Two former Manly players have described hearing their teammate Keith Titmuss screaming after a training session that led up to his sudden death.

Moses Suli and Sione Fainu both gave evidence at an inquest on Tuesday, more than three years after emerging talent Titmuss fell ill during the Sea Eagles’ preseason training.

The 20-year-old suffered a seizure after a cardio workout at the club’s base at Narrabeen, on Sydney’s northern beaches, on November 23, 2020 and died five hours later in hospital.

Suli and Fainu, both Tongan internationals who now play for St George Illawarra and Wests Tigers respectively, remembered the day of Titmuss’s death being hot.

In a police interview played to the court, Fainu described the training session as a “nine out of 10” for intensity.

It was one of the first sessions back from the off-season break. 

“It was hot, the sun was out on the field … we were all saying ‘we got this, we got this’,” Fainu said, describing how the team would encourage each other through tough training sessions.

After training on the field for about an hour-and-a-half, the team moved into the “dojo” where they continued another cardio workout. 

Fainu said he heard Titmuss telling another teammate he had cramps when the training had finished, but he did not specify where in his body they were.

His next recollection was hearing Titmuss screaming. 

Fainu and Suli told the court they could not see Titmuss as staff ushered them away, but both of them heard him. 

While an autopsy was unable to find the cause of death, counsel assisting the coroner Adam Casselden SC told the court on Monday Titmuss most likely suffered exertional heat stroke.

Paramedics who arrived at the scene noted Titmuss’s temperature was 41.9C, while his heart rate was over 140 beats per minute.

But coaching staff and medical practitioners did not identify that Titmuss was suffering heat stroke, treating the symptoms of his seizure instead.

Asked whether the NRL were enforcing their heat policy on the club at the time, then Manly chief medical officer Luke Inman told the inquest “they weren’t and they don’t”.

“They recommend a period of acclimatisation in the NRL, but there’s no exact way of guiding teams on what that entails,” he said.

“What it should mean is a graded increase in exposure to the heat so the body can adjust gradually and build a tolerance to it.”

Current Manly player Ben Trbojevic is due to give evidence on Tuesday.