Concussion Inc. (9 page)

18
More on this aspect of the hearing follows, in the chapter on Dr. Joe Maroon.

JOE MAROON AND OTHER PITTSBURGH WITCH DOCTORS

14 December 2009..........

In an article on ESPN.com about the brain damage of yet another dead pro wrestler, Andrew “Test” Martin,
1
World Wrestling Entertainment — the company of Connecticut U.S. Senate candidate Linda McMahon — stated in part: “WWE is unaware of the veracity of any of these tests, be it for Chris Benoit or Andrew Martin … WWE has been asking to see the research and test results in the case of Mr. Benoit for years and has not been supplied with them.”

The second sentence is a grossly, and characteristically, misleading statement by the pro wrestling death mill. The following background reveals that “lie” may not be too strong a word.

Here's the full chronology.

In June 2007, WWE star Chris Benoit murdered his wife and their son, and killed himself. Chris Nowinski, a former pro wrestler who had been forced to retire because of the cumulative effects of in-ring concussions, had started a research and advocacy group, and Nowinski prevailed upon Chris Benoit's father, Mike Benoit, to donate his son's brain for studies by Dr. Bennet Omalu, a pioneering researcher of what is being called chronic traumatic encephalopathy. Later in the year Nowinski and Mike Benoit publicized Omalu's research.

In March 2008, WWE began baseline neurological testing for its performers, using an emerging system of sports-medicine protocols called ImPACT. WWE itself did not announce this change. However, in an April 11, 2008, news release, Sports Legacy Institute's Nowinski, citing “anonymous wrestlers,” reported: “WWE management has instituted a concussion management program. At a mandatory meeting for all performers in early March WWE performers took a computerized neuropsychological testing protocol, which evaluates such things as memory, cognitive skills, and reaction time. They will be re-tested aggressively every six months to look for long-term health issues, as well as re-tested after suspected concussions to help determine when it is safe to return to in-ring action.”

According to Dave Meltzer, publisher of the authoritative
Wrestling
Observer Newsletter
, March 2008 corresponds with when Dr. Joseph Maroon was hired to coordinate WWE's ImPACT program and supervise the work of two doctors who henceforth traveled to all WWE shows.

On October 1, 2008, Dr. Maroon visited the Brain Injury Research Institute in Morgantown, West Virginia. The institute is co-directed by Dr. Julian Bailes, chair of the neurosurgery department at West Virginia University, and Dr. Omalu, a medical professor and coroner now based in California. Also present at the meeting were the brain institute's general counsel, Bob Fitzsimmons, and Peter Davies, a professor of pathology and neuroscience at Yeshiva University's Albert Einstein College of Medicine in New York.

On the phone with me this morning, Omalu was hopping mad about the WWE statement to ESPN. “Dr. Maroon was there with us and he was shown all our research information, slides, and specimens — on Chris Benoit and all the athletes' brains we studied,” Omalu said.

The only possible confusion about any of this would be painfully hairsplitting. But that's WWE's M.O.

Maroon also has long been a team physician for the NFL's Pittsburgh Steelers and a familiar league consultant throughout the public debate in recent years — culminating in hearings earlier this year before the House Judiciary Committee — over football concussions. An impossibly tortured rationalization could be offered to the effect that when Maroon was in West Virginia, he was representing the NFL, not WWE.

The WWE corporate website prominently calls Maroon the company “medical director.” Maroon's own website and bio at the University of Pittsburgh Medical Center say he became WWE medical director “in 2008,” though not the month. Again, March 2008 was when the company hired Maroon with a brain-injury portfolio, whether or not the title at the time was “medical director.”

Omalu pointed out that there is a lot more to how this story relates to the slow and grudging acceptance of his research by the NFL as well as by WWE. The October 2008 meeting was his third with Maroon dating back to 2006. Like WWE, the NFL started with a bureaucratic Alphonse and Gaston act of pretending to ignore Omalu or discredit his research.

For now, the story is that WWE's medical director was given full access to Chris Benoit brain studies, in person, 14 months before WWE told ESPN that the company “has been asking to see the research and tests results in the case of Mr. Benoit for years and has not been supplied with them.”

