July 26th, 2012 By RingTalk
TEXAS CITED ON JULIO CESAR CHAVEZ JR. & ALISTAIR OVEREEM
By Eric Dexheimer of Statesman.com
Note from Pedro Fernandez: This is a lengthy in depth article that shows how “lame” the Texas Athletic Commission is on boxing and MMA. It also illustrates that the Assn. of Boxing Commissions has the strength of sewing thread. The author, Eric Dexheimer certainly did his homework.
Three months ago, professional mixed martial arts fighter Alistair Overeem of the UFC appeared before the Nevada Athletic Commission. A charismatic heavyweight from Holland with a superhero build, he had been scheduled to fight for the Ultimate Fighting Championship (UFC) heavyweight title in Las Vegas in May.
But in early April, Overeem had failed a random drug test administered by Nevada regulators, which revealed that he had four times the testosterone of most healthy young men. High levels of the hormone — considered a controlled substance — are forbidden because it can artificially enhance athletic performance.
At the April 24 hearing, Overeem told Nevada commissioners he had unknowingly been injected with the synthetic hormone by a physician he’d seen a single time, for muscle soreness. The Texas doctor, Hector Oscar Molina, who also testified, confirmed he had injected the fighter at his Irving clinic with a four-drug cocktail that contained testosterone. He also gave Overeem a vial of the mixture so the fighter could self-administer additional doses later. Nevada’s regulators came down hard on Overeem, refusing to issue him a license for at least nine months.
Once a bloody curiosity among combative sports, MMA has grown into a billion-dollar business that rivals boxing in popularity. Fight experts estimated the Nevada sanction cost Overeem several million dollars.
For his part, Molina returned to Texas, where he not only continues to practice medicine but also is a state-licensed ringside physician representing the Department of Licensing and Regulation, the agency responsible for ensuring that boxing and martial arts rules are followed in Texas. State records show he has worked at more than two dozen events since late 2009 — including a fight card held three days prior to the Nevada hearing — in addition to performing an unknown number of pre-fight physical exams on behalf of the state regulatory department.
A spokeswoman for the Texas licensing agency said it had no plans to review Molina’s role in the Overeem case, nor did its rules address how to discipline a doctor. That a physician can admit to culpability in a Nevada doping incident yet continue to represent the agency responsible for regulating the same sports here raises questions about Texas’ oversight of combative sports, which has suffered a reputation of being permissive and ineffectual.
Molina explained that he gave Overeem testosterone to treat muscle soreness and speed recovery. And Overeem was “not the only one I’ve used it on,” the doctor told commissioners; he’d treated other fighters, as well as professional baseball, football and hockey players with the drug.
Yet endocrinologists say there is no medical reason to administer the hormone outside of certain specific and uncommon conditions. “There is absolutely no indication for the use of testosterone for muscle pain or injury,” said Dr. Steven Taylor, an assistant professor at the University of Texas Southwestern Medical School. Moreover, “We don’t just prescribe testosterone and send patients on their way; doctors need to monitor them closely.”
Under questioning from Nevada commissioners, Molina, who has twice been disciplined by the Texas Medical Board, for improperly prescribing drugs and a liposuction surgery gone bad, also agreed that he ignored common medical protocols by not telling Overeem what was in the drug mixture he injected.
“For a doctor to inject a professional athlete with a banned substance without their knowledge and proper consent is malpractice,” said Dr. Johnny Benjamin, a UT Southwestern-trained physician who in addition to his Florida surgery practice comments on mixed martial arts. “It’s embarrassing. I’m a proud Texan. But I’m not proud of this at all.”
No issues with Texas
Molina could not be reached for this story. A receptionist at his Men’s Performance Enhancement Clinic, with advertised sites in Fort Worth and Irving, said, “He’s the medical director, but does not come in on a daily basis.” He said he would leave Molina a message.
Molina also could not be contacted at the several North Texas medical clinics in his name. Numbers for offices in Garland and Fort Worth were disconnected. Kelly Akins, a Dallas attorney who represents Molina, said he asked his client to contact the Statesman; however, Molina did not respond over a week.
The Texas Department of Licensing and Regulation — as well as the head of the agency’s Combative Sports Medical Advisory Committee, which has not met in two years — referred questions to agency spokeswoman Susan Stanford. She said in a statement that Molina continues to meet the state’s legal requirements for licensing as a ringside physician: a current license with the Texas Medical Board and no felony convictions.
