Rachel Apa, a 24-year-old Pennsylvania woman running her first New York City Marathon, died Sunday after collapsing two miles from the finish line. Rhabdomyolysis, a rare condition caused by muscle breakdown during exertion, was confirmed as the cause of death by her father, Steve Apa, on Monday.
Apa, a former Division I field hockey player at Bucknell University, had been texting her father throughout the race, expressing increasing discomfort before collapsing near mile 24 in Central Park. Emergency responders administered CPR and used a defibrillator before transporting her to Mount Sinai Medical Center, where she was pronounced dead hours later.
Immediate Response and Medical Intervention
Emergency medical staff and bystanders initiated CPR immediately after Apa collapsed. The New York Road Runners (NYRR), the nonprofit organizing the marathon, confirmed that race medical teams were on-site and provided assistance. A defibrillator was used during the response, and Apa was taken to Mount Sinai Hospital in critical condition.
The New York City Office of the Chief Medical Examiner has not issued a final determination of the cause of death, though Apa’s family has attributed it to rhabdomyolysis. NYRR declined to confirm the cause of death but issued a statement expressing deep sadness over Apa’s passing.
Background on Apa and the Marathon
Apa was running the NYC Marathon to raise funds for the Parkinson’s Foundation in honor of her grandfather. She had trained for months and was in what her father described as "perfect health." Her fundraising efforts exceeded her $4,000 goal, raising $7,656.68.
Apa graduated magna cum laude from Bucknell University in May 2024 and worked as a product manager at TE Connectivity. She had also begun an MBA program at Charleston Southern University.
Understanding Rhabdomyolysis
Rhabdomyolysis, or "rhabdo," occurs when muscle tissue breaks down rapidly, releasing myoglobin and other compounds into the bloodstream. These substances can overwhelm the kidneys, leading to potential kidney damage or failure. Symptoms include severe muscle pain, weakness, and dark urine.
The condition is rare, with about 26,000 cases reported annually in the U.S., according to the Cleveland Clinic. While exercise-induced rhabdo is uncommon, it can occur after intense or prolonged physical activity, particularly in hot conditions or without adequate hydration. Athletes are advised to build endurance gradually, stay hydrated, and avoid strenuous exercise while ill or dehydrated.
Race Safety and Marathon Fatalities
Marathon-related fatalities are rare, with research suggesting approximately 1 death per 500,000 runners due to cardiac events. While dozens of runners have been treated for rhabdomyolysis during the NYC Marathon, there is no documented data on marathon deaths specifically attributed to the condition.
NYRR has not indicated any immediate changes to race protocols following Apa’s death. The organization stated it is reviewing the incident in coordination with medical partners.
Family and Community Reaction
Steve Apa described the situation as "unfathomable," emphasizing his daughter’s health and fitness. Apa’s mother and friends were present along the race route, tracking her progress via text messages until her collapse.
Michaela Nicholas, a hospital social worker who witnessed the collapse, attempted to comfort Apa while others administered CPR. Nicholas recalled calling out encouragement to Apa moments before she collapsed.
Ongoing Investigations
The NYRR and medical examiners continue to review the circumstances surrounding Apa’s death. No further details have been released regarding the timeline of events or additional medical findings.