CAS 2002/A/383 IAAF vs CBAt & Dos Santos

In May 2001 the IAAF reported an anti-doping rule violation against the Brazilian Athlete Fabiane Dos Santos after her A and B samples tested positive for the prohibited substance Testosterone with a T/E ratio above the WADA threshold. The Athlete's samples were collected in May 2001 in Brazil and in June 2001 in Spain and thereupon tested in the Laboratories in Montreal, Madrid, Oslo and Cologne.

Considering the findings of the Laboratories and the opinion of experts the IAAF concluded that the positive findings of the samples provided in Brazil were related to application of exogenous androgenic steroids and not to a pathological of physiological condition.

However the Brazilian Athletics Confederation (CBAt) Sports High Court accepted the evidence of an expert witness and decided on 11 March 2002 to absolve the Athlete due to there was doubt about the reliability of the B sample results.

Hereafter in May 2002 the IAAF appealed the CBAt Decision with the Court of Arbitration for Sport (CAS). The IAAF requested the Panel to set aside the Appealed Decision and to impose a lifetime ban on the Athlete.

The Panel assessed and addressed the following issues raised by the Parties:

• The doping offence;
• The Athlete's T/E ratio is inconsistent with normal endogenous production;
• IRMS analysis demonstrates that synthetic Testosterone was exogenously administered;
• The Athlete's allegation that the A sample and B sample are not from the same person;
• The Athlete's submission that Prof. Ayotte and Prof. Hemmersbach are not independent;
• The Athlete's submission that there was a violation of due process.

Accordingly the Panel determines that:

1. a prohibited substance, Testosterone, was present in the body of Ms. Dos Santos;
2. the presence of this prohibited substancej in and of itself, constitutes "doping" within the meaning of IAAF Rule 55.2;
3. this is the Athlete's second doping offence;
4. pursuant to IAAF Rule 60.2, the sanction of “ineligibility for life” automatically applies in the case of a second doping offence, and, therefore;
5. the CBAt Sports High Court "reached erroneous conclusion" within the meaning of IAAF Rule 22.3 when it absolved M. Dos Santos of a doping offence in its decision dated 11 March 2002.

Therefore the Court of Arbitration for Sport decides on 27 January 2003:

1.) The Appeal filed by the IAAF on 13 May 2002 is granted in part.

2.) The decision lssued by the CBAt's Sport High Court in Mauaus City on 11 March 2002 shall be modified as follows:

"Ms. Fablane Dos Santos committed an offence of doping within the meaning of IAAF Rufe 55.2(i) and is declared ineligible for life pursuant to IAAF Rule 60. 2(a)(II)".

3.) The Court Office fee of CH 500.- (five hundred Swiss francs) already paid by the IAAF shall be retained by the CAS.

4.) IAAF and CBAt shall each bear their own costs. IAAF is ordered to pay an amount of CH 5'000 (five thousand Swiss francs), together with interests at 5% from tho date of the decision, to Ms Fabiane Dos Santos as a contribution towards her fogal fees and expenses.

CAS 2010/A/2162 Doping Control Centre, Universiti Sains Malaysia v. World Anti-Doping Agency (WADA)

• Doping
• Revocation of a laboratory’s accreditation
• CAS power of review
• Duty of a first instance body to act fairly
• Standard of proof
• Duty of a laboratory to be aware of and implement all WADA technical documents
• Absence of harm
• Duty of a laboratory to operate and be seen to operate according to implemented standards

1. The reference in art. R57 of the Code to the power to review the facts and law does not refer to the facts and law that were before the body producing the original decision. The facts and law referred to are rather those which bear on the issues in the appeal: CAS is restricted only by the subjective and objective limits of the case remitted to it. Any more limited interpretation would have the potential to create unfairness for both parties, by disabling an appellant as well as a respondent from adducing fresh relevant material before CAS. It would also place an obstacle in the path of sensible and speedy resolution of a dispute which is particularly desirable in the world of sport.

2. The fact that a first instance body’s decision may be cured by the appeal to CAS does not have as its corollary an absence of requirement for such first instance body to act fairly. It is obliged to obey the two basic rules of natural justice audi alteram partem and nemo judex in causa sua i.e. to let the party to know the case against it and to give it an opportunity to respond; and to have the issue determined by a body that both is and is seen to be impartial and independent. Failure to comply with these fundamental principles may incite the recipient of an adverse decision to appeal when it might not otherwise have done so. It also deprives the decision (and its reasoning) of such utility it might otherwise have by way of guidance for the CAS Panel in its appellate capacity. Moreover, it risks undermining the stature of the first instance body itself.