Applicants must also disclose if their medical license has been “revoked, suspended, probated or denied.” And “nobody has filed a complaint with us” against Molina, Stanford said. State rules contain no mechanism to review or remove a physician’s ringside license, she added.
That doesn’t mean the relationship should continue, said Keith Kizer, executive director of the Nevada Athletic Commission. “If I found out one of our doctors was giving a prohibited substance to a fighter,” he said, “I’d say maybe it’s time to do something else.” (He said a comparable situation has never come up in Nevada.)
Overeem’s testosterone suspension also reveals gaps in how regulators communicate with one another. States routinely honor sanctions against fighters levied in other jurisdictions; a boxer whose license is suspended in California can’t compete in New York. But the same give-and-take does not necessarily occur when it comes to keeping an eye on other regulated personnel — particularly physicians, who seldom suffer serious consequences in doping schemes.
Kizer agreed that sharing questionable behavior observed by his commission with other states “makes sense.” Nevertheless, he added, “I’ve got no plans to tell” Texas regulators about Molina’s role in Overeem’s failed drug test: “It’s pretty public what happened here. I’m sure the Texas Medical Board knows about it.” Incidentally, there are lots of Texas detox centers that could help athletes like Overeem get rid of any illicit substances out of their system.
No, it doesn’t, said Leigh Hopper, a spokeswoman for the agency. She said her agency, like the licensing and regulation department, opens investigations into physician misbehavior after receiving a complaint. “I wish Nevada had contacted us about this,” she said. “This is the type of thing we would look into.”
‘A greater problem’
At the very least, Molina’s treatment of Overeem adds to Texas’ reputation as an anything-goes place for professional fighting — where behavior not tolerated in other states is occasionally overlooked. “It speaks of a greater problem — the Texas DLR,” Benjamin said. “Texas has turned into a state that takes what other states reject.”
In 2009, boxer Antonio Margarito had his license suspended by the California State Athletic Commission after fight officials discovered plaster inserts wrapped in his boxing gloves prior to a title fight. In August 2010, when Margarito re-applied for a California license after Nevada turned him down, officials told him he’d have to wait another year to fight there.
“Some conduct is so egregious, you should never get a second chance,” the State of California’s attorney said at the time. Margarito’s infraction was considered serious enough that the Association of Boxing Commissions advised its member state regulatory agencies to insist the fighter appear in person to explain himself before deciding to issue him a license.
A week later, without requiring the fighter to appear, the Texas Department of Licensing and Regulation granted Margarito his license to fight Manny Pacquiao in Cowboys Stadium that November. “(We) did not agree with the Texas decision,” the association’s president, Timothy Lueckenhoff, said in an email.
Critics of the state’s fighting sports oversight also cite Texas’ bare-bones drug-testing program compared with some other states. While Kizer said Nevada has screened fighters for banned substances since 2001, Texas began drug testing its professional combatants only eight months ago. The result: Nevada’s program has uncovered 79 drug users; Texas’, only one, for marijuana.
On paper, Texas’ fledgling program now requires all fighters in championship bouts to undergo drug screening. For other professional fights, random tests — with eight to 12 fighters per card selected by computer — are done at the licensing commissioner’s discretion.
In the eight months since Texas began screening, Department of Licensing and Regulation records show slightly less than 300 professional boxing bouts were held in the state, including about a dozen championship fights. Yet, Stanford conceded, none of the more than 500 nonchampionship boxing contestants has been asked to submit to a random drug screen. “We’re still in the process of developing our protocols,” she said.
Even some of the boxers fighting in championship bouts have managed to bypass Texas drug screening. At a Feb. 4 card at the Alamodome, which included two title fights broadcast on HBO, none of the fighters was tested for drugs — including one, Julio Cesar Chavez Jr., who two years earlier was fined $10,000 and suspended for seven months by the Nevada Athletic Commission for using a banned substance.
The reason: the licensing department forgot to book a lab to perform the tests.
Doctor’s record spotty
Kizer said the Nevada Athletic Commission closely reviews a doctor’s past disciplinary record prior to granting a license to represent the state as ringside physician. If the Texas Department of Licensing and Regulation did that, it would find Molina to be a physician with a spotty record.
Texas Medical Board records show Molina was licensed to practice medicine in Texas in 1997. Five years later, the agency filed its first complaint against him.
