Froome and Wiggins TUEs

[smutchin]

Here's UKAD's statement about the jiffy bag - no mention of any other areas of investigation:
https://www.ukad.org.uk/news/articl...vestigation-into-the-package-delivered-to-tea

 

[mjr]

http://www.cyclingnews.com/news/cancellara-cummings-fuglsang-featured-in-latest-fancy-bears-leak/

Backdated TUEs for Cancellara but I think I remember at least one of the bee stings - but do the hanging judges here think a bee sting should end your stage race?

Undated stuff for Fuglsang saying MTB but with a Rio logo on it. Very strange. Anyone else thinking that might be faked? Has Vino upset some Russians lately?

Cummings for Salbutamol back when at Barloworld - a TUE that maybe wouldn't be needed now. The main interesting thing is it's another Barloworld 2009 rider like Froome... but is Impey's contaminated capsules case the closest that cohort has come to doping so far?

 

[Bollo]

pretty sure they investigated a lot more than just the jiffy bag and why would you investigate a TUE?

It's not so much 'why investigate a TUE' as 'on what grounds can you investigate a TUE'. At the moment, the teams have been able to assert their own medical justification for anything with limited scrutiny or blow-back (until now), as long at they don't bang up against the prohibited or restricted lists.

As @Milkfloat and others have pointed out, anything not prohibited by the rules can't be against the rules. Expand the rules to close the loopholes, even if it prevents under-par riders from continuing. If a rider needs an asthma shot then tough, out of the race. The only risk would be that riders might come under pressure or choose to turn down treatment in order to remain in the race. In this case the real responsibility would reside with he team doctors under their duty of care to the riders, with the risk of being struck off.

 

[Bollo]

Backdated TUEs for Cancellara but I think I remember at least one of the bee stings - but do the hanging judges here think a bee sting should end your stage race?

If it required treatment with a substance that's on a recognised list as a PED, then yes, it should end your race. Send him down.

 

[smutchin]

Backdated TUEs for Cancellara but I think I remember at least one of the bee stings - but do the hanging judges here think a bee sting should end your stage race?

Older readers will remember Jonathan Vaughters quitting the 2001 Tour for just that reason - if he'd gone to the doctor complaining of knee pain, he could have had the injection, but the rules didn't allow injections for allergic reactions at the time.

If only he'd stayed at USPS, he would have had free rein over the medicine cabinet without risk of the officials interfering.

 

[mjr]

If it required treatment with a substance that's on a recognised list as a PED, then yes, it should end your race. Send him down.

Did it require treatment with a PED or is it just that the treatment hospitals use is one that's a PED? Choices may be limited... but maybe at World Tour level, there's a strong argument that team doctors should be carrying the preferred medication for any riders with known allergies so there should be no second TUE for an in-race case.

 

[mjr]

Expand the rules to close the loopholes, even if it prevents under-par riders from continuing. If a rider needs an asthma shot then tough, out of the race. The only risk would be that riders might come under pressure or choose to turn down treatment in order to remain in the race.

Does anyone really think that's the only risk? I suspect that idea would fark over a lot of paralympians - but hey, survival of the fittest and no-one with any treatable chronic illness should even think of athletic competition. How about we send them all to camps(?)

 

[mjr]

I'm imagining teams secretly launching angry bees at their riders from their team cars in order to justify a mega-dose of Wasp-Eze.

I'm fairly sure I remember reading of riders in the 1990s allegedly doing silly stuff like walking into walls or injuring each other in attempts to cause not-very-cycling-impairing injuries so they'd have an arguable medical reason for a steroid shot, but I don't remember whose book it was.

 

[jowwy]

There was a separate investigation looking into JTL's claims that Tramadol was being handed out like sweets at the 2012 World Championships but I can't remember if that came to anything.



If a TUE has been obtained under false pretences, that is a clear anti-doping violation.

how would they know if its false pretences when the UCI would need medical evidence to sign it off?? just asking questions here

 

[Milkfloat]

I agree with @Dogtrousers , I am not anti-TUE, I am anti the teams doctors and UCI having control over it. If a TUE is needed then it should be an independent body (WADA?) who investigate and grant/deny it.

 

[Bollo]

Does anyone really think that's the only risk? I suspect that idea would fark over a lot of paralympians - but hey, survival of the fittest and no-one with any treatable chronic illness should even think of athletic competition. How about we send them all to camps(?)

That's hyperbole and you know it (and an indirect invocation of Godwin. And I don't like the inference). So, how do you deal with Oscar Pistorius' bid to run in the Olympics? At what point does his prosthesis cease to compensate for a disability and start to become an enhancement? And the converse - should Caster Semenya have to take hormones to be allowed to compete in women's races? The answer is that there are no simple answers, only decisions and consequences.

I'm quite happy to argue the other approach where we have a list of proscribed or restricted medicines. Outside that riders are free to take what the hell they want. I don't actually care that much, because I don't look to sports-people for validation or moral guidance.

