A former collegiate athlete ran her first New York City Marathon in honor of her deceased grandfather. Still, she collapsed in Central Park two miles from the finish line on Sunday and died that night, according to her family.
Rachel Apa, 24, of Lewisberry, Pennsylvania, went down near mile 24 at about 1:40 p.m., according to police, who said she was transported to Mount Sinai Hospital in critical condition. Doctors there fought for about six hours to save her life until she was pronounced dead at 9:40 p.m., according to her father, Steve Apa, speaking to The New York Times.
According to her family, the cause of death was rhabdomyolysis, which is a rare yet dangerous disorder wherein damaged muscle tissue breaks down rapidly and pours its contents into the bloodstream. In an interview with NBC News, Steve Apa described his daughter’s death as “unfathomable.”
Apa was running on the Parkinson’s Foundation’s Champions team to honor her grandfather, who had Parkinson’s disease and died in 2022. “My grandfather was one of my role models growing up,” she posted on LinkedIn.
She had played forward on Bucknell University’s Division I field hockey team, starting every game during her senior season in 2023 and receiving Patriot League academic awards. With a bachelor’s degree in business, she began working as a product manager at TE Connectivity. At this electrical components manufacturer, her father and grandfather also worked. She had recently moved to Charleston, South Carolina, and was pursuing a master’s degree in business administration at Charleston Southern University.
“She did everything she’s supposed to for the training up to the marathon,” he told the Times in a separate interview. “She was in perfect health, perfect shape, 24 years old.”
Steve Apa was tracking his daughter from their Pennsylvania family home via the race’s app and encouraged her to go slow during the marathon. His wife, Michelle, followed her through the boroughs with two of Rachel’s friends, recording her smiling at mile 14.
By miles 18 and 19, Apa was answering his messages saying that she was in pain by replying “Ow, Ow.” At mile 23, he encouraged her, saying that she was in the “final stretch,” and again asked her not to overdo it during her first marathon. She never replied.
He sent one more message at mile 24 around 1:30 p.m. and noticed she had stopped moving in the app. Michelle Apa, who was farther along the route, started searching for her. She learned from spectators that she was being carried away to the hospital by an ambulance at mile 24.
Apa’s brothers are trying to cope with this loss, according to her father. Her fundraising page for the Parkinson’s Foundation is still active and has raised more than $5,400, surpassing her $4,000 target.
Rhabdomyolysis is relatively rare and affects about 26,000 people annually in the U.S., according to the Cleveland Clinic. Muscle breakdown causes muscle fibers to release potassium, myoglobin, and other substances into the blood, thus overwhelming the kidneys and leading to kidney failure. Warning signs include weak, swollen, or sore muscles and dark, tea-colored urine.
Marathon runners are at higher risk, especially if they push themselves too hard without breaks. Heat and dehydration increase the risk of rhabdomyolysis. Up to half of the patients have acute kidney injury. Rhabdomyolysis may prove to be fatal without treatment.
Doctors from Mount Sinai and Lenox Hill Hospitals studied this condition during this exact race in a paper published in April in the medical journal Nephron. They found 24 runners with rhabdomyolysis after the 2022 New York City Marathon, the warmest on record, with temperatures rising to 75 degrees. In comparison, 15 patients experienced this disorder during five other recent editions of the race. Nearly all of them had acute kidney injury, but the study found no deaths.
Sunday’s race was much cooler, with the forecast calling for 50 degrees for the early-start groups and a high near 60. So far, only an account of what led to Apa’s death comes from her family.
Organizers of the event, New York Road Runners, said that a bystander started CPR on her before their medical team took over, continued CPR, and used an automated external defibrillator. Spectators near 85th Street were the first to reach Apa, and three good Samaritans, including two doctors, took turns performing CPR, according to the Times. An ambulance then took her to Mount Sinai.
“We are deeply saddened by Rachel’s passing following running in Sunday’s race,” NYRR said in a statement, offering its sympathy to Apa’s family, friends and the entire running community. NYRR added that the last time a runner died after a medical incident at the marathon was in 2024.
Sunday’s race was 50 years since the marathon first ran through all five boroughs. It attracted 61,529 starters and ended with a record 61,146 finishers in Central Park, making it the first marathon with more than 60,000 finishers. Sweden’s Andreas Almgren took the men’s victory in 2:06:01 in his marathon debut. At the same time, Kenya’s Sheila Chepkirui won the women’s race in 2:24:36. Charity runners like Apa raised over $100 million before the race, a record for the organization.
Deaths at large city marathons are rather rare. A study published last year in JAMA found 176 cardiac arrests among more than 29 million participants in U.S. marathons and half-marathons between 2010 and 2023. The researchers found that the death rate had halved compared to the previous decade. They mostly attributed this improvement to bystander CPR and defibrillators on the race routes.
Yet Apa’s death follows the deaths of three other young runners at major races this fall: two men, both 25, at the Great North Run half marathon in England in September, and Trey Lara, 24, a pastor who had cardiac arrest at the Portland Marathon in October.