Molina “on numerous occasions prescribed controlled substances and dangerous drugs over the Internet without ever seeing the patient, performing a physical examination or completing an adequate history,” the November 2003 complaint said. In one instance, Molina prescribed the painkiller Hydrocodone over the Internet to a patient already “in a drug rehabilitation facility as a result of his addiction to Hydrocodone.”
Molina agreed to a $25,000 fine and a three-year restriction on prescribing many painkillers, steroids, stimulants and depressants with potential for abuse. The medical board lifted the restriction in December 2005 after less than two years.
He was sanctioned again by the medical board three months ago, for “extensive liposuction on a patient that resulted in severe complications,” medical board records show. Molina, who is not a board-certified surgeon, said “his entire knowledge of the procedure consisted of reading a book provided by the manufacturer of the liposuction equipment, completing an online program over two weeks … and completing one procedure under the direct supervision of another surgeon,” according to board filings.
On April 13, Molina agreed to temporarily stop performing any cosmetic surgery, the agency documents show. Hopper said a final action by the medical board is still pending. The patient, Irma Carabajal Lecroy, has filed a lawsuit against Molina. In court filings, he has denied any wrongdoing. Akins, his lawyer, declined to comment on the suit.
In an interview, Lecroy said she was referred to Molina by a friend. Following her surgery, she said she was taken from Molina’s office by ambulance to an emergency room after her sister called 911; the doctor and his staff had left the clinic. More than 20 operations later to repair Molina’s liposuction, “I’m still unable to walk, I can’t sit for more than two hours, I can’t drive,” she said.
To support her lawsuit, Lecroy sought opinions of Molina’s work on her from plastic surgeons. After reviewing Molina’s medical records of the procedure, Houston physician Sean Boutros concluded, “It will be impossible for me to state more clearly what a gross deviation from the standard of care has occurred in this case.”
‘Tetra mix’ injection
Molina “is a very experienced physician,” Overeem’s attorney, David Chesnoff, said to open the April 24 Nevada hearing. “He has impeccable credentials.” Reached at his Las Vegas office, Chesnoff declined to answer questions. He said he would ask Overeem if he wanted to comment, but the fighter did not respond.
According to testimony during the two-hour proceeding (MMA Fight Corner, a Las Vegas radio show and news organization covering the sport, taped the entire hearing), Overeem first met Molina in June 2011, when the doctor, representing the Texas Department of Licensing and Regulation, performed a pre-fight examination on him. He next saw Molina on Jan. 12 at his clinic.
In Dallas on a promotional tour, Overeem arrived complaining of rib, elbow and thigh pain. It was “pretty vague,” Molina recalled to the Nevada commissioners. “I couldn’t really pinpoint” the cause. He said he conducted a physical exam and ordered X-rays, which were negative.
Still, he said, “being that he is a high-performance, high-grade athlete, I know he’s got to get back to training.” So he gave Overeem an injection of “tetra mix” — a combination of Vitamin B-12, the anti-inflammatory Dexamethosone, the painkiller Toradol and “an aqueous form of testosterone.”
When Overeem left the clinic, Molina said, he gave him a vial of the solution labeled “AO anti-inflammatory mixture.” Overeem said he self-injected the solution on March 23 after re-injuring his ribs and shoulder. Four days later, Nevada regulators took a sample of his urine. “That’s what I think caused the spike,” Molina testified, adding, “In the amount that it was given, should not be enough to enhance his performance.”
Overeem said he was never told what was in the mixture; Molina said he did not tell the fighter the injection contained testosterone. The doctor said that while he typically informed patients about their drugs and had them fill out a consent form, he did neither with Overeem.
Overeem said he was referred to Molina’s medical clinic by a retired Dallas MMA fighter, Tra Telligman. (Telligman could not be reached.) When asked what investigation he did on Molina prior to his visit, Overeem said, “I made none.”
But, he noted, it also didn’t occur to him that a physician who treated athletes would give him a banned substance: “In Holland, doctors cannot inject you with material that is on the (World Anti-Doping Agency) list. … It didn’t go through my mind that I was going to be injected by material that was illegal.”
Especially, Chesnoff stressed in his closing statement, not by a licensed doctor. “When you’re dealing with a physician who has credentials, who deals with other athletes — who Alistair met in the context of a sanctioned fight where the doctor was representing the governmental authority that was putting on the fight — was Alistair to question what he was getting?”
Contact Eric Dexheimer at 214-445-1774