A high school football player who ruptured his spleen during a game Saturday is fortunate that a doctor on the sidelines recognized the “life-threatening” nature of his injury and acted quickly to have him rushed to the hospital.

Adam Smith, a senior lineman at Leavitt Area High, was listed in fair condition Monday night at Maine Medical Center in Portland. Earlier in the day, he was moved from the intensive care unit to a room in the Barbara Bush Children’s Hospital at Maine Med.

His mother, Susan Smith, said doctors categorized the injury as a Grade V spleen injury – the most serious of its type. Dr. Kate Quinn, who assessed Adam Smith on the sidelines Saturday at Greely High in Cumberland, said a ruptured spleen “can be life-threatening if not caught in time. You can lose a lot of blood in a hurry.”

Earlier this fall, a New Jersey high school quarterback, Evan Murray, died from a ruptured spleen after he took a hit in a game.

School officials said the quick response by Greely’s medical team and paramedics may have saved Smith’s life.

“It could have been a lot worse than it was,” Leavitt athletic director Ryan Holmes said. “We’re thankful that the care was immediate and that the professionalism on all parts was top-notch.”

“It was a pretty grave situation,” said Mike Hathaway, the head coach at Leavitt. “I give a lot of credit to my assistant coaches – their physician, who knew right away how urgent it was to get him in the ambulance and get him out of there right away.”

Smith was injured when he was hit by a Greely player while running down field on a punt in the fourth quarter. He walked off the field, then collapsed on the sidelines.

“We were both running at each other,” Smith said in an interview from his hospital bed. “He had a little bit of an edge on me in speed. And when we came together and stalemated, he was a little shorter than me so all the impact went into my ribs and straight to my spleen. That led to me not being able to breathe, and that was why I got off the field.”

He didn’t get concerned until the pain didn’t subside. “It was a lot worse of a pain than I had ever felt before,” he said.

A Leavitt assistant coach, Marco Madison, notified Hathaway that medical assistance was needed. Quinn, who joined Maine Medical Partners Orthopedics and Sports Medicine in September and is Greely’s team physician at home football games, immediately recognized Smith’s symptoms as a spleen injury. She had treated another football player for similar trauma.

“He was complaining that his stomach was hurting and that he was nauseous and having trouble breathing,” Quinn said. “He told me how he got hit. I had a high index of suspicion that he injured his spleen. I don’t mess around with cases like that. I ship him off. You hope it was a rib fracture, but I’d rather be safe than sorry.”

It was then, after being told that he was going to the hospital, that Adam Smith got worried. “I’d never had to go to a hospital, especially in the back of an ambulance,” he said. “I didn’t know what was going to happen to me.”

En route to the hospital, Smith’s blood pressure dropped precipitously. He said he never lost consciousness, but “I definitely felt like I was getting loopy. If I wasn’t close to a hospital like this …”

Quinn is just glad Smith is better now. “I was just doing my job out there,” she said. “I was glad to be able to get him off and get him to the hospital. They’re taking good care of him.”

The spleen is in the upper left part of the abdomen. It can vary in size and shape, but it’s commonly a fist-shaped organ that’s about 4 inches long. It serves as a filter for blood as part of the body’s immune system. An injured spleen can cause extensive internal bleeding.

During the examination, it was also discovered that Smith had suffered a fracture of the L2 vertebra in the lower back. “The coach thinks it might have happened earlier in the game,” Susan Smith said.

Her son will not require surgery, but will remain at the hospital for a while longer. “He’s here to be monitored because he is still at risk to bleed,” she said.

“He’s still in quite a bit of pain, he still hasn’t been able to eat and he still isn’t able to walk.”

And that’s an improvement.

“I’m feeling a lot better than I was the last couple of days,” Adam said.

His injury and recovery have been a big topic in Turner, where Leavitt is located. Chris Gray, the Leavitt junior varsity coach, spoke to his players about it before their game Monday morning. When Gray received a text message during the game that Smith had been moved out of the ICU, he turned to the crowd and made the announcement. “It got a standing ovation,” he said. “It’s been the talk of our little town.”

Smith was considered one of the emotional leaders of the team.

“I’ve played with him for a long time,” said Levi Craig, the Hornets’ senior quarterback. “He’s kind of the heart of the team. He gets people up, he gets us going in the right direction.”

Senior Chandler Lajoie, one of Smith’s best friends, will replace him on the defensive line. “It’s not going to be the same without him,” he said. “I was real worried because I’ve never seen this kid in so much pain and he’s real tough. It’s going to be a tough spot to fill. The kid’s got a motor. He’s always going on every play.”

While high schools are not required by the Maine Principals’ Association to have ambulances and EMTs on site for athletic events, most schools that play football do, according to Mike Burnham, an assistant executive director at the MPA. “It’s common sense to do it,” he said.

Hathaway and Greely head coach David Higgins said their players weren’t aware of the severity of the injury on Saturday.

“It all happened so fast,” Hathaway said. “He actually got up and walked off the field, it wasn’t like the game got stopped. Other than the kids on the sideline, I don’t think a lot of kids knew until after the game.”

Higgins was not aware of what happened until Sunday.

“It was one of those things that you hate, but we were prepared and everyone did their job and took care of the kid,” he said. “I’m just thankful we had everything in place.”

Susan Smith said her son also had suffered two concussions while playing football. She was not at Saturday’s game, which had been postponed from Friday night. She was working at Rumford Hospital, where she is an X-ray technologist. She was with a patient when Adam was taken to the hospital and couldn’t get there for four hours.

“I was in a little bit of a panic, because I do work in health care and I do CT scans so I know these injuries can be minor, or they can be major,” she said. “But I knew where he was going and I knew that he was exactly where he needed to be.”

Hathaway and several players visited Smith in the hospital. “I walked into his room earlier and there were 14 of his teammates there,” Susan Smith said,

She said it has been difficult for her son because not only is his football season over, but he also has been told that he will not be able to play any sports until the spring.

“He loves football and he is devastated that he’s not playing anymore,” she said. “And he can’t play basketball in the winter and he can’t snowboard, all of his favorite things.”

“Football is my favorite by far,” Adam Smith said. “It’s going to be rough wishing I could play.”

But Hathaway said Smith needs to take care of himself.

“It certainly puts the game itself in a lot of perspective for you,” Hathaway said. “You’re concerned not with what’s happening (in the game), but with what happened with that kid.”

Staff Photographer Gabe Souza contributed to this report from Turner.