3. In a novel situation which does not concern a usual disciplinary case of a doping offence engaging the established test of “comfortable satisfaction”, it must be determined precisely what standard of proof should apply. It is not appropriate to assess whether a laboratory deserves revocation of accreditation in purely quantitative terms. The assessment must also be a qualitative one. Therefore, it is for a panel to decide on the balance of probabilities that the decision to revoke was wrong: WADA’s judgment must itself be accorded due deference, but the panel must nonetheless be persuaded that in all the circumstances, revocation is necessary to ensure the full reliability and accuracy of testing and the reporting of the same.

4. It is indisputable that a laboratory has an obligation to be aware of and implement all WADA technical documents. The plea of ignorance of the existence of key documentation because of technical or administrative problems faced by the laboratory aggravates rather than mitigates the offence.

5. The causation of loss by inappropriate actions is relevant to civil claims for compensation but not to disciplinary (or criminal) charges where it is the degree of fault and not its consequences which is relevant. Therefore, a plea that no harm was done by the errors is without weight.

6. The entire anti-doping system presupposes that, and can only work if, WADA-accredited laboratories actually operate in accordance with the International Standard for Laboratories and in accordance with their own Standard Operating Procedures. The credibility of the system also requires that laboratories be seen to operate in accordance with these standards: any doubts about one laboratory could very quickly jeopardise the entire system.

On 25 May 2010 the World Anti-Doping Agency (WADA) suspended the accreditation of the Malasian Doping Control Center in Penang with immediate effect. WADA deemed that the Center seriously and repeatedly had violated the ISL and relevant technical documents.

Hereafter in July 2010 the Centre appealed the WADA Decision with the Court of Arbitration for Sport (CAS). The Centre requested the Panel to declare illegal and unenforceable the imposed revokation of its accreditation.

WADA contended that the Centre is guilty of not solitary, but serial errors by way of imperfect sample analysis in breach both of the ISL and of its own Standard Operating Procedures (SOP). Also WADA asserted that these errors continued after a period of suspension in 2009.

The Panel assessed and addressed the existence and gravity of the analytical errors made by the Centre and established that the Centre had reported Adverse Analytical Findings (AAFs) for six athletes who did not dope. The Panel holds that the types of failures which led to these AAFs, and the Centre's attempt at explanation, raise serious questions about the Centre's managment.

The Panel concludes that the problems are growing, uncorrected at bench level and above and endemic. Without reform, of which there are no real signs, the reliability of the Centre’s work is suspect. The Panel therefore confirms WADA's revocation of the Centre's accreditation.

The Court of Arbitration for Sport decides on 15 June 2011:

1.) The appeal filed by Doping Control Centre, Universiti Sains Malaysia on 8 July 2010 is dismissed.

(…)

4.) All other and further prayers for relief are dismissed.

Tsitsimpikou C, Chrisostomou N, Papalexis P, Tsarouhas K, Tsatsakis A, Jamurtas A.
Int J Sport Nutr Exerc Metab. 2011 Oct;21(5):377-84

Although the use of nutritional supplements by professional athletes and the benefits thereof have been extensively studied, information on recreational athletes' use of supplements is limited. This study investigated the consumption of nutritional supplements, source of information and supply of supplements, and level of awareness with regard to the relevant legislation among individuals who undertake regular exercise in Athens, Greece. A closed-ended, anonymous questionnaire was answered by 329 subjects (180 men, 149 women), age 30.6 ± 12.1 yr, from 11 randomly selected gym centers. Preparations declared as anabolic agents by the users were submitted to a gas chromatographic analyzer coupled to a mass spectrometric detector. Consumption of nutritional supplements was reported by 41% of the study population, with proteins/amino acids and vitamins being the most popular. Age (r = .456, p = .035), sex (χ2 = 14.1, df = 1, p < .001), level of education (χ2 = 14.1, df = 3, p < .001), and profession (χ2 = 11.4, df = 4, p = .022) were associated with the subjects' decision to consume nutritional supplements. Most (67.1%) purchased products from health food stores. Only 17.1% had consulted a physician or nutritionist, and one third were aware of the relevant legislation. Two preparations were detected containing synthetic anabolic steroids not stated on the label. In conclusion, use of nutritional supplements was common among recreational athletes in Athens, Greece. A low level of awareness and low involvement of health care professionals as sources of information and supply were observed.

Facts
The Royal Dutch Athletics Association (Koninklijke Nederlandse Atletiek Unie, KNAU) reported a violation of the Anti-doping Code (ADC). His urine sample taken during a doping test was positive for the a metabolite of stanozolol which is on the list or prohibited substances. Also the B sample tested positive.

History
The athlete was unaware of the cause of contamination. He had sent a few products for testing to the RIVM for examination, and on of these products which was used to treat muscle pain contains a metabolite of stanozolol.

