A Marine recruit who died in 2023 during a physical fitness test had a history of breathing problems, an investigation by the Marine Corps found.

After Pfc. Noah Jamar Evans, 21, died April 18, 2023, at Marine Corps Recruit Depot Parris Island, South Carolina, the Corps said it was investigating the cause of his death.

Evans’ death came amid heightened scrutiny on the recruit depot, with a senior drill instructor slated to go on trial that summer for the alleged negligent homicide of another recruit in 2021.

But the Corps’ investigation into Evans’ death, which Marine Corps Times obtained a redacted copy of under the Freedom of Information Act, found that the young man likely knew he had asthma before signing up for the Marine Corps and did not disclose it during his enlistment process.

“Evans’ death was due to a medical complication that occurred during the conduct of a Marine Corps physical fitness test while in recruit training,” Chief Warrant Officer 3 Bobby Yarbrough, a spokesman for the recruit depot, said in a statement to Marine Corps Times on March 28.

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The spokesman said that depot staff, including drill instructors, “made every effort” to resuscitate Evans.

“Our deepest sympathy and condolences remain extended to those who were impacted by the death of Pfc. Noah Evans,” Yarbrough said in the statement.

Marine Corps Times attempted to reach Evans’ family via telephone, email and social media and didn’t hear back.

A native of Decatur, Georgia, Evans graduated in 2020 from Georgia Premier Academy, whose programs are geared toward baseball players, according to his enlistment paperwork and the academy’s website. After that, he was enrolled for one year at Arkansas Baptist College in Little Rock, Arkansas, and one year at Allegany College of Maryland in Cumberland, Maryland.

Then Evans enlisted in the Marine Corps under the infantry option. In June 2022, during his enlistment process, he reported on an official Defense Department form that he had never had asthma or other breathing problems.

Evans secured a waiver for being 20 pounds overweight, according to the investigation.

Evans enlisted in the months after the military rolled out a medical screening system, Military Health Systems Genesis, that is supposed to flag applicants’ documented medical issues. Recruiters have voiced frustration about Genesis forcing even healthy applicants to seek time-intensive waivers or barring them from military service altogether.

Pentagon spokeswoman Lisa Lawrence told Military Times in April 2023 that Genesis “merely confirms the physical and mental readiness of applicants by enabling authoritative review of their health history.”

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Evans arrived at Marine Corps Recruit Depot Parris Island, South Carolina, on Jan. 23, 2023. Three days later, he reported to the depot’s sick call for shortness of breath and was prescribed an albuterol inhaler.

That same day, he was dropped to a remedial training unit for recruits who need to get into better shape before embarking on the normal training.

It is unclear whether any medical professionals had documented Evans’ asthma before his enlistment. Evans told one recruit that he had experienced breathing problems before boot camp but hadn’t gotten diagnosed with asthma, that recruit recounted to the investigator.

But another recruit told the investigator that Evans “always changed his social,” likely a reference to his social security number, “when getting medically evaluated so that the asthma would not show up on his permanent record.” It was a tactic Evans said he had learned from a relative, the recruit recalled to the investigator.

On Feb. 10, 2023, Evans began official recruit training. A week later, he reported to sick call and was diagnosed with pneumonia, for which he was given two sick days and two days of light duty, according to the investigation.

Evans “had heart and motivation, and he was not a problem child,” one Marine told the investigator. He was always smiling, a fellow recruit told the investigator.

Evans was strong, drill instructors and recruits recalled. But he had trouble with running.

In March 2023, Evans failed the run portion of his initial physical fitness test, although he passed the combat fitness test, according to the investigation.

Evans went to sick call on April 8, 2023, for stomach pains and was diagnosed with gastritis and prescribed medication. He went back the following week to get a replacement inhaler but denied that he was experiencing difficulty breathing.

On the morning of April 18, 2023, Evans and his fellow recruits began the final physical fitness test.

Recruits complete their final physical fitness test on Marine Corps Recruit Depot, Parris Island, South Carolina, on Dec. 5, 2023. (Cpl. Jacqueline Kliewer/Marine Corps)

It was good weather for a cardio-intensive fitness test: just a little chilly, a chief drill instructor recalled to the investigator. Evans successfully completed the pull-ups and plank.

Then came the three-mile run.

About halfway through the event, Evans used his inhaler, according to the investigation. Roughly 25 minutes after the event began, Evans slowed to a walk, clutched his chest and started to wobble, before two others lowered him to the ground.

Navy medical personnel and first responders from the depot tried to save him, initially treating him for suspected heat injury and then giving him CPR and using an automated external defibrillator, according to the investigation.

At 8:02 a.m., less than an hour after Evans collapsed, first responders took him to the hospital in nearby Beaufort, South Carolina. Evans was pronounced dead at 8:35 a.m.

The next day, depot spokesman Maj. Philip Kulczewski stated that Evans had died during a physical fitness test and said the cause of death was under investigation. In his statement, the spokesman called Evans a private first class, a title the service often gives to recruits who die while training to become Marines.

Evans was the fourth recruit to die at the boot camp in the span of two years.

That summer, the senior drill instructor Staff Sgt. Steven T. Smiley, 35, went on trial for negligent homicide and other charges in connection with the 2021 death of recruit Pfc. Dalton Beals, 19. A jury of Marines acquitted Smiley of most charges after his lawyers argued Beals died not from being pushed too hard in the heat but rather from an unpreventable heart issue.

The redacted copy of the Marine Corps’ investigation into Evans’ death doesn’t contain a definitive conclusion about what caused the death, and most of the investigator’s opinions and all four of the investigator’s recommendations are redacted.

But Yarbrough told Marine Corps Times that Evans died “due to a personal medical condition.” The Marine Corps has not taken punitive actions against any of its personnel as a result of the death, the spokesman said.

A coroner who examined Evans’ body found a hyperinflated lung — a sign of asthma — and an aorta anomaly that could cause issues like shortness of breath, Brig. Gen. Walker Field wrote in a July 2023 letter endorsing the investigation.

Navy medical personnel who met with Evans before his death suspected he had asthma, but Evans denied experiencing severe breathing issues, so they didn’t order further testing. Multiple recruits told NCIS that Evans had disclosed his asthma to them, according to Field.

“I continue to find PFC Evans’ tragic death in the line of duty and not due to his own misconduct,” Field wrote in the letter. “PFC Evans’ family and friends continue to be in my thoughts and prayers.”

Irene Loewenson is a staff reporter for Marine Corps Times. She joined Military Times as an editorial fellow in August 2022. She is a graduate of Williams College, where she was the editor-in-chief of the student newspaper.

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