31 March 2010..........

I've been exploring how a cluster of University of Pittsburgh Medical Center physicians came to join the medical staff of World Wrestling Entertainment.

In my view, these three doctors — WWE medical director and neurologist Joseph Maroon, cardiologist Bryan Donohue, and endocrinologist Vijah Bahl — have done little except give political cover to this billion-dollar publicly traded corporation and to the McMahon family, which runs and profits from it.

At the moment, I am especially interested in Dr. Bryan Donohue, who is supposed to be supervising cardiovascular screening of WWE talent under a 2007 revision of the company wellness policy. In December 2009, six months after being fired by WWE for refusing to go to drug rehab, wrestler Eddie “Umaga” Fatu died at age 36 of a massive coronary brought on by a toxic mix of prescription medications. Fatu's autopsy showed that he had an enlarged heart.

In addition, Dr. Donohue's overall portfolio of outside business interests may be a bit too entrepreneurial for my blood. Leveraging his medical credentials, he recently started a hype-happy company in the largely unregulated supplement industry.

In 2008, the University of Pittsburgh Medical Center (UPMC) published a new ethics policy, which has been widely praised for controlling the undue influence of pharmaceutical companies on the clinical decisions of doctors. However, when I viewed the text of the policy online, I noticed it included links to general University of Pittsburgh guidelines for faculty conflicts of interest — and those links did not work.

Yesterday I spoke to Frank Raczkiewicz, a UPMC media relations director, about getting access to the blocked documents. Raczkiewicz referred me to Dr. Barbara Barnes, the UPMC vice president who authored the ethics policy. Dr. Barnes told me that the links within the UPMC ethics policy to the University of Pittsburgh policies were designed not to be publicly accessible because the latter are “internal” documents.

In our phone conversation yesterday, Dr. Barnes did not have time to get into the substance of my reporting on the relationship between UPMC and WWE. I emailed her with my contact information but did not hear back. Later yesterday I sent around to all the principals an email with the following text:

TO:

Ed Patru / Linda McMahon for Senate campaign, media relations

Robert Zimmerman / World Wrestling Entertainment, media relations

Bryan C. Donohue, M.D.

Joseph C. Maroon, M.D.

Barbara E. Barnes, M.D. / University of Pittsburgh Medical Center, Vice President of Continuing Medical Education, Contracts and Grants and Intellectual Property

Frank Raczkiewicz / University of Pittsburgh Medi­cal Center, media relations

I am about to post to my blog a report headlined, “­Umaga Autopsy Turns Focus to Linda McMahon's WWE Cardio Program and Docs.” The post — to which I invite all of your comments (see my contact information below) — includes the following points:

• The autopsy report on wrestler Eddie “Umaga” Fatu — a WWE performer until six months before his December 2009 death from a heart attack caused by prescription drug toxicity — showed that he had an enlarged heart. This raises questions about the cardiovascular screening under the WWE wellness policy. Dr. Maroon is WWE's medical director. Dr. Donohue is the consulting cardiologist.
  
• Dr. Maroon, Dr. Donohue, and a third member of the WWE medical team, Dr. Vijay Bahl, have UPMC practices. This raises questions about the UPMC ethics policy that took effect in February 2008.
  
• The UPMC ethics policy seems primarily aimed at the issue of pharmaceutical companies' inducements to doctors, which can compromise patient care. However, there are also general conflict-of-­interest issues, as well as specific ones involving physicians' relationships with the non-regulated supplement industry. Dr. Donohue is a co-­founder of a supplement company, which he aggressively promotes in media appearances. Dr. Maroon has written a book touting the same supplement and is cited prominently on its website.
  
