Another contentious decision

The National Anti-Doping Disciplinary Panel has issued another contentious decision. It has imposed a two-year sanction on an athlete who tested positive for steroid stanozolol in an out-of-competition dope test conducted by the International Association of Athletics Federations (IAAF) in April last year.

A steroid offence can get a lesser sanction than a standard sanction of four years but such instances are rare and such decisions are invariably based on irrefutable evidence and convincing arguments.

In the present case the decision, dated 9 March, 2016  to impose a milder sanction rested on the fact that the athlete had written down the name of the supplement that he had consumed and that, according to the hearing panel, showed he had no intention to cheat. It was presumed that the supplement was contaminated by stanozolol and it caused the positive test.

The standard sanction for a steroid offence under the 2015 Code is a four-year suspension unless the athlete can establish that the commission of the anti-doping rule violation was “not intentional” in which case it will be two years. For a ‘specified substance’ also the sanction would be two years unless the anti-doping authority can prove that the anti-doing rule violation was “intentional”. Steroids do not come under the category of ‘specified substance’.

This was a case in which the authority to pursue part of the ‘results management’ process was delegated to the National Anti-Doping Agency (NADA) by the Athletics Federation of India (AFI). Just as in the case of two of the woman 400m runners in 2011, Mandeep Kaur and Jauna Murmu, this was a test conducted by the IAAF at Patiala. The athlete happened to be a national-level shot putter.

AFI delegates authority

Again, just as in the Mandeep-Murmu instance, the AFI passed on the hearing process to be completed by NADA. In the case of Mandeep and Murmu, along with four other quarter-milers, the eventual verdict of two-year suspension was handed down by the Court of Arbitration for Sport (CAS) to which the IAAF appealed when the Indian panels imposed one-year sanctions for the steroid infractions.

The top Indian woman quarter-milers took the plea that they had consumed a supplement (ginseng) supplied by the foreign coach of the team and that could have been contaminated. The Sports Authority of India (SAI)_and not the NADA_got the supplement tested at the National Dope Testing Laboratory (NDTL) and the tests returned positive results for steroids methandienone and stanozolol. The women were finally penalized since they, according to the CAS arbitrator, could not establish “No significant fault or negligence”.

In the present case, that of the Chandigarh shot putter, the plea once again was he had consumed dietary supplement and that might have caused the ‘positive’ result for stanozolol since it could have been contaminated. The athlete stated that he had written down the name of the supplement in the doping control form and that, the panel was to crucially observe, was a clear indication that the athlete did not have any intention to cheat. The athlete argued, through his counsel, that he had always been taking supplements and had never in the past returned a ‘positive’ dope test.

Under the 2015 rules, this could have been a “contamination” plea and theoretically could have ended up with as little as a ‘reprimand’, the least of the punishments possible under article 10.5.1.2 (‘contaminated products’).

But it did not though the athlete’s lawyer did try to argue the case under “no significant fault or negligence” rule. But seemed to have been guided eventually by what the panel itself suggested.

The details of all the written submissions made by the athlete’s lawyer and NADA are not available. But the order by the panel headed by Mr. Ramnath does give a good idea about how the arguments went and how the panel arrived at its eventual conclusions and decision.

The order stated: “The pane has also deeply gone through the relevant citation of both parties, again the question of intention of the athlete is very material whether he intent (sic) to cheat. Here, in the present case the athlete from the very beginning i.e. at the filing of doping control form has mentioned of taking nutritional supplements, ‘Tri Troubles’ as athlete is not well educated it means that he had taken in fact ‘Tri Tribulus’ supplement and not the ‘Tri Troubles’. This substance is a nutritional substance which has a unique growth formula and is not banned rather it was recommended and purchased by Indian Weightlifting Federation by inviting quotations (photocopy of letter dated 11.12.2012 of Sahdev Yadv Secretary General, Indian Weightlifting Federation was filed from the side of the athlete wherein in the list of supplements at serial No. 23 Tri Complex Tribulus was mentioned). On the other hand, the Counsel for NADA did not show any document/evidence that this supplement is banned.”

Banned or approved supplements?

Several key points emerge from the above statement. The athlete had consumed Tri Tribulus, a herbal supplement derived from Tribulus terrestris. The panel has noted that the substance is a “nutritional substance” which was not “banned”. It was, on the contrary, recommended by the Indian Weightlifting Federation.

No one apparently told the panel that there is no “banned nutritional substance”. WADA only bans drugs and doping methods, not supplements. WADA also does not ban brand names, only generic drugs. For example, stanozolol is among the banned steroids, not Winstrol, one of the more popular drugs available in the market that contains stanozolol.

NADA should have told the panel that it cannot “show any document/evidence” that the supplement (Tri Tribulus) was banned since it was not in the business of either approving or banning supplements. Or for that matter WADA was not in the business of approving or banning supplements.

Quite often we hear the mention of “WADA-approved” supplements during dope hearings. There are no such supplements in the world. WADA warns athletes about the use of dietary supplements because of their propensity to get contaminated by banned drugs. All the anti-doping agencies including National Anti-Doping Organisations (NADOs) are also supposed to warn athletes about such dangers.

While guiding athletes towards the use of supplements some of the anti-doping agencies make it clear that it is ultimately the sole responsibility of the athlete to make sure the substance is safe.

Athletes are responsible for what goes into their systems. “I didn’t know “ can never be a clinching argument in a doping case.

Coming back to the order of the panel that took note of the mention of Tribulus in the doping control form, it goes on to say “…therefore the possibility of contaminated nutritional supplement Tri Tribulus which the athlete was consuming, cannot be ruled out, however the great burden lies upon the athlete to show that he had consumed contaminated supplement Tri Tribulus. The …Counsel for NADA has submitted that they have not filed any cash memo or not mentioned the name of the shop from where he has purchased and, therefore, he cannot be given any benefit of provisions of “No significant fault or negligence”. But the panel is of the view that it is very difficult for the athlete to keep cash memo etc as he was not knowing at the time of purchasing the nutritional supplement Tri Tribulus that it will contain contaminated supplement.”

