WigginsPackage
SII Focus 2nd March 2017

Wiggins package: British Cycling & Team Sky kept no medical records

British Cycling and Team Sky kept no records of what medicines were prescribed to cyclists from a medical store at the Manchester Velodrome, including a package delivered to Bradley Wiggins at the end of the 2011 Critérium du Dauphiné, heard members of the Culture, Media and Sport (CMS) Committee of the UK Parliament yesterday. British Cycling and Team Sky’s Dr. Richard Freeman, who was not at yesterday’s hearing due to illness, could face investigation by the General Medical Council (GMC) for failing to keep secure medical records of what had been administered to cyclists.

“We have seen invoices and records that indicate when he [Freeman] was ordering medical products he was wearing one of those two hats”, UK Anti-Doping (UKAD) CEO Nicole Sapstead told the CMS Committee. “When those products were delivered, they were all delivered to the Manchester Velodrome. They were all delivered to one area. There was no segregation of the products designated for British Cycling or Team Sky. Neither have we been able to obtain any medical records of what was going in and out of that medical supply…It is very clear from our investigation that there is no audit trail of what is going in and out of that comprehensive supply of medical products.”

Sapstead, was told by Freeman that the package delivered to Wiggins contained fluimucil, a medicine used for the build up of mucus or catarrh. “We’ve interviewed Sir Bradley Wiggins”, said Sapstead. “His recollection was that he was treated with fluimucil on the evening of the 12th of June. He does not know what was in the package”.

Fluimucil & the Wiggins package

Fluimucil was not a licensed medication in the UK at the time it was allegedly obtained for Dr. Freeman. Sapstead said that British Cycling and Team Sky obtained their supplies from Europe. “Our records indicate that the fluimucil used by Team Sky and British Cycling was coming from two outlets – one in Germany and one in Switzerland”, she said. However, British Cycling did not apparently keep records regarding fluimucil ordering or use. “My understanding…is there seems to be no record of this ever being ordered in the UK”, said Sapstead.

The CMS Committee has already heard how British Cycling spent £1,263.90 in sending women’s road coach Simon Cope to France to deliver the package. Yesterday, the CMS Committee heard that Freeman had asked British Cycling’s former Technical Director Shane Sutton to arrange for the package to be sent out, which was put together by British Cycling’s Head physiotherapist Phil Burt for Cope to collect from the Manchester Velodrome.

Cope reiterated that he didn’t ask what was in the package, despite knowing that he would have to carry it through airport security where he would be asked if he had packed his bags himself. Sapstead said that Burt also had no recollection of what was in the package, despite putting it together.

Cope said he knew the package was “obviously something medical”, as a post-it note on the package said it had been requested by Dr. Freeman. Although Cope said that it was a fairly regular occurrence to be asked to take small packages abroad by British Cycling, he said that this was the first medical package he had been asked to deliver. “I never asked what was in them”, he said.

Cope was also vague on the details of his role whilst in France. Chairman of the CMS Committee, Damian Collins, pointed out that due to his tight travel schedule, Cope could only have been with Team Sky for about three hours. “I needed to bring Shane back to the airport”, said Cope. “I delivered the package to the doctor, helped sort a few bikes here and there. I was under the impression I had to bring some bikes back, but that never happened.” Cope said that it would not be unusual for him to bring bikes back to the UK through use of a hire car and and Easyjet fight.

Fluimucil was freely available in France, where the Critérium du Dauphiné took place, and in Italy, where Wiggins and Team Sky were heading for a training camp in Sestriere. There are five pharmacies within 10 kilometres of Sestriere.

“The reason that Dr. Freeman chose to ask for it to be transported from the UK to France was that he was unsure of his prescription rights in France and he wanted to be 100% sure of the concentration of the flumicul he was administrating, as I understand it can vary in strength”, said Sapstead. However, it is understood that fluimucil is not a recommended product for sufferers of asthma, such as Wiggins.

Triamcinolone

Sapstead said that UKAD started its investigation into British Cycling and Team Sky on 23 September 2016 after receiving information that an anti-doping rule violation (ADRV) may have been committed at the Dauphiné. Sapstead said that “additional information” had been received that the Package delivered to Wiggins on 12 June 2011 contained triamcinolone, a corticosteroid often known under the trade name kenalog, which is used to treat allergies. The UKAD investigation began after the hacking group Fancy Bears leaked documents purporting to indicate three therapeutic use exemptions (TUEs) held by Wiggins.

“We’ve seen orders from Team Sky and British Cycling that indicate that triamcinolone has been ordered”, said Sapstead, adding that the amount of triamcinolone that UKAD understood to be held in the Manchester Velodrome was much more than Wiggins would have required for the three TUEs he held. “That’s clear from the inventory of orders that have come into the Manchester Velodrome…you would assume that the triamcinolone was too much for one person, or that it was being used by a number of riders…Specifically regarding the TUE held by Bradley Wiggins, there was far more triamcinolone than he required.”

