Commentary: Team Sky’s ‘clarification’ documents leave much still unclear

In an effort to stem the tide of bad publicity surrounding the administration of drugs to its riders that are prohibited in competition, but not outright banned — as well as hoping to answer questions regarding its adherence to the rules of Therapeutic Use Exemptions (TUEs) — Team Sky released on Tuesday two documents that, it hopes, will clarify its position and prove that no wrongdoing took place.

The first is a letter from team boss Dave Brailsford to Damian Collins, the Chair of the UK Parliament’s Culture, Media and Sport Committee, which Brailsford faced in December 2016. Brailsford acknowledges that “mistakes were made” by Team Sky, while also contending that some criticism of Team Sky has been “unreasonable and incorrect.”

The second is an eight-page document which, the team says, provides context around issues relating to UK Anti Doping’s investigation into alleged wrongdoings within Team Sky. The eight-page document, titled “Points of clarification on UKAD investigation and evolution of anti-doping and medical practices,” is long on the steps the team has taken to strengthen its anti-doping efforts, but short on explanations as to exactly what happened with Bradley Wiggins and the mystery package delivered to the team at the 2011 Criterium du Dauphine.

And while the documents do provide some context, they are also fraught with unanswered questions, with phrases like “as far as we understand” and “to our knowledge” sprinkled throughout.

Below, we highlight several questions that remain — and how Team Sky’s “clarification document” leaves much still unclear.

Letter to the Culture, Media and Sport Select Committee

In his letter, Brailsford writes that the events of recent months have “highlighted areas where mistakes were made by Team Sky.”

“Some members of staff did not comply fully with the policies and procedures that existed at that time. Regrettably, those mistakes mean that we have not been able to provide the completeset of records that we should have around the specific race relevant to UKAD’s investigation. We accept full responsibility for this.

However, many of the subsequent assumptions and assertions about the way Team Sky operates have been inaccurate or extended to implications that are simply untrue. There is a fundamental difference between process failures and wrongdoing. Our commitment to anti-doping has been a core principle of Team Sky since its inception. Our mission is to race and win clean, and we have done so for 8 years.”

Brailsford assets that no anti-doping violations took place, and writes that UKAD’s extensive investigation “has found nothing whatsoever to support this allegation, which we believe to be false.” This is true, because there no records exist that would support, or absolve, the allegations.

Also, the use of the word “believe” is curious. Does Team Sky know that there was no anti-doping rule violation at the 2011 Dauphiné, or does it “believe” there was no anti-doping rule violation at the 2011 Dauphiné?

Instead, we are left to “believe” that a team that has made a point of building a reputation around advanced science and training methods has no records of treating its star athlete?

Points of clarification: Triamcinolone

Of particular interest in the eight-page “points of clarification” letter is a section regarding Triamcinolone, the powerful corticosteroid that is banned in competition without a Therapeutic Use Exemption (TUE).

Wiggins was granted a TUE to use the Triamcinolone three times between 2011 and 2013, twice in the week leading up to a Grand Tour. The question surrounding Wiggins is not whether he used the drug, but rather the timing — his 2011 TUE was authorised from June 29, 2011, several weeks after the Dauphine, and for a single-use injection.

The UKAD investigation has, in part, focused on the delivery of a package at the Dauphine, several weeks prior to the TUE date, to Team Sky doctor Richard Freeman. Freeman, a doctor with both the British Cycling federation and Team Sky, has said he administered Fluimucil to Wiggins, through a nebuliser, to help break down mucus.

Last week, during an inquiry hearing held by the Culture, Media and Sport Select Committee inquiry, UKAD Chief Executive Nicole Sapstead said that Freeman had no documentation to show that the package contained Fluimucil. She said that there was no record of British Cycling’s stores containing Fluimucil, but that the records did show what she termed an “excessive amount [of the corticosteroid triamcinolone] being ordered.”

The Sky document addresses these issues in the following section:

“It has been subsequently reported in the media that as many as 70 ampoules of triamcinolone were ordered by Team Sky in 2011 alone. This is incorrect. Our records indicate that 55 ampoules of triamcinolone were ordered by Team Sky over a 4-year period between 2010 and 2013.