What the panel apparently wanted to say in the last sentence above was the athlete couldn’t have known at the time of purchasing the supplement (Tri Tribulus) that it would contain a banned substance/steroid.

No testing of supplement

The main point here seemed to have been missed by the panel as well as NADA. There is only a claim that the supplement must have been “contaminated”. No one tested it! No one seemed to have sought a test! NADA did not ask for a test. The panel did not seek a test to find out whether the supplement was contaminated by stanozolol. The panel would have been within its rights to demand such a test. It did not.

The panel wrote: “However it is the duty of the athlete to explain how the prohibited substance entered in his body, for that to some extent he is able to show that contaminated substance stanozolol entered into his body through Tri Tribulus (emphasis mine) supplement which he consumed regularly. If he would not have mentioned Tri Tribulus supplement in the doping control form, the position would have become different and he would have been guilty of taking the said substance with intention to cheat. Therefore panel has come to the conclusion that the athlete did not consume the substance with intention to cheat and therefore the athlete case comes under clause 40.2 (b) of the IAAF anti-doping rules 2015 where period of ineligibility has been two years only.”

The panel obviously is uncertain about how the prohibited substance entered the athlete’s body. Otherwise it would not have stated “to some extent he is able to show”.

Precedents

There was one case in India of a female judoka who was reported for methylhexaneamine in 2012. She was exonerated on the argument that the substance must have come from beauty aid products. The decision was upheld by the Indian appeal panel, but was eventually overturned by the Court of Arbitration for Sport (CAS) and she given a two-year suspension.

Interestingly, NADA tried to bring in laboratory investigation report rather late during the appeal stage of judoka’s case but was not allowed. The lab report stated that MHA was not present in the beauty aid products that the athlete had applied. The company gave a signed statement that its products did not contain MHA. 
It was widely believed at that time that geranium plant and roots contained MHA. Later in another case, that of a woman swimmer, once again the theory that soaps, shampoos etc may contain geranium which in turn could mean MHA, was proposed and accepted. The swimmer was given a reduced sanction by an appeal panel without testing any product and without NADA advancing what was known to it through laboratory tests in the judoka's case.

In the present case the lawyer representing the athlete mentioned a couple of cases in the athlete’s defence. One of them involved a British rugby player who tested positive for 1-3,dimethylbutylamine, a stimulant, in an in-competition test. The player claimed that his positive test had come out of his use of a supplement.

Many of his arguments were accepted by the UKAD which did not claim that the player had used a doping substance “intentionally”.

The UKAD only pressed for a six-month suspension for the level of negligence shown by the player. It accepted that the prohibited substance had come from the supplement only. But before doing so, it tested the product from a tub of left-over stuff given by the player and the laboratory reported that the substance he tested positive for (dimethylbutylamine) was indeed present in the supplement.
The player received a six-month suspension. He was able to satisfy the panel that he had taken certain basic precautions before purchasing the supplement and consuming it.

There could be dozens of cases like these across the world including in India where either the anti-doping agency would have tested the supplement and found out what it contained or else a panel would have ordered such a test and satisfied itself what its ingredients were or else an athlete would have on his/her own got the tests done to defend oneself.

The mere presence of the banned substance in a supplement alone may not, however, help an athlete escape sanction or get reduced punishment since degree of fault or negligence would also be assessed if a 'no significant fault or negligence'argument is taken. That is what happened in the case of the six woman quarter-milers when their cases went up to CAS in 2012.

Had the substance been tested in this case and found to be contaminated the athlete could have fallen back on the ''Contaminated Products' rule introduced in the 2015 Code which might have enabled him get a simple ‘reprimand’ and no suspension.

His lawyer was keen to proceed on the “No significant fault or negligence” argument. But the panel stated, rather surprisingly: “The argument of the learned counsel for the athlete that his case may be taken under the rules of “No Significant Fault or Negligence” does not appeal to our mind, as the panel has already reached to (sic) the conclusion that the athlete was not having intention to cheat.”
A particular line of defence did not "appeal" to a hearing panel!

Pertinently neither NADA nor WADA (or IAAF) has appealed this decision which may well set a precedent about supplements use.
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Other recent debatable decisions:
Click here for Prescription v TUE
Click here for Same class of substance, two vastly different sanctions

Prescription v TUE

Can an athlete take testosterone without having obtained a therapeutic use exemption (TUE) from the authorities and eventually get a reduced sanction when he is tested and found ‘positive’?

Yes, he can. At least in India that is possible as has been established through an order given by the National Anti-Doping Disciplinary Panel (NADDP) in the case of an athlete last February.

The athlete, a javelin thrower from Punjab, had tested positive for testosterone in the all-India Police Championships in November, 2014. His T/E ratio showed 13.0, well above the prescribed limit of 4.0. Isotope ratio measurement spectrometry (IRMS) analysis confirmed the use of exogenous (outside the body) steroid.

The athlete happened to be a second-time offender. He was handed down a three-year suspension for his second offence, the first one having come in 2009. That was for stanozolol, and he copped a two-year ban then.

The 2014 offence was also handled under the 2009 rules even though the final hearing in the case was held on 7 December, 2015.

Went by doctor's advice

The athlete’s defence mainly hinged on the premise that he had taken medicines as prescribed by his doctor. In his written submission he stated, according to the order, that he “was suffering (sic) from infertility and taking treatment…” The athlete also submitted medical records of his wife to support his arguments. He submitted that he had been taking medicines for his condition “much prior” to the competition in which he tested positive.

The athlete pleaded that he was “not well literate” (sic) as per the order and did not have knowledge of English medicines. His doctor apparently prescribed him Andriol Testocaps (testosterone in capsule form).

The National Anti Doping Agency (NADA) argued before a panel headed by Mr. Ramnath that the athlete did not obtain a TUE for the use of testosterone. It said the athlete had not disclosed in his doping control form that he was undergoing testosterone therapy.

