Warren Hills Regional High School quarterback Evan Murray died from massive internal bleeding due to a lacerated spleen, the Morris County Medical Examiner’s Office has determined.

Doctor Ronald Suarez, the Morris County medical examiner, conducted the autopsy Saturday and the results were released Monday.

Suarez determined that the spleen was abnormally enlarged, making it more susceptible to injury, the medical examiner's office said. There was no evidence of head trauma or heart disease, it said. The manner of death was determined to be accidental.

Teammates and friends said Murray took several hits through the game Friday night against Summit, but after one particularly hard hit shortly before halftime, had to be helped up. They said he lost consciousness for a moment on the sidelines, woke up and looked out at the crowd, but seemed dazed.

Teammate Mark Formichelli said Murray had been holding his side after one of the earlier hits, but seemed to walk it off and continued playing.

Murray was taken to Morristown Medical Center, where he later died.

Interim Superintendent of Schools Dr. Gary R. Bowen told New Jersey 101.5 Monday the school has a team physician and a certified trainer at its games. Two EMS services are on call at the stadium as well, he said.

He said all of those professionals were available and ready to help Friday. But Bowen said he didn't know if Murray had indicated he was in any distress prior to the hit that took him out of the game, and didn't know what sort of protective gear he might have been wearing.

Eric Schwartz, president of the Athletic Trainers' Society of New Jersey, said spleen injuries are "very, very rare," and are usually related to a pre-existing condition, either an illness or a hereditary anomaly.

A piece of equipment known as a flac jacket is recommended by Schwartz to protect the area of the abdomen. The jacket is seen regularly on NFL broadcasts.

The Mayo Clinic said an enlarged spleen can be linked to liver disease and certain cancers, and most people don't show symptoms.

A splenic injury, though, can come with signs, according to Dr. Adam Fox with the New Jersey Trauma Center at University Hospital in Newark. Those signs range from almost nothing to extreme pain and shock.

"You might find pain in the left-upper portion of the abdomen; you might find pain in the left-lower portion of the chest," Fox said. "You might have some nausea or vomiting, but that's very vague."

Other symptoms in that area of the body include bruising and being extremely sensitive to the touch.

Most splenic injuries do not result in death, Fox said, and quick recognition is a big part of that statistic.

“While we don’t yet have specific details related to this tragic incident, initial reports indicated that both a physician and trainer were present on the Warren Hills sideline," Steve Timko, executive director of the New Jersey State Interscholastic Athletic Association, said in a statement released Monday.

He also said 97 percent of New Jersey's high schools have trainers on their sidelines, and coaches are required to take a series of health-related courses, including those focused on basic first-aid, CPR, concussions, and heat acclimation.

The NJSIAA requires its member schools to submit reports following catastrophic injuries, which is in turn submitted to its medical advisory board and to the National Federation of State High School Associations as part of its National Center for Catastrophic Sport Injury Research.

Funeral arrangements are being made by the Warren Hills Memorial Home in Washington Township, Warren County. Visitation is from noon to 9 p.m. Wednesday at Faith Discovery Church in Washington Township. The funeral will be 11 a.m. at the church Thursday.

Murray's family has asked that in lieu of flowers, memorial contributions be made to a scholarship in his name — Evan Murray Scholarship Fund in care of the funeral home, 234 W. Washington Ave., Washington, NJ 07882.

Dino Flammia and Kevin McCardle contributed to this story.