Only a small proportion of this was administered to Team Sky riders. According to Dr Freeman, the majority was used in his private practice and to treat Team Sky and British Cycling staff. It is common in professional cycling for team doctors to provide medical services to staff who require advice or treatment, and this is part of the formal job description for all of our doctors.

As well as a general practice, Dr Freeman’s offered non-riders a specialist musculoskeletal practice (having previously been Head of the East Lancashire Muskuloskeletal Medical Service for five years). We understand that triamcinolone is used commonly in that area of medicine in relation to conditions such as inflammation, arthritic joints and tennis elbow, and is administered via an intra-articular injection.

While it is not possible for Team Sky to confirm why and when triamcinolone was administered to non-riders (as we would, rightly, not have access to those private medical records), with regard to riders we would only ever allow triamcinolone to be provided as a legitimate and justified medical treatment in accordance with the applicable anti-doping rules.”

What Team Sky did not address was how many of the 55 ampoules that were ordered between 2010 and 2013 were used for staff, rather than athletes. The team also has not explained why British Cycling was ordering drugs that were then being used in Freeman’s private practice.

Instead, we are asked to accept, without documentation, that between 2010 and 2013 a large proportion of 55 ampoules of triamcinolone was used in Freeman’s private practice, and to treat Team Sky and British Cycling staff, for ailments such as inflammation, arthritic joints and tennis elbow.

https://twitter.com/velocast/status/839173344368947201

Points of clarification: Medical records

During its investigation, UK Anti-Doping suggested that it hadn’t been able to find any medical records related to Wiggins’ treatment during the 2011 Dauphine.

Crucially, this means no documentation to confirm that Wiggins was indeed administered Fluimucil on June 12. According to Sky, “Dr Freeman (as the race doctor) should have uploaded these records to a shared Dropbox folder.” And, had this happened, “the relevant records could have been made available to UKAD (with the rider’s permission).”

“While Dr Freeman appears to have failed to comply with team policy on this occasion, that does not mean that he kept no medical records at all. We understand that his preferred method of record keeping whilst on the road was to keep notes on his laptop (stored locally). Dr Freeman reported his laptop as stolen in 2014. As a result, UKAD has been unable to confirm what records relating to treatment given at the 2011 Dauphiné were in fact made.

While we accept that there are no medical records for this particular rider at this particular race, it is wrong to draw the conclusion that Team Sky has no medical records or that our medical team as a whole have been deficient in their record keeping. On the contrary, it is an area we take very seriously and have sought to strengthen and improve over time.”

As Nicole Sapstead, head of the UK’s anti-doping agency, said to the Culture, Media and Sport Committee on March 1, the evidence her team had uncovered dealt a blow to the self-declared mission of Sky to be demonstrably clean.

“It strikes me as odd, too, yes,” she said. “I would expect, particularly for a professional road cycling team that was founded on the premise of exhibiting that road racing could be conducted cleanly, to have records that would be able to demonstrate any inferences to the contrary.”

As The Guardian’s Marina Hyde wrote on Wednesday, “Having sold themselves as the ultimate in professionalism, Team Sky and British Cycling are now asking us to accept a remarkable litany of basic mistakes as the anti-doping investigation rolls on.”

Points of clarification: Fluimucil

The claim that Team Sky would have transported Fluimucil from British Cycling headquarters in Manchester to France was met with some incredulity, given the drug was readily (and cheaply) available in France.

Sky claims that “the particular form used by the team” was not available in France, and further, even if it had been, Dr. Freeman “does not have prescription rights in France.”

“As the Select Committee was told by the Medicines and Healthcare Products Regulatory Agency, Fluimucil is not licensed for sale in the United Kingdom, in any of its forms. It is our understanding that while Fluimucil is licensed for sale in France, the particular form used by the team (i.e. 3ml, 10% ampoule form for use in a nebulizer) is not available for sale in France, nor to our knowledge was it available for sale in 2011.

In addition, since Fluimucil is a prescription medication, Dr Freeman would not have been able to purchase it in France, even if the required form had been available to purchase (which, to our knowledge, it was not), because – according to Dr Freeman – he does not have prescription rights in France.

As a result, Team Sky typically ordered Fluimucil from a pharmacy in Munich where Dr Freeman does have prescription rights and where the required form of Fluimucil (i.e. 3ml, 10% ampoule form for use in a nebulizer) is licensed for sale. Any surplus Fluimucil was then stored in Manchester.

