Monday, Nov. 14, 2005 | 7:55 a.m.
A longtime Nevada ringside physician has called for an investigation into the September death of a boxer who died in a Las Vegas bout, believing that it could lead to necessary health and safety improvements in boxing.
Dr. Margaret Goodman, a Las Vegas neurologist who worked more than 3,500 bouts over the past 11 years, feels so strongly about the need for more stringent safety standards in boxing that she resigned last week from her ringside physician post to draw attention to the issue.
"I gave up the very thing I love the most because I think the standards and the process we have to evaluate and take care of the boxers need improvement," Goodman said. "I've tried as best I could to work with the system in place but haven't been able to do the job I felt needed to be done."
Goodman was one of the ringside physicians Sept. 17 when Leavander Johnson was pummeled by 409 punches from fellow lightweight Jesus Chavez.
Before what proved to be the final round of that bout, Goodman quickly examined Johnson, conversed with him and concluded that he could continue with the bout, even though he was being thoroughly whipped. Moments later, the fight was stopped in the 11th round. Johnson collapsed after returning to his dressing room and died five days later.
The Nevada State Athletic Commission responded to Johnson's death -- the second boxing fatality in Las Vegas this year -- by appointing a five-member Advisory Committee on Boxer Health and Safety to make recommendations by April on possible new health guidelines to make boxing safer.
This year, the deadliest in Nevada boxing in more than seven decades, also has seen the death of boxer Martin Sanchez in July and two other boxers suffer career-ending brain injuries.
"There needs to be a complete review of Leavander Johnson's death, and I'm hoping to participate in that," said Goodman, who remains chairwoman of the state commission's medical advisory board.
"If that is part of what the safety committee does, that would be fantastic. It should be done for the benefit of the boxing officials so that we can learn from it. They should also look at Leavander's career and what he did in the gym. How else will we learn to protect the next guy?"
Commission Chairman Raymond Avansino Jr. of Reno is not convinced, however, that the state regulatory body could learn anything more from an investigation. The commission, in an earlier look at the case, concluded that nothing more could have been done to prevent Johnson's death.
"We didn't think it was necessary to conduct an investigation," Avansino said. "We thought everything we did during that fight was right and what she (Goodman) did was right."
But the commission's executive director, Marc Ratner, said the advisory committee, as part of its own study, will be able to review tapes of the Johnson and Sanchez fights.
"Certainly, everything is on the table and they can look at everything," Ratner said.
Few Nevadans are more qualified to address boxing health and safety issues than Goodman.
"I still hope to work cooperatively with the commission to set standards and I want to continue to be an advocate for boxers," she said.
Ratner, for one, was surprised by her resignation.
"She is one of the top ringside physicians in the world," Ratner said. "I would have loved to see her stay."
Even before Johnson died, Goodman made numerous health and safety recommendations to the commission. Some were adopted, such as requiring ringside physicians to attend pre-fight weigh-ins, while other recommendations were not.
"We have always faithfully considered and implemented them whenever possible," Avansino said.
Still, Goodman believes that from the time a fighter applies for a state boxing license to when he is seen by a ringside physician after his bout, much more can be done to reduce the chances he will suffer a serious brain injury.
"The bottom line is every fighter will have to retire at some point, and they should do it in the best health possible," Goodman said.
Goodman began serving as a ringside physician at amateur bouts before joining the professional ranks with the state commission in 1994. At first, the health and safety problems that have gripped the sport were not immediately apparent to her. But eventually, the experience of observing fighters up close gave her plenty of ideas on how to improve the sport's health and safety.
"One reason boxing is not as safe as it could be is that there is not a good exchange of information," she said.
Her recommendations include calls for:
* The commission to follow New York's lead by hiring a physician to review all medical records submitted with a fighter's application for a state boxing license. Goodman said the only records automatically reviewed by medical professionals in Nevada at the time of a license request involve special circumstances, such as boxers who are at least 36 years old or applicants who have not fought in three years.
In August, the commission approved regulations requiring that medical records be received by its office no later than one week before a fight. But while the records are to be reviewed by physicians during pre-fight physicals, it still is possible for a boxing license to be approved before that review.