 

[smutchin]

how would they know if its false pretences when the UCI would need medical evidence to sign it off?? just asking questions here

The system hasn't been rigorously policed in the past - it's largely a case of self-reporting. If the team doctor says the rider needs the meds, the UCI doctor will sign off the TUE without asking too many questions. Given the findings of the DCMS committee, UKAD may well decide to open an investigation into Wiggo's TUEs - and Lappartient is talking about getting the CDAF to investigate as well. I don't know how they would prove it, but if there are grounds to suspect wrongdoing, it should be investigated at least.

In some cases in the past, such as Lance's infamous saddle sore as mentioned by @Dogtrousers, evidence has surfaced of active complicity by the UCI to bend the rules. I don't think Lappartient would countenance anything like that, to be fair, but it's clear that the TUE system still needs further reforms to prevent potential abuse by teams.

I agree with @Milkfloat that any requests for TUEs should be investigated by an independent doctor, not a team employee, and preferably not a UCI employee either. In fact, I think I already said something similar upthread. Such measures would, however, be costly to implement.

 

[jowwy]

The system hasn't been rigorously policed in the past - it's largely a case of self-reporting. If the team doctor says the rider needs the meds, the UCI doctor will sign off the TUE without asking too many questions. Given the findings of the DCMS committee, UKAD may well decide to open an investigation into Wiggo's TUEs - and Lappartient is talking about getting the CDAF to investigate as well. I don't know how they would prove it, but if there are grounds to suspect wrongdoing, it should be investigated at least.

In some cases in the past, such as Lance's infamous saddle sore as mentioned by @Dogtrousers, evidence has surfaced of active complicity by the UCI to bend the rules. I don't think Lappartient would countenance anything like that, to be fair, but it's clear that the TUE system still needs further reforms to prevent potential abuse by teams.

I agree with @Milkfloat that any requests for TUEs should be investigated by an independent doctor, not a team employee, and preferably not a UCI employee either. In fact, I think I already said something similar upthread. Such measures would, however, be costly to implement.

so unless this has changed recently, this is what is required to get a TUE

TUEs related to beta-2 agonist medication to treat asthma
Inhaled beta-2 agonists are prohibited at all times and require a Therapeutic Use Exemption (TUE), except for:

• i. inhaled salbutamol when taken in dosages of less than 800 micrograms in any 12 hour period
• ii. inhaled formoterol when taken in dosages of less than 54 micrograms in any 24 hour period
• iii. inhaled salmeterol when taken in dosages of less than 200 micrograms in any 24 hour period

Inhaled terbutaline and inhaled indacterol are prohibited when taken in any dose and therefore require a TUE.

The following documentation is required to support a TUE application related to the use of prohibited beta-2 agonist medication to treat asthma:

• A complete and legible beta-2 agonist TUE application form
• Lung function test results
• Justification from the prescribing physician as to why permitted alternatives cannot be used

Athletes should check Global DRO for confirmation about the prohibited or permitted status of their asthma medication.

Standard TUE
For all other substances and methods, a standard TUE form is required.
The following medical evidence is required:

• History of medical condition
• Evidence of diagnosis (such as hospital review letters, test results, examinations and investigations)
• Evidence of using alternative permitted medications

--------------------------------------------------

So is that not enough evidence to get a TUE or do you think they should provide more? if so what?

 

[mjr]

That's hyperbole and you know it (and an indirect invocation of Godwin. And I don't like the inference).

Well, I didn't like the implication of almost any chronic condition getting riders disqualified. That felt like the view you were heading towards, that sport is only for the superhumans (in the old sense of the word).

So, how do you deal with Oscar Pistorius' bid to run in the Olympics? At what point does his prosthesis cease to compensate for a disability and start to become an enhancement?

I don't know and I think that's a much more difficult decision than a normally non-enhancing chronic illness treatment like salbutamol or even a one-off PED shot or tablet by A&E for a bee sting, so I'm surprised if you don't see prosthetic limbs as justifying a ban.

I'm quite happy to argue the other approach where we have a list of proscribed or restricted medicines. Outside that riders are free to take what the hell they want. I don't actually care that much, because I don't look to sports-people for validation or moral guidance.

It's not that I look to sports-people for validation or moral guidance, but more that I do care about whether people with chronic conditions are demonised.

 

[smutchin]

Standard TUE
For all other substances and methods, a standard TUE form is required.
The following medical evidence is required:

• History of medical condition
• Evidence of diagnosis (such as hospital review letters, test results, examinations and investigations)
• Evidence of using alternative permitted medications

--------------------------------------------------

So is that not enough evidence to get a TUE or do you think they should provide more? if so what?

In the case of Wiggins and the triamcinolone, it all hangs on the "evidence of diagnosis". If the diagnosis is made by the team doctor, what safeguards are in place to prevent fabrication of evidence? How stringent were the UCI in checking that evidence? These are the questions that an investigation would address.

This is why I think the diagnosis should be made by an independent doctor.