It further argued that the athlete had taken nearly five months to submit his defence and the submissions made by the athlete were afterthoughts and “documents produced on record have been obtained by fraudulent means and should not be taken into consideration.”

NADA also argued that it was the duty of the athlete to ensure that no prohibited substance entered his body and it was also his duty to advise his doctor that he was an athlete and was bound by certain rules.

'Documents authentic'

The panel ruled: “NADA could not establish that medical documents of athlete and his wife are fraudulent/manipulated after athlete was found guilty of violating anti-doping rules 2010. As the perusal of medical documents of athlete are of dated (sic) 07-07-2014 and 10-08-2014 and 27-09-2014 and the consulting doctor is Dr…, MD, Consulting Physician. No evidence was submitted from the side of NADA to show these papers are frivolous. Secondly the medical documents filed by the athlete, of her (sic) wife were original and they are dated 30-06-2014…”

The order, dated 5 Feb, 2016, further stated: “The submission of NADA with regard to non-submission of facts of taking medicines at the time of sample collection while filing the doping control form or not obtaining TUE can be said (sic) maximum lapses on the part of athlete. As the athlete already submitted (sic) in written reply that he was not well educated and did not have knowledge of English medicines and hail from village farmer’s family (sic).”
(A TUE panel, normally comprising doctors, takes up applications for exemptions from athletes for use of banned substances on medical grounds. A TUE granted or rejected by an anti-doping agency can be reviewed by WADA.)

Case of a weightlifter in 2010

In a similar case involving a weightlifter who was also advised testosterone therapy for “infertility”, a disciplinary panel had ruled in August, 2010 that the contention of the athlete was valid and imposed no ineligibility.

On an appeal from WADA, however, an appeal panel headed by Justice C. K. Mahajan (retd), set aside the disciplinary panel ruling in July 2011 and imposed a two-year sanction on the lifter.

Almost simultaneously another case of an athlete, a woman sprinter from Tamil Nadu, had also ended up in similar fashion. That was a case of stanozolol usage, prescribed by a doctor. The disciplinary panel ruled in favour of the athlete; the Mahajan panel ruled otherwise. The sprinter’s stanozolol case was brought into the arguments by NADA during the javelin thrower’s recent case, but it made no impact. The lifter’s case was apparently not mentioned.

The Mahajan panel wrote in the order that imposed a two-year suspension on the weightlifter: “In order to eliminate or reduce the period of ineligibility the respondent has to establish that he bears no fault or negligence for the violation of the Anti Doping Rules and if he is successful then the period of ineligibility shall be eliminated. We are unable to uphold this finding.

“The question that needs to be answered that whether the respondent bore no fault or negligence. The respondent admits during hearing that he took substances that caused adverse analytical finding in the test. Therefore we can safely conclude that the respondent would have discussed treatment therapy with his doctor and its

effects in relation to the Anti Doping Rule violation.

“A sanction cannot be completely eliminated on the basis of no fault or negligence even when the administration of the prohibited substance has been done by the athlete’s physician/doctor without disclosure to the athlete. In order to benefit from an elimination of the period of ineligibility for no fault or negligence, the athlete

must establish that he did not know or suspect and could not reasonably have

known or suspected, even with the exercise of the utmost caution, that he had

used or been administered the prohibited substance.

Athlete's responsibilities

“In the present case the respondent did not establish that he took any

precaution or made any inquiry to assess whether the medical treatment he was following was free from prohibited substances. He did not either demonstrate having informed his doctor that he was an athlete, bound by a duty of care to avoid the ingestion of any prohibited substance. It is true that the medical

treatment was prescribed by the respondent’s doctor. However, the respondent

cannot hide behind his doctor’s ignorance of the Anti Doping rules in order to

escape from sanctions due to Anti Doping Rule violation.

“The medical treatment prescribed by the doctor does not dispense the athlete to control if the medicine he is prescribed contain prohibited substance. The respondent has not established that he exercised utmost caution and therefore that he bore no fault or negligence. The respondent has also not shown any truly exceptional circumstance to warrant reduction of the otherwise applicable period of ineligibility. It is the duty of the athlete to ascertain that the drug he was prescribed for a long period of time does not contain any prohibited substance. If the athlete fails to exercise this caution he should not get the benefit of no fault or negligence/no significant fault or negligence.”

A TUE for testosterone use is very rare in anti-doping parlance. Here in the case of the javelin thrower there was no TUE but medical prescriptions and laboratory investigation reports. Once again, as had been the case in several instances in the past, the “village” background of the athlete and his inability to read and understand the medicines prescribed in English went in favour of the athlete.

Sanction reduced twice

As for arriving at a sanction of three years for a second offence the panel stated: “…the only consideration left before the panel is to see how much ineligibility be reduced under Article 10.7.1 wherein a table has been prescribed for second violation (sic), therefore, for the second violation the panel is of the view to sanction (sic) one half of the period of ineligibility which comes to 3 years for No Significant Fault & Negligence in the table indicated below”.

The table is a reference point for administering sanctions under the 2009 WADA Code. Various combinations of offences have been given in the table. In this case it happened to be one of “No significant fault or negligence” (as deemed by the panel) in combination with a previous offence that could be described as ‘standard’ since a maximum sanction of two years was given in the earlier case.

Now, NSF (no significant fault or negligence) clubbed with ‘St’ (standard) on the table gives a sanction of 6 to 8 years.

The panel apparently came to the conclusion that this six or eight could be further reduced to half if “no significant fault or negligence” had been established.

That amounted to a reduction being granted twice over after having concluded that this was a case “no significant fault or negligence” and based on that conclusion this could be fitted into the 6-8 year bracket.

It is pertinent to point out here that had the panel come to the conclusion that the second offence was also “standard”, then a combination of two “standard” would have meant a sanction of eight years to life.