• Dr. Maroon's professional associations in pro ­football — as a doctor for the Pittsburgh Steelers and as a member of the National Football League's concussion policy committee — are also noted. I point out the case of Richard Rydze, yet another UPMC physician who was dropped by the Steelers after he was found to have purchased huge quantities of growth hormone from the internet gray-market dealer Signature Pharmacy. I also review my previously published reports that Dr. Maroon's NFL concussion work has been criticized as too passive, and that he and WWE last year gave ESPN misleading information about his access to the postmortem brain studies of WWE performer Chris Benoit, who committed double murder/suicide in 2007.
  

9 September 2010..........

We have more information on Dr. Joseph Maroon and WWE's failure to disclose the October 1, 2008, meeting of experts at the West Virginia University Brain Injury Institute — where Maroon was shown studies of dead wrestler Chris Benoit's brain.

Among the participants in that meeting was Peter Davies, ­professor of pathology and neuroscience at Yeshiva University's Albert Einstein College of Medicine. Davies holds an endowed chair in Alzheimer's disease research and directs a center on Alzheimer's and memory disorders. Here is Davies' full statement to me:

I was at a meeting in West Virginia in October 2008, originally at the request of Dr. Ira Casson, who at the time was a member of the NFL Head Injury Committee (I'm not sure exactly what it was called then). Ira asked me to try to look at the material collected by Dr. Omalu and Dr. Bailes, because I am considered to be an expert in the kind of pathology that Dr. Omalu had reported seeing in the brains of ex-NFL and WWE cases. Dr. Omalu was not an expert in this kind of pathology, and Dr. Casson wanted an outside expert to see if there was anything significant going on. I was not then nor am I now affiliated with the NFL. I flew to West Virginia at my own expense: Dr Maroon (who was also a member of the NFL committee) “brokered” the meeting, arranging for me to meet with Dr. Omalu and Dr. Bailes, and I did have the chance to examine several brain sections.

It was clear that there was pathology in these ­cases, although Dr. Omalu had not done the kind of extensive staining of tissues that my lab has developed. I suggested to Dr. Omalu that my lab could do much more extensive staining on these cases to better define the pathology. Dr. Omalu readily agreed and sent me samples from several brains. We stained them and reported on our findings to the NFL committee in June 2009; a brief summary report was prepared ahead of the meeting and sent to Dr. Maroon, Dr. Omalu, Dr. Bailes, and the NFL committee. The issue I had been asked to address was the nature and extent of the pathology in these cases. I reported that there was a unique and very serious pathology. I did not and do not discuss individual cases in a manner that can lead to their identification, although others involved with examination of this material have done so.

At the same time, the Boston University group also obtained samples of these cases from Dr. Omalu and has published extensively on their findings. There is no doubt that what is called CTE exists and is a serious concern for professional athletes in sports where the risk of concussions is high. Quite how common CTE is remains a question, as are the nature of the risk factors for development of CTE. I am now part of an NFL Players Association group trying to further investigate this.

Having read your blogs, I should add that I have never had any involvement with the WWE, and that I have never been contacted by anyone with a declared interest in the WWE.

4 January 2011..........

The entrepreneurial careers of Dr. Bryan Donohue and Dr. Joseph Maroon expose a giant loophole of the University of Pittsburgh Medical Center's ethics policy: the role of physicians in outside ventures, including with unregulated supplement companies. Donohue directs talent cardiovascular screening for WWE. Maroon, a team physician for the Pittsburgh Steelers and a member of the NFL concussion policy committee, is WWE's medical director.

Both are proponents of the red-grape extract resveratrol for its asserted benefits for a healthy heart, energy, and fighting cancer and aging. They have taken to hyping, for their own profit, a particular brand called Vindure.

Though many among us might wonder if we could achieve just about the same effect by drinking a glass of grape juice every morning, as Larry King used to recommend in his radio commercials for Welch's, the larger issue of supplement regulation is far from the only eyebrow-raiser for the UPMC clinicians affiliated with WWE. Equally troubling is Donohue's exploitation of his UPMC credentials on behalf of Vindure even as the med center congratulates itself for more rigorous conflict-of-interest rules with respect to pharmaceutical companies. In at least some of his promotional efforts, Donohue doesn't even disclose to potential medical patients and supplement consumers his equity interest in Vindure's company, Vinomis Labs.