"When you step onto the field of battle, whether it's football or a marathon, there's an inherent risk of the sport and you accept that as a participant and it's up to each individual to be ready to go," said C.T. Moorman III, the director of sports medicine at Duke University.
Moorman says that in a situation like the Chicago Marathon, runners have to use "common sense."
"It's a really hot day. Make sure electrolyte balance is good. A lot of good sports drinks can do that," Moorman said. "Go slow and hydrate and if you're not in shape don't do it."
Experts agree that if you feel nauseous, lightheaded or if you have stopped sweating during a race, you should seek medical attention.
But there's also another potential element to the marathon-gone-wrong equation: running novices, who may not as easily recognize warning signs that could indicate dehydration or heat exhaustion.
Other critics point out that the Chicago Marathon, at 35,000 runners, is one of the largest in the country that does not require runners to qualify.
The Chicago race is renowned for having a less challenging, flat course, one that attracts eager beginners hoping for a relatively easy run.
"That's exactly what you're going to hear. I think novice runners definitely listen to that kind of advice," said Christopher Ingersoll, editor in chief of the Journal of Athletic Training and a professor of sports medicine at the University of Virginia.
"On one hand, it would be a shame to exclude someone who is not an elite athlete, but is in adequate condition. … Medical professionals and race organizations need to put their heads together … to think about inclusions criterion for entrance" to races, Ingersoll said.
Moorman, a one-time marathoner, agreed that more limits on who enters marathons might help alleviate race-day problems.
"Events that don't require qualifying time are going to have more novice runners than others and that are perceived as less difficult are going to draw more novice runners," he said.
A few marathons, including the Boston Marathon, have minimum requirements for runners wanting entry into the race.
Over the years, however, some charities have actively targeted those novices to train for marathons and other arduous racing events, including Iron Man competitions.
One of the most well-known is Team in Training, a part of the Leukemia and Lymphoma Society. The group leads would-be marathoners, including many who have never done any running before, through a six-month training program that is meant only to get them across the finish line, while raising money for the charity in the process.
"My first answer is … if they [Chicago runners] had only been with Team in Training," said Tommy Owens, Team in Training's national training coordinator and head coach of a Georgia-based group. "We prepare them for those eventualities. I tell my people they're better prepared than most people at the start line."
But some, more serious athletes have criticized groups like Team in Training for putting nonathletes into what some believe is an extreme sport.
While Sankoff, a Team in Training alum, has witnessed the criticism and understands it, he doesn't agree with it.