Team Sky has provided UKAD with the receipts for purchases of Fluimucil from that pharmacy from 2011. There is also an example in records provided to UKAD of Fluimucil being purchased in Switzerland earlier in 2011, where it is also licensed for sale (and Dr Freeman had prescription rights).”

However, shortly after Sky posted its document Tuesday, Conor McGrane, a doctor for Cycling Ireland, challenged the assertion that Freeman would not have been able to purchase Fluimicil in France, writing on Twitter that, “all EU doctor prescriptions are valid.”

@SkyOrla @velocast Some spoofing going on re availability to only French doc, all EU doctor prescriptions are valid https://t.co/Jefqfi27Ag

— Conor McGrane (@ConorTMcGrane) March 7, 2017

McGrane linked to a page on the European Union website that states, “a prescription delivered by a doctor in your country is valid in all EU countries… You can ask for your doctor to give you a prescription to use in another EU country, also known as a “cross-border prescription.”

The fact remains, there is no way to prove the substance carried to the Dauphine was Flumicil, and not Triamcinolone. There are no records.

Further, this explanation could have been provided in December of last year, when Brailsford spoke with the Culture, Media and Sport select committee. Why did it take over eight weeks to offer up this explanation?

Too little, too late?

The issuing of the documentation on Tuesday appears to be an attempt by the team to turn things around after a spate of negative publicity. However the success of that appears to be in question, as articles such as Hyde’s column in the Guardian demonstrate.

While much of the “clarification” document focuses on changes to the medical guidelines in recent years, the period in question is 2011 and, arguably, 2012 and 2013. These were the years Wiggins had a TUE to use a strong corticosteroid immediately prior to his main season goals.

Recent press reports state that Team Sky’s other doctors moved to block a fourth TUE by Wiggins later on in 2013, illustrating that others on the team had concerns about the use of such documentation to green-light powerful substances.

It is worth remembering that David Millar, Michael Rasmussen, and Jorg Jaksche — three riders who admitted to doping and served suspensions — have all said that they used TUEs to use triamcinolone specifically to gain a performance-enhancing effect.

Indeed, the UCI’s own anti-doping rules state that if an athlete uses a stronger substance or treatment than is absolutely necessary, this may be a contravention of the regulations. In September both Jaksche and McGrane called on WADA to investigate Wiggins’ TUEs.

While it is a plus if the team did tighten up on its procedures in the years since, the large focus on this in the latest Sky document reads like an attempt to misdirect — to shift the emphasis onto a time other than the period under scrutiny.

What appears striking is that the team renowned for marginal gains was so lackadaisical in carrying out necessary duties. Whether it’s a lack of records for substances taken out of storage and transported across international borders, the declared failure of team staff to follow procedures in terms of sharing medical records, or the apparent lack of backups of the computer of a senior team doctor, the squad known for its precise attention to detail was haphazard in its actions when it mattered most.

This is furthered by the long delay in Brailsford stating what was in the package delivered to Wiggins, the delay in explaining why it was deemed necessary to be flown from the UK to France, and some unconvincing performances before the select committee by Brailsford, Shane Sutton, and Simon Cope.

A recent Sunday Times report that testosterone was – mistakenly, Team Sky claims – delivered to Freeman at the team’s headquarters has also not helped with Team Sky’s defense. Wiggins’ apparent provocation on Instagram on December 18, one day before of Brailsford’s appearance before the select committee, also didn’t help, coming across as aloof and cavalier.

Another chink in Brailsford’s armor was evident this week when star rider Chris Froome did not join in the chorus of rider voices expressing support for their boss on Twitter, following a Cyclingnews story that at least two anonymous Sky riders had discussed asking Brailsford to resign. While 16 riders took to Twitter to voice their support for Brailsford, Froome did not. Reports in the Telegraph and the Daily Mail claim that the three-time Tour winner refused to add his name to a statement of support that all riders were asked to sign.

Ultimately the outcome of the UKAD inquiry will carry far more weight than the documents issued by the team on Tuesday. Those releases attempted to stem the flow of negative information, but will be of little value if the findings of the inquiry are in any way as scathing as UKAD head Nicole Sapstead was when speaking to the select committee earlier this month.