A 24-year-old runner collapsed near mile 24 of the New York City Marathon and died hours later, and her father says rhabdomyolysis was to blame.
Story Snapshot
- Rachel Apa collapsed in Central Park about two miles from the finish line.
- Bystanders and race medics used CPR and a defibrillator before an ambulance transport.
- Her father said she died from rhabdomyolysis, a breakdown of muscle during hard exertion.
- Officials had not released a final medical-examiner ruling at the time of reporting.
What happened on race day in the final miles
The New York Police Department told the Associated Press that Rachel Apa collapsed while approaching mile 24 of the 26.2-mile course through Central Park. A bystander started chest compressions. Race medical staff took over, delivered shocks with a defibrillator, and moved her to an ambulance. She was transported to a Mount Sinai hospital, where she died after further treatment later that day. New York Road Runners issued condolences and described the rapid response at the scene.
24-year-old Rachel Apa dies after collapsing in Central Park just two miles from completing the New York City Marathon.
Her parents say they were tracking her on the marathon tracking app when she stopped moving at Mile 24.
"Final stretch," her father texted her at Mile 23,… pic.twitter.com/bK8aGNWXjm
— Collin Rugg (@CollinRugg) November 3, 2026
Her father, Steve Apa, told reporters that Rachel had texted him during the race about pain before she went down, including “Ow” and “Ow ow” messages. He later told outlets that she died from rhabdomyolysis, which can occur when muscle fibers break down during extreme effort and release proteins and electrolytes into the blood. The New York City Office of the Chief Medical Examiner had not issued a final determination at that time, but the timeline of exertion, collapse, and hospital care is not in dispute.
What rhabdomyolysis does inside the body
Rhabdomyolysis is a condition where damaged muscle cells spill their contents into the bloodstream. Myoglobin, potassium, and enzymes surge. The kidneys can clog and fail. The heart can slip into an abnormal rhythm from high potassium. Severe cases move fast. Warning signs can include severe muscle pain, weakness, swelling, and dark urine. In exertional cases, heat, dehydration, and long effort can raise risk. Quick care focuses on fluids, electrolyte control, and treating any heart rhythm problems.
Most runners will never face this condition. Marathon deaths remain rare when viewed across millions of race starts. A large review spanning more than 3.29 million marathon participants recorded 26 sudden cardiac deaths, a rate under one per 100,000 runners. That perspective matters. It does not reduce the loss here. It shows how unusual a fatal medical event during a marathon is, which is why any single case draws intense focus and demands careful review.
How this case aligns with known exertional risks
The course position near mile 24, the long duration of intense effort, and reported pain texts fit known triggers for exertional muscle injury. Long events can deplete fluids and stress muscles. If muscle breakdown becomes widespread, toxins flood the blood. The kidneys and heart can fail. Medical teams look for classic lab spikes in creatine kinase, rising potassium, and falling kidney function. Public reports did not include such hospital data. The father’s account names rhabdomyolysis; officials were still finalizing the cause.
Conservative common sense says two things at once. Take the father’s detailed account seriously, because he is named and close to events. Wait for the medical examiner’s ruling to close the record, because official findings rest on lab results and autopsy. That approach respects the family while keeping public guidance grounded in evidence that helps protect other athletes.
What runners, coaches, and families should watch for
Training plans should build distance slowly. Runners should learn body cues that matter: severe cramping, sudden weakness, or pain that spikes beyond normal fatigue. Dark, cola-colored urine can be a red flag. Heat and humidity raise risk, so adjust pace and hydration to conditions. Support crews should have ice, fluids, salt sources, and a plan to stop and seek help at the first serious sign. Race medical teams already drill these basics; bystanders who start CPR can save lives, as they tried to here.
Families can ask doctors about sickle cell trait, metabolic issues, or past heat illness. Gyms and teams should keep defibrillators close and train people to use them fast. Personal freedom means people choose hard goals. Personal responsibility means prepare, respect the heat, know your limits, and act early when danger shows. That balance keeps endurance sports open, tough, and as safe as they can be without softening what makes them meaningful.
Sources:
abcnews.com, apnews.com, cbsnews.com, runnersworld.com, pmc.ncbi.nlm.nih.gov
