"No, there is not," answered the caller, whose name was deleted from an audio copy of the call.
Medical experts said problems such as Reeb's can complicate emergency care.
"When you have a structural abnormality like a cardiomyopathy, the heart doesn't behave like a normal heart," said Dr. Salvatore Silvestri, associate medical director of Orange County Emergency Medical Services. "So it is less likely that the rhythm could be converted by a defibrillator."
Defibrillators shock the heart; when used successfully, they restore a normal heartbeat. But success isn't certain.
Still, Dr. Luis Alvarez, a cardiac electrophysiologist at Orlando Heart Center, said defibrillators can be useful even when a person suffers from a heart abnormality.
"We feel a defibrillator can be lifesaving in cases like this," Alvarez said. "Cardiac arrest is like an electrical storm in the heart -- it can be reprogrammed with a defibrillator."
Dr. Vidor Friedman, chief of staff at Florida Hospital Celebration Health, said that even when a defibrillator is used right away, reviving a patient with a heart condition can be complicated. Reeb was pronounced dead at Celebration Health.
"There may not have been anything that anybody could have done," Friedman said. "Somebody with significant cardiomyopathy would be much more difficult to get a response from than a person with a relatively normal heart."
Walt Disney Co. distributed 650 defibrillators in 2003 at Disneyland and Disney World and on Disney Cruise Line ships. Declaring last month that the defibrillators may have already saved as many as 40 lives, Disney announced its intention to install 250 more of them on its properties, including another 200 at Disney World. The company also has trained thousands of employees to use them, including 3,000 at its Central Florida resort.
500 workers to be trained
Finger, the Disney World spokeswoman, said the resort plans to train 500 more employees in CPR even as it adds the 200 defibrillators to the 500 already on resort property. Of the three units in Animal Kingdom, the company said Tuesday that one was at a first-aid station a couple of hundred yards away from the Everest ride, while another was on a mobile cart.
Disney World posts warnings at ride entrances that advise people they should be in good health and free of medical complications that include high blood pressure and heart, back or neck problems.
Alverez, the cardiac specialist, said any activity that raises the body's adrenaline level can trigger a cardiac crisis. He said he doubted the Everest ride caused Reeb's death but said the excitement from the ride could have contributed.
By Wednesday afternoon, many Disney customers had heard about Reeb's death. Still, long lines formed at Expedition Everest. Disney reopened the ride late Tuesday after determining it was working properly.
Stephen Wilkins, visiting from Columbia, S.C., said he had been looking forward to riding the attraction.
"We were hoping that it would be open," Wilkins said. "We were more worried about the ride not being open than anything."
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