Decision
The disciplinary committee will impose a period of ineligibility of two years commencing on the date of the doping control.
The legal costs and fees will be borne by the athlete.

Facts
The Royal Dutch Billiards Federation (Koninklijke Nederlandse Biljartbond, KNBB) reported a violation of the Anti-Doping Code. During a competition match the defendant was tested, his A-sample was found positive for the prohibited substance benzoylecgonine, a metabolite of cocaine.

History
The defendant claims that the cause of the positive test was smoking cigarettes after drinking beers the day before the doping test. The cigarettes where offered by people he didn't knew. Since the doping control he didn't participate in competition anymore.

Decision
The disciplinary committee did not accept the defendant's statement and decides to impose a period of ineligibility of two years commencing on the day of the decision.
The legal costs and fees will be borne by the defendant.

Facts
The French Basketball Federation (Fédération Française de Basket-Ball, FFBB) charges respondent M110 for a violation of the Anti-Doping Rules. During a match on May 27, 2012, a sample was taken for doping test purposes. The analysis of the sample showed the presence of prednisolone and prednisone. Prednisolone and prednisone are prohibited substance according the World Anti-Doping Agency (WADA) prohibited list, they are regarded as specified substances.

History
The positive test is caused by medication the respondent used to treat chronicle sinusitis. The use of the medication was mentioned on the doping test form. He has proof of subscriptions for this condition.

Decision
1. The respondent receives a warning.
2. The decision dated August 31, 2012, from the disciplinary committee of the FFBB will be cancelled.
3. The decision will start on the date of notification.
4. The decision will be published and sent to the parties involved.

Facts
Defendant appeals against a decision of the Disciplinary Committee from the Dutch Royal Strength Sport Fitness Federation (Koninklijke Nederlandse Krachtsport en Fitnessfederatie, KNKF).

History
Defendant didn't attend a doping test out of competition. The Defendant wasn't a member of the KNKF at that time and wasn't practicing his sport anymore. Due to sport injuries he ended his membership.

Submission appeal committee
Although a membership ends on the end of the calender year it is obvious the defendant ended his participation in active sport.

Decision
The Committee agrees that the defendant is released form all the charges and penalties. Legal costs and fees will be borne by the KNKF.

The supply of doping products and the potential of criminal law enforcement in anti-doping : an examination of Italy's experience : executive summary / Letizia Paoli, Alessandro Donati. - KU Leuven, 2013

Motivation and Aims of the Study:

The present study draws its main motivation from the growing dissatisfaction of World Anti-Doping Agency (WADA) and numerous international and national policy-makers with the traditional anti-doping approach. This has developed since the 1960s through the interaction of the International Olympic Committee (IOC), international sports federations, and national governments, and since 2001, WADA, “focus[ing] squarely on the athlete[s]” (WADA, 2010b) and their testing. The 2012 London Olympics again demonstrated the limits of athletes’ testing: despite the 6,000 tests conducted, only two athletes tested positive during the Olympics, whereas seven others were “caught” in the preceding two weeks, which also belong to the official testing period for the games (Associated Press, 2012; Niggli, 2013, personal communication).
Today, there is a growing consensus among national and international policy-makers and many scholars (e.g., Bannenberg and Rössner, 2006; Rössner, 2011; Howman, 2011; Houlihan and García, 2012; see also AFP, 2011) that a broader approach is needed, including the use of criminal law instruments and, specifically, the repression of “trafficking.” According to the WADA (2010), for example, “it is imperative that additional strategies be combined with testing, research and education to ensure an efficient and effective anti-doping fight.” Testing alone cannot tackle five of the eight core violations listed in the WADA Anti-Doping Code, which constitutes the cornerstone of the current international drug 3 control regime and is implemented by national governments through the ratification of the 2005 UNESCO International Convention against Doping in Sport.

In this study, we have examined Italy’s anti-doping criminal law experience with the two main aims:
1) analyzing the production and distribution (collectively referred to as trade or supply) of doping products—an expression that includes both doping substances and methods and
2) understanding how anti-doping criminal provisions and their enforcement can contribute to improve the fight against doping within and outside the sports world. Since the late 1990s, in fact, Italy has played a pioneering role in the criminal law control of doping, and numerous investigations have shed light in Italy on different facets of the problem of doping and specifically of the supply of doping products.

By implementing a multi-method research design (see below), we have mapped the distribution system of doping products from producers to final users in Italy and built a typology of suppliers, identifying their motivations, modus operandi and mutual relationships and assessing their revenues and profits. On the basis of the same and other secondary sources, we have also evaluated the legislative bases, actors and outcomes of Italy’s anti-doping criminal law action, identifying a series of challenges that this action faces. To provide necessary context for assessing the supply of doping products, we have also estimated the size and financial dimensions of the Italian market for doping products—to our knowledge our study constitutes the first attempt to estimate these aspects of a national market for doping products.