The panel had to understand from the table meant for sanctions for multiple violations that once the nature of the offence was determined by it as ‘reduced sanction’ (RS), ‘standard’ (St) or ‘no significant fault or negligence’ (NSF) etc and placed against the table to determine what could be the punishment for a second offence, there could be no further reduction except the range prescribed in the table.

In December last year, in a similar case like that of the javelin thrower, an appeal panel upheld the decision of a disciplinary panel which arrived at the same conclusions about reduction of the punishment under the “no significant fault or negligence” rule. In that case, also that of an athlete, it was reduced to four years though the applicable sanction was six to eight years.

Once the appeal panel had set a precedent, it was expected that other panels would follow suit though it was not a binding precedent.

(Updated 5 May 2016)

Were athletes actually robbed of Rio qualification?

Were some of the elite athletes of the country deprived of a chance to qualify for the Olympics because of a power shutdown at the Capital’s Jawaharlal Nehru Stadium on Sunday?

Before the events started in the afternoon, yes surely they were confronted with a fait accompli: “Run your best, no matter what your timings are in the sprints, you won’t make it to Rio Olympics”.

The regulations laid down by the International Association of Athletics Federations (IAAF) for Olympic qualification state: “Hand timing performances in 100m, 200m, 400m, 800m, 110m/100m Hurdles, 400m Hurdles and 4x100m Relay will not be accepted”.

As such the AFI knew, at least the technical officials knew, that there would be little point in athletes gaining any timings in short races without a fully automatic timing system in place. Perhaps the media knew, too, at least those familiar with IAAF regulations, record ratifications etc.

One is not sure whether the athletes knew about the futility of clocking personal bests and Olympic standards when there was no power supply and thus no electronic timing system.

Blame game

 There is little point now in going through the blame game that was expectedly resorted to by the host, Delhi State Athletics Associaion, the AFI and the Sports Authority of India (SAI) for not having provided a back-up for electricity supply for a “qualification meet” of this nature. We can go on and on but it would not be of any use.

Should the sprint events have been cancelled since the AFI knew there could be no qualification? That would have been foolish. Why deprive athletes of a chance to compete? Moreover this meet was a good build-up exercise for the more important Federation Cup starting at the same venue four days later.

The power outage made headlines in the National dailies.  “Power failure robs athletes of Olympic qualification”. That was the crux of the argument in most of the reports.

Before the events started, as I noted earlier, yes it robbed them of a chance. But after the end of the events? Who were all close to the Olympic standards in sprint events? Or was there anyone at all? It may look easy when the difference is 0.2s or 0.4s but place it alongside a 100m timing and then see the difference between 10.1 and 10.3. Better still 10.1 and 10.10s.

It has been reported that both men’s and women’s 100m timings were better than existing National records and both also were better than the Olympic entry standards. But since there was no automatic timing system in place, both would be deprived of both the honours.

This is not a true description of the events or the timings returned by the athletes. In men’s 100m Odisha’s Amiya Kumar Mallick clocked 10.09 seconds. This was hand-timed. This should have been rounded off to 10.1s before it was cleared by the technical officials (chief timekeeper, chief judge etc) and passed onto the recorders and from there to the communications team and onto the media. Same with the timing of 11.23s clocked by Srabani Nanda, also of Odisha. That should have been 11.3s.

Just because modern stop watches provide timings up to a hundredth of a second it should not mean these are equivalent to electronic/automatic timings. Nor should it have meant that the chief timekeeper would pass on a timing measured up to a hundredth of a second and the recorder would also make it look as though this was automatic timing without re-checking.
Once you get 10.09s for a 100m it is taken for granted that this was automatic timing. On the other hand a timing given out as 10.1 would make it clear it was hand-timed.
Now if the media were pre-briefed about the power breakdown and absence of automatic timings and the resultant bar on Olympic qualification and provided these results as 10.1 and 11.3 in the official results sheets things would have been far better and different.

Media could have been briefed

It could have been done with an explanation that though these hand-timings may look to be better than the existing National records they indeed were not since a fully automatic time of 10.30s (National record in men’s 100m) was always superior to a hand-timed 10.1s and an automatic 11.38s (National record in women’s 100m) was clearly above a hand-held timing of 11.3s.

Would anyone have then reported that there were ‘national records’?

Or for that matter an automatic timing of 45.48s (achieved by K. M. Binu in 400m in Athens Olympics) has to be surely rated far above that of a hand time of 45.5 (rounded off to the next lower tenth of a second from 45.41s that was credited initially to Mohammad Anas in the Delhi meet).

In order to compare hand-held timings with automatic ones, athletics statisticians had devised a formula by which 0.24s was added to the 100m and 200m timings and 0.14s to 400m and above.

Though several of the Olympic Games timings were officially recorded as hand-timings, automatic timings, where available were later approved as “automatic” for those events including for example for the 1960 Rome Olympics. (It was not until 1964 that Olympics started using automatic timings but till 1972 Games results were given only in hand timings.)

Milkha's record

Rome was where the great Milkha Singh clocked 45.6s (hand) for the fourth place in the 400m. Later when the IAAF, guided by leading statisticians around the world accepted automatic timings ‘where available” and incorporated them within parenthesis to those results, it became 45.73 (not 45.74 the mark that could have been logical had the 0.14s conversion formula been applied to it).

Why this particular record of Milkha is being mentioned here is because of the controversy the subsequent national records in 400m created thanks to this “revision”. Milkha never accepted the argument that someone could clock 45.7-plus and still claim his record of 45.6 was bettered! Paramjeet Singh did that (45.70s) in Calcutta in 1998 and the AFI ratified that record. Any other dispute related to Paramjeet’s record is a different matter.

Hand-timings are nothing new in Indian athletics. We have had these for longer periods than most developed countries around the world. Sometime in the 1990s the AFI brought in automatic timings. Gradually, all senior national-level meets and then junior national-level meets were mandatorily timed with automatic system.

