US swimmer Madisyn Cox is considering an appeal to the Court of Arbitration for Sport (CAS), after the international swimming federation (FINA) sanctioned her with a two year ban due to an adverse analytical finding (AAF) for trimetazidine. Cox said that a biochemist had compared the 0.1 ng/mL of trimetazidine detected his her urine to ‘a pinch of salt in an Olympic size swimming pool’, in a statement provided to Swimming World. ‘At such a trace level, the substance provided me with no performance benefit of any kind’, continued the statement.

The FINA Doping Panel decision (PDF below) reveals that it believed Cox and her evidence that she may have ingested the hormonal and metabolic modulator through contaminated tap water, despite her having no evidence to prove this. Cox’s statement said that she is looking into the possibility of obtaining testing data on the presence of chemicals in water supply of Austin, Texas, where she resides. 

‘Due to the credible nature of her testimony, her moral character, the very low level of the drug detected, plus the evidence received from other witnesses, the Panel is prepared to take the highly unusual step of accepting that Ms. Cox did not act with intention in the absence of proof regarding the source of the Trimetazidine that came into her body’, reads the decision. ‘However the Trimetazidine did enter her body (which is admitted), it was unintentional. In other words, Ms. Cox did not intend to dope and the adverse analytical finding (AAF) that has been admitted was unintentional. This conclusion reduces the presumptive sanction from 4 years to 2.’

The FINA Panel said that it due to the absence of evidence regarding the water supply, it could not conclude that it was ‘more likely than not’ that water contamination caused the AAF. It said that it remained unclear if water contamination cased the AAF, or if it was caused by ‘some other incidental and inadvertent contact’ with trimetazidine such as through food or supplements consumed, ‘contact with food handlers or social contact with friends or strangers’.

In July 2016, the US Anti-Doping Agency (USADA) sanctioned US Gymnast Kristen Shaldybin with a finding of No Fault, after accepting that her AAF for hydrochlorothiazide was caused by contaminated tap water. ‘USADA reviewed all the evidence, including laboratory reports demonstrating very low parts per billion concentrations of the prohibited substance in the athlete’s urine sample’, reads USADA’s statement. ‘Together with the circumstances of ingestion and scientific evidence provided by published literature and expert reports, USADA concluded on a balance of probabilities that the athlete unknowingly ingested the hydrochlorothiazide through tap water obtained from the municipal water supply. As the prohibited substance originated in the municipal water supply, Shaldybin will not face a period of ineligibility or loss of results obtained on or subsequent to June 7, 2016, the day her sample was collected.’