ABOUT a month or two ago, a slightly agitated Dr Carlton Frazer made contact with me. He wanted me to read a report that he had sent to FIFA explaining the circumstances surrounding the administration of Dexamethasone to national player Jermaine Hue.
The Reggae Boy was an unused substitute in the June 11, FIFA World Cup qualifying match against Honduras, but was nevertheless tested based on the testing rules of FIFA. His sample returned an adverse analytical result for Dexamethasone, a corticosteroid often used to treat inflammation of the joints, but which is also listed on the 2013 WADA Prohibited List as an anabolic agent.
An anabolic agent is used to increase muscle size and strength and is linked to testosterone in males. It therefore gives an athlete more power to perform better. Dr Frazer had worked with the Reggae Boyz as a team doctor since 2007, and therefore clearly knows about the use of Therapeutic Use Exemption (TUE) for medications. If there is no alternative to the use of the otherwise prohibited substance and if the athlete would experience significant health problems without taking the otherwise banned substance, then a TUE can be granted by a medical panel.
A TUE thus gives the athlete via a certificate the authorisation to take the particular medication that falls under the prohibited list without applicable sanction. I, therefore, agreed with Dr Guyan Arscott, chairman of the Jamaica Football Federation Medical Committee about grey areas in terms of when an athlete becomes a patient. As he said, there are different approaches. How does the physician separate the athlete from the patient? I am sure Dr Frazer in his best judgement thought Jermaine was in pain in Honduras and administered the corticosteroid without thinking. Professionals have to be extra careful, especially team doctors.
If there is an emergency administration of drug, a TUE must be filled out immediately. The doctor must explain to the athlete if alert, what was given. It is advisable to have a chaperone or witness with the athlete because often the athlete might not be able to decipher the information. If the athlete is tested, he/she should know what was administered and declare all medications and substances taken or have been taken in the previous seven days as the kidneys may not have cleared the substances from the system.
After reading Dr Frazer's report to FIFA, I told him, I was a little afraid that he might be unfairly punished because there is a suspicion of irregular practices associated with Jamaica. He assured me that he was fairly confident that the report explained everything. He had done an extensive medical search of the literature on the drug, compiled a comprehensive report with relevant citations and case history and therefore felt the panel should be convinced he did no wrong.
My recommendation was that he visit the FIFA and CAS websites to compare his case to similar cases that dealt with the absence of a TUE. I also recommended that he talked to a professional friend who was an executive in FIFA and have dealt with sport arbitration matters in the European Union for guidance. He said he felt he should be 'OK' and was willing to take his sanction if any.
I know he never thought he would get four years.
What is more frightening is that a new article 2.10 has been drafted in the World Anti-doping Code and will likely be adapted as part of the revised code for 2015. Proposed article 2.10 makes it a violation for athletes and support persons to associate with a coach or trainer, doctor or manager who is currently serving a ban, or has in the last eight years been convicted of conduct that would amount to a violation.
So even in 2017 when Dr Frazer's sanction should be lifted, based on the new rule, he will quite likely not be able to associate with footballers before 2023. By then, he will be almost 80 years old.
And poor Jermaine, he went to Honduras as a national representative was treated by the team doctor and got banned. Jermaine, this is a warning to you and all athletes. There is the Strict Liability Clause. You are responsible for whatever gets into your system regardless of where, who or what.
Jermaine, please listen to something even more frightening than your case. If a doctor prescribes a banned drug and you are cleared to use it by a TUE and the pharmacist dispenses a similar drug which is slightly different to the one on the prescription, you can be sanctioned.
When all is said and done there are certain questions I would like to address to the JFF. Do you have a TUE committee that is fully functional? And if so, why would a longstanding member of your medical team administer a drug that FIFA probably felt should not have been administered. Was there a knowledgeable manager at the match who co-ordinates the day's happenings, and if so, why did the manager not remind Dr Frazer and Mr Hue about the missing TUE? The blame cannot be theirs alone. This is unacceptable and I hope this serves as a wake-up call for the JFF.
Football is serious business.
Editor's note: Dr Rachael Irving is Senior Research Fellow in the Department of Basic Medical Sciences, Faculty of Medical Sciences at the University of the West Indies, Mona.