Middleton football player Hezekiah B. Walters, who collapsed during conditioning drills in almost 90-degree heat four months ago , died from exertional hyperthermia — core body temperature usually above 104 degrees that often accompanies heat stroke and impacts the central nervous system — according to the autopsy report released by the Hillsborough County Medical Examiner Department on Tuesday.The report also lists obesity, left cardiac hypertrophy (an abnormal thickening of the heart muscle that can be the result of strenuous exercise), and hypernatremia (too much sodium in the blood due to dehydration) as contributory causes of death.Walters, 14, was running sprints and taking part in other drills for about 20 minutes when he began to vomit and suffered a seizure on June 11, according to the investigative summary released by the medical examiner the day after his death. His body temperature was 102 degrees when he arrived in the emergency room, the report said.This was the first year Walters would have participated in organized tackle football. The 5-foot-11 incoming freshman was 210 pounds when he started summer conditioning sessions.Erik Nason, president of the Athletic Trainers’ Association of Florida, said high body mass is an identifying risk for exertional heat illness. He also said any attempt to cool Walters could have lowered his body temperature. There was no immersion tub and no athletic trainer present during the workout when Walters’ collapsed.Walters became the third high school player in the state to die during summer training in the past five years, joining Sebastian River’s William Shogran Jr. (2014) and Fort Myers Riverdale’s Zach Martin-Polsenberg (2017).All three were linemen who engaged in heavy exertion with no athletic trainer present.The lack of trainers is prevalent throughout Florida. Of the 738 public and private high schools surveyed state-wide by the Korey Stringer Institute’s Athletic Training and Locations Services (ATLAS) program, only 340 had full-time trainers as of this summer.Pasco County has athletic trainers full-time throughout the year for its public high schools, and Pinellas County has them during the school year.In August, Hillsborough County spent $270,000 to hire certified athletic trainers for its high schools, something superintendent Jeff Eakins requested in the aftermath of Walters’ death.Besides trainers, the Walters family also wanted to see more safety protocols put in place and all coaches in attendance at every practice and game.The Yerrid Law firm representing the Walters family sent a legal claim letter to the school district in July seeking documents related to the workout. The letter said that Walters’ father informed Middleton coaches that his son had never performed rigorous training and “would need appropriate instruction, supervision and guidance while being gradually conditioned into team activities that only experienced and prepared athletes are acclimatized to endure.”Fred Reid, Middleton’s head coach at the time, was not present the day Walters died but had conducted previous workouts. Reid was forced to transfer to another school and assistant principal Mark Jones was demoted.Former Plant High and Southern California standout Mike Williams, who was a first-round pick of the Detroit Lions, took over Middleton’s football program in August. He left a high school head coaching job in California to become the Tigers’ coach because he was so moved by Walters’ death.Middleton is 4-3 this season.