Hand-timings have inherent deficiencies. The time-keepers are actually expected to look for the flame/smoke from the gun (held aloft by the starter against the background of a black board) and not hear the sound before pressing their stop watches. You are not sure how many of them would be seeing the flame and how many of them would have pressed when they heard the sound. There is a considerable time gap if the sound determines the action of the official in the short sprints.

At the finish, too, there is considerable margin for error.

To have clocked 10.09s (10.1 hand) and then be credited, even if through the mistakes of the technical officials, with a national record, bettering the existing one of 10.30s is something that should not have happened at all. 

For comparison purposes, through the conversion formula, 10.09 will first become 10.1 (adjusted up to the lower tenth of a second) and then if we add 0.24s it will become 10.34s. Not good enough to beat NR of 10.30, and nowhere near the Olympic entry standard of 10.16 if we were to just compare these timings and not presume that hand-timings would be allowed for qualification.

Of course the IAAF does not accept hand-timings for sprints as entry standards for Olympics and World Championships etc, as mentioned above, and it also does not accept hand-timings for races up to and including 800 for the purpose of world record ratification. The AFI follows the IAAF pattern mostly, though there is nothing written down about ratification regulations.

That an explanation was eventually made to the media, despite having been supplied with the timings of 10.09, 11.23 and 45.41 was thanks to the intervention of the AFI Technical Committee Chairman, Tony Daniel, who was away in Kerala and could not make it for this meet in Delhi, but who was alerted about the discrepancy by a journalist, baffled by the news about a flurry of “national records”!

Suriya's record is legitimate

Now, a curious mention was made in several reports about the timing returned by Suriya Loganathan in the 3000 metres. Amidst the confusion created by the sprint timings, national records that were never set, Olympic standards etc it was also reported that Suriya’s 9:04.5 will also not be considered for National record ratification  purposes even though it was better than Molly Chacko’s existing mark of 9:06.42 set at the Hiroshima Asian Games in 1994.

Why should Suriya be denied her legitimate right for this distance, where an auomatic timing system is not mandatory, is not clear. Obviously someone made a mistake in informing the media. Unless there are other issues related to Suriya’s performance, the Tamil Nadu woman has to be credited with the NR in this event run occasionally in domestic meets nowadays. It is an early-season event for the distance runners these days to prepare for the tougher and longer races.

“Suriya robbed of record amidst confusion” would have been an apt headline.

In athletics, unlike say in swimming, there are no pre-designated qualification meets to attempt entry standards for Olympics. Any ‘recognized’ meet conducted by a national federation under the IAAF rules would do provided qualified officials and standard equipment were utilized. Thus there should be no question of either stripping the Delhi meet of the ‘qualification’ tag or informing the IAAF that such a tag has been removed. Had a couple of athletes qualified in say long jump or triple jump or discus would such a tag have been removed? (If it indeed had been removed!)

The participation level in a meet in which individual entries were entertained for the first time was pathetically poor. The standards too remained ordinary if we were to exclude the hyped up sprints and a couple of other events. Hand-timings do provide a rather distorted picture in sprints and that is what happened in the Delhi meet.

Amiya Mallick (previous best 10.51s), Srabani Nanda (11.58s) and Anas (46.66s) will surely be expected to look forward to the Federation Cup from April 28 to 30 to repeat their performances and make the cut for Rio. They will need to clock 10.16s, 11.32s and 45.40s. all through automatic timing system to make the Rio-bound team. It is a tough task.

Hopefully the AFI will have the power back-up this time just in case things go wrong again!

(updated 26 April 2016)

The meldonium conundrum

Has WADA thrown a lifeline to athletes who have turned in positive tests for meldonium as has been widely reported? Or is there a meldonium-linked amnesty as is being suggested by certain people and being debated in the international media?

Can Maria Sharapova greatly benefit_or benefit at all_from the latest clarification by WADA regarding ‘excretion times’ for the drug that was brought into international focus on March 7 last when the Russian tennis star announced that she had tested positive for the little-known cardiac drug?

These questions are being raised and discussed across the world following WADA’s fresh guidelines for pursuing the meldonium doping cases. The meldonium infractions have risen to 201 as on April 15. The numbers are unprecedented for a single drug within a four-month span of its inclusion in the banned list.

Unprecedented intervention

WADA’s intervention in such a short period of time after a drug being introduced into the Prohibited List, with detailed clarifications regarding thresholds to be pursued or ignored for a non-threshold substance is also unprecedented.

With some of the athletes and organizations questioning the ‘excretion times’ of the drug, perhaps WADA perforce had to step in and issue guidelines which has led to speculation about the basis of its inclusion in the Prohibited List as well as about the “escape route” that the “guidance” may provide to at least some of the athletes. WADA stated that several anti-doping agencies were seeking guidance and because of the “unprecedented situation” created by meldonium it felt the need to provide “additional guidance for the anti-doping community.”

Ukrainian athlete Nataliya Lupu was one of the earliest among the meldonium offenders to claim that even after stopping the drug a good two months ahead of the January 1 deadline, she had tested positive. She stated that she had been taking the drug for the past 15 years for medical reasons and thought she had stopped well in time to prevent a ‘positive’. It was the second doping offence for the former European indoor 800m champion.  She was withdrawn from the World Indoor Championships in Portland, US.

In the third week of March Russian middle distance runner Andrey Minzhulin made the claim that the Prohibited List was translated into Russian only in October 2015 and if the drug was taking as much as 100 days to clear from the system (as was being claimed at that time) then it would be unfair to penalize athletes if they tested positive in January 2016.

Manufacturer's claim

Around the same time, Grindeks, the manufacturer of meldonium, told Reuters that the drug had a half -life of four to six hours but “its terminal elimination from the body may last for several months”. (Half-life means the time it takes to reduce the concentration of a drug in the body by half).

WADA has now conceded in its note to anti-doping agencies that meldonium may remain in the system for “a few months”. It has issued concentration levels that could be considered for different periods. The fundamental rationale is if an athlete is claiming that he or she took the drug in October-November there is still a possibility of a positive test in January and the athlete deserves the benefit of some concession.

