Imani Bell struggled to keep up with her teammates, as girls basketball practice moved from the cool of the Elite Scholars Academy gymnasium into what was record-setting August heat.

It was the first day of conditioning drills for the 16-year-old and her seven teammates.

The girls were given water to drink as they began a 1 mile run around the track followed by calisthenics and an uphill run in the feels-like temperature that hit 103 degrees.

As she lagged, Bell was asked by one of the three adults working with the team if she was OK.

“Yeah, I’m good,” Bell replied. She wasn’t.

After another lap around the track, Bell walked up stairs near a concession stand with the help of a coach and used the railing to pull her body up the last step. Bell then went limp and fainted on the stairs shortly before 5:54 p.m. She was pronounced dead at the hospital more than two hours later, after extensive emergency efforts failed to save her.

The description of Bell’s final moments are found in an autopsy report, obtained by The Atlanta Journal-Constitution from the Georgia Bureau of Investigation on Friday.

Using information obtained from Clayton County Schools Sgt. Ernest Mitchell, investigative reports from the Clayton County Police, DFACS and other sources, the autopsy confirmed what many have suspected since Imani collapsed — that the young student-athlete died of heat stroke on Aug. 13.

The GBI ruled her death an accident, and concluded hyperthermia, acute renal failure and rhabdomyolysis caused Imani’s death, according to the autopsy. The teen had had no prior medical issues that would have contributed to her passing.

“This is what was pretty expected going in,” Dr. James Downs, a former medical examiner with the GBI who was not involved in the autopsy, said of the medical findings. “The only symptom that she had was sudden death.”

A spokesman for Imani’s family, Justin Miller, could not be immediately reached for comment Friday. But Miller has said in the past that getting the autopsy was important in bringing the family closure. They received a copy of the autopsy, which is dated Dec. 12, last week.

“Thanksgiving was difficult,” he said. “Christmas will be even harder.”

Miller has also said the autopsy will help the family decide whether to sue the Clayton County school system, which appears to have violated district policy that requires suspension of outside athletic activities when the heat index hits 95 degrees. 

The district declined to comment Friday about the autopsy findings pending possible litigation, a spokesman said.

The narrative in the autopsy of Imani’s final moments provides a more complete description of what happened than was previously known. It says the players had access to water and had it squirted on their backs. Two coaches and a parent volunteer were outside with the girls during practice, and the report says Imani was provided water as she labored with the workout.

“The coaches believed Miss Bell was struggling a bit because she was out of shape,” the autopsy says. “Miss Bell said it had been a while since she had last worked out, and it was not out of the ordinary for her to start the season out of shape.”

The adults poured ice water on Imani after she collapsed, but she did not respond, according to the autopsy.

“She was unresponsive, incoherent, breathing, her eyes were partly open and she tried to pull herself up by grabbing the railing,” the report says. “She continued to be unresponsive and was moaning, and the ambulance was called.”

Paramedics arrived within minutes, the report says. Ice packs were applied to her body and medical personnel performed CPR after Imani went into cardiac arrest, according to the autopsy.

“She had at least two episodes of return of spontaneous circulation,” the report says. “She was pronounced dead at 8:23 p.m.”

The death shocked Clayton and the school system added extra measures to keep students safe from the unprecedented heat this summer and fall, including canceling physical education classes, unstructured play and athletic practices on days when temperatures soared in the high 90s and heat indexes were above 100 degrees.

Clayton State University gave Imani a posthumous associates degree of arts in integrative studies earlier this month. The teen enrolled at the school in fall 2018 as a dual student earning college credit while completing her high school requirements.