* Nevada to follow California's example by accepting medical records only from accredited or approved medical facilities to reduce the possibility of falsified documents.
"Right now we have no way of knowing if the results we get are correct," said Goodman, who also chairs the medical committee of the Association of Boxing Commissions.
Ratner said he had no problem with that recommendation with respect to U.S. medical facilities, but is concerned it could be difficult to implement in regard to foreign clinics.
* Every fighter to receive MRI brain scans before and after each fight -- even though the tests may not reveal everything about a boxer's chance of suffering a serious brain injury.
Goodman proposes that Nevada pay for the MRIs by applying a $1 surcharge on all admissions to professional bouts in the state.
While Ratner supports a special fund to pay for brain scans, he said that he is not certain that an admissions surcharge is the best way to go. A flat-rate surcharge would penalize a smaller promoter who charges $15 for a ticket versus a bigger promoter who charges $100, he noted.
* Boxing gymnasium officials to gain access to a list of all fighters who have been suspended from the sport due to injury. It also should be illegal, she said, for a suspended boxer to spar in a Nevada gym.
"It's not a bad idea," Ratner said of the list of suspended fighters. "It's feasible. As for the law, that would be a legislative question. But I believe that anyone we have suspended should not be sparring."
* Weigh-ins to be conducted the day of the fight, rather than the day before, to ensure that fighters are at prescribed weights when they enter the ring.
"You could have unfair or unsafe matches where a fighter puts on a lot of weight in the day before the fight," Goodman said.
Ratner agreed that fighters often enter a ring much heavier than their weigh-in weight. But he said the reason that weigh-ins are held the day before fights also is based on the medical opinion that fighters need time to rehydrate before a fight, especially if they have lost several pounds to make the prescribed weight for the weigh-in.
* The time spent on pre-fight physical exams to be extended from five minutes to at least 15 minutes to give physicians more time to ask boxers questions from a checklist about their health and medical history.
"The bottom line is the whole thing is done in a rush," she said. "We have a checklist but it doesn't encompass a lot you would want to know about the athlete. The fighters often lie on these forms or they conveniently forget things. ... You want to know as much about that individual so you can make a decision that could avoid a life-threatening situation."
She also would like to see post-fight physical exams extended from five minutes under normal circumstances to at least 10 minutes, because "the fighter may be hopped up on adrenaline and forget to tell you something." A more thorough exam would make it easier, she said, for physicians to determine whether follow-up medical testing is necessary.
* Ringside physicians in Nevada to attend refresher courses and obtain certification in recognition of the fact that working a fight involves a specialized form of medicine. New York and Washington are two states that require certification.
"I have no problem with that at all," Ratner said.
* Lengthening medical suspensions for a fighter knocked out in Nevada -- usually 45 days -- to at least 60 days.
"The suspension also needs to include follow-up medical testing," Goodman said. "We worry about the immediate triage but we also need to worry about what will happen to the boxer before (he goes) to the next jurisdiction."
* A peer review system of the performance of Nevada referees, fight judges and ringside physicians.
"What we have now is a system that often becomes damage control," Goodman said. "If a ring official is involved in a controversial decision or a tragic outcome, there should be a peer review because that is the only way we can get better."
Ratner, though, argues that peer review is not needed because the commission, which licenses boxing officials, reviews performances and takes necessary action.
Goodman also supports proposals in Congress to establish a federal boxing commission that would include creation of a medical database that all state panels could use to check on the medical histories of boxers seeking licenses.
"The only way to really protect these boxers is to have continuity of care among the states, which is impossible under the current system," Goodman said. "We don't always know what happened to a fighter in a prior fight in another state. You don't always know if a knockout was from a head shot or body blows.
"I believe in the right to privacy, but when fighters travel from jurisdiction to jurisdiction with injuries it puts the ring physicians and boxing commissions at risk of liability."
And Goodman has one other major concern -- that waiting until April for the special safety panel to make its recommendations may be too late.
"We have medical issues that need to be dealt with now -- I believe needed attention many months ago," she said.
"While I understand that recommendations take time in boxing, time is never on our side. These fighters are the life blood of the sport. They deserve the best care now -- and that cannot wait."
Steve Kanigher can be reached at 259-4075 or at [email protected].
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