The cut-off of 1 to 15 microgram/ml stipulated for samples collected before March 1 may not, however, be too encouraging for those trying to find a way out if they had committed an offence. Nor would the 1mcg/ml (0.000001g/ml) limit given for tests done after March 1.

“In the case of meldonium, there is currently a lack of clear scientific information on excretion times. For this reason, a hearing panel might justifiably find (unless there is specific evidence to the contrary) that an athlete who has established on the balance of probabilities that he or she ingested meldonium before 1 January 2016 could not reasonably have known or suspected that the meldonium would still be present in his or her body on or after 1 January 2016. In these circumstances, WADA considers that there may be grounds for no fault or negligence on the part of the athlete” WADA notice stated.

“Based on the preliminary results of the aforementioned studies, this translates to urinary concentrations higher than 10 μg/mL up to 72 h (first elimination phase), followed by a persistent long-term excretion (second elimination phase) yielding concentrations up to approximately 2 μg/mL over the following three weeks. Long term urinary excretion below 1 μg/mL down to several hundred ng/mL can persist for a number of weeks and in the low tens of ng/mL for a few months,” WADA said. (1ng=000000001g).
WADA has recommended that proceedings may be continued if the concentration is above 15 mcg/ml since it would suggest recent intake of the drug. 

No blanket amnesty

This is not a blanket amnesty. It may turn out to be a lifeline for some of the offenders. It is difficult to guess what those numbers could be from among the 200-odd meldonium positive cases reported so far. Already at least 14 athletes in Russia and Georgia have had their provisional suspensions lifted because of the guidelines issued by WADA. There could be more that had not been reported.

Those who might have ingested the drug prior to January 1 and concentration levels show below 1mcg/ml would be reprieved when the hearing process begins. Their provisional suspensions would be lifted straightaway. Meldonium being a 'non-specified'drug a provisional suspension was standard. Because of the uncertainty over éxcretion times' WADA has now given anti-doping authorities the right to lift the provisional suspension in case ingestion prior to Jan 1 is firmly indicated.

The final decision on all these cases would be dependent on the outcome of the ongoing ‘excretion studies' which alone would be able to determine with some measure of certainty when the athlete would have taken the banned drug. The studies may well be challenged scientifically and legally.

“Cases where the concentration is below 1 μg/ml and the test was taken before 1 March 2016 are compatible with an intake prior to January 2016. If the anti-doping organization finds that the athlete could not reasonably have known or suspected that the substance would still be present in his/her body on or after 1 January 2016, then a finding of no fault or negligence may be made."

At this point all these could be sounding rather confusing. But once the hearing process begins and news gets out, we would be in a position to understand the implications of this WADA notice in a better way.

Sharapova's case

How much of an advantage Maria Sharapova might have following the latest WADA notice?

None perhaps!

The International Tennis Federation (ITF) has stated that it had taken note of the WADA notice and it would go ahead with a hearing for the superstar. The Russian tennis star’s provisional suspension has not been lifted, an indication as to how the fresh guidelines would have worked in her case.

Sharapova did not say she knew the substance was banned and had made sure that she stopped taking meldonium_prescribed to her by her family doctor for an ostensible cardiac condition 10 years ago_in October or November. On the contrary she told the media that she did not know meldonium was banned. No one had told her and she missed clicking a link in a WADA communication that could have given her the crucial information.

She did not say when she took it last. But as things turned out, one of her sponsors, tennis racquet manufacturer, Head, issued a statement on March 11 which stated, among other things:

“On this basis we conclude that although it is beyond doubt that she tested positive for the use of a WADA banned substance, the circumstantial evidence is equally beyond doubt that the continued use of meldonium after Jan 1st, 2016 in the dosages she had been recommended, which were significantly short of performance enhancing levels, was a manifest error by Maria. In the absence of any evidence of any intent by Maria of enhancing her performance or trying to gain an unfair advantage through the use of mildronate, we further conclude this falls into the category of 'honest' mistakes.”

The Head Chairman couldn’t have visualized how things would turn out when he issued the above statement.

WADA has said that in case an athlete admits that the substance was taken after 1 January or if there is “other evidence” that it was taken after 1 January, the proceedings would continue.

Can Sharapova now disown the statement by Head Chairman and CEO, Johan Eliasch, that the she was taking meldonium in small quantities even after January 1? It looks doubtful whether such an argument could be made convincingly before a hearing panel.

Much would depend on the concentration levels being returned in their urine samples by individual athletes including Sharapova. Also the eventual outcome of the ‘excretion studies’ that the WADA-accredited laboratories are conducting at the moment. 
We should not forget the capabilities of the lawyers who would be representing a majority of the athletes. This is a good season for lawyers, especially those who have the experience in anti-doping rule violation cases.

Efimova fails to get suspension lifted

With the Olympics getting closer there is understandable anxiety among athletes to get out of this “meldonium mess” and get on with competitions and qualification process.

One such athlete, Russian swimmer Yulia Efimova, 100m world breast-stroke champion, had tested positive for meldonium on a sample she provided last February. The US-based swimmer apparently told her coach that she had taken the drug last December.

However, as ill luck would have it (from her perspective) another test in January this year turned up negative, according to Swimvortex.

 Probably based on this evidence International Swimming Federation (FINA) has refused to lift her provisional suspension to enable her to compete in the Russian National Championships. Efimova, world number three, may still have an opportunity to make the Olympic selection if she is cleared of the doping charges. This is her second doping offence, she having served a suspension in 2013.

Just as the debate started about WADA’s wisdom of including meldonium in the Prohibited List immediately after the Sharapova bombshell, the latest WADA notice has triggered another round of arguments about how the agency goes about banning drugs.

People have called for conclusive evidence of performance-enhancement through clinical research before WADA includes any substance in the banned list. Russian President Vladimir Putin has gone to the extent of saying meldonium was never a performance-enhancing substance.

Critics and experts will continue to argue that WADA’s methods are arbitrary.

