Drug probe doctor 'altered athlete medical records'

L-carnitine
L-carnitine is a legal supplement which helps convert fat to energy

The doctor at the centre of the Nike Oregon Project (NOP) drugs investigation altered athletes' medical records before handing them to anti-doping authorities, according to new disclosures.

Dr Jeffrey Brown, along with controversial NOP coach Alberto Salazar, has been under investigation by the US Anti-Doping Agency (Usada), since the BBC's Panorama programme and ProPublica alleged doping and unethical practice at NOP in 2015.

The elite endurance camp is funded by Nike and led by Salazar, who has coached Britain's double Olympic champion Mo Farah since 2011.

Both Salazar and Dr Brown strongly deny any wrongdoing.

In February this year, an interim report by Usada investigators into the NOP claims was leaked by the Russian hacking group Fancy Bears. Details of various alleged anti-doping rule breaches outlined in the report were published by the Sunday Times, the BBC and the New York Times.

Usada has yet to formally charge anyone in relation to its investigation.

Boost performance

Now, new disclosures seen by the BBC and ProPublica further implicate Dr Brown, a Texas-based endocrinologist who has treated many of Salazar's athletes and has been previously accused of prescribing thyroid medication (which is not banned under World Anti-Doping Agency rules) to athletes to boost performance. Dr Brown denies this.

Dr Brown, who is Salazar's personal physician, handed to Usada the medical records of certain athletes, including Steve Magness, then also Salazar's assistant coach.

But Magness, a central contributor to the BBC/ProPublica investigation in 2015, says his medical notes have been altered by Dr Brown.

He says he asked for a copy of his notes to be provided to him in August 2015, before he signed a release form to allow Usada to recover them from his former physician.

One note shows details of an infusion of a controversial but legal supplement L-carnitine carried out by Dr Brown in his office in Texas, on the instructions of Salazar, in 2011.

The notes

The note on the left is, according to Magness, his copy of the note of the infusion, a medical procedure that involved Dr Brown putting him on a drip for more than four hours.

In the same note later provided by Dr Brown's office to Usada, on the right, and seen in the Usada report, various additions appear to have been made.

A number of ticks seem to have been added under 'EXAM' options, including 'General,' 'Lungs,' 'Thyroid,' 'CV' (cardio vascular), and 'Neuro,' suggesting a full health check has been carried out by Dr Brown on Magness.

Magness, who left NOP in 2012 and is now a coach at the University of Houston, says those checks were never done.

He says: "I do not recall these being done. I wasn't even in a patient room, but instead in his office during this visit. I do not recall him going through his normal checks of my thyroid or [anything else].

"My only speculation is that [those boxes were ticked] to make it look like care for the patient had been given. He might have realised after the fact that when you have a patient, your doctoral duty is to the health of that individual.

"And that without the proper checks, it might look like he was prioritising a company, Nike, Salazar, that was paying him over the health of his patient.

"Dr Brown had been my physician since the age of 16."

Anti-doping rules

The Usada reports alleges Dr Brown committed at least four anti-doping violations.

Dr Brown strongly denies breaking anti-doping rules.

The Texas Medical Board is also investigating Dr Brown, but it declined to comment.

The supplement, L Carnitine, is legal, and is produced naturally in the body and helps convert fat to energy.

Salazar had been excited by a study suggesting the benefits of L-carnitine and had been eager to try it on his athletes.

Alberto Salazar
Alberto Salazar denies any wrongdoing

After trialling it on Magness, Salazar wrote to Lance Armstrong, who was then training for a long-distance triathlon.

He told the now disgraced former cyclist: "Lance, call me asap! We have tested it and it's amazing. You are the only athlete I'm going to tell the actual numbers to other than Galen Rupp. It's too incredible."

Magness says he had been a reluctant guinea pig.

Wada rules stipulate that infusions of any kind must be of less than 50ml every six hours - but according to the Usada report infusions of this relatively tiny amount of L-carnitine would be largely useless to an athlete's performance.

Analysing the available data from the notes, Usada experts have concluded the infusion levels must have been much greater than 50ml and therefore constitute a breach of doping rules.

'Larger conspiracy'

Usada believes similar protocols were used on up to six of Salazar's other US NOP athletes, including Dathan Ritzenhein.

Usada also believe the medical notes relating to Ritzenhein provided by Dr Brown have also been altered surreptitiously to suggest the infusion was within the Wada limit of 50ml. In this case, an annotation of "40ml" appears to have been added before submission to Usada.

The Usada report concludes that Salazar and Dr Brown were aware that infusions given to NOP athletes including Magness and Ritzenhein were above the legal limits and broke Wada rules.

The report concludes: "Usada has found that these potential anti-doping rule violations appear to have wholly or largely occurred in the context of a larger conspiracy between Nike Oregon Project coach Alberto Salazar and Houston endocrinologist Dr Jeffrey Brown to collude in order to employ risky and untested alternative and unconventional [and sometimes potentially unlawful] uses of medical procedures and prescription medications [including both substances and methods prohibited under the rules of sport…] to attempt to increase the testosterone, energy and blood levels of Nike Oregon Project athletes in order to boost athletic performance."

The Usada report credits Magness, who became aware that rules had been broken, for withdrawing from future competitions because he felt he had been given an unfair advantage.

Steve Magness
Steve Magness has contributed to the Usada investigation

Though Magness has contributed significantly to the Usada investigation as a whistleblower, he may also face a ban for his part in the L-carnitine experiment.

Dr Brown's lawyer told the BBC and ProPublica the allegations against him were false.

In a letter, lawyer Joan Bain stated the Usada report "leak" was unlawful and accused it of "fake news".

Ms Bain said patient confidentiality prevented Dr Brown from responding to specific enquiries.

'False information'

Ms Bain was also highly critical of Usada and its investigation, stating: "Notwithstanding its name, you should understand that Usada is not an official government entity, but rather a private corporation which stands to gain financially through publicity, essentially using the press to spread its own 'fake news'."

She wrote that this was the "latest attempt by Usada to bait Dr Brown into breaking the law by 'leaking' false information to journalists in the hope that Dr Brown will cross the line while trying to defend himself".

In reference to the allegations notes were altered, she said: "No-one at Dr Brown's office has inappropriately changed medical records. All medical records provided to Usada were accurate and provided with the patient's consent."

She added: "Dr Brown did not break any Wada rules and is unaware of any violation of Wada rules by Alberto Salazar… Dr Brown did not infuse any active athlete with more than 50ml of an L-carnitine solution. L-carnitine is an FDA approved amino acid supplement. It is not a banned substance."

Following the response from Ms Bain, Magness wrote to her and Dr Brown waiving confidentiality on the specific notes the BBC and ProPublica were enquiring about, but Ms Bain did not provide further comment.

Legal limit

Alberto Salazar has always strenuously denied breaking Wada rules or putting the health of his athletes at risk, and in response to the BBC and ProPublica's investigation published a lengthy and detailed response.

In 2014, Mo Farah received an injection of L-carnitine before a major race which UK Athletics (UKA) doctor Robin Chakraverty failed to record properly.

Before the Culture, Media and Sport Select Committee in April, Dr Chakraverty said the injection was 13.5mls, well within the legal limit of 50ml, though UKA chairman Ed Warner called his failure to record the treatment properly "inexcusable".

The use of the substance by Farah remains under investigation by Usada, according to the leaked report, to determine whether rules were broken.

Farah says he has never broken any rules and has vowed to stand by Salazar unless he's proven to have cheated anti-doping rules.

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