HOUSTON, Texas (KTRK) — Victor Ramos started walking everywhere after he got in a bad car accident.
His brother, Robert Ramos, said his family always told Victor to run errands in the mornings to beat the afternoon heat or wait until the evening when their mom could drive him to the store.
But, during one of Victor’s morning walks to the store last summer, he collapsed in a parking lot.
“I got a phone call from my sister saying that my brother was in the hospital. He had previous episodes (related to his schizophrenia diagnosis), and I’m like, ‘Oh, it’s probably another episode,’ but I kind of felt like it was a little different, too. She wouldn’t tell me what had happened, and she just said, ‘You just need to get here quick,'” Robert Ramos said. “I left work, and I was on my way there, and I had a feeling that he wasn’t with me or with us anymore.”
Victor was just 27 years old when he died on Aug. 21, 2023, according to the Harris County Institute of Forensic Sciences. Medical records listed his cause of death as hyperthermia, which is when the body overheats. There were no other factors that contributed to his death.
Victor is one of 61 people who died of heat-related causes last year in Harris County, according to official records.
Statewide, at least 361 people died of heat-related illness – up from 99 heat deaths in 2018.
Despite the increase in heat-related deaths, experts tell 13 Investigates the actual number of deaths is likely much higher because there are no national standards requiring heat-related deaths to be recorded.
“We know from epidemiology that heat-related deaths are grossly underestimated because utilizing medical examiner reports are a certain level of subjective, and there may be times when the medical examiner does not write down extreme heat as a contributing or an underlying cause of death,” Kevin Lanza, who teaches environmental health science for UT Health Houston School of Public Health, said.
Dr. Reade Quinton, vice president of the National Association of Medical Examiners, told 13 Investigates, “There are no national standards I am aware of that enforce what should or shouldn’t be reported as a heat-related death. I also suspect that these deaths are underreported.”
Quinton said the association, which accredits local medical examiner’s offices, does not have “an official definition of a ‘heat-related death’ because medical examiners do not classify cases as ‘heat-related’ or by any other theme. We classify deaths on the basis of the actual cause of death. A death due to the direct effect of a hot environment would generally be attributed to ‘hyperthermia’ on the cause of death line of the death certificate.”
For example, Quinton said officials would not classify a death as a “hot car death” because that is a “situational descriptor” and not a cause of death. Instead, he said, they might list hyperthermia as the cause of death and “exposure to hot environment in a parked car” in the “how injury occurred” field of a death certificate.
The Harris County Institute of Forensic Sciences told 13 Investigates it is accredited to the National Association of Medical Examiners standards.
“Those standards do not prescribe the specifics behind investigating each heat-related fatality. The recommendation is to base the determination on a history of exposure to high ambient temperature and the reasonable exclusion of other causes of hyperthermia,” according to a statement from the Institute.
Lanza said what worries him about the heat in Texas is that the climate is only getting warmer and warmer each year.
“Texans have known heat for as long as Texas has been around, yet this is not Texas of a generation ago in terms of the climate, and heat is an invisible killer. You don’t see it,” Lanza said. “It’s something you experience, but perhaps you just treat it as, ‘OK, I should remove myself from this situation, or I can tough it out.’ But what folks don’t know is we’re not – communicating enough about how intense this risk can be.”
It’s been nearly one year since Victor Ramos died of hyperthermia, but Robert Ramos said he’ll never forget his little brother.
“It’s something you carry with you for the rest of your life,” he said. “I often ask or tell myself, ‘It could have been prevented,’ but I am a believer. We’re all here for a short time, and all of our time is like – I don’t know how to say this in words, but basically, when it’s your time to go, I feel like you can’t really beat that.”
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