For jumper rider Ryan Haselden and her family, Feb. 19, 2025, will be a day seared into their memories forever. That afternoon, the day of Haselden’s 14th birthday, the teen suffered a sudden cardiac arrest while competing at Fox Lea Farm in Venice, Florida. Haselden’s parents, Will and Lindsay, attribute the rapid and correct actions of medical personnel in the immediate moments that followed her collapse with saving their daughter’s life. It was only afterward that they learned Ryan had a previously undiagnosed health condition and came to understand just how incredibly miraculous their daughter’s story of survival truly is. They hope it can inspire action in the broader equestrian community. 

It started out like any other horse show day. Based for the winter season out of Declan Egan’s Birchgrove Sporthorses in Ocala, Florida, the Haseldens were beginning their second week showing in Venice. Lindsay, who operates her own EqSport International in Alpharetta, Georgia, had several clients competing as well. The family arrived at the barn early, cleaned and braided horses, and began preparing for that afternoon’s classes.

The weather was mild, and Ryan’s three mounts were settled. That afternoon, after finishing fourth in a 1.10-meter class on her first horse Ryan tacked up Hector Du Gue for the 1.20-meter section. Her warm-up went according to plan, and she entered the ring with her usual confidence. 

“Her first three jumps were completely normal,” Will, 39, said. “She was riding well; it was a good round.”

But as Ryan and “Hector” navigated the bending line from fence three to four, the horse suddenly veered toward the left, aiming for the décor between two sets of jump standards. Ryan was still sitting upright in the tack, her arms held in front of her, but she didn’t seem to be responding to his deviation from the line.

“From an observer’s standpoint, my first thought was, that’s very bizarre,” Will recalled. “Is the horse being bad? Did he run out? But it didn’t look like she was fighting with him.”

From her seat under the pavilion, amateur hunter/jumper rider Dr. Karley Koch, DO, was only partially paying attention to the class, but she and her friends paused in their conversation as they noticed what was happening in the arena. Hector jumped the décor, made his way to the perimeter fence, and then turned abruptly. Ryan, her body now limp, fell from the saddle, landed on her back, and lay completely still. 

Koch paused a moment; in general, it isn’t her habit to interfere with the medical management of injured riders at horse shows. But for the hospitalist, whose job involves managing critical care and acutely ill patients at Duncan Regional Hospital in Duncan, Oklahoma, when riders don’t move or get up, she pays close attention.

“I saw her fall off; I waited a second,” Koch said. “She wasn’t moving, she wasn’t getting up, she wasn’t responding. That’s when I ran into the ring.”

The memory of the next moments has become a blur for all involved. Ryan would later tell her parents that she could feel herself blacking out. Her chest didn’t hurt, and she felt no pain. It seems likely there were at least several seconds in which Ryan was unconscious in the tack before she fell. By the time she hit the ground and help arrived, the eighth-grader had no pulse.

Koch and the show’s EMT, Katy McPhee, reached Ryan’s side almost simultaneously. Lindsay, who witnessed her daughter’s fall from horseback, cantered to the ring and hopped off; Will was right beside her. Koch remembered that she was only dimly aware of the growing crowd around them as she performed a quick medical assessment on Ryan.

“You see she is unconscious, she’s agonal breathing, and she is cyanotic, which means her lips and face are turning blue,” Koch said. “Her eyes were rolled back in her head. That is enough of an initial assessment to make you worry.”

Both Koch and McPhee checked for a pulse, and finding none, immediately initiated two-person CPR. While McPhee performed compressions, Koch completed rescue breaths, and in between she asked someone to call 911 and to find an automated external defibrillator, or AED.

“An AED measures the electrical activity of the heart,” Koch explained. “For this type of AED, you put two sticky pads on the person’s chest, and it will determine if a shock is required to change the electrical rhythm of the heart.”

Koch and McPhee performed four rounds of CPR prior to the ringside arrival of the AED; when the device determined Ryan needed a shock, Koch administered it. As she went to resume CPR, Ryan gasped.

“It was like a half gasp, half cry,” Will said, his voice shaking. “It was very emotional in the moment, because there was, quite quickly, a large crowd of people. It was a pretty impactful sound, a sign that she had returned.”

As Ryan regained consciousness and began breathing on her own, she was aware of where she was and what was happening. Koch admits she took a deep breath of her own as she stabilized Ryan’s cervical spine and began a secondary assessment to search for physical trauma. By this time, the ambulance team had arrived, and arrangements were made to fly Ryan first to Sarasota Memorial. From there she was transferred to Tampa General, which has a pediatric trauma unit, and then sent to Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, which has a pediatric cardiac intensive care unit.

Will admits he has spent a lot of time in recent days reflecting on the moments he watched helplessly while his only child was being resuscitated. 

