Agent Has Questions Over Kile’s Death

Darryl Kile and Barry Axelrod were united by more than their business relationship as baseball player and agent. Their fathers died of heart disease before Kile and Axelrod reached the pinnacle of success.

Axelrod remembers sharing his excitement with Kile last year after undergoing a daylong “executive’s physical” at Scripps Clinic in La Jolla that revealed his arteries were clear.

“You know, it doesn’t matter how successful you are, your thinking toward your health can be ridiculous, just stupid, and mine was,” Axelrod said. “Because my dad had died of coronary disease, I kept putting off an examination. My thinking was, ‘I don’t want to know.’ ”

Axelrod couldn’t recount how Kile reacted to the good health news. Kile frequently dismissed his own ailments to Axelrod with comments like, “Everyone has flu-like symptoms sometime during the year. It’s my job to set the example and step up and do my job no matter how I feel.”

Axelrod said Monday he wished he had pressed for a more extensive discussion of health with Kile, the St. Louis Cardinal pitcher who was found dead in his Chicago hotel room Saturday at age 33.

Edmund Donoghue, the Cook County, Ill., medical examiner, said Kile probably died because of 80% to 90% blockage in his coronary arteries. Kile’s brother, Daniel, told Donoghue that Darryl complained of shoulder pain and weakness Friday night during dinner.

“In the times I negotiated a multiyear guaranteed contract for Darryl, with the Rockies and Cardinals, there was standard language that allowed for the clubs to do a more extensive physical for insurance purposes within 30 days of the signing,” Axelrod said. “If either of those teams did one, I never made a point of finding out or seeing a copy of the results.

“My concern has always been: Did he pass? Because if he did, we got the contract. Maybe now I’m going to get more in my players’ face about these things. Maybe now I’m going to get copies of all their reports and try to find out if there are any red flags.”

Cardinal spokeswoman Melody Yount said Monday that head trainer Barry Weinberg refused to comment on numerous media requests about Kile’s medical treatment. “That’s doctor-patient confidentiality,” Yount said.

The death of Kile, a three-time All-Star who was born in Garden Grove and attended Norco High and Chaffey College in Rancho Cucamonga, has raised questions about whether there were any red flags in the pitcher’s medical file.

“This is an unusual event, but we see this more than we need to,” said Dr. Gregg Fonarow, a cardiologist and an associate professor of medicine at UCLA. “The important message is for individuals with a family history of heart problems to see a physician, and to understand that a standard physical is not enough.”

Doctors agree the most obvious issue in Kile’s medical history was the 1993 death of his 44-year-old father, David, after a heart attack.

“It is a huge assumption to say we know the Cardinals knew that family history,” said Dr. Michael Mellman, a Dodger team doctor. “Doctors can be viewed as an agent of the team. Sometimes, players don’t tell us everything.”

Mellman said doctors’ treatment of players varies in the major leagues from team to team. “Doctors discuss what they do with other doctors, trying to make sure that the collective knowledge benefits the players,” Mellman said.

All teams put their players through a spring training physical, conducting tests that require urine and blood samples.

Mellman said teams test players’ blood-sugar level, blood pressure and cholesterol level. High cholesterol can contribute to the condition Kile had, called atherosclerosis or hardening of the arteries.

“The cholesterol risk would not be identified by only a blood test,” Fonarow said. “A better test is a fasting lipid panel, where specific cholesterol types are looked at.”

Thorough health tests of players who sign big contracts are commonly requested by insurance companies, two player agents said.

Said one player agent: “The extra test could be an EKG, or whatever else the insurance company can find out about the player’s history. There are no set rules.”

Reports said Kile, whose $8 million-a-year contract with the Cardinals ran through the 2003 season, underwent an electrocardiogram during spring training.

But Mellman said an EKG will not reveal coronary blockage in all cases.

“If any of those tests--blood, urine, cholesterol, EKG--reveal abnormal numbers, it is our job to use the clues to define the problem and intervene,” Mellman said.

Fonarow said if Kile revealed the family history of heart trouble to a team doctor, a stress test (hooking an EKG to a patient who runs on a treadmill) or a noninvasive heart scan should have been required.

Had Kile taken and failed either of those tests, he would have been subject to angioplasty--a process that unclogs arteries.

More than a million angioplasties are performed on Americans annually.

“It’s a very common misconception that the so-called ‘complete physical’ of a chest X-ray, listening to the heart and lungs and an EKG will detect blockage,” Fonarow said. “It won’t.”

Said Donoghue: “It sneaks up on you, this silent killer. We see it in this office all the time, people dead who never knew they had this.”

Although Pat Camden, the deputy director of news affairs for Chicago police, confirmed the medical examiner’s finding of a small amount of marijuana in Kile’s hotel room bathroom Saturday, Fonarow said, “There’s no way marijuana use caused those blockages nor would it precipitate a fatal arrhythmia.”

Mellman said Donoghue’s final autopsy report, due in four to six weeks with toxicology results, could note Kile’s enlarged heart--estimated to be nearly 25% bigger than normal--as a factor in his death.

The Cardinals announced that Kile’s memorial will be at 10:30 a.m. PDT on Wednesday at Busch Stadium in St. Louis. The Cardinals will also have a 20-minute pregame tribute to Kile before tonight’s home game against the Milwaukee Brewers.