As a scout leader who should be in better shape......
I think we remember the details on these fatalities more than the others. We know its someone trying to get kids outdoors and we know kids are nearby when the tragedy occurs.
Our troop had planned and did a Mizpah Hut trip in 2015 a week after the Maryland leader had a heart attack in the same area. I had done the pre-hike the same weekend not knowing about the fatality. I had planned to give the group times it took me to get from point to point but after learning about the MD leader, my email was we, had hours to get to where we were going, go slow, enjoy the day and trip & not worry about being at hut first or what bunk you get. Our two mishaps were minor. On a Monodnock pre-trip, we had a leader fall and get a head abrasion which bled a bit as head cuts will. (I probably should have been more assertive on when he stopped as I saw he had difficulty on the steep terrain, he stopped when he saw the summit cone, about 1/3 of a mile from the top.)
The second was when we had that leader and one of the youth leader head down the Mizpah Cut-off before the rest (a month after Monadnock) they missed the cut-off turn in the pouring rain & got a mile or so to Jackson before turning around. I started as a sweep & went ahead to move cars and never passed them after catching other parts of our group, I figured they missed the turn. For the unfamiliar, it does look pretty easy to miss the junction. (I got to do the Cut-off 3x that morning in the rain.)
Guidelines are for what the BSA calls High Adventure. I get a physical every year before summer camp but if I did not attend summer camp, I would not need one. If I was going on an official BSA High Adventure Trip, Philmont, Sea-Base, etc., they have a height & weight guideline & I'd need a physical. I could be a sedentary person who just doesn't eat much and make that guideline. (as opposed to an very active chronic over-eater.... both have issues, the active person would know what they've done and can do. Currently, I would not qualify for Philmont.) This incident sounds like he was a pretty active leader, father and family man. It's timing was coincidental to the scouting trip.
This year, my son & a few friends did see their first fatality out on the trail. Our trip was to the ADK's with a couple of dads from Scouts & we've done trip several years now. We opted for a short but pretty steep hike up Giant. We started the trail with a few brothers (may have been brothers & cousins) and we were leap-frogging each other. One of the men had a history of heart disease. I was in back with the boy and another Dad. I saw the faster guys sitting on an open ledge enjoying what I thought was the view. Once I got there, they were just below where one of the men collapsed. We had one dad who had medical training & had worked in the medical field & he was leading a small group doing CPR.
It is a sad tale & my heart goes out to the family and the troop as another Dad & leader. You don't have to be a Dad to be a leader & scouting can always use more leaders. Leaders make the program and help decide what the troop does and doesn't do. BTW, IMO the whites technically don't qualify as high adventure on their own. If you were planning a Presi or Pemi Traverse, maybe but a trip over Pierce and stay at Mizpah or even Lakes & Mizpah wouldn't be.
If you plan your own trip, I'm not sure what you need to do for permits & physicals. While out west, we saw a troop from NJ that had just finished an extended trip where the backpacked the Grand Canyon and then did a multi-day rafting trip through the Canyon. Thinking about it now, I should have asked but it was well over 90 on the Hoover Dam & I was more in awe (& pity) as they were in their Class A Uniforms. If you go through an outfitter, I believe you may need less permitting as the outfitter provides in some cases, the safety net that BSA requires for the sake of the boys.