Melanotan II injection resulting in systemic toxicity and rhabdomyolysis / Nelson ME, Bryant SM, Aks SE
Clin Toxicol (Phila). 2012 Dec;50(10):1169-73

INTRODUCTION:
Melanotan products are currently purchased over the Internet and are designed to induce melanogenesis to create sunless tanning as well are used as sexual stimulants. We report a novel case of systemic toxicity with sympathomimetic excess and rhabdomyolysis after use of Melanotan II.

CASE REPORT:
A 39 year-old Caucasian male injected subcutaneously 6 mg of Melanotan II purchased over the Internet in an attempt to darken his skin during wintertime. This dose was six times the recommended starting dose per the patient. In the emergency department two hours post injection, he complained of diffuse body aches, sweating, and a sensation of anxiety. Vital signs included BP 151/85 mmHg, HR 130 bpm that peaked at 146 bpm, and temperature of 97.8°F. Physical exam demonstrated a restless and anxious appearing male with mydriasis, diaphoresis, tachycardia, and diffuse muscle tremors. Pertinent laboratory values were creatinine 2.25 mg/dL, CPK 1760 IU/L, troponin 0.23 ng/mL, WBC 19.1 k/μL. Urinalysis demonstrated 3 + blood with red cell casts but 0-2 RBC/hpf. Qualitative urine drug screen was negative for metabolites of cocaine and amphetamines but positive for opiates. The patient received benzodiazepines for agitation and anxiety and had improvement in his symptoms. He was admitted to the ICU and during hospitalization his CPK elevated to 17773 IU/L 12 hours later. He continued to receive intravenous fluids with sodium bicarbonate for rhabdomyolysis and his CPK decreased to 2622 IU/L with improvement of creatinine to 1.23 mg/dL upon discharge from the ICU after 3 days. The substance, which he injected, was analyzed via mass spectrometry and was confirmed to be Melanotan II when compared with an industry purchased standard sample.

DISCUSSION:
Melanotan products are purchased via the Internet and have three main formulations (Melanotan I, Melanotan II, and bremelanotide). Melanotan I increases melanogenesis and eumelanin content to produce sunless tanning. Melanotan II also increases skin pigmentation but also produces spontaneous penile erections and sexual stimulation. Bremelanotide is a variation of Melanotan II that is specifically designed for sexual stimulation. This unique case highlights the potential of systemic toxicity with sympathomimetic excess, rhabdomyolysis, and renal dysfunction from Melanotan II use.

CONCLUSION:
Melanotan II use resulted in systemic toxicity including apparent sympathomimetic symptoms, rhabdomyolysis, and renal dysfunction.

Antonino Bianco, Caterina Mammina, Antonio Paoli, Marianna Bellafiore, Giuseppe Battaglia, Giovanni Caramazza, Antonio Palma, and Monèm Jemni
J Int Soc Sports Nutr. 2011; 8: 25.

Background: It is known that supplement use is a widespread and accepted practice by athletes and people who attend commercial gyms. Little is known about protein supplement amongst people undertaking strength trainingin commercial gyms in Italy when compared to the US.

Objective: The purpose of this study was to examine the use of protein supplementation, alone or in association with other supplements, and dietary behavior amongst regular fitness center attendees in Palermo, Italy.

Design: Resistance training information have been collected from 800 regular fitness center attendees for the initial analysis. A specific questionnaire was generated for the experimentation. Data were collected using a face-toface interview method. Supplement users were then compared to the non users and analyzed using a one-way ANOVA, Kruskall-Wallis, chi-square test or exact test of Fisher when appropriate.

Results: 30.1% of the respondents use dietary supplements during their training as a believe it is the “way to gain muscles and strength”. Whey protein shakes (50.0%) mixed with creatine and amino-acids (48.3%) were the most frequent choices amongst the users. A majority of the subjects (34.0%) appeared to rely on their gym instructors’ advice for their intake; a lower proportion (13.0%) consulted physicians, while none of them consulted nutritionists.
A high consumption of milk has been noticed in both users (67,7%) and non-users (52,8%); supplement non-users consumed significantly more snacks and bakery products than users per week (P < 0.001), while users consumed significantly more protein-rich foods (P < 0.01) with a particular preference for meat (48.0%).

Conclusions: A considerable number of regular strength training adepts consume protein supplements mixed with other products (mainly creatine and amino-acids). Limited numbers consult “dietary specialists” and rely mainly on their instructors. We emphasize on the importance of the dissemination of scientifically based
information about supplementation in this environment and the promotion of updated educational programs for the instructors.