Inclusion of meldonium in Prohibited List

WADA, in the mantime, has stated: “The inclusion of meldonium on the 2016 Prohibited List concluded a long process conducted by the WADA List Committee between 2011 and 2015. This process, which included a review of the available scientific information and the generation of specific data (in particular via the 2015 Monitoring Program, which revealed a high prevalence of the use of meldonium by athletes and teams of athletes) ultimately led to the conclusion that meldonium met two of the three criteria listed at Article 4.3.1 of the World Anti-Doping Code (Code). In particular, claims of performance enhancement had been made by various authors, including the manufacturer of meldonium.”

The manufacturer, Grindeks, had of course denied when the focus shifted to it following the Sharapova announcement that meldonium was a performance-enhancer. Its inventor, Latvian Ivar Kalvins had also said, however, that he had developed the drug for use by Soviet troops in Afghanistan since operating in the mountains could result in lack of oxygen.

Is that not performance enhancing?

Someone will have to go to court to challenge the inclusion of meldonium or any other drug in the Prohibited List. WADA does not disclose all the selection criteria adopted for particular substances all the time. Nor has there been conclusive research about the performance-enhancing capacity of the hundreds of drugs listed by WADA. But it is always prepared to defend its decisions and in the case of meldonium it seems to have done its homework well enough barring of course the 'excretion' study.

One thing is clear, all of 200 athletes would not have been using meldonium either because they had cardiac problems or because they felt it was fashionable to use it. What could happen to it next year, without the controversy surrounding ‘excretion times’ is anybody’s guess.
*****

Click here for previous piece on meldonium.

(updated 18-04-2016)

Same class of substance, two vastly different sanctions

Much as the World Anti-Doping Agency (WADA) has tried to bring uniform anti-doping rules and uniform application of those rules, differing interpretations often lead to contrasting sanctions. These sanctions through the years have differed from country to country and, as we will soon be able to observe, within a country itself.

Hearing panels in India generally tend to take a sympathetic view of the offence when doping cases are brought before them, especially when the substance belongs to the cannabinoids group or the corticosteroids one.  Unless the case is one of steroid abuse, the panels, at least in India, give plenty of room for the athletes to seek a lenient punishment. Perhaps this is a world-wide phenomenon. But in India, quite often the lack of education programme to familiarize athletes with anti-doping measures, prohibited substances, TUE etc plus the background of the athletes, in several cases those from villages with little understanding of English or awareness about anti-doping rules, contribute towards the eventual sanctions.

Two cases that came out of the National Games in Kerala in February, 2015 deserve mention here. Both were disposed of last December.

In both instances the substances involved belonged to the glucocorticosteroids group. One involving a male athlete from Tamil Nadu ended up in a four-year sanction and the other involving a female wrestler from UP in a one-year suspension.

Corticosteroids are steroid hormones produced in the human body. Glucocorticoids such as cortisol are anti-inflammatory drugs. In sports corticosteroids used to be a restricted drug that required advance notice and permission some years ago. Over a period of time the rules changed. It was a permitted drug through certain routes (periarticular, meaning into a joint, for example) but prohibited through some other routes.

Now there is a simple stipulation in the WADA prohibited list. “All glucocorticoids are prohibited when administered by oral, intravenous, intramuscular or rectal routes.” This will mean an injection into a joint is permitted though it is not specified as it used to be in the past.
Corticosteroids are grouped in the 'specified'category of the Prohibited List, thus enabling a reduction in sanctions if the athlete is able to prove certain conditions.

Corticosteroids, we know, are anti-inflammatory drugs and are used to manage painful conditions. They are also supposed to give a euphoric sensation that could probably explain their misuse in sports. But can that be all?

Do corticosteroids enhance performance?

Some studies have also claimed that they also delay fatigue and thereby enhance performance but this is yet to be conclusively proved. In fact there are scientists who want this class of drugs removed from the prohibited list. This is a debate for the scientists and doctors to pursue and we should leave them the task.

The widespread use of these drugs among athletes has, however, apparently prompted WADA to retain glucocorticoids in the banned list.

No credible defence

Coming back to the National Games context, the Tamil Nadu athlete tested positive for betamethasone, used in rheumatic disorders and treatment of allergic conditions, among others. He did not have much of a defence to present when he confronted the disciplinary panel headed by Mrs Gouri Karuna Mohanti.

The medicines that he claimed to have consumed mainly related to bronchial conditions. He also said he had taken some ayurvedic and unani medicines that he had been consuming over a long period of time.

“He apologized that he committed mistake and mentioned that he will accept the decision of the Panel”, stated the order.

The order goes on to say:

“As per the anti-doping rule of NADA 2015: 10.2.1 The period of ineligibility shall be four years where: 10.2.1.1 The anti-doping rule violation does not involve a specified substance unless the athlete or other person can establish that the anti-doping rule violation was not intentional.

10.2.1.2 The anti-doping rule violation involves a specified substance and NADA can establish that the anti-doping rule violation was intentional (emphasis mine).

“In the present case the anti-doping rule violation does involved (sic) a specified substance and the athlete was not able to establish that the anti-doping rule violation was not intentional” (emphasis mine).

The panel expected the athlete to prove his culpability while the rule demanded that NADA prove that he had intentionally doped. Otherwise, for specified substance the sanction should be suspension for two years.

The athlete was suspended for four years on the argument that he was not able to prove that the violation was “not intentional”, something that he was not required to do under the rules. It was NADA’s responsibility to prove that he had intentionally doped and that, even if it was proved by NADA to the satisfaction of the panel, is not explained in the order.

Wrester tests positive for three corticosteroids

Now, let us look at the other case, that of the female wrestler. She tested positive for not one but three different glucocorticosteroids, prednisone, prednisolone and betamethasone.

She argued that she had been prescribed medicines by a set of doctors for “severe back ache”. The prescription that contained tab medrol (which contained methylprednisolone) was issued to her in October 2014. Her sample was collected on 3^rd Feb, 2015.