“At the time, there is a part of me that is saying, of course she is going to be OK,” Will said. “You are witnessing this, and there’s no part of you that would allow you to believe it is going to end right here. You are witnessing this, and you’re thinking, ‘Of course she’ll be fine, she was just riding a second ago.’ 

“You can’t process it fast enough to believe that she is not going to be OK,” he continued. “I don’t know if that is optimism, or if that is just the way we protect ourselves from trauma in the moment. I’ve come to learn since then that the fact she survived is unbelievably lucky—that’s the wrong word to use, but it is the only one I can think of. The fact she has come out of it the way that she has is incredible.”

AEDs Save Lives

The truth is that fewer than 10 percent of people who suffer sudden cardiac arrest outside of a hospital setting, like Ryan did, survive. Those who do often suffer long-term effects from a loss of oxygen to key organs, such as the heart and brain, which can leave them with permanent physical limitations and cognitive impacts. 

“When you are in cardiac arrest, we say that ‘time is muscle,’ meaning as every second goes by, that could be damage to the heart muscle,” Koch said. “Without oxygen, time is also brain, meaning you can have an anoxic brain injury. Every second really does count, and the first four minutes are the most important time period for a cardiac arrest.”

A 2010 study published in the Journal of the American College of Cardiology reviewed the outcomes of over 2 million cases involving patients who suffered out-of-hospital cardiac arrests. After narrowing down the sample size to 14,000 cases, researchers determined that those who received only CPR prior to the arrival of EMS had a survival rate of just 9%. But for those patients who received CPR and were treated with an AED, the survival rate shot up to 38%.

“That is drastic,” Koch said. “To go from 9% to 38% is drastic. Unquestionably, AEDs save a lot of lives.”

All of those connected to Ryan’s case agree: Without the quick application of an AED, her outcome that day would likely have been quite different.

“Without the AED, without them being prompt in retrieving it, I don’t think we would have been able to resuscitate Ryan,” Koch said. “I have to give a huge shout-out to Fox Lea Farm, for them knowing exactly where the AED was, and for following protocol pretty perfectly. The fact they had one, it worked appropriately, it was up to date, and they got it to us so quickly, made such a big difference.”

Although AEDs are becoming an increasingly common sight in public venues, they can easily be the most expensive item in a facility’s first aid kit—certified refurbished models cost $500-$800, or up to $2,500 new. Further, for optimal performance, they also require regular maintenance in accordance with the manufacturer’s recommendations. For these reasons, there can be an inclination to store AEDs in a secure location. But when time is of the essence, having an AED readily available—and people familiar with its use—is more important.

Currently, hunter/jumper is the only U.S. Equestrian Federation discipline in which shows are mandated by the rulebook to have an AED onsite (with the exception of Level 1 jumper shows). By default, any show or event which hires an ambulance to be on grounds will also have an AED present. Otherwise, the choice to have an AED available is left up to the show management. However, Vicki Lowell, USEF chief marketing and content officer, says the federation strongly recommends having an AED at all shows, regardless of discipline. In a statement shared with competition managers within the past 18 months, USEF emphasized the importance of having an AED available and ensuring personnel are both familiar with its location and trained in its use.

But for medical professionals who are also equestrians, like Koch, and families like the Haseldens, who have now been directly impacted by the availability of an AED, there is more work to be done. Koch points out that in her home state of Oklahoma, there are no USEF-sanctioned hunter/jumper shows but there is a robust local schooling circuit—so figuring out how to help local and regional organizations become conversant with AEDs, and to ensure they are available, is an essential next step.

“It’s important to note that what happened with Ryan wasn’t a horse-riding accident, it was a medical emergency,” Koch said. “She just happened to be riding a horse, but this could happen at any sporting event, and this could happen to anyone—any athlete, any official, or grandma in the stands.

“It’s important to note that what happened with Ryan wasn’t a horse-riding accident, it was a medical emergency. She just happened to be riding a horse, but this could happen at any sporting event, and this could happen to anyone—any athlete, any official, or grandma in the stands.”

Dr. Karley Koch, DO

“AEDs are game changers, without a doubt,” she continued. “They should be available at any facility, any sporting event, anything that has a large group of people gathered.”

Further, ensuring that as many people as possible are trained in CPR and the use of AEDs is essential to saving lives; becoming certified is a relatively simple process and takes only a few hours. For its part, the U.S. Hunter Jumper Association emphasizes the necessity of proper medical preparedness, particularly regarding sudden cardiac arrest in student-athletes.

“We encourage all participants to pursue CPR and AED training,” said Dr. Michele Hollis, MD, chair of the USHJA Safety Committee. “As a demonstration of our commitment, USHJA has provided such training at the World Championship Hunter Rider competition.”

Hollis also commended Fox Lea Farm for their preparedness.

