agc5k wrote "Its her first marathon, so of course she's gonna be inexperienced taking in fluids and hydrating. Flanagan's first marathon she only took fluids once."
Sure if you don't prepare. It isn't that hard to practice grabbing a fluid bottle in training. Some elites practice taking them off tables, while others have coaches hand them to them. Most folks don't think about it until they are in the race, hence the awkwardness you often see. To be well prepared you need to think about how much fluid, gels, etc. you will take in during the race. You can base this off your training and how you did testing different quanities on long or MP runs. Some folks need more, some need less.
Looks like quad cramps and dealing with heat issues. Having talked to Steve a few months before at a coaching clinic, I know they were doing a lot of fluid practice and some downhill running to get used to the hills. So it seemed like they were covering their bases.
Just a bad day it seems like and she hadn't had a bad day the whole training cycle. These things happen in the marathon, especially under tough conditions even if you're well prepared.
Maybe instead of coming from altitude, you'd be better off coming from somewhere warm. But hindsight is 20/20 and until the week of, no one expected really bad heat.