NADA argued, as per the order, that the “presence of glucocorticosteroids cannot be consumed (sic) through the medicines as prescribed in the prescriptions. There is substantial gap between the last prescription and the date of the dope test.”

It was not mentioned in the order how long she had been taking the medicines and whether she took them right into the competition in the National Games. Prednisolone/prednisone (5mg) has a half-life of 18 to 36 hours, and betamethasone (0.75mg) 36 to 54 hours.

(Half-life means the time it takes for the drug in your system to drop by 50 per cent)

It was stated in the order that the anti-doping authorities were aware of the “ongoing condition” of her back just before competition. How this could have been possible has not been explained. Perhaps NADA was told of it at the time of sample collection or else she had written down her course of treatment and medications in the doping control form.

It was also stated that the athlete being of a village background did not have much knowledge of English and was not aware of the NADA rules. She had also never received “any formal anti-doping training or booklet”.

High concentration levels

Even though none of the substances was a threshold substance requiring the laboratory to provide concentration of the drug in the urine sample, NADA presented the following facts to the panel:

“Approximate rough concentration of substances: Prednisolone-191ng/ml, prednisone-317ng/ml, betamethasone-40ng/ml.”

The wrestler apparently claimed that she had applied Panderm Plus, a cream, to relieve pain. The medicine which can also contain clobetasol, a corticosteroid, is used for the treatment of skin rashes.

NADA pointed out that none of the prescriptions that she presented contained Panderm Plus. It need not have put forward an argument since the substances detected did not contain clobetasol.

The panel, chaired by Mr. Rajeev Kapoor, however concluded: “It is admitted case that the substances found in the sample was (sic) specified, therefore as per article 10.2.1 the ineligibility shall be for two years. In this case the athlete submitted that she consumed prednisolone, which contains the prohibited substance but same was prescribed by the doctor for severe back ache and not for performance enhancement. The athlete therefore showed and proved that how the substance entered in her body and therefore she is entitled to have reduced punishment.”

NADA argued in vain that the athlete “must have intentionally consumed the prohibited substance as the laboratory reports show that the sample contained different substances belonging to the same group.”

One medicine caused it all?

Apart from medrol, the drugs given in the prescriptions were Zerodol MR (combination of aceclofenac, a non-steroidal anti-inflammatory drug, tizanidine, a muscle relaxant, and paracetamol, anti-inflammatory and fever-reducing medicine), Rantac (antacid), Tryptomer 25 (anti-depressant) and a cough syrup.

Even if assuming that Medrol, which contained methylprednisolone, did contribute prednisolone (while failing to produce the parent drug methylprednisolone or any of its primary metabolites in the urine sample), how did Medrol and the rest of the medicines either together or singly produce betamethasone?

It was apparently assumed that the class of substances being the same (glucocorticosteroids), the presence of methylprednisolone in one of the medicines was enough to prove that the positive test for prednisone, prednisolone and betamethasone was established.

It has long been accepted, even in India, that a mere prescription is no certificate to consume banned drugs.

No clue what doping control form contained

The order of the panel did not mention whether the drugs claimed to have been prescribed for back ache were mentioned in the doping control form by the athlete.

How the substance entered an athlete’s body is the key clause that determines whether “no significant fault or negligence” (article 10.5.2) could be applied in a case. Though in this case there was no explanation as to how this had been proved, as NADA pointed out, the panel concluded:

“In view of the above, the panel has no hesitation in holding that athlete was successful in proving that (sic) how the substance had entered her body and according to article 10.5.1.1 the period of eligibility (sic) shall be reduced if the athlete re-established that she was not significant fault and negligence (sic). Therefore it is decided that the period of ineligibility in this case will be 1 (one) year which will start from the date of provisional suspension i.e. from 13-04-2015”.

At one stage the order states: “These seems (sic) that the athlete indirectly admits her guilt and nor in the position (sic) to explain which resulted (sic) in prohibited substance entered in her body”

Contradictory

Through the above paragraph, the panel has possibly suggested that the athlete could not explain how the prohibited substance entered her body. Yet the panel also concluded in its final summing up that the athlete was “successful in proving” how the substance entered her body!

Thus we have two cases of glucocorticosteroids use, ending in two drastically different sanctions. The Tamil Nadu athlete did not even know perhaps how to argue that his case came under ‘specified substances’ and it was up to NADA to prove that he had taken the banned substance intentionally. Otherwise the worst that he could have got was a two-year suspension. He got four.

The female wrestler, represented by a lawyer, managed to not only convince the panel that it had to go by the prescriptions she presented, though she did not have a TUE to use any of the medicines (and the prescribed medicines did not account for all the drugs detected in her urine sample), and oral administration of prednisolone/prednisone etc was clearly banned, but also that she deserved further reduction under the “no significant fault or negligence” clause.

The wrestler’s village background and lack of understanding of English and familiarity with NADA rules were cited in the order as mitigating factors. The fact that it was her first doping offence also went in her favour. Strangely the fact that she had not tested positive for a “masking agent” was also mentioned to drive home the point that she was not intending to dope!

It is not the first time that disciplinary panels in India have taken note of the “village background” of an athlete, lack of understanding of English, lack of education material having been made available to the athletes etc in reducing sanctions.

But then the Tamil Nadu 400m runner also confessed that he was unaware of the rules that stipulated application and approval for a TUE in case some prohibited medicines were to be consumed. Mere ignorance of rules and procedures did not provide an alibi for him. He did not even get the concession that the ‘specified substance’ allowed him under the anti-doping rules.

NADA will need to make enthusiastic efforts to counter this argument about lack of awareness regarding the rules by holding more ‘athletes outreach’ programme in the coming months and years if its anti-doping efforts have to prove successful.

WADA and NADA, apart from educating athletes and support personnel about doping and anti-doping measures, about the harmful effects of the drugs etc, will also need to hold workshops and seminars involving legal experts and international arbitrators to make Indian panel members acquaint themselves better with the provisions of the Code.

(updated 01-04-2016)