“Fox Lea Farm demonstrated what we expect from our competition venues: having an emergency action plan, ensuring qualified medical personnel and appropriate equipment are in place, and responding swiftly in an emergency,” Hollis said. “USHJA remains committed to supporting all competition managers with the resources needed to uphold these critical safety measures for all riders.”

‘All It Takes Is One’

Fox Lea Farm owner Kim Farrell comes from a medical family, so when they began building the facility over 40 years ago, the safety of riders, spectators and horses was paramount. Farrell learned early on that AEDs save lives, and she served on the USHJA Competition Management Committee which advocated for the USEF rule mandating AEDs. She believes there is no excuse for a venue to not have one.

“Horse shows spend so much on tractors, water trucks, jumps, scoreboards, computers, etcetera—an AED is a small investment compared to other expenses,” Farrell said. “We always have at least one on the property and currently have two.”

During Fox Lea shows, an AED in a waterproof case is always ringside with the EMT. After the shows, they are stored in an unlocked glass case clearly labeled “AED” on the walls in both offices. Farrell believes that not only should AEDs be available at every horse show, they should also be considered  must-have items at boarding stables.

“After experiencing this situation, and with the knowledge that the chances of survival from this episode are less than 10% if you’re not in a hospital, we understand that without the AED, the end result could’ve been very different,” Farrell said. “All it takes is one, and it was worth it.”

Increasing Awareness

Although the Haseldens never expected their daughter to be the face of a movement to promote AED availability and education, it is a mantle they are grateful to be able to carry. In conjunction with the Wills Park Foundation, they are planning to host a large workshop to help the Alpharetta-area equestrian community become CPR and AED certified. The Haseldens are looking forward to expanding their efforts and supporting additional initiatives to promote cardiac health and ensure the safety of equestrian athletes.

“Because of what happened to Ryan, people are reaching out to their own horse shows and state equestrian organizations asking, ‘Do we have this?’ ” Will said. “The number of answers that have come back with, ‘We are supposed to have one,’ or ‘We don’t know where it is,’ for me, I’ve found that to be the most horrifying thing to come out of it. To hear that, even if people say they are prepared, they are not prepared. Because if someone has to spend 5 or 6 minutes looking for the AED before they even make it to the ring, the odds are against you.

“This is something that I imagine hits close to home for a lot of people,” he continued. “A lot of people know Ryan; she’s a lifetime horse show kid, and she’s fairly visible. But everyone imagines their own kid in that scenario. It’s the very first place your mind goes. [Sudden cardia arrest] is a thing that happens, not just in equestrian sports but in youth sports all over, and there are things that can be done to ensure a much better outcome for a lot of kids.”

The Path Forward

Ryan spent a week working with a team of electrophysiologists at All Children’s Hospital before a stress test led them to identify a probable cause for her arrest: catecholaminergic polymorphic ventricular tachycardia, or CPVT. The rare and typically inherited condition is triggered by a spike in adrenaline; Will admits that his daughter is, unfortunately, “fueled by adrenaline,” but added that the condition can be managed with medication. In addition, Ryan underwent surgery to have an automatic implantable cardioverter-defibrillator implanted in her shoulder. The device will monitor her heart rhythm and apply a shock if it requires correction. Ryan’s medical team is optimistic that she will make a complete recovery, hopefully returning to the saddle in about six weeks.

“There is a balance between, how do we protect her, but how do we also lead her to the best possible outcome?” Will said. “She has very big goals, and they are not all congruent, but she would have you believe she will achieve all of them.”

Ryan has already built an extensive jumper-ring resume which includes competing at a CSI1* in Paris, the Royal Dublin Show in Ireland, and representing Zone 4 in Traverse City, Michigan, at the 2024 Gotham North/FEI North American Youth Jumping Championships, where she earned fifth place individually in the children’s division and her team finished second. This year, Ryan is still hoping to return to both the Royal Dublin Show and the NAYC, and to contest some regional grand prix classes. And thanks to an AED, her doctors believe those outcomes are still possible.

“They said, ‘Take your risks in the things that matter,’ ” Will said. “So—continue chasing your riding dreams? Absolutely. Sky dive alone? Maybe not. They are very optimistic for her, and they believe she will return to riding and chasing whatever dreams she had before, which are lofty to say the least.”

After being discharged from the hospital late last week, Ryan and Will returned to Ocala to visit her horses and rest for a few days before heading home to Georgia. Her morale was also boosted by Olympians Laura Kraut and Margie Engle, who both reached out to send their well-wishes.

“Her spirits are high, her personality is fully there,” Will said. “She is funny and witty, and it’s all on display. She is ambitious, and there is always a danger that Lindsay and I will overcorrect the other way—we will be navigating that ourselves. But we have a really good team of people behind her.”