There are also a number of risks involved with intravenous injections of triamcinolone. “You don’t treat people with it lightly”, said Sapstead.

Dr. Freeman and the General Medical Council

The Medicines, Healthcare and Regulatory Authority (MHRA) said that although fluimucil and triamcinolone are prescription-only medications, Dr. Freeman would not have needed a prescription to obtain them. However, at the time that Dr. Freeman ordered fluimucil, it was unlicensed in the UK.

‘In October 2010, the UK licence holder for Fluimucil cancelled their licence so at the time it was obtained by Dr Freeman it would have been an unlicensed medicine in the UK’, read evidence submitted to the CMS Committee. ‘We note that the medicine was ordered to France and so we do not know if it was instead covered by a French licence. Nevertheless, in the UK a doctor can obtain and supply an unlicensed medicine on his own responsibility to meet the particular special clinical needs of a patient.’

Sapstead said that Dr. Freeman did keep records of what was prescribed to cyclists on his laptop, which he was required to upload to a DropBox folder. He didn’t do that and the laptop was reported to British Cycling as stolen whilst on a 2014 summer holiday in Greece.

“We believe that it was reported to the police”, said Sapstead. “We are working with Interpol to ascertain when it was reported. It was reported to British Cycling. We are unable to ascertain when Team Sky was told. There is a record at British Cycling that the theft was reported to them”.

The GMC, which sets standards of practice for doctors, confirmed that Freeman (GMC number 2854524) is listed as registered with a licence to practise. It also confirmed that under its rules on Good Medical Practice, registered doctors are required to keep a record of ‘any drugs prescribed or other investigation or treatment’.

GMC Guidance also requires doctors to make records ‘at the time the events happen, or as soon as possible afterwards’. It also requires doctors to store patient records securely. ‘If you are responsible for the management of patient records or other patient information, you should make sure that they are held securely and that any staff you manage are trained and understand their responsibilities’, reads GMC guidance on confidentiality. ‘You should make use of professional expertise when selecting and developing systems to record, access and send electronic data’.

“We have been communicating with the GMC”, said Sapstead. The GMC could not confirm if it is investigating Freeman for breach of its Good Medical Practice rules, as it does not confirm any investigations unless there is a risk to patient safety.

Odd, strange, weird & baffling 

It is important to state that neither fluimucil or triamcinolone feature on the World Anti-Doping Agency’s (WADA) Prohibited List, however as it is a corticosteroid, the regulation triamcinolone of is more complicated. A TUE is required if it is used in competition (IC) via ‘oral, intravenous, intramuscular or rectal routes’, and its ‘topical’ use – for example, to treat injury – is permitted out of competition (OOC).

Its use in competition is also permitted via other routes. As such, use of triamcinolone is problematic for UKAD to police. “It is difficult to detect”, said Sapstead. “If detected, it is hard to detect whether it was administered via a permissible route”.

Team Sky was founded on the principle of wining the Tour de France within five years, and winning it ‘clean’. From the evidence given to the CMS Committee, it appears that the team needed a supply of fluimucil and triamcinolone. Given the nature of triamcinolone’s status under WADA’s Prohibited List as outlined above, it is very strange that neither British Cycling or Team Sky appear to have kept records on the use of either substance, in case they were required to prove that they had indeed won ‘clean’.

“It strikes me as odd”, said Sapstead. “For a professional road cycling team that was founded on the premise of exhibiting that road racing could be conducted cleanly, not to have records that would demonstrate inferences to the contrary”.

It also appears odd that British Cycling would spent £1,263.90 on sending its women’s road coach to France to deliver a medication not licensed in the UK – and not recommended for asthma sufferers – to Bradley Wiggins, an asthma sufferer. It is strange that British Cycling would agree to spend such money when the medication alleged to be in the package was freely available in France and Italy, where Wiggins was competing and training. It is weird that extensive records were kept of Cope’s expenses but not about the package sent, its contents or the medications supplied to cyclists by British Cycling or Team Sky. It is baffling that Cope, who knew that he would be carrying a medical package through airport security, failed to ask what was in that package.

“When you are talking about prescription only medicines, then there should absolutely be some record of to whom that bulk order of medicines are being administered at any given time”, agreed Sapstead. She said that although Team Sky had a policy on the keeping of records, it appeared that it had not been adhered to. However there was no such excuse from British Cycling. “There was just an acknowledgement that there were no records”, said Sapstead. “That’s it.”

The facts just do not appear to add up – unless you take into consideration the hypothetical possibility that there was something else in the package which the parties concerned do not want uncovering. Unfortunately, despite yesterday’s hearing, the Commons CMS Committee are no closer to uncovering whether the package did indeed contain fluimucil as Dr. Freeman has claimed; whether it contained triamcinolone as evidence presented to UKAD indicates; or something else entirely.

 

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